Efficacy of amitriptyline, pizotifen and propranolol in the prevention of migraine.

This intervention study conducted in the Neurology outpatient Department of Mymensingh Medical College Hospital (MMCH) from January 2006 to December 2007 to compare efficacy of amitriptyline, pizotifen and propranolol in the prophylaxis of migraine. Ninety cases were selected following certain inclusion and exclusion criteria. Result showed that the differences in duration, frequency and severity of attack were reduced in all groups but the differences among the groups were not significant (p>0.05). However, compared with amitriptyline and pizotifen, the propranolol group needed tablet paracetamol as abortive therapy less frequently which was statistically significant (p<0.05). All the drugs were well tolerated with minimum adverse effects.

Proteinuria is an independent risk factor for ischemic stroke among diabetic patients.

This study was done to assess the relationship between proteinuria and ischemic stroke in subjects with diabetes mellitus, and to determine whether proteinuria is an independent risk factor for stroke. This comparative study was conducted in Mymensingh Medical College Hospital from January 2009 to June 2010. It was done to establish the relationship between proteinuria (Microalbuminuria) and ischemic stroke among diabetic patients. Other risk factors were also assessed. Patients were divided in Group A - diabetic patients with ischemic stroke (n=50) and Group B diabetic patients without stroke (n=50). Mean age of the Group A & B were 60.16±8.33 and 57.19±7.73 years (p=0.068). Mean Blood sugar (2 hours after Break Fast) was 14.68±4.32mmol/L in Group A and 14.75±4.02mmol/L in Group B (p>0.05). Albumin Creatinine ratio was abnormal in 84.0% in Group A and 22.0% in Group A (p=0.001) [Odds ratio (95%CI) = 18.61 (6.78-51.09)]. Logistic regression analysis has also shown that microalbuminuria (ACR) is an independent risk factor for ischemic stroke (p=0.001), [Odds ratio (95%CI) = 19.811(5.915-66.348)]. In diabetic patients increased urinary protein is a risk factor for stroke. Estimation of urinary protein (Microalbuminuria) may be used as a predictor for ischemic stroke in patients with diabetes.

Sex differentiation and risk factor evaluation in stroke patients.

This study was conducted to find out the possible influencing factors on stroke in two sexes. It was a descriptive type of cross sectional study, conducted on 177 stroke patients admitted in Mymensingh medical college hospital from February 2009 to March 2010. Patients were selected according to WHO stroke definition and confirmed by CT or MRI. The results of the study showed that Stroke was more common (58.19%) in male than female (41.8%), mean age of male stroke patients was 60.58±12.36 years and that of female was 63.58±13.62 years with no significant statistical sex difference. But after 70 years, females are more sufferer than male. Hypertension, Diabetes mellitus, ischemic heart disease, atrial fibrillation and dyslipidemia in male and female were equally present without significant difference, although male had a higher rate of smoking and previous stroke (p<0.05). Motor weakness was more in male than female and unconsciousness was more in female (p<0.05). Type and sub types of stroke showed no significant difference. Females had more severe stroke in terms of severity score (Scandinavian Stroke Scale) on admission. Duration of hospital stay were similar among male and female but on discharge functional scale (Modified Rankin Scale) score was higher in male (p<0.05) and in hospital mortality was higher in female (p<0.05) which was statistically significant.

Spectrum, antibiotic susceptibility and virulence factors of bacterial infections complicating severe acute pancreatitis.

