Scleredema adultorum of Buschke associated with hypothyroidism and liver cirrhosis.

Scleredema adultorum of Buschke is a rare disorder of the connective tissue, involving the skin. Here, we present a 61-year-old male, who is a known case of compensated liver cirrhosis with a past history of being treated for autoimmune thyrotoxicosis, who presented with complaints of alopecia, skin tightening, dry skin, pruritus, and woody indurated plaques on the skin of the upper back, shoulder, and arms. Skin biopsy of the arm revealed the characteristic features of scleredema. He was extensively evaluated for known literature-cited causes of scleredema, and the work up revealed a negative result. He was also found to be hypothyroid on presentation. Hence, we present a case of scleredema occurring in a patient with hypothyroidism and chronic liver disease, which to our knowledge is being described for the first time in literature.

Anticoagulation Management in Patients with Valve Replacement.

Background: Prosthetic valve implantation requires postoperative prophylactic anticoagulation to preclude thrombotic events. The aim of this review is to assess the role of anticoagulation therapy in the management of valve replacement patients. Methodology: Literature from PubMed, Embase, Medline and Google Scholar were searched using the terms "valvular heart disease", "anticoagulant", "mechanical heart valve", "bioprosthesis", "bridging", "Vitamin K antagonist (VKA)", and "acenocoumarol". A committee comprising leading cardiothoracic surgeons from India was convened to review the literature and suggest key practice points. Results: Prosthetic valve implantation requires postoperative prophylactic anticoagulation to preclude thrombotic events. A paramount risk of thromboembolic events is observed during the first three months after surgery for both mechanical and bioprosthetic devices. The VKA therapy with individualized target international normalized ratio (INR) is recommended in patients after prosthetic valve replacement. Therapies for the management of prosthetic valve complications should be based on the type of complications. Special care is mandated in distinguished individuals and those with various co-morbidities. Conclusion: In patients with prosthetic valve replacement, anticoagulant therapy with VKA seems to be an effective option. The role for non-VKA oral anticoagulants in the setting of prosthetic valve replacement has yet to be established. Furthermore, whether the novel oral anticoagulants are safe and efficacious in patients after placement of a bioprosthetic valve remains unanswered.

Crystal structure of bis[4-(di-methyl-amino)-pyridinium] bis(2-nitro-benzoate) trihydrate.

The title salt, 2C7H11N2 (+)·2C7H4NO4 (-)·3H2O, crystallized with two anions and two cations in the asymmetric unit, together with three water mol-ecules. Both 4-di-methyl-amino-pyridinium cations are protonated at their pyridine N atoms with the plane of the N(CH3)2 hetero atoms inclined to the pyridine ring by 4.5 (2) and 1.4 (2)°. In the 2-nitro-benzoate anions, the carboxyl and nitro groups are inclined to their respective benzene rings by 77.1 (3) and 20.0 (3)°, and 75.8 (2) and 20.9 (3)°. In the crystal, the anions are linked via O-H⋯O hydrogen bonds involving the water mol-ecules, forming chains along [100]. The cations are linked to these chains by N-H⋯O hydrogen bonds. The chains are linked via C-H⋯O hydrogen bonds and C-H⋯π and π-π inter-actions [inter-centroid distances range from 3.617 (1) to 3.851 (1) Å], forming a three-dimensional structure.

Fault causes and its detection in standalone PV system using ANN and GEO technique.

Power generation systems using photovoltaic (PV) technology have become increasingly popular due to their high production efficiency. A partial shading defect is the most common defect in this system under the process of production, diminishing both the amount and quality of energy produced. This paper proposes an Artificial Neural Network and Golden Eagle Optimization based prediction of the fault and its detection in a standalone PV system to recover the optimum performance and diagnosis of the PV system. The proposed technique combines the Artificial Neural Network (ANN) and Golden Eagle Optimization (GEO) algorithm. The major contribution of this work is to raise PV systems' performance. The result is a defect in the classification and identification of an ANN is used. The use of GEO provides an efficient optimization technique for ANN training, which reduces the training time and improves the accuracy of the model. The proposed technique is executed on the MATLAB site and contrasted with different present techniques, like genetic algorithm (GA),Elephant Herding Optimization (EHO) and Particle Swarm Optimization (PSO). The findings displays that the proposed technique is more accurate and effective than the existing methodologies for detecting and diagnosing defects in PV systems.

