Traditional eye medications (TEM) usage is still a common practice as most patients in India consult a traditional healer. Poverty, socio-cultural beliefs, poor health-seeking behavior, and lack of access to health facilities are reasons for the persistence of this practice. ^[1],[2] Fifty patients with kerato conjunctivo uveitis who used TEM, especially some leaf extract for 3 days, visited ophthalmology clinic, Narayana Medical College Hospital during June 2012. Ocular complications included purulent conjunctivitis in 25 subjects, keratitis in 15 subjects, corneal ulcer in 1 subject, and iridocyclitis in 9 subjects respectively. All patients' disease condition was reversed by the local application of steroid drops, topical antibiotics, anti-allergic drops, and artificial tears. The use of TEM is harmful, further leads to blindness. Proper health education to the public can reduce the prevalence of preventable blindness.

Background and Aims: Human Immunodeficiency Virus infections have developed into a global pandemic with cases reported from virtually every country. Manipur has also shown an increase in the incidence of HIV/AIDS since the past decade. Thus far, very little data is available in this part of the country about the effect of 1 ^st and 2 ^nd line antiretroviral therapy (ART) on the glycemic status of the patients. Hence, this study was undertaken to assess and compare the effect of 1 ^st line and 2 ^nd line ART on glycemic status of HIV patients. Subjects and Methods: The study was carried out in the ART centre in Regional Institute of Medical Sciences, Imphal. It was a cross-sectional comparative observational study carried out from October 2010 to September 2012. A total of 292 patients were included in the study, of which 211 patients were receiving ART 1 ^st line and 81 patients receiving ART 2 ^nd line. HIV patients receiving ART were investigated for fasting, 2 hours post-prandial glucose, CD4 cell count, total cholesterol, and serum triglyceride levels. Chi-square and Student's t tests were used to find the significance between the two groups. Pearson's correlation between clinical variable and sugar and lipid parameters was performed to find the effect of relationship. Results: The difference between the two groups was statistically significant in Random Blood Sugar (RBS), Fasting Blood Sugar (FBS) and Post Prandial Blood sugar (PPBS) values (P = 0.022; P = 0.004 and P < 0.001 respectively). Patients in Group II had significantly higher values of TC and TG compared to Group I patients with a P value of <0.001. Conclusions: The glucose and lipid parameters were significantly high receiving ART 2 ^nd line patients in comparison with ART 1 ^st line patients.

Ebola virus disease (EVD) is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees). The current outbreak is in West Africa involving countries of Guinea, Liberia, Sierra Leone and Nigeria (as on August 6, 2014). The infection is transmitted to humans through close contact with the blood, secretions, organs or other body fluids of infected nonhuman primates. Clinically, patient should be diagnosed based on signs and symptoms with history of travel from Ebola affected areas or exposure to EVD patients. All suspected patient should be investigated for IgM (enzyme-linked immunosorbent assay), antigen detection, and reverse transcriptase-polymerase chain reaction to confirm. Currently, no specific therapy is available that has demonstrated efficacy in the treatment of EVD. In the absence of specific therapy, a number of modalities have been tried. General medical support is critical. Steriod therapy has no role. There is no role for antibiotics unless there is evidence of secondary bacterial infection. Nutrition is complicated by the patient's nausea, vomiting, and diarrhea. Good hydration is to be ensured with good amount of protein supplement. Experimental vaccines are under trial.

Respiratory viruses (RV) have become an important cause of community-acquired pneumonia in immunocompromised patients with the highest rates of morbidity and mortality. The advances in molecular diagnostic methods have increased our understanding of the role of viruses in pneumonia. However, little is known about their impact on patients with human immunodeficiency virus (HIV) infection. In this review, we focus on the most prevalent RV that has been implicated in viral respiratory infections, particularly in pneumonia in HIV infected patients. We discuss the epidemiologic characteristics and clinical presentations of these viral infections and the most appropriate diagnostic approaches and therapies if available.

Streptococcus pneumoniae causes invasive and noninvasive infections. Among infectious diseases, invasive pneumococcal disease (IPD) is a leading cause of morbidity and mortality in children and adults. Community acquired pneumonia in adults is the main presentation of non-IPD and is the most common infectious source of IPD. The incidence, severity and mortality of pneumococcal disease vary widely depending on several factors, some are host related, and others are organism related. After introduction of the vaccine, rates of pneumococcal disease caused by vaccine serotypes have dramatically decreased among vaccinated children, nonvaccinated children, and adults. However, incidents of pneumococcal disease due to new emerging nonvaccine serotypes and antimicrobial resistance have increased. Continuous monitoring and surveillance studies focused on the clinical and molecular epidemiology of pneumococcal disease will be required to understand the impact of the new vaccines and possible alteration in the pattern of disease presentation.

In this era of immune suppression and potential biological warfare, we need to be aware of cutaneous manifestations of relatively uncommon bacterium, their atypical variants, and the early treatment protocols. We present atypical presentation of Indian possible tick typhus diagnosed clinically and confirmed both by biopsy of the lesion and serological tests.

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.

Atypical pathogen, especially Mycoplasma pneumoniae is a common and important pathogen of community-acquired pneumonia. Physicians should pay more attention on them. Compared with bacteria, the clinical treatment of atypical pathogens is different, as beta-lactams are not effective for atypical pneumonia. Therefore, laboratory diagnostic methods and clinical biology research is particularly important for the diagnosis and treatment of atypical pneumonia. In order to provide more theoretical basis for clinical diagnosis of atypical pathogens infection, we performed a review of the research progress of prevalence, laboratory testing of atypical pathogens related infections.

The novel mechanism of action of macrolides was discovered when a significant improvement in the survival of patients with diffuse panbronchiolitis (DPB) receiving low dose of erythromycin was observed, and when their beneficial effect was found to be independent of their anti-microbial activity. Macrolides that are members of the 14- and 15-ring groups show beneficial effects against DPB but not those of the 16-ring groups. We could recognize these effects of macrolides because their administration was associated with reduced inflammatory response in chronic airway diseases including upper- and lower-respiratory tract infections. The anti-inflammatory action of macrolides during infections by bacteria and virus with high virulence has been recently the focus of several studies. Thus, this interesting anti-inflammatory effect of macrolide is currently being assessed not only in the rare condition of DPB but also in common diseases such as viral airway infection. In this review, we will summarize the use of macrolides in common and rare diseases during the past 25 years.