Echocardiographic Changes in Controlled Type 2 Diabetes Mellitus with Reference to Body Mass Index and Waist Hip Ratio

Type2 diabetes mellitus is associated with central obesity. Studies showsthat central obesity, leads to insulin resistance is an important determinant for insulin resistance and cardiovascular morbidity. In the present study clinical profile of type2 diabetics with special reference to cardiac changes were studied and their relationship were established. This is a prospective cross-sectional study conducted in Sree Balaji Medical College and Hospital. 50 obese patients with controlled diabetes less than 5 years of duration were compared with obese non diabetics. There is significant statistical correlation with obese diabetic subjects particularly females, alterations in LV geometry. Obese female subjects had predominantly higher left ventricular mass. From the data of the present study high BMI, WHR have increased incidence of cardiovascular disease

Neurobrucellosis: a case report.

Neurologic involvement of brucellosis is common but exact prevalence of it is unknown due to difficulty in diagnosis and inadequate reporting all over the world. Neurologic involvement may manifest as chronic meningitis, lymphocytic meningoencephalitis, a variety of cranial nerve deficits, or ruptured mycotic aneurysms. We report a case of young male who had history of fever and headache on and off for 2 years and later developed signs of meningitis, lateral rectus palsy, altered sensorium and bilateral papilledema. He did not respond to anti-tubercular therapy and antibiotics. CT scan and MRI brain were normal. He had hepato-splenomegaly with small hypoechoic lesions in the spleen. CSF culture grew gram negative bacilli. Brucella IgG antibodies in serum by EIA 7, IgM negative, Brucella antigen titer was positive, 1:160. Patient received inj. streptomycin 0.75 g for 21 days and doxycycline 100 mg twice daily doxycycline for 6 weeks. The complete improvement in patient’s condition after a long lasting illness motivated authors to report this case. Delay or failure in diagnosis of this treatable disease may lead to significant morbidity and mortality so high index of suspicion should be kept in such cases.

Fulminating septicemia due to persistent pan-resistant community-acquired metallo-β-lactamase (IMP-1)-positive Acinetobacter baumannii

Acinetobacter baumannii is considered as an emerging nosocominal pathogen and is renowned for its multi-drug resistance. We report a case of community-acquired pan-resistant A. baumannii strain isolated from blood, pus , urine and tracheal aspirate was confirmed by 16S r-RNA sequence homology and found positive for metallo-ß-lactamase IMP-1, and was found to be a strong biofilm producer The isolate was only susceptible (moderately) to colistin.

Clinical and demographic features of infection caused by Acinetobacter species.

BACKGROUND: Recently, Acinetobacter emerged as an important pathogen and the prevalence of isolation has increased since the last two decades worldwide. AIMS: To determine Acinetobacter incidence, their clinical demography, antibiotyping and speciation. SETTINGS AND DESIGN: A study of the clinical samples submitted to microbiology laboratory of a teaching hospital over a period of 3 years (December 1994 through November 1997). MATERIALS AND METHODS: Identification, speciation and antibiotyping were performed for the isolates of Acinetobacter recovered from infective samples. Clinical demographic characteristics were studied retrospectively. RESULTS: Total 510 of 5391 (9.6%) of isolates were Acinetobacter, responsible for 71.2% (363 of 510) monomicrobial and 28.8% (147 of 510) polymicrobial infections. The organism was responsible for 156 (30.6%) cases of urinary tract infection and 140 (27.5%) cases of wound infection and was most prevalent in the intensive care unit (30.8%, 140 of 455). The crude mortality rate due to multi-drug resistant Acinetobacter septicemia was 7.9% (36 of 455). The isolates could be classified into 7 species, with A. baumannii being most predominant. No peculiar pattern during antibiotyping was observed, but most of them were multi-drug resistant. CONCLUSION: Multi-drug resistant Acinetobacter nosocomial infection has emerged as an increasing problem in intensive care units of the hospital, responsible for 7.9% deaths. The analysis of risk factors and susceptibility pattern will be useful in understanding epidemiology of this organism in a hospital setup.