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   2004| January  | Volume 58 | Issue 1  
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Reduced minimum inhibitory concentration of chloramphenicol for salmonella enterica serovar typhi
S Mandal, MD Mandal, Nishith Kumar Pal
January 2004, 58(1):16-23
BACKGROUND: Ciprofloxacin replaced chloramphenicol (C), the best choice of antibiotic in the treatment of enteric fever, when C-resistant enteric fever emerged and caused outbreaks in different parts of the world. C-sensitive S. enterica serovar Typhi emerged again due to withdrawal of the antibiotic pressure. AIMS: To assess the in vitro efficacy of C against Salmonella enterica serovar Typhi isolates (1991-2003). MATERIAL AND METHODS: A total of 464 blood culture isolates of S. enterica serovar Typhi were subjected to C susceptibility by disc diffusion and agar dilution methods using Mueller-Hinton agar. The antibiotic susceptibility of S. enterica serovar Typhi isolates obtained in the year 2002 and 2003 was determined using ampicillin, cotrimoxazole, ciprofloxacin, nalidixic acid, ceftriaxone and cefotaxime, in addition to C. Escherichia coli strain ATCC 25922 was used as the control. Changes in C sensitivity of the isolates were analyzed using 2 test with Yates correction. RESULTS AND CONCLUSIONS: All the isolates of 1991 were C-resistant with minimum inhibitory concentration values (MICs) of 2000-5000 mg/ml. In the following years decrease in frequency of C resistance was noticed: 1992 (50%), 1993 (32%), 1994 (27%) and 1995 (05%). The isolates of 1996-99 and 2001 were 100% C-sensitive. In 2000, sensitivity was also high (79%). The strains isolated in the year 2002 and 2003, showing reduced susceptibility of ciprofloxacin, were nalidixic acid resistant, but sensitive to the third-generation cephalosporins (ceftriaxone and cefotaxime). The MICs for C-sensitive isolates (1991-2003) ranged 0.1-5 g/ml. Results suggest the necessity for re-evaluation of C therapy in typhoid fever.
  22 10,900 772
Evaluation of serum steroid hormones in schizophrenic patients
M Taherianfard, M Shariaty
January 2004, 58(1):3-9
BACKGROUND: Recent studies have implicated the abnormalities in the -aminobutyric acid (GABA) neurotransmmiter system in the pathophysiology of schizophrenia. There are also evidences indicating that steroids of central or peripheral origin may modulate GABAergic system through direct interaction with the GABAA receptor complex. These raise the possibility that alternations in serum steroid hormones may contribute to the pathophysiological process in the schizophrenia. AIMS: The purposes of this study were first, to determine whether alternations in steroid serum levels occur in schizophrenic patients, and secondly to determine whether such alternations normalize with clinical improvement. Methods and material: Serum concentrations of testosterone (T), estradiol (E), progesterone (P) and cortisol (C) were determined in male schizophrenic patients (N=49) before treatment, during treatment and after recovery and in age-matched healthy male subjects (N=17). All steroid hormones were assayed by ELISA method. Statistical analysis used: Differences in steroids concentrations between groups were assayed by One-Way Analysis of Variance (ANOVA), followed by Tukey's post hoc test. The level of significance was considered at P<0.05. RESULTS AND CONCLUSION: The serum concentrations of E, P and C were significantly (P<0.05) lower in male schizophrenic patients in all three stages of the study, compared with healthy subjects. Serum concentrations of T were significantly (P<0.05) lower in male schizophrenic patients before and during treatment, but not after recovery, compared with healthy subjects. These findings support the occurrence of abnormal steroid concentrations in schizophrenic patients and suggest that lower T level in this disorder is related to the illness and normalizes with remission, while trait-related factors may contribute to lower serum E and C levels in schizophrenia.
  21 5,790 481
Bacteriological and antimicrobial susceptibility profile of soft tissue infections from Northern India
S Mohanty, Arti Kapil, B Dhawan, BK Das
January 2004, 58(1):10-15
BACKGROUND: Soft tissue infections require a judicious combination of antimicrobial therapy in addition to surgical debridement to limit tissue loss and preserve life. AIMS: To study the bacterial etiology of soft tissue infections and their antimicrobial susceptibility pattern. Settings and design: A single institutional retrospective study of one year duration from January to December 2002. MATERIALS AND METHODS: A total of 5039 consecutive pus samples received in the Bacteriology Laboratory was analyzed from the records. RESULTS: There were a total of 2783 bacterial isolates comprising of 1504 gram negative bacilli and 1279 gram positive cocci. Staphylococcus aureus was the commonest isolate followed by Escherichia coli and Pseudomonas species. Methicillin resistance in S. aureus was found to be 38.56%, high level aminoglycoside resistance was observed in 53.3% enterococci and 66.75% of the gram negative bacilli were extended spectrum beta-lactamase producers. Rifampicin and vancomycin showed best activity for S. aureus; for gram-negative bacilli, piperacillin-tazobactam combination showed best activity. CONCLUSIONS: Continuous monitoring of antimicrobial susceptibility pattern in individual settings together with their judicious use is emphasized to minimize emergence of drug resistant bacteria.
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Asha Shah
January 2004, 58(1):24-25
  2 4,595 337
Approach to a patient with anemia
BC Mehta
January 2004, 58(1):26-29
  1 16,128 643
2004 - Indian Journal of Medical Sciences
Published by Wolters Kluwer - Medknow
Online since 15th December '04