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1.
Mymensingh Med J ; 31(2): 289-294, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35383740

RESUMO

Proteus is considered as one of the major opportunistic pathogens liable for nosocomial infections and acquired several resistances to a wide range of antimicrobials such as aminoglycosides. The most common mechanism of aminoglycoside resistance is the inactivation of drugs by modifying enzymes. So, this cross-sectional study was undertaken to investigate the occurrence of aminoglycoside resistance and identify aminoglycoside modifying enzyme (AME) genes among clinical isolates of aminoglycoside resistant Proteus spp. A total of 40 Proteusmirabilis and Proteus vulgaris were isolated in the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from July 2018 to June 2019 of 500 wound swab & pus, urine and blood samples. Disk diffusion test was performed by modified Kirby Bauer method. Minimum inhibitory concentration (MIC) of amikacin was determined by agar dilution method. PCR was used to detect aac(3)-Ia, aac(6')-Ib, ant(4')-IIa, ant(2'')-Ia a and aph(3'')-Ib AMEs genes among aminoglycoside resistant Proteus spp. Sequencing of aac(6')-Ib gene was performed to identify aac(6')-Ib-cr variant. Thirty-two (80%) aminoglycoside resistant isolates were detected during disk-diffusion technique. The marked increase in MIC was observed between 256 - ≥2048µg/ml to amikacin. The most prevalent AME-genes were aac(6')-Ib (37.5%), ant(2'')-Iaa (21.86) followed by ant(4')-IIa(12.5%), aph(3'')-Ib (12.5%) andaac(3)-Ia (9.38%). The most frequent combination was aac(6')-Ib + aac(3)-Ia+ant(2'')-Iaa and aac(6')-Ib + ant(4')-IIa + aph(3'')-Ib(2 strains) followed by aac(6')-Ib + aac(3)-Ia(1 strain). Sequencing of aac(6')-Ib gene in this study did not harbor aac(6')-Ib-cr variant gene. The results of this study provide insight into the presence of high AME-genes among Proteus spp. in Bangladesh.


Assuntos
Aminoglicosídeos , Farmacorresistência Bacteriana , Aminoglicosídeos/farmacologia , Antibacterianos/farmacologia , Bangladesh , Estudos Transversais , Farmacorresistência Bacteriana/genética , Humanos , Testes de Sensibilidade Microbiana , Proteus/genética , Centros de Atenção Terciária
2.
Mymensingh Med J ; 31(1): 31-36, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34999676

RESUMO

Plasmid mediated quinolone resistance (PMQR) has been revealed to play not only a significant role in quinolone resistance but also this drug resistance can spread from one bacterium to another. There is limited data regarding the prevalence of PMQR are available from Bangladesh. So, the aim of this study was to detect the prevalence of qnr and aac(6')-Ib-cr genes among clinical isolates of ciprofloxacin resistant Proteus spp. This cross-sectional study was carried out in the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from July 2018 to June 2019. Fourty (40) Proteus spp. was isolated from 300 culture positive samples. Proteus mirabilis and Proteus vulgaris were identified by culture and biochemical test. Antibiotic susceptibility was performed by disc-diffusion technique. Quinolone resistance genes (qnrA, qnrB, qnrC, qnrD, qnrS and aac(6')-1b-cr) among ciprofloxacin resistant Proteus spp. were detected by PCR. Thirty (75%) ciprofloxacin resistant isolates were detected during disk-diffusion technique. Among them, quinolone resistance genes were found positive 11(36.67%) for aac(6')-Ib-cr, 6(20%) for qnrA, 5(16.67%) for qnrD, 4(13.33%) for qnrS and 3(10%) for qnrB genes. Co-existance of qnrA + aac(6')-Ib-cr and qnrD + qnrS were found in 3(10%) wound swab & pus and urine samples respectively followed by qnrA + qnrB in 2(6.67%) wound swab and pus and qnrA+qnrS in 1(3.33%) urine sample. The results of this study showed presence of high (66.67%) percentage of PMQR genes as well as high (30%) rate of co-carriage of the two genes among Proteus spp. isolates. The incidence of PMQR genes was found to be high which could be due to the increased prescription of fluoroquinolones. Thus, there is a need for rational usage of fluoroquinolones.


