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Background: Oral health care in pregnancy is often neglected by women and is also not appropriately addressed by prenatal and other health care providers and justify appropriate attention. The purpose of this cross sectional study was to describe percentage of oral disease occurrence and underlying causes in this sample of pregnant women. Methods: The study included 147 women aged between 15 to 49 years receiving prenatal care at the outdoor department of Azimpur Maternal and Child Health Training Institute in Dhaka, Bangladesh were invited to participate in this study from January 2013 to April 2013. Semi-structured interviews were conducted for data collection. Clinical exam data were recorded using validated scales in a special form. Results: Majority (72%) of the women were between 20 to 24 years. 57% had secondary school education. 88% of the women were unemployed and 52% women had very low family income of BOT s;10000. More than 90% of the women had good oral hygiene practices. However, 68% liked to have sugary snacks or drinks in between main meals, 7% visited their dentists during pregnancy , only 3% received advice for routine oral health screening from their prenatal care providers and only 4% women started their antenatal check-up during first trimester. All these negative influences might expose expecting mothers to high level of dental caries (54%), dental erosion (52%), gingivitis (100%) and periodontitis (27%). This study also showed that majority of the women acquired oral health information through watching television (61%) or reading newspaper (12%) while only 4% received information from doctors/dent ists throughout their lifetime. Conclusion: The undertaken research highlighted the importance of using media in modifying Bangladeshi pregnant woman's behaviours toward oral health. It also emphasizes the need for inclusion of oral health preventive programme as part of pre and postnatal care. Further study in this area on a large scale will facilitate formulation of appropriate oral health policy to achieve satisfactory oral and general health outcomes during pregnancy and ensure optimum oral health conditions of their offspring. JOPSOM 2020; 39(1): 50-59

Background: Proper patient selection for most appropriate treatment option for hepatic hydatid is crucial to ensure successful treatment outcome. Chemotherapy, newer approaches, like PAIR procedure, (puncture, aspiration, injection and reaspiration) laparoscopy are available. As the indications for these approaches are restricted, surgery remains the key treatment strategy with hope for complete cure. Radical surgical excision coupled with chemotherapy and long-term aggressive chemotherapy for partially resected ensures lowest morbidity and mortality. Methods: This cross sectional observational study of 15-year single-institution experience, intended to further validate different surgical procedures in management of hydatid disease of liver and its outcome. Patients were randomly selected irrespective of their age, sex and mode of presentation. Different preferred surgical treatment modalities, perioperative complications, recurrences, and length of hospital stay were retrospectively analyzed. Result: The study was carried out on 79 Bangladeshi patients diagnosed hepatic hydatidosis, treated surgically from January 2002 to December 2017 in BIRDEM General Hospital. Among them was no anastomotic leakage or mortality in the immediate postoperative period in our series. Conclusion: This study revealed, proper case selection and consideration of risks-benefits, indicationscontraindications for each case of Hydatid cyst of liver, for making a decision for type and timing of surgery is key to successful outcome. Surgery is the mainstay of treatment strategy. Radical surgery is key to effective and successful outcome, ensures better quality of life and prevents recurrence of the disease. Journal of Surgical Sciences (2018) Vol. 22 (2) : 118-124

Thiopurine methyltransferase (TPMT) enzymes play a crucial role in azathioprine metabolism. Mutations in the enzyme initiate generation of excess thioguanine, which causes suppression of various cell lineages. The objectives of this study were to investigate the prevalence of TPMT mutation in Bangladeshi patients with systemic lupus erythematosus (SLE) requiring azathioprine therapy and its relation to the development of myelosuppression. 250 patients with SLE were enrolled, then monitored for myelosuppression adverse events for 4 months. TPMT*3C (rs1142345), TPMT*3B (rs1800460), and TPMT*2 (rs1800462) polymorphisms were analyzed using polymerase chain reaction–restriction fragment length polymorphism. The risk of myelosuppression (i.e., leukopenia, thrombocytopenia, and anemia) was estimated as the odds ratio (OR) with 95% confidence intervals (CIs) and p values. Of the 250 patients, 17 (6.8%) were heterozygous for the TPMT*3 mutation and 233 (93.2%) were homozygous for the wild type; no patients carried a homozygous mutation. Grade III/IV leukopenia, thrombocytopenia, and anemia occurred in 12.0%, 12.0%, and 27.9% of wild-type TPMT patients respectively; corresponding rates in heterozygous TPMT*3C patients were 70.6%, 64.7%, and 5.9%. Patients with Grade III/IV azathioprine-induced leukopenia were significantly more likely to have the heterozygous TPMT*3C genotype than the wild-type variant (OR 17.6; 95% CI 5.8–53.6; p

Background Several coronavirus disease (COVID-19) vaccines have already been authorized and distributed in different countries all over the world, including Bangladesh. Understanding public acceptance of such a novel vaccine is vital, but little is known about the topic. Objectives This study aimed to investigate the determinants of intention to receive a COVID-19 vaccine and willingness to pay (WTP) among people in Bangladesh. Methods An anonymous and online-based survey of Bangladeshi people (mean age = 29.96 ± 9.15 years; age range = 18–60 years) was conducted using a self-reported questionnaire consisting of socio-demographics, COVID-19 experience, and vaccination-related information as well as the health belief model (HBM). Multivariable logistic regression was performed to determine the factors influencing COVID-19 vaccination intent and WTP. Results Of the 894 participants, 38.5% reported a definite intention to receive a COVID-19 vaccine, whereas 27% had a probable intention, and among this intent group, 42.8% wanted to get vaccinated as soon as possible. Older age, feeling optimistic about the effectiveness of COVID-19 vaccination, believing that vaccination decreases worries and risk of COVID-19 infection, and being less concerned about side effects and safety of COVID-19 vaccination under the HBM construct were found to be significant factors in COVID-19 vaccination intention. Most of the participants (72.9%) were willing to pay for a COVID-19 vaccine, with a median (interquartile range [IQR]) amount of BDT 400/US$ 4.72 (IQR; BDT 200–600/US$ 2.36–7.07) per dose. Factors associated with higher WTP were younger age, being male, having higher education, residing in an urban area, having good self-rated health status, positivity towards COVID-19 vaccination's effectiveness, and being worried about the likelihood of getting infected with COVID-19. Participants who were COVID-19 vaccination intent preferred an imported vaccine over a domestically-made vaccine (22.9% vs. 14.8%), while 28.2% preferred a routine immunization schedule. Conclusion The findings indicate a considerable proportion of Bangladeshi people intended to get vaccinated and had WTP for the COVID-19 vaccine. However, urgent education and awareness programs are warranted to alleviate public skepticism regarding the COVID-19 vaccination.

