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Article
Soft Tissue Infections associated Bacteria
جراثيم مصاحبة لخمج الأنسجة الرخوة

Authors: Imad, S. Mahmoud عماد شكر --- Auroba K Abbass --- Ameera Abdulameer Mahe اميره عبدالامير
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2006 Volume: 19 Issue: 4 Pages: 349-353
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractObjectives: This work aimed to isolate and identify microorganisms from different clinical conditions; it is also to do anti microbial sensitivity test to recommend the most effective antimicrobial agents.Methodology: Each specimen collected from different sites of the body was subjected to well known microbiological methods for isolation and identification of certain microorganisms.All isolates were tested for sensitivity or resistance to the commonly used drugs employing Kirby-Bauer technique (1). Results: Out of the total samples studied (168) it was possible to isolate and identify 124 microorganisms from which Gram-Positive bacteria represented 50 isolates (62%) while Gram-negative bacteria represented 74 isolates (91.76%).From the Gram-positive bacteria it has been found that S. aureurs represented 25 (20.16%) isolates followed by' S. epidermidis 16 (12.90%) isolates.P. aeruginosa which is Gram-negative bacteria ranks the highest among all isolates representing 30 isolates (24.19%) followed by K. pneumonia 15 (12.90%) and proteus spp 14 (11.29%) respectively.No site of specimens was free from serratia although it is with low percentage ranging from (1.48% - 0.74%)Antimicrobial sensitivity test revealed that S. pneumonia is highly sensitive toClindamycin 90% and to Amoxicillin 90% respectively and less sensitive to vancomycin 60%.K. pneumonia revealed resistance to chloramphenicol 2% and to each of the drugs lincomycin, cloxacillin and erythromycin 40% respectively. P. aeruginosa showed high resistance to most of the drugs used In this study ranged between 10-52%.It reveals sensitivity to cefatriaxon 90% and less sensitive to ceftazidine 80% Serratia marcessens showed good sensitivity to all antimicrobial used in this study except co-trimoxazole to which it is resistant.Conclusion: Grams- negative bacteria are the predominant from which P. aeroginosa rank the highest among all isolates. No sit of specimens was free from serratia mercessens. S. pneumonia is highly sensitive to clindomycine (90%) P. aeroginosa showed high resistaice to most of the drugs used in this study.

الملخص:الهدف : يهدف البحث الى عزل وتشخيص جراثيم مصاحبة لخمج الانسجة الرخوة من مناطق مختلفة من الجسم وكذلك لدراسة حساسية او مقاومة الجراثيم المعزولة للمضادات الحياتية لغرض التوجيه باستعمال المضاد الحيوي و التأثير الفعال.طرق البحث : كل نموج جمع من مناطق مختلفة من الجسم عومل بالطرق المايكروبايولوجية المعروفة لغرض عزل وتشخيص الجراثيم. كافة العزلات بعد تشخيصها تعرضت لفحص الحساسية للمضادات الحياتية استعمال طريقة-Bauer Kirby.النتائج : ان المجموع الكلي للنماذج المدروسة بلغت 168نموا حيث تم بالامكان عزل وتصنيف (124) عزلة منها جراثيم الموجبة لصيغة غرام والتي مثلت 50 عزلة (بنسبة 62%) بينما الجراثيم السالبة لصيغة غرام مثلت 74 عزلة ( بنسبة 76,91%) من الجراثيم الموجبة لصيغة غرام.وجد ان العنقودية الذهبية S.aureus قد مثلت 25 عزلة بنسبة (16,20%) تبعها العنقودية البشروية S.epidermidis 16 عزلة بنسبة 12,90).P.aerurginosa الزائفة الزنجارية التي تعتبر هي جراثيم سالبة لصيغة غرام كانت المرتبة الاعلى من بين جميع العزلات حيث مثلت 30 عزلة (بنسبة 24,19) تبعها الكليبسلا الرئوية K.pneumonia 15 عزلة (12,9%) والمتقلبة proteusspp 14 عزلة وبنسبة (11,29%) على التوالي.لم يكن أي موقع من العينات خالي من Serratia وبرغم من نسبتها الواطئة التي تتراوح من (1,48-0,74%)اظهر اختبار الحساسية للمضادات الحيوية ان S.pneumonia كانت عالية الحساسية للClindamycin ( بنسبة 90%) و الاموكسسلين وبنسبة ( 90% )على التوالي واقل حساسية للفانوكوميسين وبنسبة (60% )ا ظهرت K.pneumonia مقاومة للكلور و الفينيكول وبنسبة (2% )وان كل من المضادين اللنكومايسين و الكاوكسيلين و الارثرمايسين و بنسبة 40% على التوالي. اظهرت P.aeroginosa مقاومة عالية لمعظم المضادات المستخدمة في هذه الدراسة تراوحت بين 10-52% واظهرت حساسية للسيلفاتريكسون بنسبة 90% واقل حساسية للسيفتازدين بنسبة 80%.Serratia marcessens اظهرت حساسية جيدة لجميع المضادات الحيوية المستخدمة في هذه الدراسة باستثناء نو-ترايموكسازول والتي كانت مقاومة له.الاستنتاج: يتنتج من البحث بأن جراثيم سالبة - الكرام هي الاوسع انتشارا (91,76% )ومنها الزائفة الزنجارية التي تمثل النسبة الاعلى من بين جميع العزلات (24,19% ). لا يوجد موضع لنموذج بعيد خال من Serratia mercessexs على الرغم من انها توجد بنسبة ضئيلة. السبحية الرئوية اظهرت حساسية عالية جدا للمضاد الحيوي كلندامايسين ( 90%).الزائفة الزنجارية اظهرت مقاومة شديدة لاغلبية المضادات المستعملة في البحث.

