Pattern and antibiogram of urinary tract infection at the University of Port Harcourt Teaching Hospital

ObjectiveTo explore the prevalence, pathogenicity, and antibiotic susceptibility patterns of urinary tract infections at the University of Port Harcourt Teaching Hospital.MethodsSamples from 400 patients with a presumptive diagnosis of urinary tract infection including 250 non pregnant females and 150 males were used for this study. They were distributed into two groups: children aged 2 to 17 (Group A) and adults aged 18 to 75 (Group B). The standard wire loop and agar diffusion technique were employed for culture and susceptibility testing, respectively. Data obtained were analysed using SPSS, version 14.Results30.0% of Group A and 41.0% of Group B had significant bacteriuria with 66.7% and 79.3% as females, respectively. The commonest isolates cultured were Escherichia coli (32.8%), Staphylococcus aureus (17.2%), and Klebsiella spp. (16.4%). About 76.6% of isolates were sensitive to the fluorinated quinolones, 31.2% to the aminoglycosides, and 22.7% to the urinary antiseptic, nitrofurantoin. The isolates were non-sensitive to tetracycline (93.8%), cotrimoxazole (92.2%), and nalidixic acid (86.7%). Most isolates showed non-uniform sensitivity patterns to the cephaloporins (cefuroxime and ceftazidime). Pseudomonas spp. isolates were generally resistant to the fluorinated quinolones.ConclusionThough the fluorinated quinolones are still largely effective for empirical therapy in urinary tract infections, the importance of prior sensitivity testing in checking the emergence of bacterial antibiotic resistance can not be overemphasized.     

Laser treatment of pediatric vascular lesions: Port wine stains and hemangiomas

Pediatric vascular lesions can be medically threatening and psychologically distressing to patients. This article reviews literature on the laser treatment of two common pediatric vascular lesions, port wine stains and hemangiomas. The purpose of this report was to distinguish the lesions from one another and to present the advantages, disadvantages, complications, and limitations of laser treatment for each lesion type. This review is not a comprehensive inventory but instead highlights the studies that best show promising results or the limitations of laser treatment for the lesions. Overall, port wine stain laser treatment promoted notable clearing with low side effects, whereas hemangioma laser treatment provided inconsistent benefits and severe side effects occasionally. Laser treatment of port wine stains is safe and effective, but laser treatment of hemangiomas remains controversial and is best for lesions without deeper components.     

Hemodynamic effect of norepinephrine and serotonin with and without indomethacin

Injections of serotonin (5-HT) into the aortic arch of rats caused greater reductions of blood pressure (BP) and less increases in renal vascular resistance (RVR) than that into jugular veins, in contrast to norepinephrine (NE) which tended to cause larger increases in BP and RVR by the intra-aortic route. Indomethacin (INDO) enhanced renal vasoconstrictor responses to NE, but did not affect those of 5-HT. These data support a central nervous system (CNS) hypotensive effect of 5-HT not shared by NE, and a less interaction with vasodilator prostaglandins for 5-HT, when compared with NE.     

Dynamic magnetic resonance angiography for localization of hyperfunctioning parathyroid glands in the reoperative neck

Objectives

To evaluate the use of dynamic magnetic resonance angiography for localization of hyperfunctioning parathyroid glands in the reoperative neck.

Methods

We retrospectively evaluated the head-neck MRIs of 30 patients with a history of hyperparathyroidism, prior head-neck surgery, and intraoperative proven adenomas. The protocol included conventional imaging with T2-weighted STIR sequences, T1w axial and coronal prior to and after contrast media administration, and dynamic magnetic resonance angiography. We compared the results from MRI, dynamic magnetic resonance angiography with 99m-Tc-Sestamibi with intraoperative findings as the gold standard.

Results

In conventional MRI 19/30 true positives were detected with a sensitivity and specificity of 63.3% and 100%, respectively. However, by adding dynamic magnetic resonance angiography the detection rate increased to 28/30 true positives. Based on intraoperative findings, the sensitivity and specificity of dynamic magnetic resonance angiography were 93.3% and 100%, respectively. 99m-Tc-Sestamibi detected 24/30 true positives, sensitivity was 80%.

