Study of serum homocysteine level in cases of non-diabetic ischemic stroke

Background: Aim of the study was to measure serum homocysteine levels in non-diabetic ischemic stroke and to co-relate its significance with other risk factors of ischemic stroke. It was a case control study.Methods: The study was done in the Department of Medicine, VSS.I.M.S.A.R, Burla, Odisha. 42 patients of non-diabetic ischemic and 42 age and sex matched controls were included in the study. Adults above the age of 18 years who were non-diabetic presenting with first-ever ischemic stroke, confirmed by CT scan of brain were included. Diabetic patients, haemorrhagic stroke, suspected embolic stroke, patients on vitamin supplementations, chronic usage of phenytoin were excluded. Routine investigations, fasting serum lipid profile and serum homocysteine levels were done.Results: Mean serum homocysteine level in ischemic stroke patients were found to be much higher (25.83 micro mol/L) in comparison to control group (9.77 micro mol/L) which is statistically significant. Mean serum homocysteine levels were found to be higher in patients with age group of more than 60 years, male sex, sedentary lifestyle, vegetarian diet, hypertensive patients and patient with normal fasting lipid profile. Statistical analysis for significance of difference was done using Chi-Square test with Yate’s correction.Conclusions: A statistically significant correlation was found between all the studied risk factors among non-diabetic patients and serum homocysteine levels. Estimation of serum homocysteine is advisable in all cases of non-diabetic ischemic strokes to know the prognosis

Spectrum of uropathogens and their antibiotic sensitivity pattern in diabetes mellitus patients at a tertiary care hospital in Odisha, India

Background: Diabetes Mellitus is the most common endocrine disorder involving almost all systems of body. Untreated or poorly treated Diabetics are susceptible to develop a series of complications responsible for raised morbidity and mortality. Diabetes Mellitus has a number of long term effects on the Genitourinary system. Urinary tract infections have long been recognised as a significant problem in patients with Diabetes Mellitus.Methods: Prospective observational study. Diabetic patients with culture positive UTI were included. Gestational diabetes, Immunocompromised patients and patients with congenital renal anatomical abnormalities were excluded.Results: Authors included 211 numbers of culture positive UTI among diabetic patients. Out of which, 65 were male and 146 were female. Maximum number of patients belong to 56-65 years age group. Escherichia coli was the predominant organism isolated. Gram positive organisms showed 100% sensitivity to Vancomycin and Linezolid. Gram negative organisms showed 100% sensitivity to Polymyxin B.Conclusions: Genitourinary tract infection is not an infrequent complication seen in diabetes patients. Most common causative organism and their antibiotic sensitivity pattern should be done in tertiary care hospital for a better antibiotic policy

CLINICAL AND ETIOLOGICAL SPECTRUM OF ACUTE FEBRILE ENCEPHALOPATHY IN ADULT PATIENTS: A PROPSPECTIVE STUDY FROM ODISHA, INDIA

Objectives: Acute febrile encephalopathy (AFE) is a medical emergency and might be an indicator of numerous systemic and central nervous system pathologies. In this backdrop, the present study was carried to evaluate the etiology and clinical features of encephalopathy succeeding short febrile illness in adults approaching to a tertiary care center. Methods: A prospective study was done up to 2 years in 110 patients beyond 14 years. The demographic variables were documented and along with routine examinations, cerebrospinal fluid analysis and radioimaging studies were performed. Results: The most common etiology of AFE was cerebral malaria (CM) that constitutes 39.1% (43 of 110) of total cases, followed by acute viral encephalitis (AVE), tuberculous meningitis (TBM), acute bacterial meningitis (ABM), sepsis associated encephalopathy (SAE), and enteric encephalopathy (EE) with 24 (21.8%), 20 (18.2%), 13 (11.8%), 5 (4.5%) and 2 (1.8%) cases, respectively. Death rate was 30.20% in CM, 23.07% in ABM, 20.83% in AVE, and 20% in TBM. Two cases of SAE and one case of EE also succumbed. Conclusion: CM found to be the furthermostcommunalsource of AFE followed by AVE, TBM, and ABM

Spectrum of uropathogens and their antibiotic sensitivity pattern in diabetes mellitus patients at a tertiary care hospital in Odisha, India

Background: Diabetes Mellitus is the most common endocrine disorder involving almost all systems of body. Untreated or poorly treated Diabetics are susceptible to develop a series of complications responsible for raised morbidity and mortality. Diabetes Mellitus has a number of long term effects on the Genitourinary system. Urinary tract infections have long been recognised as a significant problem in patients with Diabetes Mellitus.Methods: Prospective observational study. Diabetic patients with culture positive UTI were included. Gestational diabetes, Immunocompromised patients and patients with congenital renal anatomical abnormalities were excluded.Results: Authors included 211 numbers of culture positive UTI among diabetic patients. Out of which, 65 were male and 146 were female. Maximum number of patients belong to 56-65 years age group. Escherichia coli was the predominant organism isolated. Gram positive organisms showed 100% sensitivity to Vancomycin and Linezolid. Gram negative organisms showed 100% sensitivity to Polymyxin B.Conclusions: Genitourinary tract infection is not an infrequent complication seen in diabetes patients. Most common causative organism and their antibiotic sensitivity pattern should be done in tertiary care hospital for a better antibiotic policy

Study of serum homocysteine level in cases of non-diabetic ischemic stroke

Background: Aim of the study was to measure serum homocysteine levels in non-diabetic ischemic stroke and to co-relate its significance with other risk factors of ischemic stroke. It was a case control study.Methods: The study was done in the Department of Medicine, VSS.I.M.S.A.R, Burla, Odisha. 42 patients of non-diabetic ischemic and 42 age and sex matched controls were included in the study. Adults above the age of 18 years who were non-diabetic presenting with first-ever ischemic stroke, confirmed by CT scan of brain were included. Diabetic patients, haemorrhagic stroke, suspected embolic stroke, patients on vitamin supplementations, chronic usage of phenytoin were excluded. Routine investigations, fasting serum lipid profile and serum homocysteine levels were done.Results: Mean serum homocysteine level in ischemic stroke patients were found to be much higher (25.83 micro mol/L) in comparison to control group (9.77 micro mol/L) which is statistically significant. Mean serum homocysteine levels were found to be higher in patients with age group of more than 60 years, male sex, sedentary lifestyle, vegetarian diet, hypertensive patients and patient with normal fasting lipid profile. Statistical analysis for significance of difference was done using Chi-Square test with Yate’s correction.Conclusions: A statistically significant correlation was found between all the studied risk factors among non-diabetic patients and serum homocysteine levels. Estimation of serum homocysteine is advisable in all cases of non-diabetic ischemic strokes to know the prognosis

Malignant duodeno-colic fistula

Colo-duodenal fistula is a rare complication of gastro-intestinal malignancy and inflammatory bowel disease. The fistula often results in diarrhea and vomiting with dramatic weight loss. Vomiting may be feculent or truly fecal associated with foul smelling eructation. We present an unusual case of colonic carcinoma, where a 61-year-old female patient presented with pain abdomen and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Ultrasonography showed a mass in the hepatic flexure area, and invasive adenocarcinoma was confirmed on histology from biopsy obtained during colonoscopy. Coloduodenal fistulae from colonic primaries are rare, but early diagnosis may allow curative surgery