Thermal, dielectric, mechanical and structural behavior of 2-amino 4-methylpyridinium 4-nitrophenolate 4-nitrophenol bulk single crystal.

Applications in both science and industry have received increased attention as a result of bulk single crystals with particular orientations. However, due to the instability of organic crystals at high temperatures and stress, there is an interest in growing good-quality bulk single crystals with stable thermal and mechanical properties. Here, the 2-amino 4-methylpyridinium 4-nitrophenolate 4-nitrophenol (2A4MPPP) crystal was prepared employing a single-wall ampoule and the vertical Bridgman technique. Structure and functional groups were determined by XRD, NMR, and FTIR studies. More importantly, detailed thermal and kinetic properties such as activation energy, frequency factor, rate constant, and Avrami exponent are discussed. The mechanical stability and dielectric studies are also demonstrated for the title compound. According to the single crystal XRD investigation, 2A4MPPP is a member of the orthorhombic crystal system with the Pna21 space group. Through the TGA and DTA analyses, it was confirmed that the compound starts to melt at 98 °C and complete melting occurs at 103.3 °C. The dielectric experiments reveal the crystal's poor dielectric constant and high-frequency dielectric loss. Vickers microhardness investigations show that grown 2A4MPPP belongs to the soft materials group. As a result of these findings, the 2A4MPPP crystal should be well suited for usage in thermomechanical, microelectronic, optical communications, and nonlinear optical applications.

Metal contamination in select species of birds in Nilgiris district, Tamil Nadu, India.

Variation in metal contamination in six species of birds, namely the Cormorant (Phalacrocorax carbo), Cattle Egret (Bubulcus ibis), Little Egret (Egretta garzetta), Pond Heron (Ardeola grayii), Common Myna (Acridotheres tristis) and Jungle Babbler (Turdoides striatus) in Nilgiris district, Tamil Nadu, India. The accumulation of heavy metals differed among the species studied. On an average, Little Egret accumulated high concentrations of copper (53.31 ± 23.19 ppm) followed by Cattle Egret (16.27 ± 9.83 ppm) in liver. Of all the species, Jungle Babbler recorded the maximum concentrations (20.59 ± 9.07 ppm) in muscle. The Pond Heron recorded the maximum concentration (35.38 ± 11.14 ppm) in brain. On an average the maximum level was in the kidney of Common Myna (7.76 ± 1.80 ppm).

Organochlorine pesticide residues in eggs and tissues of house sparrow, Passer domesticus, from Tamil Nadu, India.

This study provides information on the current status of contamination by organochlorine pesticides (OCPs) in eggs and tissues of House Sparrow, Passer domesticus, in Tamil Nadu, India. The mean concentration of total hexachlorocyclohexane (∑HCH) and total dichloro-diphenyl-trichloroethane (∑DDT) in eggs ranged from 0.01 to 1.81 µg/g and 0.02 to 1.29 µg/g, respectively. Concentration of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE) ranged from below detectable limit (BDL) to 0.64 µg/g, representing more than 60% of the ∑DDTs. About 28% of samples had p,p'-DDE levels above the critical concentration associated with reproductive impairment. However, the mean concentrations of cyclodiene insecticides were less than 0.5 µg/g. Although OCPs levels detected in tissues are not indicative of toxicity, continuous monitoring is recommended.

Neera, a non-fermented traditional drink from coconut spadix restores the redox status in sodium fluoride intoxicated mice.

OBJECTIVES: Neera, non-fermented coconut inflorescence sap (NFCIS) and its fermented form, toddy (FCIS) are the two well-known traditional drinks in South India. Both the saps show high rejuvenation effect and NFCIS is used for the curing of bronchial suffocation, anemia, tuberculosis and piles in traditional medicine. But, a few scientific studies have been reported on their health benefits so far. Presently, the antioxidant effect of both non-fermented (NFCIS) and fermented form (FCIS) of coconut inflorescence were analyzed in experimental animals. METHODS: The free radical scavenging property of FCIS and NFCIS was analyzed in vitro. The effect of these saps on mitigating sodium fluoride (NaF) deteriorated redox status was evaluated in mice. RESULTS: NFCIS exhibited high antioxidant activity than its fermented form. NFCIS reduces metal ions and scavenge hydroxyl and DPPH radicals with IC50 values 6.5 ± 1.9 and 44 ± 3.14 µL/mL, respectively. Supplementation of NFCIS for 14 days increased SOD, CAT and GPx activities and GSH level in liver by 51.67, 52, 27.88 and 35.77%, respectively against NaF induced decline with a concomitant decrease in lipid peroxidation to 40.76%. Saps rich in minerals indicate pharmaceutical and nutritional value. CONCLUSION: The study revealed the antioxidant efficacy of non-alcoholic natural drink, Neera and recommends an alternative for synthetic carbonated soft drinks. The regular consumption of Neera may protect the body from various chronic diseases especially where the oxidative stress played as a key role.

Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings.

BACKGROUND: Short-term peripheral venous catheter-associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter-associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available. METHODS: Prospective, surveillance study on peripheral venous catheter-associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. RESULTS: We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter-associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter-associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter-associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: Escherichia coli (22.9%), Klebsiella spp (10.7%), Pseudomonas aeruginosa (5.3%), Enterobacter spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were Staphylococcus aureus (11.4%). CONCLUSIONS: Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter-associated bloodstream infections.

Diclofenac residues in blood plasma and tissues of vultures collected from Ahmedabad, India.

The study reports residues of diclofenac, a non-steroidal anti inflammatory drug, in tissues of 11 White-backed Vulture, Gyps bengalensis collected between 2005 and 2007 and blood plasma of 12 White-backed Vulture, four Egyptian Vulture, Neophron percnopterus and two Griffon Vulture, Gyps fulvus collected during 2005. Samples were analysed using High Performance Liquid Chromatograhy (HPLC) equipped with UV detector. One of the White-backed Vultures collected during 2005 had substantial urate deposits on its viscera and diclofenac was detected in its liver (1.42 ppm wet weight) and kidney (1.18 ppm wet weight), which is suggestive of diclofenac exposure and intoxication. Although uric acid crystals were not observed in the remaining birds received during 2005, the residues of diclofenac detected were at levels higher than the toxic limits (0.25-1 ppm). No residues were detected in any of the tissues of birds collected during 2006 and 2007 (6 birds). About 89% (16 of 18) of plasma samples collected during 2005 had diclofenac residues (White-backed vulture: BDL to 0.17 ppm; Egyptian vulture: BDL to 0.09 ppm; Griffon vulture: 0.07-0.14 ppm). However, plasma diclofenac concentrations were less than the concentrations reported to be toxic. Although use of diclofenac for treating cattle has been banned in India, regular monitoring is recommended to assess the effectiveness of the ban on the drug in support of the conservation of these species.

Ameliorative effect of Neera, nonfermented coconut inflorescence sap, on cisplatin-induced renal toxicity by abating oxidative stress.

Objectives Neera, nonfermented coconut inflorescence sap (NFCIS) from unopened spadix of Cocos nucifera L., is a well-known traditional beverage. But, scientific reports on its health benefits are limited. NFCIS is reported to exhibits free radical scavenging activity, and its chemical composition is found promising. In the present study, the effect of NFCIS on alleviating cisplatin-induced nephrotoxicity was analyzed in mice. Methods The renal toxicity was induced by cisplatin (16 mg/kg b.wt. ip) in Swiss albino mice. The antioxidant activity of NFCIS was evaluated by nitric oxide radical scavenging assay and phorbol-12-myristate-13-acetate-induced superoxide radical generation in mice peritoneal macrophages. Total polyphenolic content of sap was determined using Folin-Ciocalteu reagent. The phytochemicals present in NFCIS was identified using Fourier transform infrared (FT-IR) spectroscopy. Results NFCIS was found to scavenge nitric oxide (NO) radicals (IC50 = 32 ± 2.47 µL/mL) and shown to inhibit superoxide (SO) generation (53.5 ± 2.1%) in macrophages. High polyphenolic content (193 µg gallic acid/mL) was determined in the sap. The FT-IR spectrum of NFCIS revealed the presence of several phytochemicals indicate its pharmaceutical and nutritional value. Cisplatin-induced hike in urea, creatinine and lipid peroxidation was significantly decreased to 65.16, 87.74 and 53.41% by NFCIS, respectively. Hb (42.37%) and total count (72.81%) were also found to be increased. Additionally, the activity of antioxidant enzymes superoxide dismutase, catalase, glutathione peroxidase and reduced glutathione was enhanced to 53.06, 40, 52.22 and 38.49%, respectively. Conclusions Results indicate that NFCIS effectively alleviates cisplatin-mediated renal toxicity by its antioxidant activity.

