Antibiotic Susceptibility and Plasmid Profiles of Shigella Species in Sudan

This study was carried out to determine the antibiotic susceptibility; plasmid profile and conjugative abilities of Shigella species isolated from different towns in Sudan during 2005-2007.Methods:Stool specimens were collected in Carry Blair transport medium from patients presenting with diarrhea from different sites in Sudan between the years 2005-2007.All specimens were inoculated on Mac Conkey's agar and Xylose Lysine Dioxycholate (XLD) (Mast group Ltd. Merseyside U.K.). Bacteria was isolated and subjected to different antibiotics to detect sensitivity and transference of resistance.Results:One hundred and fourteen Shigella isolates were included in the study.Eighty (70.1) were Shigella flexeneri representing the dominant isolate; followed by 20 (17.5) isolates of Shigella dysenteriae; 9 (7.9) Shigella sonnei and 5 (4.5) Shigella boydii.Most of the isolates showed resistance to streptomycin (70);tetracycline (52) and co-trimoxazole (43).They were highly sensitive to norfloxacin (97); nalidixic acid (95); gentamicin (89) and chloramphenicol (77).Multi-drug resistance to two or more antibiotics was apparent in most of the isolates (64; 56.1).Fifty nine of the resistant Shigella isolates were studied for their ability to transfer resistance to the donor E. coli K12 by conjugation.Of these;six were able to transfer resistance to streptomycin; tetracycline and co-trimoxazole.Extraction of the plasmid DNA from both donors and trans-conjugants showed a single type of plasmid with a molecular weight of 4.6 Kb.Conclusion The transfer of multi-drug resistant plasmids and the emergence of antibiotic Shigella and other bacterial species should raise the awareness and the seriousness of the uncontrolled (unsupervised) use of antibiotics in the medical practice

Actometry in measuring the symptom severity of restless legs syndrome.

In a previous, controlled study we demonstrated that the general lower limb activity measured by three-channel actometry is a promising objective measure of restless legs syndrome (RLS) severity. In the present study we have further evaluated the method in measuring RLS symptom severity in an open, single-day pramipexole intervention with 15 RLS patients. Both our standardized actometric parameters (nocturnal lower limb activity and controlled rest activity) decreased significantly during the intervention in parallel with the subjectively reported relief of RLS symptoms.

Ethanol modulates cortical activity: direct evidence with combined TMS and EEG.

The motor cortex of 10 healthy subjects was stimulated by transcranial magnetic stimulation (TMS) before and after ethanol challenge (0.8 g/kg resulting in blood concentration of 0.77 +/- 0.14 ml/liter). The electrical brain activity resulting from the brief electromagnetic pulse was recorded with high-resolution electroencephalography (EEG) and located using inversion algorithms. Focal magnetic pulses to the left motor cortex were delivered with a figure-of-eight coil at the random interstimulus interval of 1.5-2.5 s. The stimulation intensity was adjusted to the motor threshold of abductor digiti minimi. Two conditions before and after ethanol ingestion (30 min) were applied: (1) real TMS, with the coil pressed against the scalp; and (2) control condition, with the coil separated from the scalp by a 2-cm-thick piece of plastic. A separate EMG control recording of one subject during TMS was made with two bipolar platinum needle electrodes inserted to the left temporal muscle. In each condition, 120 pulses were delivered. The EEG was recorded from 60 scalp electrodes. A peak in the EEG signals was observed at 43 ms after the TMS pulse in the real-TMS condition but not in the control condition or in the control scalp EMG. Potential maps before and after ethanol ingestion were significantly different from each other (P = 0.01), but no differences were found in the control condition. Ethanol changed the TMS-evoked potentials over right frontal and left parietal areas, the underlying effect appearing to be largest in the right prefrontal area. Our findings suggest that ethanol may have changed the functional connectivity between prefrontal and motor cortices. This new noninvasive method provides direct evidence about the modulation of cortical connectivity after ethanol challenge.

Akathisia masked by hypokinesia.