There have been numerous studies about the health implication of COVID-19 on patients, but little attention has been paid to the impacts of the pandemic on physicians. Our paper attends to this gap by exploring the mental health of physicians in Bangladesh during the COVID-19 pandemic. This is particularly important since the mental health of physicians impacts not only on themselves, but also their professional performance and hence the care of patients. This study examined physicians' mental health outcomes by evaluating the prevalence and associated potential risk factors of anxiety and depression. Using a web-based cross-sectional survey, we collected data from 114 physicians. Seven-item Generalized Anxiety Disorder (GAD-7) scale and Nine-item Patient Health Questionnaire (PHQ-9) were used to measure the anxiety and depression, respectively. Multivariate logistic regression models were used to explore the potential risk factors related to anxiety and depression. The prevalence of anxiety and depression were 32.5 and 34.2%, respectively. Findings revealed that marital status, work per day and current job location were the main risk factors for anxiety while sex, age, and marital status were the main risk factors for depression. Our results highlight the need to implement policies and strategies for positively impacting the mental health of physicians during and after the COVID-19 pandemic.

Aim This study aimed to assess knowledge, attitudes, and practices (KAP) toward COVID-19 among youth in Bangladesh. Subject and methods A cross-sectional survey was conducted from 5 May to 25 May 2020. People aged between 18 and 35 years were approached via social media to complete an online questionnaire that consisted of socio-demographic information and KAP toward COVID-19. Descriptive statistics, t-tests, one-way analysis of variance (ANOVA), and multiple logistic regression analyses were conducted. Results Out of 707 survey participants, 57.1% were male, the majority were students (60.3%), aged 24-29 years (61.5%), having a bachelor’s degree (57%), having family income 25,000-50,000 BDT (40.5%) and living in urban areas (64.4%). Participants gathered information on COVID-19 mostly through social media (70.4%). Overall, 61.2% had adequate knowledge with 78.9% having a positive attitudes toward COVID-19 and only 51.6% had good practices. Most (86.8%) of the participants were confident that COVID-19 will be successfully controlled and Bangladesh was handling the COVID-19 health crisis well (84.20%). Only 75.2% of participants always washed their hands with soap or hand-sanitizer, and 70.6% wore a mask when going outside the home. Factors associated with adequate knowledge were being female, having a master’s degree and above, and living in an urban area (p < 0.05). Participants having adequate knowledge of COVID-19 had higher likelihood of positive attitudes (OR: 6.41, 95% CI = 2.34–25.56, p = 0.000) and good practices (OR: 8.93, 95% CI = 3.92–38.42, p = 0.000). Conclusion The findings highlight the need for tailored education programs for COVID-19 which incorporates consideration of associated factors to improve the level of public knowledge, attitudes, and practices.

The outbreak of the COVID-19 pandemic has dramatically shaped higher education and seen the distinct rise of e-learning as a compulsory element of the modern educational landscape. Accordingly, this study highlights the factors which have influenced how students perceive their academic performance during this emergency changeover to e-learning. The empirical analysis is performed on a sample of 10,092 higher education students from 10 countries across 4 continents during the pandemic’s first wave through an online survey. A structural equation model revealed the quality of e-learning was mainly derived from service quality, the teacher’s active role in the process of online education, and the overall system quality, while the students’ digital competencies and online interactions with their colleagues and teachers were considered to be slightly less important factors. The impact of e-learning quality on the students’ performance was strongly mediated by their satisfaction with e-learning. In general, the model gave quite consistent results across countries, gender, study fields, and levels of study. The findings provide a basis for policy recommendations to support decision-makers incorporate e-learning issues in the current and any new similar circumstances. info:eu-repo/semantics/publishedVersion

Background Ischemic heart disease (IHD) is a major cause of death globally. Countries vary in their rates, and changes have occurred over time. Nowadays, developing countries pose new public health challenges. Objectives The objective of the present study was to appraise the alterations in the levels of serum Zn, Cu, Fe, and Mn that occur in patients with ischemic heart disease and to depict the correlations of the effects of these changes that lead to the pathogenesis of IHD. Methods Zn, Cu, Fe, and Mn in the IHD patients were determined by Atomic Absorption Spectroscopy (AAS). Results This study evaluated 52 patients with IHD, and 61 healthy volunteers served as controls. The primary outcomes of interest were explored regarding the correlations of the serum levels of these trace elements in patients with IHD. The secondary outcomes were explored in terms of inter-element relations to connect them with the pathogenesis of IHD. Our study found significantly reduced levels of Zn and Cu (2.50 ± 0.19 mg/L and 2.52 ± 0.17 mg/L, respectively) and an elevated level of Fe (148.97 ± 17.25 mg/L) in the patient group with IHD. The level of Mn (7.32 ± 1.23 mg/L) was elevated in the sera of the patients with ischemic heart disease (IHD) compared to healthy control subjects. Conclusion Our results indicate strong associations of the pathogenesis of IHD with depleted serum levels of Zn and Cu and elevated Fe and Mn levels, which may provide a prognostic tool for the treatment of this concerning the disease., Cardiology; Biochemistry; Molecular biology; Pathophysiology; Public health; Pharmacology; Clinical research; Ischemic heart disease, Case-control study, Trace elements, Pearson's correlation, Bangladesh.

Aim This study aimed at exploring the perception and experiences with regard to the COVID-19 pandemic among Bangladeshi urban young adults. Subject and methods Using a mixed-method approach, an online cross-sectional survey among 315 participants and in-depth interviews (IDI) among 20 young adults were conducted from May 1 to May 25, 2020. Descriptive statistics and chi-square tests were performed for quantitative data, along with the thematic analysis for qualitative data. Results The mean (± SD) age of the participants was 26.54 (± 3.05), and the majority were male (54.9%). About 81.6% of the participants reported COVID-19 as a viral disease, transmitted through droplets of sneezing and coughing, and close contact with another person (90.8%). Nearly 40% of participants reported news channels as a reliable source of information for COVID-19. Participants who were male were less likely to be aware than females in terms of mode of transmission of COVID-19 such as going outside of the home (82.7% male vs 90.8% female; p

Background To determine whether work ability and well-being predict return to work (RTW) among women with long-term neck/shoulder and/or back pain at 1-year follow-up, and to assess the ability of the Work Ability Index (WAI) and Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW). Methods A survey was sent to 600 women receiving sick leave (SL) benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and well-being predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted. Results Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04–1.22). Well-being was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after one year (AUC 0.78, 95% CI: 0.70–0.86), but the LiSat-11 did not. Conclusions Our results indicate that work ability is an important factor for RTW among women on SL for long-term neck/shoulder and/or back pain. The findings also indicate that the WAI, but not the LiSat-11, is able to discriminate between RTW and NRTW in the population under study. The WAI may be used to identify women at risk of NRTW.

Currently shaping a large part of the development and humanitarian agenda the concept of resilience has been embraced by a large number of donors, development agencies, and international NGOs. As a consequence, an increasing number of development interventions that aim at strengthening the resilience of vulnerable households and communities are now being implemented across the globe. Along with these interventions, a growing and urgent call for rigorous monitoring and evaluation has emerged. Unfortunately, the very few resilience measurement frameworks that are available are often too “academics”, data-demanding, and therefore poorly adapted to the reality faced by practitioners on the ground. In this paper we develop a resilience impact assessment framework which addresses this challenge. Using an ex-post treatment vs. control approach, the framework satisfies the requirement for rigor that should be found in any proper impact assessment framework, but remains operational in the data- and resource-constrained situations which characterize most of the current interventions in the field. We illustrate the approach through the case of the Enhancing Resilience program that was implemented by the World Food Programme and its partners in Bangladesh during 2011–13.

