Antimicrobial Sensitivity Pattern in Neonatal Sepsis in Neonatal Intensive Care Unit of Mymensingh Medical College Hospital.

This cross-sectional descriptive study was conducted at the neonatal intensive care unit (NICU) in the department of Neonatology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from July 2017 to December 2017 to determine antimicrobial sensitivity pattern in neonatal sepsis. Ninety four neonates (0-28 days) who were admitted in NICU with suspected sepsis were included in this study by purposive sampling technique. After admission written informed consent from parents or guardians obtained and then septic screening along with blood culture and antimicrobial sensitivity was done. All data were compiled, tabulated and then analyzed by SPSS version 21.0. Among 94 cases, 68(72.3%) were preterm and 26(23.4%) were term. There was male predominance and male female ratio was 1.9:1. Most of the patient admitted within 72 hours of birth. Most (84%) had low birth weight (<2500gm). Pre-mature onset of labour, pre-mature rupture of membrane >18 hours, vaginal route of delivery, instrumental resuscitation, pre-lacteal feeding, bottle feeding were the major perinatal risk factors in this study. Early onset sepsis (76.6%) was most prevalent in this study. Blood culture yielded positive growth in 20(21.3%) cases. Among them, Klebsiella was found in 7(35%). E. coli in 6(30%), Acinetobacter was in 3(15%), Staphylococcus aureus in 2(10%) cases. Pseudomonas and Enterobacter were found in rest 2(10%) of the cases. Gram negative bacteria were found in 18(90%) cases. Klebsiella was sensitive to Imipenem (85.7%), Colistin (85.7%) and Ciprofloxacin (77.5%). Sensitivity of E. coli was Imipenem (100%), Colistin (100%), Amikacin (66.7%), Ciprofloxacin (66.7%), Netilmicin (66.7%) and Gentamicin (50%). Acinatobecter had sensitivity to Netilmicin, Colistin, Imipenem (100%). Staphylococcus was 100% sensitive to Imipenem, Netilmicin and Vancomycin. Pseudomonas was found sensitive to Imipenem (100%), Amikacin (100%), Netilmicin (100%) and Colistin (100%). Enterobacter was found highly sensitive to Ciprofloxacin, Colistin and Imipenem. Almost all organisms were resistant to Ampicillin, Gentamicin, Cefotaxime and Ceftazidime. Based on result it is concluded that Klebsiella pneumoniae and Escherichia coli are the leading cause of neonatal sepsis in this study and most of them resistant to multiple antibiotics. Organisms found more sensitive to Imipenem, Colistin, Ciprofloxacin and Netilmicin.

[Tthe efficacy and safety of drug therapy divaza in patients with chronic cerebral ischemia]. / Effektivnost' i bezopasnost' primeneniya preparata divaza v terapii patsientov s khronicheskoi ishemiei golovnogo mozga.

AIM: To evaluate the efficacy and safety of divazа in the treatment of cognitive and emotional disorders in patients with chronic cerebral ischemia (CCI) based on clinical findings and laboratory markers of endothelial dysfunction. MATERIAL AND METHODS: Thirty patients with CCI, aged 40 to 70 years, were examined. All patients were treated with divazа (2 tablets 3 times a day) for 12 weeks. Cognitive functions and markers of endothelial dysfunction (the activity of endothelial NO-synthase (eNOS), the number of circulating desquamated endothelial cells in blood plasma) were measured at baseline and after treatment. RESULTS: Divazа significantly reduced the severity of clinical symptoms and had a positive effect on endothelial dysfunction normalizing the tone of cerebral vessels and preventing deendotheliazation. CONCLUSION: The use of divazа resulted in clinical improvement and normalization of markers of endothelial dysfunction as well.

[Nontraumatic chylopericardium and chylothorax in premature neonates].

Deaths of extremely premature babies undiagnosed as having spontaneous chylopericardium (CP) and chylothorax (CT) are analyzed. The specific features of these death cases are the polyetiology of CP/CT and the similarity of their pathogenesis in the absence of specific clinical symptomatology.

[Unusual amidation reaction of Asn-containing glycopeptide antibiotics using the coupling reagent PyBOP].

