Purpose: To determine the prevalence and genetic basis of tetracycline resistance in Staphylococcus aureus. Methods: One hundred and thirty (130) clinical isolates of S. aureus were collected from Khyber Teaching Hospital, Peshawar, Pakistan. Susceptibility to antibiotics (doxycycline, tetracycline and minocycline) was determined by Kirby-Bauer disc diffusion method with minimum inhibitory concentration (MIC) evaluated on Muller-Hinton agar as described by the Clinical and Laboratory Standards Institute (CLSI). The tetracyclineresistant strains (TET-R) were screened by polymerase chain reaction (PCR) for the presence of four common tetracycline resistance determinants, viz, tet(K), tet(L), tet(M) and tet(O). Results: Sixty (46.0 %) of these isolates were methicillin-resistant S. aureus (MRSA) while 70 (54.0 %) were methicillin-susceptible S. aureus (MSSA). Seventy four (56.9 %) strains were resistant to tetracycline (TET-R), 30 (23.1 %) to minocycline and 23 (17.7 %)

Introduction:Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly.Materials and Methods:Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed.Results:CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall.Conclusion:3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT.

Abdominal wound dehiscence after laparotomy is a surgical emergency with high morbidity and mortality leading to escalation in hospital costs and prolonged illness. This complication can be avoided if the factors involved in wound dehiscence are properly addressed.

BACKGROUND Soft tissue defects of distal third leg has always been a reconstructive challenge. Though free flaps are the first choice, cross-leg flap is still the saviour in difficult non-reconstructable situations. This study was conducted to analyse the outcome of using external fixator for immobilising cross-leg flaps. MATERIALS AND METHODS This was a retrospective descriptive study done on 42 patients over a period of 3 years starting from

Food handlers and workers are exposed to several occupational hazards not frequented by the general population. Grinder injuries of the hand present a devastating consequence of industrial food processing that is infrequently described. Herein, we describe two cases that presented to our department with meat grinder injuries of the hand.