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In today’s digital age, the Internet has become an integral part of our lives, providing a wealth of information at our fingertips. However, the ease of accessing medical information online has given rise to a new phenomenon known as cyberchondria (CCD). CCD is characterized by the excessive anxiety and worry caused by the information discovered on the internet, leading individuals to believe that they have a serious medical condition. Although it shares similarities with hypochondria or illness anxiety disorder, there is an ongoing debate about whether CCD should be regarded as a separate condition or simply a manifestation of preexisting hypochondria. Those who engage in self-diagnosis and self-management of their health concerns without confirming the accuracy of the published material are presumed to be affected by CCD. No research has yet been undertaken on CCD therapeutic approaches. Psychoeducation is the cornerstone of CCD therapy. There is no specific pharmaceutical therapy. CCD is a developing public mental health concern in India that needs prompt response or might seriously harm the general public.

Abstract The present study was aimed at showing the importance of HPV DNA status and the clinical history of the patients required by the cytologist for accurate reporting. A total of 1250 symptomatic women who attended the gynaecology outpatient department of the Mahavir Cancer Sansthan and Nalanda Medical College, Patna, for pap smear examinations were screened and recruited for the study. Due to highly clinical symptoms out of the negative with inflammatory smears reported, one hundred and ten patients were randomly advised for biopsy and HPV 16/18 DNA analysis by a gynaecologist to correlate negative smears included in the study. Pap smear reports revealed that 1178 (94.24%) were negative for intraepithelial lesions (NILM) with inflammatory smears, 23 (1.84%) smears showed low-grade squamous intraepithelial lesions (LSIL), 12 (0.96%) smears showed high-grade squamous intraepithelial lesions, and 37 (2.96%) smears showed an atypical squamous cell of undetermined significance (ASC-US). A biopsy of 110 out of 1178 (NILM) patients revealed that 15 (13.63%) women had cervical cancer, 29 women had CIN I, 17 women had CIN II + CIN III, 35 women had benign cervical changes, and 14 women had haemorrhages. On the other hand, HPV 16/18 DNA was detected as positive in 87 out of 110. The high positivity of HPV in biopsied cases where frank cervical cancer and at-risk cancer were also observed in the negative smear-screened patients reveals that the HPV status and clinical history of the patients will be quite helpful to the cytologist for accurate reporting, and suggests that a negative HPV DNA result may be a stronger predictor of cervical cancer risk than a negative Pap test.

Key Clinical Message Shiitake mushroom‐induced flagellate dermatitis is a rare but important condition to consider in patients presenting with pruritic skin lesions following mushroom ingestion, especially in regions where such cases are uncommon. Early recognition and appropriate management with oral and topical steroids are crucial for effective symptom resolution and preventing complications. Clinicians should be aware of the characteristic rash and the temporal relationship between mushroom consumption and rash onset. Educating patients about the risks associated with consuming raw or undercooked shiitake mushrooms is essential to prevent recurrence.

Introduction: Diabetes Mellitus (DM) is traditionally known as silent disease. Diabetes is no more restricted in urban areas only but is also established at rural areas as well. It is one of the leading cause of long term morbidity and a major health hazard in a developing country like India, therefore, it is pertinent to ind its associated risk factors.Objectives:To study the clinical presentation and risk factors associated with type2 diabetes mellitus patients attending SGT hospital. Method: It was a hospital based case control study done in medicine department of Tertiary Care Hospital, Gurugramusing the purposive sampling. There were 800 participants including 400 cases of type 2 diabetes mellitus and 400controls (age and gender matched).Information was collected on sociodemographic variables and risk factors using a pre-tested structured interview schedule.Results: The mean age among cases was 55.20+ 8.54 years and among control group was 53.96+9.29 years. The difference between education status and occupation of study subjects was found to be signiicant. Pain and numbness was the most common symptom which was 70.75%. On assessing risk factors, physical activity, the habit of smoking, family history and Body mass Index (BMI) had a positive association. Conclusion: The indings of the study revealed that a high proportion of risk factors such as family history of diabetes, literacy status, occupation, BMI, smoking and physical activity were prevalent in the type 2DM subjects.