The coupling reagent PyBOP is widely used for the synthesis of different peptides and their amides, particularly for carboxamides of glycopeptide antibiotics of vancomycin or teicoplanin groups. The amidation reaction of the peptide core of the glycopeptide antibiotic eremomycin (I) with highly reactive amines in the presence of PyBOP is usually not accompanied by the formation of side products. However, the amidation of I with bulky amines (e.g., decyl amine and adamantyl amine) in the presence of PyBOP and Et3N or di-(i-Pr)2EtN (pH - 8.5) yielded N-unsubstituted carboxamide of eremomycin (Ia) as an admixture. The reaction of (I) or vancomycin (II) with an excess of PyBOP and Et3N (pH - 8.5) without addition of an amine or ammonia gave a mixture of products which contained higher amounts of the corresponding N-unsubstituted carboxamides (-20%). The structures of the samples of Ia and vancomycin amide (IIa) were proved by 1H NMR and ESI MS methods and confirmed by comparing with the authentic samples.

[Analysis of sequences of ITS1 internal transcribed spacer and 5.8S ribosome gene of Malus species].

The nucleotide sequence of the ITS1-5.8S ribosomal DNA spacer fragment was determined for 41 samples of the Malus species. The total length of compared sequences ranged from 389 to 392 bp. The nucleotide sequence of the 5.8S gene within the genus was highly conserved. The level of polymorphism of ITS 1 region comprised 14%. Both species- and group-specific substitutions were identified. The analysis of M. orientalis and M. turkmenorum sequences revealed their full identity, which indicates the need to perform more research with a larger number of samples of both species from other collections to clarify the taxonomic status of the M. turkmenorum species. The previous findings on the synonymy of species M. baccata, M. mandshurica, M. pallasiana, and M. sachalinensis were also confirmed.

[Molecular differentiation and taxonomy of the sunwatcher toadheaded agama species complex Phrynocephalus superspecies helioscopus (Pallas, 1771) (reptilia: agamidae)].

Lizards of the sunwatcher toad-headed agama species complex Phrynocephalus superspecies helioscopus, mostly distributed in Middle Asia and Middle East, were examined using analysis of variation at the mitochondrial cytochrome oxidase c subunit I gene fragment and fingerprint analysis of nuclear DNA (inter-SINE PCR technique). A total of 86 individual tissue samples from 53 populations, to the full extent representing different parts of the species complex range, were subjected to molecular genetic examination, and surprisingly deep differentiation was revealed. The populations analyzed split into 12 isolated phylogroups, many of which were characterized by a narrow range and genetic isolation. Monophyly of sunwatcher (Ph. helioscopus) and Persian (Ph. persicus) toad-headed agamas was confirmed. However, both of these species probably represent the species complexes. Zoogeography of Middle Asiais discussed.

[Forensic medical evaluation of the severity of harm to the health in the cases of a fracture of the zygomaticoorbital complex complicated by ophthalmological disorders].

Expert reports of the cases of a fracture of the zygomaticoorbital complex are presented along with their comprehensive assessment based on the available investigative, clinical, and anamnestic data. The analysis included 71 patients, materials of forensic medical examination and other medical documentation, civil, criminal, and administrative proceedings. It was shown that forensic medical evaluation of the severity of harm to the health in the cases of a fracture of the zygomaticoorbital complex including those complicated by ophthalmological disorders is possible both in terms of the total duration of health impairment and in terms of the persistent loss of ability to work (on a percentage base). It is concluded that the degree of harm to the health in the cases of a fracture of the zygomaticoorbital complex complicated by ophthalmological disorders can be categorized as mild, moderate, and severe depending on the total duration of health impairment and percentage loss of ability to work. In case of irreparable facial disfigurement, the moderate harm to the health can be re-evaluated by the court as a severe one.

[The role of therapeutic exercises in the combined treatment and rehabilitation of patients with pain syndrome associated with the dysfunction of temporomandibular joint].

In a group of patients with pain syndrome associated with the dysfunction of temporomandibular joint positive results of combined therapy and rehabilitative treatment including remedial gymnastics persisted significantly longer than in controls (p < 0.01). Results of long-term follow-up confirmed the desirability of rehabilitation based on therapeutic exercises. This approach permits to enhance the effectiveness of therapy and rehabilitation of patients with pain syndrome associated with the dysfunction of temporomandibular joint, reduce the number of the patients' visits for repeated treatment and its total duration during a year.

[Forensic medical criteria for the assessment of severity of harm to the health in subjects with zygomatic bone fractures].

Expert reports concerning subjects with zygomatic bone fractures were analysed and comprehensively evaluated using investigatory, clinical and anamnestic data. A total of 704 forensic medical reports were available for the purpose including 225 (32%) isolated and 479 (68%) combined fractures. It was shown that most complications of zygomatic fractures develop late in the post-traumatic period which requires repeated examination of the patients within at least one month after the injury. It is emphasized that such examination must involve neuropathologist, ophthalmologist, and maxillofacial surgeon to adequately evaluate harm to the health in patients with isolated zygomatic fractures. The main causes of discrepancy between results of estimation of harm to the health during primary and subsequent forensic medical examination of subjects with zygomatic fractures are considered.

