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Background: Diabetic foot infections are important cause of morbidity and mortality among persons with diabetes mellitus. The reported prevalence rates in India range from 0.9–8.3%. Diabetes foot lesions are the leading cause of non-traumatic amputations worldwide. A study has been conducted to isolate and find the antibiotic susceptibility pattern of the bacteria from diabetic foot infections from the patients of Kancheepuram district, Tamil Nadu, India. Methods: Sixty patients previously diagnosed or newly diagnosed as diabetic, presented with lower extremity infection attending Tagore medical college and hospital and its peripheral centres were selected for the study. Various specimens (pus, wound exudates, or tissues biopsy) for microbiological studies were obtained from the infected region. The specimens were cultured on blood agar and MacConkey agar for aerobic / facultative anaerobic organisms and on Neomycin Blood Agar for anaerobic organism. The plates were then incubated at 37°C. For anaerobic culture the plates were incubated in the McIntosh anaerobic jar. Isolates obtained are identified by standard laboratory techniques. Results: The result showed that Pseudomonas aeruginosa (48.3%) is the predominant bacterium followed by Staphylococcus aureus (38%) and other bacteria. The anaerobic bacteria are also isolated from the diabetic foot ulcers. The Peptostreptococcus species (26.7%) are the predominant bacteria followed by other bacteria. Further the results showed that 22 patients (37%) showed the multi-bacterial infection and remaining 38 patients (63%) showed mono bacterial infection. The drugs like amikacin, cefepine, ciprofloxacin, cotrimoxazole and roxythromycin are sensitive to many gram positive bacterial isolates. Conclusion: The present study has given the data of various bacteria encountered in the diabetic foot ulcer in the district of Kancheepuram, Tamil Nadu, India and its antibiotic sensitivity pattern. The results clearly reveal that there is no definite aetiology in diabetic foot infections. Many patients presented the infection with the involvement of many bacteria. Further it is evident that many bacteria are multi drug resistant and thus complicating the management of diabetic foot infections.
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PURPOSE: To comprehensively study the possibility of autoimmune reactivity by hepatitis viruses B and C (HBV &HCV) in Indian chronic liver disease (CLD) patients. METHODS: One hundred and sixty histopathologically proven CLD cases and 100 matched controls were analysed for viral serology for HBV and HCV and autoimmune serology for antinuclear antibody (ANA), anti smooth muscle antibody (ASMA) and Liver kidney microsomal antibody (LKM) using standard immunofluorescence technique. RESULTS: 43.7% of cases were chronic hepatitis B while 16.2% were positive for HCV. CLD-B cases showed ANA positivity in 27.1% and ASMA positivity in 25.7%. CLD-C cases revealed 26.9%, 46.1% and 11.1% positivity for ANA, ASMA and LKM antibodies respectively. These rates and titres of autoantibodies were statistically significant (p=< 0.02) when compared with that of controls. Conclusions: Based on the pattern of autoantibody positivity, it could be concluded that chronic HBV infection may induce autoimmune hepatitis (AIH) type I and chronic HCV infection might trigger AIH - Type II in Indian CLD cases.
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The diagnosis of childhood tuberculosis is based on circumstantial evidence in the absence of a gold standard in the majority of cases. Sero-diagnosis offers scope for an early diagnosis in a variety of clinical conditions and is simple to perform. A number of mycobacterial antigens have been used for antibody detection assays and several are available as kits in the market. This study was done to evaluate the value of antibody detection kits (ELISA) against the A60 antigen and 38 kDa antigen of Mycobacterium tuberculosis in the diagnosis of childhood tuberculosis at the outpatient department of the Institute of Social Paediatrics, Government Stanley Hospital in collaboration with Tuberculosis Research Centre, Chennai. Thirty five children with pulmonary tuberculosis, 7 with TB lymphadenitis and 22 healthy controls were studied. In addition to routine investigations including gastric lavage for AFB culture, serum antibodies against the A60 and 38 kDa antigens were assayed using commercially available ELISA kits. With A60, IgM serum levels were positive in 74% of pulmonary TB cases, 57% of TB lymphadenitis cases and 50% of controls. A60 IgG was positive in 17% of pulmonary TB, 86% of TB lymphadenitis and 14% of controls. The 38 kDa IgG antibody was positive in 37% of pulmonary and 86% of TB lymphadenitis cases and 27% of controls. Among 10 culture confirmed cases, A60 IgM was positive in 8, A60 IgG in 3 and 38 kDa IgG in 5 patients. The sensitivity of the tests ranged between 29% and 71% and specificity between 50% and 86%. Although the numbers are small, the results suggest that serodiagnosis using the currently available antigens of M. tuberculosis is unlikely to be a confirmatory test for tuberculosis in children.