Introduction: Anemia is the most common nutritional deficiency disorder in the world. Its Prevalence is inordinately higher among developing nations, because of unfavorable socio- demographic factors and indigent access to healthcare services. Therefore, it is pertinent to find the prevalence of anemia and its associated factors. Objective: To find out prevalence and socio- demographic factors associated with anaemia among females of age group 10-45 years in a rural population of Gurugram, Haryana. Method: A cross sectional study was conducted in villages under PHC Garhi Harsaru in Gurugram, Haryana among 452 females of age group 10-45 years by two stage random sampling technique. Results: The mean age of the study subjects was 25 ± 6.39 years. The overall prevalence of anemia among women of age group of 10-45 years was found to be 62.39%. Joint family, lower literacy, and low socioeconomic status were found to be statistically significant risk factors for anaemia among study subjects. Conclusion: The prevalence of anemia was very high; therefore attempts should be made to sensitize the rural population through health and nutrition education, information, education and communication (IEC) and appropriate behaviour change communication (BCC) activities.

Abstract In recent times Gallbladder cancer (GBC) incidences increased many folds in India and are being reported from arsenic hotspots identified in Bihar. The study aims to establish association between arsenic exposure and gallbladder carcinogenesis. In the present study, n = 200 were control volunteers and n = 152 confirmed gallbladder cancer cases. The studied GBC patient’s biological samples-gallbladder tissue, gallbladder stone, bile, blood and hair samples were collected for arsenic estimation. Moreover, n = 512 gallbladder cancer patients blood samples were also evaluated for the presence of arsenic to understand exposure level in the population. A significantly high arsenic concentration (p

The pathogenesis of COVID-19 is complicated by immune dysfunction. The impact of immune-based therapy in COVID-19 patients has been well documented, with some notable studies on the use of anti-cytokine medicines. However, the complexity of disease phenotypes, patient heterogeneity and the varying quality of evidence from immunotherapy studies provide problems in clinical decision-making. This review seeks to aid therapeutic decision-making by giving an overview of the immunological responses against COVID-19 disease that may contribute to the severity of the disease. We have extensively discussed theranostic methods for COVID-19 detection. With advancements in technology, bioinformatics has taken studies to a higher level. The paper also discusses the application of bioinformatics and machine learning tools for the diagnosis, vaccine design and drug repurposing against SARS-CoV-2.

Background: Accurate dosimetry is crucial in radiotherapy to ensure optimal radiation dose delivery to the tumor while sparing healthy tissues. Traditional dosimetry techniques using homogeneous phantoms may not accurately represent the complex anatomical variations in cervical cancer patients, highlighting the need to compare dosimetry results obtained from different phantom models. Purpose: The aim of this study is to design and evaluate an anthropomorphic heterogeneous female pelvic (AHFP) phantom for radiotherapy quality assurance in cervical cancer treatment. Materials and method: Thirty RapidArc plans designed for cervical cancer patients were exported to both the RW3 homogeneous phantom and the anthropomorphic heterogeneous pelvic phantom. Dose calculations were performed using the anisotropic analytic algorithm (AAA), and the plans were delivered using a linear accelerator (LA). Dose measurements were obtained using a 0.6 cc ion chamber. The percentage (%) variation between planned and measured doses was calculated and analyzed. Additionally, relative dosimetry was performed for various target locations using RapidArc and IMRT treatment techniques. The AHFP phantom demonstrated excellent agreement between measured and expected dose distributions, making it a reliable quality assurance tool in radiotherapy. Results: The results reveal that the percentage variation between planned and measured doses for all RapidArc quality assurance (QA) plans using the AHFP phantom is 10.67% (maximum value), 2.31% (minimum value), and 6.89% (average value), with a standard deviation (SD) of 2.565 (t = 3.21604, p = 0.001063). Also, for the percentage of variation between homogeneous and AHFP phantoms, the t-value is −11.17016 and the p-value is p < 0.05. We can see that the outcomes differ significantly due to the influence of heterogeneous media. Also, the average gamma values in RapidArc plans are 0.29, 0.32, and 0.35 (g ≤ 1) and IMRT plans are 0.45, 0.44, and 0.42 (g ≤ 1) for targets 1, 2, and 3, respectively. Conclusion: The AHFP phantom results show more dose variability than homogenous phantom outcomes. Also, the AHFP phantom was found to be suitable for QA evaluation.

