Bacteriological profile of diabetic foot ulcer with special reference to drug-resistant strains in a tertiary care center in North-East India

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus, major observations of DFU cases have reported on amputation of foot region, and microbial bioburden during DFU is a major cause that affects healing of the wound regions. Pathogenic microbes are routinely isolated from these wound regions, especially Staphylococcus, Pseudomonas, Klebsiella, and Escherichia coli have been reported, whereas higher prevalence of Pseudomonas species during chronic condition in the deeper part of the wound, when left untreated, leads to gangrene. Multiple drug-resistant Pseudomonas strains are a new threat because of their biofilm-forming ability, making it more potent and incurable. Acyl homoserine lactones (AHL) are a group of signaling molecules that can regulate biofilm growth, and Las and Rhl operon generally work in tandem to initiate biofilm formation by Pseudomonas species. These signaling molecules also initiate virulence factors that correlates upregulation of inflammatory responses, and AHL can be a therapeutic target in order to prevent the efficacy of multiple drug-resistant strains that form biofilm and also can be an alternative solution against control of multiple drug-resistant strains.

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Ocular biometry characteristics and corneal astigmatisms in cataract surgery candidates at a tertiary care center in North-East India

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_1353_18 ◽

2019 ◽

Vol 67 (9) ◽

pp. 1417

Author(s):

Tanie Natung ◽

Wakaru Shullai ◽

Benjamin Nongrum ◽

Lanalyn Thangkhiew ◽

Prasenjit Baruah ◽

...

Keyword(s):

Cataract Surgery ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

North East India ◽

North East ◽

Ocular Biometry

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Prevalence of previously undiagnosed hypothyroidism in patients with cholelithiasis in a tertiary care center, North-East India

International Surgery Journal ◽

10.18203/2349-2902.isj20170507 ◽

2017 ◽

Vol 4 (3) ◽

pp. 932

Author(s):

Debabrata Singha ◽

Naresh Manohar Pawar ◽

Prabhu B. J. ◽

Nitesh Kumar ◽

Sankamithra Gopalarathnam

Keyword(s):

Thyroid Hormone ◽

Subclinical Hypothyroidism ◽

Hormone Receptors ◽

Care Center ◽

Tertiary Care ◽

Sphincter Of Oddi ◽

North East India ◽

North East ◽

A Prospective Study ◽

Low Prevalence

Background: Earlier, the studies had an increased prevalence of previously diagnosed hypothyroidism in gallstone patient and recent studies also demonstrated low bile flow in hypothyroid subjects or the sphincter of oddi expresses thyroid hormone receptors and thyroxin has a direct prorelaxing effect on the sphincter. Iceberg of hypothyroidism was present in cholelithiasis patients. The objective of this study was to find out the prevalence of previously undiagnosed hypothyroidism in cholelithiasis patients.Methods: A prospective study was conducted in the 500 consecutive patients with cholelithiasis between 1st October 2014 and 31st March 2016 to find relation between gallstone and hypothyroidism. Patients already diagnosed as hypothyroidism were excluded. In each patients, detailed history and clinical examination was done and sent for ultrasound of neck for goitre detection and laboratory Thyroid hormone assay (S-FT3, S-FT4 and S-TSH).Results: A total of 2.2%, 5.0% and 6.6% (total 13.8%, 69 of 500) of the cholelithiasis patients were diagnosed to have clinical, subclinical and borderline subclinical hypothyroidism. In women older than 50 year, the prevalence of clinical and subclinical plus borderline-hypothyroidism was 6.8% and 25.6% (11.7%±13.9%) and clinical plus subclinical plus borderline-subclinical hypothyroidism was 32.4% in cholelithiasis patients.Conclusions: Although a low prevalence of hypothyroidism was found in this study, but it is evident that subclinical and borderline subclinical hypothyroidism were significantly more common, compared with the clinical hypothyroidism and with increasing age there was increase in its prevalence, so we recommend that S-TSH level should be measured for every patient with cholelithiasis older than 50 years.

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Etiological profile of gastric outlet obstruction and its treatment: a hospital based prospective study in a tertiary care center, north-east India.

International Journal of Advanced Research ◽

10.21474/ijar01/3005 ◽

2017 ◽

Vol 5 (1) ◽

pp. 2258-2262

Author(s):

Debabrata. Singha. ◽

◽

NareshM. Pawar. ◽

AshikIqbal. Mazuder. ◽

Sankamithra. Gopalarathnam. ◽

...