Use of impaza in the treatment of erectile dysfunction in patients with essential hypertension and CHD.

Impaza treatment of erectile dysfunction in patients with essential hypertension and CHD receiving cardiotropic therapy improved erectile function and increased reserve circulation. Addition of impaza to the treatment protocol in cardiological patients considerably increased perfusion and reduced the content of desquamated epitheliocytes. No side effects of impaza were noted.

[Professional stress and development of stress-induced hypertension].

AIM OF THE STUDY: to elucidate rates of development of arterial hypertension (AH) at working place (wp), risk factors of cardiovascular diseases (CVD), anxiety depressive disorders in persons with professional stress. We carried out monitoring of arterial pressure during working hours and hours of rest, assessed risk factors of CVD development, and evaluated severity of symptoms of anxiety and depression using the Hamilton scale in 138 men (mean age 40.0+/-1.2 years). Results of the study evidenced for high frequency (46.4%) of development of AHwp among representatives of stressful occupations. Patients with AHwp have risk factors of CVD development and total coronary risk comparable with those of patients with hypertensive disease. Patients with AH have more pronounced anxiety depressive disorders than healthy subjects.

[New derivatives of eremomycin containing (15)n or f atoms for NMR study].

New semisynthetic derivatives of eremomycin containing (15)N or F atom were obtained for studying the antibiotic-target interaction in intact cells of Gram-positive bacteria by REDOR NMR method. Interaction of the terminal carboxyl group of amino acid 7 (AA7) of eremomycin with amines in the presence of PyBOP and TBTU reagents resulted in the corresponding [(15)N]-amide, p-fluorobenzylamide, p-fluorophenylpiperazide, and 6-N-(p-fluorobenzyl)aminohexylamide. A selective method of [(15)N]-amidation of carboxyl group of amino acid 3 (AA3) of carboxyeremomycin was developed, and the amide of eremomycin containing [(15)N] in AA3 amide group near the antibiotic binding pocket was obtained. Carboxyeremomycin bisamides substituted at AA3 and AA7 and containing two atoms of [(15)N] or F were obtained from carboxyeremomycin and [(15)N]NH4Cl or the corresponding p-fluorobenzylamine hydrochloride in the presence of PyBOP at pH ~8. The Edman degradation of eremomycin p-fluorobenzylamide gave de-(D-MeLeu)-eremomycin p-fluorobenzylamide, a hexapeptide derivative incapable of the antibiotic binding with -D-Ala-D-Ala fragment of growing cell wall peptidoglycan. Among the compounds studied, carboxyeremomycin bis-p-fluorobenzylamide showed the best activity against both the glycopeptides-sensitive and glycopeptides-resistant strains of staphylococci and enterococci.

[Anthracycline antibiotics and their derivatives--inhibitors of topoisomerase I].

The relationship between the structure of new semisynthetic derivatives of doxorubicin, daunorubicin, and carminomycin and their ability to inhibit topoisomerase 1 were studied. The new derivatives inhibit the activity of topoisomerase 1 at low concentrations, induce the death of K-562 leukemia cells in culture, and produce an antitumor effect in experimental animals with P388 leukemia.

[Treatment of erectile dysfunction in patients with essential hypertension and ischemic heart disease].

AIM: To evaluate the effect of impasa on activity of N0-dependent processes in cardiological patients with erectile dysfunction (ED). MATERIAL AND METHODS: 58 patients with IHD and angina of effort and 48 patients with hypertension participated in the study of efficacy of conventional treatment combined with impasa on the course of the basic disease, peripheral blood count of desquamated endotheliocytes, microcirculation and erectile function. RESULTS: IHD patients given impasa showed increased exercise tolerance, less number of anginal attacks, improved coronary microcirculation, improved metabolism of vascular endothelium. Manifestations of erectile dysfunction regressed. Hypotensive therapy also reduced the above manifestations in hypertensive patients. CONCLUSION: The addition of impasa to conventional cardiotropic and hypotensive therapy promotes ED regression.

[A family of short retroposons (Squaml) from squamate reptiles (Reptilia: Squamata): structure, evolution and correlation with phylogeny].

