Spectrum of microbial flora in diabetic foot ulcers Bansal, Ekta; Garg, Ashish; Bhatia, Sanjeev ...
Indian Journal of Pathology and Microbiology/Indian journal of pathology and microbiology,
04/2008, Volume:
51, Issue:
2
Journal Article
Peer reviewed
Open access
A prospective study was carried out on patients with diabetic foot lesions to determine their clinical characteristics, the spectrum of aerobic microbial flora and to assess their comparative in ...vitro susceptibility to the commonly used antibiotics. A total of 157 organisms (143 bacteria and 14 fungi) were isolated and an average of 1.52 isolates per case was reported. Polymicrobial infection was found in 35% of the patients. In this study, Pseudomonas aeruginosa among the gram-negative (22%) and Staphylococcus aureus among the gram-positive (19%) were the predominantly isolated organisms, while Candida was the most predominantly isolated fungus. Antimicrobial sensitivity pattern of the isolates is discussed in detail. There was a linear increase in the prevalence of organisms with increase in Wagner's grade. Neuropathy (76%) and peripheral vascular disease (57.28%) was a common feature among the patients. Poor glycemic control was found in 67% of the patients. Awareness about lower limb complications of diabetes was very low (23%) among the patients.
AIM, To study the role of N-acetylcysteine （NAC） as a protective agent in rifampicin （RMP）-induced oxidative hepatic injury of young rats. METHODS： Hepatic injury was produced by giving 50mg/kg body ...weight/day of RMP for 3 wk. A dose of NAC （100mg/kg body weight/day） was given in combination with RMP intraperitoneally. Analysis of lipid peroxidation, thiol levels, cytochrome P4se, superoxide dismutase （SOD）, catalase, glutathione peroxidase, reductase and transferase were estimated in liver along with the body weight, liver weight and histological observations. RESULTS： RMP exposure resulted in no change in body and liver weight while antioxidative enzymes were altered but the non protein thiol （GSH） status was well preserved. Cytochrome P450 system and peroxidation of lipids were induced by RMP exposure. Partial protection was observed with NAC against RMP-induced changes in liver, which was evidenced from the prevention of increase in lipid peroxidation and the reduction in SOD and catalase enzyme levels. CONCLUSION. NAC protects young rats against RMP- induced oxidative hepatic injury.
Zygomycosis is highly invasive fungal infection, with high mortality rate. In most of patients, diabetes mellitus is an underlying factor but in primary cutaneous zygomycosis, presentation may be ...different. Here we present the description of clinical presentation, fungi isolated and management of cases with cutaneous zygomycosis seen in a tertiary care hospital in north India during 2001-2007.
All patients diagnosed with primary cutaneous zygomycosis between November 2001 and September 2007 presenting with clinical diagnosis of necrotizing fasciitis were included. Detailed history of each patient was taken, clinical presentation, site of involvement, underlying illness and risk factor, if any were noted. The diagnosis was established by direct microscopic evidence of broad, aseptate or sparsely septate ribbon-like hyphae with right angle branching in KOH wet mount and histopathological examination of stained sections. Cultures were put up for fungal isolation and species identification. Outcome of the therapy was analysed.
Of the nine patients reviewed, only one had diabetes mellitus. Commonest risk factor was injection abscess (33.3%). Apophysomyces elegans was isolated in four cases, Saksenaea vasiformis and Absidia corymbifera in one each. The fungal culture was sterile in three cases. Mortality rate was high with only four patients responded well to surgical and/or medical therapy.
Primary cutaneous zygomycosis appears to be on rise in India that calls for high index of clinical suspicion and an early biopsy of the affected area for timely diagnosis. The standard treatment is a combination of amphotericin B therapy, surgical debridement, and reversal of the underlying disease or immunosuppression.
Formation of ozone by fireworks ATTRI, Arun K; KUMAR, Ujjwal; JAIN, V. K
Nature,
06/2001, Volume:
411, Issue:
6841
Journal Article
Peer reviewed
Open access
Several natural processes lead to the formation of ozone, a problematic secondary pollutant and greenhouse gas. Various factors influence the formation of ozone, including the presence of volatile ...hydrocarbons, carbon monoxide, and methane. Researchers also found that significant levels of ozone are emitted by fireworks. Findings are presented from a project investigating emissions of ozone from fireworks lit during Diwali festivities for Hindus in India and elsewhere during October and November. Evidence indicates that the fundamental process of ozone formation by fireworks ignition resemble ozone formation induced by ultraviolet radiation in the stratosphere. The study monitored concentrations of nitrogen oxides, ozone, and other microclimatic factors at a site in New Delhi.