Introduction: Preeclampsia is a pregnancy disorder with gestational hypertension and proteinuria, it affects maternalfoetal vasculature. The risk of preeclampsia increases upon exposure to different genetic mutations, environmental changes, obesity, gestational diabetes mellitus, multifoetal gestations, and hydatidiform mole. Preeclampsia affects the mother and foetus; its pathogenesis is complex involving inflammation, stress, and molecular factors. Aim: To measure the circulatory levels of Endothelin-1 (ET-1), Glutathione (GSH), Interleukin-6 (IL-6), and Tumor Necrosis Factor-a (TNF-a) by Enzyme Linked Immunosorbent Assay (ELISA) kit (sandwich) in preeclamptic women and healthy controls. Materials and Methods: The present study was a casecontrol study carried out in the Department of Biochemistry at Government Institute of Medical Science (GIMS), Greater Noida, and Santosh Medical College, Ghaziabad, Uttar Pradesh, India, from November 2018 to November 2020. The demographic data was recorded, and blood samples were studied. Preeclamptic women (cases, n=90) were grouped as group A: with BP 140/90- 149/99 mmHg, group B: with BP 150/100-159/109 mmHg, and group C: with BP 160/110 mmHg along with controls (n=70). The normotensive pregnant women without family history of preeclampsia were included as controls. The competitive ELISA principles were used to quantify ET-1, GSH, IL-6, and TNF-a levels. One-way Analysis of Variance tests (ANOVA) and Tukey Posthoc Test was carried out to compare the clinical characteristics, ET-1, GSH, IL-6, and TNF-a between the cases and controls. Results: The demographic data of age, gestational age, and Body Mass Index (BMI) were not significantly different between cases and control. The ET-1 levels were significantly (p-value=0.042) higher in groups (A: 116±79.4, B: 99.2±72, C: 159±96) than controls (54±49). In contrast, GSH levels were low in preeclampsia. In addition, cases had elevated IL-6 and TNF-a levels (IL-6; groups A: 112.3±49.3, B: 127±17.5, C: 324±52.9, and control 40.3±13, TNF-a; groups A: 241±179, B: 200.9±196, C: 391±299 and controls: 167±104). GSH levels decreased with the rise in Blood Pressure (BP), while IL-6 increased significantly with an increase in BP. Conclusion: Every 10 mmHg increase in BP led to increasing in IL-6 levels. The ET-1 and TNF-alpha levels were increased in all three groups when compared to controls. Similarly, the GSH levels were decreased. Thus, the present study provided evidence that links oxidative stress, inflammation, and a potent vasoconstrictor ET-1 with altered antioxidants (GSH) that led to the pathophysiology of preeclampsia.

