Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
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Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




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Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
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Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2012 | Month : May | Volume : 6 | Issue : 4 | Page : 652 - 655

A Bacteriological Study of Dacryocystitis

Prakash R., Girish Babu R.J., Nagaraj E.R., Prashanth H.V., Jayashree S. Shah

1. Assistant Professor, Department of Microbiology, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India - 572107. 2. Assistant Professor, Department of Microbiology, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India - 572107. 3. Professor and HOD, Department of Microbiology, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India - 572107. 4. Professor, Department of Microbiology, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India - 572107. 5. Associate Professor, Dept of Ophthalmology, Sri Siddhartha Medical College, Agalakote, Tumkur, Karnataka, India - 572107.

Correspondence Address :
Dr. Prakash R.
Assistant Professor, Dept of Microbiology,
Sri Siddhartha Medical College, Tumkur, Karnataka, India.
E-mail: prakashssmc@gmail.com

Abstract

Introduction: Dacryocystitis is an inflammation of the lacrimal sac and duct. It is an important cause of ocular morbidity, both in children and in adults.

Aims:The aim of this study was to isolate, identify and to determine the antibiotic susceptibility pattern of the bacterial isolates which were found in cases of dacryocystitis.

Setting and design: Prospective study.

Methods: 83 cases of dacryocystitis were studied over a period of one year. The samples from the lacrimal sac and the conjunctiva were collected by applying pressure or lacrimal syringing. The isolates were identified by conventional methods and their antibiotic susceptibility pattern was established.

Statistical Analysis: The results were analyzed by using mean, median and the Chi-square (χ2) test.

Results: Chronic dacryocystitis (51) was the most common type of dacryocystitis as compared to acute (20) and congenital dacryocystitis (9). Females were affected more than the males. Staphylococcus aureus (26), Streptococcus pneumoniae (22) and Pseudomonas aeruginosa (14) were the most common isolates which were found. The gram positive isolates were most sensitive to vancomycin (100%), tobramycin and linezolid (99.36%). The gram negative organisms were most sensitive to tobramycin and gentamicin (100%), followed by cefepime (98.79%) and choramphenicol (97.14%).

Conclusion: Chronic dacryocystitis was the most common type of dacryocystitis than acute dacryocystitis. Gram positive organisms were most commonly isolated than gram negative organisms.

Keywords

Dacryocystitis, Epiphora, Staphylococcus aureus, Pseudomonas aeruginosa

Introduction
DACRYOCYSTITIS is an inflammation of the lacrimal sac and duct. It may be congenital or acquired. Acquired dacryocystitis assumes two main forms: acute and chronic (1). There are distinct patterns of geographical variation in terms of the aetiology, according to the local climate in infective keratitis and also in microbial conjunctivitis. Hence, an understanding of the regional aetiological agents is important for the management of this disease. The knowledge of the bacteriology of chronic dacryocystitis would contribute to the choice of effective antimicrobial agents and it would also help in reducing the unnecessary load of anti-microbial agents (2). During the past years, only few studies had been conducted on the bacteriology of dacryocystitis. Hence, this study was done.

Material and Methods

A total of 80 clinically diagnosed cases of dacryocystitis, who attended the Ophthalmology Out-Patients Department at the Sree Siddhartha Medical College Hospital and District Hospital, Tumkur, India were studied over a period of one year.

Inclusion criteria: Clinically diagnosed cases of dacryocystitis were included in the study.

Exclusion criteria: The patients who had received either topical or systemic antibiotics for the past one week during their visit to the hospital were excluded.

An informed consent was obtained from all the patients who were enrolled. The specimens were collected with the help of an ophthalmologist. The surrounding area was aseptically cleaned, to avoid contamination from the surface microorganisms and the samples were collected in two sterile cotton swabs from the lacrimal sac, either by applying pressure over the lacrimal sac and allowing the purulent material to reflux through the lacrimal punctum or by lacrimal syringing. The sample from the refluxing material was collected by ensuring that the lid margins or the conjunctiva were not touched. One swab was inoculated immediately on plates of MacConkey’s agar, 5% Sheep Blood agar and Chocolate agar and another swab was used for gram staining. The stained smear was screened for the presence or absence of pus cells and bacteria. The isolated organisms were identified by using standard procedures (3). The sensitivity of the organisms was tested by the Kirby-Bauer disc diffusion method as per the Clinical and Laboratory Standards Institute (formerly NCCLS) guidelines (4).

Chi-square (χ2) distribution was used to test the qualitative distribution. A p (predictive) value of <0.05 was considered as a significant association between the variables which were tested.

