Background and Objective: The life span of the children living with Hiv/AIDS has increased with the invention of Retroviral drugs. As they are entering in to late adolescents and early adulthood, it becomes necessary to understand their expectations. The study aimed to explore the future expectations among the adolescents with HIV/AIDs. Materials and Methods: An exploratory study design was adopted for the study. Semi structured interviews were undertaken with adolescents and interpretative phenomenological analysis was used to analyze the results. The universe of the study were HIV infected adolescents who are registered in the Pediatric ART Centre and are coming for follow up in Indira Ghandhi Institute of Child Health Hospital, Bangaluru. Results: Emergent themes demonstrated that, the adolescent with HIV/AIDS are concerned regarding their future. The themes emerged from the study was knowledge about the illness, physical health, future expectations about career and relationship and social support. Conclusion: Lives of the children adolescents being infected by HIV/AIDS, unlike those of their counterparts are complicated with stigma, adjustment problems, and many other psychosocial issues. While studies done in India bring to light the adjustment problems of these children, they fail to look at their future expectations and their dreams for them.

Background: In the USA, up to 2 million health-care-associated infections (HAIs) per year are reported, of which 80,000 are lethal. Materials and Methods: This was a hospital-based observational (retrospective) study. Results: Hospital-wide rate of HAI ranges from 0.35 to 1.96 per thousand patients per day. The most common organism observed in the last 5 years is Acenatobacter (88 [27%]) followed by Pseudomonas aeruginosa (73 [22%]). Significant cases in these 5 years were reported from Intensive Care Unit (157 [48%]) followed by medical wards (males and females) (106 [32%]). The common site reported in the present study is catheter-associated urinary tract infection which was significantly higher (CA-UTI) (152 [46%]) followed by ventilator-associated pneumonia (VAP) (66 [20%]). The common organisms reported to cause UTI are P. aeruginosa (22%) followed by Escherichia coli (19%), and the most common microbial agent associated with VAP is Acenatobacter baumannii (48 [72%]) which was found to be significantly higher. The antibiogram of microorganism responsible for HAI was observed, and 56% isolates of Acinetobacter baumannii were sensitive to aztreonam followed by imipenem 54%, ceftazidime 47%, and amikacin 36%. Another common organism reported was P. aeruginosa, and the majority of isolates of this were sensitive to imipenem 79% followed by amikacin 68%, ceftazidime 53%, aztreonam, and ciprofloxacin 49% and least sensitive to meropenem 9%. Most of the Klebsiella pneumoniae strains during the same period were found to be sensitive to imipenem 94% followed by piperacillin/tazobactam 71%, amikacin 69%, cefepime 59%, and ceftriaxone 56% and least sensitive to nitrofurantoin 11% only. Conclusion: HAI is a big threat for patients' safety and prolongs patients' stay and cost of health care, so effective utilization of hospital data is crucial for prevention and control.

Background and Objectives: Particulate matter 2.5 (PM2.5) has been recognized as an important factor which may cause human respiratory tract related cancer and affect the growth of embryos. In this experiment, the toxicity of PM2.5 on zebrafish's embryos was explored. Methods: Zebrafish animal models were used in the experiment. The zebrafish embryos were exposed to PM2.5 solution of different concentrations, and the aggregation rate, the hatching rate and the malformation rate as the changes in the concentration of PM2.5 were observed. Result: The results showed that when the concentration of PM2.5 was 0-.250 μg/L, it had no significant effect (P > 0.05) on the embryo aggregation rate, the hatching rate or the malformation rate. When the concentration of PM2.5 was 500-.2500 μg/L, it had a significant effect (P < 0.05) on the embryo aggregation rate, the hatching rate and the malformation rate, and PM2.5 concentration was positively correlated with the embryo aggregation rate, but negatively correlated with the embryo hatching rate. Conclusion: The experiment shows PM2.5 has clear toxic effects on zebrafish embryos, which may provide a basis for further research on PM2.5 pathogenesis.