Therapeutic vaccination is one of the most effective immunotherapeutic approaches, second only to immune checkpoint inhibitors (ICIs), which have already been approved for clinical use. Head and neck squamous cell carcinomas (HNSCCs) are heterogenous epithelial tumors of the upper aerodigestive tract, and a significant proportion of these tumors tend to exhibit unfavorable therapeutic responses to the existing treatment options. Comprehending the immunopathology of these tumors and choosing an appropriate immunotherapeutic maneuver seems to be a promising avenue for solving this problem. The current review provides a detailed overview of the strategies, targets, and candidates for therapeutic vaccination in HNSCC. The classical principle of inducing a potent, antigen-specific, cell-mediated cytotoxicity targeting a specific tumor antigen seems to be the most effective mechanism of therapeutic vaccination, particularly against the human papilloma virus positive subset of HNSCC. However, approaches such as countering the immunosuppressive tumor microenvironment of HNSCC and immune co-stimulatory mechanisms have also been explored recently, with encouraging results.

BackgroundObesity is significantly associated with renal cell carcinoma. Surgery is the preferred treatment for demarcated lesions of renal cell carcinoma; however, obesity increases the complexity of surgical outcomes. Minimally invasive surgical techniques are preferred over open partial nephrectomy (OPN), but controversy remains regarding the most efficacious technique in patients with obesity. ObjectiveThis study aims to determine whether minimally invasive partial nephrectomy (MIPN) or OPN better preserves renal function and investigate short- and long-term renal outcomes in patients with obesity undergoing a partial nephrectomy. MethodsWe conducted a retrospective chart review of 242 adult patients aged ≥18 years who underwent MIPN or OPN between January 1, 2005, and December 31, 2016, at the University of Arkansas for Medical Sciences. Using creatinine as a measure of kidney function, patients’ preoperative levels were compared with their postoperative levels in 2-time frames: short (3-6 months postsurgery) or long (>6 months). The primary outcome was the change in creatinine values from preoperative to >6 months postoperatively in patients with obesity. Secondary outcomes included the change in creatinine values from preoperative to 3 to 6 months postoperatively in patients with obesity who underwent MIPN versus OPN. We also analyzed the creatinine values of nonobese patients (BMI 6 months after MIPN (n=20), the odds of patients with obesity having a decrease or no change in creatinine values was 1.24 times higher than those who had OPN (n=13; OR 1.24, 95% CI 0.299-6.729; P=.80). At 3 to 6 months after MIPN (n=27), the odds were 0.62 times lower than those after OPN (n=17; OR 0.62, 95% CI 0.140-2.753; P=.56). In the nonobese group, at 3 to 6 months after undergoing minimally invasive surgery (n=18), the odds of having a decrease or no change in creatinine values was 4.86 times higher than those who had open surgery (n=21; OR 4.86, 95% CI 1.085-21.809; P=.04). At more than 6 months after MIPN (n=14), the odds were 4.13 times higher than those after OPN (n=11; OR 4.13, 95% CI 0.579-29.485; P=.16). ConclusionsWe observed a nonstatistically significant preservation of renal function in patients with obesity who underwent OPN at 3 to 6 months postoperatively. Conversely, after 6 months, the same was true for MIPN, indicating the long-term benefit of MIPN. In the nonobese group, MIPN was favored over OPN.

Introduction Mental health disorder, particularly depression, is one of the leading causes of ‘disease related disability’ in women that both affects the women but has adverse effect on their children. This can have an impact on mothers’ capacity of child care which ultimately increases the risk of infection, malnutrition, impaired growth and behavioural problems in children that might extend to adulthood too. Diminished child growth has an irreversible effect both short and long terms, affecting physical growth, brain development, performance in education, working capacity and increased risks to non-communicable diseases. To date, the reviews conducted are only limited to few countries or maternal depression or certain age group of children. Our aim is to provide a global perspective focusing on all early childhood undernutrition (under 5 years) and to see if the association between maternal mental health and child undernutrition has yielded similar or different result. Furthermore, we intend to explore the risk factors associated with copresence of maternal mental health issues and undernutrition in children.Methods and analysis MEDLINE (PubMed), PsycINFO, CINAHL, Cochrane Library, Global Health Library Relevant reports from the WHO, United Nations of Children Education Fund and organisations working in maternal and child health will also be searched. Database of systematic reviews and database of abstracts of reviews of effects will also be searched for relevant literature. Papers published from 1995 to 2020 in English will be included. Title, abstract or both will be screened independently by reviewers. For data analysis and synthesis, we will present all the outcomes mentioned in the studies and a subgroup analysis for age and sex will be conducted. This study aims to conduct a meta-analysis.Ethics and dissemination Ethical approval is not required to conduct this review.PROSPERO registration number CRD42020189315.