Background/Purpose Nearly all published studies of recurrent Clostridium difficile infections (CDI) report recurrent CDI within 8 weeks after the primary infection. This study explored the molecular characteristics of C. difficile isolates from the first recurrent CDI more than 8 weeks after the primary infection. Methods Consecutive hospitalized patients with a recurrent CDI more than 8 weeks after a primary infection were enrolled prospectively from January 2008 to February 2011. All C. difficile isolates of the primary and recurrent infections were collected and subjected to polymerase chain reaction ribotyping and antimicrobial susceptibility testing. Results There were 62 cases of CDI in this study, which included 32 cases (51.6%) of recurrence due to the same ribotype of C. difficile , 26 (41.9%) cases due to a different ribotype, and four (6.5%) cases with 2–4 recurrences due to the same or different strains. One hundred and forty C. difficile isolates were obtained, which included 62 primary CDI isolates and 78 recurrent isolates. Ribotype 020 was the most common C. difficile strain in primary and recurrent infections. Ribotype 001 accounted for 15.4% (10/78) of recurrent infections and 3.2% (2/62) of primary infections ( p = 0.0447). The minimum inhibitory concentration at 90% (MIC 90 ) values of linezolid, moxifloxacin, and clindamycin against type 001 strains were much higher, compared to the three other common ribotypes. Conclusion Recurrent CDI more than 8 weeks after a primary infection can be caused by the same or different C. difficile ribotype at similar percentages. Ribotype 001 C. difficile strains, which have a lower susceptibility to antimicrobials, were isolated more frequently in patients with a recurrent CDI.

Introduction: Approximately 15% of couples are infertile. Male infertility plays an important role in about half of these couples. This study has been done to determine whether sperm morphology and motility do really affect sperm count or spermatogenesis and at the same time causes a problem with fertility.Objectives: The objective of this study was to evaluate a male’s inability to cause pregnancy in a fertile female.Materials and Methods: This is a prospective study of 100 diagnosed infertile and subfertile couples in the age group of 23-58 yrs old male. They were selected from 01 March 2013 to 28 Feb 2014 undergoing treatment for infertility in Dhaka CMH. On the basis of sperm count the cases were grouped as follows: Normozoospermia, oligozoospermia & Azoospermia. Semen analysis was done in all the cases and the results were described with arithmetic mean and standard deviation.Results: Normozoospermia: Mean and SD of sperm count, sperm abnormality, sperm motility are 65.98± 5.05, 24.44±1.57 and 45.5±2.94 respectively; Oligozoospermia: Mean and SD of sperm count, sperm abnormality, sperm motility are 7.74±1.23, 41.1±3.78, 14.54±2.77 respectively; Azoospermia: Mean and SD of sperm count, sperm abnormality, sperm motility are absent.Conclusion: Here data statistically showed person with normozoospermia having good sperm morphology and motility than oligozoospermia and azoospermic subjects thereby causing male infertility which is responsible for hindrance in achieving pregnancy clinically.Journal of Armed Forces Medical College Bangladesh Vol.11(1) 2015: 50-53

A study way carried out in Dhaka city to find out the management and treatment patterns of diabetic patients those having blood pressure complications. It was a cross sectional study of 150 patients by using self administered survey questionnaire and founded data was analyzed and described. In this study, it is found that almost all of the patients (92%) were from Dhaka and just were a few those were outsider but came as referred patients. The male and female percentages were accordingly 64.67% and 35.33% and among those diabetes patients 47.33% had hypertension and 10.66% had hypotension and most of them (74%) check their diabetes monthly. Among those patients 79.33% patients were prescribed only drugs while 17% patients were prescribed to change their routine only and 4% were prescribed both (drug and routine). Most of the diabetes patients having blood pressure complicacy were prescribed only drugs which is very significant and those are going to do further research in this aspect will be benefited by getting this information.Asian J. Med. Biol. Res. September 2016, 2(3): 458-463

This paper presents localization of tumor at 13 different positions deep inside a dense human breast using only 4 meander line microstrip patch antennas of operating frequency 1.5 GHz for the detection of breast cancer. The reflection coefficients of the antennas demonstrates a very uniform pattern for localization of the tumors in CST Microwave Studio simulation environment. The result of this work can help to develop a portable medical device for breast cancer detection at home by analyzing the reflection coefficient data of the 4 antennas.

The objective of this study was to examine the restorative effects of methanol extract of Commelina benghalensis leaves in antidiarrheal activity in Swiss albino mice model and anthelmintic activity in Tubifex tubifex. Antidiarrheal activity study in Swiss albino mice were divided into four groups. Group I was treated as the control group and received 10 ml/kg of 2% Tween-80 orally; Group II served as a positive control and took standard drug (loperamide) in 5 mg/kg orally; Groups III and IV were the test groups which received the methanol extract of C. benghalensis orally at 200 and 400 mg/kg, respectively. Dependent upon the model comprehensive weight of dry feces, aggregate weight of wet defecation, length of intestinal travel and intestinal weight were gathered. At long last, information were investigated using restricted analysis of variance (ANOVA) took after by Dunnett test. Anthelmintic action on aquarium worm T. tubifex by utilizing three focuses of 10, 5, and 2.5 mg/ml of C. benghalensis movement was assessed by in vitro system. The property of the extract on defecation, intestinal transit and intestinal fluid accumulation (antienteropooling) were assessed in castor oil induced diarrhea. Leaves extract of C. benghalensis at 200 and 400 mg/kg exhibited significant (p

Breast cancer patients may experience multiple symptoms due to the disease itself, treatment or combination of both. The aim of the present study was to identify group of symptoms experienced by the patients with breast cancer using cluster analysis. We examined symptom profiles of 120 patients with breast cancer who attended a hospital palliative care centre in a tertiary institution. Following symptoms were analyzed: pain, nausea, loss of appetite, constipation, weakness, cough, breathlessness, sleeplessness, lymphedema, sadness, anxiety and depression. Hierarchical cluster analysis was used to identify the natural groupings within the set. We could identify three clusters. Cluster 1 was characterized by pain, depression, anxiety, weakness, sleeplessness and loss of appetite. Cluster 2 comprised of cough, breathlessness, nausea and constipation. Cluster 3 consisted of two symptoms lymphedema and sadness. The results revealed that the patients with breast cancer experienced symptoms that are multiple and clustered together. Neuro-psychiatric symptoms and weakness formed a significant strong relationship. Knowledge obtained from this study can be beneficial for better understanding, assessment and management of symptom clusters in women with breast cancer. It may also help patients to plan ahead for them to seek management of concurrent symptoms to improve their quality of life.Bangladesh Med J. 2016 Jan; 45 (1): 25-30