We have isolated and characterised sequences of a SINE family specific for squamate reptiles from a genome of lacertid lizard that we called Squam1. Copies are 360-390 bp in length and share a significant similarity with tRNA gene sequence on its 5'-end. This family was also detected by us in DNA of representatives of varanids, iguanids (anolis), gekkonids, and snakes. No signs of it were found in DNA of mammals, birds, amphibians, and crocodiles. Detailed analysis of primary structure of the retroposons obtained by us from genomic libraries or GenBank sequences was carried out. Most taxa possess 2-3 subfamilies of the SINE in their genomes with specific diagnostic features in their primary structure. Individual variability of copies in different families is about 85% and is just slightly lower on the genera level. Comparison of consensus sequences on family level reveals a high degree of structural similarity with a number of specific apomorphic features which makes it a useful marker of phylogeny for this group of reptiles. Snakes do not show specific affinity to varanids when compared to other lizards, as it was suggested earlier.

[Treatment of erectile dysfunction in patients with ischemic heart disease and angina of effort].

A total of 58 patients with ischemic heart disease and angina of effort (FC II) (mean age 55.6 years) participating in the study were diagnosed to have erective dysfunction (ED) of a mild (35%), moderate (57%) and severe degree (8%). All the patients were randomized into two groups. Group 1 (n=21, mean age 56.4 years) received standard cardiotropic therapy (nitrates, beta-blockers, ACE inhibitors on demand, diuretics, antioxidants) and placebo. Group 2 (n=37, mean age 54.3 years) received the same standard cardiotropic therapy plus impase (1 tablet each other day for 3 months). The results of the trial show that impase addition to cardiotropic therapy raised exercise tolerance, diminished the number of anginal attacks in mild and moderate exercise, enhanced coronary microcirculatory blood flow, increased reserve circulation index by 34%, improved metabolism of vascular endothelium in the whole body. Impase acts pathogenetically in endothelial insufficiency. Prevention of endothelial dysfunction by impase allows both to stop progression of cardiovascular disease and to prevent erectile dysfunction.

[New conjugates of antitumor antibiotic doxorubicin with water-soluble galactomannan: synthesis and biological activity].

New water-soluble conjugates in the form of Schiff bases (DGM-1 and DGM-2) were prepared by the interaction of water-soluble periodate-oxidized galactomannan with doxorubicin or N-(L-lysyl)doxorubicin, respectively. The water-soluble galactomannan (DAVANAT a commercial product of Pro-Pharmaceuticals company) was obtained by partial acidic hydrolysis of high-molecular-mass galactomannan from Cyamopsis tetragonoloba (guar gum) seeds. The conjugate stability was studied in aqueous solutions. The DGM-1 antiproliferative activity was comparable with that of doxorubicin on three models: cell lines of murine melanoma B 16-F1, human breast cancer MCF-7 (HTB-22), and human colon cancer HT-29 (HTB-38). DGM-2 was poorly active in all the three tests. DGM- 1 can thus be regarded as a high-molecular-mass depot form of doxorubicin.

[Frequency of detection the of Brugada syndrome signs in the course of ECG registration].

The aim of the study was to assess prevalence of the Brugada syndrome during carrying out ECG in the conditions of medico-sanitary division of a large industrial enterprise. Signs of the Brugada syndrome were found on 20 of 42779 ECGs (0.047%) registered during 1 year in patients aged 22-68 years. Type 2 syndrome was noted in 4 patients, others had type 2 of the syndrome. Men comprised 90% of patients. At 24 hour ECG monitoring paroxysm of nonsustained ventricular tachycardia was registered in 1 patient during night hours. Cases of sudden death were registered in families of 3 patients (all men older than 45 years). Four patients experienced syncopi clinical picture of which resembled more neurocardiogenic but not arrhythmic attacks. Thus prevalence of the Brugada syndrome in our population was quite low.

[Structure-activity relationships in a series of semisynthetic polycyclic glycopeptide antibiotics].

The main achievements in the development of methods for the design of semisynthetic antibiotics of a new generation belonging to the group of polycyclic glycopeptides directed against infections caused by multidrug-resistant bacteria and dangerous human and animal viruses are reviewed. The review is focused on the results obtained at the Gauze Institute in the area of chemical modification of natural antibiotics (eremomycin, vancomycin, teicoplanin, etc.) directed toward modification of their antibacterial and/or antiviral activity. A special emphasis is placed on the study of the mechanisms of action of these antibiotics, which could be the basis of a rational approach to their chemical modification involving the transformation of the inner binding pocket and the peripheral regions of the molecules that participate in the formation of their complexes with targets. The study of the recently discovered antiviral activity of modified glycopeptide antibiotics is also discussed. A possibility of obtaining new highly active anti-HIV-1 and anti-HIV-2 preparations on the basis of hydrophobic derivatives of the aglycones of glycopeptide antibiotics was demonstrated. New semisynthetic derivatives of antibiotics that exhibit a high antibacterial activity in vivo, have good pharmacological characteristics, and are promising for practical use are described.