Knowledge of the use of a nasogastric tube (NG) is integral in medical practice as a whole and more so in gastrointestinal diseases because of its wide range of uses. Accidental fixation of the ...nasogastric tube during surgery is a rare complication. Various methods have been described for retrieval of an entrapped, retained or stapled nasogastric tube. We describe here a novel technique in which an endoscopic needle knife sphincterotome using a side-view endoscope was used successfully to cut the knots and release the entrapped NG tube. Although stress should always be laid on prevention, the flexible endoscopic approach is a small-duration procedure, a minimally invasive, cost-effective technique for the removal of a nasogastric tube that avoids the need of redo surgery and unnecessary exposure to anaesthesia.
Multidrug-resistant Acinetobacter baumanii is a major pathogen encountered in pyogenic infections, especially from burns patients in hospital settings. Often there is also coexistence of multiple ...beta-lactamase enzymes responsible for beta-lactam resistance in a single isolate, which further complicates treatment options. We conducted a study on burn wound pus samples obtained from the burns unit of our hospital. Phenotypic tests were used to determine the Extended Spectrum Beta-Lactamase, AmpC Beta-Lactamase and Metallo-Beta-Lactamase producing status of the isolates. Almost half of the samples from the burn wounds yielded Acinetobacter baumanii as the predominant pathogen (54.05%). Coexistence of the three resistance mechanisms was seen in 25 of the 100 (25%) isolates of Acinetobacter baumanii. This study emphasizes the need for the detection of isolates that produce these enzymes to avoid therapeutic failures and nosocomial outbreaks.
Primary hydatid disease of musculoskletal system is rare. A 60 year old woman presented with soft swelling in medial aspect of thigh, of long duration which was gradually increasing in size. She was ...initially diagnosed as lipoma of thigh, but ultrasonography revealed to be a cystic swelling suggestive of hydatid disease. MRI further reinforced the diagnosis. However serologic test (ELISA) was negative. Patient was given albendazole preoperatively. The swelling was removed en bloc and advised for adjunctive albendazole chemotherapy (15 mg/kg/day) for three months.
Pyrenochaeta romeroi is a rare agent of chronic, suppurative subcutaneous infections which ultimately lead to mycetoma. It has only rarely been reported from deep, non-mycetomatous infections. We ...describe a case of a subcutaneous phaeohyphomycotic cyst in a 45-year-old Indian female who suffered from verrucous plaque and a swelling (30 mm in diameter) on the right forearm that gradually increased in size over a period of 3 months. Direct microscopic examination with 10% KOH and histopathological investigation of exudates revealed septate hyphae without granules, the hallmark of mycetoma. The lesion appeared to be a subcutaneous phaeohyphomycotic cyst caused by P. romeroi. The suspected agent was recovered in culture, identified on the basis of morphologic features and its identification confirmed by sequencing of the internal transcribed spacer regions of rDNA. Treatment consisted of surgical excising of the cyst without any antifungal therapy. There was no relapse during a one-year follow-up and the patient was successfully cured. In vitro antifungal susceptibility tests demonstrated that itraconazole (0.5 μg/ml), isavuconazole (0.125 μg/ml) and posaconazole (0.5 μg/ml) had potent activity against this isolate of P. romeroi. High MICs were found with amphotericin B (4 μg/ml), fluconazole (>64 μg/ ml), voriconazole (4 μg/ml) and caspofungin (8 μg/ml). However, their clinical effectiveness in the treatment of P. romeroi infections remains to be evaluated.
Lipomas and lipomatosis of colon are rare in clinical practice. We herein report a case of diffuse colonic lipomatosis, fifth such case in literature which presented as perforation peritonitis, a ...presentation, never been reported earlier. On laparotomy, the findings suggested malignancy and appropriate surgery was done. Diffuse Colonic Lipomatosis, a rare and benign condition mimicks malignancy and should be kept as a differential diagnosis is unusual cases of colonic perforations.
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