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  Citation statistics : Table of Contents
   2016| January-March  | Volume 6 | Issue 1  
    Online since January 8, 2016

 
 
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ORIGINAL ARTICLE
Phenotypic detection and molecular characterization of beta-lactamase genes among Citrobacter species in a tertiary care hospital
Ashok Kumar Praharaj, Atul Khajuria, Mahadevan Kumar, Naveen Grover
January-March 2016, 6(1):17-27
DOI:10.4103/2231-0770.173578  PMID:26952135
Objective: To examine the distribution, emergence, and spread of genes encoding beta-lactamase resistance in Citrobacter species isolated from hospitalized patients in a tertiary care hospital. Methods: A prospective study was conducted in a 1000-bed tertiary care center in Pune, India from October 2010 to October 2013. A total of 221 Citrobacter spp. isolates were recovered from clinical specimens from different patients (one isolate per patient) admitted to the surgical ward, medical ward and medical and surgical Intensive Care Units. Polymerase chain reaction (PCR) assays and sequencing were used to determine the presence of beta-lactamase encoding genes. Conjugation experiments were performed to determine their transferability. Isolate relatedness were determined by repetitive element based-PCR, enterobacterial repetitive intergenic consensus-PCR and randomly amplified polymorphic DNA. Results: Among 221 tested isolates of Citrobacter spp. recovered from various clinical specimens, 179 (80.9%) isolates showed minimum inhibitory concentration (MIC) >4 μg/ml against meropenem and imipenem. One hundred and forty-five isolates with increased MICs value against carbapenems were further processed for molecular characterization of beta-lactamase genes. Susceptibility profiling of the isolates indicated that 100% retained susceptibility to colistin. Conjugation experiments indicated that blaNDM-1was transferable via a plasmid. Conclusion: The ease of NDM-1 plasmid transmissibility may help their dissemination among the Citrobacter species as well as to others in Enterobacteriaceae. Early detection, antimicrobial stewardship and adequate infection control measures will help in limiting the spread of these organisms.
  2 2,937 399
CASE REPORT
Image-guided ureteral reconstruction using rendezvous technique for complex ureteric transection after gunshot injuries
Mohammad Arabi, Abdulaziz Mat'hami, Mohammad T Said, Muhammad Bulbul, Maurice Haddad, Aghiad Al-Kutoubi
January-March 2016, 6(1):28-30
DOI:10.4103/2231-0770.173581  PMID:26955601
Management of complex ureteric transection poses a significant clinical challenge, particularly after gunshot injuries due to marked distortion of anatomy and associated tissue loss. We report two cases of total ureteric transection due to gunshot injury successfully repaired using fluoroscopy-guided rendezvous procedure and double J stent placement. This minimally invasive approach may offer a safe and effective technique to repair complete ureteral transection and obviate the need for complex surgical procedures.
  1 2,423 260
REVIEW ARTICLES
The current approach of atrial fibrillation management
Anish Amin, Aseel Houmsse, Abiodun Ishola, Jaret Tyler, Mahmoud Houmsse
January-March 2016, 6(1):8-16
DOI:10.4103/2231-0770.173580  PMID:26955600
Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. Aging populations coupled with improved outcomes for many chronic medical conditions has led to increases in AF diagnoses. AF is also known to be associated with an increased risk of adverse events such as transient ischemic attack, ischemic stroke, systemic embolism, and death. This association is enhanced in select populations with preexisting comorbid conditions such as chronic heart failure. The aim of this review is to highlight the advances in the field of cardiology in the management of AF in both acute and long-term settings. We will also review the evolution of anticoagulation management over the past few years and landmark trials in the development of novel oral anticoagulants (NOACs), reversal agents for new NOACs, nonpharmacological options to anticoagulation therapy, and the role of implantable loop recorder in AF management.
  1 6,197 1,054
EDITORIAL
Avicenna Journal of Medicine: 5-year milestones
Mohammad Arabi, Bassel Atassi, Abdulrahman Masrani, Fares Alahdab, Ahmad Al-Moujahed, Haitham Arabi
January-March 2016, 6(1):1-2
DOI:10.4103/2231-0770.173582  PMID:26955598
  - 2,280 276
REVIEW ARTICLES
Analytic hierarchy process as module for productivity evaluation and decision-making of the operation theater
Abdelrahman E. M Ezzat, Hesham S Hamoud
January-March 2016, 6(1):3-7
DOI:10.4103/2231-0770.173579  PMID:26955599
The analytic hierarchy process (AHP) is a theory of measurement through pairwise comparisons and relies on the judgments of experts to derive priority scales, these scales that measure intangibles in relative terms. The aim of the article was to develop a model for productivity measurement of the operation theater (OT), which could be applied as a model for quality improvement and decision-making. AHP is used in this article to evolve such a model. The steps consist of identifying the critical success factors for measuring the productivity of OT, identifying subfactors that infl auence the critical factors, comparing the pairwise, deriving their relative importance and ratings, and calculating the cumulative effect according to the attributes in OT. The cumulative productivitycan be calculated by the end and can be compared Ideal productivity to measure the productive of OT in percentage fraction. Hence, the productivity could be calculated. Hence, AHP is a very useful model to measure the productivity in OT.
  - 2,375 292
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