Patterns and outcomes of empirical antimicrobial use in elderly outpatients: A pilot observational study from North India

Introduction: Despite the rampant use of antimicrobials in health?care settings, the safety and clinical outcome data of antimicrobials are scarce in the elderly population. The main aim of this study is to assess the prescription pattern, therapeutic gains, and adverse reactions resulting out of antimicrobial use in elderly outpatients. Subjects and Methods: This was a prospective observational study conducted for 7 months from June 2019 to December 2019 in elderly patients visiting the geriatric outpatient department of a tertiary hospital of North India. Primary outcomes included clinical improvement as well as the incidence and type of adverse drug reactions (ADRs) observed with antimicrobial use. Results: Of 110 participants recruited, 107 were assessed for clinical outcomes. The common indications of antimicrobial use were lower respiratory tract infection (48.6%), urinary tract infection (18.7%), and worm infestations (14%). Macrolides (57%) and beta?lactams (43%) were the commonly prescribed individual antimicrobials. Outcome?wise, clinical improvement was seen in 91.3%, 88.5%, and 14.3% of patients receiving beta?lactams, macrolides, and antiprotozoals, respectively. ADRs occurred in 17.7% of participants and gastrointestinal disturbance was the commonly reported ADR. Beta?lactams and macrolides were responsible for the majority of ADRs, in 19.6% and 13.1% of participants, respectively. No association of antimicrobial?associated clinical responses or ADRs was observed with demographics and underlying comorbidities. Conclusions: Elderly patients with respiratory tract infections showed improvement with empirical extended-spectrum beta-lactams and azithromycin therapy. The response was suboptimal to empirically selected antiprotozoal therapy. Elderly patients are at increased risk of ADRs. Close to one out of every five elderly prescribed beta?lactams may develop ADR to the antimicrobial agent. Larger clinical studies are required to predict the risk factors of ADRs and poor responsiveness to antimicrobials.

The Deadly Duo of Hypertension and Diabetes in India: Further Affirmation from a New Epidemiological Study

Introduction: Hypertension is highly prevalent in patients with type II diabetes mellitus. India has some of the highest rates of diabetes and hypertension worldwide, but there is a lack of local data on the coexistence of these two risk factors. This study determined the prevalence of hypertension in patients with, or at high risk of, type II diabetes mellitus from across India. Methods: Data came from a nationwide trial evaluating the effects of yoga-based lifestyle modification for the prevention/management of type II diabetes. Participants were recruited based on randomized house-to-house screening in urban and rural areas from 65 districts of 29 states/union territories. Eligible individuals were aged 20–80 years and had diabetes or were at high risk of diabetes (IDRS ? 60). Anthropometric and demographic data were obtained, and resting blood pressure and blood glucose levels were recorded. Results: This analysis included data from 14,135 individuals. Of these, 25% had self-reported diabetes, 19% were diagnosed with diabetes during the trial, and 26.8% were at high risk for type II diabetes. In these three patient groups, hypertension prevalence rates were 58%, 41.0%, and 35.8%, respectively. The prevalence of hypertension was highest in the North East region and lowest in the North West. Conclusion: The high prevalence of hypertension in patients with, or at risk of diabetes, highlights the urgent need for policies to manage this population, who are at high risk of cardiovascular disease and death.

Iatrogenic Isolated Ruptured Dorsalis Pedis Artery Pseudo Aneurysm : A Rare Case Report

A Dorsalis Pedis Artery (DPA) pseudo aneurysm is one of the most uncommon peripheral arterial aneurysms. These aneurysms can cause distal embolization and thrombosis, leading to limb loss. However, their rupture is unusual1. Any type of injury or perhaps an iatrogenic intervention can cause a pseudo localized swelling of the dorsalis pedis artery, which is a relatively unusual condition. Whenever it presents as a non-pulsatile soft tissue mass in the presence or absence of a specific predeceasing event, it can lead to a difficult diagnostic dilemma2. The rare instance of an iatrogenic pseudo aneurysm of the dorsalis pedis artery which mimicked cellulitis of the right foot is discussed in this case report. Coil embolization of the proximal artery, and the aneurysm was successfully done by the intervention radiologist. After the procedure, collateral circulation was maintained. No ischemic symptoms such as intermittent claudication or pain at rest were observed. This approach may be useful in treating similar cases