Sixty-eight hospital-admitted patients with a first episode of Clostridium difficile infection (CDI) were included and followed up during 1 year. Faeces samples were collected at 1, 2, 6 and 12 months after inclusion and analyzed for the presence of C. difficile toxin B, genes for toxin A, toxin B, binary toxin and TcdC deletion by PCR. All strains were also PCR-ribotyped and the MICs of the isolates were determined against eight antimicrobial agents. In 68 patients initially included, antibiotics, clinical signs and co-morbidities were analyzed and 56 were evaluable for recurrences. The mean number of different antibiotics given during 3 months prior to inclusion was 2.6 (range 0-6). Six patients had not received any antibiotics and three of them had diagnosed inflammatory bowel disease. Thirty-two patients (57%) had either a microbiological or clinical recurrence, 16 of whom had clinical recurrences that were confirmed microbiologically (13, 23%) or unconfirmed by culture (3, 5%). Twenty-nine patients were positive in at least one of the follow-up tests, 16 had the same ribotype in follow-up tests, i.e. relapse, and 13 a different ribotype, i.e., reinfection. Most common ribotypes were 078/126, 020, 023, 026, 014/077, 001 and 005. No strain of ribotype 027 was found. Strains ribotype 078/126 and 023 were positive for binary toxin and were the strains most prone to cause recurrence. All strains were sensitive to vancomycin and metronidazole. Patients with recurrences were significantly older (p = 0.02) and all patients had a high burden of comorbidities, which could explain the high fatality rate, 26 (38%) patients died during the 1-year follow-up.

The present study was undertaken to evaluate safety and efficacy of methotrexate in Rheumatoid arthritis patients. This study was carried out on ARA criteria fulfilling 35 diagnosed Rheumatoid arthritis patients of either gender, aged 20-60 years, presented in Medicine department of Rajshahi Medical College Hospital, Rajshahi from July 2007 to June 2008. Patients with normal liver function tests and HBsAg and anti-HCV negative cases were given oral methotrexate (10-15 mg/wk) for 6 weeks. Baseline prothrombin time was 12.97±0.34 seconds. After 6 weeks of methotrexate therapy prothrombin time was found 13.47±0.46 seconds. During methotrexate therapy change of prothrombin time was not significant (p>0.05).KYAMC Journal Vol. 6, No.-1, Jul 2015, Page 550-552

This paper compares structured history, auditory processing abilities and neuropsychological findings of children with functional hearing loss (FHL) to those with suspected auditory processing disorder without FHL (control). The main aim was to evaluate the value of a holistic assessment protocol for FHL used in a routine pediatric audiology clinic. The protocol incorporated a commercially available test battery for auditory processing disorder (APD), non-verbal intelligence (NVIQ) and tools to screen for common co-existing neurodevelopmental conditions such as attention deficit hyperactivity disorder (ADHD), language impairment (LI) and developmental coordination disorder (DCD). The outcome of such holistic assessment was expected to help in understanding the nature of FHL and to provide individualized support to mitigate their difficulties.This retrospective study compared two groups, 40 children (M = 17, F = 23) in each group between seven and sixteen years of age, one group with a history of FHL and the other with suspected APD without FHL (control). The groups were matched against age, gender, hand use, diagnosis of APD or non-APD (31 with APD and 9 without APD in each group) and non-verbal intelligence. All the children were healthy English speaking children attending mainstream schools with no middle or inner ear abnormalities. Structured history was obtained from parents regarding different nonacademic and academic concerns. The SCAN-3:C and SCAN-3:A test batteries were used to assess auditory processing abilities; Lucid Ability test for NVIQ; Children's Communication Checklist-2 (CCC-2) for language ability; Swanson Nolan and Pelham-IV Rating Scale (SNAP-IV) for ADHD; and the manual dexterity components of the Movement Assessment Battery for Children-2 (MABC-2) as a screening tool for DCD.About 60% of children in both the groups had concerns regarding listening in noisy background. In the history, poor attention was reported in 45% of children in the FHL group compared to 82.5% in the control group (p 0.01). Hyperacusis was present in 35% of children in the FHL group and in 62% of children in the control group (p 0.05). Concerns about overall academic abilities were present in 59% of children in the FHL group and 75% of the controls (p 0.05). Only 15% of children in the FHL group had concerns with numeracy skills in contrast to 41% of the controls (p 0.05). Significantly fewer (p 0.01) children in the FHL group (41%) received additional support at school than the controls (75%). Fewer children performed poorly in Filtered Words (FW) test of the SCAN-3 batteries, 30% in the FHL group and 17.5% in the control group, in contrast to Auditory Figure Ground 0 (AFG0), 85% in FHL and 80% in the control group. The number of children performing poorly in AFG0 was significantly higher compared to all the other SCAN-3 tests in FHL (P 0.05), in contrast to FW and Competing Sentences (CS) only in the control group (p 0.05). The control group had higher prevalence of atypical ear advantage (AEA) in left directed Competing Words (CW) (32.5%) and Time Compressed Sentences (TCS) (32.5%) compared to FW (7.5%). In contrast, FHL group had higher prevalence of AEA in AFG0 (48.7%) compared to CS (21%). High proportions of children in both the groups had LI (80% in FHL and 82.5% in the control group), with significantly lower (p 0.05) levels of ADHD symptoms in the FHL group (39.5%) compared to the control group (72.5%). Impaired manual dexterity was present in 30.7% of children in FHL group and 47.5% in the controls.The prevalences of APD and language impairment are high compared to ADHD symptoms in children with FHL, and holistic assessment is recommended. Despite some similarities in the auditory and neuropsychological profiles between children with FHL and those with suspected APD without FHL some differences were noted. The results suggest that children with FHL have genuine difficulties that need to be identified and addressed. Future research is required to identify the neural pathways which could explain the similarities and dissimilarities between the two groups.

The aim of this study was to assess the impact of ciprofloxacin, clindamycin, and placebo administration on culturable Gram-negative isolates and the antibiotic resistance genes they harbor. Saliva and fecal samples were collected from healthy human volunteers before and at intervals, up to 1 year after antibiotic administration. Samples were plated on selective and nonselective media to monitor changes in different colony types or bacterial species. Following ciprofloxacin administration, there was a decrease of Escherichia coli in feces and after clindamycin administration a decrease of Bacteroides in feces and Leptotrichia in saliva, which all returned to pretreatment levels within 1 to 4 months. Ciprofloxacin administration also resulted in an increase in ciprofloxacin-resistant Veillonella in saliva, which persisted for 12 months. Additionally, 949 aerobic and anaerobic isolates purified from ciprofloxacin- and clindamycin-containing plates were screened for the presence of resistance genes. Resistance gene carriage was widespread in isolates from all three treatment groups, and no association was observed between genes and antibiotic administration. Although the anaerobic component of the microbiota was not a major reservoir of aerobe-associated antimicrobial resistance (AMR) genes, we detected the sulfonamide resistance gene sul2 in anaerobic isolates. The longitudinal nature of the study allowed identification of distinct Escherichia coli clones harboring multiple resistance genes, including one carrying an extended-spectrum β-lactamase bla CTX-M group 9 gene, which persisted in the gut for up to 4 months. This study provided insight into the effects of antibiotic administration on healthy microbiota and the diversity of resistance genes harbored therein.

