BACKGROUND Staphylococcus aureus is a frequent cause of bacterial infections in both developed and developing countries. The Clinical and Laboratory Standards Institute (CLSI) recommends D-test, which is a phenotypic screening method for inducible Clindamycin resistance. Therefore, all erythromycin resistant S. aureus should be tested for inducible Clindamycin resistance to prevent Clindamycin treatment failures and to report prevalence resistant phenotypes which varies widely. MATERIALS AND METHODS This cross-sectional study was conducted for a period of one year from January 2017 to January 2018. We analysed 125 nonduplicate consecutive isolates of S. aureus isolated from various clinical specimens like pus, wound swab, aspirates, blood and sterile fluids. A total of 125 S. aureus isolates derived from wound infection were evaluated for antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method. Methicillin Resistance was detected using Cefoxitin (30 µg) disk and inducible Clindamycin resistance was determined in all erythromycin resistant isolates by using D-zone test. RESULTS Out of 125 S. aureus isolates of the MRSA 46 (36.6%) were derived from respective Pus samples 19 (41.53%), the S. aureus isolates derived from Wound samples were MRSA 8 (18.03%), the S. aureus isolates derived from Blood samples were MRSA 10 (22.40%), the S. aureus isolates derived from Miscellaneous samples were MRSA 6 (13.66%) and the S. aureus isolates derived from urine samples were MRSA 2 (3.75%). A total of 26 S. aureus isolates showed inducible Clindamycin resistance by giving a positive D-zone test; hence, its prevalence was found to be 21.00% (26/125) with percentage distribution of cMLSB phenotype and MS phenotypes in all S. aureus isolates as 19.4% and 24.6% respectively. The susceptible phenotype (E-S and CD-S) predominated in MSSA (39.75%) as compared to MRSA (13.11%). Whereas, the constitutive resistant (cMLSB) predominated in MRSA (50.27%) as compared to MSSA (15.46%). Both the MS phenotype and the inducible resistant (iMLSB) phenotypes predominated in MSSA (19.87 and 24.92%, respectively) as compared to MRSA (22.40% and 14.20%, respectively). The antimicrobial susceptibility test result of all the 105 S. aureus isolates with iMLSB phenotype revealed that they were 100% sensitive to Vancomycin and Linezolid with moderate sensitivity (71.14%) to Gentamicin, Cefuroxime and least sensitivity (23.81%) to Doxycycline and 20.95% to Ciprofloxacin. CONCLUSION Due to high prevalence of Erythromycin resistance amongst S. aureus isolates, we suggest that D-zone test should be routinely done in all laboratories for appropriate prescription of Clindamycin and thereby preventing emergence of inducible resistant strains and treatment failure.

Background: Typhoid fever is a gastrointestinal infection caused by Gram-negative bacterium Salmonella enterica serovar typhi (S.typhi). Typhoid fever continues to be one of the major public health problems in developing countries. Antimicrobial therapy is critical for the clinical management of enteric fever. Incidences of multi-drug resistance to S. typhi (MDRST) and nalidixic acid resistant (NAR) strain have limited treatment options. Resistance pattern and time to fever clearance vary in different geographical areas and overtimes. Hence, this study was conducted to compare efficacy and safety profile of Cefixime and Ofloxacin in uncomplicated typhoid fever in this region.Method: 50 adults proven cases of typhoid fever of the age group of 18-57 years of either sex were included in the study. Group I was treated with Cefixime 200 mg twice a day for 7 days and CG I was treated with Ofloxacin 200 mg twice a day for 7 days. Patients were clinically and bacteriologically evaluated during the study period and follow-up.Result: So both study groups were found comparable in terms of mean fever clearance time. 96% cure rates were observed in both groups. No relapse was recorded.Conclusion: Both Cefixime and Ofloxacin are equally efficacious and safe in the treatment of uncomplicated typhoid fever.Med Phoenix Vol.2(1) July 2017, 3-7

