Microbial biofilms pose great threat for patients requiring indwelling medical devices (IMDs) as it is difficult to remove them. It is, therefore, crucial to follow an appropriate method for the detection of biofilms. The present study focuses on detection of biofilm formation among the isolates from IMDs. We also aimed to explore the antibiogram of biofilm producers. This prospective analysis included 65 prosthetic samples. After isolation and identification of bacteria following standard methodology, antibiogram of the isolates were produced following Kirby-Bauer disc diffusion method. Detection of biofilms was done by tube adherence (TA), Congo red agar and tissue culture plate (TCP) methods. Out of 67 clinical isolates from IMDs, TCP detected 31 (46.3 %) biofilm producers and 36 (53.7 %) biofilm non-producers. Klebsiella pneumoniae, Pseudomonas aeruginosa and Burkholderia cepacia complex were found to be the most frequent biofilm producers. The TA method correlated well with the TCP method for biofilm detection. Higher antibiotic resistance was observed in biofilm producers than in biofilm non-producers. The most effective antibiotics for biofilm producing Gram-positive isolates were Vancomycin and Tigecycline, and that for biofilm producing Gram-negative isolates were Polymyxin-B, Colistin Sulphate and Tigecycline. Nearly 46 % of the isolates were found to be biofilm producers. The antibiotic susceptibility pattern in the present study showed Amoxicillin to be an ineffective drug for isolates from the IMDs. For the detection of biofilm production, TA method can be an economical and effective alternative to TCP method.

Objective:Despite the increasing incidence of type 2 diabetes mellitus (T2DM) in South Asian countries, there have been no studies related to insulin resistance (IR) and beta-cell function (BCF) in Nepal. Measurement of both of these parameters at T2DM diagnosis can be a potential tool in evaluation, risk stratification and monitoring treatment. In this study, we used C-peptide modified homeostatic model assessment (both HOMA1 and HOMA2) and correlated the obtained IR with cardiovascular risk factors. We also intended to find out whether reduced insulin sensitivity or beta-cell failure predominates in new T2DM cases. Also there has been some dilemma in using either body mass index (BMI) or waist-hip ratio (WHR) as a better predictor of IR in our population. Lipoprotein ratios TC/ HDL and TG/HDL also needed evaluation in this regard.Results: Participants were sixty newly diagnosed T2DM patients visiting Tribhuvan University Teaching Hospital (TUTH), Nepal. The mean IR and beta-cell function were HOMA1IR=4.91 ± 1.62; HOMA2IR=2.61 ± 1.06 and HOMA1%B=40.28 ± 23.64; HOMA2%B=47.10 ± 24.67 respectively. Both HOMA1 and HOMA2 showed greater reduction in insulin sensitivity than beta-cell function at diagnosis. ROC curves analysis showed WHR and TC/HDL ratio as better predictors of IR.

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