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Background: Rising antimicrobial resistance (AMR) rate is a challenge for treating patients in health-care settings globally. Most intensive care unit (ICU) patients are frequently on antimicrobial agents; this induces selective antibiotic pressure and increases the threat of the development of AMR. The objective of this study was to document the microbiological profile and antimicrobial susceptibility pattern of the isolates from blood culture-confirmed cases of sepsis from ICUs at a tertiary care center. Materials and Methods: A retrospective data collection was conducted after obtaining a waiver of consent from the institute ethics committee. A total of 151 patients, aged 18 years and above, admitted to the ICUs between January and December 2019 with blood culture-proven sepsis were included in the study. Data on demographic details, ICU stay, underlying risk factors, infecting organisms, and antimicrobial susceptibility reports were collected and analyzed using Microsoft Excel. Results: A total of 1020 clinically suspected sepsis patients were admitted to the ICUs during the study period. Of these, 151 patients (14.8%) had blood culture-proven sepsis. Gram-negative bacteria were the most frequent isolates (63.6%), among which Escherichia coli was the most common pathogen (25%), followed by Klebsiella pneumoniae (15%), and Acinetobacter baumannii (13.6%). The rate of resistance was more against cephalosporins as compared to carbapenems and tigecycline. Commonly documented gram-positive bacterial isolates were coagulase-negative staphylococci (8.6%), viridans streptococci (7.1%), and Staphylococcus aureus (5%). About 65.2% of penicillin-resistance and 15.8% of methicillin-resistant staphylococci were documented. Conclusion: This study on AMR was useful to know the prevalence of sepsis among ICU inpatients and the microbiological profile with their AMR pattern in our tertiary care hospital. This may help to generate local antibiograms which may further contribute to formulating the national data. Based on available antibiogram data, the choice of antibiotics for empiric treatment becomes easier. It may also guide the clinicians to escalate or de-escalate the antibiotics wherever possible.

Introduction: Bipolar patients show increased impulsivity during symptomatic period. Impulsivity during euthymic phase is not much studied. Impulsivity is a risk factor for future episodes of BPAD, suicidality, poor functional outcome and mortality. Aims and Objectives: The current study conducted during euthymic phase to study impulsivity compared with controls and to assess any particular personality trait manifests in the disorder. It is also aimed to study the correlation between the variables “impulsivity and personality” profiles among cases. Materials and Methods: This study was conducted on patients of euthymic bipolar disorder (n=50) and healthy controls (n=50). Patients were assessed using Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) to diagnose remission. They were administered Barratt Impulsiveness Scale-11(BIS-11) and Eysenck Personality Inventory (EPI).The healthy attendants of bipolar patients without any psychiatric disorder were taken as controls. Results: All three facets of impulsivity of test and control sample were found to be statistically significant. The difference between test and control scores of extraversion was found to be statistically significant (p=.002). Among test sample the extraversion scale and total score of Barratt impulsivity scale and its subscale facets i.e., attentional, motor and non-planning showed positive correlation. Among test sample, correlation between extraversion, BIS total score (p=0.018) and non-planning impulsivity (p=0.026) was found significant. The neurotic scale also showed positive correlation with BIS total and sub scales but none of them found statistically significant among test sample. Conclusions: Impulsivity was found to be increased during euthymic phase of bipolar patients. It is associated with substance abuse, suicide and poor functional outcome. Hence it is very important that impulsivity has to be assessed in all bipolar affective disorder patients.

Introduction: Asn40Asp Opioid Receptor (OPRM1) polymorphism of the MU-OPRM1 gene has been widely studied with regard to its association with alcohol dependence however results have been conflicting with evidence of ethnicity mediated effects. Aim: To examine the association between OPRM1 polymorphism and alcohol dependence in patients of South Indian ethnicity. Materials and Methods: This cross-sectional study was conducted at Department of Psychiatry, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India, from November 2018 to May 2019. Cross-sectional assessments and peripheral venous blood genotyping were done in 50 male South Indian participants attending a tertiary care psychiatric setting. Clinical parameters such as severity of dependence and craving were assessed in addition to the subject’s OPRM1 genotype. The data collected was analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: The mean age of the subjects was 39.62±8.50 years. This study showed a statistically significant association between alcohol dependence and the OPRM1 polymorphism Asn40Asp among the study subjects (p-value