Keywords

Bacteria --- soft tissue --- antibiotic


Article
Soft Tissue Sarcomas: A review of 40 cases

Author: Nada S. Al-Rubai’ee
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2006 Volume: 5 Issue: 1 Pages: 87-93
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Soft tissue sarcoma (STS) represents a heterogeneous group of rare malignant tumors. Many diagnostic problems and difficulties are often encountered in the differential diagnosis of these tumors. The variety of appearance gives a wide range of tumor types and subtypes with a high discrepancy rate in tumor typing among pathologists. METHODS: This study was conducted at the Military Medical Academy (EGYPT) during the period from (1989-1990). The study aimed to reexamine a routinely processed H and E stained slides of cases previously diagnosed as STS by a group of pathologist and match the old and new diagnoses, with the application of some special stains; histochemical and immunohistochemical, then evaluate the results. Forty cases previously diagnosed as STS were reexamined and classified according to the criteria of Enzinger and Weiss. A descriptive or morphological classification was also used; as spindle, round, myxoid and pleomorphic STS. The results were compared to, and matched with the previous diagnoses. Histochemical stains used are, Picro Sirius red (PSR), Masson trichrome (MT), and Periodic-acid schiff stain (PAS). Myoglobin was used as immunohistochemical marker for the detection of cross-striated muscle cell differentiation by peroxidase antiperoxidase method (PAP). RESULTS: Agreement in diagnosis between the previous and the recent diagnosed STS was found to be 47.5%. For spindle cell malignant tumors the agreement was 58.8%, while for round cell malignant tumors was 33.3%. Agreement in diagnosis in mixed malignant soft tissue tumors was 62.5%. PSR and MT demonstrate the amount and distribution of collagen. MT also demonstrates muscle fibers. Using Myoglobin immunohistochemical marker in the previously diagnosed STS: one out of four cases diagnosed as Rhabdomyosarcomas gave a positive result, while two cases from the unsuspected group gave positive results. In the recently diagnosed tumors: all cases diagnosed as Rhabdomyosarcoma gave positive results, while from the unsuspected group one gave positive result. CONCLUSION: While the ordinary H and E stain will suffice to permit recognition of many of STS, it will not do so for all. Limitation of diagnosis of these tumors, especially the rare ones, to specialized centers or highly qualified pathologists is recommended. Histochemical stains are supportive rather than exclusive for the diagnosis of STS. Myoglobin immunohistochemical marker could be used to aid in the diagnosis of rhabdomyosarcomas. Definite diagnosis of many STS needs further special stains and/or electron microscopy and other sophisticated procedures

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