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Mar 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5429
Malaria and bacteraemia are significant public health concerns and economic threats. In Africa, the intensity for simultaneous transmission and co-infection of Plasmodium spp and other bacteria pathogens are extremely high. It is believed that malaria suppress the immune system and enable the translocation of bacteria in the gastrointestinal tract to other cellular compartments in the body. Some of the factors that contributed to the co-emergence of these pathogens are poor access to clean water, sanitation and hygiene (WASH), poor infection control measures, inefficient health care systems. In addition, the similarities in the clinical signs and symptoms of these febrile diseases and the fact that the etiologic diagnostic testing can be complex, costly, and limited are the reasons why clinicians in resource-constrained setting often prescribe antibiotics empirically prior to or without laboratory testing to prevent severe outcomes in any patient hospitalized with malaria. However, this indiscriminate use of antibiotics has been identified as the driving force for antibiotic resistance, which is already at alarming rate in malaria endemic nations. In developed countries where malaria had been previously eradicated, there are increasing reports of imported malaria with concurrent bacteraemia. In this review, we emphasized the role of malaria in the indiscriminate use of antibiotics and the fact that eliminating malaria in Africa is one of the best strategies to address the emergence and the global spread of multi-drug resistance organisms.
Mar 2025 DOI 10.14302/issn.2641-5518.jcci-24-5362
Bacterial resistance to antibiotics is becoming a major public health challenge in the Bahamas. Indiscriminate use of antibiotics by medical practitioners is a major contributor to this problem. We describe a 53-year-old woman who presented with symptoms of a urinary tract infection. Empiric treatment with first- and second-line antibiotics, namely trimethoprim-sulfamethoxazole and ciprofloxacin, respectively, were ineffective in clearing the infection. After culture and sensitivity testing via minimum inhibitory concentration analysis, nitrofurantoin proved to be the only effective oral antibiotic.
Mar 2024 DOI 10.14302/issn.2640-690X.jfm-24-5016
Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.
Dec 2020 DOI 10.14302/issn.2998-4785.ijne-20-3617
Background Overuse and abuse of antibiotics resulted in emergence of multidrug-resistant organisms (MDRO), increased rates of invasive candidiasis, prolonged hospital stay, NEC (Necrotizing enterocolitis), LOS (Late onset sepsis) or death. Restriction of the prescription, switching to a narrower spectrum and stopping antibiotics when not needed are some of the major approaches to antibiotic stewardship. Methods We identified restricted antimicrobials and devised an antimicrobial justification form. Clinicians needed to fill the form before prescribing restricted antimicrobials thereby comparing the antimicrobial usage pattern before and after the introduction of form. Babies enrolled before the introduction of the justification form were labelled as Group 1, and as Group 2 after justification form. The HIC (hospital infection control) staff nurse paid daily visits to NICU to monitor number of babies started on restricted antibiotics and whether the forms were duly filled or not. Any lag would be intimated to the Head HIC team for rectification. Any change of antibiotic within the restricted group also warranted justification. Culture report notified within 48 – 72 hrs so as to facilitate the stoppage of antibiotics in case of negative culture. Results There was a statistically significant reduction in the usage of restricted antimicrobials in the Group B as compared to Group A 150 (40.54%) vs 190 (49.35%) (p = 0.01). There was a statistically significant increase in the % of babies de-escalated from high end antimicrobials in Group B as compared to Group A 90 (60%) vs 56 (29.47%) (p = <0.0001). Duration of restricted antimicrobials reduced from 13.78 ± 2.7 days in Group A to 9.9 ±1.8 days in Group B (p = <0.0001). No difference in the number of babies started on any antibiotic between both the groups (p = 0.1). Conclusion Introduction of the antibiotic justification form as a part of antimicrobial stewardship program resulted in an overall reduced usage of restricted antimicrobials along with rapid de-escalation.
