Diabetic foot infection; frequency of microbes and antimicrobial sensitivity pattern at tertiary care hospital, Karachi

Objectives: To determine the frequency of common bacterial isolates cultured from diabetic foot infection in patients with type 2 diabetes mellitus [DM] falling in Wagner's grade-2 and grade-3 classification of diabetic foot [DF] infection

Study Design: Descriptive study

Period: A six months

Setting: Dow University of health sciences and civil hospital Karachi

Methods: Completed to examine the bacterial identification in cases admitted with the infection diabetic foot along with gave Wagner's evaluation 2 and 3 at tertiary care hospital Karachi. Bacteriological finding and anti-biotic affectability profiles were completed and analyzed with utilizing standard strategies

Results: Out of 115 cases, 82 [71%] were male and 23 [29%] were female. The mean age of patients was 51.7 +/- 9.45 years, mean duration of diabetes was 10.6 +/- 4.73 years, similarly mean length of time of diabetes foot wound was 46.15 +/- 23.75 days. 45 [39%] patients had Wegner's evaluation 2 and 70 [61%] patients had Wagner's evaluation 3. 99 cases indicated with culture growth, out of which 65 [65.65%] with gram negative microbes and 25 [25.25%] gram-positive microbes. The most successive bacteria's were Proteus [35.35%], Staph. Aureus [25.25%], Klebsiella [16.16%] and Pseudomonas [15.15%]. Both gram positive and gram negative showed frequent resistance to Cloxacillin, Amoxacillin, Levofloxacin, and Linezolid, gram negative life forms likewise indicated high resistance rate to Clindamycin, Vancomycin, and Cefotaxime. Tienam [Imipenem], Sulzone [salbactam in addition to cefoperazone] and Amikacin were the best effective against gram -ve and gram +vemicrobes. Staph. Aureus and Staph. Epidermidis were profoundly susceptible to Ciprofloxacin, Ceftriaxone, Clindamycin, and Vancomycin

Conclusion: Gram negative microbes were more common than gram positive living beings. Proteus, Staph Aureus, Klebsiella and Pseudomonas aeruginosa were the most widely recognized microorganisms of DF infection. Tienam [Imipenem], Sulzone [salbactam in addition to cefoperazone], and Amikacin were best effective agents

Frequency of low serum magnesium level in diabetic and non-diabetic patients compared with other risk factors of cardiovascular diseases

To assess the frequency of serum magnesium level in heart failure patients with and without diabetes mellitus. Cross Sectional Study. This study was conducted at Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi, in collaboration of National Institute of Cardiovascular Diseases [NICVD] Karachi, from April 2003 to December 2003. A sample size of 45 was drawn through convenient sampling, between the age group of 35-65 years. Serum magnesium, glucose levels were estimated, using Kit method, data was analyzed on the SPSS 11 for statistical significance. Out of 45 cases of heart failure, 15 were diabetic with low level of serum magnesium [1.67mg/dl] as compared to 30 non-diabetics with significantly high level of serum magnesium [1.75mg/dl]. This study concluded, in heart failure patient with diabetes mellitus had low serum magnesium level and was at increased risk of complications related to magnesium

Heart failure patients are prone to develop magnesium deficiency as a result of diuretic/digoxin therapy

To evaluate serum magnesium level in chronic heart failure [CIIF] patients receiving diuretic and digoxin therapy. Study Design: A case-control study. The study was conducted at the Basic Medical Sciences Institute [BMSI]. Jinnah ostgraduate Medical Centre [JPMC], Karachi with collaboration ofNational Institute of Cardiovascular Diseases [NICVD], Karachi from April to December 2003. Serum magnesium levels were evaluated in 65 subjects including 45 patients of heart failure admitted in the NICVD, Karachi. Twenty subjects were healthy, age and gender matched controls [group l]. Patients were divided into two groups [groups-II and III] according to treatment with diuretics or combination of diuretic and digoxin. Other electrolytes including sodium, potassium, chloride and calcium were also evaluated. Student't' test at ranging p-values of [<0.05. <0.01, <0.001] were used to determine the statistical significance. The cardiac failure patients showed lower [1.72 +/- 0.07 mg/dl] level of serum magnesium when compared with normal [0.53 +/- 0.19 mg/dl] control subjects and even more significantly lowered [1.65 +/- 0.09 mg/dl] in patients who were receiving diuretics and digoxin as compared to patients [1.80 +/- 0.10 mgidl] who were on diuretics only [p<0.001]. Patients with chronic heart failure were characteristically prone to develop magnesium deficiency along with other electrolytes [potassium. calcium, and chloride] due to administration of diuretics and digoxin