European Journal of Cardiovascular Medicine

The antibacterial activities of many medicinal plants have been carried out to assess their potential use in bacteria borne diseases. In this study the antibacterial activities of two medicinal plants, Moringa oleifera and Dialium guineense as well as their phytochemical contents were carried out and compared. Their leaves were collected separately, dried, pulverized to powder and extracted with ethanol. The phytochemical analysis of M. oleifera and D. guineense extracts were carried out using standard methods, while their antibacterial activities were evaluated and compare using some bacterial isolates and by agar well diffusion method. The result of the phytochemical screening showed that both plants possess the same phytochemicals with exemption of steroids which is present only in D. guineense, and cardiac glycosides only present in M. oleifera. The results of the antibacterial activities are as follows; on Staphylococcus aureus, at concentration of 100 mg/ml, M. oleifera and D. guineense gave inhibition zone diameters

Mucormycosis is a fatal fungal infection predominantly occurring in a diabetic and in immunocompromised patients. Infection is acquired by inhalation, ingestion or traumatic inoculation in a susceptible host. Impairment of host defence mechanisms affecting innate immune system facilitates invasive fungal infection. Skin and soft tissue mucormycosis, necrotizing fasciitis has been described in victims of road traffic accidents, natural disasters (Tsunami, tornado) who had dirt contaminated wounds. Clinical presentation of such patient is non-specific for mucormycosis and represents bacterial necrotizing skin and soft tissue infection. Early clinical suspicion and appropriate microbiological work up allow early diagnosis and appropriate antifungal therapy. With this case report we are describing mucormycosis involving anterior abdominal wall in a diabetic patients and challenges faced in the treatment.

Post-partum Thrombotic Thrombocytopenic Purpura (TTP) is a life-threatening occurrence. A lady with such illness was successfully cured with anti-CD-20 monoclonal antibodies and mycophenolate [1]. This lady had been infertile for seven years, and underwent six attempts of in vitro fertilization without success. Several authors, and ourselves, found that a common cause of couple infertility is the infection by Helicobacter pylori, which can be cured at low price if recognized [2-4]. Moreover, in vitro fertilization reportedly failed in cases of ladies suffering of unrecognized infection by H. pylori [5], possibly by molecular mimicry between sperm and bacterial antigens [3,5,6]. Not only so, but this woman had been known to suffer of Idiopathic Thrombocytopenic Purpura (ITP). This illness had been found closely linked to H. pylori infection and to be reversible by eradication of the bacterium [7-9]. In conclusion we wish to stress the opportunity to test for presence of H.pylori in the long list of tests usually performed in infertile couple, and prior to pregnancy.

This study was conducted on 60 samples of local dairy products from fresh unsalted white sheep cheese, locally manufactured pasteurized and non-pasteurized, as well as salted cheese found in the local markets of Samarra city.For the period form January to March 2021, which microbial tests were carried out, included the total bacterial number, the total count of Coliform, and the total number of molds. Research results showed a high content of unsalted cheese from the Microorganisms that included a number of human pathogens and food poisoning triggers. The results in this study showed the emergence of five different types of bacteria, namely Salmonella, Escherichia coli, Shigella, Brucelle and Staphylococcus aureus. The highest numbers, ranging from (7000) × 10 - 3 in unsalted cheese samples, were significantly higher than salted cheese samples, with the highest percentage (300) × 10-3 for fungi. These species appeared in local products studied and were more often in unsalted and non-pasteurized cheese samples. Also, studied allergic types for Antibiotic.

“CRISPR” (pronounced “crisper”) stands for Clustered Regularly Interspaced Short Palindromic Repeats, which are the hallmark of a bacterial defense system that forms the basis for CRISPR-Cas9 genome editing technology. CRISPR is becoming an indispensable tool in biological research. Once known as the bacterial immune system against invading viruses, the programmable capacity of the Cas9 enzyme is now revolutionizing diverse fields of medical research, biotechnology, and agriculture. CRISPR-Cas9 is no longer just a gene-editing tool; the application areas of catalytically impaired inactive Cas9, including gene regulation, epigenetic editing, chromatin engineering, and imaging, now exceed the gene-editing functionality of WT Cas9. Here, we will present a brief history of gene-editing tools and describe the wide range of CRISPR-based genome- targeting tools. We will conclude with fu Cas9 enzyme, ture directions and the broader impact of CRISPR technologies.

Background: H. pylori is the most common human bacterial pathogen that colonizes the gastric epithelium especially in those habitual Qat chewers; it influence can absorption of glucose which is also abnormal in DM patients, its common infection in diabetic patients who have inadequate metabolic control, this study was conducted to reveal the prevalence of H. pylori among T2DM and non-DM patients and potential risk factors. Methods: A cross-sectional study was conducted in the department of medicine, a tertiary care hospital in India, and there were 250 patients who included in this study. Data were collected through structural intervals questionnaire and sampling information. Results: The overall prevalence of H. pylori among diabetics was 29.2%. There was no significant association between H. pylori infections and diabetes (P> 0.05), most of the patients were 46-60 year age group, with male predominance (76.7%) H. pylori infections were not significantly associated with the smoking, hypertension, dyslipidemia and obesity. H. pylori infection increased in longer duration of diabetes and the increase in HbA1c level. Conclusion: Positive H. pylori DM patients should update their sugar level values and control the disease. Further research is highly recommended on relationship between H. pylori infections and diabetes

Introduction: Skin and soft tissue infection contribute to a substantial proportion of infective disease pool in OPD attendees, in both urban and rural set up across the globe and staphylococcus aureus is one of the common causative agent of cutaneous bacterial infections involving skin & soft tissue. MRSA can cause severe problems , if not detected early, resulting in complications like septicaemia, pneumonia, sepsis and death. Community acquired MRSA(CA-MRSA) infections are common among skin & soft tissue infections (SSTIs), making their management quite difficult. One simple method to reach the diagnosis is the culture and sensitivity pattern. As sensitivity and distribution pattern vary according to different geographical area as observed in other bacterial infections, it has become imperative to know the extent of MRSA distribution and it’s sensitivity pattern in a particular community

Introduction: Meningitis is a clinical syndrome characterized by inflammation of the meninges; it is one of the most common infectious diseases of the central nervous system (CNS). Infection with the human immunodeficiency virus (HIV) is emerging as a major risk factor for meningitis in adults. Meningitis causes significant morbidity and mortality globally. Long term sequelae of bacterial meningitis in adults include hearing and visual loss, seizures, and cognitive impairment

Introduction: In this study, percutaneous suturing for the treatment of acute Achilles tendon (AT) rupture was compared to open reconstruction for the treatment of chronic AT rupture. Materials and methods: We conducted a prospective comparison research at Department of Orthopaedics, Guntur Medical College, Guntur, Andhra Pradesh, India, between March 2021 to February 2022. Patients having a primary diagnosis of total Achilles tendon rupture were included in the analysis. Twenty-five patients were given advice on their treatment choices and encouraged to return in a year for follow-up. Results: Results of multivariate and univariate logistic regression methods are used. Comparable gram-positive and gram-negative bacterial growth was seen in this study of pleural space infections. pH, loculation, positive stain, culture, fever, and serum albumin were all statistically significant in their own right when analysed in isolation. After doing a multivariate analysis, we found that pH, loculation, and serum albumin were significant predictors of tube thoracostomy success or failure. Conclusion: Comparing open repair for chronic AT rupture to percutaneous suturing following acute AT rupture, one may find similar clinical and functional results, but a thicker tendon.

Background: The term "asymptomatic bacteriuria" (ASB) refers to persistent, aggressive bacterial growth in asymptomatic females' urinary tracts. The quantitative diagnosis is a clear catch mid urine sample with more than 100,000 organisms/ml.1 The incidence is often population-dependent geographical variance, ranging from 2 to 7%. The incidence is between 25 and 35 percent in emerging nations like India

Aim:  To determine the bacteriological profile and antibiogram of burn wound patients in teritiary care hospital.

Materials And Methods : A cross sectional descriptive study conducted  from January 2022- June 2022 and collected  50 specimens ( swabs ) from burn wound patients admitted in Burns ward  and processed in Microbiology Department ,Andhra Medical college, Visakhapatnam.  Drug susceptibility tests were performed using Kirby Bauer method   according to CLSI guidelines.

Results: Out of 50 samples , 42 samples  shown bacterial growth in which 34 bacterial isolates were GNB and 8 were GPC. Out 0f 42 , most frequently isolated was Pseudomonas aeurginosa ( 24 )(57.14% )of which 8 were ESBL producing , followed by Staph aureus ( 7) (16.66%), Klebsiella species (4)(9.52%), Acinetobacter species (4)(9.52% ) ,Escherischia coli (2)( 4.76%) ,Proteus species (1)(2.38% ). GNB were mostly sensitive to Piperacillin- Tazobactam, Fluoroquinolones, Macrolides and were  resistant to Beta lactams. GPC were sensitive to Vancomycin , Linezolid and were resistant to Cefoxitin .

Conclusion: Due to increased morbidity and mortality associated with burn wound infections, early detection and intervention are a prerequisite for better clinical outcomes of burn patients

Introduction: Nephrotic syndrome, characterized by presence of heavy proteinuria, hypoalbuminemia, edema and hyperlipidemia, is a common renal disorder in pediatric population and is most common in Asian child.

Aims & Objectives: To know the bacterial etiologies and their antibiogram in urinary samples of Pediatricnephrotic syndrome.

Materials And Methods:   This was a Cross sectional, Descriptive study conducted for a period of 6 months i.e., January 2022 – June 2022 in pediatric patients admitted in PICU’s of KING GEORGE HOSPITAL, VISAKHAPATNAM.  Urine samples are collected and transported to Department of Microbiology, ANDHRA MEDICAL COLLEGE, VISAKHAPATNAM.

Results: Out of 70 urine samples studied, 21(30%) have urinary tract infection, 13(62%) were asymptomatic and 8(38%) are symptomatic.  Majority of UTI caused by E.coli 8(38%) followed by klebsiella 6(29%), Proteus 4(19%), Staphylococcus aureus 2(10%), Acinetobacter 1(4%).

Gram negative bacilli were sensitive to Amikacin, Cefixime, Piperacillin plus Tazobactum, Nirofurantoin, Meropenem.

Gram positive cocci were sensitive to Amoxicillin, Vancomycin, Linezolid.

Conclusion: Children with nephrotic syndrome are frequently predisposed to UTI and in most cases, it is asymptomatic.  It is necessary to examine the patient and prevent the risk of complications by initiating appropriate antibiotic therapy

Introduction: Ventilator associated pneumonia is defined as pneumonia occurring more than 48hours after the initiation of endotracheal intubation and the most common nosocomial infection in intensive care unit.VAP is second most common health care associated pneumonia in spite of wide range of preventive measures. Aim: To isolate the bacterial pathogens and their antibiogram of organisms causing VAP. Materials and Methods: Cross sectional descriptive study conducted for a period of 6 months i.e January 2022 - June 2022 in patients admitted in ICUs of King George hospital on ventilator for more than 48 hours. Endotracheal aspirates are collected and transported to department of Microbiology, AMC, Visakhapatnam. Results: From 50 endotracheal samples studied ,15(30%) were culture positive. Among them the most predominant organism is Pseudomonas aeruginosa 5(33.3%) followed by Methicillin resistant Staphylococcus aureus 4 (26.6%), Klebsiella species 3 (20%) and Acinetobacter species 3(20%).Gram negative bacilli were sensitive to Piperacillin – Tazobactam, fluoroquinolones, macrolides, Polymyxin whereas resistant to beta lactams.Gram positive cocci were 100% resistant to Cefoxitin, Oxacillin and sensitive to Linezolid and Vancomycin. Conclusion: Knowledge of incidence of VAP, their causative microbial flora along with their susceptibility pattern help in selection of appropriate antibiotics for therapeutic use and better outcome

Background: One of the most typical illnesses seen in clinical practise is urinary tract infection (UTI). 50% to 60% of adult women may encounter a urinary tract infection at some point in their lives, making it one of the most prevalent bacterial illnesses in women. Due to their anatomical characteristics, such as a narrow urethra, as well as other variables like pregnancy, the use of diaphragms, and sexual activity, women are more likely to acquire UTI. Objectives: 1. To isolate and identify the uropathogens from the urine samples. 2. To detect the antimicrobial resistance of uropathogens to fluoroquinolones. Material & Methods: Study Design: Descriptive Cross-sectional study. Study area: Department of Obstetrics & Gynecology, Murshidabad Medical college and Hospital, Berhampore, West Bengal. Study Period: Jan 2022 – Dec. 2022. Study population: Urine culture sensitivity reports were analyzed of patients who were suspected to be having urinary tract infection. Sample size: Study consisted a total of 300 subjects. Sampling Technique: Simple Random technique. Results: The resistant pattern of E.coli and Klebsiella to the 4 fluroquinolones, highest resistance is seen to ciprofloxacin followed by norfloxacin. In this study the most sensitive drug was Amikacin, followed by Pippericillin/Tazobactum and imipenem. In this study the drug with maximum resistance was cotrimoxazole. Amoxycillin and quinolones followed the list. Conclusion: We need to take a number of steps to address the significant worldwide opposition issue we are facing. These include (i) using fewer antibiotics to lessen the pressure for resistance to develop. (ii) increasing our understanding of the mechanisms by which bacteria acquire resistance and how they reduce the ensuing fitness costs.

