Real World Evidence of Bempedoic Acid on Efficacy and Safety in Patients with Uncontrolled LDL-c and at High Risk of CVD

Background and Objective: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality worldwide, with high-risk patients requiring effective management to reduce their risk of cardiovascular events. Bempedoic acid is a novel therapeutic agent recently approved as an add-on therapy to statins in patients with uncontrolled LDL-c. Bempedoic acid inhibits cholesterol synthesis in the liver, which ultimately reduces the risk of cardiovascular events. Therefore, the present study aims to assess the efficacy and safety of bempedoic acid in patients with uncontrolled LDL-c (Previously on moderate or high-intensity statins) with a high risk of CVD in real-world settings. Methods: This is a multicenter, retrospective, observational study on the data of high-risk-CVD patients collected from Bempedoic Acid on Efficacy and Safety in patients (BEST) Registry. The clinical data of 140 patients who were already on statin therapy and were receiving Bempedoic acid at a dose of 180 mg, along with measurements of the level of LDL-c, HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, serum creatinine was taken into consideration. The primary outcome includes a change in LDL-c level, and secondary outcomes involve a change in the level of HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, and serum creatinine at week 12 and 24. Adverse events were reported at both time points. Results: A total of 140 patients were included in the present study with a mean age of 51.8 ± 9.2 years and had primary confirmed diagnosis of dyslipidemia with uncontrolled LDL-c. The mean levels of LDL-c decreased from the mean baseline value of 142.67 ± 46.49 mg/dL, to 106.78 ±33.92 mg/d; a statistically significant reduction by 23.23% (p < 0.01) at week 12. Similarly, at week 24, the mean LDL-c value reduced to 90.39 ± 38.89 mg/dL. A 33.38 % decrease was observed (p < 0.01). Other parameters such as non-HDL, FPG, PPPG, AST and serum creatinine also showed statistically significant reduction at week 12 and week 24. Conclusion: The present study demonstrates that bempedoic acid is an effective add-on medication in lowering LDL-c levels in high-risk CVD patients with uncontrolled LDL-c.

Assessment of serum magnesium and correlation with glycemic control and complication in type 2 diabetes mellitus – A cross-sectional study in a tertiary care hospital in eastern zone of India

Background: Diabetes mellitus (DM) is an expanding global health problem. Type 2 DM (T2DM) patients account about 90% of total DM patients. Magnesium is important for different physiological mechanism. Hypomagnesemia is common in T2DM patient. Magnitude of hypomagnesemia is related with glycemic control and is associated with complications of T2DM. Aims and Objectives: Our aim of the study was to assess the prevalence of hypomagnesemia in patients of T2DM patients and to find their correlation with glycemic control and complications of T2DM patients in rural population of eastern zone of India. Materials and Methods: The hospital-based cross-sectional study includes 99 male and female DM patients between 15 and 60 years age. Fasting blood sugar, postprandial blood sugar, HbA1c, serum total magnesium, and urine albumin creatinine ratio were measured. Data were entered into Microsoft Excel spreadsheet and then analyzed by SPSS (version 25.0; SPSS Inc.) and GraphPad Prism (version 5.0). P < 0.05 was considered statistically significant. Results: From our study, we observed that hypomagnesemia is common in T2DM patients. The magnitude of hypomagnesemia is correlated with glycemic control (P < 0.0001). Moreover, hypomagnesemia is associated with diabetic kidney diseases (P < 0.05). Conclusion: It can be concluded that serum magnesium should be monitored in all T2DM patients and should be managed appropriately because hypomagnesemia may induce complications in T2DM patients.

A cross-sectional study to know the prevalence of thyroid dysfunction in systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is a persistent autoimmune disease, the pathogenesis of which remains elusive. Autoimmune factors may be a cause of SLE and thyroid dysfunction. Many studies have revealed that the prevalence of thyroid disorder is higher in SLE patients than in the general population. SLE is a multisystem and hypothyroidism is an organ specific autoimmune disorder and can occur successively or simultaneously. Aims and Objectives: The aim of the study was to study the prevalence of thyroid disorder in patients with SLE. Materials and Methods: Patients admitted with definite clinical features of SLE and Antinuclear Antibodies positive, in medicine ward and healthy blood donors are taken as control. Sample was tested by fully automated analyzer. Results: Subclinical hypothyroidism was found in 24% of study group and 8% of control group which is statistically significant. Central and secondary hyperthyroidism was found in 10% of study group and 12% of control group but it was statistically insignificant. Several studies have documented an association between SLE and other autoimmune diseases such as Sjogren’s syndrome, autoimmune hemolytic anemia, and antiphospholipid syndrome. Subclinical hypothyroidism was higher than another thyroid dysfunction such as primary, central, and subclinical hypothyroidism was found to be higher in frequency, probably depicting the slow destructive process which is pathognomic of autoimmune thyroiditis. Conclusion: Subclinical hypothyroidism was more prevalent in SLE than that of overt hypothyroidism as compared with general population.