Conclusion

The diagnostic value of MRI including dynamic magnetic resonance angiography is superior to MRI alone and superior to that of 99m-Tc-Sestamibi in the diagnostic workup of hyperfunctioning parathyroid glands when compared against intraoperative findings.     

Sonography of the larynx in children. New perspectives due to the use of computerized sonography: 2: Sonographic findings in a case of laryngeal papillomatosis

On our opinion one important indication for sonographic diagnosis in future are masses in the larynx area: in infancy or childhood mainly laryngeal papillomatosis. In one of our boy patients with massive laryngeal papillomatosis laser surgery was first performed at 15 months of age. After a second and third procedure interferon-therapy was begun. Sonographically it was easily possible to follow the course in control examinations. Sonographic findings correlated well with laryngoscopic findings. Laryngoscopy could therefore be limited to a minimum.     

Clinico-pathological correlates in IgA nephropathy

Summary: There were 2758 biopsies of glomerulonephritis diagnosed in the Department of Pathology in the 20 years from 1976 to 1995. Of these 1893 (76.1%) were of primary glomerulonephritis while 577 (23.2%) were of secondary glomerulonephritis. Immunofluorescence studies were available in 1494 (80%) cases. Predominantly mesangial IgA staining was seen in 49.1% of cases, thus identifying them as IgA nephropathy. Mesangial glomerulonephritis was found in 79.1% of cases whilst 17.7% had sclerotic lesions either focal or global. One hundred and fifty-one patients were followed up. Of these, 98 (65%) were detected through health screening while 53 (35%) presented with symptoms. Uncontrolled hypertension, proteinuria of more than 2 g, the presence of crescents and glomerulosclerosis on biopsy were unfavourable prognostic factors. Hypertensive patients also had a higher incidence of medial hyperplasia of the blood vessels. However IgA nephropathy is a benign disease with a cumulative renal survival of 91% after 6 years.     

Reciprocal renal effects of dopamine and 5-hydroxytryptamine formed within the rat kidney

1. Clearance of inulin and p-aminohippurate and excretion of water and sodium were measured for eight to 11 clearance periods of 20 min duration in anaesthetized, 3% volume-expanded rats, before and after intravenous infusions of the amino acids L-dopa (L-3,4-dihydroxyphenylalanine) and 5-hydroxytryptophan. During the final two clearance periods, the peripheral decarboxylase inhibitor, carbidopa (S-alpha-hydrazino-3,4-dihydroxy-alpha-methylbenzenepropanoic acid monohydrate), was infused additionally. 2. Renal formation of dopamine (3,4-dihydroxyphenethylamine) and 5-hydroxytryptamine was demonstrated during infusions of L-dopa and 5-hydroxytryptophan, respectively; carbidopa blocked the renal formation of these biogenic amines. 3. During infusion of dopa, a diuresis and a natriuresis were observed; during the infusion of 5-hydroxytryptophan, slight reductions in clearances of inulin and p-aminohippurate, but significant reductions in sodium and water excretion, were measured. 4. The addition of carbidopa diminished diuretic and natriuretic responses to dopa as renal dopamine excretion decreased; the infusion of carbidopa also ameliorated the antinatriuretic and antidiuretic effects of 5-hydroxytryptophan, as 5-hydroxytryptamine excretion decreased. 5. Although dopa and 5-hydroxytryptophan are substrates for the same enzyme, aromatic L-amino-acid decarboxylase, simultaneous infusions of both amino acids at comparable rates gave no evidence of competitive inhibition of amine synthesis. However, the infusion of dopa, after 5-hydroxytryptophan, decreased its antinatriuretic and antidiuretic effects. 6. These data raise the possibility that dopamine and 5-hydroxytryptamine are formed as reciprocal intrarenal hormones by the identical enzyme, aromatic L-amino-acid decarboxylase, which is located within cells of the renal tubule.