Background and Objectives: Human immunodeficiency virus (HIV)-related stigma is present at all levels which act as critical barriers for effectively addressing it. This also influences the treatment uptake and under or nonparticipation in treatment available. In view of this, the present study was aimed to assess the stigma of otherwise healthy individuals of the community toward HIV infection/acquired immunodeficiency syndrome (AIDS). Methods: The study was conducted on 100 healthy individuals. Their responses were taken on a self-designed semi-structured questionnaire. Results: The results showed that there is more perceived stigma as compared to enacted stigma. Nearly 46% of the individuals feel that HIV-infected persons should be blamed for their illness and 41% individuals feel that they will feel ashamed if they have HIV. It was also seen that older adults. (between 46 and 55 years) had more stigma as compared to the younger adults (between 16 and 25 years). The educated individuals still have stigma to a certain extent. Most of the individuals would like to tell their partner if they were diagnosed with HIV. Participants were divided into two groups on the basis of their level of education. (<12 years of formal education and >12 years of formal education). Stigma related to HIV/AIDS was compared among these two groups, and there was no significant difference in the level of stigma in these distinctly different educational groups. Conclusion: There is still stigma present to a certain extent in the society in the educated and urban individuals. Level of stigma may not be significantly different in people with educational difference. Stigma needs to be addressed for prevention and better management of HIV/AIDS.

Background and Objectives: Carbapenems and beta-lactam-beta-lactamase inhibitors are empirical drugs of choice in the treatment of urinary tract infection. (UTI); however, de-escalation of therapy is necessary to ensure compliance. Objectives: The objective is to study the impact of antibiotic susceptibility report on the management of community-acquired UTI. Materials and Methods: Patients were classified prospectively as uncomplicated UTI (UC-UTI) and complicated UTI (C-UTI), and symptoms, microbiology, antibiotic susceptibility pattern, and treatment modification following culture report were analyzed. Extended spectrum beta-lactamase (ESBL) prevalence in patients was compared among naive and those who received empirical treatment before presentation. Patients with a history of recurrent UTI were given prophylaxis and all were followed up for 1 month. SPSS version 20 package was used for statistical analysis. Results: Nearly 75% of the study population had C-UTI. Around 70% of C-UTI and 50% of UC-UTI had ESBL-producing Gram-negative enterobacteriace. In UC-UTI, failed empirical treatment before presentation at our center was significantly associated with positive ESBL producer status. Sensitivity to amikacin and carbapenems was over. 90%; nitrofurantoin and piperacillin-tazobactam followed at around 70%. Following culture report, a significant number of C-UTI were de-escalated to oral regimens. Conclusions: Despite the high prevalence of ESBL-producing pathogens in community.acquired UTI, once systemic signs of sepsis are controlled, de-escalation is possible in the majority of patients.

Background and Objectives: Chronic obstructive pulmonary disease is a common problem in both developed and developing nations. It is directly linked with smoking. It is associated with frequent exacerbations and then hospitalizations. A large percent of Gross domestic product is spent on its management. We conducted a hospital-based study in such patients who got admitted with exacerbation, whether infective or noninfective, and who required invasive ventilation during management. Such kind of study has not been reported from our country so far. The aim of this study is to determine the prevalence, etiology, and sensitivity of infective exacerbations and its impact on the outcome with the use of invasive ventilation. Materials and Methods: We enrolled 150 admitted patients for the study and recorded their clinical and laboratory parameters. The respiratory specimen was obtained by different ways and sent for culture and drug sensitivity. The outcome was noted with the use of invasive ventilation, and prognostic values of different variables were ascertained. Results: The infective exacerbation was seen in 65% and organisms involved were Gram-negative bacteria, with a predominance of Acinetobacter in 35%, Klebsiella in 32%, Pseudomonas in 17.5%, and Escherichia coli in 5%. The number of hospitalization days of the 150 patients ranged from 5 to 40 days with a mean of 16.39 ± 11.45 days. The number of Intensive Care Unit days range was 0-25 days with a mean of 7.35 ± 7.9 days. The number of days of invasive ventilation range was 2-18 days with a mean of 3.28 ± 5.2. The number of days on Bi-level positive airway pressure ventilation (BiPAP) was between 2 and 22 with a mean of 6.15 ± 5.7 days. The outcome was significant between the survivors/nonsurvivors in terms of a number of days of invasive ventilation required (P < 0.004). Conclusion: There was higher mortality among patients admitted with multiorgan dysfunction and multiple infiltrates on chest X ray, and there was significant advantage in outcome on invasive ventilation.