Abstract Background Leprosy is a disease that was declared eliminated in 2010 from Nepal; however, new cases are diagnosed every year. The difficulty arises when the presentation of the patient is unusual. Case presentation In this case report we present a case of a 22-year-old Tamang man, from the Terai region of Nepal, with a clinical presentation of fever, malaise, and arthralgia for the past 2 weeks with hepatosplenomegaly and bilateral cervical, axillary, and inguinal lymphadenopathy. Features of chronic inflammation with elevated erythrocyte sedimentation rate of 90 mm/hour and liver enzymes were noted. With no specific investigative findings, a diagnosis of Still’s disease was made and he was given prednisolone. On tapering the medication, after 2 weeks, the lymphadenopathy and fever reappeared. On biopsy of a lymph node, diagnosis of possible tuberculosis was made. On that basis anti-tuberculosis treatment category I was started. During his hospital stay, our patient developed nodular skin rashes on his shoulder, back, and face. The biopsy of a skin lesion showed erythema nodosum leprosum and he was diagnosed as having lepromatous leprosy with erythema nodosum leprosum; he was treated with anti-leprosy medication. Conclusion An unusual presentations of leprosy may delay its prompt diagnosis and treatment; thus, increasing morbidity and mortality. Although leprosy has been declared eliminated, it should not be forgotten and physicians should have it in mind to make it a differential diagnosis whenever relevant.

Physicians in training may experience harassment and discrimination from supervisors, consultants, colleagues, or patients and families. Instances of discrimination towards students may impact students’ self-esteem, self-efficacy, and ultimately performance. In this particular time, many institutions are looking to enhance their curriculum regarding bias. More tools are needed to help students feel empowered to respond professionally when they encounter challenging situations. This study was designed to assess the impact of a training intervention in addressing biased patient statements. The training was strategically placed prior to clinical interactions. The authors’ intention was to present discriminatory statements by patients as one of the many difficult clinical situations that students are being trained to navigate. The authors developed a clinical rubric for decision-making in flowchart style to mimic the decision trees used in diagnostic or treatment decisions. They then created a workshop to help learners use the flowsheet. The workshop was delivered to third-year medical students as part of “Junior Bootcamp,” a day-long session of events to orient students to the clinical experiences of the M3 year. The workshop was delivered in the summer of 2019. Respondents indicated that they were more likely to be able to appropriately respond to discriminatory comments after completing the workshop. They also felt that they were more likely to be able to engage in respectful dialogue with a patient and to debrief with a faculty member. Fewer participants felt that they were likely to use the flowchart. Findings indicate that the workshop was useful to participants. It may be especially useful to educators dealing with the COVID pandemic because it is scalable and easily delivered remotely. Further studies are needed to determine if introducing this topic in the clinical years of medical school leads to improved skill in addressing instances of bias that come from patients and families.

Medication-induced cutaneous hyperpigmentation has variable clinical presentations and is dependent on the specific drug involved. Most commonly, an attentive patient observes such changes early in the course; when missed by the patient, such changes are usually noted by an observant clinician. Clinical diagnosis can be challenging if the patient is on multiple medications because other causes must be excluded. This condition occurs via multiple mechanisms. Frequently, the pigmentary change is reversible with discontinuation of the drug. Causative medications include nonsteroidal; anti-inflammatory agents, antimalarials, antibiotics, psychotropics, amiodarone, and chemotherapeutic agents. The; antimicrobials responsible for hyperpigmentation are antimalarials, tetracyclines, tigecycline, dapsone, rifampicin, and antiretrovirals such as zidovudine. Sunlight exposure can worsen the pigmentation seen with some of the above antimicrobials (e.g., dapsone). Here, we describe an older adult white woman presenting with acute cutaneous; hyperpigmentation of the bilateral lower extremities while on levofloxacin therapy. Hyperpigmentation resolved after cessation of the agent. Our case highlights this unique acute presentation after only a few days of oral levofloxacin.