Secondary infection of pancreatic necrotic tissue and peripancreatic fluid is a serious complication of acute pancreatitis resulting in significant morbidity and mortality. The aim of this study was to find out the spectrum of bacterial infections, their antibiotic susceptibility patterns and virulence features in patients with severe acute pancreatitis (SAP). A total of 19 patients with acute pancreatitis were consecutively selected from 153 clinical cases of septic abdominal surgical emergencies (age 29-80, 12 males, 7 females) admitted during 2009-2011, in the First Surgical Clinic of the University Emergency Hospital of Bucharest. All 19 SAP cases were submitted to pre-operatory antibiotic empiric treatment. Ten cases were culture negative, in spite of the positive microscopy registered in eight of them. The rest of nine cases were culture positive, 17 different bacterial strains being isolated and identified as belonging to eight aerobic and four anaerobic species. Polymicrobial infection was seen in six patients and the etiology was dominated by Gram-negative bacilli, followed by gut anaerobic bacteria, attesting their colonic origin. The susceptibility testing of the isolated strains confirmed in vitro in all cases the efficiency of the antibiotics that had been used in the empiric pre-operatory treatment. Out of 19 cases submitted to pre-operatory empiric treatment, 14 proved a favorable evolution and five a lethal outcome. The host depending factors (sepsis and other co-morbidities), as well as the aggressivity of the isolated microbial strains (mediated by the presence of different factors implicated in adherence, toxicity and invasion) were found to contribute to the unfavorable, even lethal clinical outcome of SAP cases. In spite of all theoretical controversies, the antibiotic therapy remains at present a very important therapeutic mean for the SAP treatment; although it cannot solve the septic necrotizing pancreatitis in 100% of cases, however, associated with the surgery and all other medical means of intensive therapy, the antibiotic treatment can influence the clinical evolution to the benefit and recovery of patients in a significant number of cases.

Lipid profile among ischemic and haemorrhagic stroke patients.

This study is a prospective cross- sectional study conducted in the Neurology and Medicine department of Mymensingh Medical college Hospital (MMCH) to see the association of different components of serum lipids among ischemic and hemorrhagic stroke patients. Cases were selected following certain inclusion and exclusion criteria. Result showed that both types of stroke were more common after the age of 50 years. Male suffered more than female. M:F in ischemic stroke group was 1.73:1, and in hemorrhagic group was 1.42:1. Both types of stroke belong to middle class people. Smoking, hypertension and diabetes mellitus were equally common in both types of stroke. Low density lipoprotein (LDL) level were more than desired level in both types of stroke and there was no significant difference between two groups (p>0.05). Other components of lipid profile (total cholesterol, HDL, Triglyceride) were within normal range and there was no significant difference between two groups (p>0.05).

Bacteriological aspects implicated in abdominal surgical emergencies.

UNLABELLED: The purpose of the present study was to establish the microbial etiology of abdominal surgical emergencies as well as the relationship between the bacterial etiology and the virulence factors produced by the respective isolated strains. 110 bacterial strains were isolated from 100 randomized clinical cases, operated during 2009-2010 in the First Surgical Clinic of the University Hospital of Bucharest. The clinical cases (sex ratio 52 M/48F aged between 22-85 years old) were classified into three risk groups, as related to their severity. The isolated strains were characterized by cultural, microscopic and biochemical methods. After identification, the bacterial strains were investigated for their virulence potential (adherence to abiotic surface and production of soluble virulence factors). RESULTS: The specimens were collected from different clinical pathologies: diffuse acute peritonitis, biliary duct infections, severe acute pancreatitis followed by septic processes etc. The 110 bacterial (72 aerobic and 38 anaerobic) strains were isolated only in 70 out of 100 cases. Out of these 70 cases, in 45 already submitted to pre-operatory empiric broad spectrum antibiotic therapy, there were isolated 74 strains, whereas in 25 cases without any treatment, there were isolated 36 strains. The etiology was either mono-specific or multi-specific (aerobic-anaerobic associations, especially in old persons). Out of the 30 negative culture cases, 16 were already submitted to pre-operatory parenteral empiric antibiotic therapy at the moment of specimen collection. The aerobic etiology was dominated by Enterobacteriaceae. The most frequent anaerobic species belonged to Clostridium, Peptococcus and Bacteroides genera. It is to be mentioned that the isolation of Bifidobacterium and Veillonella spp. in 11 (10%) severe cases of the studied abdominal surgical emergencies is pleading for the fact that in certain conditions, bacteria belonging usually to commensal gut flora can turn to pathogenic becoming responsive for life-threatening cases. All aerobic and anaerobic strains exhibited some of the following virulence factors: mucinase, esculinase, pore-forming toxins (lecithinase), proteolytic enzymes, adherence ability (slime factor). The presence of these virulence factors (VF) could explain the severity of the clinical aspects. CONCLUSIONS: The bacterial etiology of the abdominal surgical emergencies exhibited a very large spectrum, the highest number of strains being of endogenous origin (Enterobacteriaceae and anaerobic strains). It was demonstrated that the isolated strains produced (cell associated and soluble) VF proving in this way their role as important virulence sources in the hospital environment and explaining the large diversity and severity of the clinical abdominal pathology. The results of the present study are also pleading for periodical readjustments of the pre-operatory empiric antibiotic therapy.

