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Introduction- Enterococci are part of normal intestinal flora of humans and animals but have also emerged as important pathogens responsible for serious infections in hospital and community acquired infections.it is second most common cause of nosocomial infections in gastrointestinal tract, wound and genitourinary tract. To process all the clinicalAim- samples from various department in our hospital, for isolation of Enterococci spp. To speciate the isolates & to have resistance pattern of the isolates of vancomycin total 926 sample were collected from both outMaterial & Methods- patients and in patient in all clinical departments and transported to microbiology laboratory. specimens were processed by inoculating on to blood agar, MacConkey Agar, nutrient agar, potassium tellurite agar and incubated at 37°C for24-48 hr. Enterococci were identified by their typical arrangement in and salt tolerance test Gram stain, bile esculin test and biochemical tests. Antimicrobial susceptibility patterns were determined by performing Kirby-Bauer disc diffusion method and Minimum inhibitory concentration (MIC) values were identified by tube dilution methods. Result- a total of 926 sample, 645 (69.72%) were culture positive and 281 (30.28%) were culture negative. Among 645 culture positive cases, 81(12.55%) were Enterococcus faecalis. Antimicrobial susceptibility & MIC done as per standard protocols. The E. Faecalis showed 99% sensitive to Vancomycin. the resistance to vancomycin was 1% & further confirmed by MIC via tube dilution methods. In which MIC was ?32 ?g/ml in one isolate. About 8 of Enterococcal strains showed MIC of 0.0125?g/ml. species level identification of Enterococcus is important forConclusions- epidemiological study and also for analysis of drug resistant pattern. Effective detection of vancomycin resistance helps in reducing the morbidity and mortality of VRE in hospitalized patients
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Drug resistance among gram positive aerobic cocci poses a significant problem in management of patients with skin and soft tissue infections (SSTI's). S. aureus is the most common organism that causes mild skin and soft tissue infections to serious infections such as sepsis and toxic shock syndrome. Enterococcus and Streptococcus species have also emerged as a cause of skin and soft tissue infections and health care associated infections (HAI's). SSTI's is an inflammatory microbial invasion of epidermis, dermis and subcutaneous tissue. It is classified according to the layer of infection, severity of infection and microbiologic etiology. The practice guidelines of the Infectious Disease Society of America (IDSA) for the diagnosis and management of skin and soft tissue infection classifies SSTI's into five categories comprising superficial and complicated infections which include impetigo, erysipelas, cellulitis, necrotizing fasciitis, surgical site infection. Risk factors associated with development of SSTI's include poor hygiene, overcrowding, co- morbidities like diabetes, immunocompromised state, overuse of antibiotics, prolonged hospital stay, burn patients etc. Prompt recognition, timely surgical debridement or drainage with appropriate antibiotic therapy is the mainstay treatment for SSTI's. Empirical therapy includes penicillin, cephalosporins, clindamycin and cotrimoxazole. Multi-Drug resistance is of major concern commonly caused by MRSA (Methicillin resistant staphylococcus aureus) which includes CA-MRSA (Community acquired methicillin resistant Staphylococcus aureus), HA-MRSA (hospital acquired methicillin resistant Staphylococcus aureus), VRSA (vancomycin resistant staphylococcus aureus) & VRE (vancomycin resistant Enterococci). HA-MRSA is generally susceptible to clindamycin, vancomycin, Linezolid & trimethoprim- sulfamethoxazole. In contrast, CA-MRSA is usually sensitive to these former antibiotics as well as broader range of oral antimicrobial agents like clindamycin, linezolid, quinolones, daptomycin, tigecycline etc. These empirical therapeutic agents provide coverage for both S. aureus, Streptococcus species and Enterococcus species. Therefore, demographic knowledge of antimicrobial agents and their resistance pattern plays a significant role in management of SSTI's
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Background : The presenting study was performed to assess the efficacy in terms of tumour response and toxicity profile of a curative intent organ preservation approach in Inoperable Non-metastatic Muscle-Invasive Urinary Bladder Carcinoma. Materials and Methods : Prospective Interventional Single-Arm, Single Center study with a duration of one and half year in which 47 patients with Muscle-invaded Bladder Cancer were treated with Radiotherapy with 64 Gy in 32# along with Concurrent Chemotherapy with three weekly injection Cisplatin in dose of 70 mg/m2. Response evaluation was done using both Clinical and Radiological means and categorized using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. For adverse events measurement: NCI CTCAE (Common Terminology Criteria for Adverse Events, v4.1) and RTOG/EORTC Acute and Late Morbidity criteria was used. Results : Of the 47 patients who completed chemoradiation, complete treatment response was seen in 25 patients (53.2%), 17 patients (36.2%) had partial response on initial assessment and one patient had disease progression both in form of locoregional and distant (lung) metastasis. Stable disease found in (8.5%). Patients with residual disease were advised to undergo salvage treatment. Grade 3 Nephrotoxicity reported in one patient, Grade 2 Cystitis in 32 patients (68.1%), while Grade 2 Diarrhoea occurred in four patients (8.5%). Hematological toxicity attributable to Chemoradiotherapy included Grade 2, Grade 3 Neutropenia seen in 6.4% and 2.1% respectively and Grade 2 Anaemia in 4.3% patients. Conclusion : Concurrent Chemoradiotherapy is well-tolerated, effective and convenient curative treatment option for patients with Inoperable Non-metastatic Muscle Invasive Carcinoma of Urinary Bladder
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OBJECTIVE: The aims of the present study were to explore the behavioural effects and to understand the possible mode of action of Bacopa monnieri extract (BME) on chronic unpredictable stress (CUS) induced depressive model and the biochemical alterations such as brain derived neurotrophic factor (BDNF), Akt, cyclic-AMP response element binding (CREB) protein level in the hippocampus of rats. METHODS: We examined the effects of chronic administration of BME on CUS exposed rats for 28 days. Behavioural changes were assessed by sucrose consumption and open field test to assess the effect of BME on CUS-induced depression. The mechanisms underlying antidepressant like action of BME was further evaluated by measuring levels of BDNF, Akt, and CREB in the hippocampus of rat brain and compared with the standard tricyclic antidepressant drug imipramine (20 mg/kg body weight). RESULTS: Exposure to CUS for 28 days produced depression-like behavior in rats, as indicated by significant decreases in sucrose consumption, locomotor activity including decreased BDNF, Akt and CREB levels in the hippocampus. Daily administration of BME at a dose of (80 mg/kg body weight) significantly reverses the behavioral alteration and restored the normal level of BDNF, total and phospho-Akt, total and phospho CREB in the hippocampus of CUS induced rats as compared to vehicle treated control rats. CONCLUSION: These findings suggest that BME ameliorates CUS induced behavioural depression in rats and that can be used as a potent therapeutic agent in treating depressive like behavior.