The purpose of the study was to assess the effect of ciprofloxacin (500 mg twice daily for 10 days) or clindamycin (150 mg 4 times daily for 10 days) on the fecal microbiota of healthy humans for a period of 1 year as compared to placebo. Two different methods, culture and microbiome analysis, were used. Fecal samples were collected for analyses at 6 time-points. The interval needed for the normal microbiota to be normalized after ciprofloxacin or clindamycin treatment differed for various bacterial species. It took 1-12 months to normalize the human microbiota after antibiotic administration, with the most pronounced effect on day 11. Exposure to ciprofloxacin or clindamycin had a strong effect on the diversity of the microbiome, and changes in microbial composition were observed until the 12th month, with the most pronounced microbial shift at month 1. No Clostridium difficile colonization or C. difficile infections were reported. Based on the pyrosequencing results, it appears that clindamycin has more impact than ciprofloxacin on the intestinal microbiota. © 2015 The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

The present study was engineered to find out the anti-arthritic and thrombolytic activity of methanolic extract of Protium serratum by using in vitro method. Methanolic extract of P. serratum was assessed with the inhibition of protein denaturation model which was used to evaluate anti-arthritic potential and this extract assessed with human blood to evaluate thrombolytic effect. The extract showed remarkable anti-arthritic activity which was evaluated by the percentages of inhibition of protein denaturation in different concentration of plant extract compared to diclofenac sodium, a reference drug. The maximum percentage inhibition of protein denaturation was observed as 83.94% at 1000 μg/ml. It has significant thrombolytic effect compared to streptokinase. During assay for thrombolytic activity, the methanolic extract of P. serratum revealed 59.653 ± 8.626% lysis of clot, while standard streptokinase (SK) and water used as positive and negative controls, demonstrated 72.835 ± 5.702 and 2.725 ± 0.983% lysis of clot, respectively. These findings demonstrate that the leaves extract of P. serratum have excellent anti-arthritic and thrombolytic effect. Key words: Protium serratum, anti-arthric, thrombolytic, % lysis of clot, protein denaturation.

An in vitro thrombolytic model was used to check the clot lysis effect of two herbal extracts viz., Desmodium paniculatum (L.) and Sarchochlamys pulcherrima (Roxb.) by using Streptokinase as positive control and water as negative control. D. paniculatum and S. pulcherrima showed 31.92 ± 8.09% and 36.12 ± 6.81% clot lysis, respectively. From our study we found that D. paniculatum and S. pulcherrima showed significant % of clot lysis effect with reference to Streptokinase (72.54 ± 6.03%). and water (3.48 ± 0.84%). DOI: http://dx.doi.org/10.3329/bpj.v17i1.22318 Bangladesh Pharmaceutical Journal 17 (1): 67-69, 2014

In the present study silver nanoparticles (Ag-NPs) were prepared by using chemical synthesis. Silver nanocolloid solution has been prepared chemically by the reduction of silver salt using sodium borohydride (NaBH4) and trisodium citrate (C6H5Na3O7.2H2O). Triangular silver nanoplates were also prepared by reducing silver salt using ascorbic acid which is a mild reducing agent. The nanoparticles were characterized by UV-VIS spectrophotometry and Scanning Electron Microscopy (SEM). The reducing character of ascorbic acid was used to determine the amount of ascorbic acid in real sample like vitamin C tablets that are available in the market of Bangladesh. Dhaka Univ. J. Pharm. Sci. 12(1): 29-33, 2013 (June) DOI: http://dx.doi.org/10.3329/dujps.v12i1.16297

One hundred thirty-three Clostridium difficile strains were collected from 71 patients and analyzed for the presence of C. difficile toxin B by the cell cytotoxicity neutralization assay, genes for toxin A, toxin B, binary toxin and TcdC deletion by PCR. All strains were also PCR-ribotyped and analyzed for sporulation frequency. The MICs of the isolates were determined against cadazolid and seven other antimicrobial agents by the agar dilution method. All isolates were positive for toxin B by the cell cytotoxicity neutralization assay. One hundred fourteen isolates were positive for toxin A and B and 16 isolates were positive for toxin A, toxin B and binary toxin by PCR. Three isolates were negative for toxin A but positive for toxin B. Thirty-three different ribotypes were identified. No strain of ribotype 027 was found. No differences in sporulation were noticed between the primary and recurrent isolates. All 133 isolates were sensitive to cadazolid (0.064–0.5 mg/l), fidaxomicin (0.008–0.125 mg/l), metronidazole (0.125–2 mg/l), vancomycin (0.125–1 mg/l) and tigecycline (0.032–0.25 mg/l). Three isolates were resistant to linezolid (8 mg/l), 15 isolates were resistant to moxifloxacin (8–32 mg/l) and 103 isolates were resistant to clindamycin (8–256 mg/l). No association between toxins A, B and binary toxin, ribotypes or the sporulation and the sensitivity to cadazolid could be found. Cadazolid has a potent in vitro activity against C. difficile.

This study included 34 healthy volunteers (16 male and 18 female) aged 19-37 years, of whom 17 received doxycycline 40 mg capsules orally once daily (o.d.) and 17 received placebo 40 mg capsules orally o.d. for 16 weeks. Plasma, saliva and faecal samples were collected before drug administration and at 4, 8, 16 and 20 weeks. Plasma samples were assayed for doxycycline concentrations, and saliva and faecal samples were investigated for doxycycline concentrations and microbiological analyses. Plasma concentrations of doxycycline in the doxycycline group were as follows: baseline visit (2 h), 0.20-0.61 mg/L; 4-week visit, 0.30-1.04 mg/L; 8-week visit, 0.43-1.49 mg/L; 16-week visit, 0.32-1.12 mg/L; and 20-week visit 0 mg/L. No doxycycline was detected in plasma in the placebo group. No doxycycline concentrations in the saliva samples were found in the doxycycline or placebo groups at the five visits. Faecal concentrations of doxycycline in the doxycycline group were as follows: baseline visit, 0 mg/kg; 4-week visit, 0-3.71 mg/kg; 8-week visit, 0-1.85 mg/kg; 16-week visit, 0-4.10 mg/kg; and 20-week visit, 0 mg/kg. No doxycycline faecal concentrations were detected in the placebo group. Minor effects on the aerobic and anaerobic oropharyngeal microflora were observed both in the doxycycline and placebo groups. There were minor changes in the number of enterococci and Escherichia coli in the doxycycline and placebo groups. The anaerobic intestinal microflora in the doxycycline and placebo groups was not changed, and no Clostridium difficile strains were isolated.

