Tezpur Medical College and Hospital

Background: Pyogenic infections refer to infections that leads to formation of pus. Selection of an effective antibiotic has a great role in reducing the morbidity and mortality among such infections. The awareness of the microbial profile causing pyogenic infections and their antibiogram is crucial for its management. Objective: To identify the bacteria, isolated from pus culture of suspected pyogenic infections, received in this hospital and to determine their antimicrobial susceptibility pattern. Materials and Methods: In this hospital-based retrospective study, a total of 1040 pus samples were subjected to culture according to standard microbiological procedure. Bacterial isolates were identified using conventional biochemical tests. Antibiotic susceptibility testing was done by Kirby-Bauer disk diffusion method and interpreted as per CLSI guideline. Results: Out of these 1040 samples, 59.4% were culture positive. Most of the positive samples were from Surgery Department (39.2%). The most common isolate was Staphylococcus aureus 39%. Overall, the Gram-positive bacteria demonstrated higher susceptibility to Doxycycline, Linezolid and Vancomycin. Whereas, the Gram-negative bacteria showed good susceptibility to Aztreonam, Carbapenems, and Piperacillin/ Tazobactam. Conclusion: The study provides an insight into the diverse bacterial etiology of pyogenic infections, and antibiogram revealed varying degree of resistance to some commonly used antibiotics.

Bats, often silent carriers of lethal pathogens, serve as natural reservoirs for numerous viruses capable of crossing species barriers with devastating effects. Among them, Rousettus aegyptiacus (R. aegyptiacus) has emerged as a pivotal species in understanding viral spillovers. This fruit bat hosts the Marburg virus (MARV), supporting its replication and occasional transmission to humans, where it causes fatal hemorrhagic fever. However, a striking paradox remains while MARV infection is deadly in humans, R. aegyptiacus remains asymptomatic. Driven by this contrast, our study explores the codon usage patterns to reveal evolutionary mechanisms underlying viral adaptation and host tolerance. Far from being a passive carrier, R. aegyptiacus represents an insightful model for antiviral research. Our analysis revealed distinct codon usage patterns in MARV, indicating fine-tuned evolutionary alignment with the host's codon preferences. MARV exhibited low codon bias, suggesting broad compatibility with the host's translational machinery. Further, COA and PR2 analyses suggested that ecological factors shape codon selection in both virus and host. RNA modification analysis revealed frequent cytosine-to-thymine transitions, implying conserved mutational pressures or host-driven editing. Variations in RCDI values indicated deoptimized codon usage.

Introduction Leptospirosis, a zoonotic disease with worldwide distribution, has emerged as an important public health concern. Rodents are the most common reservoir of infection. Humans are the accidental host who acquires infection by direct or indirect exposure to urine or other products of infected animals. It presents with a wide range of clinical manifestations from mild fever to severe hepatic and renal involvement. Due to a lack of clinical awareness, proper epidemiological data, and proper diagnostic facilities in resource-limited settings, leptospirosis still remains an underdiagnosed and underreported disease. This study aims to determine the seroprevalence of leptospirosis among suspected patients with acute febrile illness who attended the OPD or were admitted to wards of this tertiary care hospital in Northern Assam and to analyse the clinical pattern of disease occurrence. Materials and methods A hospital-based retrospective study was conducted in the Department of Microbiology, Tezpur Medical College and Hospital, Assam, from April 2023 to March 2024. A total of 1,372 serum samples, collected from acute febrile illness patients, were tested for Leptospira IgM antibody using a commercially available Leptospira IgM enzyme-linked immunosorbent assay (ELISA) kit, and the clinical pattern of disease occurrence among the positive cases was studied. Data were analyzed using descriptive statistics and the chi-square test. Results Out of 1,372 patients of acute febrile illness, 213 were tested positive for Leptospira IgM, with a seroprevalence of 15.5%. Most prevalent in 61-70 years of age, with no statistical difference between females (115/687; 16.7%) and males (98/685; 14.3%). The highest frequency occurred during October-December (64; 30.1%). The most common clinical presentation was fever with cough (43; 20.2%), followed by vomiting (31; 14.6%) and headache (30; 14.1%). Conclusion With a seroprevalence rate of 15.5%, leptospirosis has emerged as an important cause of acute febrile illness in this region. Awareness among the clinicians is crucial for early diagnosis, and in a resource-limited setup, serological assays like ELISA can be an effective diagnostic approach.