Results

Out of the 86 samples which were obtained from 80 cases of clinically diagnosed dacryocystitis over a period of one year, 80 samples were culture positive and 6 samples were culture negative. Both eyes were involved in 8 (10%) cases, only the left eye was involved in 40 (50%) cases and the right eye was involved in 32(40%) cases, as shown in (Table/Fig 1a).

In this study, females were affected more i.e., 56 (70%) as compared to males 24 (30%). The male to female ratio was 2.3:1. In both congenital dacryocystitis (7.5%) and acquired dacryocystitis 62.5%), females were affected more. This study showed the highest number of dacryocystitis cases among the people who were in the age group of 4 –60 years (35%), followed by those in the age group of 31–45 years (27.5%), those in the age group of 61 years and above (13.75%), those in the age group of 16–30 years (12.5%) and those in the age group of 0–15 years (11.25%). Chronic dacryocystitis was the most common type of dacryocystitis in the present study, comprising of 51 cases (63.75%) as compared to acute dacryocystitis 20 cases (25%) and congenital dacryocystitis 9 cases (11.25%), as shown in (Table/Fig 1b). In our study, 40 (50%) cases showed only epiphora and 32 cases (40%) showed epiphora with discharge (mucous or mucopurulent or purulent) as their major symptoms. Only 8 cases (10%) presented with swelling and redness.

Out of the 80 samples which were collected, 66 samples (82.5%) yielded a single organism and 14 (17.5%) yielded mixed organisms i.e., 94 isolates altogether. 61 (64.9%) isolates were gram-positive bacteria and 33 (35.1%) isolates were gram-negative bacteria. The organisms which were isolated are shown in (Table/Fig 2) and (Table/Fig 3). The most common gram-positive isolate which was identified was Staphylococcus aureus 26 (27.65%) and the most common gram-negative isolate which was identified was Pseudomonas aeruginosa 14 (14.9%).

Streptococcus pneumoniae was the predominant gram-positive organism in acute and congenital dacryocystitis and Staphylococcus aureus was the predominant gram-positive organism in chronic dacryocystitis. Pseudomonas aeruginosa was the most common gram-negative isolate in both congenital and acquired dacryocystitis. The antibiotic sensitivity test was done for all the isolates. The sensitivity pattern is as shown in the (Table/Fig 4) and (Table/Fig 5).

Discussion

Dacryocystitis, as a disease entity, is known since ancient times. It is an important cause of ocular morbidity, both in children and adults. Hence, it requires special attention with respect to the initiation of the appropriate treatment at the earliest. The pattern of the relative incidence of various factors varies in different studies. In our study, females were found to be commonly affected in congenital and acquired dacryocystitis, with a male to female ratio of 2.3: 1, which correlated with the findings of Badhu B et al., (5) (2.1: 1). The predilection in females may be due to the smaller nasolacrimal canal diameter in females than in men and hormonal factors (6). Most of the females came from the middle and the lower income groups, who used wood and dried cow dung for cooking, which gave away a lot of smoke particles which could have settled down in the conjunctival sac, entered the nasolacrimal duct through tears and in turn had blocked the nasolacrimal duct. Kajal which was artificially prepared in the house by the women may have been contaminated with organisms, which when applied on the margin of the eyelids, may have infected the lacrimal sac. Females blew the nose infrequently as compared to the males, which may have caused stagnation of the nasolacrimal duct secretions, leading to infection (2). The stagnation of tears due to the obstruction and the resultant accumulation of the debris in the lacrimal sac together act as the potential nidus for the organisms to propagate within the sac, causing inflammation, hyperaemia, oedema and hypertrophy of the mucosal epithelium. Accumulation of mucoid and mucopurulent exudates causes the sac to dilate, ultimately leading to a pyocele (7).

In our study, the involvement of the eye was mainly unilateral (90%), either the right or the left eye and there were also some bilateral (10%) cases. This correlated well with the findings of Ghose et al., (8) (90%:10%), There was a relatively high incidence of the disease on the left side (40%) as compared to the right side (32%). This correlated well with the findings of Brook I et al., (9), in which the left lacrimal sac was involved in 36 patients (58%). In general, the disease had predilection to the left side, especially in females, because of their narrow bony canal. The nasolacrimal duct and the lacrimal fossa formed a greater angle on the right side than on the left side (6).

In the present study, chronic dacryocystitis was the most frequently encountered clinical type 51 (63.75%), followed by acute dacryocystitis 20 (25%) and congenital dacryocystitis 9(11.25%). This was probably because acute dacryocystitis invariably led to chronic dacryocystitis. A single organism was isolated in 66 (82.5%) cases and mixed organisms were isolated in 14 (17.5%) cases, which correlated with the findings of Kundu PK et al., (10) (82.5% and 10.5%) and Sainju R et al., (11) (81.82% and 18.18%). The mixed growth might be due to stagnation of the tear for a longer time, thus providing a better environment for the pathogenic organisms to get established by suppressing the normal flora (2).

