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September-October 2014 Volume 7 | Issue 5
Page Nos. 219-247
Online since Thursday, April 9, 2015
Accessed 21,933 times.
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ORIGINAL ARTICLES |
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Distribution of ESBL producing Uropathogenic Escherichia coli and carriage of selected β-lactamase genes in Hospital and community isolates in west of Iran |
p. 219 |
Parviz Mohajeri, Zhila Rostami, Abbas Farahani, Baharak Norozi DOI:10.4103/1755-6783.154823 Background and Objective: For many years, extended-spectrum-beta-lactamase (ESBL)-producing bacteria were problems mainly located in medical facilities. Within the last decade, however, ESBL-producing bacteria have started spreading into the community and the hospital. The aims of this study were to detect ESBL-producing uropathogenic Escherichia coli (UPEC), susceptibility to antibiotics, and β-lactamase genes. Materials and Methods: Two hundred bacterial isolates were collected from inpatients and outpatients in the west of Iran from December 2011 to February 2013. All isolates were identified by conventional bacteriological tests. Antimicrobial susceptibility and interpretation were assessed by disk diffusion. ESBL-producing E. coli isolates were tested by polymerase chain reaction (PCR) assay for blaTEM , blaSHV , blaCTX-M , blaOXA-I , and blaOXA-II genes. Results: Of 200 UPEC, 22% (n = 44) were ESBL-producing; 0% showed the least resistance to imipenem, and 97.7% showed high resistance to carbenicillin and ampicillin. The ESBLs CTX-M, SHV, TEM, OXAI, and OXAII were detected in 93.3%, 68.2%, 43.2%, 31.8%, and 22.7% of isolates respectively. Conclusion: A prevalence of ESBL-producing UPEC was observed in outpatients and inpatients; the high levels of resistance to different antibiotics show that treatment options are limited and that infection control measures remain of high importance. |
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Seroprevalence of hepatitis A virus infection in different age groups of children |
p. 223 |
Yogendra Singh Verma, Neelam Rajput, Satyendra S Rajput DOI:10.4103/1755-6783.154825 Context: Hepatitis A is one of the most common causes of hepatitis in the pediatric age group and the most common cause of fulminant hepatic failure (FHF) among children in India. Hepatitis A is a waterborne disease. High endemicity obviates the need for vaccine in the community. Aims: We studied 116 children in the outpatient department (OPD) to know the seroprevalence of hepatitis A virus (HAV), total antibodies, and the effect of various demographic and water sanitation variables on it. Settings and Design: Children attending the pediatric OPD with minor problems in a medical college hospital were chosen for this study. It is a descriptive, cross-sectional, and seroepidemiologic investigative study. Materials and Methods: Blood samples of randomly selected children were collected and competitive enzyme-linked immunosorbent assay (ELISA) test was done for the detection of total anti-HAV antibodies, [both immunoglobulin M (IgM) and immunoglobulin G (IgG)], using a commercially available ELISA kit. "Dia.Pro" (Diagnostic Bioprobes srl via Columella n° 31 20128 Millano, Italy). Statistical Analysis Used: Statistical analysis was performed by the chi-square test using Epi Info software 3.5.4 version (2012) [Center for disease control and prevention (CDC), Atlanta, Georgia (USA)]. Results: Seroprevalence in children from the upper social class was 54.5% versus 87.2% in the lower social class (P = 0.00075). 90.9% of the children with rural background were seropositive compared to 77.1% of children with urban background. The mother's education above and below secondary level had a seropositivity for HAV in children up to 69.23% and 87.1%, respectively. The method of water treatment using boiled water, mechanical filtration, filtration plus ultraviolet (UV) light treatment, and no treatment had a seropositivity of 50.0%, 83.33%, 37.5%, and 84%, respectively, (P = 0.0036). Seropositivity was the highest when the water source was municipal bore well pipeline (88.88%), followed by municipal dam water through pipeline (79.16%), and personal bore well (68.16%) (P = 0.026). Conclusion: Children of this geographical area have high seroprevalence for HAV antibodies at a younger age with a significant difference between their social classes, water sources, and water treatment methods. |
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Epidemiology of viral hepatitis among patients undergoing hemodialysis at nephrology center Benghazi |
p. 227 |