Introduction: Carbapenems are the drugs of choice for the treatment of many multidrug resistant hospital acquired infections. Resistance to carbapenems also is not uncommon and is increasingly being reported now-a-days. Though various tests like modified hodge test are available for the detection of carbapenemases, they lack sensitivity and specificity. Recently, the Carba NP test has been introduced for carbapenemase detection which has been approved and included in CLSI guidelines. Aim: To identify the prevalence of carbapenemase producing isolates and the utility of Carba NP in house as well as commercial RAPIDEC Carba NP test in the identification of these carbapenemases. Materials and Methods: All the carbapenem resistant organisms isolated during the study period from July 2018 to December 2018 were included in the study. A total of 91 isolates were identified during the study period which were further tested for carbapenemase production by both in House Carba NP test as well as commercially available RAPIDEC Carba NP (Biomerieux) as per the existing protocols. Twenty five carbapenem sensitive isolates were also tested. Klebsiella pneumoniae BAA ATCC1705 and BAA ATCC-1706 were used as controls. Results: Out of 91, carbapenem resistant strains tested, 72 were identified as carbapenemase producers. Out of them, Klebsiella pneumonia accounted for 59.7% of the total carbapenemase producing organisms followed by Pseudomonas aeruginosa (25%) and E.coli (6.9%) followed by Acinetobacter and Enterobacter which constituted less than 5%. Among enterobacteriaceae, 43 out of 59 carbapenem resistant Klebsiella were carbapenemase producers whereas all the 5 carbapenem resistant E.coli were positive for Carba NP test. Among Pseudomonas 18 out of 21 were carbapenemase producers. All the positive isolates by in-house Carba NP test were also positive by commercial RAPIDEC test and vice-versa and none of the 25 carbapenem sensitive strains tested were positive for Carba NP test by either method indicating 100% correlation between the two methods studied. Conclusion: Carba NP in house as well as commercial RAPIDEC Carba NP test were equally effective in the identification of the carbapenemase producing gram negative bacilli. Wide adaptability of these tests by various laboratories will help in the early identification of these potentially spreading carbapenemase producers, which in association with appropriate treatment and infection control practices will prevent the emergence of these strains and will decrease the mortality and morbidity.

Introduction: The macrolide, lincosamides, and streptogramin (MLS) group of antibiotics are one of the few alternative antibiotics available for the treatment of methicillin-resistant staphylococcal isolates. Clinical failures with these antibiotics have been reported because of the usage of these drugs in improperly characterized and tested isolates. The purpose of this study was to know the prevalence of different phenotypes in our area, with an emphasis on inducible resistance detection. Materials and Methods: A total of 100 methicillin-resistant staphylococcal isolates were included in the study. Phenotypic characterization was done by using erythromycin and clindamycin disks kept at a distance of 15 mm on the Muller Hinton agar plate and incubating at 24 h. Results: Among 100 isolates, 23 were sensitive to both erythromycin and clindamycin (S phenotype). Thirty-one isolates were resistant to erythromycin but sensitive to clindamycin (MS phenotype). Inducible resistance (iMLSB) was seen in 26 of the total isolates. Isolates which were resistant to both the antibiotics numbered 19 (cMLSB). There was only one isolate which was sensitive to erythromycin but resistant to clindamycin (L phenotype). Conclusion: MLS group of antibiotics is still an effective group of antibiotics against methicillin-resistant staphylococcal isolates, and routine testing for the inducible resistance in these isolates will help in the prevention of therapeutic failure and for the better management of the patient.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has now become a serious global threat after inflicting more than 8 million infections and 425,000 deaths in less than 6 months. Currently, no definitive treatment or prevention therapy exists for COVID-19. The unprecedented rise of this pandemic has rapidly fueled research efforts to discover and develop new vaccines and treatment strategies against this novel coronavirus. While hundreds of vaccines/therapeutics are still in the preclinical or early stage of clinical development, a few of them have shown promising results in controlling the infection. Here, in this review, we discuss the promising vaccines and treatment options for COVID-19, their challenges, and potential alternative strategies.

