Antimicrobial Resistance Profile of Bacteria Causing Pediatric Infections at the University Teaching Hospital in Rwanda.

Bacterial infections pose a global threat, especially in the pediatric population. Antimicrobials that are used to treat such infections continuously show reduced efficacy, and empirical therapy is a major treatment option in Rwanda. This study aimed to determine the resistance rate of commonly used antibiotics in pediatric patients. The study was conducted from June 1, 2018 to May 30, 2019, and microbiological samples were collected from 712 children with suspected bacterial infections. Antimicrobial sensitivity testing was performed on 177 positive cultures (24%) that were considered for data analysis. The findings show that the major bacterial isolates were Klebsiella pneumoniae (n = 50, 28.2%), Escherichia coli (n = 47, 26.5%), and Staphylococcus aureus (n = 38, 21.4%). In general, the greatest antibiotic resistance rate was observed in ampicillin (n = 125, 86.2%), amoxicillin-clavulanic acid (n = 84, 82.4%), amoxicillin (n = 64, 79%), cefadroxil (n = 83, 69.2%), tetracycline (n = 72, 59.7%), ceftazidime (n = 42, 55.3%), and cefuroxime (n = 14, 53.8%). More specifically, Klebsiella pneumoniae was 100% resistant to amoxicillin-clavulanic acid, cefuroxime, trimethoprim-sulfamethoxazole, ceftazidime, erythromycin, and clindamycin. Staphylococcus aureus was 86.7% resistant to ampicillin, and Escherichia coli was 91.7% resistant to tetracycline, 90.6% resistant to ampicillin, 83.3% resistant to amoxicillin-clavulanic acid, 79.3% resistant to cefadroxil, and 78.6% resistant to ceftazidime. Moreover, Klebsiella pneumoniae from blood and urine was 96.8% and 100% sensitive, respectively, to meropenem. Staphylococcus aureus from blood was 100% sensitive to vancomycin, whereas Escherichia coli from urine was sensitive to clindamycin (100%), nitrofurantoin (80.6%), and ciprofloxacin (72.7%). In conclusion, our findings show a high resistance rate to commonly used antibiotics, which suggests precaution in empirical therapy and continued surveillance of antimicrobial resistance.

Neurobehavioral and Immunohistochemical Studies of the Cerebral Cortex Following Treatment with Ethyl Acetate Leaf Fraction of Tamarindus indica During Prenatal Aluminum Chloride Exposure in Wistar Rats.

Purpose: The recent increase in aluminum exposure and its effect on the development of the brain call for serious attention. The study investigated the behavioral and immunohistochemical changes in the cerebral cortex of Wistar rats following prenatal co-administration of ethyl acetate leaf fraction of Tamarindus indica (EATI) and aluminum chloride (AlCl3). Methods: Pregnant Wistar rats were divided into 5 groups (n=4). Group I (negative control), Group II-V were experimental groups treated with 200 mg/kg of AlCl3 s/c. Group III and IV received an additional 400 mg/kg and 800 mg/kg of EATI respectively, while Group V received an additional 300 mg/kg of Vitamin E for 14 days (prenatal days 7-21) via the oral route. The pups were then exposed to cliff avoidance, negative geotaxis, and elevated plus maze (EPM) test on the post-natal day (PoND) 4-6, 7-10, and 18 respectively. On PoND 21 pups were sacrificed, and the skull dissected to remove the brain. The harvested brain tissues were processed for Cresyl fast (CF) and glial fibrillary acid protein (GFAP). Results: The study showed that EATI administration during AlCl3 exposure was associated with significant improvement in sensory-motor development. The EPM, CF, and GFAP results revealed significant improvement in anxiety-like behavior, motor activities, GFAP expression, pyramidal cell count, and Nissl staining following prenatal EATI administration during AlCl3 exposure. Conclusion: The present study concludes that EATI was associated with some protective potential during prenatal AlCl3 exposure in Wistar rats.

