RESUMO
BACKGROUND: The surge in antibiotic-resistant Salmonella enterica serotype Typhi strains has led to heightened morbidity, mortality, and treatment expenses. This study aims to assess the resistance patterns of Salmonella Typhi to diverse antibiotics among patients seeking care at a tertiary hospital in Pakistan. METHODS: A database from a tertiary care hospital in Pakistan was reviewed, and data on blood cultures that isolated Salmonella enterica serotype Typhi were collected. Data were collected and analyzed using Microsoft Excel (Microsoft Corporation, USA) and IBM SPSS software (IBM Corp., Armonk, NY). RESULTS: Demographic information of the selected data was retrieved from the hospital database, and the results showed that 63.7% were male, 36.1% were female, and 0.2% were categorized as neutered. Regarding antibiotic resistance, ampicillin exhibited the highest resistance rate (91.50%), while meropenem demonstrated the lowest (3.00%). Antibiotic sensitivity patterns also varied across different age groups, although statistical analysis indicated no significant differences. Significant associations were found between antibiotic resistance and comorbidities, as well as previous antibiotic use. CONCLUSION: Salmonella enterica serotype Typhi showed a high resistance to ampicillin and fluoroquinolones, such as ciprofloxacin. The emergence of resistance and decreased sensitivity to current first-line antibiotics necessitates a shift towards alternative options, such as third-generation cephalosporins, azithromycin, and newer antibiotics like meropenem.
RESUMO
Cerebral venous thrombosis refers to complete or partial occlusion of the cerebral sinus/es or the feeding cortical veins, resulting in secondary effects of vascular congestion and focal or generalized neurological deficits. One of the important causes of venous thromboembolism is inherited thrombophilia. Our case is of a 34-year-old male with no previous comorbidity who presented to the emergency department with complaints of sudden onset left-sided weakness, seizures, and loss of consciousness for one day. Thrombosis of the vein of Trolard was diagnosed based on magnetic resonance venography (MRV) film. His MRI with MRV revealed an attenuated caliber of the vein of Trolard along with abnormal signal intensity in the right fronto-parietal region and the right falcine location. He was managed with intravenous medication, including levetiracetam and topiramate. Once the diagnosis was established, he was commenced on subcutaneous Enoxaparin. Consequently, his GCS improved from 6/15 to 15/15 within the first 24 hours, and he could move his limbs on the day of discharge without any significant disability.
