Bacteriological study of diabetic foot infection in Egypt

Foot infections are one of the major complications of diabetes mellitus and are a significant risk factor for lower extremity amputation. Providing effective antimicrobial therapy is an important component in treating these infections. This study assesses the microbial isolates of patients with diabetic foot infections and their antibiotic susceptibility pattern. A prospective study of 75 patients with diabetic foot infections admitted to Al-Azhar university hospitals was undertaken. Bacteriological specimens were obtained and processed using standard hospital procedure for microbiological culture and sensitivity testing. Overall, 40 [54%] patients had subcutaneous infections, 22 [29%] had infected superficial ulcers, seven [9%] had infected deep ulcers involving muscle tissue, and six [8%] patients had osteomyelitis. A total of 99 pathogens were isolated. Forty percent of patients had polymicrobial infection, 39 [52%] had single organism infections, and six [8%] had no growth. Gram-negative bacteria [67%] were more commonly isolated compared with Gram-positive bacteria [30%]. The three most frequently found Grampositive organisms were Staphylococcus aureus [10.2%], Streptococcus pyogenes [7.1%] and methicillin-resistant S. aureus [7.1%], and the most common Gram-negative organisms were Pseudomonas aeruginosa [19.4%], Klebsiella pneumoniae [15.3%], and Acinetobacter spp. [10.2%]. Vancomycin was found to be the most effective against Gram-positive bacteria, whereas imipenem and amikacin were most effective against Gram-negative bacteria on antibiotic testing. Forty percent of diabetic foot infections were polymicrobial. S. aureus and P. aeruginosa were the most common Gram-positive and Gram-negative organisms, respectively. This study helps us to choose empirical antibiotics for patients with diabetic foot infections

Comparison between pre-operative fine needle aspiration cytology and intra-operative frozen section biopsy in the diagnosis of solitary thyroid nodule

Controversy continues to exist concerning the diagnosis of solitary thyroid nodule. Even today there is a wide spread disagreement as to the best method of establishing a definitive diagnosis. Fine needle aspiration cytology [FNAC] is a standard diagnostic procedure for patients with solitary thyroid nodule and the necessity for frozen section [FS] intraoperative biopsy has been the subject of discussion. The purpose of this study is to compare between preoperative FNAC and intraoperative FS biopsy in the diagnosis of solitary thyroid nodule. Twenty patients [17 women and 3 men with mean age 36.5, range 23-64 years] suffering from solitary thyroid nodule were admitted to hospital. Combined preoperative FNAC and intraoperative FS examination were assessed in all patients. In the benign cytology, the diagnostic accuracy was 78.6% for FNAC and 100% for FS biopsy. In those with suspicious cytology [cellular FNAC diagnosis], the diagnostic accuracy was 15% for FNAC and 95% for FS biopsy. In those with malignant cytology, the diagnostic accuracy was 50% for preoperative FNAC and 83.3% for intraoperative FS biopsy