Background: Acute abdomen is defined as “a spectrum of surgical, medical and gynecological conditions ranging from trivial to life threatening conditions, which require hospital admission, investigations and treatment. The possible causes of acute abdomen may range from benign and psychogenic pain to life threatening aortic dissection. This study aims to find out the etiological spectrum of surgical acute pain abdomen among patients attending emergency department of a medical college of Eastern India.Methods: An institution based, cross-sectional study was conducted from January- June 2018, among patients admitted with pain abdomen in IQ City Medical College and Narayna Hospital, Durgapur, West Bengal, India. Data were collected on the day of discharge, with the help of pre-tested, semi structured Schedule.Results: Total 8688 patients were admitted through emergency during data collection period. 1236 (14.2%) of them were admitted with complains of pain abdomen. Frequency of surgical and non-surgical pain abdomen was 6.0% and 8.2% respectively. Most consistent symptom and sign were pain abdomen and abdominal tenderness respectively. Most common cause of acute abdomen was acute appendicitis. It was present in 38.9% of cases followed by gall bladder pathology, renal/ ureteric colic, perforation peritonitis, intestinal obstruction, bowel ischemia in 21.0%, 14.2%, 13.7%, 7.8%, and 4.4% of cases respectively.Conclusions: About 15.0% of all emergency hospitalization is due to acute abdominal pain and about 40.0% of all acute abdominal pain was due to surgical causes. Most common cause of surgical acute abdomen was acute appendicitis.

Background: Chronic suppurative otitis media (CSOM) is a persistent middle ear disease with high risk of irreversible complications in absence of timely management. It is a massive health problem in India having the highest prevalence rate (>4%) requiring urgent attention. Aims and Objectives: The aim of the study was to find out risk factors, microbiological profile, with their susceptibility pattern, and of ear discharge in CSOM patients to provide guidelines for the empirical treatment. Materials and Methods: Ear discharge samples from 135 clinically diagnosed CSOM patients were collected and processed. Microbial isolates were identified and drug susceptibility testing was conducted using Kirby-Bauer disc diffusion method. Results: Pseudomonas species (59/135, 43.70%) was the predominant isolate followed by Staphylococcus species (37/135, 27.40%) while Aspergillus species (10/12, 83.33%) was the predominant fungus isolated. No anaerobic bacteria were isolated on culture. Gram-negative bacilli were most susceptible to Meropenem (100%) and Amikacin (100%) while Pseudomonas species was to Imipenem (98.35%). Gram-positive cocci showed 100% susceptibility to Vancomycin, Linezolid, and Doxycycline. Conclusion: A continuous and periodic evaluation of microbiological pattern of CSOM and antimicrobial sensitivity of isolates is necessary for forming the basis of empirical treatment which shall aid in decreasing the potential risk of complications. Further, accurate and timely identification, knowledge of the pathogens, and judicious use of antibiotics are the need of the hour.

Introduction: Sputum negative pulmonary Tuberculosis (TB) is a major public health problem. So, the emergence of new techniques for a more precise and rapid microbiological identification of Mycobacterium tuberculosis in clinical samples is of great importance to improve the management of TB. Aim: To determine and compare the sensitivity and turnaround time for Mycobacterium tuberculosis detection by the BACTEC Mycobacteria Growth Indicator Tube (MGIT) 960 system, Lowenstein Jensen (LJ) medium and Ziehl-Neelsen (ZN) staining. Materials and Methods: An Institution based, observational, cross-sectional study was conducted at Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India, from July 2013-March 2016. Sputum, pericardial fluid, pleural fluid, peritoneal fluid, pus and endometrial tissue samples were collected from 80 patients of suspected TB cases. All were Acid-Fast stained by ZN staining method and cultured on solid culture LJ medium and on liquid medium (MGIT). Data was analysed using Statistical Package for the Social Sciences (SPSS) software, Version 20.0 (SPSS Inc, Chicago, IL, USA). Fisher’s-Exact test was used to show association of categorical variables. Non-parametric Mann-Whitney U test was used to show median difference of non-normally distributed continuous variables of two groups. Results: Out of the 80 samples, 41 cases were positive by either of the all methods. The positive specimen for ZN staining, LJ media and MGIT were 21, 29 and 41 cases respectively. The mean Time To Detection (TTD) was shorter for MGIT system than LJ media. Both LJ medium and MGIT 960 detected all cases of sputum smear positive cases and in addition significantly higher number than ZN stain in sputum smear negative cases. MGIT 960 detected significantly higher number of cases of sputum negative cases than LJ Media. The mean TTD was also significantly shorter in case of smear positive cases than the smear negative cases by both the solid and liquid culture mediums. Conclusion: The use of liquid media (MGIT) is more accurate and rapid method for the diagnosis of TB. The combination of more than one method is also highly recommended for rapid detection and early treatment of TB.

Introduction: Globally, about 425 million people are living with diabetes mellitus. Diabetic Foot Ulcers (DFU) are one of the severe complications of poorly controlled diabetes and over the time, about 50% of DFUs become infected which may require hospitalization. Aim: To find out the DFU infection severity pattern and its predictors among T2DM patients. Materials and Methods: This cross-sectional study was conducted at Integrated Diabetes and Gestational Diabetes Clinic (IDGDC), IQ City Medical College and Multispecialty Hospital, Durgapur, West Bengal, India, among Type 2 Diabetes Mellitus (T2DM) patients from June 2018 to November 2018. Total 1534 T2DM patients attended IDGDC during data collection period of 4 months and 132 of them had diabetic foot ulcer. After taking written informed consent, detailed data were collected from 132 of study participants using predesigned, semi structured and pre tested schedule developed with the help of Infectious Disease Society of America (IDSA) and International Working Group on the Diabetic Foot (IWGDF/ IDSA) classification system. Socio-demographic characteristic like age, sex, education, residence were recorded along with clinical data like glycated haemoglobin (HbA1c), duration of diabetes, treatment modalities Anthropometric measurements were taken as per World Health Organization (WHO) guidelines. T2DM was defined and classified as per American Diabetes Association (ADA) Guidelines. DFU infection severity was classified into uninfected, mild infection, moderate infection and severe infection as per IWGDF/IDSA guidelines. Chi-square test was used to show association between categorical variable. One-way Analysis of Variance (ANOVA) with Tukey's post-hoc test was used to show association between mean HbA1c level and DFU infection severity. The p-value ≤0.5 was considered significant. Results: Proportion of DFU was found to be 8.6%. As per the IWGDF/IDSA classification of DFU infection severity was found to be moderate in 59 (44.7%) of the study participants and mild in 32 (24.2%) of the study participants. 22 (16.7%) of study subjects had severe infection and required hospitalization for optimal care. Only 14.4% of study subjects did not have DFU infection. Increasing age (p-value=0.023), rural residence (p-value=0.015), poor education (p-value=0.001), obesity (p-value=0.001), central obesity (p-value=0.001), longer duration of diabetes (p-value=0.028), and poor glycemic control (p-value=0.001) was found to be significant risk factors for severe infection in DFU. Conclusion: Routine clinical assessment of DFU infection may help in making clinical decision of treatment modalities and help in saving lower limb as well as life of people with T2DM.