Hyperprolactinemia among the patients of menstrual disorders in a tertiary care hospital

Background: Menstrual disorders are a common clinical problem due to multiple causes. Hyperprolactinemia, is disorders of hypothalamic-pituitary axis in young women, is usually associated with amenorrhea, oligomenorrhea, anovulation, and ovulatory cycles with short or inadequate luteal phase, and galactorrhoea. Menstrual disorder affects physical and mental health of every woman. Aims and Objectives: The aim of the study was to know hyperprolactinemia among the patients of menstrual disorders in a tertiary care hospital. Materials and Methods: Women with menstrual irregularities attending Gynae outpatient department and admitted initially checked clinically and their serum prolactin level were measured. Women in reproductive age group (15–45 years) with complain of abnormal uterine bleeding were included in the study. Menopausal women, women with organic diseases in uterus and cervix, and pregnant women were excluded from the study. Results: Prolactin level is statistically significant with age (P = 0.011). The patients from age group of 20 to 35 years had high proportion (14.4%) of hyperprolactinemia followed by age group <20 years. (12.9%) and >35 years (12.9%). The women presenting with menstrual disorders enlisted in the study were evaluated on the basis of their sociodemographic parameters. About (15.5%) were below 20 years. About (27%) were above 35 years and majority of the women (57.5%) enrolled in the study were from age group of 2035 years of age. Serum prolactin level was observed in 15.4% in patients with frequent menses, 9.1% in patients with metrorrhagia and 7.7% in patients with heavy menstrual bleeding. That result was statistically significant with P = 0.039. Conclusion: Serum prolactin level should be evaluated in every patient of menstrual disorders.

Hematological abnormalities in patients of alcoholic chronic liver disease – A cross-sectional study in a tertiary care hospital in Eastern Zone of India

Background: Alcohol abuse is on increasing trend in world as well as in India, especially in young population. Long-term alcohol intake may leads to alcoholic chronic liver disease which may turns in to end stage liver diseases. Alcoholic chronic liver disease is associated with some hematological abnormalities which if detected at early stage may provide clear therapeutic implications in managing these patients and reducing the adverse events. Aims and Objectives: Our aim of the study was to identify various hematological abnormalities in patients of alcoholic chronic liver disease. Materials and Methods: This hospital-based cross-sectional study includes 100 randomly selected patients with alcoholic chronic liver disease attending Out-Patient Department and admitted in General Medicine ward of Burdwan Medical College satisfying the inclusion and exclusion criteria. Data were analyzed for hemoglobin (Hb), red blood cell (RBC), total leukocyte count (TLC), platelet count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), MCH concentration, and prothrombin time-international normalized ratio. The mean and standard deviation, percentages, and ratio were calculated and presented in the form of tables with the help of SPSS (IBM) ver-23. P < 0.05 was considered statistically significant. Results: Hematological abnormalities were found more with increased duration of alcohol consumption. Prolonged bleeding time was observed in 23% cases and prolonged clotting time was observed in 21% cases. Maximum patients belonged to Child–Pugh grade C. Hematological abnormalities were more in patients belonging to Child–Pugh grade C. Hb, RBC, platelet, and packed cell volume were significantly lower in patients belonging to Child–Pugh class C, whereas TLC, MCV, and MCH were significantly higher in class C. Conclusion: It can be concluded that related hematological changes, which are common in alcoholic chronic liver disease endanger the lives of these patients. They should be detected and corrected at earliest to minimize morbidity and mortality.

Effects of air exposure, time, temperature, and humidity on different serum electrolytes

