Comparative study of early and conventional catheter removal following buccal mucosal graft urethroplasty.

The duration of catheterization period following urethroplasty is a great controversy. For buccal mucosal graft urethroplasty recommended catheterization period ranges from 2-4 weeks. In recent years, early catheter removal has been advocated for several reasons. Early catheter removal improves both patient comfort, mobility and reduces catheter related complications and shortens post operative hospital stay. This prospective observational study was done from January 2007 and December 2008, 50 patients underwent dorsal onlay buccal mucosal graft urethroplasty for stricture urethra. Among them 25 cases were selected for early catheter removal on 7th postoperative day and 25 cases for conventional catheter removal at 3 weeks. Three patients (12%) of early catheter removal group and 2 patients (8%) of conventional catheter removal group exhibited periurethral leakage. One patient (4%) and three patients (12%) developed wound infection in early and conventional catheter removal group respectively. No significant difference was observed in urinary flow (p=0.089). In these two groups the mean postoperative hospital stay was significant (p<0.001). Early catheter removal on 7th postoperative day is safe and has better impact on patient comfort with minimum catheter related complications and shortens hospital stay.

Effect of desiccation, starvation, heat, and cold stresses on the thermal resistance of Enterobacter sakazakii in rehydrated infant milk formula.

Enterobacter sakazakii is an opportunistic foodborne pathogen that has been isolated from powdered infant milk formula. This study determined the effect of desiccation, starvation, heat and cold stresses on the thermal inactivation of E. sakazakii in rehydrated infant milk formula (RIMF). Stressed cells were mixed with RIMF at 52, 54, 56, and 58 degrees C for various time periods. The D- and z-values were determined by using linear regression analysis. D-values for unstressed E. sakazakii at 52, 54, 56, and 58 degrees C were 15.33, 4.53, 2, and 0.53 min, respectively. Desiccation and heat stresses, but not starvation or cold stress, caused significant (P < 0.05) reduction in D-values. The z-values of desiccated, starved, heat stressed, and cold stressed E. sakazakii were not significantly different from unstressed cells (4.22 degrees C). Thermal resistance of E. sakazakii in RIMF is affected by the environmental stresses; that is, desiccation and heat stresses that may surround the bacterium prior to the contamination of infant formula. The results of this study may be of use to regulatory agencies, infant milk producers, and infant caregivers to design heating processes to eliminate E. sakazakii that may be present in infant milk formula.

Effect of environmental stresses on the sensitivity of Enterobacter sakazakii in powdered infant milk formula to gamma radiation.

AIM: To evaluate the effect of starvation, heat, cold, acid, alkaline, chlorine and ethanol stresses on the resistance of Enterobacter sakazakii in powdered infant milk formula (PIMF) towards gamma radiation. METHODS AND RESULTS: Stressed cells of E. sakazakii ATCC 51329 and four other food isolate strains were mixed individually with PIMF, kept overnight at room temperature, and then exposed to gamma radiation up to 7.5 kGy. The D(10)-values were determined using linear regression and for the stressed E. sakazakii strains these values ranged from 0.82 to 1.95 kGy. CONCLUSIONS: Environmental stresses did not significantly change the sensitivity of most E. sakazakii strains to ionizing radiation. SIGNIFICANCE AND IMPACT OF THE STUDY: Data obtained established that most forms of environmental stress are unlikely to significantly enhance the resistance of E. sakazakii strains to lethal, low dose irradiation treatment.

Consecutive bites on two persons by the same cobra: a case report

In tropical countries like Bangladesh, persons are bitten by snakes every day and a considerable number of patients die en route to the hospital. An event of consecutive neurotoxic bites on two men by a single snake was observed in the Snake Bite Study Clinic (SBSC) of the Chittagong Medical College Hospital (CMCH). Two brothers, working in their semi-pucca restaurant, were successively bitten by the same cobra on their lower limbs. Within an hour, they were taken to the CMCH. Few minutes after admission, both developed symptoms of neurotoxicity: ptosis, nasal voice, dysphagia, broken neck sign, etc. They received polyvalent antivenom (Haffkine Bio-Pharmaceuticals Company, India) and other auxiliary treatment immediately. Within few hours, neurotoxic features were completely absent. Later, the snake was captured in the restaurant kitchen and identified as monocellate cobra (Naja kauthia) by the SBSC. The elder brother developed significant antivenom reactions and both presented necrosis and ulceration at the bite sites. In these cases, immediate arrival to the hospital and early administration of antivenom resulted in successful recoveries.(AU)

Inactivation of Enterobacter sakazakii in infant milk formula by gamma irradiation: determination of D10-value.

