Pattern of bacteria and their antimicrobial susceptibility isolated from inanimate objects and hospital personnel

Different inanimate samples collected from surgery wards and general operation theatre (GOT) as well as animate samples from surgery personnel were subjected to aerobic culture with the aim of identifying source of infections in surgical cases. The pattern of aerobic bacteria with antibiotic susceptibility isolated from those samples were reported in the present study. Out of 91 such samples, 53 and 26 were from different locations in general wards and OT respectively and 12 were comprising of hand swabs, throat swabs and nasal swabs from surgery personnel. Pathogenic bacteria were isolated from 34 samples having Pseudomonas spp. (18/34) in the top of the list followed by Esch. coli (14). Among the Esch.coli isolates resistance to cotrimoxazole, amoxicillin and doxycycline were 78.7%, 71.4% and 57.1% respectively, whereas sensitivity to aztreonam, ceftazidime, gentamicin and ciprofloxacin were 100%, 85.8%, 78.7% and 71.4% respectively. Ceftriaxone yielded intermediate sensitive results in 21.4% strains. Isolates of Pseudomonas spp. also showed very high sensitive results to aztreonam, ceftazidime and ceftriaxone (94.7%, 94.7% and 84.2% respectively). Ciprofloxacin and gentamicin were sensitive in 68.4% and 57.9% respectively. Susceptibility pattern showed well correlation with clinical response in infected cases.     

Toxicity of shoti (Indian arrowroot: Curcuma zedoaria) for rats and chicks.

1. A flour was prepared from rhizomes of shoti(Curcuma zedoaria) in such a way that most of the protein was retained. The crude protein (nitrogen x 6.25) content in this product was 155 g/kg, compared with approximately 10 g/kg in commercial shoti flour. 2. The high-protein flour proved highly toxic to 5-week-old rats and caused 100% mortality within 6 d when given at 320 g/kg diet. 3. Fresh rhizomes were minced and dried, and the resulting meal was given to weanling rats at 400 g/kg diet. All the animals lost weight rapidly, and two of the five rats died within 4 d. 4. This same shoti meal was given to 1-d-old chicks at 100 and 200 g/kg diet. All the chicks survived the test period (20 d), but body-weight, food intake and efficiency of food conversion decreased with increase in the level of shoti meal in the diet. 5. The traditional method of preparing shoti involves prolonged washing in changes of water, which removes most of the protein and other water-soluble nutrients and, presumably, a toxic constituent. Further investigation is needed to identify the toxic principle, and to discover a less wasteful procedure for removing it.     

Comparison of PCR method with the culture method for identification of gonococci from endocervical swabs

Gonococcal infection remains still a major cause of morbidity among sexually active individuals. Diagnosis of the infection in a female case is more difficult than that in a male. This was a prospective study among 269 female commercial sex workers (CSWs) to screen them for gonococcal infection, comparing the rapid method of identification of gonococci by polymerase chain reaction (PCR) with the selective culture method. A total of 92 (34.2%) CSWs were identified positive for Neisseria gonorrhoeae by combination of the two methods. The PCR method identified 87 of the specimens to harbour cppB gene of N. gonorrhoeae, whereas culture method identified 83 specimens showing colonies of gonococci. Taking into consideration of the total positive cases (92), the PCR method showed a sensitivity of 94.57%, whereas sensitivity of culture method was 90.22%. The selective culture method appears to be the most applicable in the identification of gonococci from clinical specimens, particularly in the less resourceful countries like Bangladesh.     

Prognosis in acute stroke with special reference to some cardiac factors

Neurological assessments were done regularly during hospitalization in 283 consecutive patients (mean age 73 yr) with acute cerebrovascular disease treated at the Stroke Unit of Serafimerlasarettet. A preplanned investigation program and strict criteria for diagnosis and treatment were followed. Hospital mortality was 18%. Patients with a major cerebral infarction or haemorrhage often died very early during the hospital period and deaths due to complications increased significantly during the second week. Multivariate analysis regarding mortality showed that a low neurological score and heart failure were the most important factors for the short-term prognosis. In those patients with cerebral infarction, ambulatory capacity and ECG-diagnosed bundle branch block added significantly to the prognostic power of the neurological score. Among the 227 patients discharged alive, 1 and 2-yr mortality was 14 and 18% respectively. Here, the most important long-term prognostic factors were age and ST changes on the ECG. Again, considering only patients with cerebral infarction (N = 190), bundle branch block was found to be the single most useful predictive factor. Prognostication in acute ischemic stroke should thus be based not only on neurological findings but on careful evaluation of associated cardiac disease, especially in the long-term perspective.     

