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 profile and outcome of organ dysfunction in sepsis

Background: Sepsis is defined as life threatening organ dysfunction due to a dysregulated host response to infection. It is the tenth leading cause of death among older adults in United States. Mortality rate of the sepsis ranges from 30-40%. In severe cases sepsis can drastically reduce blood flow to the major organs, leading eventually to septic shock, widespread organ failure and death. So, the present study was done to evaluate the clinical profile, symptoms, source of infection, co-morbid conditions and outcome with respect to the organ dysfunction in sepsis cases.Methods: This prospective observational study was undertaken among 100 cases of sepsis diagnosed by the “International Sepsis Definitions Conference” criteria admitted during October 2015 to September 2017. All patients were evaluated clinically and subjected for laboratory investigations.Results: In present study, a total of 100 cases were enrolled. Mean age of cases were 38.15 years. Male and female ratio was 1.63:1. Most common symptom was fever (100%). Pneumonia was the most common (36%) source of infection. Mortality was highest in pneumonia (55.55%). 77 % of cases had organ dysfunction. Cardiovascular system was the most common system involved. Maximum mortality was within the age group of 56-65 years. Diabetes was the most common co-morbid condition. Mean APACHE II score was high among the death cases.Conclusions: Sepsis was more common in younger group of patients but mortality was more in elderly age group. Overall mortality was 38%.

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

Clinico-laboratory profile of dengue patients in a tertiary hospital of Eastern India

Background: Dengue is the most rapidly spreading mosquito-borne viral disease of mankind. According to WHO, about 50-100 million new dengue infections are estimated to occur annually in more than 100 endemic countries.So, the present study has been done to analyzed varied clinical and laboratory profile of confirm dengue cases.Methods: Cross-sectional observational study was undertaken among 106 adult Ig M Ab positive cases admitted during October 2015 to September 2017. All patients were evaluated clinically and subjected for relevant laboratory investigations.Results: In our study male and female ratio was 20.2:1. Most common symptom was fever (95.3%) and least common was jaundice. Second most symptom was headache (70.8%). Myalgia was present in 49.1% of cases. 54.7% had nausea/vomiting. Hypotension was noticed in 33% of cases whereas encephalopathy and melaena was found in 6.6% and 2.83% respectively. Leucopenia was present in 57.5% and thrombocytopenia in 50.9% of cases.Conclusions: Younger male were commonly affected with dengue fever and promptly responded to conservative therapy due to early confirmation of diagnosis. Mortality was only 1.8% cases, may be due to delay in seeking medical attention

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 profile and outcome of organ dysfunction in sepsis

Background: Sepsis is defined as life threatening organ dysfunction due to a dysregulated host response to infection. It is the tenth leading cause of death among older adults in United States. Mortality rate of the sepsis ranges from 30-40%. In severe cases sepsis can drastically reduce blood flow to the major organs, leading eventually to septic shock, widespread organ failure and death. So, the present study was done to evaluate the clinical profile, symptoms, source of infection, co-morbid conditions and outcome with respect to the organ dysfunction in sepsis cases.Methods: This prospective observational study was undertaken among 100 cases of sepsis diagnosed by the “International Sepsis Definitions Conference” criteria admitted during October 2015 to September 2017. All patients were evaluated clinically and subjected for laboratory investigations.Results: In present study, a total of 100 cases were enrolled. Mean age of cases were 38.15 years. Male and female ratio was 1.63:1. Most common symptom was fever (100%). Pneumonia was the most common (36%) source of infection. Mortality was highest in pneumonia (55.55%). 77 % of cases had organ dysfunction. Cardiovascular system was the most common system involved. Maximum mortality was within the age group of 56-65 years. Diabetes was the most common co-morbid condition. Mean APACHE II score was high among the death cases.Conclusions: Sepsis was more common in younger group of patients but mortality was more in elderly age group. Overall mortality was 38%.

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