Background and Objectives: Treatment responsiveness to pegylated interferon-α and ribavirin against hepatitis C virus genotype 1 has strongly been associated with two single nucleotide polymorphisms (rs8099917 and rs12979860) in the region of the interleukin 28B (IL28B) gene. The aim was to perform three genotyping methods and evaluate their specificity, technical characteristics, and costs. In addition, the distribution of both polymorphisms in an Uruguayan population was assessed. Materials and Methods: One hundred DNA samples were genotyped by allele-specific polymerase chain reaction (AS-PCR), real-time PCR high resolution melting (RT-HRM), and Sanger sequencing methods. Results: The rs12979860 CC genotype, followed by the CT, was the most prevalent (52% and 39%, respectively). For rs8099917, the TT genotype was the most common (61%) followed by the GT (34%). AS-PCR and RT-HRM assays were specific for both IL28B genotypes determinations and showed a total concordance with Sanger sequencing results. Conclusions: Any of three genotyping methods is suitable for IL28B genotyping. The choice of the assay will depend on costs, special equipment availability, turnaround time, and specialized human resources.

Background and Objectives: Appropriate empiric antibiotic therapy in patients with severe community-acquired pneumonia (CAP) is crucial in terms of outcome. International guidelines suggest combination therapy (CT) for CAP patients admitted to Intensive Care Units (ICU). However, that type of combination of antibiotics is not clear. This study aims to determine the empiric antibiotic treatment of severe CAP in two periods. Our hypothesis was that macrolide use has decreased in the recent years. Materials and Methods: We compared in two prospective similarly designed cohort studies (1) CAP in ICU (2000-2002) and (2) H1N1 SEMICYUC (2009-2011) of critically ill patients with CAP: (a) Rate of CT and (b) use of macrolide or quinolones in each period. Demographic, severity of illness and clinical data were recorded. Chi-square test (categorical variables) and Student's t-test (continuous variables) were used. Results are shown as median, standard deviation, odds ratio, and 95% confidence interval. P < 0.05 was considered. Results: We included 1059 patients, 529 (49.9%) in the first period and 530 (50.1%) in the second period. The severity of illness and mortality rate was not different between periods. In overall, 866 (81.7%) received CT and this therapy was more frequent in the second period (85.3% vs. 78.3%, P < 0.003). A significant reduction in macrolide use in the second period was observed (26% vs. 55%; P < 0.01) even in patients with shock. Conclusions: Despite published evidence, CT use with quinolones has increased in the last years in Spanish ICUs.

Background and Objectives: Antitubercular drugs just like other drugs used in clinical practice are not free from ADRs(Adverse drug reactions).The added problem is that combination of drugs are used for prolonged periods of time. Moreover the ADRs to drugs used is one of the major reasons for patient default, hence leading to emergence of resistant organisms. Identification of the ADR profile of drugs in a hospital setup can be useful for the prevention, early detection and management of ADRs. 1) We aim to study the demographic profile of patients receiving Antitubercular therapy. 2) To identify the pattern and incidence of ADRs in the intensive phase Antitubercular therapy following DOTS strategy. Materials and Methods: A descriptive longitudinal study conducted for twelve months at tertiary care hospital in Eastern India. All the adult T.B. patients attending the outpatient department from January 2015 till December 2015 were included as per the study criteria and were monitored for ADRs. The data were evaluated for patient demography, type of DOTS treatment, type of ADRs and Organ site/system affected. ADRs were then subjected to severity assessment as per Hartwig scale.Statistical analysis was done using statistical software Graf Pad Prism version 4.03 for Windows. Results: Out of 296 patients, majority were males (59.79%), belonged to the age group of 20-30years(53.37%). Out of 296 patients 196 patients developed 312 detected ADRS mostly reported in the 5th week of DOTS therapy. In 11(5.61%) cases drugs were withdrawn, 21(10.71%) cases drugs were reduced and remaining 164 (83.67%) cases drugs were continued in original dose. Among them 164 cases received symptomatic treatment. The most common organ system involved was G.I.T. The most common type of ADR was nausea and vomiting (23.07%). On evaluation of severity assessment showed that most of the patients ADRs were of mild level-1(79.39%). Conclusion: Regular ADR monitoring is required to reduce morbidity and development of multiple drug resistance among patients with ADRs and also to improve patient compliance.

