Epidemiology of antimicrobial resistance in bacteria isolated from inpatient and outpatient samples, Ecuador, 2018.

Objective: To compare the epidemiology of antimicrobial resistance in bacteria isolated from inpatient and outpatient samples in Ecuador.

Methods: A secondary analysis was done of data on bacteria isolated from inpatient and outpatient samples. Data were taken from the 2018 national antimicrobial resistance surveillance database of the National Reference Center for Antimicrobial Resistance.

Para-Hisian pacing: The eyes see what the mind knows.

A young male presented with pre-excited atrial fibrillation. During an electrophysiology study, preexcitation suggestive of a pathway in posteroseptal location was confirmed but no tachycardia was inducible. Para-Hisian pacing was done during sinus rhythm.

Designing a universal tool for developing content of debriefing: The how and what questions.

Objectives: Clear and specific content for debriefing promotes learning and reflection for the learner. Currently, there is no universal tool for developing the content for debriefing.

Methods: We developed a tool for debriefing that can be applied for developing content for debriefing, which can be used for instructor-led and within-team debriefing.

Outcome of older adults at risk of frailty.

Background: The integral part of the definition of frailty is the outcome associated with it. Older adults at risk of frailty are in the process of becoming frail. This study looked at the clinical characteristics and outcomes of older adults at risk of frailty.

'Hydro-point' - The forgotten and unspoken entity in hydropneumothorax.

Effusive pneumothorax is an abnormal collection of air and fluid within the pleural space: blood, pus, or serous fluid. Thus, effusive pneumothorax can be categorized as hemopneumothorax, pyopneumothorax, or hydropneumothorax, depending on the type of fluid accumulation. Hydropneumothorax is a clinical condition defined by the presence of air and serous fluid within the pleura space.

Pulmonary melioidosis complicating foreign body aspiration in a young adult.

Melioidosis is caused by an environmental Gram-negative bacilli . Diabetes mellitus, occupational exposure to soil and water, pre-existing renal diseases and thalassemia are significant independent risk factors for melioidosis. A 30-year-old male carpenter and smoker had a history of accidental aspiration of foreign body 2 months prior.

Preclinical animal studies in ischemic stroke: Challenges and some solutions.

Despite the impressive efficacies demonstrated in preclinical research, hundreds of potentially neuroprotective drugs have failed to provide effective neuroprotection for ischemic stroke in human clinical trials. Lack of a powerful animal model for human ischemic stroke could be a major reason for the failure to develop successful neuroprotective drugs for ischemic stroke. This review recapitulates the available cerebral ischemia animal models, provides an anatomical comparison of the circle of Willis of each species, and describes the functional assessment tests used in these ischemic stroke models.

Does operative fixation of isolated fractures of ulna shaft results in different outcomes than non-operative management by long arm cast?

Objective: The optimal treatment for isolated fractures of ulnar shaft is debatable. The purpose of this study was to compare functional outcomes and radiological union in patients treated for isolated fractures of the ulnar shaft by open reduction and internal fixation and a long arm cast.

Methods: This prospective study was conducted at level I trauma center from November 2014 to March 2016.

DRESS syndrome: Addressing the drug hypersensitivity syndrome on combination of Sodium Valproate and Olanzapine.

A case of an adolescent with symptoms of Mania, who developed Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) syndrome on exposure to combination of oral Olanzapine and Sodium Valproate is presented. We have attempted to highlight the atypical presentation of DRESS syndrome in this patient as well as management difficulties in patient who develops DRESS syndrome with the conventional psychotropic medication. Hence, it is necessary for mental health professionals to be vigilant about this life threatening drug reaction associated with high morbidity and mortality, thus ensuring prompt diagnosis and management.