Background: Fungal keratitis is one of the most devastating microbial keratitis with the worst visual prognosis, potentially leading to blindness. The clinical characteristics of Fungal keratitis are mild pain, the insidious growth of fungal pathogens in the deep cornea, and difficult to differentiate it from other kinds of microbial keratitis early on. Therefore, the early and accurate diagnosis of Fungal keratitis by means of clinical features is sometimes impossible due to patients’ delayed visits or the great similarities of Fungal keratitis with other types of microbial keratitis in early stages of the disease. [3] Materials and methods: This is a prospective and observational study was conducted in the Department of Microbiology, SIMS over a period of 6 months. This includes 35 patients with clinically suspected fungal corneal ulcer within an age group of 15–60 years. Sociodemographic data, chief complain, history of present illness like onset, duration, associated features, aggravating or relieving factors were noted. Corneal scraping of the affected eye was collected under slit lamp illumination. The direct microscopy of 10% potassium hydroxide (KOH) wet mount and gram staining of the materials directly smeared on the slides were performed. The samples were also inoculated onto Sabouraud Dextrose Agar (SDA) plates for fungal culture at 27°C for 21 days. Result: Among the positive cases of fungal keratitis, males (65.7%) outnumbered females (34.3%) with the ratio of 1.67:1 (Table 1). The maximum number of positive cases were seen in age group of 21-30 years, followed by the age groups of 31-40 years and 11-20 years. The most common cause of Aspergillus fumigatus (28.6 %), Fusarium solani (20%), Cladophialophora bantiana and Candida tropicalis (14.3 % each), and Mucor and Candida albicans (5.7 % each), Curvularia (11.4%). Aspergillus species were found to be isolated from 50% of cases of keratomycosis.  Filamentous fungi were predominantly associated with mycotic keratitis, accounting for 71.4% of cases, as compared to yeasts which had caused keratitis in 28.6% of cases. Amongst the cases of keratomycosis (n=35), all were positive for fungal growth on culture, out of which 85.7% cases were also positive for the presence of fungal elements on direct microscopy. Conclusion: Fungal keratitis is often a severe disease in which diagnosis can be challenging, the response to medical treatment is slow, and the clinical outcome is poor. Corneal perforation is 5 to 6 times more likely with fungal keratitis than it is with bacterial keratitis. Because of serious consequences of infectious keratitis, it is important to know the exact aetiology of corneal ulcer to institute appropriate therapy in time

Background: The most significant cause of infant fatalities in the neighborhood is neonatal sepsis. Objective: To identify the typical bacterial infections linked to neonatal sepsis, as well as their pattern of antibiotic sensitivity. Materials and Methods: A total of 100 newborns admitted to the neonatology unit during the study period had their physical examinations and clinical characteristics. All infants were observed using conventional methods and the Kirby-Bauer disc diffusion method. Samples were also tested for standard antibiotic sensitivity.  Results: The present study showed that out of 100 clinically suspected neonatal sepsis cases. 44% newborn sepsis patients with clinical suspicion and positive screening test results were confirmed by culture. The majority pathogen in the culture-positive cases was discovered to be Gram Negative 66% (n= 29); among them 62.06% (n=18) belonged to EONS and 37.93% (n=11) belonged to LONS. Klebsiella pneumoniae 46.15 % (n=12) was the most common isolate followed by Escherichia coli  23.06 %(n=6) whereas 34 % (n=15) were Gram Positive isolates. Out of 15 Gram-Positive isolates, 53.33% (n=8) were of EONS and 46.7 % (n=7) were of LONS. Staphylococcus aureus 19.23% (n=5) was the most common isolate followed by CoNS 7.69 %(n=2) and Enterococcus faecalis 3.85% (n=1).  Conclusion: The timely diagnosis and prompt use of antibiotics according to standard policy is warranted to save newborns from septicemia. Knowing the bacterial infections that are widespread in NICUs and their antimicrobial susceptibility pattern can assist the doctor choose the right drugs for treating cases of suspected newborn sepsis in light of the developing bacterial resistance to commonly used antibiotics

Background: -Brain abscess is defined as a focal infection within the brain parenchyma which starts as a localised area of cerebritis which is subsequently converted into a collection of pus within a well vascularised capsule.Intracranial abscesses are life-threatening infection that pose a diagnostic challenge not only to the neurosurgeon but also to the microbiologists. Detailed studies documenting the spectrum of infecting agents involved in brain abscesses are limited from India. Case report: -A 17-year-oldboy presented to Trauma and emergency Department AIIMS Raipur in a drowsy state with complaints of severe headache and right sided ear discharge for 15 days,fever on and off and weakness over all limbs for 1 day.Patient had a history of chronic suppurative otitis media (CSOM) of right ear discharge without any evidence of recent trauma or neurological procedure.Contrast enhanced CT brain showed cerebellar abscess with compressed fourth ventricle. Patient underwent emergency craniotomy, drainage of abscess and extra ventricular drain. Pus sample on gram stain showed gram positive cocci in chains and pairs and few gram-negative bacilli.Aerobic bacterial culture revealed pinpoint beta-haemolyticcolonies along with few translucentnonhaemolytic colonies which failed to grow in MacConkey agar.The two isolates were identified asStreptococcus constellates and.Spingobacterium multivorumby VITEK II system.Antibiotic susceptibility pattern was performed by Kirby Bauer Disk diffusion and VITEK II system compact automated ID/ AST system.Initial empirical antibiotics were replaced withIV vancomycin as both the organisms were found sensitive to it. Patient responded with improved Glasgow comma Score and gradual resolution of abscess size which was evident on successive postoperative CECT Scan findings. Conclusion: Streptococcus constellatus and Spingobacterium multivorumboth are ubiquitous.Haematogenous spread from ear could have resulted in brain abscess.Appropriate sampling and use of automated instruments may increase isolation of new and unusualpathogensand result in early and appropriate management of brain abscess

Background: The profile of cirrhosis may vary with different age and ethinic groups, geographical, social and etiological factors. So the present study will be undertaken  to study the  clinical profiles of patients with cirrhosis of liver in the form of demography, aetiology, clinical presentation, laboratory evaluation and  complications in this region of north Karnataka. Methodology: A two  years observational study after ethical committee approval was conducted at a tertiary care hospital among 200 cirrhotic patients in whom after explaining the purpose of the study,  detailed history, clinical and laboratory data was collected. The DATA was analyzed using  IBM SPSS Statistics for Windows, Version 25.0. Result. In our study the commonest age group was 31-50 years, mean age 44.10±13.08 years. Majority (88.5%) were males. Symptoms were abdominal distension (85.5%), lower limb edema(63.5%), jaundice (48%), gastrointestinal bleed(18.5%), altered sensorium in 14%. Aetiology were alcohol related (57.5%), HBV (13.5%), NAFLD(11.5%), viral and alcohol(5%), HCV (3%), Cryptogenic cirrhosis (4.5%) and Autoimmune Hepatitis (2.5%). Commonest   complications were hepatic encephalopathy (14%), Spontaneous bacterial peritonitis(14%), major renal impairment(12%) and Hepatocellular carcinoma (0.5%). 49% had CTP category B disease and 47.5% had CTP category C, 165 patients had MELD Na of >15. Conclusion: Cirrhosis is common among the most productive age group of society with change in lifestyle habits and increased alcohol use this has gained more importance. Recent advances in treating these patients may take a few more years in yielding new results and this article will act as a benchmark for comparison.

Background and Objectives: Bacterial meningitis (BM) poses a considerable global public health concern. C-reactive protein (CRP) has emerged as a viable diagnostic marker, particularly in differentiating bacterial and aseptic meningitis, especially in cases where bacterial culture results are negative in both blood and cerebrospinal fluid (CSF) samples. The present study was done with the primary objective of estimating the serum CRP levels in pediatric meningitis cases caused by bacterial pathogens. Materials and Methods: A hospital-based descriptive cross-sectional study was undertaken at a renowned tertiary care hospital in India, involving the evaluation of 222 samples. Cerebrospinal fluid samples were collected following standard guidelines, and bacterial identification and antimicrobial susceptibility testing were carried out using an automated system. Quantitative estimation of CRP levels was performed using a solid-phase, sandwich-format immunometric assay employing a gold antibody conjugate. Results: The study cohort consisted of pediatric meningitis cases with a median age of 3.9 years, ranging from 1 to 4.6 years. Among the bacterial isolates, Escherichia coli was identified as the most prevalent pathogen, followed by Klebsiella pneumoniae. Notably, 31.32% of the participants exhibited elevated serum CRP levels. Moreover, a statistically significant association was observed between elevated serum CRP levels and cases with Gram-negative bacterial etiology. Conclusion: Elevated serum CRP can serve as a valuable diagnostic marker for identifying pediatric bacterial meningitis cases with a Gram-negative etiology. The utilization of CRP as a diagnostic adjunct can aid in timely and accurate differentiation between bacterial and aseptic meningitis, facilitating appropriate clinical management and improved patient outcomes.

Background- Cervical Lymphadenopathy is a common problem in children and it is considered significant if the diameter exceeds 1 cm for cervical and 1.5 cm for axillary lymph node. Common pathology is infective and mostly benign and self limiting.

Objective- To study the clinicopathological profile of significant cervical lymphadenopathy in age group 1 month to 12 year

Methodology- This is a prospective observational study of 75 patients with significant cervical lymphadenopathy. This study was conducted at Department Of Paediatrics & Neonatology, RIMS, Ranchi, Jharkhand from April 2018 to March 2019. History, clinical examination, Mantoux test,  Hemogram, Fine Needle Aspiration Cytology (FNAC) were performed in maximum cases. USG and CT were done in some cases.

Result- Out of 75 cases, cervical lymphadenopathy was maximum in 4 to 8 years  (42.7%), 8 to 12 years (36%), and least in 1 month to 4 years (21.3%). Neck swelling (89.3%), fever (90.7%), cough (50.7%), loss of weight (26.7%), and ear discharge ( 10.7%). Most common site of cervical lymphadenopathy was cervical and least was in occipital. Lymph node consistency was firm ( 89.4%), soft (93%) and rubbery (1.3%). Associated findings were tonsillitis and/or pharyngitis, hepatosplenomegaly.

Conclusion- Lymphadenopathy is a sign of many underlying disorders and mostly benign. Few are serious which should be ruled out through examination . FNAC should be done in doubtful cases. Reactive Lymphadenitis due to bacterial or viral pathogens were the most common cause.

Background: Chronic renal failure (CRF) is manifested by various skin symptoms. New changes have been described continuously since the advent of hemodialysis, which increases life expectancy and allows time for these changes to occur. Objective: The aim of this study was to determine the frequency of skin manifestations in chronic renal failure (CRF) patients receiving hemodialysis.  Methods: it was a cross sectional observational study in which skin changes were studied in a total of 500 CRF patientsreceiving hemodialysis attending dermatology OPD in a tertiary hospital in central India.  Results: 80% of the patients complained of some skin problems.However, at examination, all patients had at least one skin condition caused by CRF. The most common finding was xerosis (80%), followed by pallor (70%), itching (50%), and skin hyperpigmentation (40%). Other skin manifestations include Kell's disease (20%), fungal (40%), bacterial (15%),  purpura (10%) and dermatitis (2%). Nail changes include koilonychia (25%), onychomycosis (20%), subungual hyperkeratosis (10%), onycholysis (10%) and hemorrhages (5%), Mee’s line (5%), Muehrcke lines (5%) and Beau's lines (2%). Hair changes include thinning hair (35%) and brittle and dull hair (15%). Oral changes include striated macroglossia (40%), xerostomia (30%), ulcerative stomatitis (30%), angular cheilitis (15%), and uremic breath (10%). Some rare side effects of CRF have also been observed, such as uremic frostbite, gynecomastia, and pseudoKaposi's sarcoma.  Conclusion: CRF is associated with a complex set of cutaneous manifestations caused by disease or treatment. The most common are xerosis and pruritus, and early recognition of skin symptoms can reduce pain and morbidity.