Introduction: Fosfomycin is a broad spectrum anti-microbial agent with activity against various bacterial agents. It is a bactericidal antibiotic which interferes with cell wall synthesis. Fosfomycin is rapidly absorbed orally and majority of the drug is excreted unchanged in urine with very high concentration levels achieved in urine after a single oral dose. Urine levels remain high for prolonged period which makes it a suitable drug in the treatment of Urinary Tract Infections (UTI). E.coli is the most common organism causing the UTI. With the inappropriate and inadvertent use of higher antibiotics, these bacterial isolates have acquired multidrug resistance for which treatment options are limited. Aim: To evaluate the in-vitro activity of fosfomycin against uropathogenic E.coli and to compare its activity with the other anti-microbial agents. Materials and Methods: This study was a prospective study done in the Department of Microbiology SVS Medical College, Mahbubnagar from Jan 2016 to Mar 2016. A total of 564 urine samples from suspected UTI cases were processed during the Fosfomycin has a renal elimination of 95% and no tubular secretion occurs [4]. It has a relatively long elimination half-life, which varies between 4 and 8 hour [4]. Urine levels remain high for prolonged period which makes it a suitable drug in the treatment of UTI. Fosfomycin has good distribution into tissues, achieving clinically relevant concentrations in serum, kidneys, bladder wall, prostate, lungs, inflamed tissues, and other body fluids [3-6]. UTIs are the most common infections in any healthcare set-up with E.coli being the most common organism causing the infection [2]. With the inappropriate and inadvertent use of higher antibiotics, these bacterial isolates have acquired multidrug resistance and it has become much tougher than ever to treat these infections. As the antibiotic pipeline is empty with only few alternatives available for treating these resistant infections, old antibiotics like fosfomycin, nitrofurantoin, colistin have gained importance recently [7,8]. In the present study we have evaluated the fosfomycin activity against E.coli isolates from urine and compared with various other antimicrobial agents used for the treatment of UTIs. Materials and Methods This was a prospective study done in the Department of Microbiology SVS Medical College, Mahbubnagar from Jan 2016 to Mar 2016. The study was approved and ethical clearance was obtained by the Institutional Ethics Committee. A total of 564 urine samples study period out of which 170 E.coli were isolated. Identification of the organisms were done by routine biochemical testing and antibiotic sensitivity testing was done by Kirby-Bauer disc diffusion testing according to the CLSI guidelines (M100-S23). Results: A total of 170 E.coli isolates were tested for antibiotic susceptibility. Out of 170 isolates 60 (35.30%) were isolated from males and 110 (64.70%) from females with male to female ratio of 1:1.83. Majority of the isolates were obtained from the age group of 21-30 years (25.8%). Antibiotics like fosfomycin, imipenem and methenamine mandelate showed the highest sensitivity with all the isolates (100%) being susceptible to these drugs. Whereas, least sensitivity was observed for amoxyclav (15.2%) followed by cefixime (16.4%) and norfloxacin (21%). Fosfomycin has shown very good in-vitro activity against all the tested isolates when compared with many other antibiotics. Conclusion: In view of emergence of multidrug resistant pathogens, testing for old and forgotten antibiotics like fosfomycin is gaining importance. Because of its unique mechanism of action and low incidence of resistance it can be a potential therapeutic alternative in the treatment of UTI.