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 204 intensive care units of 57 hospitals in 19 cities of India: International Nosocomial Infection Control Consortium (INICC) findings.

BACKGROUND: Short-term peripheral venous catheters-related bloodstream infections (PVCR-BSIs) rates have not been systematically studied in developing countries, and data on their incidence by number of device-days are not available. METHODS: Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013 to May 31, 2019 in 204 intensive care units (ICUs), members of the International Nosocomial Infection Control Consortium (INICC), from 57 hospitals in 19 cities of India. We applied US INICC definition criteria and reported methods using the INICC Surveillance Online System. RESULTS: We followed 7,513 ICU patients for 296,893 bed-days and 295,795 short term peripheral venous catheter (PVC)-days. We identified 863 PVCR-BSIs, amounting to a rate of 2.91/1,000 PVC-days. Mortality in patients with PVC but without PVCR-BSI was 4.14%, and 11.59% in patients with PVCR-BSI. The length of stay in patients with PVC but without PVCR-BSI was 4.13 days, and 5.9 days in patients with PVCR-BSI. The micro-organism profile showed 68% of gram negative bacteria: Escherichia coli (23%), Klebsiella spp (15%), Pseudomonas aeruginosa (5%), and others. The predominant gram-positive bacteria were Staphylococcus aureus (10%). CONCLUSIONS: PVCR-BSI rates found in our ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs.

Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 727 intensive care units of 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific Regions: International Nosocomial Infection Control Consortium (INICC) findings.

BACKGROUND: Short-term peripheral venous catheter-related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available. METHODS: Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. RESULTS: We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%). CONCLUSIONS: PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.

International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module.

BACKGROUND: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS: During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS: Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.

Comparative evaluation of two cold staining methods with the Ziehl-Neelsen method for the diagnosis of tuberculosis.

In developing countries pulmonary tuberculosis is usually diagnosed by detecting acid-fast bacilli (AFB) in sputum using a Ziehl-Neelsen (Z-N) staining method. However, in the field the traditional method of staining is difficult to carry out. This study evaluates the efficiency of two cold staining methods, namely Gabbet's and a modified two reagent cold staining method compared with the Z-N taken as the gold standard. Triplicate smears were prepared from 267 sputum samples and stained by the Z-N, Gabbet's, and a modified cold staining method, the smears were positive for AFB in 21 (7.87%), 18 (6.74%) and 19 (7.12%), respectively. The sensitivities for the Gabbet's and modified cold stain were 85.7% and 90.5%, respectively. The positive agreement between the Z-N and Gabbet's (92.3%) and Z-N and modified cold stain (95%) were good. The modified cold staining method was less time consuming and easier to perform in the field.

Follow-up and management of valvular heart disease patients with prosthetic valve: a clinical practice guideline for Indian scenario.

PURPOSE: Valvular heart disease (VHD) patients after prosthetic valve implantation are at risk of thromboembolic events. Follow-up care of patients with prosthetic valve has a paramount role in reducing the morbidity and mortality. Currently, in India, there is quintessential need to stream line the follow-up care of prosthetic valve patients. This mandates the development of a consensus guideline for the antithrombotic therapy in VHD patients post prosthetic valve implantation. METHODS: A national level panel was constituted comprising 13 leading cardio care experts in India who thoroughly reviewed the up to date literature, formulated the recommendations, and developed the consensus document. Later on, extensive discussions were held on this draft and the recommendations in 8 regional meetings involving 79 additional experts from the cardio care in India, to arrive at a consensus. The final consensus document is developed relying on the available evidence and/or majority consensus from all the meetings. RESULTS: The panel recommended vitamin K antagonist (VKA) therapy with individualized target international normalized ratio (INR) in VHD patients after prosthetic valve implantation. The panel opined that management of prosthetic valve complications should be personalized on the basis of type of complications. In addition, the panel recommends to distinguish individuals with various co-morbidities and attend them appropriately. CONCLUSIONS: Anticoagulant therapy with VKA seems to be an effective option post prosthetic valve implantation in VHD patients. However, the role for non-VKA oral therapy in prosthetic valve patients and the safety and efficacy of novel oral anticoagulants in patients with bioprosthetic valve need to be studied extensively.