Musculocutaneous and median nerve branching: anatomical variations. Case Series from UR clinical anatomy and literature review.

Introduction: The brachial plexus is highly variable, which is a well-known anatomical fact. Repeated observations on anatomical variations, however, constitute current trends in anatomical research. Case series: In an anatomical dissection course, three uncommon variations in the brachial plexus were identified in three young adults' cadavers. In one case, the musculocutaneous nerve gave a branch to the median nerve, while the median nerve gave or received musculocutaneous branches in the two remaining corpses. Conclusion: Anatomical variations of the brachial plexus do occur in our setting. The cases we presented are about anatomical variations of branching patterns of the median and musculocutaneous nerves. Knowledge of those variations is essential for surgery and regional anesthesia of the upper limbs.

Unusual anatomical variations of the hepatic arteries and bile ducts: What are the surgical implications.

Introduction: The knowledge of anatomy is essential for surgical safety and impacts positively on patients' outcomes. Surgeons operating on the liver and bile ducts should keep in mind the normal anatomy and its variations as the latter are common. Case Presentation: We conducted a structured surgical dissection course of the supra-colic compartment of the abdominal cavity on 2nd and 3rd October 2020. While dissecting a 46years-old male cadaver, we encountered unusual anatomical variations of the hepatic arterial branching, the biliary tree, and arterial supply to the common bile duct. The common hepatic artery was dividing into two branches: a common short trunk for the left hepatic artery and the right gastric artery (hepato-gastric trunk) and a common trunk for the right hepatic artery and gastroduodenal artery (hepato-gastroduodenal trunk). The right hepatic duct was duplicated with a main right hepatic duct and an additional smaller duct. The bile duct was supplied by an artery coming from the abdominal aorta. Conclusion: We described three unusual anatomical variations: a variation of the hepatic arteries branching pattern, an aberrant right hepatic duct, and blood supply to the bile duct from the abdominal aorta. Surgeons should be aware of these rare variations.

Comparative Microscopic Assessments of the Effect of Aqueous and Ethanol Extracts of Phoenix dactylifera L. in a Rat Model of Mercury-Triggered Hippocampal Changes.

Mercury is an environmental neurotoxicant that triggers structural and physiological alterations in different brain parts. The hippocampus is associated with learning and memory, and injury to this brain part may lead to behavioural and cognitive changes. Phoenix dactylifera (date palm) has been demonstrated to possess a variety of medical benefits. This study comparatively assessed the neuroprotective property of aqueous and ethanol fruit pulp extracts of P. dactylifera in a rat model of mercury-triggered hippocampal changes using microscopic examinations. Twenty-eight Wistar rats were divided into seven groups (I-VII, n=4). Group I (control) was administered distilled water (2ml/kg); group II was administered mercuric chloride, HgCl2 (5mg/kg); group III was administered vitamin C (100mg/kg) as reference drug +HgCl2; groups IV and V were administered aqueous extract (250mg/kg and 500mg/kg, respectively) +HgCl2, while groups VI and VII were administered ethanol extract (250mg/kg and 500mg/kg, respectively) +HgCl2. Extracts' neuroprotective property were evaluated using histological and histometric assessments of CA1 and CA3 hippocampal sub-regions. Results revealed cytoarchitectural changes including karyopyknosis, basophilic necrosis and remarkably decreased histometric features of hippocampal pyramidal neurons in HgCl2-treated group relative to control. Administration of the extracts remarkably ameliorated mercury-induced degenerative changes by preservation of cytoarchitectural features comparable to reference drug. Comparatively, neuroprotective efficacies of the extracts are relatively similar, especially at doses of 500mg/kg and could be attributed to antioxidant activities of constituent phytochemicals. Results suggest that aqueous and ethanol fruit pulp extracts of P. dactylifera may prove efficacious in ameliorating mercury-triggered microscopic alterations in the hippocampus of Wistar rats.