Background: Acne affects an increasing number of adult females, impairing quality of life, with significant negative psychological effect and social impact. Adult female acne (AFA) is defined as one that affects women over the age of 25 and may persist continuously or intermittently from adolescence or manifest for the first time in this period. It is believed that genetic and hormonal factors contribute to the pathogenesis of AFA, characterized by chronic evolution, requiring maintenance treatment, in some cases for years. The etiopathogenesis of acne vulgaris involves a complex interaction between the main factors such as: genetic predisposition; androgenic hormone stimulation leading to an increase in sebaceous secretion; alteration of the lipid composition; follicular hyperkeratinization; bacterial colonization mainly by Propionibacterium acnes (P. acnes) and periglandular dermal inflammation. Materials and methods: Patients having acne of age ≥25 years were analyzed using a pre devised proforma to elicit trigger factors while the severity was graded using the Global Acne Grading System (GAGS). A detailed hormonal assessment was undertaken that assessed total testosterone (TT), sex hormone‑binding globulin (SHBG), free androgen index (FAI), AMH, 17‑hydroxyprogesterone (17‑OHP), dehydroepiandrosterone sulfate (DHEAS), follicle‑stimulating hormone (FSH), luteinizing hormone (LH), thyroid‑stimulating hormone (TSH), and prolactin. Result: This research involves 90 students as the sample. The profile of the samples that contain average age, gender, degree of acne vulgaris, father genetic history, and mother genetic history. Statistical analysis of the father’s genetic history resultsin a p-valuel3t of 0.001, which means that the father’s genetic history was significantly related (p0.05) to the degree of acne vulgaris. Topical steroid use was found to be an important factor responsible for aggravation of acne in our study population. The objective assessment implicated the role of diet in 14.4% of patients with the common foods being ―oily ―and dairy products. Conclusion: Adult female acne may be triggered by diet, stress, and cosmetics and there is a distinct hormonal milieu that accounts for hyperandrogenemia. We noted high levels of adrenal androgens which have been known to be associated with stress and sleep deprivation. Our study shows the value of counseling adult female acne patients about various acne triggers.

Background: Cataract phacoemulsification surgery is a highly effective intervention, yet not without the risk of postoperative complications, including endophthalmitis. The prophylactic use of antibacterial drugs has gained prominence in mitigating these risks. This study aimed to assess the effectiveness of prophylactic antibacterial drugs, specifically moxifloxacin, in preventing post-cataract surgery complications. Materials and Methods: A prospective, randomized controlled trial was conducted, enrolling 400 adult cataract patients randomized into two groups: the Antibacterial Prophylaxis Group (APG) and the Control Group (CG). The APG received topical moxifloxacin preoperatively and postoperatively, while the CG did not receive prophylactic antibiotics. Surgical outcomes, microbial profiles, antibiotic resistance patterns, patient satisfaction, and adverse events were assessed. Results: The APG exhibited a significantly lower incidence of postoperative endophthalmitis (0.5%) compared to the CG (1.8%) (p = 0.032). Coagulase-negative Staphylococcus and Streptococcus pneumoniae were the predominant pathogens. Antibiotic resistance profiles included methicillin-resistant Staphylococcus and penicillin-resistant Streptococcus. Patient satisfaction scores were consistently high in both groups. Adverse events were infrequent and manageable. Conclusion: Prophylactic moxifloxacin significantly reduced the incidence of post-cataract surgery endophthalmitis. The microbial profile underscores the persistent role of specific pathogens, while antibiotic resistance highlights emerging challenges. Patient satisfaction remained high, emphasizing the holistic approach to surgical care. Our findings contribute to evidence-based perioperative strategies and emphasize the importance of antibiotic stewardship in ocular infections.

Background: Oral cancer is a significant public health concern in India. This longitudinal study aimed to assess the incidence, risk factors, causative microorganisms, and outcomes of postoperative infections among oral cancer patients in a tertiary medical college in India. Data were collected from patients undergoing surgical treatment for oral cancer over a defined period. The findings shed light on the prevalence of infections and can guide the development of preventive strategies and optimize postoperative care for this vulnerable patient group. Methods: it was a longitudinal observational study in which a total of 600 patients who were operated for oral cancer attending dental OPD in a tertiary hospital in Indiafrom September 2022 to August 2023 were studied and followed up. Results: A total of 600 patients who underwent surgery for cancers of the oral cavity during the study period of September 2022 to August 2023 were followed up. SSIs were noticed in 60 (10%) post-operative cases. This included 42 (70%) incisional SSIs and 18 (30%) organ/space SSIs. Culture of the surgical site in 60 infected patients yielded a total of 120 isolates. 15 patients (25%) had polymicrobial infections. Gram-negative bacterial isolates (70%) outnumbered gram-positive bacterial isolates (30%). Majority of the patients (48 patients—80%) were in stage IV disease. Successful management of patients with bacterial infections depends on early identification of bacterial pathogens and selection of an effective antibiotic against the organism. Judicial use of antibiotics is also very essential to prevent the development of drug resistance.

Introduction: In conjunction with the Millennium Development Goals, the under-5 mortality rate had a remarkable global decline of 53% between 1990 and 2015 [1]. Currently, the first month of life accounts for 45% of under-5 mortality. Infections rank among the main causes of newborn mortality, along with intrapartum issues and problems from premature delivery [2]. Together, neonatal sepsis and meningitis account for 6.8% of all under-5 fatalities worldwide [3]. Material and Method: The limitations of the study are those characteristics of design or methodology that impacted or influenced the interpretation of the findings from your research. Study limitations are the constraints placed on the ability to generalize from the results, to further describe applications to practice, and/or related to the utility of findings that are the result of the ways in which you initially chose to design the study or the method used to establish internal and external validity or the result of unanticipated challenges that emerged during the study. Result: In the present study ,100 cases of neonatal bacterial meningitis have been taken from SVPPGIP and SNCU OF SCBMCH, Cuttack and their results were statistically analysed and compared. Conclusion: One of the leading causes of morbidity and death in neonates is still bacterial meningitis. Since LP is so widely used for diagnosis, an increasing number of cases have been diagnosed in the last ten years. Although the morbidity has not changed, the mortality has decreased dramatically as a result. Our study examined the relationship between greater complications and delayed hospital presentations.

Introduction: UTI is a prevalent condition that affects approximately 40% of the adult population. Clinical Syndrome may be characterized as Asymptomatic Bacteriuria, Uncomplicated Cystitis, Pyelonephritis, Prostatitis, or complicated UTI. The goals of treatment of urinary tract infection are to eliminate the pathogen, to prevent Urosepsis, and to reduce the risk of renal scarring. Objective: To study the culture and sensitivity patterns of urinary tract infections in asymptomatic patients in a tertiary care hospital. Methods: A total of 120 samples were collected from January to June 2023. Identification was conducted by conventional biochemical tests. Antibiotic sensitivity test was analysed by disc diffusion method using different antibiotics and their zone of inhibition was measured. Results: Out of 120 subjects enrolled, 67 were males and 53 females The most common urinary pathogen isolated was E. Coli (64%) sensitive most often (82% sensitivity) to Amikacin. Overall sensitivity of different urinary isolates to amikacin was highest (82%).  Conclusion: Epidemiology and resistance patterns of bacterial pathogens in pediatrics urinary tract infection show large interregional variability, and rates of bacterial resistances are changing due to different antibiotic treatment. Knowledge of spectrum of pathogens and their patterns of drug resistance is indispensable for the empirical section of an effective therapeutic agent prior to availability of culture result.

Introduction: Corneal ulcers, characterized by epithelial loss, stromal infiltration, suppuration, and inflammation, pose a global health concern, especially in the context of corneal blindness. Infectious keratitis, attributed to microbial agents, is a leading cause of corneal ulcers. This study focuses on the incidence, microbial etiology, and management strategies for corneal perforations arising from infectious keratitis. Objective: To investigate the incidence of corneal perforation in cases of infective keratitis, identify specific microorganism groups associated with corneal perforations, determine appropriate treatment modalities, and assess the prognosis of various interventions in perforated corneal ulcer management. Materials and Methods: A total of 150 patients with infectious perforated corneal ulcers were enrolled. Inclusion criteria covered patients aged 18 to 60 years, irrespective of gender, with infectious etiology. A comprehensive clinical examination, microbiological analysis, and various treatment modalities, including Bandage Contact Lens, Cyanoacrylate Glue, Amniotic Membrane Transplantation, and Corneal Transplantation, were employed. Results: Prevalence is observed in the age group of 25-50 years (70 patients), followed by 50-60 years (53 patients), and 18-25 years (27 patients). There is a significant male preponderance (117 cases) compared to females (33 cases). There is a higher incidence among farmers (44 cases) and laborers (27 cases), suggesting potential occupational risk factors. Paracentral perforations are the most prevalent (71 cases), followed by central (45 cases), and peripheral perforations (34 cases). A total of 132 positive cases indicate a predominantly infectious etiology. There is a higher prevalence of bacterial infections (75 cases), followed by fungal (29 cases), and mixed infections (28 cases). Micro perforations (<1mm) are the most common (68 cases), followed by small (59 cases), and large perforations (23 cases). Bandage Contact Lens (67 cases), Amniotic Membrane Transplantation (45 cases), and Penetrating Keratoplasty (38 cases) are frequently employed. Discussion:   Infectious keratitis, if not promptly managed, poses severe complications. Factors such as occupation, accessibility to medications, and gender influence delayed presentations. Corneal perforation, a consequence of various corneal disorders, requires timely recognition and intervention to prevent vision loss. Treatment modalities include medical approaches, tissue adhesives, and various surgical interventions. Conclusion:  The study underscores the multifaceted approach required for infectious keratitis management. Prompt intervention, gender-specific prevalence, and the efficacy of diverse treatments based on perforation characteristics are highlighted. The findings contribute valuable insights for the effective management of corneal perforations arising from infective keratitis.

Introduction: Bacterial keratitis is also often referred to as a 'corneal ulcer'. In practice, these terms are not directly interchangeable because a cornea may harbor a bacterial infection (i.e bacterial keratitis) without having a loss of tissue (an ulcer) and a cornea may have an ulcer without a bacterial infection. Bacterial keratitis is a serious bacterial infection of the cornea which can, in severe cases, cause loss of vision. Materials and Methods: This is a prospective study conducted over a period of six months at the Department of Ophthalmology. Inclusion Criteria: Patients above the age of 18 years presenting with suspected corneal ulceration and having symptoms of pain, redness, watering, photophobia and decreased vision were included in the study. Exclusion Criteria: Patients with typical features of viral infection and healing ulcers were excluded as were Mooren's ulcers, interstitial keratitis, sterile neurotropic ulcers, and any ulcer associated with autoimmune conditions. Results: Total 90 patients were enrolled with a corneal infiltration that was clinically compatible with the diagnosis of bacterial corneal ulcer. Majority of them were male 54 (60%) and female 40%. The age of patients ranged from 1 to >60 years. Majority of 21-40 years age group (41.1%). The keratitis was induced by foreign body particles were most common risk factor 24.4%. Corneal localization of the ulcers was distributed as in 51 (56.6%) patient's central and in 39 (43.3%) peripheral. The diameter of the corneal ulceration was of 1-2 mm in 24 (26.6%), 3-4 mm in 29 (32.2%), 5-6 mm in 21 (23.3%), 7-8 mm in 9 (10.0%) patients, 7 (7.7%) patients had entire corneal involvement. Ulceration depth was less than 1/3 conreal thickness in 46 (51.1%), between 1/3 to 2/3 in 26 (28.8%) patients and over 2/3 in 18 (20.0%) patients. Anterior chamber inflammation was absent in 9 (10%) patients. A1+ to 2+ Tyndall effect with 1+ to 2+ cells were present in 17 (18.8%) patients, and severe anterior chamber inflammation (3+ to 4+ Tyndall effect and cells, with or without hypopyon) was present in 64 (71.1%) patients. Conclusion: Bacterial Corneal ulcers are a vision-threatening ocular emergency. It is imperative that health care providers across specialties work together so that these patients may have the best possible outcome and avoid the many potential complications.