Cross-country transport and isolation and identification of Streptococcus pneumoniae by use of alternate sources of blood supplemented media among laboratories in India.

Background: The isolation of S. pneumoniae (Sp) depends on specimen integrity / transport, media and expertise. The non-availability of sheep blood agar poses a challenge in identification of colonial morphology and identification in India. Methods: Laboratories processed swabs containing either pure Sp or Sp in mixed cultures with a second (confounding) bacterium shipped across the country in cold conditions. Duplicate set of swabs was shipped back to the central laboratory to assess the impact of shipping on culture viability. The identical swab was cultured on sheep, human blood and one additional agar plate used in the laboratory. Results: 46/60(77%) of cultures containing only Sp were correctly identified. In specimens where Sp was present in mixed culture, the proportion of isolates in which Sp was correctly identified varied, with most variability attributed to the particular confounding organism rather than the media. There was no discernible impact of temperature-controlled (4-6°C) transport on the isolation of Sp from culture swabs. Conclusions: The study clearly elucidates the ability of laboratories for isolation of S. pneumoniae on human blood agar in resource limited settings. The results highlight the difficulties inherent in correctly identifying pathogens in mixed cultures in needs improvement using standardized tests across the study centers. The study also reaffirms the ability to transport biological specimens over long geographical distances without loss.

Persistent organochlorine pesticide residues in tissues and eggs of white-backed vulture, Gyps bengalensis from different locations in India.

Organochlorine pesticide residues were determined in tissues of five Indian white-backed vultures and two of their eggs collected from different locations in India. All the samples had varying levels of residues. p,p'-DDE ranged between 0.002 microg/g in muscle of vulture from Mudumali and 7.30 microg/g in liver of vulture from Delhi. Relatively higher levels of p,p'-DDT and its metabolites were documented in the bird from Delhi than other places. Dieldrin was 0.003 and 0.015 microg/g while p,p'-DDE was 2.46 and 3.26 microg/g in egg one and two respectively. Dieldrin appeared to be lower than the threshold level of 0.5 microg/g. p,p'-DDE exceeded the levels reported to have created toxic effects in eggs of other wild birds. Although varying levels of DDT, HCH, dieldrin, heptachlor epoxide and endosulfan residues were detected in the vulture tissues, they do not appear to be responsible for the present status of population in India.

Cutaneous Bacteriological Profile in Patients with Pemphigus.

BACKGROUND: Pemphigus is an autoimmune blistering disease. The common cause of death in pemphigus is septicemia which is usually secondary to cutaneous bacterial infection. AIM: The aim was to study the cutaneous bacteriological profile in patients with pemphigus. MATERIALS AND METHODS: Pus for culture and sensitivity was collected from clinically infected lesions of pemphigus patients in the Department of Dermatology, St. John's Medical College Hospital, Bengaluru, from June 2013 to June 2014. RESULTS: Of the 49 patients included in the study, 44 were suffering from pemphigus vulgaris, 4 from pemphigus foliaceus and one had pemphigus vegetans. There were 31 male and 18 female patients. The mean age of the group was 35.51 year. Mean Autoimmune Bullous Disorder Intensity Score was 17.36. About 32.7% were diabetic. About 40.81% showed the growth of Staphylococcus aureus, 12.24% of Pseudomonas aeruginosa, 6.12% of Proteus mirabilis, 4.08% of ß-hemolytic streptococci and nonfermenting Gram-negative bacilli, and 2.04% of Proteus vulgaris, Staphylococcus saprophyticus, Enterococcus species, and Klebsiella species. S. aureus showed 100% sensitivity to antibiotics - tetracycline, amikacin, chloramphenicol, and netilmicin; 90% resistance was found for penicillin and 55% resistance was found for ciprofloxacin and erythromycin. Methicillin-resistant S. aureus was 30%. P. aeruginosa showed 100% sensitivity to ciprofloxacin, amikacin, gentamicin, piperacillin, piperacillin + tazobactam, and netilmicin. CONCLUSION: S. aureus was the most common organism showing sensitivity to tetracycline, amikacin, chloramphenicol, and netilmicin and resistance to penicillin, ciprofloxacin, and erythromycin.