Abstract Introduction: Anterior cruciate ligament (ACL) reconstruction commonly utilizes semitendinosus tendon autografts, where graft length plays a crucial role in fixation, tensioning, and overall surgical success. Semitendinosus autografts can be harvested using either an open or closed tendon stripper technique, but limited research has directly compared the impact of these methods on graft length. This study aims to evaluate the variations in graft length between these two techniques and their implications for ACL reconstruction outcomes. Materials and Methods: A single-center comparative study was conducted on 100 skeletally mature patients who underwent ACL reconstruction, with 50 patients in whom the semitendinosus autograft was harvested using an open tendon stripper and 50 using a closed tendon stripper, irrespective of age and gender. Patients with multiligamentous injuries, prior arthroscopic/revision procedures, or diagnosed semitendinosus tears/previous semitendinosus harvest were excluded. The surgical technique involved standard arthroscopy, tendon identification, and graft harvesting. In the closed tendon stripper group, the tendon was detached before passing through the stripper, while in the open tendon stripper group, the tendon remained attached to the tibia during harvesting. The primary outcome measured was graft length, with statistical analysis performed to compare the groups. Results: The mean age was 32.4 ± 4.9 years in the closed stripper group and 32.8 ± 4.9 years in the open stripper group. Both groups showed a marked male predominance (closed: 48 males and 2 females; open: 49 males, 1 female). The mean body mass index (BMI) was 26.2 ± 1.8 and 25.6 ± 1.7, respectively, with no statistically significant differences between groups ( P > 0.05). The mean graft length in the open tendon stripper group (78.3 ± 4.43 mm) was significantly longer than in the closed tendon stripper group (75.56 ± 4.79 mm), with a P = 0.003. These graft lengths fall within the expected range for quadrupled semitendinosus grafts and are consistent with reported raw tendon lengths of approximately 260–290 mm in existing literature. Patient height showed a strong positive correlation with graft length in both groups ( r = 0.98, P < 0.0001). No significant difference in patient height was observed between the two groups, ensuring that height did not influence the observed differences in graft length. Conclusion: The study demonstrated that the open tendon stripper technique resulted in significantly longer semitendinosus autografts compared to the closed tendon stripper technique. This finding suggests that the open technique may be preferable in cases where maximizing graft length is critical for surgical success. The results highlight the importance of selecting a graft harvesting method based on individual patient characteristics and surgical requirements.

Introduction Orthopaedic infections are one of the common causes of high morbidity and are challenging complications to treat. It includes non-healing ulcers, osteomyelitis, diabetic foot, compound fractures, and SSIs (surgical site infections), such as implant-associated infections and prosthetic joint infections. The most commonly associated organisms include Staphylococcus aureus, Escherichia coli, Pseudomonas, Proteus, and Enterococcus species. However, most of the bacterial isolates exhibit resistance to commonly used antibiotics. Moreover, the spectrum of microbial flora and the antibiotic susceptibility pattern may vary across regions. Therefore, the present study was undertaken with the primary objective of identifying the bacteria isolated from pus samples received for culture in the microbiology laboratory from the Department of Orthopaedics, Tezpur Medical College and Hospital, and determining the antimicrobial susceptibility pattern among the isolated bacteria. The secondary objectives were to analyze the distribution of culture-positive cases by age and wound aetiology and to report MRSA (methicillin-resistant Staphylococcus aureus) prevalence among the isolates. Materials and methods This hospital-based retrospective study was conducted between January 2023 and December 2023. A total of 76 culture-positive pus samples obtained from orthopaedic wound infections were included in the study. The samples were subjected to culture according to standard microbiological procedures and were identified using conventional biochemical tests. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) 2023 guidelines. Data were retrieved from laboratory records, test requisition forms, and hospital records. Results Of the 76 culture-positive pus samples, most of the positive samples were from the 21-40 age group and from male patients. The majority of the positive cultures were from compound fractures. Although Gram-negative bacilli constitute an overall large proportion, the most common isolate in the present study was Staphylococcus aureus (32, 42.1%). MRSA accounts for 3/32 (9.4%) among the Staphylococcus aureus isolates. Overall, the Gram-positive bacteria demonstrated higher susceptibility to linezolid and levofloxacin, whereas the Gram-negative bacteria showed good susceptibility to aztreonam, carbapenems (imipenem and meropenem), and piperacillin/tazobactam. Conclusion The study highlights the diverse bacterial aetiology of orthopaedic wound infections, with Staphylococcus aureus being the most predominant organism. It provides insight into the need for periodic surveillance to determine the local bacterial profile and its antibiogram to initiate effective empirical therapy and optimize patient outcomes.