Australasian Medical Journal
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Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome (CIKPLA) in Western Australia?
Get PDFVirulent serotypes of Klebsiella pneumoniae are recognised to cause metastatic infections at various sites. Prevalence of this invasive syndrome has been observed worldwide with predominance in Asian series. However, reports in an Australian setting have been limited. We report two cases of fulminating community-acquired invasive Klebsiella pneumoniae liver abscess syndrome occurring in two Caucasian patients, from two different, distant suburbs in Western Australia with no known clinical comorbidities prior to the hospital presentation and no history of recent travel overseas. The interval between both admissions was 18 days, where only one patient survived
Hepatitis C, a silent threat to the community of Haryana, India: a community-based study
Get PDFBackground Hepatitis C is a global public health problem. About 12 million persons may be chronically infected in India and most do not know that they are infected. Aims To found out real situation of hepatitis C in Ratia block, district Fatehabad (Haryana). Method This cross sectional study was carried out by house to house visits in 2 weeks time. After obtaining the written consent, blood sample was drawn from suspected case by the laboratory technician maintaining all necessary safety precautions and sterilization. Results 1630 (22.3%) samples were found to be positive for Hepatitis-C by ELISA while 253 (15.5%) patients were previously hepatitis C positive and maximally adults (21–60 years) were affected (70.0%). Conclusion The study emphasizes on public awareness campaigns, where HCV exposure is prevalent i.e. at the health care providers and patient level
Bilateral variations of brachial plexus involving the median nerve and lateral cord: An anatomical case study with clinical implications
Get PDFDuring the routine dissection of upper limbs of a Caucasian male cadaver, variations were observed in the brachial plexus. In the right extremity, the lateral cord was piercing the coracobrachialis muscle. The musculocutaneous nerve and lateral root of the median nerve were observed to be branching inferior to the lower attachment of coracobrachialis muscle. The left extremity exhibited the passage of the median nerve through the flat tendon of the coracobrachialis muscle near its distal insertion into the medial surface of the body of humerus. A variation in the course and branching of the nerve might lead to variant or dual innervation of a muscle and, if inappropriately compressed, could result in a distal neuropathy. Identification of these variants of brachial plexus plays an especially important role in both clinical diagnosis and surgical practice.
Mandatory entrance examinations for foreign students applying to enrol in Nepalese medical schools: A good step
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A study of antibiogram of Salmonella enterica serovar Typhi isolates from Pondicherry, India
Get PDFBackgroundEnteric fever caused by Salmonella enterica serovar Typhi (S. Typhi) is an important public health problem in developing countries like India.1 The emergence of resistance to fluoroquinolones has reduced the therapeutic options available. Currently, the uniform laboratory interpretation of ciprofloxacin and azithromycin susceptibility remains unclear. AimsTo study the antibiogram of S. Typhi isolates with special emphasis on in-vitro activity of ciprofloxacin and azithromycin. Method We evaluated the antimicrobial susceptibility pattern of 16 S. Typhi isolates from January 2012 to June 2013. We also determined by Epsilometer-test (E-test) method, the minimum inhibitory concentration (MIC) of ciprofloxacin and azithromycin against these isolates and compared them with their corresponding disc diffusion sizes. ResultsFifteen (93.75 per cent) isolates were sensitive to chloramphenicol, 14 (87.5 per cent) were sensitive to co-trimoxazole. All isolates were resistant to nalidixic acid. MICs for ciprofloxacin ranged from 6 μg/ml to 15 μg/ml and corresponding zone diameters ranged from 15 mm to 26 mm. MIC and zone diameters for ciprofloxacin had significant negative correlation. MICs for azithromycin ranged from 3 μg/ml to 24 μg/ml, corresponding zone diameters ranged from 13 mm to 19 mm. However, MIC and zone diameters for azithromycin had no significant negative correlation. ConclusionThe widespread emergence of resistance to fluroquinolones and reappearance of sensitivity to first-line drugs has reinforced the need for antibiotic recycling. There is a need to have uniform laboratory testing guidelines for testing susceptibility to ciprofloxacin and azithromycin for S. Typhi isolates
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Get PDFMedicines shortages–unpicking the evidence from a year in South Africa
Get PDFAlthough medicines shortages are a persistent and challenging problem for all health systems, the reasons for such shortages vary considerably between settings. Understanding the range of problems encountered, and the specific reasons for each medicines shortage event, may help to identify the most appropriate systems-wide responses. South Africa’s health system is, at this point, still clearly divided between a better-resourced private sector and an overwhelmed public sector. Medicines selection and procurement processes in the two sectors are markedly different. However, in both sectors there is a dearth of publicly accessible information about the incidence and consequences of medicines shortages. This brief report describes the medicines selection and procurement processes currently applied in South Africa’s public health sector, and then describes the nature of the medicines shortages that have been experienced in the KwaZulu provincial health services between July 2012 and June 2013. The degree to which these shortages might have been managed differently, had the recommendations developed by the International Pharmaceutical Federation Summit on Medicines Shortages been implemented, is then explored.