Successful management of congenital bronchial web in an adolescent using bronchoscopic ablation: A case report and review of literature.

Airway webs are abnormal fibrous membranes in the airway lumen that rarely occur but can lead to serious or even life-threatening symptoms because of critical airway obstruction. Airway webs can be acquired or congenital. Acquired webs are likely to be secondary to trauma, infections, or neoplasm. Congenital laryngeal, subglottic and tracheal webs present early in infancy or childhood and are more common than congenital bronchial webs. To our knowledge, there are a few reports on the bronchial web in the literature, and the true incidence of these lesions is unknown as many probably go undetected across the lifespan. We here report a case of a congenital bronchial web and provide a review of the literature of all reported bronchial webs. Our patient is a teenage boy who was diagnosed with a congenital bronchial web obstructing the right main-stem bronchus (RMB) and causing right lung hypoplasia and persistent right middle and right lower lobe collapse. The web was treated successfully using endoscopic ablation by argon plasma coagulation and balloon dilatation. Treatment resulted in remarkable relief of right main stem obstruction and significant improvement in right lung collapse as well as clinical, spirometric, and radiological findings. Due to the rarity of bronchial web, the clinical knowledge and the bronchoscopic interventional strategies demonstrated of this report make it relevant. Furthermore, it emphasizes that early diagnosis and management lead to favorable clinical outcomes.

Antibiogram and molecular characterization of multi-drug resistant microorganisms isolated from urinary tract infections.

Bacteria are the commonest etiological factor among the microbes that cause UTIs. The most prevalent bacteria identified in the lab are Escherichia coli, Klebsiella pneumonia and Pseudomonas aeruginosa. Antibiotics are the empiric therapy for such infections but the reoccurrence rate is becoming high owing to the development of resistance due to their irrational and indiscriminate use across the globe. This study was designed on UTI cases of OPD, Medical, Nephrology, Surgical, Main OT, Urology and ICU wards of Allied hospital Faisalabad. 11 antibiotics were used which showed that E. coli is sensitive to Amikacin, Gentamicin, Imipenem, Piperacillin tazobactam, and Polymyxin B. Klebsiella pneumonia showed sensitivity for Amikacin, Gentamicin, Nitrofurantoin, Imipenem, Polymyxin B, Piperacillin tazobactam and Trimethoprim-sulfamethoxazole. While Pseudomonas aurignosa showed resistance to Amikacin, Ciprofloxacin, Gentamicin, Piperacillin tazobactam, Imipenem, and Polymyxin B. E. coli exhibited the highest sensitivity for Piperacillin tazobactam, Klebsiella pneumonia for Imipenem and Pseudomonas aurignosa for Ciprofloxacin. Further, the isolated DNA samples of these microorganisms were confirmed by gel electrophoresis and subjected to molecular characterization by performing trace file and phylogenetic tree analysis.