Helicobacter pylori is a common and important transmissible bacterial human pathogen. The prevalence of this infection varies world-wide from as low as 10 per cent in developed western nations to higher than 80 per cent among the indigenous populations of many developing countries. H. pylori infection is typically acquired in childhood. The risk of infection is inversely related to the overall sanitary conditions and requires exposure to other infected humans. Contaminated water is often the primary mode of transmission in rural areas without reliable supplies of potable water7,8. However, in regions of higher socio-economic status the risk of infection best correlates with the level of household hygiene. METHODOLOGY The present study was cross sectional in nature. It includes one hundred and fifty eight (158) patients both male and females patients attending OPD at Tertiary care teaching hospital with symptoms suggestive of gastro duodenal diseases, who fulfilled the inclusion and exclusion criteria. The study period was from April 2022 to March 2023. A total of 158 consecutive adult patients who presented to Hospital with symptoms of gastroduodenal diseases and referred for upper gastrointestinal endoscopy. RESULTS: Among the study subjects10.8% were found to be having normal UGI scopy inspite of symptoms suggestive of gastro-duodenal diseases, majority of patients was diagnosed to be having Duodenal ulcer (25.3%), Gastric ulcer (21.5%), and gastric erosions (17.7%). In our study out of 158 study subjects 40 were found to be negative for H-pylori infection. Majority of H-pylori positive patients were found to be having H-pylori density 1+ (44.9%) Even though upper GI Endoscopy was normal, 9 patients were found to be having H-pylori infection. Among 18 Gastric malignancies patients, 8 were negative for H-pylori infection. 80% of the duodenal ulcer patients were found to be having H-pylori infection. 68% of the Gastric ulcer patients were found to be having H-pylori infection. 85.7 % of the gastric erosions patients had H-pylori infection. Conclusion: From Our study, we would like to conclude that age related prevalence is more in relatively younger age group than elderly, and prevalence is more in males. Among the gastro duodenal diseases the prevalence of H.pylori infection is high in duodenal ulcers followed by gastric ulcer. In our study we found that specificity and negative predictive value of Cag-A strain for gastric carcinoma were high and it has practical importance that Cag-A positive H-pylori strains are strongly associated with gastric cancers. In our study we found that specificity and negative predictive value of Ure-C strain for gastric carcinoma were high

Introduction: India has a diabetic population of about 50.8 million, which is expected to increase to 87 million by 2030. Infection worsens the wound condition, delays the healing mechanism, and if appropriate measures are not taken in time, it could lead to systemic infection, septicemia, amputation, or even death. Diabetic foot problems, such as ulcerations, diseases, and gangrene, are the most common cause of hospitalization among diabetic patients. Objective: To determine the microbiological profile and antibiotic susceptibility patterns of organisms isolated from diabetic foot ulcers. Material and methods: A six-month retrospective study was carried out between January 2023 and June 2023 in the Department of Microbiology Government Medical College Anantapur. 250 Wound swabs were collected from diabetic foot ulcer patients and processed per the standard procedure. Antibiotic sensitivity testing was performed using the Kirby Bauer disc diffusion method by CLSI guidelines. Results: Out of 250 samples, 175 (70%) samples yielded growth. Among 175 GNB 124 (70.8%) and GPC 51 (21.6%). Conclusion: In this study, among Gram-negative bacilli, Pseudomonas aeruginosa was the predominant organism 45(36.2%), followed by Escherichia coli 32(25.8%). Among Gram positive cocci, Staphylococcus aureus are 27 (52.9%) out of 27staphylococcus aureus 12 (44.4%) were resistant to Methicillin [MRSA].  The antibiotic profile shows that proper antibiotic usage, if enacted through institutional policy, can reduce morbidity among diabetic foot ulcer patients.

Background:   Tuberculosis is an infective disease, mostly affecting the lungs. Extra pulmonary tuberculosis (EPTB) comprises 23- 30% of all TB cases. Even with so many recent advances and development regarding TB, is still a challenge to diagnose in clinical practice. Among all the presentation of EPTB, cutaneous sinus tract presentation is a rare entity. It is a prospective study from May 2020 to May 2023 in IMS SUM hospital, Bhubaneswar.  AIM-Study and follow up of rare cases of cutaneous TB with different clinical diagnosis. Methods:   Operative patients contacted TB due to faulty sterilization and other cutaneous TB cases which clinically misguiding are reported.  EXCLUSION CRITERIA- Patients with present or past history of TB and HIV patient are excluded.  DIAGNOSIS CRITERIA –Positive microscope finding of AFB, HPE and Genexpertultra MTB/RIF positive, AFB culture with positive growth. Results:   Due to faulty sterilization, healthy patients contacted TB during operation and tubercular sinuses of skin misdiagnosed as bacterial origin.   Conclusion: Due to increased turnover of surgical patients and inadequate sterilization of instruments, normal patients are infected with tuberculosis which creates dilemma to the surgical team in diagnosing the cause of infection. The case series highlights the importance of TB as an etiology in chronic non healing sinus of breast and axilla. Rapid drug sensitivity testing like line probe assay strips for early diagnosis and treatment of TB should be utilized. NTM Is difficult to diagnose, takes long time for treatment.

Background: The skin over the the external genitalia is a common site for rashes, itching, and minor infections as the skin  of this area has homeostasis around the ano-genitalia and also this area is warm, moist, and occluded, and it is frequently exposed to irritating urine, feces, and vaginal secretions. Genital dermatoses pose serious diagnostic and therapeutic challenges due to privacy persistant checkups, embarrassment, and the inability of necessary investigations. Hence this study has been undertaken to know the distribution and  determination of associated epidemiological factors of Nonvenereal Genital Dermatoses among the children & adolescents in our setup. Research Question: What is the distribution and determination of associated risk factors of Non venereal Genital Dermatoses in our set up? The setting of the study was at department of DVL, Government General Hospital, Government Medical College, Ongole, Andhra Pradesh. A one year observational study was conducted during the period from December 2022 to November 2023 on about 200 patients of various Non venereal Genital Dermatoses attending DVL OPD & Paediatrics OPD during the above period by studying their socio-demographic profiles, Type of skin lesions, clinical pattern and associated epidemiological factors etc. Results: The Non venereal Genital Dermatoses problem was more distributed among adolescents 9-18 years(36%) followed by School children 6-9 years (29%), Preschool children 3-5years(20%) toddlers 1-2years(15%) respectively with the mean Mean age = 7.4, Mean + 2SD = 3.54 – 18.34,  P < 0.01 and in this study males were more in number (71.5%) significantly when compared to females (28.5%). Among the total study subjects Infective Genital Dermatoses accounted for 80% and Non-Infective Dermatoses accounted for 20%. And among all the Infective Dermatoses Scabes occupies the major position (50.2%) followed by Fungal infections (26.5%), Bacterial infections (19%) and Viral infections (4) respectively. And among Non Infective Genital Dermatoses Phrynoderma (40%) was the most common one followed by Vitiligo Vulgaris (22.5%), Eczema (10%), Drug eruptions (7.5%), P.alba (5%), Fordyce spots (2.5%) Lichen Planus (2.5%), Lichen Striatus (2.5%), Haemangioma (2.5%), Phimosis (2.5%) and Traumatic ulcer (2.5%) respectively. And more number of study subjects were belongs to middle & lower class of SES. And furthur it was also observed that among both the Genital Dermatoses more number of  study subjects were belongs to Rural area (60.5%) followed by Sub urban (26.5%) and Urban (13%) significantly. About 34.5% of study subjects were residents of Hostels among the total study group..In adition to the above findings it was observed significantly that Genital Dermatoses was more observed  among the study subjects who wear under garments (90.5%).

Background: Sexually transmitted infections (STIs) are the most often reported infectious disorders in the world.   Sexual intercourse with an infected partner is the most significant risk factor for STIs.¹Sexually transmitted infections (STIs) are a major global health concern, with serious co-morbidities and mortality rates.

Objectives:

1. To identify the aetiology of ulcerative STIs among hospital patients.
2. To study the HIV and GUD co-infection
3. To study the prevalence of contacts and partners
4. To Identify different factors influencing genital ulcer diseases

Material & Methods: Study Design:  Hospital-based, cross-sectional study.  Study area: The study was conducted in the Department of OBG & Microbiology of a Medical College, in Kolkata.  Study period: 1st July 2023 to 30th June 2024.  Study tools and Data collection procedure: The project was evaluated and approved by the ethics committee, of the institution. Written, informed consent was obtained from each participant at the time of enrolment in the study, and socio-demographic characteristics were recorded. Detailed sexual exposure history was taken of each individual including sexual partners, sexual behavior, and sexual practices. Only strongly suspected cases of ulcers of STD origin were studied after thorough clinical examination. Results: Out of 51 cases who used condoms, in 22 cases (18.3%) aetiology was identified. Whereas out of 69 cases who did not use condoms, in 62 cases (51.6%) aetiology was diagnosed. So, in condom used cases, the incidence of GUD was 43% whereas in condom not used cases, the incidence of GUD was 89.8%. This shows the impact of condom use in preventing genital ulcers. The present study included 4 cases from the high-risk group, Men having sex with men (MSM) 3 cases and female sex workers (FSW) 1 cases. These patients presented with genital ulcers and were diagnosed. Conclusion: This study concluded that eliminating bacterial GUDs caused an increase in cases of Viral GUDs (Genital Herpes). The presence of GUD increases HIV susceptibility, hence proper and regular use of latex condoms is required to avoid the transfer of STIs. Laboratory tests detected GUDs with numerous etiologies that had previously gone undetected clinically. This aids in the identification of cases and allows patients to obtain proper and appropriate care.

Objective: Utilizing a confocal laser scanning microscope (CLSM) and a culture of bacteria test, the goal of this research was to determine the bactericidal impact of different doses of triple antibiotic paste (TAP) against Enterococcus faecalis (E. faecalis) in dentinal tubules. Techniques: E. faecalis (ATCC 29212) infected 90 human teeth, which were then divided into 5 groups at random: 1 mg/ml, 5 mg/ml, 7.5 mg/ml, and 10 mg/ml TAP (n = 18). The negative control group did not receive TAP. Samples were taken both the root canal space and root dentin at 100-μm and 200-μm depths following a three-week TAP treatment. Ten bacterial culture assays were performed on the gathered samples. A CLSM analysis was performed on eight roots from each group in order to identify the live and dead cells of bacteria. Results: The negative control samples were all culturable, according to the results of the bacterial culture assay. Following TAP treatment, there were less culture-positive samples at 1, 5, 7.5, and 10 mg/ml, with 2, 2, 1, and 0 culturable samples, in that order. Nonetheless, there were no appreciable variations between the TAP treatments. Remarkably, the CLSM investigation showed that all samples included live bacteria in the dentinal tubules. There were 52.36%±3.24 viable bacteria in the negative control. The smallest percentage of viable bacterial cells (40.58%±5.40) was observed with 10 mg/ml of TAP treatment. This was followed by 7.5 mg/ml (44.14%±6.03), 5 mg/ml (46.31%±5.32), and 1 mg/ml (52.55%±8.82). Conclusion: TAP treatment significantly decreased the percentage of viable E. faecalis cells in the dentinal tubules and its bactericidal effect was dose-dependent.

Background: Stillbirths constitute a major part of perinatal deaths. It is influenced by a wide range of maternal social and circumstantial factors. The study was done to find out the various factors associated with stillbirth in our hospital with the help of the existing ReCoDe System.  Materials And Methods: A cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Government Medical College, Thrissur by collecting data from all pregnant women who had during the study period of 12 months, i.e., from 1^stJanuary 2022.Data was then collected using a semi-structured interview after obtaining informed and signed consent. The questionnaire included general information, detailed clinical history. The relevant investigations, ultrasonography (growth parameters, liquor, biophysical profile, doppler parameters) were noted. After delivery, the stillborn baby Placenta, Umbilical cord and Amniotic fluid examined for any abnormalities. Results: Out of the134 cases of stillbirths during the study period of 12 months majority (52, 38.8%) were in the age group of 20 – 25 years, and 25 patients were included in the high-risk group in which 10 (7.5%) were below 20 years and 15 (11.2%) were above 35 years. Among the study participants, 51 (38.1%) were overweight and 27 (20.1%) were obese, 10 (7.5%) women had a Bad Obstetric History. There were 58 (43.3%) primigravida women. There were 4 (3.0%) women who were unbooked, while 20(14.9%) women had irregular antenatal care. 15 of the participants had maternal infection in the antenatal period of which 5 (3.7%) had viral and 10 (7.5%) had bacterial infection. 47(35.1%) patients had anemia in our study. A significant number of pregnant women (60, 44.8%) had gestational hypertension which was the most common cause leading to intra uterine fetal death. Gestational diabetes accounted for 49 (36.6%) of stillbirth in our study, 47 (35.1%) had hypothyroidism. IUGR was present in 51 (38.1%) of the study participants, and this was the second most common cause identified, resulting in stillbirth. Conclusion: Hypertensive Disorders of pregnancy was seen as the most common cause associated with intra uterine foetal demise. Intra uterine growth restriction and Gestational diabetes were the other important associated factors identified that led to stillbirth.

