Background: Asymptomatic bacteriuria (ASB) is defined as the presence of actively multiplying bacteria, which is greater than 105/ ml of urine within the urinary tract excluding the distal urethra, at a time when the patient has no symptoms of UTI. Untreated and undiagnosed ASB is associated with adverse maternal and perinatal outcomes. The objective was to determine the profile, prevalence, microbiological isolates with susceptibility, and risk factors of ASB among pregnant women attending an antenatal clinic at a tertiary care hospital, Andhra Pradesh, India.Methods: A prospective cross sectional study with 200 pregnant women was conducted for a period of 3 months from January to March 2016. The mid- stream urine specimen was collected and processed from all the cases and social and baseline obstetric data was collected. The isolates from all the cases of ASB were identified by standard biochemical tests. Antimicrobial susceptibility was performed by Kirby- Bauer disc diffusion method and interpreted as per CLSI guidelines.Results: Prevalence of ASB in our study was 30.5%, mean age of the cases was 27.3± 2.9 years. ASB was most common in 25- 30 year’s age group, during 3rd trimester and among multiparous and multigravidae. Previous history of UTI, pre-eclampsia was having significant association among cases with ASB. Escherichia coli was the predominant isolate in the study followed by K. pneumoniae, CONS (Coagulase-Negative Staphylococci), Staphylococcus aureus, citrobacter and Enterococci.Conclusions: Undiagnosed and untreated asymptomatic bacteriuria is associated with complications during pregnancy. Hence routine screening of antenatal women during all trimesters must be considered in preventing the complications and adverse foetal outcomes particularly with known risk factors like increasing age, multiparity and previous history of UTI.

Background: Diabetes is considered as one of the most important and rapidly evolving non-communicable disease which requires top priority around the world. 10-25% of diabetics develop foot infections [DFI’s] during the course of their disease period ranging from simple calluses to major Osteomyelitis. 3 Microbial infections of the diabetic foot ulcers are difficult to manage because of multiple factors associated in response including overall glycaemic control, associated complications like vascular disease and neuropathy. The present study was done to assess the microbial flora according to Wagner’s classification for diabetic foot disease. To isolate, identify the aerobic bacterial pathogens and their drug sensitivity pattern with reference to ESBL productionMethods: A prospective study was conducted at a tertiary care hospital by department of general surgery among Diabetics presenting with diabetic foot infections. All the enrolled cases were classified based on Wagner’s classification and socio demographic data was noted. Specimens from the ulcer were collected and processed for isolation, identification of pathogens based on standard CLSI guidelines. The antibiotic sensitivity of the isolates was done and ESBL production was demonstrated by standard guidelines.Results: 346 cases were enrolled in study and grade-3 Wagner’s ulcers were predominant. Males were predominant, 46-55 years age group was common with mean age of 55.3±1.4 years. Peripheral arterial disease was more common than peripheral neuropathy and both were found significantly associated with development of ulcers. Methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa were most common isolates. MRSA exhibited maximum sensitivity to vancomycin, clindamycin and linezolid. Gram negative isolates exhibited maximum sensitivity to meropenems, piperacillin-tazobactam. The prevalence of ESBL producers in the study was 16.24%.Conclusions: DFI are a serious concern in uncontrolled diabetics and require proper management. Outcome of the infection depends upon the grading of the ulcer as per Wagner’s classification and also the nature of the infection either polymicrobial or with a single organism. Our study highlights and suggests that prospective multicentre studies are required to assess the appropriate antibiotic regimen in diabetic foot ulcers and proper management of antibiotics must be implemented to decrease the incidence and development of multi drug resistant organisms.

Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India.Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted.Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero.Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.

Background: Globally every year 1.7 billion cases of diarrhoea are registered as per the WHO report 2017. Intestinal parasitic infections [IPI] are one of the top ten major public health problems in developing countries with an estimated prevalence of 30-60% in developing countries compared to 3% in developed countries. School age children are the common vulnerable group with the highest prevalence and infection intensities. The objective of the present study is to study the prevalence of parasitic infections in school children as a causative factor for diarrhoea and associated risk factors involved with relation to their hygiene and socio demographic characters.Methods: A cross sectional study was conducted for a period of two years from January 2015 to December 2016 and stool specimens from the children aged 5-18 years suffering from diarrhoea were screened for parasitic infections following standard guidelines and as per the ethical committee guidelines. The socio demographic characters, risk factors and hygienic characters of the cases were noted from the parents or guardians or children in a separate predesigned questionnaire sheet. Data was analyzed using SPSS software version 13 and P value<0.05 was considered significant.Results: T The prevalence of parasitic infections in the Present study was 22.95% and males were more common. 8-11 years was the most common age group and mean age was 11.6±1.8 years. Statistically significant association was found with hand washing before meals, socio economic status, and method of hand washing after defecation. Entamoeba histolytica was the major parasitic pathogen followed by Ascaris lumbricoides. Other parasites were Giardia lamblia, Ancylostoma duodenale, Cryptosporidium, Isospora, Enterobius and Trichuris trichura.  Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.

