(SUMMARY) Aim: To determine common pathogens isolated in diabetic foot ulcers & in vitro antimicrobial activity. Setting:Muhammad Medical College Hospital, Mirpurkhas and Liaquat University of Medical & Health Sciences Jamshoro. Period: 1s t November2007 to 30th June 2008. Research Methodology: Pus samples for bacterial culture were collected from 60 patients admitted with diabeticfoot infections. Anti-microbial susceptibility testing of aerobic isolates was performed by the standard disc diffusion method as recommendedby the National Committee for Clinical Laboratory Standards. Microbroth dilution test was arranged for susceptibility of anaerobic organismsto metronidazole and amoxicillin/clavulanate. A vancomycin screen agar (6 Lig/ml) was used to detect vancomycin intermediate isolatesof Staphylococci. Results: Clinical grading and bacteriological study of 60 patients revealed, 44 (73.33%) patients had gram-negativeorganisms, & Pseudomonas aeruginosa was the most common. While 16 (26.66%) patients had gram-positive organisms & Staphylococciwas the most common organism. Infection with anaerobes was observed in one patient (1.66%). Both gram-positive and -negative organismswere seen in 8 (13.33%). Pseudomonas aeruginosa & S.aureus exhibited a high frequency of resistance to the antibiotics tested. All theisolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin. Conclusions: Pseudomonas aeruginosa,Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis and Proteus were the most common causes of diabetic foot infectionsin this study. And the rate of antibiotic resistance was 66.66% among the isolates. All the isolates were uniformly susceptible to fosfomycin,levofloxacin, amikacin and vancomycin.
Stroke is characterized by the sudden loss of blood circulation to an areaof the brain, resulting in a corresponding loss of neurologic function. It is also called ascereberovascular accident (CVA) or stroke syndrome. Objectives: To determine frequencyof hypertension, diabetes mellitus and smoking in patients with ischemic stroke. Patientsand methods: This cross sectional study of six months was carried out in the department ofmedicine, Liaquat University of Medical and Health Sciences. Patients aged 20-70 years of agewith ischemic stroke on CT were enrolled in the study after taking consent from caretaker ofpatients. Detailed history focusing on hypertension, diabetes and smoking and their durationwas taken. Blood pressure was recorded and fundoscopy was done to find out diabetic orhypertensive retinopathy. Thorough neurological examination was done and blood sugar(fasting and random) was evaluated. Data was entered and analyzed using SPSS version 16.Results: A total of 100 patients were included in the study during study period. 64% of patientswere in ≥ 50 years of age group with mean age of 52±11 years. A total of 66 (66%) were male;with male to female ratio was 2:1. Hypertension was present in 61% of cases, Diabetes wasfound in 32% cases and 40 patients were cigarette smokers. Conclusions: It was concludedthat high blood pressure, diabetes mellitus and smoking are associated with ischemic stroke.
Aims and Objectives: We evaluated whether HBV +ve and HCV +ve patients areat high risk for developing drug induced hepatitis than control subjects during treatment fortuberculosis with standard short course regimens. Study design: Observational cohort study.Place and duration: This study was conducted at Department of Medicine, Liaquat University ofMedical and Health Sciences Jamshoro from May 2008 to May 2011. Material and Methods: Allnewly diagnosed active tuberculosis patients were included in the study population and theywere further screened for hepatitis B surface antigen and HCV antibodies. All patients weredivided into three groups. One having no co-infection with hepatitis B and Hepatitis C and wastaken as control group, second group was co-infected with hepatitis B and third was co-infectedwith hepatitis C. short course anti tuberculous regimen was started and patients were followed forsix months. Results: One hundred and twenty eight tuberculous patients were divided into threegroups. 92 in control groups without any co-infection with hepatitis B and C, 10 were HBV +veand 26 were HCV +ve. During follow up 24 developed drug induced hepatitis, 8(38.33%, n = 24)in control group, 2(8.33%, n = 24) in hepatitis B group and 14(58.33%, n = 24) in hepatitis Cgroup. Conclusions: These findings suggest that treatment for tuberculosis in HCV seropositivepatients is a risk factor for the development of hepatitis exacerbation and HBV seropositivepatients shows no any increased risk of hepatitis exacerbation.
Systemic inflammatory response syndrome (SIRS) is a generalized disorder,immune response to infection which results in disturbed microcirculation, visceral perfusion andultimately visceral failure. Objectives: To determine the frequency of systemic inflammatoryresponse syndrome in patients with liver cirrhosis. Design: Cross sectional descriptive.Period: Six months study. Setting: At Liaquat University Hospital Hyderabad. Patients andmethods: All the patients with liver cirrhosis for 06 months duration admitted in the ward werefurther evaluated for systemic inflammatory response syndrome. The data was analyzed inSPSS 16 and the frequency and percentage was calculated. Results: During six months studyperiod, total 100 cirrhotic subjects were studied for SIRS. The mean ± SD for age in all (100)cirrhotic patients was 45.74 ± 7.537. The mean temperatures was 40.42±0.32 where as it was39.72±0.43 and 38.92±0.11 in male and female population respectively. The mean heart beatwas 128.42±6.74 where as it was 115.83±8.93 and 120.62±5.53 in male and female populationrespectively. The mean respiratory rate was 25.31±3.52 where as it was 23.52±2.31 and26.63±3.21 in male and female population respectively. The mean white blood cell count was28.81±4.51 where as it was 23.74±4.73 and 30.83±5.73 respectively. The SIRS was observedin 70% subjects of which 47(67.1%) were males and 23(32.9%) were females (p=0.04). Majorityof SIRS subjects were 30-39 years of age and male population was predominant (p=0.03). Thegender distribution in relation to severity of liver disease was statistically significant (p=0.05)while the SIRS in relation statical analysis. Conclusions: The systemic inflammatory responsesyndrome occurs in patients with liver cirrhosis.
Objective: To determine the frequency of raised C-reactive protein (CRP) inpatients with metabolic syndrome. Patients and methods: This cross sectional descriptivestudy of six months study was conducted at Liaquat University Hospital Hyderabad. All thepatients of 20 to 60 years of age, of either gender presented with symptoms of metabolicsyndrome for more than 01 year duration were admitted and evaluated for C-reactive protein.The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Results:Total one hundred patients (59 females and 41 males) with metabolic syndrome were evaluatedfor C-reactive protein. The mean waist circumference for males and female patients with raisedCRP was 48.93±2.33 and 48.42±3.41 while the mean ±SD of serum triglycerides level for maleand female with raised CRP was 192.41±3.21 and 196.31±3.43 respectively. The mean ±SD ofserum HDL-C level for male and female with raised CRP was 28.32±1.22 and 25.31±1.42. Themean ±SD of systolic and diastolic pressure for males and female patients with raised CRP was150±3.42 and 100.51±4.42. The mean ±SD of serum fasting blood sugar for male and femalepatients with raised CRP was 131.52±3.33 and 143.42±7.42 respectively. The mean ±SD ofCRP for male and female patients with raised CRP was 4.42±1.21 and 5.8±2.52. In relationto gender distribution, the majority of subjects from 40-49 years of age group with femalepredominance (p = 0.01) while the CRP was raised in 67% patients in relation to age (p=0.05)and gender (p=0.04) respectively. Out of 67 subjects with raised CRP 44 were females and 23were males.Conclusions: The CRP was raised in patients with metabolic syndrome.
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