Background:Onychomycosis is a fungal disease of the nail apparatus caused by both dermatophytic and nondermatophytic strains. Treatment involves long duration antifungal therapy. However, long treatment duration without identifying the causative species may lead to resistance. Confirmation of diagnosis and speciation by culture before administering antifungal therapy is ideal.Aims:To study the clinical and epidemiological aspects of onychomycosis in Hadoti region (south-east Rajasthan) and identify various mycological strains and predisposing factors causing onychomycosis.Materials and Methods:A prospective study of clinically diagnosed cases of onychomycosis attending the outpatient Department of Dermatology in our institute conducted from June 2012 to May 2013. The clippings were subjected to potassium hydroxide (KOH) examination and culture in the appropriate medium.Results:A total of 150 cases were enrolled in our study. There were 110 males (73.33%) and 40 females (26.66%) and male to female ratio was 2.75:1. The total dystrophic onychomycosis was the most common presentation seen in the majority of cases (46%) followed by distal lateral subungual onychomycosis in 52 cases (34.6%), mixed onychomycosis in 16 cases (10.66%), superficial white onychomycosis in 11 cases (7.33%), and proximal subungual onychomycosis in 2 cases. None had the endonyx variant. Direct microscopic examination of the nail clipping mounted with 40% KOH demonstrated fungal elements in 83 (55.33%) cases. Rate of isolation of organisms by culture was 64%. Nondermatophytes were isolated in 53 (35.33%), dermatophytes in 28 (18.66%), and yeasts in 15 (10%) of cases. The most commonly isolated species was Aspergillus in 45 (30%) cases. Aspergillus flavus was more commonly isolated compared to Aspergillus niger.Conclusion:The nondermatophyte molds appear to be more common causative agents of onychomycosis compared to usual dermatophyte species in south-east Rajasthan. Our study re-emphasizes the importance of culture for diagnosis of onychomycosis in every suspected case prior to therapy.

Background: Enterococci are common commensal organism of enteric tract and act as opportunistic pathogen and may cause infection in community as well as in hospitalised individuals. In present study association of several types of virulence factors like haemolysin, gelatinase and biofilm formation have been studied among HLAR and Vancomycin resistant Enterococci (VRE) isolates of enterococci among UTI patients.Methods: The samples were collected from all hospitalized and OPD patients of MBS Hospital, JK Lone Hospital and NMC Hospital. Government Medical College, Kota, Rajasthan, India. A total of 360 isolates of enterococcus were collected during the period of 2 years from April 2016 to April 2018 in microbiology laboratory, Department of Microbiology, Government Medical College, Kota, Rajasthan, India. All virulence factors were detected by phenotypic methods and MIC values were detected for high level gentamicin and vancomycin.Results: Among all enterococcal isolates most common factor was biofilm production 191 (53.05%) followed by haemolysin 131 (36.38%) and gelatinase production 72 (20%). Total resistant (MIC> 500 µg/ml) isolates for gentamicin was 194 (89.4%). In agar dilution 14 (11.2%) isolates were found sensitive, 61 (48.8%) isolates were found intermediate and 50 (40%) isolates were found to be resistant for vancomycin. HLAR and VRE was maximum associated with haemolysin + bio-film followed by gelatinase+biofilm, haemolysin+gelatinase+bio- film and least with haemolysin + gelatinase.Conclusions: In present study enterococcus show significant production of biofilm and other virulence factors. With production of biofilm they become more resistant to routinely used concentration of antibiotics posing threat for treatment failure. A continuous monitoring is needed particularly for resistance to aminoglycoside and vancomycin to stop their institutional spread. Judicial use of antibiotics should be encouraged both in community as well as in institutions.

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Onychomycosis is a fungal infection of nail commonly caused by dermatophytes, yeast and mould. The prevalence of onychomycosis seems to vary across the world because of various socioeconomic and cultural factors. However, all the nail diseases are not fungal in origin Hence laboratory investigations are needed to differentiate accurately between fungal infections and other conditions. MATERIAL AND METHODS: All clinically suspected cases of onychomycosis send to microbiological evaluation at Department of Microbiology Govt. Medical College & Hospital Kota over a period of one year (January to December 2012) were included in present study. RESULTS: A total of 109 samples (82 male and 27 females) were tested in period of one year (January to December 2012). Among them 55 samples (35 male and 20 females) showed fungal growth, the major pathogen found in present study were Tricophyton spp. 28 (50.9) followed by Candida 10 (18.18%) then Aspergillus spp. 9 (16.36%), Scopulariopsis 5 (9.09%), Fusarium 2 (3.63%) and Alternaria spp 1 (1.81%). DISCUSSION:-Onychomycosis is a chronic mycotic infection of finger nails and toe nails that affect the quality of life in a significant proportion. There has been a recent increase in the incidence as well as the spectrum of causative pathogens associated with onychomycosis. In our study we found more incidences among men 35 (63.63%) than women (36.36%). the most common etiology of onychomycosis is dermatophytes (Tricophyton) 50.9% but there is a considerable increase in Non dermatophytes moulds 17 (30.9%). For proper management of onychomycosis, diagnosis and accurate treatment play a key role in better outcome.

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