R ecent reports have shown that infections with nontuberculous mycobacteria (NTM) are increasing worldwide and often are difficult to diagnose and to treat (1-3). Consequently, improved diagnostics are needed. Clinical and Laboratory Standards Institute (CLSI) guidelines (4) describe methods for assessing the ability of transport devices to maintain microorganisms in a viable condition for up to 48 h during transport at room temperature (RT) (20 to 25°C) and refrigerator temperature (FT) (2 to 8°C). There are no formal published data on the viability of NTM using swab-based systems; however, a study conducted only at RT was presented at the 110th General Meeting of the American Society for Microbiology (5). The present investigation was designed, using CLSI methods, for evaluation of the Copan ESwab transport system (Copan Diagnostics Inc., Murrieta, CA) for NTM species commonly causing skin and soft tissue infections. Nine NTM clinical isolates (Mycobacterium porcinum, Mycobacterium abscessus subsp. abscessus, Mycobacterium senegalense, Mycobacterium mucogenicum, Mycobacterium fortuitum, Mycobacterium avium, Mycobacterium chelonae, Mycobacterium marinum, and Mycobacterium haemophilum), which had been previously identified using the Bruker MALDI Biotyper CA system (Bruker Daltonics Inc., Billerica, MA, USA), and Nocardia asteroides ATCC 19247 were evaluated in this study. After 5 to 7 days of growth on blood agar plates, a heavy stock suspension of each organism was prepared in 4.0 ml of sterile saline and vigorously vortex mixed. From this, suspensions were prepared in triplicate and adjusted to match a 0.5 MacFarland turbidity standard (1.5 ϫ 10 8 CFU/ml), using a Vitek nephelometer (6). Each suspension was serially diluted 1:10 in normal saline to obtain working suspensions of ϳ1.5 ϫ 10 7 CFU/ml to ϳ1.5 ϫ 10 3 CFU/ml. One hundred microliters of each working suspension was placed in 18 wells of a microtiter plate. Flocked swabs were placed in the wells, allowed to absorb the inoculum for ϳ10 s, and returned to their respective labeled ESwab transport vials. Each microorganism/device combination was assayed in triplicate at three time points (0, 24, and 48 h). The 0-h swabs were removed from the transport vials, containing 1.0 ml of Amies broth, after ϳ15 min of incubation and discarded; 100 l of the inoculum was plated onto a Middlebrook 7H10 agar plate, streaked for isolation, and incubated at 30°C in O 2. The remaining ESwabs were incubated at RT or FT for 24 or 48 h. Results were calculated by taking an average of the colony counts from triplicate tests. Counts at 24 and 48 h were compared to 0-h reference counts. Results are summarized in Table 1. The CLSI criterion for acceptable recovery using the roll plate method (i.e., Ն5 colonies recovered from the dilution yielding a baseline count closest to 250 colonies [1]) was met for 6 of the 10 organisms tested at 24 h in RT incubation. Of these 6, 5 also met the CLSI criterion at 48 h at RT. Another 4 NTM Citation Gandhi B, Woods G, Mazzulli T. 2020. Recovery ...
Congenital heart and vessel malformations occur in 5–8 per 1000 live births, resulting in an occurrence of around 0.7%. Some of these malformations (10%–15%) do not need correction. The key aims of recovery are to remove impairments, disabilities, and disabilities, improve quality of life (QOL), and minimize disease-related morbidity and postoperative disease. Aim: This study aimed to investigate the effect of exercise programs of 2 weeks on the outcomes of functional capacity and QOL in a postoperative surgery. A 12-year ventricular septal defect survivor underwent primary treatment consisting of open-heart surgery. The patient was given an exercise program comprising techniques of clearance, re-expansion maneuver, vibration, percussion, compression, manual hyperinflation, positioning, postural drainage, cough stimulation, aspiration, breathing exercise, and increased expiratory flow mobilization. For 2 week (three times/day), functional capacity and QOL were measured before and after completion of the exercise program. Considerable improvement in functional capacity and QOL was observed after 2 weeks of the multiple techniques and exercise intervention. The complementation intervention was found to be effective for improving various physiological aspects associated with open-heart surgery. This case study concluded that the complementation intervention was effective for improving various physiological aspects associated with open-heart surgery including QOL.
Anterior Cruciate Ligament injuries are one of the commonest injuries related to the knee joint. They can either be a ligament tear or a ligament sprain. They usually occur due to landing from a jump incorrectly, rapidly changing the direction of motion, sports injuries (direct collisions), and stopping suddenly. This type of injury requires conservative treatment and/or Anterior Cruciate Ligament Reconstruction (ACLR) surgery. In both cases, physiotherapy has been proven to be useful in the treatment and rehabilitation of the condition. Physiotherapy treatment aids in relieving the symptoms, strengthening, endurance and gait training. The patient came to the hospital with the complaints of there being a difficulty in walking without support. The pain was present as the patient tried to bend his right knee, the swelling was also present on the right knee and there was a restricted range of motion. All these complaints were present for 15 days. The patient was a post-operative case of ACLR. An X-ray and MRI scan showed these results. Physiotherapy interventions included educating the patient, reducing the swelling, reducing the pain using electrotherapy modalities, Range of Motion exercises for the right knee, strengthening and endurance exercises, and teaching normal gait pattern. The patient eventually gained an improved range of right knee movement, decreased pain, swelling and tenderness, and learned to walk with a normal gait pattern. The questionnaires and tests carried out pre and post-treatment showed a positive result.
<p class="abstract"><strong>Background:</strong> Anterior shoulder dislocation is one of the commonest dislocation of our body. We here by introduce a simple, safe, successful and easily reproducible “Chennai Handshake Technique” to relocate anterior dislocation of shoulder joint.</p><p class="abstract"><strong>Methods:</strong> This method was performed by a single surgeon on sixty cases (51 males, 9 females) of anterior shoulder dislocation with a mean age of 38 years (18 to 58 years) between 2008 to 2013 in tertiary care center. Among sixty patients, there were 12 cases (20%) of fresh dislocation and 48 cases (80%) of recurrent dislocation. It comprises of holding the hand in a classical double shake position and then giving a gentle longitudinal traction (stage I) followed with slow abduction and external rotation of arm (stage II), thus reducing the shoulder dislocation. Vertical oscillation may be a part of stage II in some cases before the external rotation.<strong></strong></p><p class="abstract"><strong>Results:</strong> The index time of patient presenting to the casualty ranged from one hour to 18hrs with a mean of 4.45 hrs. The reduction time ranged from 1 to 16 min with a mean of 5.6 min. 17 dislocations (28.3%) were reduced during stage I. 41 dislocations (68.3%) were reduced during stage II. 5 dislocations (12.1%) needed vertical oscillation during stage II. we failed in two cases (3.3%).</p><p><strong>Conclusions:</strong> No need of assistant, no need of anesthesia, no complications makes this technique, a more look back one.</p>
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