Background: Invasive pulmonary aspergillosis is a major cause of morbidity and mortality in neutropenic patients. Microbiological and serological tests are of limited value. The diagnosis should be considered in neutropenic patients with fever not responding to antibiotics, and typical findings on thoracic computed tomography scan. Whenever possible, diagnosis should be confirmed by tissue examination. Newer serological techniques like ß-D-Glucan Assay and Galactomannan assay are used in diagnosis and monitoring therapy in such patients. Aim: To early diagnose Invasive pulmonary aspergillosis and to decrease mortality. Methods: A total of 150 patients of hemato-oncological malignancies were prospectively enrolled intostudy. Results: Only 10 (6.6 %) patients developed invasive pulmonary aspergillosis and mortality was 30%.Patients were treated medically with never azoles and echinocandin antifungals, with long term survival in seven patients and early mortality in rest of patients. Conclusion: IPA is a difficult infection to treat in immucompromised state. It needs very high degree of suspicion to diagnose. Sick patients should be treated with combination antifungal of different mechanisms at outset and therapy should be continued for six months.

Background and Objectives: Trachoma is the most common cause of infectious blindness worldwide and despite various control programs, it persists, leads to significant ocular morbidity. In this article, we aim to determine the burden of trachoma and its related risk factors amongst the urban and rural populations of Sagar, Madhya Pradesh. Materials and Methods: Rapid assessment for trachoma was conducted in urban and rural Community Health Center (CHC) of Bundelkhand Medical College, Sagar according to standard World Health Organization guidelines. An average of 60 children in rural CHC and 50 children in urban CHC aged 1-10 years was assessed clinically for signs of active trachoma with status of hygiene. Additionally, all adults above 15 years of age in these centers community were examined for evidence of trachomatous trichiasis (TT) and corneal opacity. Environmental risk factors contributing to trachoma like limited access to potable water and functional latrine, presence of animal pen, hand wash and garbage within the urban and rural CHCs populations. Results: Overall, 18 of 110 children (16.36%; confidence interval [CI]: 9.5-23.2) had evidence of follicular stage of trachoma and 12 children (10.91%; CI: 5.2-16.6) had evidence of intense trachomatous inflammation intense and scarring stages trachomatous scarring of trachoma. Nearly 19 (17.27%; CI: 10.3-24.2) children were noted to have unclean faces and 17 (15.45%; CI: 8.8-22.1) children were found with unclean hands in both the centers. TTs & TO was noted in 19 adults (1.05%; CI: 0.8-1.2). The environmental sanitation was not found to be satisfactory in the study centers mainly due to the co-habitance of people with domestic animals like pigs, hens, goats, dogs, etc., in most (66.67%) of the person households. Conclusion: Active trachoma and trachomatous trichiasis were observed actively in both urban and rural populations wherein trachoma surveillance and control measures are needed.