Assuntos
Farmacorresistência Bacteriana , Proteínas de Escherichia coli , Antibacterianos/farmacologia , Bangladesh/epidemiologia , Estudos Transversais , Escherichia coli , Humanos , Testes de Sensibilidade Microbiana , Prevalência , Proteus , Centros de Atenção Terciária
3.
J Pharm Bioallied Sci ; 13(Suppl 1): S496-S500, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34447141

RESUMO

BACKGROUND AND OBJECTIVES: At present, none of the routinely used irrigating agents and activation techniques were able to completely remove the Ca(OH)2 intracanal medicament placed inside the root canal system during endodontic therapy. With this as the background, the aim of this study was to achieve complete removal of Ca(OH)2 when mixed with two different vehicles, using various irrigant activation techniques such as K-file, canal brush technique, and sonic irrigation technique, from the root canals of extracted human teeth. MATERIALS AND METHODS: Seventy-two mandibular premolar teeth with straight single root canal were selected and filled either with oil-based Metapex or calcium hydroxide powder mixed with distilled water and were activated using different activation techniques such as K-file, canal brush, and sonic MM1500 and NaOCl alone. Volumetric analysis was performed utilizing cone-beam computed tomography. RESULTS: None of the irrigants used were able to completely remove Ca(OH)2 from root canal. Sonic MM1500 showed significant removal efficacy than K-file, canal brush technique, and NaOCl for both aqueous-based and oil-based calcium hydroxide. CONCLUSION: Sonic MM1500 performed better than K-file, canal brush technique, and NaOCl in removing both Metapex and Ca(OH)2 powder. Regardless of the vehicles and agitation technique used, the remnants of Ca(OH)2 were present on all thirds of the canal walls.

4.
Mymensingh Med J ; 30(2): 355-361, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33830114

RESUMO

Different Proteus species are encountered in human infections and may vary with the type of infections they cause. So, the present study was conducted to detect species of Proteus by PCR and RFLP along with their antibiotic resistance pattern. This cross-sectional study was conducted in the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh, from July 2018 to June 2019. A total of 500 wound swab and pus, urine and blood samples were tested for bacterial pathogens. Proteus spp. were identified and differentiated by biochemical test, PCR and RFLP. Antibiotic susceptibility was performed by disc-diffusion technique. Fourty Proteus spp. was isolated from 300 culture positive samples, giving 13.33% prevalence of Proteus infections. Proteus mirabilis and Proteus vulgaris were identified by culture, biochemical test, PCR and RFLP. The results were similar by both methods (biochemical tests and PCR). RFLP of 16S rRNA fragments digested with HaeIII revealed that P. mirabilis consisted of two bands at approximately 110 and 190 bp and P. vulgaris consisted of three bands at approximately 100, 180 and 220 bp. The proportion (80%) of P. mirabilis was more than P. vulgaris. Highest proportion (77.5%) of Proteus spp. was isolated from wound swab and pus followed by urine samples. A significant proportion of Proteus spp. was multidrug resistant (90%) and extensively drug resistant (37.5%). Fosfomycin was found the most sensitive drug followed by imipenem. This study provided an insight into antibiotic resistance pattern of Proteus spp. and showed high level resistance towards commonly used antimicrobial agents. PCR and RFLP may be suitable method to identify and differentiate species of Proteus and to treat them accordingly.


Assuntos
Antibacterianos , Proteus , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bangladesh , Estudos Transversais , Resistência Microbiana a Medicamentos , Humanos , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Proteus/genética , RNA Ribossômico 16S
5.
Mymensingh Med J ; 29(1): 202-208, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915359

RESUMO

Giant cell tumors (GCT) are usually benign bone tumors with aggressive characteristics. Giant cell tumors have a benign indolent course in most patients, but tumors may recur locally in as many as 50% of cases depending on the type of treatment and initial presentation of the tumor. The aim in the management of long bone GCT is to eradicate the tumor and prevent local recurrences. In this study, we retrospectively assessed the functional outcomes in 5 patients having recurrent GCTs of the distal femur treated with custom made modular endoprosthesis following wide resection of the tumor from January 2017 to December 2018 in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Tumor Society functional score (MSTS) was used to assess the results of our patients. The mean follow-up period was 13.2 months. We achieved good to excellent results with our mean functional score of 80.66%. To the best of our knowledge, probably first started by us using customized modularendoprosthetic massive replacements for recurrent GCTs in our country. The use of custom made modular mega prosthesis is a simple and technically superior method of feeling the bone defects after wide resection in aggressive recurrent GCTs. In our opinion endoprosthesis replacement for recurrent GCTs had early good to excellent functional results 5.


