1.Evaluation of BACTEC MGIT 960 system for recovery of Mycobacterium tuberculosis complex in Pakistan
Luqman Satti ; Aamer Ikram ; Shahid Abbasi ; Tariq Butt ; Nasarullah Malik ; Irfan Ali Mirza
Malaysian Journal of Microbiology 2010;6(2):203-208
We evaluated the performance of MGIT 960 system in terms of recover rate, detection time of mycobacteria and
contamination rate from various human clinical specimens and compared it with already in use BACTEC 460 TB system
and conventional LJ medium. This is the first reported study on MGIT 960 and its comparison with BACTEC 460 system
in Pakistan. A total of 260 different clinical specimens received for the culture of mycobacteria were dealt during the six
months study period. All the specimens were digested and decontaminated according to the standard N-acetyl-Lcysteine
NaOH method. All the processed specimens were inoculated on both the liquid systems and solid medium and
incubated for six weeks and eight weeks consecutively. A total of 44 mycobacterial isolates (Mycobacterium
tuberculosis, n=43; Mycobacteria other than tuberculosis, n=1) were recovered from 260 clinical specimens. The
recovery rate of M. tuberculosis complex was 97.6% on BACTEC MGIT 960 system and 93.0% on BACTEC 460 system
and 83.7% on LJ medium. The mean detection time of mycobacteria on BACTEC MGIT 960 system was 11.2 days in
smear positive cases, 14.2 days in smear negative cases and 14.8 days in smear positive cases on BACTEC 460
system. Contamination rates were 9.6% and 5.6% and 3.4% for BACTEC MGIT 960, BACTEC 460 system and LJ
medium respectively. The non-radiometric, fully automated BACTEC MGIT 960 system has better diagnostic ability as
compared with radiometric, semi-automated BACTEC 460 system and LJ medium, so it can be used as a reliable
alternative in over burden laboratories.
2.Isolated clival subdural haemorrhage from a dolicoectactic vertebrobasilar aneurysm: Case report and overview of endovascular treatment strategies
Luqman MALIK ; Waleed BUTT ; Permesh Singh DHILLON ; Robert LENTHALL
Journal of Cerebrovascular and Endovascular Neurosurgery 2021;23(4):365-371
Posterior fossa aneurysms presenting with isolated subdural haemorrhage (SDH) have scarcely been described with no cases attributed to a vertebrobasilar (VB) location. Non-saccular VB aneurysms are a distinct sub-group and in this report we also discuss the pathophysiology and treatment options for these difficult-to-manage lesions. We present a case of a 49 year-old man who presented with a 7-day history of severe headaches who was found to have an isolated acute clival SDH. Vascular imaging revealed a VB dolicoectatic segment with superimposed fusiform dilatations that contacted the dura adjacent to the SDH. A staged treatment was performed with initial parental vessel occlusion of the ruptured vertebral artery segment and subsequent insertion of a braided stent (LEO) with flow diverting properties into the progressively dilating basilar artery. A third procedure was performed to occlude a recurrent pouch at the lower basilar dilatation. Complete angiographic occlusion was achieved and the patient is under continued surveillance. To our knowledge, this is the first case of a ruptured non-saccular VB aneurysm presenting with radiologically isolated clival SDH. Clinical history will often inform the need for vascular imaging in such atypical presentations. Managing these lesions remains an endovascular challenge and requires a specialist multi-disciplinary approach.