Cephalosporin resistant shigella flexneri from a clinical isolate--a rare finding

Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of dysentery aimed at resolving diarrhea or reducing its duration, and to prevent transmission to other close contacts. Isolates with resistance to first line drugs have been reported throughout world, third generation cephalosporins and quinolones are mainstay of treatment. Shigella flexneri resistant to third generation cephalosporins in a clinical isolate is a rare finding, and this has been reported for the first time in Pakistan

Frequency of isolation of shigella serogroups/serotypes and their antimicrobial susceptibility pattern in children from slum areas in Karachi

Objectives: To assess the frequency of serogroups and serotypes, as well as the antimicrobial susceptibility pattern of Shigella species isolated from known cases of diarrhoea and dysentery from Karachi, Pakistan. Methods: A cross-sectional study was conducted between January 2002 and March 2003 at Aga Khan University on stool samples received from children with diarrhoea and dysentery from four low socio-economic areas (Sultanabad, Rehri Goth, Hijrat and Sherpao colony) of Karachi. Stool samples yielding growth of Shigella species, were further identified for serotypes by slide agglutination. Antibiotics susceptibility was performed by Kirby Bauer disk diffusion methodResults: Out of 4688 stool samples received, 193 (4.1%) were positive for Shigella species. Shigella flexneri was the predominant serogroup (58%) followed by Shigella sonnei (16%), Shigella boydii (15%) and Shigella dysentriae being the least common (11%). A number of serotypes were isolated in each serogroup, 8 serotypes in S. flexneri, 8 serotypes in S. dysenteriae, 9 serotypes in S. boydii, and Phase 1& 2 were found in S. sonnei. 17% isolates remained non-serotypeable. All isolates were susceptible to Ofloxacin and Ceftriaxone, high rate of resistance was observed in Cotrimoxazole (87.75%) and Ampicillin (55.5%). Emerging resistance against Nalidixic acid (39%) was observed.Conclusion: Shigella still accounts for a significant proportion of bacillary dysentery in many tropical and subtropical countries. Serotype identification can help in devising strategies such as development of effective vaccine for controlling this problem. Increasing antibiotic resistance against commonly prescribed drugs signify that treatment options have become difficult in cases of severe dysentery (JPMA 55:184;2005)

Endocrine cell dysplasia (nesidioblastosis): A relatively unrecognized entity in Pakistan?

Nesidioblastosis is quantitative as well as qualitative abnormality of pancreatic endocrine cells. There is scattering of small endocrine cell clusters arranged haphazardly rather than the peripheral location within the lobule1,2. Islet contours are irregular, tailing off into parenchyma3. These islets are present in intimate association with ducts forming ductuloinsular complexes1 We recently encountered a new born baby with signs and symptoms of endocrine cell dysplasia

Implications of use of contaminated drugs: a developing world scenario

Infections after use of inadequately sterilised therapeutic products have been reported worldwide. We believe that, in the absence of well established surveillance and notification procedures (as is often the case in developing countries), such instances are frequently not detected, and contaminated drugs continue to be marketed

Bacteremia associated with central line infection by chryseomonas luteola in a case of recurrent meningiomas

A 52 years old diabetic and asthmatic lady was admitted with a post-operative wound infection 10 days following removal of meningioma. The patient had a history of recurrent meningiomas for which she had undergone multiple surgeries during the past ten years. On admission, the patient was febrile and drowsy. There surgical wound site over the scalp was swollen, exuding a pussy discharge. Subsequently, a lumbar drain was inserted for CSF drainage, the yellowish discharge from the wound was sent for culture, which grew Streptococcus pyogenes for which I/V Ceftriaxone was started. The patient improved and remained stable till about the 25th day of hospital stay when she developed fever, chest infiltrates as well as copious pussy discharge from the wound. Due to rapid deterioration in patient`s condition she was shifted to ICU. Piperacillin tazobactam was started and lumbar drain was removed. The scalp wound was re-explored and a flap closure was done; an epidural drain was inserted for CSF drainage. As the patient did not improve clinically, all antibiotics were stopped and patient was rescreened for infection. One set of blood culture drown from a peripheral vein and the tip of pulmonary artery catheter grew Chryseomonas luteola. This organism was sensitive only to Ofloxacin and the patient`s antibiotic regimen was changed to Ofloxacin along with Aztreonam and Amikacin. The patient gradually improved on this regimen, was moved out of the ICU and subsequently managed in the ward

Plasmonic Nano Silver: An Efficient Colorimetric Sensor for the Selective Detection of Hg2+ Ions in Real Samples

Environmental pollution caused by heavy metal ions has become a major health problem across the world. In this study, a selective colorimetric sensor based on starch functionalized silver nanoparticles (St-Ag NPs) for rapid detection of Hg2+ in real samples was developed. The environmentally friendly green approach was utilized to synthesize starch functionalized silver nanoparticles (St-AgNPs). A multi-technique approach involving UV-Vis absorption spectroscopy, Fourier transform infrared (FT-IR), X-ray diffraction (XRD), and scanning electron microscope (SEM) was used for the characterization of St-Ag NPs. These starch functionalized AgNPs were tested for the detection of heavy metals at 25 °C. The screening process revealed clear changes in the AgNPs color and absorption intensity only in the presence of Hg2+ due to the redox reaction between Ag0 and Hg2+. The color and absorption intensity of nanoparticles remain unchanged in the presence of all the other tested metals ion. The proposed method has strong selectivity and sensitivity to Hg2+ ions, with a detection limit of 1 ppm revealed by UV-visible spectrophotometry. The proposed procedure was found to be successful for the detection of Hg2+ in real samples of tap water

The 21st century disaster: The COVID-19 epidemiology, risk factors and control

The 21st century will be indelible in the world as ruin of the outbreak of COVID-19 was arose in Wuhan, China has now spread all over the world, up to August 2020. This study was based on the factors affecting the epidemiology of this virus in human societies of global concern. We studied the articles published in journals on various aspects of nCoVID19. The Wikipedia and WHO situation reports have also been searched out for related information. Outcomes were followed up until 2020. The COVID-19 is a virus with pandemic potential which may continue to cause regular infection in human. The pandemic outbreak of COVID-19 threatened public health across the globe in form of system as reflected in the shape of emergency. Approximately 21 million humans are infected and 759,400 have lost their lives till 2020 in all over the world. We have described epidemiological features, reservoirs, transmission, incubation period, rate of fatality, management including recent clinical chemotherapeutic approach and preventive measurements and masses which are at risk of COVID19. This virus causes viral pneumonia when it attacks on respiratory system and multiple failure which can leads to life threatening complications. It is believed to be zoonotic importance although it is not clear from which animal and how it is transmitted. Zoonotic transmission of COVID-19 has not yet known by science. The current study will help to establish a baseline for early effective control of this rapidly spreading severe viral illness. The available data on COVID-19 indicates that older males with comorbidities would have been more infected, which can result in severe respiratory complications. Implementation of preventive measurements, investigation of proper chemotherapeutics and detection of cross species transmission agents must be ensured