May 16, 2011

a galacti ae?

Part of my clinical interest is dissection. Not just body dissection. Also literate dissection, which simply means I dissect out the phrase that people like to use as whole and look deeply into every words. I do that only for academic purpose, otherwise purely for the entertainment during stressful times in clinic.

For the last 2 weeks, in the absence of the medical officer in-charge of the clinic, I had to struggle through lunch hours, finishing the clinic barely few minutes to 2pm. And some people think doctors made them wait for few hours just because we're hiding in the room blasting off the Elvis Zombies with the Machine Gun Plants, in between patients. Of course, many left around 1pm when they see there are no more patient's folder in the tray, while a few continue to see the patient they still holding up in the rooms. And on top of that, after finishing clinics, I gotta rushed back to my ward to see to it that everything got carried out before I'm stuck in meeting/pm clinic/some departmental formal gathering which usually started around 230pm. I guess my main bulk of nutrient came from swallowing my own saliva and the residual breakfast that I had stuck between my lower molars, assuming those amylase haven't knock them out yet by then. Thank God my parotids are working well.

It is relatively not uncommon for house officers to turn to me, holding on to a patient’s folder, semi-clerked and semi-examined, eager to discuss the patient with me, asking the most simple yet (fill in vulgarity here, please) question - “Errr, Dr. Pilo, are you available?”

This may sound like a question, but it is anything but. It is a cry for help as much as a cry for lunch.

My reply would be - “No, I am already married.”

Someone echoed this answer on my behalf today. I am truly surprised. Possibly, my dark twisted annoying purposeful misinterpretation had finally found a fan.

I am more surprised to see another patient in the ward which I had committed to having Group B Streptococcus (GBS) had been re-labeled as GBS negative but Streptococcus agalactiae positive.

GBS is important in obstetrics mainly because adequate antibiotics coverage should be given, usually in the event of prolonged membrane rupture, mainly to prevent neonatal streptococcal pneumonia which is associated with grave outcome. If my memory doesn't fail me, one in four will die if not properly treated.

Just for the sake of academic dissection, GBS is actually the Group B groupings of streptococcus microbes.

Streptococcus is

a genus of spherical Gram-positive bacteria belonging to the phylum Firmicutes[2] and the lactic acid bacteria group. Cellular division occurs along a single axis in these bacteria, and thus they grow in chains or pairs, hence the name — from Greek στρεπτος streptos, meaning easily bent or twisted, like a chain (twisted chain).

... for people who can't handle heavy reading - it's a bacterial that grows like a chain.

Before streptococcus being grouped by Lancefield, they are being grouped by their hemolysis (breaking down of blood) potential.

alpha, ironically, unlike alpha dogs, only breakdown partially.
beta breaking down completely and
gamma is a no-action, lame to blood.

Then, the beta-hemolytics are subgrouped by Lancefield based on specific carbohydrates in the bacterial cell wall.

· Group A - Streptococcus pyogenes

· Group B - Streptococcus agalactiae

· Group C - Streptococcus equisimilis, Streptococcus equi, Streptococcus zooepidemicus, Streptococcus dysgalactiae

· Group D - Enterococci, Streptococcus bovis

· Group E - Streptococcus milleri and mutans

· Group F - Streptococcus anginosus

· Group G - Streptococcus canis

· Group H - Streptococcus sanguis

· Group L - Streptococcus dysgalactiae

· Group N - Lactococcus lactis

· Group R&S - Streptococcus suis

· other Streptococcus species are classified as non-Lancefield Streptococci

Just if one is wondering, who is smart fella by the name of Lancefield, well, her full name is Rebecca Craighill Lancefield (January 5, 1895 – March 3, 1981) was a prominent American microbiologist. Yes, the smart ones are usually the females. Life aint fair, right?

As a conclusion, yes, streptococcus agalactiae IS group B streptococcus. Possibly, the microbiologist who wrote the report trying to test or prank us, since the conventional results usually comes in clear 'Group B Streptococcus' tag. That person probably is a she, i think.

Well, as you can see basic science can be rather interesting to indulge in, especially if you're NOT sitting for an examination on them.

Or else, life would be a bitch.

Glad that's all history behind me now.


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