Changes in Vibrio cholerae O1 strains isolated in Romania during 1977-95.

Six hundred and twenty-four Vibrio cholerae O1 strains, 623 serotype Ogawa and one serotype Inaba, isolated in Romania between 1977-95 were tested to detect all changing traits concerning serogroup, serotype, biotype, phage type and resistotype patterns and subsequently, the possible epidemiological relationship among these strains. Biotyping revealed one classical, 580 eltor strains and 43 intermediary variants. When tested with Mukerjee phages, 546 (87%) strains were sensitive and 78 (13%) resistant. One phage type (M4) dominated during 1977-90, two phage types (M4 and M5) exhibited the same high frequencies during 1991, a diversity of types occurred during 1993-4 whereas in 1995, two phage types (M4 and M5) showed similar distributions again. Five patterns of drug susceptibility were successively described during 1977-95. The most prominent changes in Vibrio cholerae O1 strains were noticed during 1993-4: the highest number of non-typable strains and intermediary variants, the widest spectrum of phage types and of multidrug resistance. In 1995, the strains reverted to the previous typable forms but a new drug resistance pattern was noticed.

Isolation of a new epidermin variant from two strains of Staphylococcus epidermidis--frequency of lantibiotic production in coagulase-negative staphylococci.

A novel lantibiotic identified during the screening of 187 coagulase-negative staphylococci, has been structurally characterised. (Val1, Leu6)-epidermin was purified from culture supernatants of two Staphylococcus epidermidis strains, BN-V1 and BN-V301 following successive separation by adsorption, cation exchange and C18 reversed-phase chromatography. Separation of the purified peptides by SDS-polyacrylamide gel electrophoresis suggested a molecular mass of ca. 2000 Da and electrospray mass spectrometry subsequently demonstrated that both peptides had a mass of 2151 Da; a mass which is different from that of all previously described antimicrobial peptides. Amino acid analysis showed that both peptides contained lanthionine and were very similar to epidermin, while automated N-terminal sequencing by Edman degradation confirmed the identity of the two peptides as a natural variant of the antimicrobial lantibiotic epidermin, and demonstrated the conservative amino acid exchanges in positions one and six.

Studies on the hemagglutinant activity of some Aeromonas strains.

216 strains to Aeromonas genus (158 A. hydrophila, 33 A. salmonicida, 23 A. sobria, 1 A. caviae and 1 A. veronii strains) of different sources of isolation were studied concerning their hemagglutinating behaviour to 5 different erythrocyte species (human, bovine, chicken, African green monkey and guinea pig) in the presence/absence of mannose/fucose. The study aimed to establish the spectrum of their hemagglutinating activity and any possible correlation between the source of isolation, biochemical phenotype LDC VP and HA type/subtype. Different aspects of HA type/subtype and phenotype LDC VP of Aeromonas strains are discussed. Four Aeromonas hydrophila strains isolated from pig enteritis exhibited constantly FRHA to bovine erythrocytes suggesting a possible correlation between virulence and HA type of the respective strains.

Hemolytic properties of some Aeromonas strains.