Study on 40 cases of rickettsia

Rickettsia is emerging in the subcontinent and clinically presents as non-specific febrile illness. At present there is no cheap & easily available diagnostic tool in our hand. Beside this, Weil-Felix test is becoming abandoned. So, high index of clinical suspicions is essential to diagnose rickettsia at early stage and to prevent mortality & morbidity. 40 cases were recorded among the admitted febrile patients in MMCH since 2003 to 2005. Cases were selected by clinical suspicions; exclusions of other common febrile illness & thereafter supported by lab. Investigations, specially by positive Weil-felix test. Cases were distributed through out the year but 19 (47.5%) cases were detected in March to May. 12 (30%) cases were found in August to October. The remaining 9 cases were detected in the rest 6 months. All (40) cases were presented with fever (100%), headache was present in 33 (82.5%) cases, rashes were present in 15 (37.5%) cases, isolated splenomegaly was found in 15 (37.5%) cases & hepatosplenomegaly in 12 (30%) cases, arthralgia in 13 (32.5%) cases, lymphadenopathy in 5 (12.5%) cases; 2 (5%) cases attended with unconsciousness & epistaxis in 1 (2.25%) case. Scrub typhus were 19 (47.5%), Indian tick typhus 16 (40%), 5 (12.5%) cases were with dual pathology and were associated with enteric fever. 15 (37.5%) cases were treated with tetracycline only. 20 (50%) cases with only doxyclycline & 5 (12.5%) cases with tetracycline and ceftriaxone as these cases were associated with enteric fever. All patients (100%) cured with treatment.     

Prenatal nutrition among rural Bangladeshi pregnant women

The expected outcome of pregnancy is a healthy mother with a healthy child. The single most important care which could prevent the negative outcomes of pregnancy is Antenatal Care (ANC). Proper and timely antenatal care can significantly reduce the risks of maternal mortality. In pregnancy, total cost is about 80,000 Kcal, and above normal energy requirements. To find out prenatal nutrition an exploratory study was carried out in seven villages of the Ward-2 of Jamtoil Union of Kamarkhand Upazila under Sirajganj District. Thirty pregnant women of different trimesters, gravida and parity had been studied employing the methods and techniques of "Ethnographic Field Work." Mean daily calorie consumption of the Key Informants (KIs) was 1480.49 Kcal without reference to their religious affiliation, family resource base, education, occupation, gravidity, parity and duration of pregnancy. This is indicated that the mean calorie intake of the Key Informants did not meet not only their prenatal nutritional need but also their requirement during pre-pregnancy period. It was observed that food intake was in no way different from that of the non-pregnant status. Antenatal care of rural inhabitants analyzed almost exclusively from biomedical perspectives, its cultural, socio-economic, gender, ecological and other relevant perspectives are mostly ignored. In order to have safe motherhood up through compliance of prenatal advice, nutritional one in particular, these factors should be taken into consideration.     

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 (2hours 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.     

CISH is induced during DC development and regulates DC-mediated CTL activation

The cytokine inducible SH2-domain protein (CISH) is a well-known STAT5 target gene, but its role in the immune system remains uncertain. In this study, we found that CISH is predominantly induced during dendritic cell (DC) development from mouse bone marrow (BM) cells and plays a crucial role in type 1 DC development and DC-mediated CTL activation. CISH knockdown reduced the expression of MHC class I, co-stimulatory molecules and pro-inflammatory cytokines in BMDCs. Meanwhile, the DC yield was markedly enhanced by CISH knockdown via cell-cycle activation and reduction of cell apoptosis. Down-regulation of cell proliferation at the later stage of DC development was found to be associated with CISH-mediated negative feedback regulation of STAT5 activation. In T-cell immunity, OT-1 T-cell proliferation was significantly reduced by CISH knockdown in DCs, whereas OT-2 T-cell proliferation was not affected by CISH knockdown. CTLs generated by DC vaccination were also markedly reduced by CISH knockdown, followed by significant impairment of DC-based tumor immunotherapy. Taken together, our data suggest that CISH expression at the later stage of DC development triggers the shutdown of DC progenitor cell proliferation and facilitates DC differentiation into a potent stimulator of CTLs.