Bacteriological analysis and antibiotic resistance in patients with diabetic foot ulcers in Dhaka.

The primary objective of this study was to isolate bacteria from diabetic foot ulcers and subsequently assess their antibiotic resistance capabilities. Seventy-five patients diagnosed with diabetic foot ulcers were investigated. A number of these patients (97.33%) had type 2 diabetes, with a significant proportion of them having been diagnosed for 1-5 years (29.33%). Notably, a substantial number of these individuals were on insulin usage (78.66%). Among the patients under examination, 49.33% reported having no use of tobacco products, alcohol, or betel leaf. The ulcers analyzed in this study were classified into grades 1-5 according to the Wagner scale. Wagner grade 2 diabetic foot ulcers had the highest number of culture-positive patients, at 33.33%. Pus samples collected from patients were cultured on selective media, and bacterial identity was confirmed by biochemical tests and polymerase chain reaction. A total of 141 isolates were isolated. Among the isolates, 82.97% gram-negative bacteria and 17.02% gram-positive bacteria were detected. Klebsiella pneumoniae was the most common isolate. Proteus spp., Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus were also detected. Approximately 61.33% of the ulcers exhibited were polybacterial. In this study, it was observed that all bacterial isolates, except for Proteus spp., were primarily detected in patients classified under Wagner's grade 2. Moreover, antibiotic susceptibility was also tested on these 141 isolates. Among them, Escherichia coli showed the highest multidrug resistance, 81.81%. Most of the gram-negative bacteria were resistant to ampicillin. All of the gram-negative isolates exhibited high levels of susceptibility to piperacillin-tazobactam, and these levels were Klebsiella pneumoniae (97.56%), Pseudomonas aeruginosa (95.24%), Escherichia coli (81.82%), and Proteus spp. (80%). On the other hand, gram-positive Staphylococcus aureus mostly showed sensitivity towards vancomycin and norfloxacin (79.17%).

Assessment of potential pathogenic bacterial load and multidrug resistance in locally manufactured cosmetics commonly used in Dhaka metropolis.

In Bangladesh cosmetics are being produced disregarding the Good Manufacturing Practices. So, this study aimed to test the level and nature of bacterial contamination of such cosmetics. A total of 27 cosmetics comprising eight lipsticks, nine powders, and ten creams were bought from New Market and Tejgaon areas of Dhaka city and tested. Bacteria was detected in 85.2% of samples. Majority of the samples (77.8%) exceeded the limit given by the Bangladesh Standards and Testing Institution (BSTI), Food and Drug Administration (FDA) and the International Organization for Standardization (ISO). Both Gram-negative (Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Salmonella spp.) and Gram-positive bacteria (species of Streptococcus, Staphylococcus, Bacillus and Listeria monocytogenes) were identified. Hemolysis was observed in 66.7% Gram-positive and 25% Gram-negative bacteria. Multidrug resistance was tested in 165 randomly selected isolates. Every species of Gram-positive and Gram-negative bacteria exhibited varying levels of multidrug resistance. The highest levels of antibiotic resistance were in broad-spectrum antibiotics (ampicillin, azithromycin, cefepime, ciprofloxacin and meropenem) and narrow-spectrum Gram-negative antibiotics (aztreonam and colistin). Multidrug resistance was 12-78% in Gram-negative bacteria and 12-100% in Gram-positive bacteria. Coagulase and DNase were identified in 97.5% and 5.1% of Staphylococcus aureus isolates respectively. Our findings indicate that these cosmetics pose a risk to the public's health.

A multi-disciplinary approach to the management of intra-venous and intra-cardiac leiomymatosis: A case report.

We herein report a rare presentation of leiomyoma in a 46-year-old female who presented with complaints of shortness of breath on exertion associated with palpitations for the past one year with a history of irregular menstrual bleeding. Ultrasonography of the abdomen and pelvis revealed an enlarged, distorted uterus with multiple intramural fibroids. A trans-thoracic echocardiography was then performed which showed a large right atrial mass. To investigate further, a contrast enhanced computed tomography was performed covering entire chest and upper abdomen. It showed a large lesion in the right atrium of the heart measuring 6x5cm. The lesion appeared hypo dense and was abutting the tricuspid valve and posterior wall of the Right Atrium. It revealed the Right Atrial lesion extending into the Inferior Vena Cava and lower down into the Common Iliac Confluence, Left Common Iliac and External Iliac Veins. A multi-disciplinary approach was undertaken; the patient underwent a single stage procedure involving a total abdominal hysterectomy with bilateral Salpingo-Oophorectomy followed by excision of the intra-cardiac tumour. Recovery was uneventful and the patient was successfully discharged on the 5th post-operative day. Due to the lack of literature and low incidence of this disease, this case report presents a rare opportunity to define management guidelines for such occurrences in the future.

Comparative genomics of 16 Microbacterium spp. that tolerate multiple heavy metals and antibiotics.

A total of 16 different strains of Microbacterium spp. were isolated from contaminated soil and enriched on the carcinogen, hexavalent chromium [Cr(VI)]. The majority of the isolates (11 of the 16) were able to tolerate concentrations (0.1 mM) of cobalt, cadmium, and nickel, in addition to Cr(VI) (0.5-20 mM). Interestingly, these bacteria were also able to tolerate three different antibiotics (ranges: ampicillin 0-16 µg ml-1, chloramphenicol 0-24 µg ml-1, and vancomycin 0-24 µg ml-1). To gain genetic insight into these tolerance pathways, the genomes of these isolates were assembled and annotated. The genomes of these isolates not only have some shared genes (core genome) but also have a large amount of variability. The genomes also contained an annotated Cr(VI) reductase (chrR) that could be related to Cr(VI) reduction. Further, various heavy metal tolerance (e.g., Co/Zn/Cd efflux system) and antibiotic resistance genes were identified, which provide insight into the isolates' ability to tolerate metals and antibiotics. Overall, these isolates showed a wide range of tolerances to heavy metals and antibiotics and genetic diversity, which was likely required of this population to thrive in a contaminated environment.

Daidzein effect on hormone refractory prostate cancer in vitro and in vivo compared to genistein and soy extract: potentiation of radiotherapy.

PURPOSE: Genistein, the major bioactive isoflavone of soybeans, acts as a radiosensitizer for prostate cancer (PCa) both in vitro and in vivo. However, pure genistein promoted increased metastasis to lymph nodes. A mixture of soy isoflavones (genistein, daidzein, glycitein) did not cause increased metastasis, but potentiated radiotherapy. We tested whether daidzein could negate genistein-induced metastasis. METHODS: Mice bearing PC-3 prostate tumors were treated with daidzein, genistein or both, and with tumor irradiation. Primary tumors and metastases were evaluated. The effects of each isoflavone and soy were compared in vitro using PC-3 (AR-) and C4-2B (AR+) androgen-independent PCa cell lines. RESULTS: Daidzein did not increase metastasis to lymph nodes and acted as a radiosensitizer for prostate tumors. Daidzein inhibited cell growth and enhanced radiation in vitro but at doses higher than genistein or soy. Daidzein caused milder effects on inhibition of expression and/or activities of APE1/Ref-1, HIF-1alpha and NF-kappaB in PC-3 and C4-2B cells. CONCLUSIONS: Daidzein could be the component of soy that protects against genistein-induced metastasis. Daidzein inhibited cell growth and synergized with radiation, affecting APE1/Ref-1, NF-kappaB and HIF-1alpha, but at lower levels than genistein and soy, in AR+ and AR- PCa cells, suggesting it is an AR-independent mechanism.