Introduction: Cervical carcinoma is fourth most common cancer. It is an increasing health problem and an important cause of mortality in women worldwide. Pap smear test is primary screening test to detect early cervical epithelial changes for detection of precancerous cervical intraepithelial neoplasia and it is also important for several infectious diseases. Materials and Methods: This is a retrospective study conducted at the Tertiary care Centre over a period of 1 year. Women having age 18 – 65 years undergoing Pap smear examination were taken. Women having different complaints, including hypertrophied cervix, white discharge, foul smelling discharge, irregular menstrual bleeding, postmenopausal bleeding, abdominal pain, infertility and patients with history of healthy cervix were included in this study. Results: In our study we included 1107 women with mean age of 38yrs and majority of women were aged between 36-42 years. Patients presenting symptoms of cancer cervix patients included white discharge (21.4%), Cervix hypertrophied (31%), infertility (8.4%), irregular menstrual cycle (20%), abdominal pain (7.4%) % and cervical mass (1.2%). These all were diagnosed with following cervix diseases Bacterial vaginosis 15.1%, Trichomoniasis 7%, HSIL 1.09%, LSIL 1.09%, ASCUS 1.4%, Atrophic 7.25%, SCC 1.5%, Adenocarcinoma 0.4% and normal 68.67%. The sensitivity of pap smear screening test is 94.74%. Conclusion: It is evident that cervical screening programs can reduce cervical cancer mortality by 80% or more among screened women. Out of 1107 pap smears, 759 cases were healthy clinically and 6 of them were diagnosed as SCC. Introduction of new techniques and facilities had made screening and treatment of infectious cervical diseases, cervical precancerous lesions feasible and highly cost-effective for all set ups. Early detection and treatment of premalignant lesions by help of colposcopy admixed with pap smear can result in massive improvements of survival, and are especially important in developing countries and rural areas where resources are limited and non-affordable.

Background:  Corneal ulcer is a potentially sight threatening ocular condition and the leading cause of monocular blindness in developing countries. Infectious keratitis can be caused by various pathogens i.e, bacteria, fungi, virus and parasites. Ocular trauma is a far more common predisposing factor of infectious keratitis in developing countries, whereas pre-existing ocular disease and contact lens are common risk factors in developed countries. Hence, an understanding of the aetiologic agents, epidemiologic features and risk factors that occur in specific region are important in rapid recognition, timely institution of therapy, optimal management and prevention of disease entity. Materials and methods: All patients with suspected infectious central corneal ulceration presenting to the ocular microbiology and cornea service. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined, and corneal cultures and scrapings were performed. Result: A total of 78 patients identified with bacterial corneal ulcer of which 58.97% were males, 37.17% were farmers. Trauma was seen as major predisposing factor in 75.64% cases. The major etiological agent was found in our study was Staphylococcus aureus (60.25%) followed by Pseudomonas in 16.66% and mixed infection in 7.69%. Conclusion: Bacteria are the most common cause of infectious keratitis in this patient population, with coagulase-negative Staphylococcus and Pseudomonas as the most common isolates. The prevalence of culture-positive fungal keratitis is significantly lower than that of bacterial keratitis. Contact lens wear is the most common risk factor associated with infectious keratitis.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major bacterial pathogen responsible for both healthcare- and community-associated infections. Healthcare-associated MRSA (HA-MRSA), a subtype of MRSA, is a notorious pathogen in hospital environments, particularly in susceptible patients with open wounds, invasive devices, or weakened immune systems. Community-associated MRSA (CA-MRSA), the other variant, has recently emerged as a major public health concern. This study was conducted to determine and compare the prevalence and antibiotic susceptibility patterns of HA-MRSA and CA-MRSA in a tertiary care hospital in West Bengal. Materials and Methods: In this hospital-based cross-sectional study, various clinical samples submitted to the bacteriology laboratory of the Department of Microbiology of Burdwan Medical College over a nine month period, were screened for MRSA growth using standard microbiological techniques. The isolates were classified as either community-associated MRSA (CA-MRSA) or healthcare-associated MRSA (HA-MRSA) based on the established criteria. Subsequently, antimicrobial susceptibility tests were performed on the MRSA isolates. Results: Of the 694 Staphylococcus aureus isolates, 285 (41.1%) were identified as Methicillin-resistant Staphylococcus aureus (MRSA), and 409 (58.9%) were Methicillin-sensitive Staphylococcus aureus (MSSA). Among the MRSA isolates, 191 (67%) were classified as healthcare-associated MRSA (HA-MRSA) and 94 (33%) as community-associated MRSA (CA-MRSA), with prevalence rates of 27.5% and 13.5%, respectively. Conclusions: This study showed that the prevalence and resistance of HA-MRSA to different antibiotics were significantly higher than those of CA-MRSA. These findings highlight the need for enhanced infection control measures and antimicrobial stewardship programs in healthcare settings to mitigate the spread of MRSA, particularly more resistant HA-MRSA strains.

Introduction: Exacerbations in COPD have a considerable impact on morbidity, mortality, and quality of life as it affects the health status of patients by accelerating the progression of the disease. It has been estimated that approximately 40%- 50% of acute exacerbation of COPD cases are due to bacterial infections and the cause of approximately one third of severe exacerbation cannot be identified.  Present study was aimed to study serum procalcitonin levels combined with CRP as a diagnostic marker in acute exacerbation of chronic obstructive pulmonary disease to differentiate cause for exacerbation from bacterial infections and other causes. Material and Methods: 120 patients presenting with symptoms and signs of AECOPD were included. Serum procalcitonin levels and CRP levels were correlated with growth in sputum culture. Results: Analysing the data statistically for the correlation between serum procalcitonin levels, CRP and sputum culture growth shows positive correlation between serum procalcitonin levels and CRP with Pearson Correlation coefficient of 0.73. Among patients having serum procalcitonin levels >0.5ng/dl 82.5% patients had positive sputum culture. (p<0.001) Among patients having CRP levels >6mg/L, 65.9% patients had positive sputum culture. (p=0.56). Among patients having both serum procalcitonin levels >0.5ng/dl and CRP levels >6mg/L, 87.5% patients had positive sputum culture. (p<0.001) Conclusion: Since there was good correlation between biomarkers and sputum culture growth in AECOPD, biomarkers like serum procalcitonin combined with CRP can be used as diagnostic markers in differentiating cause of acute exacerbation of COPD and to guide the antibiotics. 

Introduction Bronchiectasis a chronic lung condition, defined as the abnormal, irreversible dilation of the bronchi and bronchioles, where the elastic and muscular tissue is destroyed by acute or chronic inflammation and infection.  This anatomical definition has been evolved from the original description of ectatic bronchi found in pathological specimens in the year 1819. Bronchi, mostly medium sized, are abnormally dilated and bronchial wall shows inflammatory changes. Such changes result from disordered anatomy of bronchial tree, bacterial colonization and chronic host inflammatory response. Materials and Methods This is a prospective study was conducted in the Department of Respiratory medicine at Tertiary Care Teaching Hospital. Data were collected from inpatients diagnosed with bronchiectasis with or without asthma over a period of 1 year. Patients who had not received a chest HRCT scan examination or who had indecipherable HRCT scan images were excluded. Patients with other diseases (e.g. chronic obstructive pulmonary disease, allergic bronchopulmonary aspergillosis, α1-antitrypsin deficiency, significant immunodeficiencies and respiratory carcinomas) were also excluded. All aspects of the study were performed in accordance with relevant guidelines and regulations. Results In the present study, 618 BE were analyzed and divided into 2 groups into BE with asthma (n = 144, 23.3%) and those without asthma (n = 474, 76.6%). The characteristics of the patients are shown in Table 1. Among the 518 patients, 242 (53.3.%) were female and the median age of all patients was 65.6 years (IQR, 59.8–71.5 years). BE with asthma had higher BMI (23.8 vs. 100 Patients with asthma had more frequent hospitalizations, outpatient visits, and antibiotic usage compared to those without asthma. Conclusion The presence of bronchiectasis in patients with asthma was associated with greater asthma severity. There are important therapeutic implications of identifying bronchiectasis in asthmatic patients.

Background: Urinary tract infections (UTIs) rank among the most prevalent bacterial infections in pediatric populations.¹ It is estimated that around 1% of boys and 3% of girls will experience UTIs in their first decade of life. The primary cause of this condition is typically due to an ascending infection from the urethra.

Objectives:

• To describe the clinical profile of infants and children hospitalized with urinary tract infections.
• To study the current antibiotic susceptibility patterns of the prevailing urinary pathogens.
• To study the treatment outcome of urinary tract infections in children.

Material & Methods: Study Design: Hospital-based descriptive study. Study area: The study was conducted in the Department of Paediatrics of a tertiary care hospital. Study Period: 1 year. Study population: Hospitalized Children aged between 0-18 years and diagnosed with urinary tract infection. Sample size: The study consisted of a total of 189 subjects.

Results: Among the Escherichia coli isolates, high resistance was observed for Ampicillin (87.9%) and Nalidixic acid (88.6%) followed by Cotrimoxazole (67.5%), Cefotaxime (66.9%), Ceftriaxone (66.9%), Cefixime (64.4%), Aztreonam (64.4%) Norfloxacin (64.2%), Cefipime (57.2%), Gentamicin (53.9%), Amoxicillin-Clavulunate (47.8%).

Conclusion: This study highlights the significant burden of urinary tract infections (UTIs) in children, particularly those under 5 years of age. The emergence of antibiotic-resistant bacteria, such as ESBL and carbapenemase-producing Enterobacteriaceae, poses a major challenge in treating these infections.

Asymptomatic bacteriuria (ASB) is a prevalent condition in Type-2 Diabetes Mellitus (T2DM) patients, often exacerbated by the chronic inflammatory milieu associated with diabetes. This study aims to evaluate and compare the levels of key inflammatory biomarkers—Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), C-reactive protein (CRP), and Hemoglobin A1c (HbA1c)—in T2DM patients with and without ASB in Northern Andhra Pradesh. IL-6 and TNF-α are pivotal pro-inflammatory cytokines that contribute to both the pathogenesis of insulin resistance and the inflammatory response during bacterial infections. Elevated IL-6 and TNF-α levels are associated with poor glycemic control and increased susceptibility to infections, including urinary tract infections. CRP, an acute-phase reactant, is commonly elevated in systemic inflammation and serves as a reliable marker for infection and inflammation, which is critical in assessing the risk of ASB in diabetic patients. HbA1c, reflecting long-term blood glucose control, is also implicated in chronic inflammation, with poorly controlled diabetes being linked to higher inflammation and infection rates. By assessing these biomarkers, this study aims to elucidate the relationship between systemic inflammation, glycemic control, and the incidence of ASB in T2DM.

Introduction: Tuberculosis (TB) remains a significant public health concern, particularly in pediatric populations, where diagnosis and treatment are often challenging. The emergence of drug-resistant Mycobacterium tuberculosis strains complicates TB management. This study aimed to investigate the drug resistance patterns of M. tuberculosis isolates in pediatric pulmonary TB patients at a tertiary care hospital. Material & Methods: The present study was a prospective, observational study undertaken in a tertiary care hospital, Jaipur among 150 clinically suspected cases of pulmonary tuberculosis in paediatrics age group. Clinically relevant samples were collected depending on history and clinical findings with all aseptic precautions. Results: Out of the 150 suspected pulmonary TB specimens, 7.33% were positive for acid-fast bacilli. On Lowenstein Jensen medium, mycobacterial growth was observed in 4% specimen. The Gene Xpert positivity was observed in (8.66% patients. Resistance to first-line anti TB drugs was observed in 03 (60%) of the MTB isolates. The overall prevalence of mono resistance was observed in 02 (40%) isolates  showing resistance to Isoniazid and prevalence of multidrug-resistant TB (MDR TB) was observed as 4%. 60% concordance was observed between Gene Xpert and DST for the detection of rifampicin. Discordance in the detection of rifampicin resistance by DST, Gene Xpert, and was observed in 40%. Discordance in the detection of isoniazid resistance by DST and Gene Xpert was observed 40%. Conclusion: Management of drug-resistant tuberculosis represents a potential challenge for clinicians. Antitubercular drugs act as a gold standard in this situation. the use of conventional DST along with Gene Xpert seems promising for the detection of drug resistance in pulmonary TB cases, particularly in the scenario of the rising number of MDR TB cases. Continuous surveillance system to be advocated for evaluation of drug resistance patterns in pediatric age group.

