Culture-Based Identification of Causative Organisms in Ascitic Fluids of Patients with Spontaneous Bacterial Peritonitis Secondary to Decompensated Liver Disease and their Sensitivities to Ceftriaxone as an Empiric Therapy

OBJECTIVES To identify the pathogens in the ascitic fluids of patients with spontaneous bacterial peritonitis and then to determine their sensitivity pattern to ceftriaxone. METHODOLOGY The cross-sectional study was conducted at the Medical Unit-A, Department of Medicine, Hayatabad Medical Complex, Peshawar, from November 2021 to April 2022. Before ceftriaxone treatment was started, a minimum of 10 ml of ascitic fluid was introduced into a blood culture vial. Only patients with a positive culture were registered, and their information was gathered using a proforma. For statistical analysis, SPSS version 23 was used. RESULTSA total of 96 patients were enrolled in our study. There were 62 (59.52%) male and 34 (40.48%) female patients. Based on the isolation and identification of bacteria, the most prevalent bacteria isolated was Escherichia coli in 36 (37.5%) patients, followed by Acinetobacter Spp in 13 (13.54%) patients, Streptococcus spp in 14 (14.58%), Enterococcus spp in 11 (11.45%), Staphylococcus aureus in 9 (9.39%), MRSA in 8(8.33%) and K. Pneumonia in  5(5.21%) patients. The overall sensitivity of ceftriaxone to gram-positive bacteria was observed in 12 (42.85%) isolates, whereas the overall sensitivity of ceftriaxone to gram-negative bacteria was observed in 25 (36.76%) isolates. (p=0.091) (Figure 6). CONCLUSION Our study concludes that gram-negative bacteria were more prevalent than gram-positive bacteria in ascitic fluids of patients with spontaneous bacterial peritonitis. The most common isolated pathogen was E.coli. Gram-negative was more resistant to ceftriaxone as compared to gram-positive bacteria

T-tube management of late esophageal perforation

Esophageal perforation is a serious condition with a high mortality rate. Management strategy of such a patient depends on the extent of perforation and the time interval between perforation and diagnosis. The use of a T tube to treat delayed esophageal perforation with complete resolution and no need for future definitive surgery has been less frequently described. We adapted this principle in successful management of a 73 year old patient with four days history of fever, shortness of breath, chest pain and radiological evidence of perforation

Amelioration of experimental hyperlipidemia in rats by Portulaca oleracea Linn from Kashmir Himalaya

Background: Traditionally, Portulaca oleracea Linn. treats abscesses and dysentery as well as liver disease. Additionally, recent studies have reported its effectiveness as a neuroprotective, analgesic, anti-inflammatory, bronchodilator, anti-cancer, antioxidant, and curative, in addition to its pharmacological effects. Aim and Objective: To assess the phytochemical constituents quantitatively & qualitatively and lipid-lowering potential of different extracts of Portulaca oleracea L. from Kashmir Himalaya. Methods: Portulaca oleracea L. was extracted with chloroform, methanol, and aqueous solvents. Qualitative and quantitative phytochemical screening was carried and antihyperlipidemic activity was evaluated in experimental hyperlipidemic rats fed with cholesterol in coconut oil for 14 days. Results: Chloroform, methanol, and aqueous extracts showed the presence of alkaloids, sapon ins, tannins, cardiac glycosides, terpenes, flavonoids, phenolic compounds, proteins, and carbohydrates. Quantitatively the dried plant powder contains alkaloids 0.72 g%, saponins 1.0 g%, phenolics 1.09 g%, tannins 0.91 g%, carbohydrates 0.53 g%, proteins 0.25 g% and lipids 0.87 g%. The aqueous extract was found to decrease the plasma total cholesterol, triglyceride, low-density lipoprotein-cholesterol, very lowdensity lipoprotein-cholesterol levels, LDL-C/HDL-C ratio and significantly elevated the high-density lipoprotein-cholesterol levels as compared to methanol and chloroform extracts against cholesterol-induced hyperlipidemic rats. Conclusions: The results reveal that the Portulaca oleracea L. from the Kashmir region possesses alkaloids, saponins, phenolics, tannins, carbohydrates, proteins and lipids and aqueous extract of Portulaca oleracea L. at a dose of 200 mg/kg body weight possess highly significant antihyperlipidemic action than methanolic and chloroform extracts at similar doses

A Comprehensive Joint Learning System to Detect Skin Cancer

Skin, the body’s biggest organ and a barrier against heat, light, damage, and infection can be affected by many diseases. However, a correct diagnosis can lead to proper treatment. Skin diseases must be identified early to reduce skin lesion growth and spread. The medical field has a significant dependency on Information Technology and in this era, there is a need for a mechanism that can detect skin diseases at an early stage with higher accuracy capable of working with rapidly growing data. This research offers a joint learning system using Convolutional Neural Networks (CNN) and Local Binary Pattern (LBP) followed by its concatenation of all the extracted features through CNN and LBP architecture. The proposed system is trained and tested using the widely used publicly accessible dataset for skin cancer detection to solve multiclass skin disease issues. Furthermore, a comparison of results is developed between the architectures and their fusion. The demonstration of the results shows the robustness of the fusion architecture with an accuracy of 98.60% and a validation accuracy of 97.32%. Comparative results are also included in this research for better analysis

Gastric Cancer in Young Patients

Aim. The aim of this study was to see the clinical, pathological, and demographic profile of young patients with stomach carcinoma besides association with p53. Patients and Methods. Prospective study of young patients with stomach carcinoma from January 2005 to December 2009. A total of 50 patients with age less than 40 years were studied. Results. Male female ratio was 1 : 1.08 in young patients and 2.5 : 1 in older patients. A positive family history of stomach cancer in the first degree relatives was present in 10% of young patients. Resection was possible only in 50% young patients. 26% young patients underwent only palliative gastrojejunostomy. The most common operation was lower partial gastrectomy in 68%. Amongst the intraoperative findings peritoneal metastasis was seen in 17.4% in young patients. 50% young patients presented in stage IV as per AJCC classification (P value .004; sig.). None of the patients presented as stage 1 disease in young group. Conclusion. Early detection of stomach carcinoma is very important in all patients but in young patients it is of paramount importance