Prevalence of hearing loss in India

BACKGROUND Despite abundant literature, a clear and coherent understanding of hearing loss (HL) in India is limited by the wide disparity in studies. METHODS We did a review of published peer-reviewed journal articles. Studies reporting the prevalence and degree of HL in India from 1980 to 2020 were included. Information was gathered on the population characteristics, methodology applied and the prevalence of hearing impairment. The data were analysed to identify trends and at-risk sections of population in various categories. RESULTS Four hundred and forty studies were identified after a database search; 29 full-length articles were selected for final analysis. Using a 3-step screening protocol, hearing impairment (abnormal auditory brainstem response/auditory steady state response) in neonates ranged between 1.59 and 8.8 per 1000 births. Among ‘at risk’ neonates, it ranged from 7 to 49.18 per 1000 births. In children the prevalence of HL was 6.6% to 16.47%. Otitis media was the most common cause of HL in children. Community-based studies (all ages) reported prevalence of HL between 6% and 26.9% and prevalence of disabling HL between 4.5% and 18.3%. Rural areas and elderly showed a higher prevalence of hearing impairment. CONCLUSION Despite India’s improving health indices, hearing disability remains persistently high. It is a major contributor to the loss of personal potential and a financial strain for the individual and the country. A large-scale multicentric study to identify the degree and type of HL, social awareness campaigns, widespread neonatal screening, strengthening treatment facilities and well-funded rehabilitation programmes can counter the rising prevalence of hearing impairment.

Frequency of Chromosomally Encoded gyrA and parC Genetic Determinants of Fluoroquinolone Resistance in A. baumannii

Fluoroquinolones are administered as routine drugs of choice for treating complicated urinary tract infections caused by multidrug resistant Acinetobacter baumannii strains. It is now a world-wide issue that gyr and par induced quinolone resistance as one of the major drug resistance mechanisms. This investigation is thus aimed to assess the prevalence of quinolone resistance and to characterize the gyrA and parC producing strains of A. baumannii. Genomic DNA from 50 fluoroquinolone resistant A. baumannii were screened for gyrA and parC by PCR for the genetic relatedness with fluoroquinolone resistance, with sequencing of the representative strains. All the strains were positive for gyrA(100%) and 82% (n=41)for parC. Presence of parC was observed in 56.09% (n=23) ciprofloxacin resistant A. baumannii with 43.90% (n=18) in levofloxacin resistant A baumannii. The findings of the present study showed the prevalence of fluoroquinolone resistance among A. baumannii in urinary tract infections and the frequency of gyrA and parC in inducing the resistance

Indian scenario and an institutional experience of fatalities in COVID-19: a narrative review

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing global pandemic that has devastated our globalized economic system. Apart from infecting 12,102,328 human beings and taking a toll of over 551,046 lives globally by the 11th of July 2020, it has fundamentally affected the way we live, work, travel, and relate to each other. Despite imposing early preventive measures, India has crossed a total caseload of 820,916 with a total death of 22,123 till-date, ranking third in the descending list of worst-affected nations. Although comparatively lower, the case fatality rate in India is 2.72% against the global fatality of 4.53%. It is an empirical fact that every process and institution must evolve to meet the needs of its time. A model for categorization of fatality among real-time reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients has been developed at Uttar Pradesh University of Medical Sciences (UPUMS), to address the issue of patients being transferred very late in the course of the disease to level-3 facilities. The UPUMS model of categorization of fatalities of COVID-19 patients at level-3 center comprises of category-1 as ‘Institutional COVID-19 fatalities’, category-2 as ‘Imported COVID-19 fatalities’ and category-3 being ‘Imminent with Incidental COVID-19’ fatalities. This endeavor of categorizing COVID-19 fatalities is an opportunity to analyze facts and contemporary science to assess our response to this pandemic and thereby take lessons to prepare better for the future. Following proper analysis, we noted that most of these fatalities (64%) at the higher center are because of delayed referrals hence termed as imported fatalities, which need a modality of early attention and referral. However, there are fatalities which occur because of severe systemic illness like liver failure, cardiovascular accident (CVA), myocardial infarction (MI), etc. They need due treatment at a regional center. These constitute up to 18%. Authors found that actual COVID-19 deaths constitute only 18% of the total projected fatalities.

