ABSTRACT
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
ABSTRACT
The aim of this study is to compare between the modified Koyanagi and Snodgrass techniques in the management of proximal types of hypospadias as regards operative time, hospital stay, success rate, postoperative complications and cosmetic results. Fifty male patients with different types of proximal hypospadias [the urethral meatus is proximal penile, penoscrotal or scrotal] were enrolled in the present study; these patients underwent surgical repair using the tubularized incised plate urethroplastyand Modified Koyanagi repair. They were studied during the period between 2010 and 2012 at Pediatric Surgical Units, Al-Azhar University Hospitals [Cairo and Damietta]. All patients were subjected to: detailed history taking, full clinical examination, both general and local. Fifty patients were randomized into two groups; A; [n = 30] patients underwent TIPU; B; [n = 20] patients underwent MK technique. The range of follow up period is 4 to 8 months with a mean of 6 months. Operative time was significantly decreased in group A in comparison to group B [83.30 +/- 6.51 vs. 158.25 +/- 22.78 min respectively]. Duration of hospital stay was significantly shortened in group A in comparison to group B [9.56 +/- 1.73 vs. 17.80 +/- 2.26 days respectively]. The success rate in group A was 70.0% compared to 60.0% in group B. The fistula was more in group A than B and meatal stenosis was more in group A than B, while disruption was equal in both groups. TIP and Modified Koyanagi repair techniques could be considered as acceptable and as effective as each other for hypospadias repair, provided that a good selection of cases for each type of repair was achieved. The tubularized incised plate [TIP] urethroplasty is a reliable one stage procedure in dealing with proximal hypospadias either without or with a mild degree of chordee if the urethral plate is supple and wide enough for tubularization, while MK is a reliable one stage procedure in severe degree of chordee, small sized penis or with narrow urethral plate