Background and Objectives: Although tuberculosis (TB) is a notifi able disease in India, most of the cases of TB are either not recorded or reported. Among diagnosed cases, for improving reporting, proper feedback on referral outcome needs to be ensured to all health care providers who refer cases to the public health system. Materials and Methods: All the received feedbacks for TB patients referred for treatment from July 2013 to December 2013 were analyzed. Feedback reports including referral date, the age and sex of patients, type of disease, and date of treatment initiation were examined. Results: Of the total 1,259 referred TB patients during the study period, feedback was received for 54% of them. Only 42.3% (n = 532) of the referred patients were successfully linked at the treatment facility. Seven (0.6%) referred patients died before the initiation of treatment while 3.7% migrated, 2.4% gave the wrong address, 1.0% started private treatment, and 0.6% were nontraceable; in 3.2% cases only was the TB number given. Feedback was signifi cantly associated with sex, age group, type of treatment, disease type, and place of residence. Conclusion: The feedback received for referred patients was poor and for improving the care of TB patients, there is a need to strengthen the feedback mechanism in Revised National Tuberculosis Control Programme (RNTCP) for referred patients.

Background and Objectives: Hepatitis, a condition with liver inflammation, mostly follows hepatitis virus infection of different types A, B, C, D, and E. Each year, numerous outbreaks of hepatitis virus are being reported from around the country, more so from the “Empowered Action Group (EAG) States.” The present outbreak investigation was performed in Odisha, India to study the epidemiology, explore the reasons behind it, and suggest preventive measures for the future. Materials and Methods: A team consisting of public health doctors from All India Institute of Medical Science (AIIMS), Bhubaneswar, Odisha, India investigated the hepatitis E outbreak as per standard guidelines in one of the villages of Tangi block in the state of Odisha, using a questionnaire between January 1, 2015 and January 15, 2015. The data were entered and analyzed in Microsoft Excel 2007. Time, place, and person analysis were performed for all case patients. Result: Hepatitis E outbreak occurred between November 16, 2014 and January 1, 2015, affecting 22 individuals. The attack rate was 44/1,000 in the population and young males were mostly infected. Spot map of the outbreak probably points toward point source epidemic. Most of the infected cases had visited allopathic doctors as well as traditional healers. Less than 50% people had some knowledge about the prevention and control of hepatitis virus infection. Open defecation was highly prevalent in the village. The well was the commonest source of drinking water and the condition of wells was non-sanitary. Less than 2% started hand-washing after the end of the outbreak in the community. Conclusion: Focus of outbreak investigation should not restrict only to immediate control but should rather lead to intervention by the health system in the area for construction of community toilets, improved drinking water facilities, and sustained information, education, and communication (IEC) activities to promote personal hygiene and water safety behavior in the community.

Objective: To evaluate the clinical efficacy and safety of moxifloxacin injection in the treatment of acute exacerbation of chronic bronchitis (AECB) in daily clinical practice. Patients and Methods: From May 2009 to March 2011, a total of 1026 cases with AECB were collected from 43 hospitals in eight cities. All the patients were treated with moxifloxacin (400 mg qd) intravenously. Whether to use oral or sequential therapy was decided by the physicians according to the clinical efficacies. Patient conditions such as combined uses of drugs, efficacies and adverse events were recorded and analyzed. Results: The cure rate of infection was 83.03%, and the total effective rate of moxifloxacin injection was 93.80%. The efficacies were statistically different among subgroups with different ages, complications, forced expiratory volume in 1 s (FEV ₁ %), and combined uses of drugs, respectively. Multivariable logistic regression analysis showed that the advanced age (≥65 years) and severe obstructive pulmonary disease (FEV ₁ <50%) were significantly correlated with the clinical efficacies. A total of 15 cases of adverse events were recorded, and the incidence rate was 1.23%. Conclusion: Moxifloxacin injection can effectively control the infection of AECB patients with fewer adverse events.

