Introduction: Diabetic Foot Ulcers (DFU) represent a silent epidemic and are the leading cause of 80% of non traumatic lower-limb amputations. Anaemia in diabetes may have adverse effects on systemic diseases and predict the progression of diabetes complications. Biofilms act as a mechanical barrier to antimicrobials and immune system cells and contribute to Multidrug Resistance (MDR). Aim: To determine the bacteriome and mycobiome of diabetic ulcers and the associated biofilm formation and anti-microbial resistance profile of the pathogens. Also, to determine the molecular characterisation of biofilm-forming resistant isolates by Polymerase Chain Reaction (PCR). Materials and Methods: This cross-sectional study was done on 150 diabetic patients with non healing ulcers and was chosen and studied from January-December 2019. Pus and tissue bit samples were processed as per standard microbiological procedures. Antimicrobial susceptibility test was performed as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Biofilm formation was detected by the tissue culture plate method. Molecular characterisation of resistant pathogens was done by PCR. Variables were expressed as proportions or percentages. Results: Out of 150 diabetic patients, 17.3% of patients underwent amputation. A 90% of patients were associated with anaemia. Most ulcers were polymicrobial in nature. Predominantly isolated pathogens were Pseudomonas aeruginosa 37 (17.1%) and Staphylococcus aureus 33 (15.2%) among aerobic bacteria, Peptostreptococcus 10 (4.6%) among the anaerobes and Candida albicans 20 (9.2%) in fungus. Gram negative bacteria showed high sensitivity to piperacillin-tazobactam, meropenem, and gram positive cocci to vancomycin and linezolid. A 82% of bacterial isolates and 50% of fungal isolates were biofilm producers. Staphylococcus aureus was a strong biofilm producer. On molecular characterisation, blaCTX-M, blaTEM, blaNDM-1, blaOXA-23, mecA genes were present in resistant biofilm-forming isolates. Conclusion: Polymicrobial wound infection and biofilm formation in DFU confers antibiotic resistance and contributes to Multidrug Resistant Organisms (MDRO’s). However, proper antibiotic surveillance and antibiotic policy, and preventive strategies can curtail the spread of resistant strains.

Cigarette smoking & tobacco chewing are risk factors not only for oral and lung tumours but also for the development of systemic disorders like atherosclerosis, coronary artery disease and peripheral vascular disease. This study was undertaken to evaluate the lipid profile, plasma fibrinogen and platelet count in male smokers, compared with healthy non smokers in rural area of south India, Out of 100 male healthy volunteers, 50 members were healthy smokers and 50 healthy non smokers, subjects were divided in both groups in age around 30 to 45yrs, with no past history of diabetes mellitus, hypertension, hepatic disorders and were neither on anti hypertensive, lipid lowering drugs were included in the study. Lipid profile, plasma fibrinogen and platelet count were analyzed by standard methods. Our results showed mean platelet count for smokers is 2, 86,345per mm3 and for non-smokers 2, 04,484.6per mm3. The mean plasma fibrinogen concentration for smokers is 3.48gm/dl and for non smokers is 3.12gm/dl. The platelet count and plasma fibrinogen concentration shows a higher value for smokers when compared to non- smokers. This is statistically significant. The mean total cholesterol level for smokers (186±30.10) mg/dl and non smokers (166.3±24.26) mg/dl and the mean triglyceride level for smokers (175±59.43) mg/dl and non smokers (132.09±+33.80) mg/dl are also statistically significant. The mean HDL level for smokers (40.4±4.13) mg/dl and for non smokers (44.68±4.13) mg/dl, the mean LDL level for smokers (105.8±28.16) mg/dl and non smokers (89.68±16.50) mg/dl and the mean VLDL level for smokers (28.4± 8.16) mg/dl and non smokers (14.3.±3.2) mg/dl indicate that the Lipid profile also is statistically significant between the two groups. We concluded that there is an elevated lipid profile; plasma fibrinogen and platelet count in smokers when compared to non smokers, which shows that smokers have high risk of prevalence of cardiovascular and vessel wall diseases