Introduction: Infection of pleural space that arises due to complicated parapneumonic effusion and empyema is a common worldwide problem that is known since very ancient times. The microbial aetiology of pleural space infections has changed since introduction of antibiotics. Gram positive organisms are slowly and steadily losing their foothold in the pleural space to the more resilient and resistance gram negative bacteria. Incidence of these infections are increasing and delayed treatment causes significant morbidity and mortality. Aim: To study the age-sex profile, symptoms, microbiological findings, aetiology, management and treatment outcome of pleural space infections. Materials and Methods: This cohort study was conducted at Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha, India, from November 2016 to October 2017 on 48 consecutive patients. Each patient was followed-up for a minimum period of two months. The demographic data, clinical presentation, microbiological findings, aetiology, clinical course and management information were collected in a predesigned proforma and analysed. Results: The study population comprised of 33 (68.8%) male, 15 (31.2%) female patients. The mean age of the study population was 46±14 years. The most common presenting complaints were fever {43 (89.5%)}, shortness of breath {42 (87.5%)}, chest pain {38 (79.1%)} and cough {36 (75%)}. Pneumonia was diagnosed in 30 (62.5%) cases as the major cause of pleural space infection. Common organisms isolated were Streptococcus pneumoniae 11 (23%), Streptococcus pyogenes 9 (18.7%), Staphylococcus aureus 7 (14.5%) and Escherichia coli 7 (14.5%). The treatment was with Intravenous (i.v.) antibiotics followed by oral antibiotics. Most cases 46 (95.8%) required both thoracocentesis and Intercostal Tube Drainage (ICTD). Follow-up chest X-ray after two weeks showed complete lung expansion in 25 (52%) cases. Pleural thickening of <2 cm found in 22 (45.8%) cases and >2 cm found in 26 (54.2%) cases. At the end of one month of discharge 35 (73%) patient had complete resolution, 8 (16.7%) patients had persistent infection, 3 (6.2%) died and 2 (4.1%) patients were loss to follow- up. Out of the eight patients with persistent infection one patient had empyema necessitans and seven patients had bronchopleural fistula. On follow up after 2nd month out of the 8 (16.6%) persistence cases, 5 (10.4%) cases were cured and remaining 3 (6.2%) cases the infection persisted (pus) and ICTD was kept in-situ. Conclusion: Pneumonia is the most common cause of pleural space infections. Most common pathogen isolated was gram positive organism Streptococcus pneumoniae. In significant number of cases gram negative organism Escherichia coli was isolated. Most cases required both thoracocentesis and ICTD for resolution. The key to successful management of pleural infection remains to be early diagnosis, initiation of empirical broad spectrum antibiotics, followed by specific antimicrobial therapy after microbial identification and drug sensitivity testing.

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Background: Prevalence of gestational diabetes (GDM) has increased tremendously in India. Prevention of the condition is possible through health education. However, knowledge regarding diabetes is poor among Indian women. Thus, examining the basic knowledge regarding diabetes among expectant mothers is necessary to identify areas of deficit. Methods: An observational, analytical study of cross-sectional design was undertaken to assess the knowledge regarding diabetes among 173 expectant mothers attending the ante-natal clinic of R. G. Kar Medical College, Kolkata using a pre tested schedule. Results: Mean score of the respondents were less than 3 out of 8 which was a poor score. The overall mean diabetic score was similar for the antenatal mothers irrespective of the number of pregnancy (p=0.3154) but the score was greater than that for the non-pregnant women (p=0.0000). The expectant mothers showed better response compared to the controls when asked whether a person can have diabetes but be unaware of the condition; whether diabetes can harm a person's body before diagnosis; long term complications of the disease(P<0.05). However, answers were similar across all groups with respect to queries like the age group in which the condition is more commonly diagnosed and whether diabetes is curable (p>0.05). The pregnant women had less reported leisure time physical exercise and first degree relative with diabetes (p<0.05). Conclusions: Mean knowledge score of the expectant mothers was more than the women controls though the overall score was poor. A structured awareness program is urgently needed which would first address diabetes in general and then the specifics of GDM.