Jan 2020 DOI 10.14302/issn.2690-4721.ijcm-19-3154
Background The morbidity and mortality associated with the multi drug resistant Gram negative bacterial infections pose a significant and growing challenge to clinical practitioners. Klebsiella pneumoniae, which is a substantial nosocomial pathogen and confer high levels of resistance to broad-spectrum antibiotics including carbapenems. The aim of this study is to determine the resistance profiles of Klebsiella pneumoniae strains isolated from various clinical specimens. Material and Method In this study, the antibiotic susceptibility profiles of 2452 Klebsiella pneumoniae strains isolated from various clinical specimens between July 2015 and November 2019 were considered retrospectively. Blood culture vials were incubated in Bac T / Alert 3D automated system, other samples were cultured on blood and Eosin Methylene-blue (EMB) medium. The identification and antibiotic susceptibility tests of the isolated bacteria were performed by VITEC 2 Compact ID-AST cards (BioMérieux, Marcy l’Etoile, Fransa) and the results were evaluated according to the standards of the Europian Committee on Antimicrobial Susceptibility testing (EUCAST). The first sample of each patient was included in the study. The strains with inappropriate results were re-studied with gradient agar diffusion test (BioMérieux, Marcy l’Etoile, Fransa). Results The study included a total of 2452 Klebsiella pneumoniae strains and the distribution of samples was as follows: 894 (36, 5 %) blood, 790 (32, 2%) bronchial lavage, 211 (8,6 %) wound, 148 (6 %) drainage, 148 (6 %) peritoneal fluid, 95 (3, 9 %) tracheal aspirates, 64 (2,6%) catheter, 62 (2,5 %) urine, 40 (1,6%) other samples (pleural fluid, cerebrospinal fluid, throat ). In this study, antibiotic susceptibility test results indicated that the resistance to tigecycline was lowest (0, 3%). High colistin resistance ratio (33, 5 %) in carbapenem-resistant Klebsiella pneumoniae was considered to be of concern. Conclusion In this study, high rates of resistance to carbapenems were noteworthy. Determination of hospital antimicrobial resistance rates will be useful in developing antibiotic use policies of each hospital, in the treatment of causative agents, in selecting antibiotics according to antimicrobial susceptibility.
Nov 2019 DOI 10.14302/issn.2377-2549.jndc-19-3080
Ofloxacin is a class of fluorinated quinolone antibiotics, useful against most of the Gram-positive and Gram-negative bacterial infections. This study was designed to investigate the impact of the Trivedi Effect®-Consciousness Energy Healing Treatment on the structural properties and the isotopic abundance ratio of ofloxacin using LC-MS and GC-MS spectroscopy. Ofloxacin sample was divided into control and treated parts. The control ofloxacin did not receive the Consciousness Energy Healing Treatment, while the treated ofloxacin receives the Consciousness Energy Healing Treatment remotely by a renowned Biofield Energy Healer, Dahryn Trivedi. The LC-ESI-MS spectra of both the samples of ofloxacin at the retention time 3.05 minutes exhibited the mass of the protonated molecular ion peak at m/z 362.17 (M+H)+ (calculated for C18H21FN3O4+, 362.15). The LC-MS based isotopic abundance ratio of PM+1/PM in the treated ofloxacin was significantly increased by 56.57% compared with the control sample. Thus, 2H, 15N, 13C, and 17O contributions from (C18H21FN3O4)+ to m/z 363.17 in the treated ofloxacin were considerably increased compared with the control sample. The GC-MS based isotopic abundance ratios of PM+1/PM and PM+2/PM in the treated ofloxacin was significantly increased by 9.53% and 12.94%, respectively compared with the control sample. Hence, 2H, 15N, 13C, 17O, and 18O contributions from (C18H21FN3O4)+ to m/z 318 and 319 in the treated ofloxacin were significantly increased compared with the control sample. The LC-MS and GC-MS based isotopic abundance ratios of PM+1/PM (2H/1H or 15N/14N or 13C/12C or 17O/16O), and PM+2/PM (18O/16O) in the treated ofloxacin were considerably improved compared to the control sample. The increased isotopic abundance ratio of the treated ofloxacin would increase the chemical bond strength and increase the stability in the body. The new form of treated ofloxacin would be more stable compared to the control sample and would be very useful to design improved pharmaceutical formulations that might offer better therapeutic response against infections of the urethra and cervix, infectious diarrhoea, urinary tract infections, cellulitis, chronic bronchitis, pneumonia, prostatitis, multidrug-resistant tuberculosis, plague, otitis media, etc.