Influence of Alteration of Dry Period Feeding Management on Body Weight and Body Measurements of Jersey Crossbred Cows at Lower Gangetic Region

Alteration during far off dry period feeding management was done to see its effect on body weight and body measurements of Jersey cross bred cows. This study was conducted on 14 healthy dairy animals which were separated into two comparable groups on the basis of almost similar age groups, parity, body weight, and body condition score. Statistically analyzed data revealed that there was significantly higher (p<0.01) tail head thickness in overall dry period and at calving in control group animals than treatment group animals. Significantly higher (p<0.01) overall abdominal girth after 4 months of lactation was found in control group animals as compared to treatment group animals. Significantly higher (p<0.01) body length during overall dry period and at calving was noticed in control group animals. Non significant (p>0.05) difference was reported in body weight and heart girth among control and treatment group animals. The coefficients of correlation indicated high and significant (P<0.01) correlation among body condition score, tail head thickness, body length, heart girth, abdominal girth in this study. It can be concluded that alteration of feeding management practices during far-off dry period does not significantly change body weight during dry period and post partum period but can lead to significant difference in some body measurements of Jersey crossbred cows at tropical lower Gangetic region. Correlation of parameters suggested that the larger body sized animal of same breed may produce more milk.

Life cycle assessment of Chlorella species producing biodiesel and remediating wastewater

4,5-Dihydroxyanthraquinone-2-carboxylic acid (Rhein) has been shown to have various physiological and pharmacologicalproperties including anticancer activity and modulatory effects on bioenergetics. In this study, we explored the impact ofrhein on protein profiling of undifferentiated (UC) and differentiated (DC) SH-SY5Y cells. Besides that, the cellularmorphology and expression of differentiation markers were investigated to determine the effect of rhein on retinoic acidinduced neuronal cell differentiation. Using two-dimensional gel electrophoresis and matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry we evaluated the changes in the proteome of both UC and DC SH-SY5Y cellsafter 24 h treatment with rhein. Validation of selected differentially expressed proteins and the assessment of neuronaldifferentiation markers were performed by western blotting. Proteomic analysis revealed significant changes in theabundance of 15 proteins linked to specific cellular processes such as cytoskeleton structure and regulation, mitochondrialfunction, energy metabolism, protein synthesis and neuronal plasticity. We also observed that the addition of rhein to thecultured cells during differentiation resulted in a significantly reduced neurite outgrowth and decreased expression ofneuronal markers. These results indicate that rhein may strongly interfere with the differentiation process of SH-SY5Yneuroblastoma cells and is capable of inducing marked proteomic changes in these cells

Kangaroo mother care for low birth weight babies: supportive factors and barriers

Background: Kangaroo mother care (KMC) is skin-to-skin contact between mother and low birth weight (LBW) baby. It keeps the baby warm, increases accessibility to breast feeding, and protects the baby from infections. This study was done to identify supportive factors and barriers in practicing KMC as perceived by mothers of LBW babies and health care personnel (HCP).Methods: It was a questionnaire based descriptive study. Mothers of LBW babies and HCP were enrolled in study. Mothers and HCP were sensitized regarding KMC and after practicing KMC for 3 days, mothers were interviewed with the help of a predefined proforma. Feedback from the HCP was also taken. Data analysis was performed by using IBM SPSS ver. 20 software.Results: Most common factor in initiation and practice of KMC were, knowledge regarding KMC after training (100%), environmental factors (privacy and resources) (87.27%) and support from HCP (94.54%). Most common barriers perceived during performance of KMC were lack of knowledge about KMC during pregnancy (80%), pain due to LSCS/episiotomy (64.54%) and lack of support from family members (51.81%). Majority of the HCP strongly agree that parents must be encouraged to adopt KMC (82.92%), KMC is hampered due to presence of visitors in the ward (73.17%). KMC needs separate room (68.29%) and it is difficult due to LSCS (51.21%).Conclusions: To increase KMC practice, mother's knowledge about KMC can be improved by educating them in antenatal clinics and all HCP should receive training on KMC.

