Medical science is one of the sectors which has faced rapid advancement in the past few years. But sadly, medical schools are still following the traditional curriculum where a wide gap between the pre-clinical and clinical phases prevails. Early clinical exposure is known to act as a bridge to this gap. It contributes to the overall development of naive medical students enhancing their communication skills, clinical skills, teamwork, empathy development, and motivation towards selfdirected learning and hence making them more competent for clinical years. So, as it reinforces the conventional didactic teaching-learning method it becomes a much-needed part for the students in preclinical years.
Introduction: Group A hemolytic Streptococcal infections has worldwide distribution among children and it poses an important problem globally. There is lack of baseline information regarding Group A hemolytic streptococci in school going children in the eastern part of Nepal. Objective: The study was conducted for assessing the carrier rate of Group A hemolytic streptococci in school going children in eastern part of Nepal. Methodology: This study was community based cross-sectional study. During the study of 9 months, a total of 518 patients (school-going children) from different school who were symptomatic as well as asymptomatic were enrolled. All samples were collected by rubbing quickly and thoroughly over either tonsils (or tonsillar fossa) and over the posterior wall of the pharynx using light pressure and were subjected to microbial analysis in the clinical Microbiology Laboratory. The specimens were inoculated immediately into Blood agar (BA) and MacConkey agar (MA) and were incubated at 37°C aerobically and were checked for growth after overnight incubation. The identification of bacterial isolates was carried out by Clinical and Laboratory Standards Institute (CLSI) guidelines with colonial morphology and staining reactions. Biochemical tests such as catalase, bacitracin sensitivity test (0.004 units) and Lancefield grouping (PastorexTM Strep) were performed. All the identified S. pyogenes isolates thus obtained were subjected to in vitro antibiotics sensitivity testing by using Kirby-Bauer disc- diffusion method as recommended by CLSI (2014). Results: During 9 months period total 518 throat swabs (303 male and 215 female)from school going children attending government and private school were collected after taking verbal consent and were cultured on blood agar and MacConkey agar.Streptococcus pyogenes was identified by using standard microbiological procedures. Antimicrobial susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion method. Group A streptococci (GAS) was isolated from 28 (5.4%) school going children, of which 15 (5%) were male and 13 (7%) were female. There was no significant sex difference in colonization of GAS (p>0.05). Majority of cases were asymptomatic. In this study it was observed that the sensitive drugs for GAS were Penicillin and their deravatives (100%), Ciproflocaxin (100%) and Azithromycin (100%) followed by Erythromycin (75%) and Cotrimoxazole (71.4%) (Table 9,10). Conclusion: The present preliminary study provides the base-line information on the GAS carriage rate and resistance trend among healthy school children. The present study showed that Penicillin and its derivatives should be used to treat a case of GAS pharyngitis and Azithromycin for those who are allergic to Penicillin. The present study also showed that Staphylococcus aureus as an equally important agent of pharyngitis and hence throat swab culture should be requested for appropriate therapy.
Spleen is an unusual site of metastasis. and is usually a sign of extensive disease. Splenic metastases from solid tumors, like colon cancers, are considered exceptional (1). The most common primary sources of splenic metastasis in cases of multi -visceral cancer are breast, lung, colorectal, melanoma and ovarian carcinomas and colorectal and ovarian carcinomas in cases of solitary splenic lesion (2,3). Berge reported that the incidence of splenic metastasis from colon and rectal carcinomas as 4.4% and 1.6%, respectively (4).It is still uncertain whether the rarity of splenic metastasis is due to the splenic immunological functions or the characteristic splenic anatomical position and its bloodstream state. The rarity of splenic metastasis from other organs may be due to the histological peculiarity of splenic sinusoidal architecture and the absence of splenic afferent lymphatics (5). The prevalence of splenic metastasis, although very low, is increasing nowadays with the improvement of imaging technology (6).Studies have shown that splenectomy followed by adjuvant chemotherapy can improve survival in patients with spleen metastasis from colorectal cancer (7).When left untreated , spleen metastasis can lead to the rupture of the spleen, which can be life threatening. Interval survival following splenectomy ranged from 3 to 84 months, with a mean of 22.5 months (6).It was found that patients who received adjuvant chemotherapy after splenectomy had better survival rates than those who did not.This case report has been reported according to the SCARE 2020 guidelines (8).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.