Assuntos
Neoplasias Femorais/cirurgia , Fêmur/cirurgia , Tumor de Células Gigantes do Osso/cirurgia , Recidiva Local de Neoplasia/cirurgia , Implantação de Prótese , Bangladesh , Fêmur/fisiopatologia , Humanos , Recidiva Local de Neoplasia/patologia , Próteses e Implantes , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Resultado do Tratamento
6.
Mymensingh Med J ; 28(4): 952-956, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599268

RESUMO

Eventration of diaphragm is an abnormal elevation of diaphragmatic musculature while retaining normal attachments to the sternum, ribs and dorsolumber spine. It is a rare anomaly where the continuity of diaphragm remains intact. Pathological process can affect either all or only a portion of hemidiaphragm. Symptoms vary according to size of the defect. Large defect may mimic diaphragmatic hernia. The present case represents a full term female newborn that developed respiratory distress, cyanosis and feeding difficulties since 1st day of life. Clinical features and chest imaging of this case was assumed to be left sided diaphragmatic hernia which was found wrong in the operation theater. She was found to have left sided eventration of diaphragm to create symptom. Successful plication of ipsilateral diaphragm was done on 13th day of life. Supervised post operative ventilatory support along with other postoperative care improved the condition of this neonate. A large defect with eventration of diaphragm may be life threatening but a timely good management can save neonate from such condition.


Assuntos
Eventração Diafragmática , Hérnia Diafragmática , Diafragma , Feminino , Humanos , Recém-Nascido , Período Pós-Operatório
7.
Mymensingh Med J ; 28(2): 470-473, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31086169

RESUMO

Organophosphorus compounds (OPC) are widely used insecticides. Such poisoning is very rare in neonate. A 23 days old infant was admitted with severe respiratory distress, excessive secretion from nose and mouth, bluish discoloration of extremities and poor feeding for 4 hours. He was pale, cyanosed and lethargic with gasping respiration. Frothing was coming through mouth and nose. There was watering of eyes, pupils were pin pointed and light reflex was sluggish. The baby was hypothermic, hypotonic with altered sensorium. Capillary refill time was <3 sec. The neonate was gasping; there was crepitation over lung fields. Precordium and abdomen was normal. An odor of OPC was smelt on clothing and secretions of the infant. The baby was wrapped with a cloth that was ware during pesticide spraying in the field. In addition to general measures, decontamination of skin and clothing and gastric lavage was done. Empirical antibiotic, injection atropine and pralidoxime were given. Patient showed clinical improvement with disappearance of cholinergic signs. The baby was discharged on 7th day of admission after full recovery.


Assuntos
Antídotos/administração & dosagem , Atropina/administração & dosagem , Inseticidas/envenenamento , Intoxicação por Organofosfatos/tratamento farmacológico , Compostos Organofosforados/toxicidade , Compostos de Pralidoxima/administração & dosagem , Antídotos/uso terapêutico , Atropina/uso terapêutico , Humanos , Recém-Nascido , Masculino , Compostos Organofosforados/efeitos adversos , Compostos de Pralidoxima/uso terapêutico , Resultado do Tratamento
8.
J Conserv Dent ; 22(1): 23-27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30820078

RESUMO

Background: In vivo angiogenesis is normal and vital process in growth and development, wound healing, and formation of granulation tissue wherein new blood vessels form from preexisting vessels as part of revascularization. Platelet-rich products promote wound healing associated with angiogenesis. Biomaterials such as titanium were found to be angiogenic. Unlike in vivo situations, in vitro angiogenesis, study cells, within a controlled environment. Aims: The aim of this study is to evaluate the angiogenic potential of a novel platelet-rich product. Materials and Methods: Blood was drawn from volunteers with informed consent. Blood samples were centrifuged to obtain platelet-rich products. Platelet concentrates prepared were platelet-rich plasma (PRP), platelet-rich fibrin, and a novel platelet-rich product which is titanium-prepared PRP (TPRP), obtained using titanium. The study which compared platelet concentrate was divided into four groups subjected to tissue culture. Phase-contrast microscope was used to determine the rate of growth by cell counting. Statistical Analysis: ANOVA was used for comparison within groups and post hoc for multiple comparisons. Results: TPRP group showed granular ground substance. Group with platelet-rich fibrin (PRF) shows a high rate of growth whereas those with TPRP showed better growth rate when compared to its counterpart, PRP. Conclusions: This is the first study which introduces TPRP. Previous studies have proved that titanium-prepared PRF has better structural quality than its counterpart platelet-rich fibrin. This study concludes that TPRP has better angiogenic potential than its counterpart PRP. Further in vivo studies are needed to promote TPRP as a new generation of platelet products.

