Introduction:Diabetic foot ulcer and infections are one of the major complications in diabetic patients leading to frequent hospitalization and increased mortality. Knowledge about the microbes that cause infections will be helpful for providing appropriate antimicrobial therapy. Aim:To evaluate the bacteriological profile of patients with diabetic foot ulcers and their antibiotic susceptibility pattern. Methodology:A cross-sectional study was carried out for a period of eight months in the Department of surgery in patients with diabetic foot ulcer at a tertiary care teaching hospital. Patient data relevant to the study were collected using a standard data collection form designed as per the need of the study. Details of the organisms isolated and susceptibility pattern were collected from microbiology department. Results:A total of 122 pathogens were identified from 71 patients with male (63.38%) predominance over females (36.61%). Out of the 71 patients, 38 (53.52%) patients had monomicrobial infections and 33 (46.47%) patients had polymicrobial infections. Of the total 122 organisms, 79(64.75%) organisms were found to be gram negative organisms and 43(35.24%) were gram positive. Pseudomonas aeruginosa found in 22 (18.03%) patients was the predominant pathogen isolated followed by Klebsiella pneumonia found in 18 (14.75%) patients. The gram-positive organisms isolated showed maximum susceptibility towards antibiotics Teicoplanin and Linezolid while the gram-negative organisms showed susceptibility to Imipenem, Meropenem, and Piperacillin/Tazobactum combination. Conclusion:The study showed a preponderance of gram-negative bacilli among the isolates from the diabetic foot ulcers. It is recommended that antimicrobial sensitivity testing is necessary for initiating appropriate antibiotic regimen which will help to reduce the drug resistance and minimize the healthcare costs.

BACKGROUND Peripheral arterial disease (PAD) is one of the macrovascular manifestations of systemic, diffuse atherosclerosis. Patients with acute myocardial infarction are at 3 - 5 times higher risk of developing associated PAD. Ankle Brachial Pressure Index (ABPI) is a simple, non-invasive test to diagnose peripheral arterial diseases in symptomatic cases. We wanted to assess the utility of an alternative formula for Ankle Brachial Pressure Index as a sensitive screening tool for asymptomatic peripheral arterial diseases in patients with acute myocardial infarction and cerebrovascular accident. METHODS This is a prospective observational study, recruiting eligible patients from medicine and cardiology outpatient department (OPD). Patients included were those with acute myocardial infarction (MI) or cerebrovascular accident (CVA). Sample size was calculated to be 257. ABPI was measured using a hand-held Doppler of 8 MHz and a standard sphygmomanometer. Statistical analysis was performed using SPSS software. RESULTS Alternate ABPI showed a mean value of 0.9 + / - 0.072. In the study population, 61.1 % were found to have abnormal ABPI i.e., less than 0.9, which is nearly two thirds of the population. Receiver operating characteristic curve (ROC) was plotted against ABPI for sensitivity and specificity for the co-morbidities considered in the study. It was found that the AUC (Area Under the Curve) was statistically significant for acute MI and acute CVA, with a fair positive correlation. CONCLUSIONS The alternative, ABPI is a good screening test for detecting asymptomatic PAD in patients with acute MI and CVA. However, further comparative studies are required to confirm the utility of the same in such patients, especially in a larger, varied population. KEY WORDS Ankle Brachial Pressure Index, Atherosclerosis, Peripheral Arterial Disease, Cardiovascular Diseases

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