Background and Objective: The emergence of resistance to drugs used to treat tuberculosis (TB), and particularly multidrug-resistant TB, has become a significant public health problem globally. In spite newer modalities for diagnosis and treatment of TB, unfortunately, millions of people are still suffering and dying from the disease. The present study was aimed to study the prevalence of initial drug resistance and the treatment outcome at the end of 6 months in TB patients attending a dedicated TB outpatient department (OPD) in North India. Materials and Methods: A cross-sectional, observational study was carried out on 100 patients of newly diagnosed pulmonary TB with or without glandular involvement attending TB OPD of a tertiary care hospital over a period of 6 months. Results: Culture positivity was encountered in 82% of the cases, while 14% were smear positive though culture negative. Out of all culture positive patients, 56.1% were susceptible to all antitubercular drugs, while 43.9% were resistant to one or other antitubercular drugs (isoniazid, rifampicin, streptomycin or ethambutol). Of the 46 drug-susceptible cases, 93.48% got cured, while 2.2% defaulted and 2.2% had treatment failure. About 86.1% of the 36 initial drug resistant were cured with 2RHZE/4RH, while 5.6% (n = 2) defaulted treatment and 8.3% were treatment failures. Conclusion: Treatment outcomes of this small group of drug-resistant pulmonary TB patients treated with the standardized regimen was encouraging in this setting. Close attention needs to be paid to ensure early identification of drug-resistant cases; good laboratory methodology and quality control measures; regular supply of quality antitubercular drugs; adherence to the prescribed regimen; effective patient education and counseling; and to the timely recognition and treatment of adverse drug reactions for better treatment outcome.

Background and Aim: Foot ulcers are a significant complication of diabetes mellitus and are usually poly-microbial. Aerobic Gram-negative bacilli are isolated in higher frequency with increasing grade of ulcers, and development of drug resistance is a cause of concern. The aim of our study is to identify the extended spectrum β-lactamases (ESBL) and AmpC β-lactamases among the Gram-negative aerobic bacterial isolates in the different grades of diabetic foot ulcers. Materials and Methods: Pus samples from 104 male and female diabetic patients presenting with grade I to grade V foot ulcers were cultured according to the standard microbiological procedures and antimicrobial sensitivity performed by the Kirby-Bauer disc diffusion method as per CLSI guidelines. MIC ₅₀ of all isolates for Ceftazidime was detected by the agar dilution method. The Gram-negative bacterial isolates were further tested for ESBL and AmpC β-lactamases by the modified double disc synergy test and combined disc method. AmpC disc test was used for the confirmation of AmpC production. Results: Forty-seven isolates exhibited resistance to Ceftazidime phenotypically and 54 isolates had MIC greater than 2 μg/mL. ESBL production was observed in 55.55% of the isolates. AmpC production was seen in 19 isolates (35.18%). No mechanism of cephalosporin resistance was explainable for 5 isolates. Conclusion: The combined disc method was more sensitive in the detection of ESBLs, while the AmpC disc test was an easy way to detect AmpC beta lactamases and can be used for routine screening.

Background and Aim: Prevalence of sexually transmitted infections (STIs) shows regional variations. Various epidemiological studies report a diminishing prevalence of syphilis including other bacterial STIs and a rising incidence of viral STIs. However, a resurgence of syphilis has been observed and reported. The aim of our study was to find out the trends of syphilis among blood donors in Bastar region. Materials and Methods: This study was carried in a blood bank, attached to the Government Medical College in Bastar region, Chhattisgarh. This was a retrospective study. A total of 12,680 blood donors were screened for syphilis during 3 years (from 2011 to 2013) by Syphichik Rapid Dipstick test (Modified Treponema pallidum hemagglutination assay) and data was analyzed with respect to sero-reactive cases. Results: Out of 12,680 blood donors screened for transfusion transmitted infections, 134 donors were sero-reactive for syphilis, five donors had co-infections syphilis and hepatitis B infections, while four donors had syphilis with human immunodeficiency virus (HIV) infections. Prevalence of syphilis was more in replacement donors than voluntary donors and was in raising trend. Conclusions: Prevalence of syphilis among blood donors was in raising trends in this region and was more in replacement donors. The most common co-infections in our study were syphilis with hepatitis B infection, followed by syphilis with HIV infection. Increasing prevalence of syphilis among the donors underscores the concern about growing infection of this disease in the community as these blood donors represent the highly selective community. Proper counseling prior to blood donation, brief medical examination of blood donors and awareness about syphilis among blood donors may increase the safety of blood as well as community.