9.
Mymensingh Med J ; 28(1): 126-136, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30755561

RESUMO

Anterior cruciate ligament injury is one of the commonest sports injuries, which often markedly reduces activity and the quality of life. The autologous hamstring double bundle graft and single bundle graft are commonly used for anterior cruciate ligament reconstruction. The choice of graft material for ACL reconstruction is believed to play a major role in the outcome but still there are controversies about the graft selection for primary ACL reconstruction. The aim of this study was to compare the clinical and functional outcome of autologous double bundle (DB) hamstring graft and single bundle (SB) hamstring graft reconstruction for the ACL injury. This prospective observational study was conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2015 to September 2017. Total 42 cases of ACL injury that required reconstruction surgery was selected as per inclusion criteria. Total patients were allocated into two groups. One group was treated by single bundle graft and other group was treated by double bundle graft for the ACL reconstruction. In this study, the mean age of double bundle and single bundle groups were 28±6.63 and 30.14±7.55 years respectively and majority of the subjects were male. The post-operative symptoms and signs were more improved in double bundle group than single bundle group during last follow-up period of 6th months. The Lachman test, Anterior drawer test and pivot sift test were more negative in double bundle group than that of single bundle groups. The Lysholm and Tegner activity were better in double bundle group than single bundle group. Again rotational and anterior stability of the knee was better in the double bundle group. However, the differences were not statistically significant and all patients in our study were able to return their activity. Double bundle group showed better rotational stability than the single bundle groups and all knees were improved by anterior cruciate ligament reconstruction compared with their pre-operative status.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/cirurgia , Tendões/transplante , Adulto , Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/instrumentação , Bangladesh , Feminino , Humanos , Masculino , Complicações Pós-Operatórias , Estudos Prospectivos , Qualidade de Vida , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento , Adulto Jovem
10.
Mymensingh Med J ; 27(1): 108-115, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29459600

RESUMO

Graft selection for primary anterior cruciate ligament reconstruction is very important part of knee stability. The purpose of this Qasi experimental study was to compare the clinical outcomes after ACL reconstruction using either a BPTB graft or a four-strand hamstrings graft and conducted from January 2012 to December 2013. Patients presented with a symptomatic unilateral ACL rupture who were underwent ACL reconstruction by using either BPTB or Hamstrings graft, IPD of Department of Orthopedics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka as well as in a private hospital in Dhaka, Bangladesh were selected as study population. Patients were divided into Group A who were treated with the patellar tendon bone graft and Group B patients who were received hamstrings tendon graft. All surgery was performed by the same surgeon and the both procedures were arthroscopically assisted. Operation was performed at least three (03) weeks after initial trauma. All patients were assessed by independent examiner before surgery, at 6 months, 12 months and then annually by clinically. A total number of 70 patients were recruited for this study. The mean age with SD of Group A and Group B were 27.31±10.91 and 26.97±10.10 years respectively (p=0.892). Tegner scores were measured preoperatively and post-operatively. The score were 2.2±1.1 and 2.1±1.0 in preoperatively (p=0.817). In post-operatively the mean score were 6.0±1.7 and 5.8±1.5 in Group A and Group B respectively (p=0.508). Regarding outcome of the operation excellent was 18(51%) cases in both Group A and Group B, good was 15 (43%) and 16(46%) cases in Group A and Group B respectively (p=0.793). In conclusion there was no significant difference between the two groups of the ACL reconstructions cases.


