Introduction:Klebsiella pneumoniae are common causative agents of various infections and are of great concern for developing resistance against commonly prescribed antibiotics. This study gives an account of isolation of K. pneumoniae from various clinical specimens and their antimicrobial susceptibility, in a tertiary care hospital of Bangladesh. Materials and Methods: Various clinical specimens like urine, wound swab, sputum, blood and endotracheal aspirates were collected and processed for isolation of K. pneumoniae followed by their antimicrobial susceptibility testing. Results: Among the 316 samples that yielded culture positivity, K. pneumoniae were identified as second most common organism. The highest yield of K. pneumoniae (37.33%) were observed from wound swab followed by sputum (26.67%). Most of the isolates were resistant to sulphamethoxazole-trimethoprim (90.67%) and ceftriaxone (90.67%) followed by cefotaxime (89.33%), ceftazidime (89.33%) and cefuroxime (89.33%). The most sensitive antibiotic for the isolates was tigecycline. Conclusion: Isolated K. pneumoniae showed resistance to commonly prescribed antibiotics, which is very alarming and showing the importance on continuous monitoring and strict antimicrobial policy. Medicine Today 2020 Vol.32(2): 95-99

Background: Extended-spectrum β lactamases (ESBLs) continue to be a major challenge in clinical setups world over, conferring resistance to the expanded-spectrum cephalosporins. Objectives: The aim of this study was to determine the prevalence of extended spectrum β-lactamase (ESBL) in strains of Klebsiella pneumoniae isolated from different clinical specimens in Dhaka Medical College Hospital, Dhaka, Bangladesh. Methodology: This cross sectional study was carried out at the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from July 2016 to June 2017. Klebsiella pneumoniae were isolated from different clinical specimens from adult hospitalized patients. These isolates were screened for ESBL production according to Clinical and Laboratory Standards Institute (CLSI) guidelines. ESBL production was confirmed by the phenotypic confirmatory double disc synergy test (DDST). Results: Among the 500 collected samples 75 Klebsiella pneumoniae were isolated. Among them, 68 isolates were selected for confirmatory tests of ESBL according to CLSI guidelines. Finally, 19 isolates were confirmed as ESBL producers by DDST (25.33%). Conclusion: In the present study, a large number of isolates are found to be ESBL producers. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 101-104

Background: Presenting symptoms, treatment considerations, and outcome are strongly related to the extension of vestibular schwannomas (VS). The aim of the current retrospective study was to analyze the clinical features, microsurgical treatment, and outcome of VS with brainstem compression. Methods: Seventy patients presented with VS who had undergone operative procedures performed in our unit from 2017 to 2019. The facial nerve function and hearing assessment was done according to House-Brackmann [HB] grading and pure tone audiometry (PTA) respectively. All patients were operated by retro-mastoid suboccipital approach. Results: Most patients had large tumors and had no useful hearing (85%), had disabling cerebellar ataxia (92.86%) and presented with features of raised intracranial pressure (48.57%). Large sized tumors were in 32.86% and giant sized tumors were in 57.14% cases. Complete tumor excision was carried out 92.86% and anatomical preservation of facial nerve was achieved in 73.85% cases. Hearing preservation was achieved in 4 patients. Cerebrospinal fluid leak with or without meningitis and transient lower cranial nerve paresis were common complications. The mortality rate was 7.14%. Conclusions: Complete tumor excision with good facial nerve preservation can be achieved in large vestibular schwannomas. Hearing preservation is difficult in larger tumors. Primary microsurgical resection is an appropriate management option for large VS. In our experience, this goal can be achieved safely and successfully by using the retrosigmoid approach. Bang. J Neurosurgery 2021; 10(2): 175-181

Brucellosis is a major Bacterial Zoonotic disease worldwide. More than 500,000 new cases are reported globally every year with the annual incidence rates varying widely from <2 to >500 per 1000,000 population among different region of the world. This cross sectional descriptive study was carried out in the department of microbiology, Mymensingh medical college, Mymensingh, Bangladesh from 1st January to 31 December 2017, on total 600 patients of PUO with or without occupational exposure. Blood was taken as sample, serum was separated and screening test was done by Brucella specific latex agglutination test from all collected samples. A Titer of ≥ 1:160 was taken as positive. ICT, PCR and real time PCR were done from all screening positive samples. Among the study population 65.83% (395/600) were male and 34.17% (205/600) were female. The sero prevalence of Human Brucellosis was found 13.33% (40/300) and 5% (15/300), respectively in risk and non risk group of population. Out of 55 Brucella specific latex agglutination test positive samples 27.27% (15/55) were ICT positive, 5.45% (3/55) were PCR positive and 3.64% (2/55) were real time PCR positive. No ICT, PCR or Real time PCR cases were found from sero negative samples. Among the ICT positive cases 86.67% (13/15) from risk group and 13.33% (2/15) from non risk group of study population. Among the 3 PCR positive cases 13.33% (2/15) were from ICT positive cases and 2.5 % (1/40) from ICT negative cases. All PCR and Real time PCR positive cases were found in risk group of study population. No reliable data for Human Brucellosis is available in our country. However the present study revealed that a considerable number of Human Brucellosis is present in risk group as well as non risk group of population in both rural and urban area in Mymensingh district of Bangladesh. In our country we use only Brucella specific latex agglutination test for diagnosis of human Brucellosis. It is a non specific test and gives many false positive results. So it is necessary to introduce newer tests with higher sensitivity and specificity which will help to diagnose the disease rapidly and more accurately. Bangladesh J Med Microbiol 2020; 14 (2): 19-24