Lipopolysaccharide (endotoxin) produces an inflammatory condition leading to multiple organ failure. LPS most potent bacterial products is used for induction of host oxidative stress responses and liver injury. Present study was undertaken to investigate the effect of Asparagus racemosus Willd. root extract in lipopolysaccharide (LPS) induced oxidative stress in rats by measuring oxidative stress markers, nitric oxide, liver function test and cytokines. The obtained data showed that LPS administration significantly reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT), total cholesterol (TC) and albumin (ALB). There was significant increase in malondialdehyde (MDA), cytokines activity, serum aspartate transaminase(AST), alanine transaminase(ALT), alkaline phosphate (ALP), total bilirubin (TB) and nitric oxide(NO). The methanolic extract of Asparagus racemosus (MEAR) administration significantly (P<0.05) reduced LPS-induced oxidative stress by normalizing liver GSH, SOD, CAT, MDA, NO, cytokines and liver function markers. MEAR significantly increased ALB and TC level. Our results suggest that MEAR protects the liver against liver toxicity induced by LPS.

Introduction: Clindamycin has been used to treat pneumonia and soft tissue and musculoskeletal infections due to MRSA. One important problem in Clindamycin treatment is the risk of clinical failure during therapy caused by MLSB inducible resistance. The Clinical and Laboratory Standards Institute (CLSI) suggest D-test, which is a phenotypic showing technique for inducible Clindamycin resistance. Material and Methods:We analyzed antimicrobial susceptibility testing by Kirby Bauer disk diffusion method. Methicillin resistance was detected with cefoxitin (30 µg) disk and inducible clindamycin resistance was unwavering in all erythromycin resistant isolate by using D-zone test.Results: 100 S. aureus isolate 37 (36.6%) were methicillin resistant (MRSA) and 63 (63.4%) were methicillin-sensitive S. aureus (MSSA). Although, mainstream of the MRSA isolates were imitative from pus samples 15, however, the S. aureus isolates imitative from post-operative wound infection were mainly MRSA 7. A total of 21 S. aureus isolates with iMLSB phenotype shown that they were 100% susceptible to vancomycin and linezolid, with modest sensitivity (71.14%) to gentamicin, cefuroxime and slightest sensitivity to (23.81%) doxycycline, (20.95%) ciprofloxacin. Conclusion:Outstanding to high happening of erythromycin resistance amongst S. aureus isolates, we recommend that D-zone test have to be regularly done in all laboratories for suitable recommendation of clindamycin and thus preventing appearance of inducible resistant strains and management failure.

Aim: To determine the efcacy of combination of vitamin B1, B6 and B12 in the management of diabetic peripheral neuropathy. Methods: Patients of diabetes mellitus with diabetic peripheral neuropathy were selected from Department of Medicine, Govt. Medical College and Hospital, Bettiah, W. Champaran, Bihar and study done at Pharmacology Department of GMC, Bettiah, W. Champaran, Bihar. The duration of study was six months from March 2019 to August 2019. Patients were prescribed Tab Neurobion (vitamin B1 100mg, vitamin B6 100mg, Vitamin B12 200mcg) twice a day for a period of 4 weeks (28 days). Follow up visit was scheduled on 28th day of the initial visit. Efcacy was judged by documenting improvement in pain of at least 2 points from the baseline as assessed by numeric pain rating scale. Mean age of the patients was observed Results: 46.7±8.6 years. Out of 310 cases, 177 patients (57.0%) were male and remaining 133 patients (43.0%) were female. Duration of diabetes as follows: 83 patients (26.8%) had duration of 0-10 year, 139 patients (44.8%) had 11-20 year, 77 patients (24.8%) had 21-30 year and 11 patients (3.6%) had >30 years of duration. Combination of vitamin B1, B6 and B12 in the management of diabetic peripheral neuropathy was found to be efcacious in 271 patients (87.4%). Treatment with combination of vitamin B1, B6 and B12 Conclusion: appeared to improve pain relief among patients with diabetic peripheral neuropathy.