Assuntos
Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , Ligamento Patelar , Adolescente , Adulto , Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior/métodos , Artroscopia , Bangladesh , Humanos , Ligamento Patelar/transplante , Adulto Jovem
11.
Mymensingh Med J ; 25(3): 495-9, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27612897

RESUMO

Fracture of tibial shaft is the commonest site of long bone fractures due to its superficial location involving young or middle-age people. Proper management is an important issue regarding the future effective movements. In this study patients were grouped in closed Intra medullary interlocking nailing and locking compression plating. Post-operative follow up at 2 weeks, 6 weeks, 12 weeks and 3 months thereafter up to 6 months were done. Each of the patients was evaluated clinically and radiologically by tucker criteria of Tuker et al. Patients were assessed for pain on full weight bearing and kneeling, shortening and range of motion of knee and ankle joints. Radiological assessment for union of fracture, alignment of fracture and angulations and position of nail and screws and infection were observed during follow up. A total number of 32 patients were selected but only 27 patients were available for follow up for a period of 6 months. They were grouped into Group A, consisting of 15 patients who took the treatment in the form of closed intramedullary interlocking nailing and Group B, consisting of 12 patients those underwent ORIF with locking compression plating. In both of the groups Motor Vehicle Accident was the main mechanism of trauma. Fracture involving the middle 3rd of the tibia is common in both the groups. During post-operative follow up, four patients in Group A complained anterior knee pain, one patient in Group B had superficial infection, most of the patients had no restriction of movement in the ankle and knee joints and a single patient in Group B showed 1.5cm shortening of the lower limb. Period of hospital stay and fracture union time were less in Group A, which was statistically significant. Both groups showed excellent result with minimum complications. So this study permits to conclude that close IM interlocking nailing and open reduction and internal fixation by locking compression plating is equally effective for the management of close fracture shaft of the tibia.


Assuntos
Fixação Intramedular de Fraturas , Fraturas Fechadas , Fraturas da Tíbia , Pinos Ortopédicos , Fixação Intramedular de Fraturas/métodos , Humanos , Pessoa de Meia-Idade , Tíbia , Fraturas da Tíbia/cirurgia , Resultado do Tratamento
12.
Mymensingh Med J ; 25(3): 500-5, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27612898

RESUMO

The meniscus is the most commonly injured structure in the knee joint. Carefully performed clinical examination can give better diagnosis of meniscal tear. The aim of this study was to find out the correlation between clinical and arthroscopic findings in meniscal tear of knee. This cross sectional observational study was conducted in the Department of Orthopaedic Surgery, BSMMU, Dhaka from July 2012 to June 2014. Thirty patients of meniscal tear were selected as per inclusion and exclusion criteria. After proper evaluation and clinical examination of these patient arthroscopic examinations was done under spinal anesthesia. A total number of 30 patients were recruited in this study. Twenty seven (90%) patients were male and only 3(10%) were female. Mean±SD of age was 26.00±5.55 and range was 17-34 years. Out of 30 patients 19(63.3%) had right knee affected and the rest 11(36.7%) had left knee affected. It was found from clinical diagnosis that most of the patients had MM injury (73.4%) and LM injury was in 26.6% patients. From arthroscopic diagnosis we found most of the patients had multiple types of injury (40.0%) followed by 26.7% patents had isolated MM injury, 16.6% patients had isolated LM injury, 10.0% patients had other injuries like ACL, PCL or MCL and rest 6.7% patients had no injury at all. Sensitivity, specificity, PPV, NPV and accuracy of clinical diagnosis in diagnosis of MM injury were 94.4%, 58.3%, 77.3%, 87.5% and 80.0% respectively. Sensitivity, specificity, PPV, NPV and accuracy of clinical diagnosis in diagnosis of LM injury were 85.7%, 91.3%, 75.0%, 95.5% and 90.0% respectively. Clinical evaluation may diagnose meniscal tear accurately.


Assuntos
Traumatismos do Joelho , Lesões do Menisco Tibial , Adulto , Artroscopia , Bangladesh , Estudos Transversais , Feminino , Humanos , Traumatismos do Joelho/diagnóstico por imagem , Articulação do Joelho , Imageamento por Ressonância Magnética , Masculino , Lesões do Menisco Tibial/diagnóstico por imagem , Adulto Jovem
13.
Mymensingh Med J ; 24(2): 341-5, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26007263

