Ramakrishna Pai Jakribettu

Abstract

Background: Dengue, neglected tropical disease, caused by a RNA virus belonging to Flaviviridae family. Comorbid conditions like diabetes mellitus, can lead to severe dengue leading to higher morbidity and mortality. This study was undertaken to compare the clinical and laboratory profile of dengue patients with and without diabetes mellitus. Materials and Methods: A retrospective study conducted at the tertiary care hospital. The clinical and laboratory details of the adult patients diagnosed with dengue from January 2014 to March 2019 were included in the studied. The data was entered in Microsoft excel and analyzed. Results: We have analyzed the hematological, hepatic and renal parameters in three groups: healthy individuals (n= 80), patients with diabetes (n= 66) and dengue (n= 422). Among the patients diagnosed with dengue, 393/422 (93. 12%) survived. Among the dengue patients who were diabetic (129), 115 (89. 14%) survived and 14 (10. 85%) succumbed. The most common symptoms in dengue patients were fever (100%), vomiting (53. 32%) and body ache (51. 9%). In deceased patients, symptoms of severe dengue like reduced urine output, bleeding manifestations, pedal oedema, altered sensorium were noted. Signs of fluid leak like ascites and pleural effusion were higher in deceased patients. Among the deceased patients, anaemia, thrombocytopenia, increased renal parameters were observed in diabetic patients. Conclusion: Dengue in diabetic patients is associated with anemia, thrombocytopenia and higher mortality. There is no significant difference in hepatic and renal parameters in survived dengue diabetic and non-diabetic patients, but deceased patients had significant thrombocytopenia and increased renal parameters.   Keywords: Dengue, Diabetes mellitus, Hematological, Biochemical, Deceased

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Abstract

Introduction: Methicillin resistant Staphylococcus aureus is the common pathogen worldwide. It requires prolonged therapy to eradicate MRSA from a patient. This study was undertaken to determine the changing trend of antimicrobial resistance in MRSA over six years in a tertiary care center. Materials and and Methods : This was a retrospective observational study done at the tertiary care teaching hospital. The antibiotic sensitivity pattern of the MRSA isolated from various clinical samples from January 2013–December 2018 was studied. The data collected was entered in the Microsoft excel 2007, coded and were analyzed by frequency and percentage. Results: During the study period from January 2013 to December 2018, 1006 (27.42%) patients had MRSA out of 3668 patients diagnosed with Staphylococcus aureus infection. Almost equal gender distribution was observed with males (52.78%), geriatric patients, i.e., ?61 years constituted for around 32% infected patients. The samples that were received during this period included pus (64.59%), blood (26.23%), urine (5.53%) and sputum (3.65%). Other anti-MRSA drugs had changing resistance rate on year to year basis. Conclusion: Continuous monitoring of antibiotic sensitivity and rationalizing the use of antibiotics remain an important and effective strategy to minimize the emergence of multi-drug resistant MRSA strains.   Keywords: Methicillin resistant Staphylococcus aureus (MRSA), antimicrobial resistance (AMR), Trend, Skin & soft tissue infection (SSTI)

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