Introduction: Viral keratoconjunctivitis (VKC) is a common ocular condition characterized by inflammation of the conjunctiva and cornea, often caused by adenoviruses. It is highly contagious and can lead to significant morbidity, including blurred vision and discomfort. This study investigates an epidemic of VKC in a tertiary care hospital, focusing on its clinical presentation, epidemiological factors, and outcomes. Materials and Methods: A prospective observational study was conducted on 300 patients presenting with symptoms of VKC over six months. Inclusion criteria included clinical signs of VKC, such as redness, watering, and photophobia, while exclusion criteria involved bacterial or allergic conjunctivitis. Diagnostic tests included PCR for adenovirus and slit-lamp examination. Results: Of the 300 patients, 85% tested positive for adenovirus. The mean age was 32.5 years, with a male predominance (60%). Common symptoms included redness (95%), watering (90%), and photophobia (85%). Age >50 years and delayed presentation were significant risk factors for severe disease. Immunocompromised Status (25% of Severe Cases). Most patients experienced symptoms for 1–2 weeks, consistent with the natural course of adenoviral conjunctivitis. More than 2 Weeks (20%) are Prolonged symptoms were observed in a subset of patients, likely due to corneal involvement or delayed treatment. Persistent Blurred Vision (15%) are complication underscores the potential long-term impact of VKC on visual function. Conclusion: The epidemic was predominantly caused by adenovirus, with significant morbidity. Early diagnosis and strict infection control measures are essential to prevent outbreaks

Background: Breast abscess is a condition that can develop as a complication of lactational mastitis, which occurs during breastfeeding. Recently, there has been a rise in cases of non-lactational breast abscess, which happens in women who are not breastfeeding. The purpose of this study was to examine the types of microorganisms found in both lactational and non-lactational breast abscesses in the emergency department (ED) and to determine how these microorganisms respond to different antibiotics. Methode: This study looked back at the records of breast abscess patients who came to the emergency department (ED) over two years. Information about their age, symptoms, tests, and treatments was collected. The study focused on the results of pus culture tests, the antibiotics given to the patients, and the types of germs (microorganisms) found. The goal was to understand the pattern of microorganisms and how they respond to antibiotics. Result: The study included a total of 150 patients, with 107 women classified as having lactational breast abscess and 43women as having non-lactational breast abscess. The average age of the patients was 24 years (ranging from 18 to 56 years). Most of the women (81%) were between 18 and 34 years old. Bacterial cultures were successfully grown from pus samples in 86% of the patients. In cases of lactational breast abscess, Staphylococcus aureus was the most common organism found (79%). In non-lactational breast abscess cases, a mix of bacteria, including Staphylococcus aureus and Group B Streptococci, was identified.Conclusion:  Choosing the right antibiotics is very important for treating breast abscesses. Non-lactational breast abscesses often have mixed types of bacteria compared to lactational breast abscesses. However, Staphylococcus aureus is the most common bacteria found in both types.

Background: Periodontal diseases are primarily caused by bacterial infections, leading to inflammation and destruction of periodontal tissues. Scaling and root planing (SRP) is the gold standard for non-surgical periodontal therapy. Adjunctive therapies, such as probiotics and antibiotics like tetracycline, have been explored to enhance treatment outcomes. This study aims to compare the clinical efficacy of probiotics and tetracycline as adjuncts to SRP in managing chronic periodontitis. Materials and Methods: A total of 60 patients diagnosed with chronic periodontitis were randomly divided into three groups: Group A (SRP + probiotics), Group B (SRP + tetracycline), and Group C (SRP alone). Clinical parameters, including Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL), were recorded at baseline and after 12 weeks. Probiotics were administered as a daily oral supplement, while tetracycline was prescribed in standard dosages. Statistical analysis was conducted using ANOVA and post-hoc tests, with significance set at p<0.05. Results: At 12 weeks, both adjunctive groups showed significant improvements compared to SRP alone (p<0.05). Group A demonstrated a reduction in PPD (from 5.2 mm to 3.1 mm) and CAL gain (from 4.8 mm to 3.0 mm), while Group B exhibited a similar reduction in PPD (from 5.3 mm to 3.0 mm) and CAL gain (from 4.9 mm to 2.9 mm). However, fewer adverse effects were observed in the probiotics group compared to the tetracycline group. Conclusion: Both probiotics and tetracycline as adjuncts to SRP effectively improved periodontal health. However, probiotics demonstrated comparable clinical outcomes with fewer adverse effects, suggesting their potential as a safer alternative to antibiotics in periodontal therapy.

Introduction: Leprosy or Hansen disease is a slowly progressive infection caused by Mycobacterium leprae that mainly involves skin, peripheral nervous system, upper respiratory tract, eyes and testes. Leprosy is one of the oldest debilitating diseases, still there are no tools to diagnose subclinical infections and to culture the bacteria. Analysis of epidemiological data, clinical features and histopathological features and their interpretation plays a very crucial role in early diagnosis, treatment, disability prevention and most importantly elimination of social stigma in society pertaining to disease. Adequate clinical information combined with histopathology and bacteriological index help in diagnosis and classification of different types of leprosy there by in management of cases. Objectives: 1. To study the age and sex distribution among cases with Hansen’s disease.  2. To study the Spectrum of Clinical and Demographic features of Histopathologically proven Hansen’s disease cases and classify according to Ridley-Jopling classification. Methods: In the present study, the skin biopsies of cases clinically diagnosed or suspected of Hansen’s disease submitted to the Department of Pathology, Karnataka Institute of Medical sciences, Hubballi, over a period of 3 years (1 year retrospective and 2years prospective study) between July 2019 to June 2022, were studied. Paraffin blocks are prepared followed by staining the 5-micron thickness sections with haematoxylin and eosin with standard techniques as observed in Department of Pathology, KIMS, Hubballi. Various clinical and histopathological spectrum of skin lesions in Hansen’s disease were studied and classified according to Ridley-Jopling classification. Results: Majority of the patients, that is 72 (25.4%) cases were in age interval of 31-40 years. Least incidence of leprosy cases was observed in the age group of 71- 80 years accounting to 5 (1.8%) cases. Male to female ratio of 1.9:1. Borderline Tuberculoid Leprosy (BT) was the most common type of leprosy, accounting to 130 (45.7%) cases which was followed by Indeterminate Leprosy (IL) in 42 (14.8%) cases. Conclusions: This study concludes that correlation of clinical features, histopathological findings and bacterial index is very essential for arriving at diagnosis and proper typing of leprosy, which in turn prevents disability and drug resistance.

Background: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication in patients with alcoholic liver disease (ALD) and ascites. Identifying reliable non-invasive biomarkers for SBP could facilitate early diagnosis and treatment. Serum uric acid (SUA) is increasingly recognized as a marker of systemic inflammation and oxidative stress. This study aimed to evaluate the correlation between SUA levels and ascitic fluid neutrophil count in ALD patients. Materials and Methods: A cross-sectional study was conducted on 80 patients with ALD-related ascites at a tertiary care center. SUA levels and ascitic fluid neutrophil counts were measured and analyzed for correlation. Patients were stratified based on the presence of SBP, defined as an ascitic fluid neutrophil count ≥250 cells/mm³. Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of SUA for SBP. Results: The mean SUA level was 7.9 ± 2.1 mg/dL, and the mean ascitic fluid neutrophil count was 295.6 ± 145.3 cells/mm³. SUA levels were significantly higher in patients with SBP (8.7 ± 2.3 mg/dL vs. 7.3 ± 1.8 mg/dL, p = 0.003). A strong positive correlation was observed between SUA and ascitic fluid neutrophil count (r = 0.62, p < 0.001). SUA ≥8.1 mg/dL was associated with significantly higher neutrophil counts (398.3 ± 132.5 vs. 205.6 ± 98.2, p < 0.001). ROC analysis showed that SUA had good predictive value for SBP (AUC = 0.81, p < 0.001).= Conclusion: SUA levels correlate significantly with ascitic fluid neutrophil count in ALD patients. Elevated SUA is associated with SBP and may serve as a non-invasive biomarker for early risk stratification. Further studies are needed to validate its diagnostic utility in clinical practice.

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe, idiosyncratic drug-induced hypersensitivity reaction characterized by extensive skin rash, fever, hematologic abnormalities (eosinophilia or atypical lymphocytosis), and internal organ involvement, including liver, kidney, and lungs ¹. DRESS syndrome is indeed a severe condition with a mortality rate reaching up to 10% in cases, highlighting its potential life-threatening nature ². Rifampicin, a first-line anti-tubercular agent, is indeed implicated in the development of DRESS syndrome, alongside other drugs like aromatic anticonvulsants and certain antibiotics ³. Rifampicin is a rifamycin antibiotic that works by inhibiting bacterial DNA-dependent RNA polymerase ⁴. It is considered the cornerstone of tuberculosis treatment due to its broad-spectrum activity against Mycobacterium tuberculosis. However, like many antimicrobial agents, rifampicin can cause adverse drug reactions (ADRs), ranging from mild dermatologic reactions to more severe manifestations like DRESS syndrome ⁵. 

Background: Neonatal sepsis remains a major cause of morbidity and mortality, particularly in rural healthcare settings with limited diagnostic and therapeutic resources. Understanding the microbial profile and antibiotic resistance trends is essential for guiding empirical therapy and improving clinical outcomes. Materials and Methods: A retrospective study was conducted in the neonatal intensive care unit (NICU) of a rural tertiary hospital over a five-year period (January 2019 to December 2023). Blood culture reports from neonates with clinically suspected sepsis were reviewed. Positive cultures were analyzed to determine the prevalence of bacterial isolates and their antibiotic susceptibility patterns using the standard Kirby-Bauer disk diffusion method in accordance with CLSI guidelines. Results: Out of 1240 neonates evaluated for sepsis, 368 (29.7%) had culture-positive results. Gram-negative organisms constituted 62% of the isolates, with Klebsiella pneumoniae (27%), Escherichia coli (18%), and Pseudomonas aeruginosa (9%) being predominant. Among Gram-positive isolates, Staphylococcus aureus (15%) and Enterococcus spp. (6%) were most common. High resistance was observed against ampicillin (78%), cefotaxime (64%), and gentamicin (55%). Carbapenems retained the highest sensitivity among Gram-negative isolates, while vancomycin and linezolid showed effectiveness against Gram-positive organisms. A rising trend in multidrug-resistant organisms was noted over the study duration. Conclusion: The study highlights a high burden of Gram-negative infections and an alarming rate of antimicrobial resistance among neonatal sepsis cases in rural settings. Regular surveillance of bacterial profiles and antibiotic susceptibility is critical for formulating effective empirical treatment strategies and curbing resistance

Background: Ventilator-associated pneumonia (VAP) remains a major cause of morbidity and mortality among patients in intensive care units (ICUs), particularly in settings with high antimicrobial usage and multidrug-resistant (MDR) organisms. Objective: To study the spectrum and antibiotic resistance pattern of bacterial pathogens isolated from VAP cases in a tertiary care hospital. Methods: A prospective observational study was conducted over 12 months in the ICU. Bacterial isolates from endotracheal aspirates and BAL samples of VAP-diagnosed patients were identified, and antimicrobial susceptibility was tested. Results: Of 150 patients with clinical VAP, 134 yielded positive cultures. Predominant isolates included Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. High resistance was observed against cephalosporins and carbapenems. Colistin remained the most effective antimicrobial. Conclusion: The high prevalence of MDR pathogens in VAP cases necessitates continuous surveillance and strict antimicrobial stewardship.