Aug 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2983
Although it is a vaccine-preventable disease, tetanus is frequently found in sub-Saharan Africa. Because of its rarity, this disease poses two problems for doctors of the 21st century: to make early diagnosis in order to refer patients to appropriate care structures, and to continue to ensure correct prevention of an affection that few current doctors have met. In it generalized form, the diagnosis of tetanus is easy, but when the beginning is localized, tetanus can be change with other diseases leading to a diagnostic wandering and a delay of adequate management. We report a case of tetanus in an 18-year-old male, who was received for neck pain and stiffness of the neck with a positive Kernig sign associated to fever since 48 hours. Initially treated for meningitis, the patient will develop at day 3 of hospitalization, the signs of generalized tetanus which led to evoked the diagnosis of tetanus. This diagnosis was reinforced by the notion of a rusty nail injury to the soles of the right foot 3 weeks before hospitalization and the absence of anti-tetanus vaccination. After using tetanus serum and vaccination with antibiotics (Metronidazole and Penicillin) and Diazepam in association with stripping of the wound under the foot, the patient was improved. This case illustrates that any neurological sign with the first trismus must evoke until proof of the contrary, a tetanus especially in case of association with a wound even if the immunization schedule is up to date.
Aug 2019 DOI 10.14302/issn.2574-4526.jddd-19-2963
Four cases are reported with splanchnic aneurysms of the branches of the main arteries. Three of the cases presented as emergencies. Possible rupture was present in Case 2 and true rupture in Case 4. The etiology of Cases 1 and 2 may have been a floxacin antibiotics, Table 1. This report is the first clinical chronological association of the antibiotics and arterial and aortic pathology. This association was supported by nationwide research by Pasternak, 11. Detailed experimental work done on mice showed connective tissue fragmentation and arterial cell injury. Apparently, the above antibiotic induced mitochondrial DNA damage and dysfunction, 9.
Jul 2019 DOI 10.14302/issn.2641-4538.jphi-19-2965
Self-medication in pregnancy is a health concern in Ghana. We assessed the practice among 136 pregnant women in Effutu and Agona West Municipalities using facility-based, cross-sectional design and mixed method approach of data collection. Data analysis used SPSS and manual content analysis. Results show that pregnant women of all backgrounds self-medicate, with prevalence of 69%, motivated by cheaper treatment cost (17%), minor ailments (29%) and positive outcomes (33%). Commonly used medications include antibiotics (23%), pain killers (20%) and herbal preparations (19%). Preventing self-medication in pregnancy therefore requires awareness creation and evidence based Social Behavioral Change Communication on associated dangers.
Jun 2019 DOI 10.14302/issn.2640-690X.jfm-18-2067
Lyme disease has been a topic of debate practically since its discovery in the 1970’s. The hot topic is whether or not long-term antibiotics should be used for Lyme disease patients with persistent symptoms. The source of such a long-running debate stems from the difference in opinions over the cause of long-term, persistent symptoms after treatment in some patients. Toward its end, Medicine has finally begun to embrace the existence of Chronic Lyme Disease, but changes still need to be made in the future.
Dec 2018 DOI 10.14302/issn.2328-0182.japst-18-2517
Silver sulfadiazine is a topical medicine that belongs to sulfa antibiotics class of drugs and used in treating wound infections in burn patients. The aim of this study was to determine the effect of Consciousness Energy Healing Treatment (the Trivedi Effect®) on the various properties of silver sulfadiazine with the help of modern analytical techniques. The sample was divided into two parts; the first part was not given any treatment and considered as a control sample, while the second part was provided the Consciousness Energy Healing Treatment by the Biofield Energy Healer, Gopal Nayak remotely, named as the treated sample. The powder XRD data showed significant alterations in the peak intensities of the treated sample ranging from-30.71% to 47.54% compared to the control sample. The crystallite size was altered ranging from -78.12% to 1.47%; and the average crystallite size was significantly reduced by 31.62% in the treated sample compared to the control sample. The particle sizes were decreased in the treated sample by 12.75%(d10), 4.98%(d50), 0.89%(d90), and 2.92%{D(4,3)}; thus, the specific surface area was significantly increased by 17.31% compared with the control sample. The latent heat of fusion and latent heat of decomposition were profoundly increased by 24.62% and 156.28%, respectively in the treated sample compared to the control sample. The total weight loss was increased by 3.08% and the residue amount was reduced by 4.44% in the treated sample compared to the control sample. Thus, the Trivedi Effect®-Consciousness Energy Healing Treated sample might form a new polymorph of silver sulfadiazine that possesses reduced particle size and improved thermal properties compared to the untreated sample. Therefore, the Biofield Energy treated sample can be used in nutraceutical/pharmaceutical formulation, which would show a better bioavailability and therapeutic response against various infections in comparison to the control sample.