Solithromycin is a novel fluoroketolide with high activity against bacteria associated with community-acquired respiratory tract infections as well as gonorrhea. However, data on the activity of solithromycin against anaerobic bacteria from the normal intestinal microbiota are scarce. In this study, 1024 Gram-positive and Gram-negative anaerobic isolates from the normal intestinal microbiota were analyzed for in-vitro susceptibility against solithromycin and compared to azithromycin, amoxicillin/clavulanic acid, ceftriaxone, metronidazole and levofloxacin by determining the minimum inhibitory concentration (MIC). Solithromycin was active against Bifidobacteria (MIC50, 0.008 mg/L) and Lactobacilli (MIC50, 0.008 mg/L). The MIC50 for Clostridia, Bacteroides, Prevotella and Veillonella were 0.5, 0.5, 0.125 and 0.016 mg/L, respectively. Gram-positive anaerobes were more susceptible to solithromycin as compared to the other antimicrobials tested. The activity of solithromycin against Gram-negative anaerobes was equal or higher as compared to other tested agents.

The study aimed to determine the effects of a single-dose antibiotic prophylaxis on normal oral microflora. A single dose of 2 g amoxicillin was given to 29 healthy volunteers. Saliva was collected before antibiotic administration (day 1), and again on days 2, 5, 10, 17 and 24 and subjected to culturing and antibiotic sensitivity analysis. Twenty-one per cent (6/29) of the individuals carried penicillin-V- and amoxicillin-resistant viridans streptococci before antibiotic administration. After a single dose of amoxicillin there was a significant reduction in Streptococcus salivarius on days 2 and 5, a significant reduction in other viridans streptococci on day 2 and the proportion of viridans streptococci with reduced susceptibility to amoxicillin was significantly increased on days 2 and 5. A single dose of amoxicillin can cause an ecological disturbance and induce selection of resistant strains in the oral microflora.

Objective:Millettiapachycarpais a member of the Fabacea family and our object has been set to examine the anti-oxidant and anti-inflammatory endeavor of this plant. This plant has been reported as potential anti-inflammatory agent previously.Materials and Method: DPPH free radical scavenging and reducing power assay was carried out to assess the electron donating capability of the methanolic crude extract of the specimen. A quantitative analysis has been made to measure phenolic and flavonoid content. The anti-inflammatory potentiality of methanolic extract of M. pachycarpa has been determined via carrageenan-induced paw edema assay in rats.Results: The IC50 value estimated was, 196.47 ± 2.061 μg/ml, which is a very much promising result. From quantitative assessment, sample extract reported very good number of phenolic and flavonoid measurement, 41.23 ± 1.527 mg equivalent gallic acid per gram and 110.33 ± 2.255 mg equivalent rutin per gram, respectively. The studied specimen showed expected dose dependent result in anti-inflammatory assay. At the dose of 300 mg/kg the extract showed maximum inhibitory effect (61.36% at 2 hour; P

Telavancin is a new lipoglycopeptide antibiotic for the treatment of Gram-positive infections. It has a dual mechanism of action by inhibiting bacterial cell wall synthesis and disrupting the bacterial plasma membrane. The purpose of the present study was to investigate the effect of administration of telavancin on the human intestinal microflora. Thirteen healthy subjects (six males and seven females; age range 18-40 years) received 10mg/kg body weight telavancin by intravenous infusion over a 60-min period once every 24h for 7 days. Plasma and urine were collected on Days 5, 6 and 7 for pharmacokinetic analysis of telavancin. Faecal samples were collected on Days -1 (pre-dose), 2, 5, 7, 9, 14 and 21. Faecal specimens were cultured on non-selective and selective media. Different colony types were counted, isolated in pure culture and identified to genus level. No measurable concentrations of telavancin were found in faeces. No significant effects on the number of Enterobacteriaceae, enterococci, Candida albicans, bifidobacteria, lactobacilli, clostridia and Bacteroides spp. were observed during the study period. No Clostridium difficile strains or toxins were found. No new colonising aerobic and anaerobic Gram-positive bacteria with telavancin minimum inhibitory concentrations of ≥ 2 mg/L were found. Based on the microbiological data, telavancin has no significant ecological impact on the human intestinal microflora.

Ciprofloxacin is a well-known fluoroquinolone, active in vitro against most Gram-negative and Gram-positive bacteria. The purpose of the present study was to evaluate the ecological effects of an orally administered extended-release formulation of ciprofloxacin in comparison with an immediate-release formulation of ciprofloxacin on the normal human intestinal microflora. Thirty-six healthy female subjects were included in the study. the extended-release formulation of ciprofloxacin was given as 500 mg once daily and the immediate-release formulation as 250 mg twice daily. The treatment period was 3 days. the microbiological investigation was blinded with respect to treatment. Mean fecal concentration in the volunteers receiving the extended-release formulation ciprofloxacin was 453 mg/kg and in the immediate-release formulation ciprofloxacin volunteers, the mean fecal concentration was 392 mg/kg. The numbers of Escherichia coli were significantly suppressed while the enterococci decreased moderately in both treatment groups. No toxigenic Clostridium difficile strains were found. No major differences were observed between the two studied formulations on the normal human intestinal microflora.

DOI: http://dx.doi.org/10.3329/ibmcj.v2i1.17309 IBMC J 2011; 2(1): 08-10

Aim To elucidate the origin of Enterococcus faecalis isolated from secondary root canal infections and the possibility for a foodborne transmission by comparing them to strains recovered from food, blood and stool regarding putative virulence factors and antibiotic susceptibility profiles, where strains from common origin were hypothesized to harbour similar characteristics. Methodology A total of 108 E. faecalis strains recovered in the county of Stockholm, Sweden, were screened using PCR for putative virulence factors esp, cylA, gelE/gelatinase-negative phenotype (ef1841/fsrC), efaA, ace and asa1. The minimum inhibitory concentration (MIC) for ampicillin, piperacillin–tazobactam, imipenem, gentamicin, vancomycin, ciprofloxacin and linezolid was determined using the agar dilution method. Results Next to strains from blood, the food isolates presented the highest average number of virulence determinants and were frequently enriched with asa1 coding for aggregation substance. None of the endodontic strains carried cylA, and the gelatinase-negative phenotype caused by a deletion dominated the group. Altogether, the most prevalent genes were gelE, efaA and ace, and a combination of them was equally present in approximately 80% of the strains from food, stool and root canals in comparison with 43.3% of the blood isolates. High-level resistance to ciprofloxacin and gentamicin was observed in 30% of the blood isolates, whereas the isolates from other origins, with single exceptions, were susceptible to all tested antibiotics. Conclusions Evidence for a foodborne transmission, explaining the high reported prevalence of E. faecalis in root filled teeth, could not be determined based on the similarities in virulence factor patterns and antibiotic susceptibility. The only linkage between isolates from food and root canals consisted of a shared common combination of the genes gelE, efaA and ace. The high occurrence of putative virulence traits in food isolates questions the safety of E. faecalis in food products.

