ABSTRACT
Background: It is common for patients with type 2 diabetes mellitus (T2DM) to have vitamin D deficiency. Aim of the study is to determine the metabolic effects of oral vitamin D supplementation in a cohort of T2DM subjects.Methods: Subjects with T2DM were divided into two groups. Group A (Control) included subjects who received the standard treatment (conventional antidiabetic drugs). Group B (Intervention), apart from the standard treatment (conventional antidiabetic drugs), was also supplemented with Vitamin D3. All the patients were followed up at baseline, 6 months, 12 months and 18 months.Results: Vitamin D deficiency was noted down in all the study subjects. Even after 18 months of supplementation, all subjects remained vitamin D deficient. There was a significant improvement in the circulating levels of 25-hydroxyvitamin D. Improvement in the lipid profile of subjects was observed as evidenced by a decrease in total cholesterol (5.0±0.92 mmol/l) as compared to baseline (5.5±1.6 mmol/l). HOMA-IR changed significantly after 18 months of supplementation from baseline (7.0±1.06 vs 10.8±1.96 nmol/l).Conclusions: Supplementation to achieve higher levels of vitamin D remains a promising adjuvant therapy for T2DM patients. Additionally, the intervention brought out a favourable change in HDL/LDL ratio among study subjects.
ABSTRACT
Background: Better management of patients cannot be ensured and the antibiotic policy cannot be designed till one knows the profile of prevalent strains along with their antimicrobial resistance pattern. Objective: To assess the strategic patterns of the organisms and its resistance patterns that were isolated from the patients admitted in various ICUs in a tertiary care hospital. Material and methods: The present study was undertaken based on reports of bacterial isolates of various clinical specimens from different ICUs of a tertiary care teaching hospital, that were submitted to the Microbiology laboratory for culture and sensitivity during the period of October 2012 to September 2014. All the organisms were identified morphologically and biochemically by standard laboratory procedure and antibiotic susceptibility pattern was determined by disc diffusion methods. Results: Out of the total samples (2920) received; organisms were isolated from 66.57%. One organism was isolated in 71.19% samples whereas 2 or more organisms were obtained in 28.8% were obtained in 28.8% samples. The most frequently isolated bacteria were P. aeruginosa (38.17%). Among P. aeruginosa, tobramycin had the highest susceptibility rate (94.2%) followed by meropenem (93.93%), carbenecillin (79.11%), and levofloxacin (73.45%). Most of the frequently isolated organisms like K. pneumoniae, Acinetobacter anitratus, Enterobacter were highly resistant to ampicillin, cephalexin, cefepime, ciprofloxacin. Conclusion: Appropriate antibiotic utilization in ICU is crucial not only to ensure an optimal outcome, but also to prevent the emergence of multi drug resistance. Antibiotic policies and effective surveillance are needed for better management of ICU infections with resistant organisms, Alteration and rotation in antibiotic prescribing patterns would decline the antibiotic resistance.
ABSTRACT
Objective: To assess the efficacy of metronidazole and collagenase combination in the treatment of diabetic foot ulcers with regard to the reduction of slough formation, enhancement of granulation tissue and re-epithelization. Study design: Prospective, comparative study. Place and duration of study: Surgery department of a tertiary care teaching centre of rural Haryana, from January 2011 to February 2013. Methodology: The patients who were admitted for diabtic foot ulcers at Surgery Department of a tertiary care teaching centre during the study period were screened. 42 patients in the test group were treated with topical dressings of collagenase and metronidazole. The control group of 40 patients was treated with conventional topical dressings and bed side debridement. Ulcer's status was noted using visual score. Results: The number of patients with no necrotic tissue was significantly higher in test group at 3rd, 4th, 5th, 6th and 7th weeks than control group. Granulation tissue was significantly higher in test group at 3rd, 4th, 5th and 6th week. The test group patients had a faster wound bed preparation resulting in faster wound cover using secondary suturing, S.S.G., flap cover at the third week itself. Conclusion: Combination of collagenase and metronidazole topical application enhanced wound healing of diabetic foot ulcer as compared to conventional treatment modalities.