Aug 2018 DOI 10.14302/issn.2690-4721.ijcm-18-2217
Background Overuse of beta-lactam antibiotics has lead to selection for extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, a major cause of antibiotic resistant urinary tract infections (UTIs). Standard detection methods are time-consuming, with disputed accuracy. This study describes a novel real-time PCR method to detect CTX-M, SHV, OXA and TEM. Methods 179 Enterobacteriaceae isolates from UTIs were collected from the Leicester Royal Infirmary, UK. A multiplex Plexor®-based real-time PCR assay detected ESBLs using their specific amplicon melting temperature, during each cycle, removing the need for a melt-curve analysis. Validation was achieved by end-point PCR and disk diffusion. Results The method was able to produce rapid and accurate results, achieving a sensitivity and specificity of 94.9% and 72% respectively, and the assay can differentiate between the different ESBL genes, with ease. Conclusions With further investigation, a Plexor®-based assay could form the basis of a high-throughput kit that health services could use to detect ESBLs or other antibiotic resistance genes.
Jul 2018 DOI 10.14302/issn.2690-4837.ijip-18-2238
Background Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an association towards development of infections that may cause of morbidity among people living with Human Immunodeficiency Virus (PLWHIV). We report on the prevalence, antibiotic susceptibility pattern and risk factors associated with MRSA carriage among PLWHIV at Nyenga hospital, Buikwe district in central Uganda. Materials and Methods We conducted a cross-sectional study among PLWHIV attending Nyenga hospital anti-retroviral therapy (ART) clinic. Nasopharyngeal swab was collected from each participant, cultured to isolate Staphylococcus aureus, and drug susceptibility testing (DST) performed. Sociodemographic data and medical history was recorded. Results We enrolled 219 PLWHIV; of these, 58.4% (N=128) were females. The majority of participants (95.0%) were on ART. Ninety-eight (44.75%) of the nasopharyngeal swabs had growth, of which 41 (41.84%) were S. aureus. Of these, 11 (5.02%, 95% confidence interval: 3.67-7.02) were MRSA. Of 41 isolated S. aureus strains, only 8 (19.51%) were susceptible to all antibiotics tested. A total of three (7.32%) were multi-drug resistant (MDR), while one1 (2.43%) was a possible extensively drug resistant (XDR) strain. Deteriorating immunologic state as indicated by a low CD4 count showed a significant association with the MRSA colonization. Conclusion These results are reassuring that MRSA colonization is high among PLWHIV. As most of the antibiotics in use were resistant, it raises concerns of intricate clinical management in a low resource set up.
May 2018
Microorganisms are the main cause of food-borne illness in humans that may occur by consuming unhygienic products from poultry and other sources. With the passage of time bacterial resistance to antibiotics is ever-increasing which necessitates development of new antibiotics. One of the most obvious reasons of antimicrobial resistance in human-beings is the consumption of contaminated food with microbes. The aim of present study is to isolate, identify and characterize the food-borne pathogens from chicken eggs. For this purpose, a total of 240 egg samples were collected from eight different towns of Faisalabad. Samples were collected from egg surface, yolk, albumin and egg tray. Isolation, identification and characterization of commonly occurring egg borne pathogens including E. coli, Salmonella spp., Bacillus subtilis, Staphylococcus aureus were carried out by different cultural, morphological and biochemical tests. Antibiotic resistance pattern of recovered bacterial pathogens was determined by disk diffusion method (Kirby-Bauer). Zone of inhibition was measured through vernier calliper. The results revealed a high prevalence of Salmonella entitidis with 40.83% following Staphylococcus aureus with 22.08%, Escherichia coli with 17.92% and Bacillus subtilis in a lower ratio with 2.5%. The antibiotic sensitivity test showed different resistance patterns of the isolated microbes. For this purpose, five different drugs were used that included cefotaxime, tetracycline, gentamicin, levofloxacin and penicillin. Bacillus subtilis was highly resistant to penicillin and cefotaxime. Whereas, E. coli showed resistance to three antibiotics that were tetracycline, cefotaxime and penicillin. The only drug to which Staphylococcus aureus showed resistance was cefotaxime. Salmonella was resistant to tetracycline and gentamicin. The study concluded that chicken egg is contaminated with a number of bacteria that could be pathogenic or not. So, there is need of proper attention to cope up with possible future egg-borne illnesses.