Candida auris (C. auris) is a multidrug-resistant emerging fungal pathogen, which spreads rapidly in health-care settings and has the potential to cause nosocomial outbreaks. The lack of awareness among clinicians and challenges faced for its diagnosis in microbiology laboratories may adversely affect patient outcome. It is resistant to most of the commonly used antifungals for empiric treatment in critical care units. Hence, appropriate identification and antifungal susceptibility-guided treatment can contain infections caused by this organism. Hospital infection prevention and control measures must be in place to prevent nosocomial transmission. We report one such case of bloodstream infection by C. auris in a patient with multiple underlying risk factors and morbid obesity, who succumbed to florid sepsis after prolonged hospitalization in spite of aggressive medical management.

Introduction: Alcohol dependence is a chronic relapsing brain disorder. A combination of biological, psychological and social factors influences the outcome of de-addiction treatment. Understanding these factors help in formulation of effective relapse management strategies in alcohol dependence. Aim: To understand the occurrence and motives of drinking behaviour after de-addiction in males with past diagnosis of alcohol dependence syndrome. Materials and Methods: A cross-sectional design was employed for determining the prevalence of relapse after de-addiction treatment. A semi structured socio-demographic proforma, clinical data form and Drinking Motives Questionnaire-Revised (DMQR) were used to assess correlates of relapse and remission on men who underwent de-addiction for alcohol dependence (n=58) after obtaining informed consent. Comparisons were carried out on different variables between relapse and remission groups using Statistical Package for Social Sciences (SPSS) version 20 and were reported. Results: The occurrence of relapse after de-addiction treatment was 51.7%. Patients who had relapsed were significantly more likely to have less than a year of abstinence in the past and have received less than two de-addiction treatments in the past. More patients who had received less than two weeks of in-patient treatment for de-addiction maintained remission when compared to patients who had relapsed. Presence of high scores on social, coping and conformity motives was positively associated with relapse in this study. Conclusion: The occurrence of relapse after de-addiction treatment was found to be high. Multiple biological, psychosocial and treatment variables influence the outcomes of de-addiction treatment. This study added to the literature on treatment variables and individuals motive for drinking behaviour.

The occurrence of dipterous fly larvae in human is termed as human myiasis. Human myiasis can be classified based on clinical condition it causes like cutaneous myiasis, ocular myiasis, urogenital myiasis and intestinal myiasis. Based on the need for a particular host, myiasis can be divided as specific myiasis, semi-specific myiasis. Accidental myiasis results when the fly larvae are deposited/ingested by human resulting in infestation, which is also called as pseudomyiasis. Fly larvae may be present on the dead and decaying organic matter and domestic animals like dog and cats which are naturally infested with fly larvae and can be source for infection in children. Very few cases have been retrieved from literature on the occurrence of intestinal myiasis in children throughout the world. We report a case of two siblings in the same family infested with dipterous fly larvae.

Tetraology of Fallot is the most common congenital heart disease causing intracardiac right-left shunts. It is characterized by presence of ventricular septal defect, aortic overriding, pulmonary artery outflow obstruction and right ventricular hypertrophy. When these features are associated with atrial septal defect, it is often referred to as Pentology of Fallot (POF). If the lesions remain uncorrected, they can cause significant morbidity and mortality to the patient. Pregnancy and labour in such a patient present with significant haemodynamic changes, which can be challenging to the anaesthesiologist. Our patient with POF was managed with labour analgesia and subsequently epidural anaesthesia for drainage of vulval haematoma with successful outcome.