Enterobacter sakazakii is an emerging foodborne pathogen that has caused several cases of meningitis and necrotizing enterocolitis in infants and has been associated with infant formulas. Five strains of E. sakazakii were inoculated individually into brain heart infusion broth and rehydrated or dehydrated infant milk formula and exposed to ionizing radiation. E. sakazakii strains in brain heart infusion broth and rehydrated infant milk formula (RIMF) were exposed to irradiation dose of up to 1 kGy while strains in dehydrated infant milk formula (DIMF) were exposed to irradiation dose of up to 9 kGy. The D(10)-values were determined by using a linear regression model. Average calculated D(10)-values ranged from 0.21 to 0.29 kGy, 0.24 to 0.37 kGy, and 1.06 to 1.71 kGy in brain heart infusion broth, RIMF, and DIMF, respectively. The results obtained from this study will be useful for powdered infant milk formula industries to reduce the risk associated with E. sakazakii.

Bronchial asthma in two chemical fertilizer producing factories in eastern Saudi Arabia.

SETTING: Two urea fertilizer producing factories in Saudi Arabia. OBJECTIVE: To determine the prevalence of respiratory symptoms and diseases in employees exposed to ammonia gas. DESIGN: A cross-sectional study involving 161 exposed subjects and 355 controls. All completed a respiratory symptoms questionnaire, with additional questions on present and past occupations. Ammonia concentrations were measured in the different sections of the factories. RESULTS: The ammonia levels in factory B were well below the threshold limit value (TLV) (range 0.02-7.0 mg/m3 of air). In factory A the range was 2.0-130.4 mg/m3. The control and exposed groups were comparable with respect to their smoking habits. The exposed subjects in factory A had significantly higher relative risks (RR) for all respiratory symptoms; the same was true for haemoptysis (RR: 4.1, 95% confidence interval: 1.63-10.28). Bronchial asthma, chronic bronchitis, and a combined diagnosis were significantly higher among those exposed to high cumulative ammonia levels. However, in the logistic regression analysis ammonia concentration was significantly related to cough, phlegm, shortness of breath with wheezing and bronchial asthma. CONCLUSION: Exposure to ammonia gas in the workplace is significantly associated with increase in respiratory symptoms and bronchial asthma. Re-engineering measures to lower the levels of ammonia in factory A are strongly recommended. The affected employees should be removed from further exposure and followed up.

[Relation of the static urethral pressure profile and symptoms of urinary urgency in the female]. / Zur Beziehung zwischen statischem Urethradruckprofil und Harndrangsymptomatik der Frau.

In a retrospective study of 463 stationary urethral-pressure profiles the coherence between clinical relevant changes of the urethral pressure and bladder instability is discussed. It is shown, that clinical important pressure changes in the stationary urethral-pressure profile appear significantly more frequently in female patients with signs of bladder instability. The results and the definition of urethral-pressure changes are compared with the literature.

[Personal experiences with conservative drug therapy of urgency symptoms in the female]. / Unsere Erfahrungen mit der konservativ-medikamentösen Therapie der Drang-Symptomatik der Frau.

On the basis of clinical and urodynamic results the authors adopt a definite attitude to the treatment of the urgency syndrome in the woman with the anticholinergic drug propiverin hydrochloride (Mictonorm). The results show a satisfactory improvement in 42 of 68 women (= 62%), whereas 24 of 68 women (= 35%) reported a subjective improvement of the clinical symptoms. These results correspond with the data from literature. In 15 women with no satisfactory effect the beta 2-sympathicomimetic drug clenbuterol (Contraspasmin) was additionally applied. There was a satisfactory success under this medication in 11 of the 15 women (= 72%). The results are discussed with the references of the literature to the conservative therapy of the urgency syndrome.

[Changes in the parameters of the urethral pressure profile by measuring the patient in supine and sitting position]. / Veränderungen der Parameter des Urethradruckprofils bei Messwertaufnahme in liegender oder sitzender Position der Patientin.

For testing the influence of the examination position on the parameters of the urethrocystometry 124 findings of urethrocystometry of 103 female patients were evaluated in 3 groups. In these cases slight alterations develop when changing between lying and sitting position, whereby in sitting position a greater differentiation of an existing component of stress incontinence becomes possible. On the basis of our examination findings and the references in literature it seems to be advisable to perform the urethrocystometry in the same session both in lying and in sitting position for further improvement of the indication for therapy.

[Urodynamic follow-up of stress incontinent females following endourethral Teflon injection]. / Urodynamische Nachuntersuchungen stressinkontinenter Frauen nach endourethraler Tefloninjektion.

We examined 7 women suffering from stress urinary incontinence in whom Teflon was injected endourethrally near the orificium urethrae internum 3-4 years ago. This management will not be a long-lasting therapy of stress incontinence.