Background and Aims: There was a global influenza A pandemic in the year 2009. For this emerging infectious disease, Government of India in the year 2009 developed a training tool kit to train health care professionals for the pandemic preparedness. We present the impact of standardized training program on awareness of medical students to manage a case of influenza A (H1N1). Materials and Methods: A pre-post intervention study was designed and implemented. Before the implementation of intervention package, a baseline questionnaire was developed and administered to 179 medical students of first, second, and third semester. Training program was delivered in three batches. Each batch was given three days training. After completion of the training program, the questionnaire was re-administered. Results: The mean age of study participants was 19.2 years (SD = ΁2.3 years). Ninety-seven (45%) of the participants were female. The mean score in the pre appraisal was 6.3, which increased to 8.7 after the training component (gain index 24 %). There was a significant increase in number of medical students having "very good knowledge" (64%) and "good knowledge" (34%) after the intervention package. Conclusion: There was a significant improvement in the awareness of medical students following a training program. It is recommended that such programs should be held at regular intervals, as measure for preparedness for emerging disease outbreaks.

Background and Aims: Since 1959, treatment of infections caused by S. aureus included semi synthetic penicillin drugs such as Methicillin. Sooner a year later in 1960 Methicillin resistant S. aureus came into existence. Decade after decade the MRSA strains increased and these bacteria were marked as major cause of nosocomial infections in early 1980s. The invasion of MRSA into community is now day's matter of concern for microbiologist. This study was conducted to detect the prevalence of MRSA resistance and to prepare antibiogram of HA-MRSA and CA-MRSA isolates at our hospital. Materials and Methods: A total of 201 staphylococcus isolates were detected as MRSA. They were then separated into two categories i.e. community acquired MRSA (CA-MRSA) and hospital acquired MRSA (HA-MRSA) according prescribed criteria. Antibiogram was prepared by Kirby- Bauer disk diffusion method. Results: Out of 201 isolates, HA-MRSA prevalence was 143(28.6%) and CA-MRSA was 58(11.6%). The HA-MRSA isolates showed were 10- 30% more resistant when compared to CA-MRSA. All isolates were 100 % sensitive to Vancomycin and Linezolid. Conclusion: We strongly suggest that time to time monitoring of MRSA should be done and proper hand wash must be done to avoid spread of MRSA.

Background and Aims: Escherichia coli is the most common etiological agent in both community acquired and hospital acquired urinary tract infections. Emergence of multidrug resistance (MDR) among E. coli isolates is quite alarming. The aim of this study was to define the current prevalence of MDR and extended spectrum beta-lactamases (ESBL) production among E. coli isolates from urine samples in our hospital. Materials and Methods: Urine samples from 1225 patients were processed for wet mount followed by culture and sensitivity. All the samples were inoculated on to Hi Media Hi chrome agar plates (HiMedia Laboratories Pvt. Ltd., Mumbai, India) and growth showing significant bacteriuria (≥10 ⁵ cfu/ml) were further identified by the standard biochemical procedures and antibiotic sensitivity done as per Clinical and Laboratory Standards Institute guidelines. Detection of ESBL was done by the combined disc method. Percentage of antibiotic resistance and sensitivity and Chi-square test were used. Results: Out of 1225 samples processed, significant bacterial isolates were obtained in 357 (29.1%). The total number of E. coli isolated were 179 (50.1%) of which multidrug resistant E. coli isolates were 148 (82.6%) and 71 (39.66%) were ESBL producers. High degree of resistance was observed to amoxycillin (93.2%) and amoxycillin-clavulanic acid (90.5%). More than 80% sensitivity was seen only to imipenem (98.4%), amikacin (83.3%) and nitrofurantoin (86.6%). Conclusion: Multidrug resistant strains of E. coli are widely prevalent in the community. Antibiotics like imipenem require hospitalization, parenteral administration, drug monitoring for toxicity, all of which incur high cost to the patient and have to be used judiciously.