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Background: Vulvovaginitis is one among the major pathologies encountered in reproductive age group. Etiologies are always multiple and candidiasis, bacterial vaginitis and trichomoniasis account for 90% of etiology. The incidence is dependable upon multiple factors like age group, ethnicity, socioeconomic status, geographical locale. Improperly treated and untreated vulvovaginitis is associated with long term complications like infertility, pelvic inflammatory disease in nulliparous females and preterm labour, miscarriage, ectopic pregnancy, chorioamnionitis among pregnant females and recurrent UTIs, cervicitis, endometritis, increased risk of acquiring STIs among normal females. The present study was undertaken with the objective of understanding the etiologies associated with vulvovaginitis among women attending Obstetrics clinic of a tertiary care hospital. The risk factors associated with the conditions, the features of the vaginal discharge and symptoms associated with each etiology were studied.Methods: A cross sectional study for a period of one year was conducted among 200 female patients attending the Department of gynecology for vaginitis and evaluated for etiology. Patient’s risk factors, clinical history, symptoms were collected by questionnaire and specimens were collected from all the cases and processed as per standard guidelines. Bacterial vaginosis was confirmed based on Neugent’s criteria, Trichomoniasis by wet mount examination and candidiasis by culture. The study was approved by the institutional ethical committee.Results: 137 cases of vulvovaginitis were diagnosed based on etiology. Vulvovaginitis was most common among 27-36 years and in multiparous women. Most common causative agent was Candida (59.12%) followed by bacterial vaginosis (22.63%) and Trichomoniasis (18.25%). Vaginal discharge was the commonest symptom (100%) followed by malodor and vulval irritation. Following unhygienic practices was the commonest risk factor associated with Vulvovaginitis.Conclusions: A regular evaluation is mandatory for all the females attending hospital for vaginitis. Successful management reduces the morbid conditions and it’s essential to treat the conditions during the pregnancy which prevents the complications associated like preterm birth, miscarriage etc. and adverse outcomes.

Background: WHO estimated burden of respiratory tract infections in 2010, estimates four and half million deaths due to respiratory tract infections among children every year. In India, 1.2 million deaths have been reported among children due to RTI among 5.9 million deaths globally. Lower respiratory tract infections are most common causes of death than upper respiratory tract infections. Pneumonia and Bronchiolitis are most common types of LRTI in children. Pneumonia accounts for most of the deaths in children < 5 years of age. The present study was undertaken with an objective to know the various types of lower respiratory tract infections in children less than 12 years of age. The study also aims to know the various bacterial agents causing respiratory tract infections with their antibiotic susceptibility.Methods: Hospital based, prospective cross-sectional study was conducted for a period of one year and 375 children were enrolled. Demographic, clinical history and examination was done and signs and symptoms noted. All necessary investigations were performed and followed regularly for management and outcome.Results: Incidence of LRTI in the study was 9.76% with male preponderance (65.33%) and most common among children in 1-4 years age group. Ratio of males to females was 1.9:1. 73.6% of cases were in low socio-economic group, 35.2% were found with PEM-I grade and 18.13% had no immunization coverage. Cough and breathlessness were the major symptoms and respiratory distress and clubbing were major signs in the study. Bronchopneumonia was the commonest cause (38.7%) followed by bronchiolitis and Allergic bronchitis. 18.45 of cases had anemia and Leucocytosis was also present. Pulmonary infiltration was the major finding in the X-ray of chest. Streptococcus pneumoniae and Klebsiella pneumoniae were the common bacterial pathogens isolated.Conclusions: To conclude, our study clearly highlighted the various types of clinical presentations, risk factors and different types of LRTI in children <12 years of age. Understanding a clear knowledge of the etiology and bacterial pathogens clearly provides guidance for the physician in management and clinical outcome.

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