The bacterial isolates have been changing from time to time and from place to place. Of 94 isolates, 61 (64.89%) were gram-positive organisms and 33 (35.11%) were gram-negative organisms. In congenital dacryocystitis, the most common gram-positive isolate which was identified was Streptococcus pneumoniae 5 cases (50%) and the most common gram-negative isolate was Pseudomonas aeruginosa 2 cases (20%), which correlated with the findings of Bareja U et al., (12). In acquired dacryocystitis, the most common gram-positive isolate was Staphylococcus aureus (29.76%) and the most common gram-negative isolate was Pseudomonas aeruginosa (14.28%), which correlated with the findings of Briscoe D et al., (13) (13% and 22%). McCulloch (14) studied the origin of Pseudomonas in the conjunctiva in general and found that this organism may be present in the eye as a result of:

i. A contaminated solution which was used as drops.
ii. Being a part of the flora of the normal conjunctiva.
iii. Being associated with Pseudomonas infections elsewhere in the body ( otitis media, nose, mouth, palate, etc.).

The anti-microbial sensitivity pattern varies from community to community. This is because of the emergence of resistant strains as a result of the indiscriminate use of antibiotics. The gram-positive isolates were most sensitive to vancomycin (100%), followed by tobramycin and linezolid (99.36%). The least sensitive antibiotic against the gram-positive organisms was penicillin (71.69%). The gram-negative organisms were most sensitive to tobramycin and gentamicin (100%), followed by cefepime (98.79%) and chloramphenicol (97.14%). The least sensitive antibiotic against the gram-negative organisms was ciprofloxacin (61.64%). In this study, the limitations were time and the number of patients. For better outcomes, a larger study population should be undertaken for a longer period of time, to know the bacteriology and to select effective drugs of choice for chronic dacryocystitis.

Conclusion

Most of the cases were culture positive, which highlighted the significance of this clinical condition for the ophthalmologists to specifically investigate for the presence of the symptom of nasolacrimal obstruction before planning any intraocular procedures.

The females of middle age and above had higher cases of dacryocystitis more than men. The left eye was involved more than the right eye. Chronic dacryocystitis was the most common type of dacryocystitis than acute dacryocystitis. Serous discharge was the commonest clinical presentation. Gram positive organisms were most commonly isolated than gram negative organisms. It may be so, that with the use of antibiotics, some well known bacteria had become less important as the causes of the disease, but that other organisms had taken their place, and the host parasite relationship seemed to have continued unabated.

References

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Gupta AK, Raina UK, Gupta A. The Lacrimal Apparatus. In: Text Book of Opthalmology. 1st edn. New Delhi, BI Churchill Livingstone 1999; 275–77.
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Chaudhary M, Bhattarai A, Adhikari SK, Bhatta DR. Bacteriology and antimicrobial susceptibility of adult chronic dacryocystitis. Nep J Oph. 2010; 2(4):105-13.
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Collee JG, Miles RS, Watt B. Tests for the identification of bacteria. In:Collee JG, Fraser AG, Marmion BP, Simmons A. Mackie and McCartney, Practical Medical Microbiology, 14th ed. New Delhi: Elsevier, 2006; 131-49.
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Matthew AW, Franklin RC, William AC, Michael ND, George ME, David WH, et al. Performance Standards for Antimicrobial Susceptibility Testing; Fifteenth Informational supplement. 2005; 25(1):19-33.
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Badhu B, Dulal S, Kumar S, Thakur SK, Sood A, Das H. The epidemiology of chronic dacryocystitis and the success rate of external dacryocystorhinostomy in Nepal. Orbit 2005; 24:79-82.
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Gilliland G. Dacryocystitis. In: Agarwal S, Agarwal A, Apple DJ, Buratto L, Alio JL, Pandey SK, Agarwal A, editors. Textbook of Ophthalmology. 1st ed. New Delhi: Jaypee brothers Medical Publishers (P) Ltd, 2002; 705-12.
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Nayak N. Fungal infections of the eye and their laboratory diagnosis and treatment. Nepal Medical College J. 2008; 60(1):48-63.
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Ghose S, Nayak N, Satpathy G, Jha RK. The current microbial correlates of the eye and nose in dacryocystitis – their clinical significance. AIOC Proceedings. 2005:437-39.
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DOI and Others

ID: JCDR/2012/4244:0026

Date of Submission: Mar 07, 2012
Date of peer review: Apr 18, 2012
Date of acceptance: May 16, 2012
Date of Publishing: May 31, 2012

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