Background: The prevalence of sexually transmitted infections (STI) varies widely from region to region in India. Objective: To study the pattern of STIs and the profile of STI patients with HIV co-infection. Materials and Methods: A retrospective record-based case study of patients attending STI clinic, JNMC, Aligarh, from May 2008 to May 2013 was carried out. Results: A total of 4876 patients attended the STI clinic, out of whom 2764 (56.7%) had proven STI. STIs were more common in men, with a male (2201): female (563) ratio of 3.90:1. Their age ranged from 16 years to 55 years (mean age = 26.38 years) with the maximum number of patients in the age group of 16-25 years. Genital scabies 1466 (53.0%) constituted the most common STI followed by genital warts with 588 (21.2%) of patients. Human Immunodeficiency Virus (HIV) infection was noted in 36 (1.3%) of all STI cases.

Introduction: In the early nineties, infections due to methicillin-resistant Staphylococcus aureus (MRSA) in patients without previous healthcare exposure were reported. The continued evolution of MRSA is illustrated by the infections caused by community acquired MRSA and the majority of these infections are nonlife-threatening infections of the skin and soft tissues. We carried out the retrospective study of bacterial isolates obtained from pus specimens of community-acquired skin and soft tissue infections in our set up with special reference to MRSA. Materials and Methods: The isolation rate of various organisms isolated from pus specimens was recorded for the years 2007 to 2012. The antibiotic susceptibility patterns of S. aureus strains (MRSA and MSSA) were also reviewed. Results: 47.48% of the total pus samples received from patients with a clinical diagnosis of community acquired SSTI during the period of 6 years, that is, from 2007 to 2012, showed culture positivity. Mixed organisms were isolated from five samples. 30.21% of them were S. aureus strains out of which 23.80% demonstrated the presence of methicillin resistance (MRSA). All the MRSA strains (100%) screened from clinical specimens were resistant to penicillin, cephalexin and cefazolin; 40% to erythromycin, clindamycin and amikacin; 80% to gentamicin; 90% to ofloxacin. The isolation rate of MRSA is far outnumbered by that of MSSA that remains fairly sensitive to the first line drugs against S. aureus. Conclusion: Abscesses are the most common clinical presentation caused by CA-MRSA in this study and we recommend that physicians should consider obtaining cultures and antimicrobial susceptibility tests in all such patients.

Background: The Pneumonia Severity Index (PSI) and CURB-65 predict outcomes in community acquired pneumonia but have limitations. Materials and Methods: The study evaluated if procalcitonin in community-acquired pneumonia provides prognostic information with the PSI and CURB-65 in sickle cell adult patients. Twenty sickle cell positive adult patients with a clinical and radiographic diagnosis of community acquired pneumonia were scored using PSI and CRUB-65, and measured procalcitonin levels. Results: They were 12 female 60% and 8 males 40%with mean of age 46.0 ΁ 10.26 and were stratified with PSI, CRUB65 and sampled for procalcitonin level for PSI class I (3) patients 15%, class II (10) patients 50%,class III (3) patients 15%, class IV( one) patient 5% & class V (3) patients 15% with mean of 2.55 ΁ 1.276 were CRUB65 0 (2) patients 10% 1 (11) patients 55% two (3) patients 15%, three (4) patients 20%with mean of 1.45 ΁ 0.94 proclacitonin >0.25 (8) patients 40% and >0.50 are (12) patients 60% with mean of 1.098 ΁ 1.346. Conclusion: Procalcitonin levels on admission predict severity of community-acquired pneumonia in sickle cell patients with a similar prognostic accuracy as PSI and CRUB65 and use of procalcitonin as an adjunct to existing rules may offer additional prognostic information in high risk patients as sickle cell positive patients, further studies must address whether adding PCT to risk scores can increase their safe implementation in clinical practice. This was the scope for patients with sickle cell.