Peripheral haematological manifestations in HIV infection and its relation to CD4 count

Background: HIV infection is associated with a wide range of haematological abnormalities, which are amongst its most common complications. This study aims at discerning the peripheral haematological abnormalities associated with HIV infection and to correlate them with CD4 cell count.Methods: An observational cross-sectional study was conducted from March 2017 till August 2018. 109 patients in 15 years or more age group who were HIV positive by the NACO guidelines were included. Complete hemogram, serum iron studies, serum folate and vitamin B12 levels, and flowcytometric CD4 cell count analysis were done for all the patients. Various haematological parameters were compared between the patients with CD4 cell counts <200/µl (n=52) to those with counts >200/µl (n=57). By using student t-test, the p-value was calculated for various parameters.Results: Anaemia (58.7%), leucopenia (27.5%) and thrombocytopenia (17.4%) were seen with anaemia being the most common abnormality. Normocytic normochromic anaemia (65.6%) was the predominant type of anaemia. Overall analysis showed a statistically significant difference between two groups in haemoglobin concentration, RBC indices, serum ferritin values and absolute lymphocyte count; with p-value <0.05.Conclusions: The diagnosis and treatment of haematological disorders are essential in medical care of the HIV-infected patients. Thus, in resource limited setups, where CD4 count analysis is not possible, haematological abnormalities can be used as tools for monitoring HIV positive individuals and can aid in the treatment of the patients.

Evaluation of Clinical Outcome of Patients Undergoing Emergency Laparotomy with the Help of Portsmouth Predictor Equation for Mortality (P-Possum Score)

Introduction: Emergency laparotomy, though lifesaving, mayresult in significant morbidity and mortality. In an attempt toclinically evaluate patients undergoing emergency laparotomyand predict their mortality using the worldwide acceptedPortsmouth Predictor equation for mortality (P POSSUM), thepresent study was undertaken in the Surgery department of atertiary care hospital in eastern India.Material and methods: This observational cross-sectionalstudy included 60 patients aged between 15 to 75 years,undergoing emergency laparotomy during the specified studyperiod of one and half years.Results: It was observed that out of 60 patients, 63.3%were male, and mean age was 40.60 (16.67) years. Pepticperforation was the most common indication for laparotomy.Mean P POSSUM predicted mortality risk was 40.617%(Range-0.8 to 99.7). Twenty-four patients died during hospitalstay. ROC curve analysis of P POSSUM scores revealed thatif a cut off value of P POSSUM score of 42.45% was selected,mortality could be predicted with a sensitivity of 70.80% anda specificity of 83.30%.Conclusion: Thus, P POSSUM might be a useful tool inpredicting risk of short-term mortality following emergencylaparotomy

The duration of intra-abdominal hypertension and increased serum lactate level are important prognostic markers in critically ill surgical patient's outcome: a prospective, observational study

The present study analyzed the clinical significance of duration of intra-abdominal hypertension (IAH) associated with increased serum lactate in critically ill patients with severe sepsis. Materials and Methods: Our study was an observational, prospective study carried out in the Surgical Intensive Care Unit (ICU) at J.L.N Medical College, Ajmer, Rajasthan, India. In our study, we included a total of 100 patients and intra-abdominal pressure (IAP) was measured through intravesical route at the time of admission and after 6, 12, 24, 48, and 72 h via a urinary catheter filled with 25 ml of saline. Duration of ICU and hospital stay, need for ventilator support, initiation of enteral feeding, serum lactate level at time of admission and after 48 h, and 30-day mortality were noted asoutcomes.Results:In our study, an overall incidence of IAH was 60%. Patients with cardiovascular surgery and renal and pulmonary dysfunction were 93.3%, 55%, and 60%, respectively, at the time of admission and 65%, 10%, and 10%, respectively, after 72 h of admission in the surgical ICU. Nonsurvivors had statistically significant higher IAP and serum lactate levels than survivors. Patients with longer duration of IAH had longer ICU and hospital stay, longer duration of vasopressors and ventilator support, and delayed enteral feeding.Conclusion:There is a strong relationship "risk accumulation" between duration of IAH associated with increased serum lactate and organdysfunction. The duration of IAH was an independent predictor of 30-day mortality. Early recognition and prompt intervention for IAH and severe sepsis are essential to improve the patient outcomes

Risk-adjusted analysis of patients undergoing emergency laparotomy using POSSUM and P-POSSUM score: a prospective study

