iosr-JDMS   Volume-1 ~ Issue-6

Abstract:Background and objectives: Rapidly emerging antimicrobial resistance of Neisseria gonorrhoeae isolates to currently recommended antibiotics is a setback for effective treatment and control of disease. This study was carried out to determine the antimicrobial susceptibility profile in the isolates obtained from female sexual workers and male patients attending STI clinics in Hyderabad. Materials and methods: Isolates were tested for sensitivity pattern of penicillin, tetracycline, ciprofloxacin azithromycin, cefixime and spectinomycin. Minimum inhibitory concentration (MIC) and zones of inhibition were interpreted according to CLSI guidelines. β lactamase production was detected by chromogenic cephalosporin method using nitrocefin disc.
Keywords: Antimicrobial susceptibility, MIC values, Neisseria gonorrhoeae, PPNG

[1] Rahman M, Alam A, Nessa K, Nahar S, Dutta DK, Yasmin L, et al . Treatment failure with the use of ciprofloxacin for gonorrhea correlates with the prevalence of fluoroquinolone-resistant Neisseria gonorrhoeae strains in Bangladesh. Clin Infect Dis 2001; 32:884-9.
[2] Eva Tzelepi1, Maria Daniilidou, Vivi Miriagou, Eirini Siatravani, Efthimia Pavlidou an Alexandros .Cluster of multidrug-resistant Neisseria gonorrhoeae with reduced susceptibility to the newercephalosporins in Northern Greece.Journal of Antimicrobial Chemotherapy doi:10.1093/jac/dkn236 Advance Access publication 12 June 2008
[3] P Khaki1, P Bhalla1, A Sharma1, V Kumar Correlation between In vitro susceptibility and treatment outcome with azithromycin in gonorrhoea: A prospective study Year : 2007 | Volume : 25 | Issue : 4 | Page : 354-357
[4] Manju Bala, Krishna Ray & S.M. Gupta.Comparison of disc diffusion results with minimum inhibitory concentration (MIC) values for antimicrobial susceptibility testing of Neisseria gonorrhoeae. Indian J Med Res 122, July 2005, pp 48-51
[5] Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 15 th informational supplement, M2-A8 and M7-A6. Vol. 25, Clinical and Laboratory Standards Institute 2005. p. 1.
[6] Centers for Disease Control and Prevention. Disk Diffusion Susceptibility Testing: Neisseria gonorrhoeae reference strains for antimicrobial susceptibility testing. Neisseria Reference Laboratory ; Revised 2005
[7] Robert Lindberg, 1 Hans Fredlund, 1 Robert Nicholas, 2 and Magnus Unemo. Neisseria gonorrhoeae Isolates with Reduced Susceptibility to Cefixime and Ceftriaxone: Association with Genetic Polymorphisms in penA, mtrR, porB1b, and ponA. Antimicrob Agents Chemother. 2007 June; 51(6): 2117–2122.
[8] Manju Bala, Krishna Ray, S. M. Gupta, Sumathi Muralidhar and R. K. Jain Changing trends of antimicrobial susceptibility patterns of Neisseria gonorrhoeae in India and the emergence of ceftriaxone less susceptible N. gonorrhoeae strains. Journal of Antimicrobial Chemotherapy (2007) 60, 582–586
[9] Sparling PF. Biology of Neisseria gonorrhoeae. In : Holmes KK, Mardh PA, Sparling PF, Lemon SM, Piot P, et al, Sexually transmitted diseases, 3 rd ed. McGraw Hill: New York; 1999. p. 131-48.
[10] Martin, I. M., S. Hoffmann, and C. A. Ison. 2006. European Surveillance of Sexually Transmitted Infections (ESSTI). The first combined antimicrobial susceptibility data for Neisseria gonorrhoeae in Western Europe. J. Antimicrob. Chemother. 58:587-593.

Abstract:Thyrotoxic periodic paralysis is a disorder in which there are episodes of muscle weakness in people with high levels of thyroid hormones. It is a channelopathy characterized by an abnormality in the Na+/K+ ATPase pump due to the effect of excess thyroid hormones which cause an intracellular shift of potassium leading to hypokalaemia in the presence of normal total body potassium1. The commonest cause of hyperthyroidism in these patients is Grave's disease 2,3,4 but other causes have also been described5,6. It is commoner in males than females unlike in other thyroid disorders 7,8,9. The modes of presentation include limb paralysis, dyspnoea, dysphagia, ophthalmoplegia, and cardiac rhythm disturbances. The attacks are potentially life threatening 10,11,12 but patients are normal between attacks. The condition is rare and is seen most commonly in Asian 13, 14,15 and Latin American men 16,17 but has also been noted in caucassians 18,19,20 and African Americans 21,22. This case is reported to alert physicians to the occurrence of this rare but potentially life threatening disorder in a Nigerian patient
Keywords: Thyrotoxic periodic paralysis. Nigerian. Male.

[1] Chan A, Shinde R, Chow CC, Cockram CS, Swaminathan R. In vivo and in vitro sodium pump activity in subjects with thyrotoxic periodic paralysis. BMJ 1991; 303:1096-1099.
[2] Erem C. Thyrotoxic hypokalaemic periodic paralysis in a Turkish male with Grave's disease: a rare case report and review of of literature. Endocrine 2005; 27:63-65.
[3] Berwaerts J, Martin JJ, Mahler C. Thyrotoxic periodic paralysis, an unusual cause of hypokalaemic periodic paralysis. Acta Neurol Belg. 1996; 96:301-306.
[4] MacFadzean AJS, Yeung R. Periodic Paralysis Complicating Thyrotoxicosis in Chinese. Brit Med J. 1967;1: 450-455.
[5] Honnon MJ, Behan LA, Agha A. Thyrotoxic periodic paralysis due to excess thyroxine replacement in a caucassian. Ann Clin Biochem. 2009; 46:423.
[6] Chen YC, Fang JT, Chang TC, Chou HH. Thyrotoxic periodic paralysis in a patient abusing thyroxine for weight reduction. Ren Fail 2001; 23:139.
[7] Manoukian AA, Foote, JA, Crapo LM. Clinical and metabolic features of thyrotoxic periodic paralysis in 24 episodes. Arch Inter Med. 1999; 159:601-606.
[8] Van DAN GM, Reisman Y, Van Wieringer K. Hypokalaemic periodic paralysis: Case report and review of an oriental syndrome. Neth J Med. 1994; 49:90-97.
[9] Barahona MJ, Vinagre I,Sojo L, Cubero JM, PA-Orez A, Thyrotoxic periodic paralysis: a case report and literature review. Clin Med Res. 2009; 7:96-98.
[10] Al Jubori MA, Inkster GD, Nee PA, Andrews FJ. Thyrotoxicosis presenting as hypokallaemic paralysis in an oriental man. Ann Clin Bioch. 2006; 43:323-325.

Abstract:Purpose:To study incidence of carbapenemases in teritary care hospital among gram negative clinical isolates of both Enterobacteriaceae and nonenterobactiaceae(nonferementers). Materials and Methods:A totalof 200 gram negative isolates were subjected to various phenotypic methods for carbapenemase detection along with minimum inhibitory concentration(MIC) for Imipenem and Meropenem by agar dilution technique.The phenotypic methods testedlike Double disc synergy test(DDST), Combined disc test (CDT), Modified hodge test(MHT).

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[9] Toleman MA, Biedenbach D, Bennet DMC, Jones RN, Walsh TR. Italian metallo β lactamase: a national problem? Report from the SENTRY Antimicrobial Surveillance Program. J Antimicrob Chemother 2005;55:61-70.
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