RESUMO

DeQuervain's disease of the first dorsal compartment of the wrist, is a common wrist pathology, pain results from resisted gliding of the abductor pollicis longus and the extensor pollicis brevis tendon in the fibroosseous canal. Management of resistant cases of DeQuervain's disease with failed conservative treatment treated by surgical decompression yield satisfactory outcomes. A large number of patients being dissatisfied with the medical treatment, still present with persistent pain and positive clinical finding. Surgical decompression is an effective method for the treatment of resistant cases of DeQuervain's disease. Outcome variables were measured by Scheller, Forget and Macey evaluation criteria. Most of our patients were female 28(93.3%), housewife 17(56.7%) with mean age of 41.57 years, ranging from 25-60 years. Right sided involvement was 20(66.7%) and Left sided involvement was 10(33.3%). Restricted movement of thumb in 30(100%) were the predominant symptoms. One (3.3%) patient develop chronic tenosynovitis, 1(3.3%) patient develop hypertrophic scar. There was no wound infection in the follow-up period of 3-18 months. Satisfactory results were found in 29(96.7%).


Assuntos
Descompressão Cirúrgica , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tendões , Tenossinovite , Polegar
14.
Transfus Apher Sci ; 49(3): 507-10, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24055412

RESUMO

Plateletpheresis is a method used to remove platelet from the body either from random volunteer donors, patient's family members or HLA matched donors. A cross sectional study was carried out on 59 plateletpheresis donors aged between 18 and 55 years at National Blood Center (NBC), Kuala Lumpur. We compared the blood parameters before and after plateletpheresis and we found that the platelet count, FVIII, fibrinogen and thrombophilia markers anti-thrombin (AT), protein C and protein S were significantly reduced (p<0.05) with prolonged PT and APTT. There were significant changes in blood coagulation parameters but it is within acceptable range.


Assuntos
Coagulação Sanguínea/fisiologia , Doadores de Sangue , Plaquetoferese/métodos , Adolescente , Adulto , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
16.
N Y State J Med ; 90(1): 4-7, 1990 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-2296395

RESUMO

Fifty unselected patients undergoing routine esophagogastroduodenoscopy were evaluated for infection with Campylobacter pyloris (CP). Antral specimens were cultured, and biopsies from the antrum and the body of the stomach were examined histologically. Specimens of antral brushings were analyzed with Gram stain, and urease testing was performed on gastric aspirates, antral brushings, and antral biopsy homogenates. Twenty-seven (54%) patients were CP-positive by silver stain and/or culture of mucosal biopsies. The simplest and fastest diagnostic methods was Gram stain of antral brushing, which was 93% sensitive and 100% specific. CP-negative patients were more likely to have normal histology in antrum and body tissues, while CP-positive patients usually exhibited superficial or chronic gastritis (p less than 0.01). Using ELISA technique, 67% of all patients and 89% of CP-positive patients had serum antibodies against sonicated CP organisms. We conclude that evidence of gastric CP infection is common, is associated with inflammatory changes of the gastric mucosa, is suggested by finding antibodies to CP in serum, and can be accurately and rapidly diagnosed by staining of endoscopically derived cytology and biopsy specimens.


Assuntos
Infecções por Campylobacter/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/análise , Biópsia , Campylobacter/imunologia , Campylobacter/isolamento & purificação , Infecções por Campylobacter/imunologia , Infecções por Campylobacter/microbiologia , Duodenoscopia , Estudos de Avaliação como Assunto , Feminino , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
17.
Arch Intern Med ; 149(7): 1634-6, 1989 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-2787145

RESUMO

To determine whether the diagnostic evaluation of patients admitted for nongastrointestinal disease, who subsequently bleed while in hospital (secondary bleeders), should differ from that of patients hospitalized with a primary diagnosis of GI bleeding, patients consecutively referred to a consultant service were prospectively evaluated. Ninety-four primary and 43 secondary bleeders underwent a detailed historical survey and endoscopic or radiologic diagnostic evaluation of the upper and lower gastrointestinal tract. Primary bleeders hemorrhaged with greater severity and potential or definitive bleeding sites were found in them more often than in secondary bleeders. Primary bleeders usually had upper gastrointestinal lesions, whereas secondary bleeders frequently had colonic bleeding. Prior historical events other than the use of nonsteroidal anti-inflammatory agents did not affect the source or severity of bleeding. The clinical spectra of primary and secondary bleeders differ so that evaluation of secondary bleeders of modest severity should be modified and often can be deferred until the underlying disease has been controlled.


Assuntos
Hemorragia Gastrointestinal/etiologia , Gastroenteropatias/complicações , Gastroenteropatias/diagnóstico , Hospitalização , Humanos , Estudos Prospectivos
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