Background: Comparison of operative morbidity rates after emergency laparotomy between units may be misleading because it does not take into account the physiological variables of patients' conditions. Surgical risk scores have been created, and the most commonly used is the Physiological and Operative Severity Score for the enumeration of Mortality (POSSUM) or one of its modifications, the Portsmouth-POSSUM (P-POSSUM), usually requires intraoperative information. Objective: The objective of this study is to evaluate the POSSUM and P-POSSUM scores in predicting postoperative morbidity and mortality in patients undergoing emergency laparotomy. Methodology: This is a prospective, cross-sectional, and hospital-based study that was conducted at J.L.N. Medical College and Hospital, Ajmer, Rajasthan, India, from April 2017 to December 2017. Adult patients who presented at the causality and underwent emergency laparotomy were included in the study. Observed and predicted mortality and morbidity were calculated using POSSUM and P-POSSUM equations, and statistical significance was calculated using Chi-square test. Results: A total of 100 patients were included in this study, with a mean age of 42.83 ± 18.21 years. The observed (O) mortality was 12 (12.0%), while POSSUM predicted 40 (40%) and P-POSSUM 27 (27%). The O/E ratio for POSSUM was 0.29 and for P-POSSUM was 0.44, and this means that they both overestimate mortality. When the results were tested by Chi-square test, the P value was found to be 0.55 and 0.85 for POSSUM and P-POSSUM, respectively, which showed no significant correlation for observed and expected mortality. The observed morbidity was 69 (69%), while POSSUM expected morbidity was 79 (79%), O/E ratio is 0.87, and this again overestimates the morbidity. POSSUM is overpredicting the rate of morbidity, and test of correlation showed no significance with P = 0.75. Conclusion: POSSUM and P-POSSUM were found to overestimate mortality and morbidity in our patient's population

Formulation and evaluation of folic acid conjugated gliadin nanoparticles of curcumin for targeting colon cancer cells.

Preparation of folic acid (FA) conjugated (FA-CUR-GNPs) and non-conjugated (CUR-GNPs) gliadin nanoparticles of curcumin were successfully formulated by desolvation method for oral delivery of drug for targeting colon cancer cell. F1, F3, F5 (conjugated) and F2, F4, F6 (Non-conjugated) were formulated using various drug-polymer ratio (1:2). They were further characterized by FTIR, Mass spectroscopy, NMR, solubility studies, entrapment efficiency, TEM, particle size, surface charge, In-vitro release studies, In vivo toxicity studies and simultaneously evaluated. F3 (curcumin 10mg, gliadin 20mg and FA 5mg) and F4 (curcumin 10mg and gliadin 20 mg) were found as the optimized formulation among both the categories. For F3 and F4 formulations; average particle size (168.1 and 195.7nm), zeta potential (-16.5 and -24.4mV), cumulative % drug release (92.92 and 94%) and In vivo toxicity studies were conducted and compared with the control (phosphate-buffer saline, pH 6.8) reveals no toxicity. From the characterization and evaluation studies it was identified that F4 (FA-CUR-GNPs) had better solubility, In vitro release profile and no specified In-vivo toxicity than F3 (CUR-GNPs) formulation with nano-range particle size throughout the experiment. Improved bioavailability and increase targeting capacity toward colon cancer tumor cells were successfully achieved.

Prediction of morbidity and mortality in middle and old aged surgical patients-comparison of standard scoring system and addition of echocardiography with hemodynamic indices.

Background: A prospective study was carried out in our hospital to predict morbidity and mortality in middle and old aged surgical patients by adding echocardiography to standard scoring system with hemodynamic studies. Methods: A total of 50 patients of either sex ranging from 40-70 years of ASA grade 1 & 2 scheduled for various types of noncardiac surgeries were enrolled for the study in our hospital. Patients were divided in two groups according to echocardiographic examinations. The patients with normal echocardiographic values were kept in control group and the patients with abnormal values were kept under study group. The patients in study group were further divided in three groups according to LVEF. Group1-LEVF≥60%, Group2-LVEF≥50-59%, Gr3≥40-49% Tab lorazepam was given to all the patients’ orally prior night of surgery. All the patients were induced with same type inducing agents according to body weight. All the patients were maintained on IPPV by anaesthesia machine with supplemental fentanyl, N2O, O2 and muscle relaxant. SPO2, electrocardiograph (ECG), Non-invasive/invasive blood pressure (BP), Spirometry, Capnography and temperature were monitored. At the end of the research project data’s were compiled systematically and were subjected to statistical analysis using odd’s ratio(OR),95% confidence interval (CI), z value and p value, two statistical software programme were used. Results: Significant difference in the results seen between the three study groups (Gr1, Gr2, Gr3) for perioperative ischemic changes, CHF and arrhythmias. Conclusions: In conclusion preoperative TTE before non-cardiac surgery can predict the risk of perioperative cardiac complications in known or suspected cases of cardiac disease patients.