Keyword(s):

Prospective Study ◽

Gastric Outlet Obstruction ◽

Care Center ◽

Tertiary Care ◽

Outlet Obstruction ◽

Tertiary Care Center ◽

North East India ◽

North East

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Managing snake bite patients – our experience from a tertiary care center of North East India

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-150792023 ◽

2016 ◽

Vol 15 (07) ◽

pp. 20-23

Author(s):

Dr Priyam Goswami ◽

Dr Anupam Dutta ◽

Dr Prasanta Dihingia

Keyword(s):

Care Center ◽

Tertiary Care ◽

Snake Bite ◽

Tertiary Care Center ◽

North East India ◽

North East

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Management of Diabetic Foot Ulcer in a Tertiary Level Hospital-Faridpur

Bangladesh Heart Journal ◽

10.3329/bhj.v34i1.41908 ◽

2019 ◽

Vol 34 (1) ◽

pp. 52-57

Author(s):

AL Gaddafi ◽

DK Das ◽

G Faruque ◽

Z Islam ◽

MA Rahman ◽

...

Keyword(s):

Blood Sugar ◽

Diabetic Foot ◽

Care Center ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Patients ◽

Cross Sectional ◽

Surgical Interventions ◽

Delay In Diagnosis

A descriptive type of cross sectional study among 210 diabetic patients with foot ulcer was carried out in Diabetic Association Medical College during the period of May 2016 to April 2017 and were categorized based on Meggitt-Wagner system to find out the complications, management, below knee amputation rate and mortality rate. The aim of this study was to practise a profile of diabetic foot ulcer (DFU), complications and its management to assess the outcome of the surgical interventions. Majority of the patients were male 112(53%), and most of them 116 patients (55.23%) presented within Wegner grade - 2 and grade-3 diabetic foot ulcers. The duration of diabetes more than 10 years was 116 (55%). 99 (47%) patients out of 210 patients developed diabetic neuropathy. 76 (36%) patients presented with CKD. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center, associated habit of smoking are all factors which lead to incidence of DFU at an earlier age than that seen in other studies. After admission of diabetic foot ulcer patients, diabetic foot ulcer is classified according to Wagner grading and treated the diabetic foot ulcer patients as the using protocol ’!1.Assesment whether it was conservative or surgical. 2. Optimal blood sugar control. 3. Systemic antibiotic. 4. Moist wound environment. 5. Offloading such as total contact casting. 6. Improves peripheral arterial circulation due to lack of vascularity. 7. Surgical debridement or minor amputation or major amputation. In case of G-4 or G-5 patients, ischemia was treated before debridement or amputation so that vascular circulation improved in the ulcer area and then healing potential was fastened. Bangladesh Heart Journal 2019; 34(1) : 52-57

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Study of bacterial pathogens causing chronic suppurative otitis media and the antibiotic susceptibility pattern of the isolates at a tertiary care centre in Kochi

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201288 ◽

2020 ◽

Vol 6 (4) ◽

pp. 714

Author(s):

Geetha Nair ◽

Tanya Tonny Mampilly ◽

Bindhu Vasudevan ◽

J. Lancy

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Tertiary Care ◽

Drug Resistant ◽

Care Centre ◽

Tertiary Care Centre ◽

Suppurative Otitis Media ◽

Resistant Strains ◽

Drug Resistant Strains

Background: Chronic suppurative otitis media (CSOM) is defined as chronic inflammation of middle ear and mastoid cavity presenting with recurrent ear discharges through a tympanic membrane perforation. Complications of CSOM were frequent in pre-antibiotic era. Injudicious use of antibiotics led to the emergence of multi-drug resistant strains and complications in return. To isolate the organisms associated with CSOM in a tertiary care centre and to detect their antibiogram.Methods: In this clinical, prospective, cross sectional study, a total of 100 patients clinically diagnosed with CSOM were enrolled from January to December 2019 (1 year). Results: Of the 100 samples collected, predominant bacteria were isolated in 58 patients (58%). The most common isolate was Pseudomonas aeruginosa (29 isolates) followed by Staphylococcus aureus (24), Klebsiella species (3) and 1 isolate each of Pneumococci and Acinetobacter species. Among the 29 isolates of Pseudomonas aeruginosa, 8 (28%) were multidrug resistant. Sensitivity was 100% to imipenem followed by 97% to meropenem,79% to gentamicin, 76% to amikacin, 66% to ciprofloxacin, 41% to piperacillin tazobactam and 17% to ceftazidime. Of the 24 isolates of Staphylococcus aureus, 4 (16%) were methicillin resistant Staphylococcus aureus (MRSA).Conclusions: Pseudomonas aeruginosa was the most common isolate, of which 28% were multi drug resistant. This calls for the judicious use of antibiotics and alternative measures for treatment of drug resistant strains. Formulating an antibiotic policy based on the local antibiogram can help in preventing the emergence and spread of resistant pathogens.

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