Considering the possible correlation between hemolytic and enterotoxigenic properties of Aeromonas strains mentioned in the literature, in the present work we studied the practical value of the hemolysis tests in the diagnosis of Aeromonas strains by using comparatively the hemolysis tube tests (with goat and sheep erythrocytes suspensions) as well as the technique on blood agar in aerobic conditions. There were studied comparatively 230 Aeromonas strains (different species: A. hydrophila, A. sobriae, A. caviae, A. veronii, A. salmonicida) isolated from different sources (meat products, fish of fresh waters, mussels, sea water, pipe water, diarrhoeal disease and animal faeces). The comparison among the used tests for proving the hemolytic activity of Aeromonas strains showed that: 61.89% and 56.51% from the total number of Aeromonas strains were hemolytic in the tube tests with 1% goat and 1% sheep erythrocytes suspensions respectively after 48 hrs followed by 51.72% and 48.25% strains by the 5% goat and 5% sheep blood agar plates respectively in anaerobiosis and after 48 hrs incubation at 37 degrees C. The highest incidence of hemolysin presence was pointed out in motile Aeromonas strains (A. hydrophila--60.11% and A. sobria--56.52%). Our results showing a high frequency of hemolytic activity among Aeromonas strains isolated especially in meat products are suggesting a possible correlation between the pathogenic potential and the hemolytic activity and are pleading for introduction of this test in the diagnosis of Aeromonas species.

[Lantibiotics]. / Lantibioticele.

Lantibiotics synthesized by gram positive bacteria (Staphylococcus, Streptococcus, Bacillus, genera) are a special group of polycyclic polypeptides constituted of protein amino acids and unusual amino acids (i.e. lanthionine, beta-methyllantionine etc.) these last ones exhibiting interchain thioeter bridges and ring structures. Some lantibiotics are already used in medical therapy (nisin, gallidermin, epidermin) as well as for food preservation (nisin). Their special structures and synthesis have focused substantial scientific interest, the lantibiotics proving to be ideal experimental models not only for microbiology but also for biochemistry, molecular biology, gene technology and protein engineering in the purpose to get more insights in the fundamental aspects of the cell biology.

Isolation of motile aeromonads from foods of animal origin.

The purpose of this work was to select an available medium for Aeromonads isolation as well as to point out the Aeromonads presence in different foodstuffs of animal origin. Out of 15 tested media for Aeromonas isolation, two media, were selected: DFS as control medium and AGOS medium, both giving superposable results. 404 samples of foodstuffs of animal origin were examined; Aeromonads testing was performed qualitatively and quantitatively. 142 samples with a positivity percent of 51.40% were qualitatively tested. 262 samples with a positivity percent of 48.85% were quantitatively tested.

[Current developments in the problem of prions and prion diseases]. / Actualitati în problema prionilor si bolilor prionice.

The present paper reports data referring to the mechanism of the CNS degenerating process of prion origin, the role of the biological timing in prion diseases, the interrelations between the prion diseases and Alzheimer's disease, new data on the normal cell protein PrPc and prion protein in the PrPsc scrapie, the physico-chemical properties of the prion PrP-RN Am properties the presence of the nucleic acid in the structure of prion, interrelations between prion and AIDS/VISNA retroviruses. The paper underlines the importance, for the next decade of the molecular biology studies for clearing up: the complete structure of prion, the prion multiplication, the role of nucleic acid for the infectivity, at the molecular level, and molecular epidemiology of these cases.

Studies concerning the hemagglutinant activity of some pathogenic and opportunistic pathogenic strains of genus Vibrio.

1606 bacterial strains, belonging to Vibrio genus (189 V. cholerae 0 : 1; 1091 V. cholerae nongroup 0 : 1 and 205 V. halophilic strains) of different sources of isolation, were studied, concerning their hemagglutinating behaviour to 5 different animal red blood cells (human, bovine, chicken, African green monkey and guinea pig) in mannose/fucose presence/absence. The study aimed to establish the spectrum of their hemagglutinating activity as well as any possible correlation between the source of isolation, serogroup etc and the HA-type/subtype. Mannose/fucose sensitive as well as mannose/fucose resistant hemagglutinins were exhibited by the different tested strains. As unknown behaviour, a noticeable hemagglutination only in the carbohydrate presence was recorded. The HA-types and subtypes in 861 V. cholerae nongroup 0 : 1 tested strains are presented.