Mohd Altaf Mir

Prevalence, pattern, sensitivity and resistance to antibiotics of different bacteria isolated from port site infection in low risk patients after elective laparoscopic cholecystectomy for symptomatic cholelithiasis at tertiary care hospital of Kashmir

The aim of this study was to determine specific pattern of port site microbial colonisation, sensitivity and resistance to different antibiotics of bacteria isolated from port site infection (PSI) in low risk patients after elective laparoscopic cholecystectomy in surgical wards at tertiary care hospital of Kashmir. This is a prospective study. The study included 675 consecutive patients of postoperative PSI after elective laparoscopic cholecystectomy for symptomatic cholelithiasis over a period of 12 months. Culture swabs were taken from port sites with signs of PSI and transported to the microbiology laboratory. The positive swab cultures were subjected to antibiotic susceptibility test. The data obtained was analysed by using appropriate statistical analytical tests. The incidence of PSI after elective laparoscopic cholecystectomy is 6·7%. The commonest organism responsible for PSI is pseudomonas, 19 (42·2%) cases. Most of the strains of organisms isolated were resistant to commonly used antibiotics in the hospital,pseudomonas was found 100% resistant to the combination of ampicillin + sulbactum and ceftriaxone and it was sensitive to imipenem, amikacin and vancomycin in 89·47,57 and 52·63% of cases respectively. Our study will be helpful in choosing effective empirical prophylactic antibiotic therapy in cases of elective laparoscopiccholecystectomy and will have a great impact on morbidity and mortality in them because of PSI.

Assessment of the severity in 350 patients of acute pancreatitis by contrast enhanced computerized tomography

BACKGROUND This prospective study has been conducted with the aim to assess the severity of acute pancreatitis. METHODS The study included 350 consecutive patients with acute pancreatitis admitted over a period of five years. All these patients were subjected to detailed history and clinical examination and investigations to ascertain the diagnosis. The severity was assessed by contrast - enhanced computed tomography (CT). Data collected were tabulated and subjected to appropriate statistical analysis. RESULTS On the basis of the CT Severity Index (CTSI), the severity of acute pancreatic was classified into Group A (mild), Group B (moderate), or Group C (severe). Group C patients had the most complications (in 77 [91.67%] patients), and Group A patients had the least (in 7 [6.25%] patients). Mortality was found to be highest among Group C (14 [16.67%] patients), indicating the severe nature of disease in these patients, while no mortality was noted in Group A patients. The mean duration of hospital stay of patients in Group A was 9.25 days, Group B 12.0 days and Group C 24.58 days. CONCLUSION The use of contrast-enhanced computed tomography as a routine investigation in patients to predict a severe attack of acute pancreatitis early in the course of the disease decreases overall mortality and burden of disease.