Here, we will discuss the concept of subjective akathisia and present a patient case. Our patient was suffering from neuroleptic-induced hypokinesia and akathisia at the same time. The typical motor manifestations of akathisia were masked by hypokinesia, which made the diagnosis difficult. However, the subjective symptoms of akathisia were evident and distressing. Although not observable to bare eye, the pathognomonic pattern of motor activity detected in akathisia was demonstrated by actometric recording. Changing the conventional neuroleptic to an atypical one brought relief to the subjective symptoms of akathisia and hypokinesia, while the motor activity was clearly diminished in actometric recording. Actometric recording may be useful in diagnosing akathisia masked by hypokinesia, but the typical subjective symptoms of akathisia should not be ignored, even when actometry is not available to demonstrate the missing motor component of akathisia. Not only akathisia defined by DSM-IV but also subjective akathisia should be adequately treated to relieve the subjective distress, and to diminish the unfavorable effects on psychotic symptoms, behavior, and drug compliance.

Defense styles explain psychiatric symptoms: an empirical study.

To examine the relation between psychiatric symptoms and defense mechanisms, we administered two questionnaires, the Symptom Check-list 90 (SCL-90) and the Defense Style Questionnaire (DSQ) to 122 psychiatric out-patients and to a community sample of 337 subjects. Using regression analysis, we found that 51.8% of the variation in subject's Global Severity Index value could be explained by his defense style. Of the three defense styles, the immature style explained most of the variation in the symptoms. We found little overall evidence for specific connections between particular defenses and symptoms. Projection and dissociation were central in most of the symptom dimensions. We compared patients and controls with the same level of general symptom severity and found that patients used significantly more devaluation and splitting, and controls used significantly more altruism and idealization. Whether defenses predispose to certain symptomatology or are one of its aspects is discussed.

Measuring neuroleptic-induced akathisia by three-channel actometry.

Three-channel actometry was used to study neuroleptic-induced akathisia (NIA), a common and often serious disorder in association of traditional neuroleptic therapy. The aim was to explore the diagnostic possibilities of actometry in NIA and to examine in detail the motor phenomenology of the disorder in detail. The actometers were attached to the ankles and waists of ten patients, suffering from NIA, and to ten matched healthy controls. Five of the patients were changed to olanzapine treatment, and these patients were re-examined during the no-NIA condition. NIA was associated with manyfold movement activity during controlled rest (sitting) but not with increased daily overall motor activity. Movement frequencies in NIA seemed to be pathognomonic. Actometry is promising for investigation and clinical assessment of NIA. Olanzapine proved to be an adequate treatment choice for NIA patients.

Analysis of speech sounds is left-hemisphere predominant at 100-150ms after sound onset.

Hemispheric specialization of human speech processing has been found in brain imaging studies using fMRI and PET. Due to the restricted time resolution, these methods cannot, however, determine the stage of auditory processing at which this specialization first emerges. We used a dense electrode array covering the whole scalp to record the mismatch negativity (MMN), an event-related brain potential (ERP) automatically elicited by occasional changes in sounds, which ranged from non-phonetic (tones) to phonetic (vowels). MMN can be used to probe auditory central processing on a millisecond scale with no attention-dependent task requirements. Our results indicate that speech processing occurs predominantly in the left hemisphere at the early, pre-attentive level of auditory analysis.

A Finnish validation study of the SCL-90.

The Symptom Check-List-90 (SCL-90) is a widely used psychiatric questionnaire which has not yet been validated in Finland. We investigated the utility of the translated version of the SCL-90 in the Finnish population, and set community norms for it. The internal consistency of the original subscales was checked and found to be good. Discriminant function analysis, based on the nine original subscales, showed that the power of the SCL-90 to discriminate between patients and the community is good. Factor analysis of the items of the questionnaire yielded a very strong unrotated first factor, suggesting that a general factor may be present. This together with the fact that high intercorrelations were found between the nine original subscales suggests that the instrument is not multidimensional. The SCL-90 may be useful in a research setting as an instrument for measuring the change in symptomatic distress, or as a screening instrument. The American community norms should be used with caution, as the Finnish community sample scored consistently higher on all subscales.

Comparing two self-report measures of coping--the Sense of Coherence Scale and the Defense Style Questionnaire.

Antonovsky's Sense of Coherence Scale (SOC) and Bond's Defense Style Questionnaire (DSQ) were compared in a sample of 334 community controls and 122 psychiatric outpatients. The major question was, whether the two coping inventories with different theoretical backgrounds-stress research vs. psycho-analysis-tap similar phenomena. The affinity of the two coping measures was evident: in multiple regression analysis defenses explained 68% of the variance in sense of coherence. Not surprisingly, the SOC scale-emerging out of the salutogenic orientation-showed more expertise in measuring how people manage when they do well, whereas the DSQ-with its theoretical roots deep in psychopathology-was most sensitive to how people manage when they do rather poorly.