Aug 2017 DOI 10.14302/issn.2379-8572.joa-17-1602
Background: Dental infections, salivary gland lesions, neoplasms and developmental abnormalities can cause oral cutaneous fistulae, fistulae of the neck and intraoral fistulae. Published case reports deliver the same message; that these lesions are misdiagnosed and treated late and ineffectively and this remains a significant on-going problem. Aim: It is important to reiterate the management and diagnosis of this condition, despite the fact that it is already well documented in the current literature as patients are still being subjected to unnecessary treatment. Design and Setting: We performed a retrospective review of 5 consecutive dental sinus infections between June 2013 and January 2014 that were misdiagnosed initially. Information was extracted from the medical case notes of 2 male and 3 female patients with an age range from 12-87 years. Method: The medical records of all 5 patients were analyzed, medical photography was taken and the patients were followed up regularly in our clinic. Results: Each patient presented with a non-healing lesion and all were treated with either oral or topical antibiotics. Patients were eventually referred to the craniofacial department where they all received an orthopantomogram and underwent dental extraction, which led to complete healing. Conclusion: Cutaneous facial sinus tracts of odontogenic origin are often initially misdiagnosed which leads to prolonged and inappropriate treatment. Correct diagnosis and treatment will result in predictable and rapid healing and thus it is essential to record these case series, to ensure that medical professionals are aware of the presenting symptoms, which can often be very subtle.
Aug 2017
Iclaprim is a novel bacterial dihydrofolate reductase inhibitor in Phase 3 clinical development for the treatment of acute bacterial skin and skin structure infections and hospital acquired bacterial pneumonia caused by Gram-positve bacteria. Daptomycin, linezolid and vancomycin are commonly used antibiotic for these indications. With increase selective pressure to these generic antibiotics, outbreaks of bacterial resistance to these antibiotics have been reported. This in vitro study evaluated the activity of iclaprim against methicillin-resistant Staphylococcus aureus (MRSA) isolates, which were also not susceptible to daptomycin, linezolid or vancomycin. Iclaprim had an MIC ≤1 µg/ml to the majority of MRSA isolates that were nonsusceptible to daptomycin (5 of 7 71.4%), linezolid (26 of 26 100%), or vancomycin (19 of 28 66.7%). In time-kill curves analyses, iclaprim demonstrated ≥3 log10 reduction in CFU/mL at 4-8 hours for tested strains and isolates nonsusceptible to linezolid or vancomycin. Together these data support the use of iclaprim in serious infections caused by MRSA nonsusceptible to daptomycin, linezolid or vancomycin.
Mar 2017 DOI 10.14302/issn.2474-7785.jarh-16-1396
This is a short communication article on antibiotic resistance in the elderly. The elderly is prone to infections and therefore the use of antibiotics in the elderly is common. Literature review was done using Medline, Google and PubMed.
Oct 2016 DOI 10.14302/issn.2471-2175.jdrt-16-1296
Case Report This report describes a case of diffuse pyoderma in a 10-year-old female dog with hypothyroidism. A previous treatment, without an early diagnosis, including cephalosporin associated with prednisolon resulted to be unsuccessfully. After clinical and microbiological examination in our laboratories, a diagnosis of methicillinresistant Staphylococcus aureus (MRSA)-associated pyoderma was made. The antimicrobial susceptibility testing evidenced many resistances and susceptibility of the strain only to vancomycin and linezolid. A new therapy against hypothyroidism and associated with an appropriate antimicrobial (vancomycin) treatment, improved and resolved the infection. Clinical Significance To our knowledge, this is the first case of canine pyoderma caused by a strain of MRSA with a such severe multiresistant profile. MRSA infections present a serious challenge because of the emergence of resistance to numerous conventional antibiotics and the risk factors associated with the transfer of the bacteria to humans, who have a contact with infected pets.