Differential proteomics approach to identify putative protective antigens of Mycobacterium tuberculosis presented during early stages of macrophage infection and their evaluation as DNA vaccines.

Unsatisfactory performance of the existing BCG vaccines, especially against the adult pulmonary disease, has urged the need for an effective vaccine against tuberculosis (TB). In this study, we employed differential proteomics to obtain a list of antigens as potential vaccine candidates. Bacterial epitopes being presented at early stages on MHC class I and class II molecules of macrophages infected with Mycobacterium tuberculosis (M. tb) were identified using iTRAQ labelling and reverse phase LC-MS/MS. The putative vaccine candidates, thus identified, were tested as plasmid DNA vaccines in mice to ascertain their protective efficacy against the aerosolized M. tb challenge, based on their ability to reduce the bacterial load in the lungs of infected mice. Here, we observed that 4 out of the 17 selected antigens imparted significant protection against the challenge of M. tb. The four shortlisted antigens were further assessed in a more stringent guinea pig model, where too, they demonstrated significant protection. It concludes that combining a proteomics approach with the in vivo assessment of vaccine candidates in animal models can be valuable in identifying new potential candidates to expand the antigenic repertoire for novel vaccines against TB.

An evaluation of self medication among undergraduate medical students of a rural medical school from western Uttar Pradesh.

Background: Common problems related to self medication are wastage of resources and increasing antimicrobial resistance. They generally entail serious health hazards such as adverse reaction and prolonged suffering. Aim: The study aimed to analyze the pattern, factors influencing and potential adverse effects of self-medication among the undergraduate medical students Material and methods: The present cross sectional study was carried out by the Department of Pharmacology, MSDS Medical College, Fatehgarh among the undergraduate students currently studying in a rural medical school from western Uttar Pradesh. A 25 item self administered questionnaire was administered to the students in the classrooms just after completion of classes. Time allocated for the completion of the questionnaire was 30 minutes. After compilation of collected data, analysis was done using Statistical Package for Social Sciences, version 21 (IBM, Chicago, USA). Results: Data of 256 study subjects was analyzed. Overall prevalence of self medication among study subjects was found to be 71.5% (87.6% among males and 50.5% among females). 82.5% had trust in allopathic medicine system. 81.5% students learnt self medication from doctors prescriptions provided during their prior illness. Regarding categories of drugs commonly self-prescribed, they commonly used antipyretics (81.4%), anti-tussives (72.1%) and analgesics (68.9%). ‘Illness too trivial for consultation’ was the most common (71%) reason for self-medication cited by them. Almost 69% of them were aware of possible adverse effects. 7.7% of them even experienced the side effects of self-medication. Conclusion: The study highlighted growing trend of self-medication among medical students. Policies prohibiting the supply of medicines without a valid prescription should be enforced strictly. A robust monitoring system among the physicians and pharmacists is need of an hour.

A retrospective study of fungal corneal ulcer from the western part of Uttar Pradesh.

Background: Infectious keratitis is a major cause of avoidable blindness worldwide. Fungus is an important aetiological agent of infectious keratitis following corneal trauma with vegetative matter. This infection should be promptly treated to limit the morbidity and dangerous sequelae. The purpose of this study was to detect causative agents from corneal scrapings and to identify the predisposing factors of mycotic keratitis. Methods: Corneal scrapings were taken in full aseptic precautions in total 112 suspected patients for fungal etiology and were subjected to direct examination by 10% KOH mount, gram stain and culture. Results: A total 112 cases of suspected corneal ulcers were subjected to KOH mount to detect fungal elements in corneal scraping and culture to isolate aetiological agents. In our study 29 (25.8%) samples were found positive in KOH mount and fungus was isolated from the all KOH positive samples. Males were more commonly affected and were mostly in the age group of 30-50 years. Fusarium species was the most common fungus isolated followed by Aspergillus species. Conclusion: Mycotic keratitis is a serious problem usually following corneal trauma, it requires rapid detection and identification of fugal agents for treatment to prevent disastrous consequences.