Ceftazidime/avibactam is a new combination of the antibiotic ceftazidime with the novel, non-β-lactam β-lactamase inhibitor avibactam. The purpose of the present study was to investigate the effect of ceftazidime/avibactam on the human intestinal microbiota following intravenous (i.v.) administration. Twelve healthy volunteers received ceftazidime/avibactam by i.v. infusion (2000mg ceftazidime and 500mg avibactam) given over 2h every 8h on Days 1-6 (inclusive) and a single dose on Day 7. Faecal samples were collected on Day-1 (pre-dose), during administration on Days 2, 5 and 7 and post-dose on Days 9, 14 and 21. Samples were cultured on non-selective and selective media. The number of Escherichia coli and other enterobacteria decreased significantly during administration of ceftazidime/avibactam, whereas the number of enterococci increased. Lactobacilli, bifidobacteria, clostridia and Bacteroides decreased significantly during ceftazidime/avibactam administration. The effects on lactobacilli, bifidobacteria and Bacteroides were similar in the 12 volunteers, whilst clostridia showed different ecological patterns among the volunteers. Toxigenic Clostridium difficile strains were detected in five volunteers during the study. In four of the volunteers, loose stools were reported as adverse events. Plasma samples were collected on Days -1, 2, 5 and 7. Ceftazidime and avibactam concentrations in plasma (ceftazidime 0-224.2mg/L of plasma and avibactam 0-70.5mg/L of plasma) and faeces (ceftazidime 0-468.2mg/kg of faeces and avibactam 0-146.0mg/kg of faeces) were found by bioassay. New colonising resistant clostridia were found in five volunteers and lactobacilli were found in three volunteers.

Due to the spread of resistance, antibiotic exposure receives increasing attention. Ecological consequences for the different niches of individual microbiomes are, however, largely ignored. Here, we report the effects of widely used antibiotics (clindamycin, ciprofloxacin, amoxicillin, and minocycline) with different modes of action on the ecology of both the gut and the oral microbiomes in 66 healthy adults from the United Kingdom and Sweden in a two-center randomized placebo-controlled clinical trial. Feces and saliva were collected at baseline, immediately after exposure, and 1, 2, 4, and 12 months after administration of antibiotics or placebo. Sequences of 16S rRNA gene amplicons from all samples and metagenomic shotgun sequences from selected baseline and post-antibiotic-treatment sample pairs were analyzed. Additionally, metagenomic predictions based on 16S rRNA gene amplicon data were performed using PICRUSt. The salivary microbiome was found to be significantly more robust, whereas the antibiotics negatively affected the fecal microbiome: in particular, health-associated butyrate-producing species became strongly underrepresented. Additionally, exposure to different antibiotics enriched genes associated with antibiotic resistance. In conclusion, healthy individuals, exposed to a single antibiotic treatment, undergo considerable microbial shifts and enrichment in antibiotic resistance in their feces, while their salivary microbiome composition remains unexpectedly stable. The health-related consequences for the gut microbiome should increase the awareness of the individual risks involved with antibiotic use, especially in a (diseased) population with an already dysregulated microbiome. On the other hand, understanding the mechanisms behind the resilience of the oral microbiome toward ecological collapse might prove useful in combating microbial dysbiosis elsewhere in the body., IMPORTANCE Many health care professionals use antibiotic prophylaxis strategies to prevent infection after surgery. This practice is under debate since it enhances the spread of antibiotic resistance. Another important reason to avoid nonessential use of antibiotics, the impact on our microbiome, has hardly received attention. In this study, we assessed the impact of antibiotics on the human microbial ecology at two niches. We followed the oral and gut microbiomes in 66 individuals from before, immediately after, and up to 12 months after exposure to different antibiotic classes. The salivary microbiome recovered quickly and was surprisingly robust toward antibiotic-induced disturbance. The fecal microbiome was severely affected by most antibiotics: for months, health-associated butyrate-producing species became strongly underrepresented. Additionally, there was an enrichment of genes associated with antibiotic resistance. Clearly, even a single antibiotic treatment in healthy individuals contributes to the risk of resistance development and leads to long-lasting detrimental shifts in the gut microbiome.

Thirty healthy subjects (15 males and 15 females) were randomly assigned in three groups and clindamycin (150 mg qid) or ciprofloxacin (500 mg bid) or placebo was given for a 10-day period. Skin, nasal, saliva, faeces samples were collected at day – 1, day 11, 1 month, 2 months, 4 months and 12 months post administration for microbiological analysis. Ciprofloxacin or clindamycin had no impact on the anaerobic skin microbiota and the proportions of antibiotic resistant anaerobic bacteria were similar as in the placebo group. Ciprofloxacin had impact on the Propionibacterium acnes in the nasal microbiota that normalized after 1 month, however, ciprofloxacin-resistant P. acnes strains increased at month 2 and month 12. Clindamycin had no impact on the nasal microbiota. In the oropharyngeal microbiota, a higher proportion of ciprofloxacin resistant Veillonella was found, it lasting up to 12 months post dosing. In the clindamycin group, clindamycin-resistant Prevotella spp. were found in increased proportions compared to placebo at various time points except month 4 in the saliva samples. The relative proportion of ciprofloxacin-resistant Bifidobacteria increased in the faecal samples on day 11, 1 month, 4 months and 12 months post dosing compared to placebo. The proportion of clindamycin-resistant Bacteroides spp. increased at 1, 2, 4 and 12 months post dosing compared to placebo in the faecal samples. No Clostridium difficile was recovered from any of the samples from any of the volunteers at any visit. The concentrations of ciprofloxacin or clindamycin in the faeces were higher than the MICs for most of the organisms present in the normal microbiota. No obvious correlation between the groups in resistant patterns for anaerobic bacteria was observed. In conclusion, based on the microbiological data of the microbiota as well as the results of the bioassays for ciprofloxacin and clindamycin concentrations in the faecal samples, oral administration of ciprofloxacin and clindamycin has an impact on the anaerobic microbiota and may have a long-term effect on the development and persistence of antibiotic-resistant anaerobes in the normal microbiota.

One hundred fourteen Clostridium difficile strains were collected from 67 patients and analyzed for the presence of C. difficile toxin B by the cell cytotoxoicity neutralization assay, genes for toxin A, toxin B, binary toxin and Tcd C deletion by PCR. All strains were also PCR-ribotyped. The MICs of the isolates were determined against MCB3681 and nine other antimicrobial agents by the agar dilution method. All isolates were positive for toxin B as well as for toxin A and B genes. In addition, 13 isolates were positive for the binary toxin genes. Thirty-two different ribotypes were identified. No strain of ribotype 027 was found. All 114 isolates were sensitive to MCB3681 (0.008–0.5 mg/l), cadazolid (0.064–0.5 mg/l), fidaxomicin (0.008–0.125 mg/l), metronidazole (0.125–2 mg/l), vancomycin (0.125–1 mg/l) and tigecycline (0.032–0.25 mg/l). Three isolates were resistant to linezolid (8 mg/l), 12 isolates were resistant to moxifloxacin (8–32 mg/l), 87 isolates were resistant to clindamycin (8–256 mg/l) and 107 isolates were resistant to ciprofloxacin (8–256 mg/l). No association between toxins A, B and binary toxin, ribotypes and the sensitivity to MCB3681 could be found. MCB3681 has a potent in vitro activity against C. difficile .