Background: Periodontal tissues initiate an immune-inflammatory response to bacterial invasion and their byproducts. These agents, when introduced systemically, can also trigger significant vascular reactions. Oral infection models have proven valuable in exploring the hypothesis that infections may contribute to cardiovascular disease (CVD) risk. Among these, periodontal infections are considered a primary factor, with several studies highlighting a strong association between periodontal disease and CVD. Materials and Methods: The study included 50 individuals aged between 30 and 65 years, categorized into five groups based on their diagnosed cardiovascular condition. These groups were: ischemic heart disease, bacterial endocarditis, congestive cardiac failure, valvular heart disease, and cardiomyopathies. Dental evaluations involved the use of Ramfjord’s Periodontal Disease Severity Index and assessment of clinical attachment level. Laboratory investigations included lipid profile analysis to support systemic evaluation. Observations and Results: Ramfjord’s Periodontal Disease Severity Index revealed a statistically significant difference (p < 0.05) between patients with bacterial endocarditis and those with valvular heart disease. The index also demonstrated a significant positive correlation with total cholesterol, triglycerides, and very low-density lipoproteins (VLDL), while showing a negative correlation with high-density lipoprotein (HDL). Clinical attachment level did not show significant differences between valvular heart disease and cardiomyopathies but was positively correlated with total cholesterol. The lipid profile indicated dyslipidemia in patients with ischemic heart disease.

Ischemic stroke is a neurological emergency which reveals complex and unexpected etiologies infrequently. Embolic strokes represent a major subset of ischemic strokes and are often linked to cardiac or large vessel sources. In one-quarter to one-third of ischemic strokes, the cause may remain elusive despite comprehensive workup, and are classified as cryptogenic stroke. Emerging evidence suggests that systemic and non-cardiogenic conditions, such as malignancy-induced hypercoagulability can act as rare yet important risk factors for ischemic stroke, particularly embolic subtype. We present a case series highlighting two rare but clinically significant etiologies of ischemic stroke, namely malignancy and adenomyosis, in four patients. In addition to ischemic stroke, these patients also exhibited extreme prothrombotic tendency in varied forms such as myocardial infarction, nonbacterial thrombotic endocarditis, pulmonary and venous thromboembolism. This report also aims to highlight adenomyosis as a less-explored cause of ischemic stroke in the young.

Background: Biofilm formation is increasingly recognized as a major contributor to the persistence, treatment resistance, and recurrence of healthcare-associated infections (HAIs). In resource-limited hospital settings, the prevalence and antimicrobial implications of biofilm-forming organisms remain underexplored. Objectives: To determine the prevalence of biofilm formation among bacterial isolates from HAIs, evaluate its association with multidrug resistance (MDR), and assess its impact on clinical outcomes in a tertiary care setting in India. Methods: A prospective observational study was conducted over one year at GSL General Hospital and Medical College, Rajahmundry, Andhra Pradesh. A total of 100 culture-positive samples from patients with HAIs were evaluated. Biofilm detection was performed using the Congo red agar and microtiter plate assays. Antimicrobial susceptibility testing was conducted by standard CLSI guidelines. Statistical analyses included Chi-square tests, logistic regression, and comparisons of mean hospital stay durations, with a significance threshold of p < 0.05. Results: Biofilm formation was detected in 63% of the isolates. Strong biofilm formation was significantly associated with increased rates of MDR (p = 0.003, Cramer’s V = 0.42). Among strong biofilm producers, 84% were MDR. Patients with infections due to strong biofilm producers had significantly longer hospital stays (mean 12.4 ± 2.9 days) compared to those with weak or non-biofilm-forming isolates (mean 8.6 ± 2.2 days, p < 0.001, Cohen’s d = 1.42). Logistic regression identified Enterococcus faecalis as an independent predictor of strong biofilm formation (OR 4.72, 95% CI 1.61–13.87, p = 0.005). Conclusion: Biofilm formation is highly prevalent among HAI pathogens and strongly correlates with antimicrobial resistance and prolonged hospitalization. Routine screening for biofilm-forming capacity and targeted infection control measures are warranted to improve patient outcomes in high-risk hospital environments.

Background: Preterm birth (PTB), defined as delivery before 37 weeks of gestation, remains a leading cause of neonatal morbidity and mortality globally. Emerging evidence suggests that alterations in the vaginal microbiome during early pregnancy may influence PTB risk. A predominance of non-Lactobacillus species and microbial dysbiosis has been linked to adverse pregnancy outcomes. This study aims to investigate the association between early pregnancy vaginal microbiome profiles and the risk of spontaneous preterm birth. Materials and Methods: This prospective cohort study was conducted among 200 pregnant women recruited before 14 weeks of gestation from a tertiary care hospital. Vaginal swabs were collected during the first trimester and analyzed using 16S rRNA gene sequencing to determine microbiome composition. Participants were followed throughout pregnancy, and delivery outcomes were recorded. Microbiome diversity indices (Shannon and Simpson), community state types (CSTs), and relative abundance of bacterial taxa were compared between women who delivered preterm (<37 weeks) and those who had term deliveries. Multivariate logistic regression was used to identify independent microbial predictors of PTB after adjusting for known confounders. Results: Out of 200 participants, 38 (19%) experienced spontaneous PTB. Women who delivered preterm had significantly higher microbial diversity (mean Shannon index: 2.8 ± 0.3 vs. 1.6 ± 0.4, p < 0.001) and were more likely to exhibit CST IV, characterized by low Lactobacillus and high abundance of Gardnerella, Atopobium, and Prevotella. Logistic regression revealed that CST IV was associated with a 3.5-fold increased risk of PTB (adjusted OR: 3.5; 95% CI: 1.8–6.9; p = 0.002). Lactobacillus crispatus dominance was significantly protective against PTB (adjusted OR: 0.4; 95% CI: 0.2–0.9; p = 0.021). Conclusion: Our findings suggest that early pregnancy vaginal microbiome composition is significantly associated with the risk of spontaneous preterm birth. Dysbiotic microbiota with reduced Lactobacillus dominance and increased anaerobic diversity may contribute to an unfavorable intrauterine environment. Targeted microbial screening and interventions during early gestation may help mitigate PTB risk.

Background: Urinary tract infections (UTIs) are among the most common bacterial infections in Pediatric patients. The emergence of antibiotic-resistant uropathogens has complicated empirical treatment strategies, necessitating continuous surveillance of resistance patterns.  Objectives: To evaluate the distribution of uropathogens and their antibiotic resistance profiles in pediatric UTIs over a 12-month period. Methods: A longitudinal observational study was conducted over one year in a tertiary care hospital. A total of 100 pediatric patients (aged 1 month to 12 years) clinically diagnosed with UTI were enrolled. Midstream urine samples were collected and processed for culture and sensitivity. The isolated organisms were identified, and antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to CLSI guidelines. Multidrug resistance (MDR) was defined as resistance to three or more antibiotic classes. Results: Escherichia coli was the most common isolate (66%), followed by Klebsiella pneumoniae (14%), Proteus mirabilis (8%), Enterococcus faecalis (6%), and Pseudomonas aeruginosa (4%). High resistance rates were observed for ampicillin (84.8% in E. coli, 92.9% in Klebsiella), cotrimoxazole, and ciprofloxacin. Nitrofurantoin and imipenem retained better sensitivity. Overall, 38% of isolates exhibited multidrug resistance. A rising trend in resistance to ampicillin and cotrimoxazole was noted over the study period.  Conclusion: This study highlights the alarming prevalence of antimicrobial resistance in pediatric UTIs, particularly among Gram-negative organisms. Regular monitoring of resistance patterns is essential to guide empirical therapy and limit the spread of MDR pathogens.

Vibrio cholerae, a Gram-negative bacterium inhabiting aquatic environments, remains a significant global health concern, particularly in regions with inadequate sanitation. This paper delves into the intricate pathogenesis of cholera, focusing on the key virulence factors that enable V. cholerae to colonize the human intestine and elicit the characteristic profuse watery diarrhea. We explore the diverse epidemiological patterns of cholera outbreaks, highlighting the roles of environmental reservoirs, transmission routes, and the emergence of new serotypes and antibiotic resistance. Finally, we discuss current challenges and future perspectives in cholera prevention and control, including advancements in vaccine development, sanitation strategies, and our understanding of bacterial evolution.

: Introduction: Respiratory tract infections are commonly encountered in clinical practice and are often complicated by the presence of underlying comorbidities such as Chronic Obstructive Pulmonary Disease, Bronchial asthma, and Diabetes Mellitus. These can alter the respiratory microbiological profile. Moraxella catarrhalis, considered a commensal organism of human upper respiratory tract, has emerged as a notable pathogen in lower respiratory tract infections, particularly in individuals with chronic respiratory diseases. Understanding the relationship between specific comorbidities and the isolation of Moraxella catarrhalis can help improve clinical management and targeted therapy. Objectives: This study aimed (1) To establish the pathogenicity of Moraxella catarrhalis through microbiological identification using microscopy, culture, and biochemical reactions (2) To assess the incidence of Moraxella catarrhalis and to analyse the association between comorbidities like Chronic Obstructive Pulmonary Disease & Bronchial Asthma (3) To determine its antibiotic susceptibility profile to various antibiotic classes. Methodology: A cross-sectional study was conducted involving 250 bacteriologically significant respiratory samples. Participants were categorized based on the presence of no comorbidity, with Chronic Obstructive Pulmonary Disease, Bronchial Asthma, or Diabetes Mellitus. The isolates were identified conventionally and antibiotic susceptibility testing done with various classes of antibiotics. Results: Out of the 250 bacteriologically significant respiratory sample, 38 clinically significant Moraxella catarrhalis were isolated and accounted for 15.2% of total isolates. Antibiotic susceptibility testing showed 100% resistance to ampicillin and 100% sensitivity to amoxicillin -clavulanic acid correlating with the production of beta-lactamase enzyme by the isolates. Moraxella catarrhalis was isolated predominantly among Chronic Obstructive Pulmonary Disease patients (26.8%) followed by, Bronchial Asthma patients (17.1%). The Chi-square test showed a significant association between comorbid conditions and bacterial isolates (χ² = 14.92, p = 0.002). Conclusion: Moraxella catarrhalis should be considered as a lower respiratory tract pathogen especially in elderly patient with underlying comorbidity like Chronic Obstructive Pulmonary Disease & Bronchial Asthma.

Introduction: Sepsis is a serious kind of life-threatening complications arising out of extreme reaction induced in the body to fight infection. Materials And Methods: This retrospective study was conducted from the data available at the records of Assam Medical College Dibrugarh during the period of January 2024 to December 2024. Results: Total 80 numbers of patients were included in the study comprising patients with age group from >18 years to 77 years. The patients were grouped into sepsis and severe sepsis. Conclusion: The study concluded that both PCT and NLR can be used for early diagnosis of bacterial sepsis however, the individual performance of PCT is better than NLR

Following thorough chemo mechanical preparation, the administration of an intracanal medication may be beneficial in getting rid of any germs that remained inside root canals. The current research assessed the antibacterial properties of medications that work by touch rather than vapour release versus facultative and obligate anaerobic bacteria that are frequently present in endodontic diseases. The medications included calcium hydroxide plus distilled water, calcium hydroxide plus camphorated paramonochlorophenol (CPMC), calcium hydroxide plus glycerine, and 0.12% chlorhexidine gel and 10% metronidazole gel. The zones of bacterial inhibition surrounding each medication were noted and compared using an agar diffusion test. According to the findings, calcium hydroxide/CPMC paste worked well against every bacterial strain that was examined. Additionally, chlorhexidine inhibited every strain. For the majority of varieties, it was about as effective as calcium hydroxide/CPMC paste. Metronidazole was more effective than calcium hydroxide/CPMC against two strains and inhibited the replication of all obligate anaerobes studied. Due to the limitations of the agar diffusion test, calcium hydroxide combined with distilled water or glycerine did not exhibit zones of bacterial suppression.