Vinay Rao, Prasannalakshmi Rao DOI:10.4103/1755-6783.154826 Introduction: During hemodialysis, patients are at-risk of acquiring blood-borne viruses and pathogenic bacteria. Within dialysis units, prevention of infection is of paramount importance. The nursing staff must take adequate precaution to prevent the spread of infection within this high-risk environment. Patients and Methods: All patients undergoing hemodialysis for the period of 7 days were interviewed once during dialysis, using a closed-ended questionnaire. Patients' files were checked for seropositivity. Results: The prevalence of the hepatitis C virus (HCV) was 34% (male 39% and female 21.4%). The prevalence of the hepatitis B virus (HBV) was 7% in male and 3 % in female. A small number had a double infection. Conclusion: In this study of 186 patients on dialysis, 34% were infected with HCV and 5% with HBV. The most important risk factors were multiple blood transfusions and the duration of dialysis. |
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CASE REPORTS |
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Report of an unusual case of ileoceacal intussusception in an adult due to tuberculosis and review of the literature |
p. 231 |
K Sutariya Vaibhav, H Tank Anand DOI:10.4103/1755-6783.154827 Ileocecal intussusception in an adult is a rare clinical entity. Intussusception, when it occurs in adult, is usually associated with underlying pathologic condition. Here, we present a case of an adult presented with chronic intussusception diagnosed by computed tomography scan, managed by right hemicolectomy and found to have underlying tuberculosis as a cause on histopathology. |
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Invasive sphenoid sinus aspergillosis mimicking a cerebello-pontine angle mass lesion |
p. 234 |
Shyam Chand Chaudhary, Kamal Kumar Sawlani, Hardeep Singh Malhotra, BE Yathish, Sudhir Kumar Verma DOI:10.4103/1755-6783.151779 Invasive sphenoid sinus aspergillosis is a rare clinical entity in immunocompetent patients. It is often misdiagnosed because of its diverse clinical presentation and lack of suspicion. Timely diagnosis and early treatment of such cases may improve the outcome of this potentially fatal condition. We hereby present a rare occurrence of invasive sphenoid sinus aspergillosis in an immunocompetent host, presenting as a cerebello-pontine angle mass lesion. |
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Myiasis in Republic of Yemen (cutaneous myiasis three cases reported and genito-urinary myiasis three cases reported) |
p. 238 |
Mohammed Abdul Qader Al-Malmi DOI:10.4103/1755-6783.151778 Myiasis is a condition resulting from the invasion of living human and animal's tissues by larval stages of flies. study the cutaneous and genito-urinary myiasis in the Republic of Yemen. Two females and one male, Yemeni patient 12-30 years old presented with urethra-genital discharge, burning, and difficulty during micturition (dysuria). They saw whitish brownish blackish like worms passed in their urine. Three males, Yemeni patients 2 months to 30 years old had solitary and multiple furuncle like skin lesions in upper left thigh (myiasis pubis), right buttock (myiasis neonatorum) and in the upper trunk. It was associated with stabbing pain (caused by creeping a foreign body subcutaneously). The duration varied from 2 days to 1 week. The larvae were detected in the urine and the skin lesions. Swab from the urethral discharge was not specific. I used the forceps accidentally and gently caught the larvae and removed them from the fruncular skin lesions. The clinical data and detection of the larvae showed the two females and one male case were genito-urinary myiasis, which caused by latrine Fannia fly larvae during defecation or sleeping and ended spontaneously. The three male patients had cutaneous myiasis, and the causative agent was the larvae of the tumbu fly, Cordylobia anthropophaga species. It penetrates the patients' normal skin and removed by forceps or squeezing the skin lesion by the patient himself thinking that is abscess to remove the pus. Cutaneous and genito-urinary myiasis was not rare in the Republic of Yemen. Health education, hygiene, and control the flies restrict the incidence of this disease. |
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LETTERS TO THE EDITOR |
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Diarrhea as an atypical presentation in Middle East respiratory syndrome (MERS) 2012 |
p. 244 |
Sora Yasri, Viroj Wiwanitkit DOI:10.4103/1755-6783.154828 |
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An upper lobe cavitary lesion in a patient with sickle cell disease |
p. 244 |
B Jayakrishnan, Dawar Masud Rizavi, Khalfan Al Zeedy, Khalil Saleh Al Farsi DOI:10.4103/1755-6783.154829 |
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Quality of vaccine storage and conservation in primary health care centers |
p. 245 |
Sim Sai Tin, Viroj Wiwanitkit DOI:10.4103/1755-6783.154830 |
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YouTube as a tool to assess patient perception |
p. 246 |
Sim Sai Tin, Viroj Wiwanitkit DOI:10.4103/1755-6783.154831 |
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