Alvarado versus RIPASA Score for the Diagnosis of Acute Appendicitis.

The aim of the present study was to compare the sensitivity between Alvarado and RIPASA score for the diagnosis of acute appendicitis patients. A comparative study was conducted in the Dhaka National Medical College Hospital, Bangladesh from July 2015 to December 2015. The study was approved by the institutional ethical committee. Most of the appendicitis patients belonged to the between 21-30 years which was 64(32%). Male appendicitis patients (52%) are more than the female patients (48%). Majority of the patients (69%) complains pain occurs in the Right iliac fossa. Sensitivity of Alvarado scores was 81.60%, specificity 74.58%, accuracy 79.35%, positive and negative predictive values were 87.18% and 65.67% respectively. RIPASA score's sensitivity was 85.6%, specificity 69.49%, accuracy 80.40%, positive and negative predictive values were 85.60% and 85.60% respectively. This study reported that RIPASA score is significantly shown higher diagnostic accuracy then that Alvarado score.

Emergence of multidrug-resistant Salmonella enterica serotype Typhi with decreased ciprofloxacin susceptibility in Bangladesh.

During 1989-2002, we studied the antimicrobial resistance of 3928 blood culture isolates of Salmonella enterica serotype Typhi (S. Typhi) in Dhaka, Bangladesh. Overall 32% (1270) of the strains were multidrug-resistant (MDR, resistant to chloramphenicol, ampicillin and trimethoprim-sulphamethoxazole); first detected in 1990 (rate of 8%), increased in 1994 (44%), declined in 1996 (22%, P<0.01 compared to 1994) and re-emerged in 2001 (36%) and 2002 (42%, P<0.01 compared to 1996). An increased MIC of ciprofloxacin (0.25 microg/ml) indicating decreased susceptibility to ciprofloxacin was detected in 24 (18.2%) out of 132 randomly selected strains during 1990-2002; more frequently in MDR than susceptible strains (46.3% vs. 5.5%, P<0.001), and the proportion of them rose to 47% in 2002 from 8% in 2000 (P<0.01). Ciprofloxacin (5 microg) disk diffusion zone diameters of < or =24 mm as break-point had 98% sensitivity and 100% specificity when compared with a ciprofloxacin MIC of 0.25 microg/ml as break-point for decreased susceptibility; being a useful and easy screen test. All strains were susceptible to ceftriaxone. The emergence of MDR S. Typhi with decreased ciprofloxacin susceptibility will further complicate the therapy of typhoid fever because of the lack of optimum treatment guidelines.

Increasing frequency of mecillinam-resistant shigella isolates in urban Dhaka and rural Matlab, Bangladesh: a 6 year observation.

A total of 14,915 shigella isolates obtained in 1991-1996 from patients attending the Dhaka (urban) and Matlab (rural) treatment centres of the International Centre for Diarrhoeal Disease Research, Bangladesh were examined for susceptibility to ampicillin, co-trimoxazole, nalidixic acid, mecillinam and ciprofloxacin by a disc diffusion method. There were no ciprofloxacin-resistant shigella isolates. The prevalence of resistance to ampicillin, co-trimoxazole and nalldixic acid varied between isolates. It increased to similar degrees in isolates from both Matlab and Dhaka. However, resistance to mecillinam was more prevalent among isolates from Matlab than from Dhaka. The increase in mecillinam-resistant shigellae in the community may have grave implications for the empirical treatment of shigellosis in Bangladesh and other developing countries.

Gauze filtration and enrichment procedures for recovery of Vibrio cholerae from contaminated waters.

Gauze filtration followed by 18-h enrichment in alkaline bile-peptone water is a simple, inexpensive, and efficient method for isolation Vibrio cholerae biotype eltor from contaminated surface waters.

Uptake of Vibrio cholerae biotype eltor from contaminated water by water hyacinth (eichornia crassipes).

Vibrio cholerae biotype eltor appears to concentrate on the surface of the water hyacinth (Eichornia crassipes), thereby enhancing its survival and its potential for transmission through waterways of cholera-endemic regions such as Bangladesh.