MCB3837 is a novel, water-soluble, injectable prodrug that is rapidly converted to the active substance MCB3681 in vivo following intravenous (i.v.) administration. Both MCB3837 and MCB3681 are oxazolidinone-quinolone hybrid molecules. The purpose of the present study was to investigate the effect of MCB3681 on the human skin, nose, oropharyngeal and intestinal microbiota following administration of MCB3837. Twelve healthy male subjects received i.v. MCB3837 (6 mg/kg body weight) once daily for 5 days. Skin, nose, saliva and faecal samples were collected on Day -1 (pre dose), during administration on Days 2 and 5, and post dose on Days 8, 12 and 19. Micro-organisms were identified to genus level. No measurable concentrations of MCB3681 were found in any saliva samples or in the faecal samples on Day -1. On Day 2, 10 volunteers had faecal MCB3681 concentrations between 16.5 mg/kg faeces and 275.1mg/kg faeces; no MCB3681 in faeces could be detected in two of the volunteers. On Day 5, all volunteers had faecal concentrations of MCB3681 ranging from 98.9 to 226.3 mg/kg. MCB3681 caused no ecological changes in the skin, nasal and oropharyngeal microbiota. The numbers of enterococci, bifidobacteria, lactobacilli and clostridia decreased in the intestinal microbiota during administration of the drug. Numbers of Escherichia coli, other enterobacteria and Candida were not affected during the study. There was no impact on the number of Bacteroides. The faecal microbiota was normalised on Day 19. No new colonising aerobic or anaerobic Gram-positive bacteria with MCB3681 minimum inhibitory concentrations of ≥4 mg/L were found.

Antibiotic-resistant bacteria have emerged due to the selective pressure of antimicrobial use in humans and animals. Water plays an important role in dissemination of these organisms among humans, animals and the environment. We studied the antibiotic resistance patterns among 493 Escherichia col/isolates from different aquatic environmental sources collected from October 2008 to May 2009 in Leon, Nicaragua. High levels of antibiotic resistance were found in E. coli isolates in hospital sewage water and in eight of 87 well-water samples. Among the resistant isolates from the hospital sewage, ampicillin, chloramphenicol, ciprofloxacin, nalidixic acid, trimethoprim-sulphamethoxazole was the most common multi-resistance profile. Among the resistant isolates from the wells, 19% were resistant to ampicillin, ceftazidime, ceftriaxone, cefotaxime, chloramphenicol, ciprofloxacin, gentamicin, nalidixic acid and trimethoprim-sulphameth-oxazole. E. coli producing ESBL and harbouring bla CTX-M genes were detected in one of the hospital sewage samples and in 26% of the resistant isolates from the well-water samples. The bla CTX-M-9 group was more prevalent in E. coli isolates from the hospital sewage samples and the bla CTX-M-1 group was more prevalent in the well-water samples.

Ceftobiprole is a new broad-spectrum pyrrolidinone cephem active against meticillin-resistant Staphylococcus aureus , vancomycin-resistant Enterococcus faecalis and Gram-negative bacteria such as Enterobacteriaceae and Pseudomonas spp. The purpose of the present study was to investigate the effect of administration of ceftobiprole on the normal intestinal microflora. Twelve healthy subjects (six males and six females) aged 20–31 years received ceftobiprole 500mg by intravenous infusion every 8h for 7 days. Plasma samples were collected on Days −1, 1, 4, 7, 10, 14 and 21 for determination of drug concentration by biological and chemical methods. Faecal samples were collected on Days −1, 2, 4, 7, 10, 14 and 21. For analysis of the microflora, faecal specimens were cultured on non-selective and selective media. Different colony types were counted, isolated in pure culture and identified to genus level. All new colonising aerobic and anaerobic bacteria were tested for susceptibility to ceftobiprole. Plasma concentrations of ceftobiprole 10min after completion of infusion were as follows: Day 1, 14.7–23.6mg/L; Day 4, 15.9–24.5mg/L; and Day 7, 15.9–23.9mg/L. No ceftobiprole was detected in plasma on Days −1, 10, 14 and 21. No measurable concentrations of ceftobiprole were found in faeces on Days −1, 2, 4, 7, 10, 14 and 21. There were minor changes in the numbers of enteric bacteria, enterococci and Candida albicans and there were moderate changes in the numbers of bifidobacteria, lactobacilli, clostridia and Bacteroides spp. during the same period. No Clostridium difficile strains or toxins were found. No new colonising aerobic and anaerobic bacteria with ceftobiprole minimum inhibitory concentrations of ≥4mg/L were found. Ceftobiprole had no significant ecological impact on the human intestinal microflora.

BACKGROUND: Cataract is the leading cause of blindness in the world, and blindness from cataract is particularly common in low-income countries. The aim of this study is to explore the impact of cataract surgery on daily activities and time-use in Kenya, Bangladesh and the Philippines. METHODS/PRINCIPAL FINDINGS: A multi-centre intervention study was conducted in three countries. Time-use data were collected through interview from cases aged >or=50 years with visually impairing cataract (VA or=6/18). Cases were offered free/subsidized cataract surgery. Approximately one year later participants were re-interviewed about time-use. At baseline across the three countries there were 651 cases and 571 controls. Fifty-five percent of cases accepted surgery. Response rate at follow up was 84% (303 out of 361) for operated cases, and 80% (459 out of 571) for controls. At baseline, cases were less likely to carry out and spent less time on productive activities (paid and non-paid work) and spent more time in "inactivity" compared to controls. Approximately one year after cataract surgery, operated cases were more likely to undertake productive activities compared to baseline (Kenya from 55% to 88%; Bangladesh 60% to 95% and Philippines 81% to 94%, p

Effects of fenugreek (Trigonella foenugraecum Linn) on serum lipid profile in hypercholesteremic type 2 diabetic patients were studied. Administration of fenugreek seed powder of 25 g orally twice daily for 3 weeks and 6 weeks produces significant (p

Background Poverty and blindness are believed to be intimately linked, but empirical data supporting this purported relationship are sparse. The objective of this study is to assess whether there is a reduction in poverty after cataract surgery among visually impaired cases. Methodology/Principal Findings A multi-centre intervention study was conducted in three countries (Kenya, Philippines, Bangladesh). Poverty data (household per capita expenditure – PCE, asset ownership and self-rated wealth) were collected from cases aged ≥50 years who were visually impaired due to cataract (visual acuity

The present study was undertaken to evaluate methotrexate induced early hepatotoxicity in rheumatoid arthritis patients. This study was carried out on ARA criteria fulfilling 35 diagnosed rheumatoid arthritis patients of either gender, aged 20-60 years, presented in Medicine Department of Rajshahi Medical College Hospital, Rajshahi from July 2007 to June 2008. Patients with normal liver function tests and HBsAg and anti-HCV negative cases were given oral Methotrexate (10-25mg/week) for 3 months. Baseline level of SGPT, serum bilirubin and prothrombin time was 10.07±0.32u/l, 0.59±0.03mg/dl and 12.97±0.34 seconds respectively. After 3 months of methotrexate therapy, level of SGPT, serum bilirubin and prothrombin time was found to be 12.60±1.16 u/l, 0.70±0.06mg/dl and 13.87±0.45 seconds respectively. During methotrexate therapy SGPT level changed significantly (p