Feb 2016 DOI 10.14302/issn.2574-4488.jna-15-712
Background Dapagliflozin; the new oral hypoglycemic agent; is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that acts by inhibiting glucose reabsorption in the proximal tubule of the nephron. Main reported side effects are osmotic diuresis, dehydration, urinary tract and genital infections. Here, we report a case of acute bilateral hydronephrosis after the introduction of dapagliflozin. Case Presentation A 52 year old nurse lady, with 15 year history of type2 diabetes mellitus (T2 DM) complicated by type4-renal tubular acidosis, hypertension, proteinuria, and hyperlipidemia. Patient had two episodes of UTI’s in 2011 required full urologic work up, were successfully treated with simple courses of oral antibiotics. CT pyelography done in 2011 was normal. Dapagliflozin was added to her therapeutic regimen in March 2015. Results Within 48 hours after starting dapagliflozin, she reported increased urine output. Ten days later; she developed severe bilateral loin and lower back pain, followed by suprapubic pain, dysuria and fever. Urine analysis and cultures confirmed E. coli urosepsis. Renal US revealed echogenic kidneys with 12 mm bilateral hydronephrosis, normal ureters and urinary bladder. Discontinuation of dapagliflozin in April 2015 resulted in resolution of symptoms. Repeat CT of the abdomen in July 2015 revealed no hydro nephrosis. Conclusions This is the first case report of reversible bilateral hydronephrosis after the use of dapagliflozin. The cause of hydronephrosis, could be explained by over-diuresis and/or by the unmasking of underlying subclinical obstruction in both uretero-pelvic junctions (UPJ).
Jan 2016 DOI 10.14302/issn.2379-8572.joa-15-814
Background and Objective: The etiological factors for nasal polyps include infection, inflammation or an imbalance of a metabolic pathway. This study was designed to compare serum Helicobacter pyloriantibodies and H. pylori–DNAs between cases of nasal polyp and controls (nasal fracture). Patients and Methods: This case control study was carried out in ENT Department of Rasul Hospital in Tehran (2007-2008), upon nasal polyp tissues in 62 cases and inferior nasal turbinate mucosa in 25 controls. H. pylori–DNAs were searched by qualitative polymerase chain reaction (PCR) and serum specific H. pylori antibodies (ELISA IgG and IgA). Comparative tests were performed for the 2 groups, and P value < 0.05 was considered as statistically significant. Results: The mean age of cases and controls were 37.5 ± 13.7 and 31 ± 11.5 years, respectively. H. pylori–DNA was found in 32.3% (20/62) of the cases and 4% (1/25) of the controls (P value = 0.005). Serum H. pylori antibody (IgA) was found in 14.5% (9/62) of the cases and 4% (1/25) of the controls (P value = 0.27). However, previous immunity (IgG) was higher in 71% of the cases and 32% of the controls (P = 0.001). Conclusion: H. pylori infection may play a key role in the formation of nasal polyps. We recommend the PCR as the best method of searching for H. pylori infection. However, from the data obtained in this investigation it could not be determined whether or not H. pylori play a pathogenic role. Long-term antibiotics treatment in cases with nasal polyp, especially in cases with severe chronic rhinosinusitis where patients do not respond to surgery or steroids, may be useful. More randomized controlled trial (RCT) studies are necessary to validate the role of H. pylori infection in nasal polyp and the effect of antibiotics for eradication of H. pylori infection.
Dec 2015 DOI 10.14302/issn.2576-182X.jbsc-14-582
Pituitary abscess is extremely rare and often misdiagnosed as pituitary tumor pre-operatively. We document a case of a 64-year-old lady presented to the outpatient department with complaints of headache and blurring vision of right eye for one month. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed Actinomyces infection. This case has been documented due to the extremely rare involvement of the pituitary gland by actinomyces infection. Pituitary abscess is a rare pathology, but it must be considered during evaluating sellar masses, since its prognosis depends on surgical drainage and on the use of specific antibiotics. We report, to our knowledge, the fourth case of Actinomyces israelii infection of the pituitary region.