Introduction: The aim of this study is to report the microbiological spectrum of dacryocystitis and the antibiotic sensitivity patterns of the organisms. It was a prospective study done at Department of Ophthalmology, Dr. D. Y. Patil Medical College and Hospital, Pimpri, Pune in 2015 on 42 cases of dacryocystitis. Methodology: Patients were diagnosed with dacryocystitis and on the presence of a pus-filled lacrimal sac and peri lacrimal tissues for acute dacryocystitis. Chronic dacryocystitis patients were diagnosed by ROPLAS Test and sac syringing and were reviewed for demographic and microbiological profile.The culture results, organisms isolated, and their antibiotic sensitivity were studied. Results: In this study 42 clinical samples were evaluated, among them 33(78.5%) were culture positive and rest were reported as no growth 9(21.5%). Among all positive growth, Staphylococcus aureus encountered as the commonest isolate (56%) followed by Streptococcus pneumoniae (2%) among the Gram-positive organisms .In the Gram-negative organisms, Escherichia coli (23%) followed by Pseudomonas aeruginosa (17%) was seen. Gram-positive organisms were commonly sensitive to flouroquinolones, penicillins and vancomycin whereas gram-negative organisms were sensitive to aminoglycosides. Conclusion: Gram-positive and Gram-negative organisms were predominant in this study. The result has significant bearing on the treatment of patients and also when mass cataract surgeries are being performed.

Background: This is a prospective study of ocular trauma profile related to road traffic accidents that presented to a tertiary care centre in Western Maharashtra. Aims & Objectives: To study the epidemiology and pattern of ocular trauma among the road traffic accident cases in western Maharashtra. Methodology: Hospital based study conducted from September 2013 to March 2015. 114 subjects (122 eyes) were enrolled in the study. 8 of these subjects had bilateral ocular trauma. The examination involved assessment of visual acuity and description of nature and extent of ocular injury. The visual outcome was taken to be the best corrected vision at 3 months post trauma. The chi-square test was used to statistically analyze the data. Results: It was observed that 32.79% of injuries were extra ocular, 59.02% were closed globe intraocular injuries and 8.19% were open globe intraocular injuries. 78.69 % of the injuries were mild, 9.84% were moderate and 11.84% were severe. The visual outcome was good (visual acuity of more than 6/18 at 3 months post-trauma) in 89.34%. Only 4.10% of the total cases studied had used safety measures viz., helmets or seat belts. A total of 12% of subjects were found to be under the influence of alcohol at the time of accident. Conclusions: Primary preventive approach such as promoting safe riding practices and strict implementation of traffic rules like riding at safe speed wearing helmet and avoiding alcohol before driving are needed to prevent road traffic accidents associated ocular morbidity.

Context: Fast foods are quite popular among children owing to taste, appearance and hype created by mass media. However, the increased incidence of lifestyle disorders seen now-a-days at an early age could be attributed to fast foods. Aim: This study was done to assess the awareness of health hazards, consumption pattern of fast foods and to find out its association with overweight among high school students. Settings and Design: This cross-sectional study was done among boys of 3 private schools in Mangalore city in March 2012. Materials and Methods: Data was collected using a semistructured self-administered questionnaire. Statistical Analysis: Chi-square test, one-way ANOVA and binary logistic regression analysis was used for analysis. P-value ≤ 0.05 was considered as statistically significant association. Results: Mean age of boys was 13.5±0.9 years. Out of 300 participants, 41(13.7%) were overweight and 8 (2.7%) were obese. 292(97.3%) were fast food users of which 42(14.4%) consumed it every day. Majority of participants were introduced to fast foods through television commercials 193(64.3%). 73(57%) developed this habit as they were bored with home food. Awareness of harmful effects of fast food consumption was known to 186(62%) students and this was found to be associated with the perceived need to control its usage (p