Background: Cervical cancer is the second most common cancer in Indian women. In India, cervical cancer contributes to 6-29% of all cancers in women.[1] Late diagnosis results in poor outcomes in the majority of instances of cervical cancer. Cervical carcinoma is the leading cause of mortality (17%) in 30-69 years old women.[1] The aim of this study is to assess the knowledge in Indian women attending oncology Outpatient Department (OPD) at Kurnool medical college and Government General hospital, Kurnool regarding cervical cancer screening and Human Papilloma Virus (HPV) vaccination. The secondary goal of the study was to create awareness among patients attending OPD regarding carcinoma cervix. Materials and Methods: This is a cross sectional study, conducted in 423 women who attended OPD, Department of Oncology, Kurnool Medical college, Kurnool after taking prior permission from hospital ethics committee. After taking informed consent, the questionnaire was provided to the subjects who met inclusion criteria, in the language understandable to them. In case if subject was illiterate, the questionnaire was read aloud by doctor and the responses were recorded. After completion of questionnaire, the doctor shared knowledge regarding etiological factors, screening tests, awareness on vaccination and treatment options available for carcinoma cervix with the patients. Results: Majority of the women have poor knowledge about cervical cancer (75.82% [321/423]) and it's screening (77.7% [329/423]). Conclusion: Many women lacked knowledge regarding cervical cancer and its screening, which is the reason behind late diagnosis and high mortality. It is the high time to create awareness of cancer cervix, its screening and adoption of prevention measures like vaccination to decrease the burden of disease in India. [ABSTRACT FROM AUTHOR]

Background: Candidemia is a cause of concern today, due to their high rates of association with morbidity and mortality. Automated blood cultures are the gold standard tools for the evaluation of suspected cases of sepsis. This study was done to document the proportion of candidemia, Candida profile, susceptibility to fluconazole, and associated risk factors among suspected cases of sepsis. Materials and Methods: This descriptive study involved the retrospective analysis of data from 30 patients who were positive for Candida bloodstream infections. The patient demographic details and associated risk factors were documented. Candida isolates were identified by their colony morphology, germ tube test, growth character on CHROMagar Candida, and carbohydrate fermentation tests. Antifungal susceptibility testing to fluconazole was performed. Results: The overall prevalence of candidemia was 0.33%. The median age distribution of patients with culture-positive candidemia was 54.5 years. The associated risk factors among patients with candidemia were diabetes (60%), chronic kidney disease (26.7%), acute respiratory distress syndrome (23.3%), chronic liver disease (23.3%), and cerebrovascular accident (16.7%). The most common Candida species isolated was Candida tropicalis (46.7%), followed by Candida parapsilosis (13.3%), Candida krusei (10%), and Candida albicans (6.7%). The fluconazole sensitivity was documented to be 86% of isolates. Conclusion: Thorough knowledge of the background of candidemia, changing patterns of Candida profile, and resistance to first-line antifungals is essential to understand the presenting illness to its fullest potential and start appropriate empiric antifungal treatment while keeping in mind the risk factors. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a significant global health concern, affecting millions of women each year. The molecular characterization of breast cancer has become crucial for tailoring personalized treatment strategies and predicting patient outcomes. Among the key biomarkers that guide treatment decisions, the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her2/neu) play pivotal roles in determining the disease behavior and response to therapy. Understanding HER-2 expressions and hormone receptors is essential for developing treatment strategies and making decisions regarding breast cancer. Aims and Objectives: The study was conducted to determine the prevalence of different subtypes based on the status of ER, PR, and Her2/neu receptors in this specific patient population and to Analyze the correlation between these molecular subtypes and clinicopathological characteristics, such as age, tumor size, grade, and lymph node status. Materials and Methods: This is a Retrospective observational study conducted on 126 cases of breast carcinoma patients in Government General hospital, Kurnool. Slides were prepared from blocks containing cancer tissue, and immunohistochemical staining was done for ER PR & Her2neu expressions. Interpretation of expressions was done using Allred scoring system for ER, PR and the College of American pathologists guidelines for Her2neu expressions. Statistical analysis was performed to determine the statistical significance by applying chi-square test. Results: The majority of the tumors were HER2/neu negative, positive for ER and PR. When it came to ER and PR positive tumors, most of them were Grade I. The current investigation established a correlation between age, tumor grade and ER and PR, but not with tumor size, lymph node status. There was a correlation between ER and PR expression, but not with HER2/neu. Conclusion: Adjuvant hormonal therapy may result in a favorable outcome for cases that test positive for ER and PR. In order to provide prognostic information and therapeutic benefits, hormone receptor assessment is strongly advised for clinical management of breast cancer patients. [ABSTRACT FROM AUTHOR]