Background: Urinary tract infections (UTIs) are among the most common bacterial infections globally, with Escherichia coli and Klebsiella pneumoniae being predominant pathogens. The emergence of extended-spectrum beta-lactamase (ESBL)-producing strains of these organisms has significantly complicated treatment due to their multidrug resistance. Objective: This study aimed to evaluate the effectiveness of selective antibiotics against ESBL-producing E. coli and Klebsiella pneumoniae isolated from urine samples over a two-month period. Methods: A prospective observational study was conducted in the Department of Microbiology, Sarvodaya Hospital and Research Center, Faridabad, from February to March. A total of 234 ESBL-positive isolates were obtained from urine samples. Antibiotic susceptibility testing (AST) was performed using the VITEK 2 Compact system. The susceptibility patterns of both E. coli and Klebsiella pneumoniae were analyzed for commonly used antibiotics. Results: The highest sensitivity among E. coli isolates was observed for amikacin (91.67%), meropenem (90.00%), and imipenem (87.50%). Klebsiella pneumoniae showed the greatest sensitivity to imipenem (93.33%), ertapenem (86.67%), and meropenem (86.67%). Both organisms demonstrated high resistance to ciprofloxacin and amoxicillin-clavulanic acid. Nitrofurantoin and piperacillin-tazobactam also retained significant efficacy against both pathogens. Conclusion: Carbapenems and amikacin remain the most effective antibiotics for the treatment of UTIs caused by ESBL-producing E. coli and Klebsiella pneumoniae. The study underscores the need for continuous local antimicrobial surveillance to guide empirical therapy and antibiotic stewardship.

Background: Recurrent skin infections are a common health concern among children, particularly in low-resource settings, where hygiene practices may be suboptimal. This study aims to evaluate the association between hygiene practices and the prevalence of recurrent skin infections among school-going children. Methods: A cross-sectional observational study was conducted among 50 school-going children aged 6 to 14 years. Data were collected using a structured questionnaire focusing on demographic variables, hygiene behaviors, and history of skin infections. Participants were categorized based on hygiene practices as “good” or “poor.” Statistical analysis was performed to identify significant associations, with p < 0.05 considered significant. Results: Among the 50 participants, 28 (56%) were male and 22 (44%) were female. The mean age was 10.4 ± 1.8 years. Recurrent skin infections were observed in 18 children (36%). Significant associations were found between recurrent skin infections and poor hygiene practices, including irregular bathing (p = 0.042), infrequent nail trimming (p = 0.031), sharing of personal items like towels/clothes (p = 0.017), and not wearing freshly washed clothes daily (p = 0.023). The use of soap during bathing showed a borderline association (p = 0.056). Fungal infections (44.4%) were the most common type observed, followed by bacterial infections (33.3%) and scabies (16.7%). Conclusion: Poor hygiene practices are significantly associated with recurrent skin infections in school-going children. Targeted hygiene education and behavioral interventions may reduce infection rates and improve child health outcomes

Background: Ascites is the most frequent complication seen in patients with decompensated cirrhosis, with approximately half of those with compensated cirrhosis developing ascites over a ten-year span. The accumulation of ascitic fluid significantly increases the risk of infections due to weakened host defense mechanisms, including immune system dysfunction and reduced bactericidal capacity of the ascitic fluid. Aim: To study the diagnostic significance of Ascitic fluid lactate dehydrogenase (LDH) as a diagnostic marker of spontaneous bacterial peritonitis ( SBP). Methodology: This hospital-based prospective observational study will be conducted over a period of 18 months following approval from the Institute Ethics Committee (IEC) at Mahatma Gandhi Medical College & Hospital. Prior to enrolment, written and informed consent will be obtained from all participating patients. Result: In our study, 32.1% of ascitic patients were diagnosed with spontaneous bacterial peritonitis (SBP), with a statistically significant association (p = 0.001). Gram staining showed no pus in all 137 cases, while bacterial cultures were sterile in 61.3% and polymicrobial in 38.7%. Conclusion: Ascitic fluid LDH serves as a useful diagnostic marker for spontaneous bacterial peritonitis (SBP), particularly in cases with polymicrobial growth. Early detection using bedside methods like leukocyte esterase strips can significantly reduce SBP-related morbidity and mortality

Background: Globally, surgical site infections are the most reported healthcare-associated infection and a common surgical complication. In developing countries such as India, there is a paucity of published reports on the microbiologic profile and resistance patterns of isolates. Objective: This study aimed to assess the bacterial profile and antimicrobial susceptibility patterns of isolates among patients diagnosed with surgical site infection at a tertiary teaching hospital in Northeast India. Methods: A hospital-based study was employed among adult patients who underwent either elective or emergency surgical procedures. All the eligible patients were followed for 30 days for the occurrence of surgical site infection (SSI). From those who developed SSI, infected wound specimens were collected and studied bacteriologically. Results: Of 251 study participants, 122 (48.6%) were females. The mean ± SD age of the patients was 38 ± 16.30 years. The overall postoperative surgical site infection was observed in 118 patients, and of these, 73.7% (87/118) were culture positive. On Gram stain analysis, 71.1% of them were Gram-negative, 25.3% were Gram-positive, and 3.6% were a mixture of two microbial growths. Escherichia coli accounted for 34.48% followed by Staphylococcus aureus (20.69%), Klebsiella pneumoniae (19.54%), Proteus mirabilis (4.59%), Acinetobacter spp (4.59%), Citrobacter spp (4.59%), Pseudomonas aeruginosa (3.44%), Enterococcus faecium (2.29%), Klebsiella oxytoca (2.29%), and Proteus vulgaris (1.15%) Conclusion: Gram-negative bacteria were the most dominant isolates from surgical sites in the study area. Among the Gram-negative bacilli, Escherichia coli was the most common bacterium causing surgical site infections. Given the high antibiotic resistance observed in the current study, it is necessary to conduct routine microbial analysis of samples and their antibiogram.

Introduction: Bloodstream infections (BSIs) are a significant cause of morbidity and mortality in hospitalized patients. Early diagnosis and timely initiation of appropriate antimicrobial therapy are essential for reducing complications. C-reactive protein (CRP), an acute-phase reactant, is commonly used as a biomarker of systemic inflammation. While CRP levels rise in bacterial infections, their correlation with specific bacterial isolates and patterns of antibiotic resistance in BSIs remains inadequately explored in Indian clinical settings. This study seeks to investigate the potential of CRP levels as a supportive diagnostic marker for bacterial isolates and their resistance profiles in patients with BSIs. Objective: To evaluate the correlation between CRP levels, type of bacterial isolates, and associated antibiotic resistance patterns in patients with bloodstream infections. Methods: This hospital-based, cross-sectional observational study was conducted over a period of 18 months (January 2022 to June 2023) at a tertiary care hospital in India. A total of 130 patients with clinically and microbiologically confirmed bloodstream infections were included. Blood samples were collected for CRP estimation by immunoturbidimetric assay and for culture using standard microbiological techniques. Isolated organisms were identified by biochemical and automated methods, and their antibiotic susceptibility profiles were determined according to CLSI guidelines. Correlations between CRP levels, types of isolates (Gram-positive vs. Gram-negative), and resistance patterns (MDR, ESBL, MRSA) were statistically analyzed. Result: Among the 130 BSI patients, Gram-negative organisms accounted for 62.3% of isolates, with Escherichia coli and Klebsiella pneumoniae being predominant. Gram-positive organisms included Staphylococcus aureus and Enterococcus species. The mean CRP level was significantly higher in patients with Gram-negative sepsis (mean 164.8 ± 38.4 mg/L) compared to Gram-positive infections (mean 108.3 ± 26.9 mg/L) (p < 0.001). Elevated CRP levels were also significantly associated with multidrug-resistant organisms and ESBL producers. MRSA infections were associated with moderately elevated CRP values. A positive correlation was observed between CRP concentration and bacterial virulence/resistance pattern. Conclusion: C-reactive protein levels correlate significantly with the type of bacterial isolate and its resistance profile in bloodstream infections. Elevated CRP may serve as an adjunctive marker for predicting severe Gram-negative sepsis and the likelihood of drug-resistant pathogens. Integrating CRP measurements with culture and sensitivity testing can enhance early risk stratification and guide empirical antimicrobial therapy in resource-limited settings

Background: Decompensated chronic liver disease (DCLD) is linked to an imbalance in water regulation, resulting in abnormalities in sodium levels, known as dysnatremias. Hyponatremia occurs when water and sodium are imbalanced, with an excess of water relative to sodium. It is the predominant electrolyte abnormality observed in individuals who are hospitalized, particularly those with DCLD. Hypernatremia is a rare condition in individuals with DCLD, often caused by the use of osmotic diuretic medications and upper gastrointestinal (UGI) hemorrhage, which is associated with higher mortality rates. Research Question: What is the distribution and association of serum sodium levels among decompensated chronic liver disease patients in relation to clinico-sociodemographic factors in our setup?  Methods: An observational study was conducted from Jane 2025 to July 2025 on approximately 100 DCLD patients admitted to the Department of General Medicine at Government Medical College/Government Teaching General Hospital, Rajamahendravaram. The study analyzed socio-demographic profiles, serum sodium levels, and their association with Child-Pugh score, MELD score, alcohol consumption, HBV infection, clinical features, complications and mortality. Results: The study found that: The disease burden was higher among  individuals aged 50-70 years (53%), with a mean age of 56 years.- Morbidity was significantly higher among males (98%) compared to females (2%).- Approximately 40% of study subjects had serum sodium levels between 131-135 mEq/L, 32% had levels ≥136 mEq/L, and 28% had levels ≤130 mEq/L.- Patients with high MELD scores were significantly associated with low serum sodium levels.- Complications such as ascites and portal hypertension were significantly associated with hyponatremia compared to hypernatremia.- A mortality rate of 15% was observed among study subjects who developed hyponatremia.

Introduction: Human Immunodeficiency Virus (HIV) infection in children is associated with a broad spectrum of mucocutaneous manifestations, which are often the first clinical indicators of underlying immunodeficiency. These manifestations range from common infections to neoplastic and inflammatory conditions and significantly affect quality of life, morbidity, and sometimes mortality in pediatric patients. Early recognition of these skin and mucous membrane lesions is crucial for timely diagnosis, initiation of antiretroviral therapy (ART), and prevention of further complications. Methods: This prospective study was conducted over a period of one year at the Calcutta School of Tropical Medicine. A total of 60 patients with confirmed Human Immunodeficiency Virus (HIV) infection presenting with mucocutaneous manifestations were included. Relevant demographic and clinical data, including age, gender, and body mass index (BMI), were recorded. Detailed evaluation of associated endocrine disorders, including thyroid, adrenal, pituitary disorders, and polycystic ovarian syndrome (PCOS), was performed. Comprehensive dermatological examination was carried out to document the type of skin manifestations and specific skin features. All data were systematically collected, compiled, and analyzed to assess the pattern and association of mucocutaneous lesions with clinical and laboratory parameters. Results: In this study of 60 HIV-infected children, most were aged 6–10 years, with no significant age or gender differences. Seventy percent were on ART, and shorter ART duration was significantly associated with higher lesion prevalence. Oral candidiasis was the most common mucocutaneous manifestation, followed by seborrheic dermatitis, bacterial infections, molluscum contagiosum, and herpes zoster. Lower CD4 counts and shorter ART duration were significantly linked to higher rates of oral candidiasis and other lesions. Conclusion: Mucocutaneous manifestations are highly prevalent in children with HIV infection and often reflect the degree of immunosuppression. Recognizing these lesions can aid in early diagnosis, monitoring disease progression, and guiding timely initiation of antiretroviral therapy. Pediatricians and dermatologists should maintain a high index of suspicion for HIV in children presenting with recurrent or atypical mucocutaneous lesions.

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder frequently complicated by cutaneous infections due to impaired immunity, poor glycemic control, and long disease duration. Understanding the prevalence and spectrum of dermatological manifestations in diabetics provides insights for early diagnosis and prevention. Aim: To evaluate the association between T2DM and cutaneous infections among patients attending a tertiary care hospital. Materials and Methods: A cross-sectional study was conducted on 100 patients with T2DM. Detailed demographic data, duration of diabetes, and glycemic status (HbA1c) were recorded. Dermatological examination was performed to identify cutaneous infections. Data were analyzed, and associations were tested using chi-square statistics. Results: The mean age of participants was 54.6 ± 11.2 years, with a male-to-female ratio of 1.3:1. Poor glycemic control (HbA1c ≥ 7%) was observed in 68% of patients. Cutaneous infections were detected in 74% of cases, with fungal infections being most common (40%), followed by bacterial (22%) and viral infections (8%). Mixed infections were observed in 4%. Patients with poor glycemic control demonstrated significantly higher prevalence of infections (85%) compared to those with adequate control (50%) (p < 0.05). A longer duration of diabetes was also strongly associated with infections, rising from 58% in patients with < 5 years of disease to 88% in those with > 10 years (p < 0.05). Conclusion: Cutaneous infections are highly prevalent among patients with T2DM, particularly in those with poor glycemic control and long-standing disease. Early recognition and strict glycemic management may reduce dermatological morbidity in this population.