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Background: Antibiotic policy and appropriate antibiotic prophylaxis cannot be designed unless data is available about bacteria colonizing the bile associated with gall bladder disease. Authors aim was to assess the clinical profile and pattern of bacterial isolates from bile aspirates of cholecystectomy patients seeking care at a tertiary care teaching hospital.Methods: Patients who underwent cholecystectomy for various hepatobiliary ailments during year 2017-18 formed the study population. Bile aspirates were collected during cholecystectomy and sent to the microbiology laboratory. Ultrasonography, computed tomography and MRCP were done to confirm the gall bladder pathology before surgery.Results: Out of total eighty-six patients, bacterial growth was observed in 28 (32.56%) subjects. As per division of bile samples, maximum number of study participants (39.29%) having bactibilia were seen in Group II. Group with second highest number of patients showing bactibilia was Group III with 9 subjects (32.14%). Eight subjects (28.57%) exhibited bacterial growth in bile aspirates in Group I subjects. Three patients (10.71%) showed bile infected with multiple bacteria i.e. polymicrobial infection. The gram-negative preponderance was seen in all the three groups with Escherichia coli being most common in group I and II. Pseudomonas aeruginosa was isolated in majority of the patients in group II and III.Conclusions: It is advised that all patients undergoing cholecystectomy must have their bile aspirated during cholecystectomy and sent for microbiological examination and culture. It will help in choosing appropriate antibiotic to prevent infection.
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Background: A good and an effective empirical treatment of SBP is not possible unless bacteriological spectrum and their antibiogram is clear. This becomes more important in country like India due to high antibiotic resistance. Authors aim was to assess the prevalence of SBP, clinical and microbiological profile of its variants, in patients with cirrhosis seeking care at a tertiary care teaching hospital.Methods: Patients of liver cirrhosis with ascites seeking care at study subject during January- December 2018 formed the study population. Diagnosis was based on clinical examination, biochemical investigation and ultrasonography. Diagnostic abdominal paracentesis was performed on subjects within 24 hours of admission. Ascitic fluid was aspirated. It was sent for microbiological examination.Results: Prevalence of SBP was 16.12%. Out of total ten subjects with Spontaneous Bacterial Peritonitis (SBP), six subjects were of Culture Negative Neutrocytic Ascites (CNNA). Thus most common (60%), variant of Spontaneous Bacterial Peritonitis (SBP) was Culture Negative Neutrocytic Ascites (CNNA). Prevalence of Mono-microbial Non-neutrocytic Bacterascites (MNBA) and Classic-Spontaneous Bacterial Peritonitis (C-SBP) was 20%. Two subjects found positive for MNBA, Staphylococcus aureus and Acinitobacter spp. was detected in each patient. Klebseila pneumonia, Escherichia coli and Coagulase negative Staphylococcus were found in ascitic fluid culture of C-SBP. In clinical variants of SBP, 80% subject’s complaint about abdominal pain. Hepatic-encephalopathy and fever was seen in 7(70%) patients. Rebound tenderness was seen among 60%.Conclusions: Diagnostic paracentesis should be advised to all cirrhotic patients with ascites. Ascitic fluid analysis should be sent for better selection of antibiotics thus better outcome of cirrhotic patients.
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Introduction: Diabetic foot syndrome (DFS) is one of the mostserious, important and economically demanding complicationsthat patients with diabetes can develop. Hence; the presentstudy was undertaken for assessing and comparing the serumHbA1C level among patients with and without diabetic footcomplication.Materials & Methods: A total of 150 diabetic patients wereenrolled in the present study. Clinical examination was done inall the patients and prevalence of diabetic foot complicationwas assessed. Blood samples were withdrawn from all thepatients and mean HbA1c concentrations were assessed usingautoanalyzer. All the values were recorded in Microsoft excelsheet and were analysed by SPSS software. Chi- square testwas used for assessment of level of significance.Results: Prevalence of diabetic foot complication was found tobe present in 30 patients. Mean HbA1C values of patients withdiabetic foot complications was 10.75%, while among thepatients without diabetic foot complication, it was 8.76%. Whilecorrelation of occurrence of diabetic foot complication withdiabetic profile, significant results were obtained.Conclusion: Patients with diabetic foot complications areaccompanied by significant alteration in mean HbA1c levels.
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Introduction: Hypertensive disorders in pregnancy are one ofthe leading causes of maternal and perinatal morbidity andmortality across the world. Hypoalbuminemia is not uncommonin women with the disease state whereas macroalbumiuria is apredictor of adverse pregnancy outcomes in the population.Hence; the present study was undertaken for assessmentserum albumin levels in pregnant hypertensive women.Materials & Methods: A total of 40 pregnant subjects wereanalysed. Among 40 subjects, 20 were hypertensive while theremaining 20 were non-hypertensive. Complete demographicdetails of all the patients were obtained. Blood samples wereobtained from all the patients and serum albumin levels wereassessed using autoanalyzer.Results: Mean age of the patients of the hypertensive andnon-hypertensive group was 59.6 years and 63.2 yearsrespectively. Mean serum albumin levels among the patients ofhypertensive and non-hypertensive group was 3.39 gm/dL and3.68 gm/dL respectively. Significant results were obtainedwhile comparing the mean serum albumin levels among thetwo study groups.Conclusion: Hypertensive pregnant subjects are accompaniedby significant alterations in serum albumin levels.
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Parathyroid carcinoma is a rare disease. It accounts for lessthan 1% of all case of primary hyperparathyroidism and isusually not detected until the time of surgery or thereafter.Preoperative staging is not available for most patients. Hence aradical excision remains the standard management. Usuallythe disease has an indolent but slowly progressive course.Most of the patients suffer due to complications ofhypercalcemia, rather than direct tumor invasion ormetastases. The management of PC is difficult in terms ofdiagnosis, treatment and follow up. Here is a case report thatproves a diagnostic challenge to both the clinicians andpathologists and is discussed below
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Introduction: In quality management system for processimprovement and better inventory management, a performancemonitoring tool is critical in the blood bank to improvequality and discard rate of blood component is one of theessential elements. This study was designed to analyse bloodcomponent discard and their reason in a newly developedinstitute and blood bank setup.Material and Methods: It was a retrospective observationalstudy from May 2018 to March 2019. During the study perioddata was captured and analysed for component preparationand discarded individually and cumulatively. Major reasonswere analysed for blood component discard.Results: Total number of blood component discard observedwere 1714 out of which 368 red cell component (21.4%);1139 Platelet component (66.4%), 210 fresh frozen plasmas(11.7%); 6 cryoprecipitate and cryo poor plasma respectively(0.6%) were discarded. Major reasons for discard of bloodcomponent were expiry, TTI reactivity, leakage, and red cellcontaminations.Conclusion: The current study reflects very high discardrate compared to other published studies and recommendthe following the necessary policies and supervision forreduction of blood component discard are need based changeand production of blood components and better inventorymanagement in new hospital based setup and followingstandard procedure for manufacturing, storage and transfer ofblood components.