Background: Pre-analytical, analytical, or post analytical variations can induce, change, or alter the tests results. Laboratory errors lead to unnecessary delays in test report and also increased costs by repeat samples which have become a pain to the patients. Aims and Objectives: The aims of this study were to determine alterations in the concentration of serum sodium (Na+), potassium (K+), and ionized calcium (Ca++) concentration with reference to air exposure, time, temperature, and humidity. Materials and Methods: Fifty samples as case and 50 samples as control were included from a normal healthy population in this study. After getting the samples, first readings were taken for case samples and were uncapped and the remaining samples were set aside capped at 24°C, 20% humidity for half an hour and followed by second reading which was taken. Results: Variation in the mean serum sodium between groups is 0.06 mEq/L (0.04%) and 0.08 mEq/L (0.07%) which is very negligible and insignificant (P > 0.05). The mean level of serum K+ in cases is 4.35 mEq/L and in controls is 4.27 mEq/L. After half an hour, the mean level of serum K+ in cases is 4.51 mEq/L and, in controls, is 4.29 mEq/L. Hence, the variation in results in cases is 0.16 mEq/L (3.68%) and in controls is 0.02 mEq/L (0.47%) which is highly significant (P < 0.05). The mean level of serum Ca++ in cases is 1.15 mmol/L and in controls is 1.17 mmol/L. After half an hour, the mean level of serum Ca++ in cases is 1.09 mmol/L and in controls is 1.16 mmol/L. Hence, the variation in results in cases is 0.06 mmol/L (5.22%) and in controls is 0.01 mmol/L (0.85%) which is highly significant (P < 0.05). Conclusion: Air exposure significantly alters the serum K+ and Ca++ level, but the alteration in serum Na+ level is not significant.

Prognostic significance of mast cells and vascular density in prostatic adenocarcinoma

Context: Though mast cells infiltrate solid tumors, the exact role of mast cells in tumor biology is controversial. Mast cell density (MCD) may vary depending on its location in the tumor and tumor vascularity. MCD may influence the tumor aggressiveness. Aims: This study evaluates MCD and tumor vascularity in different histopathological grades of adenocarcinoma prostate. Settings and Design: Descriptive study with purposive sampling. Methods and Material: The subjects of study were 42 adenocarcinoma patients. 20 cases were of intermediate grade (Gleason score 2–7) and 22 were of high-grade (Gleason score 8-10). Histological diagnosis was made by examining sections stained with hematoxylin and eosin. Additional sections from the same block were stained for mast cells using Giemsa stains as per standard protocol. Mast cell count was done in minimum six random high-power microscopy fields in four different regions- intratumoral, peritumoral, stromal and perivascular regions. Statistical Analysis Used: SSPS software version 13.0. Descriptive statistics, Student's t test and ANOVA test. Results: In high-grade adenocarcinoma, mast cell counts were higher in perilesional, stromal and perivascular regions, whereas it was lower in intralesional areas as compared to the intermediate grade. However, statistical significance was observed only for the perivascular region. There was significantly higher number of blood vessels in high-grade adenocarcinoma as compared to intermediate grade adenocarcinoma. Conclusions: In this study, perilesional mast cells and vascularity increased with increased severity of adenocarcinoma. These findings suggest a possible influence of mast cells on the tumor microenvironment such as vessel density and aggressiveness of tumor. However, further studies are required to substantiate results of this study.

To Study the Clinical Efficacy and Safety of Remdesivir in Hospitalized Adult Patients with Moderate-to-Severe COVID-19 Disease in ICU of a Tertiary Center in Bihar

Background: Coronavirus disease 2019 (COVID-19) pandemic has adversely affected the human health and wealth across the globe and is still posing a serious challenge to us. In the armamentarium of various drugs approved for COVID-19, remdesivir proved to be a major breakthrough in the treatment of moderate-to-severe cases. Our study is regarding its clinical efficacy and safety in hospitalized reverse transcription polymerase chain reaction (RT-PCR) confirmed adult patients with moderate-to-severe COVID-19 disease. Material and methods: A total of 100 patients with moderate-to-severe COVID-19 (RT-PCR positive) admitted in the intensive care unit (ICU) of Sri Krishna Medical College and Hospital (SKMCH), Muzaffarpur, Bihar, were enrolled in the study from 12th August to 11th November, 2020. All patients were given injection remdesivir as 200 mg IV loading dose on Day 1, followed by 100 mg IV daily for next 4 days along with other standard treatment. Results: Out of total 100 patients, 88 patients recovered and were discharged, while 12 patients died. Mean age of patients was 54 ± 16 years with male preponderance (4:1). Mean duration of hospital stay was 10.6 ± 5.4 days. C-reactive protein, D-dimer, ferritin and interleukin-6 decreased significantly after treatment with remdesivir, with p value <0.01, as compared to values at the time of admission, without any significant side effects. Conclusion: Early administration of remdesivir helps contribute to better clinical outcome in moderate-to-severe COVID-19 disease, without any significant side effects.

Profile of distress callers and service utilisation of tele-counselling among the population of Assam, India: an exploratory study during COVID-19

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected people globally by causing psychological, social, and economic chaos. The Assam Police, India started telephone helplines to address the psychological issues. Aims: To evaluate the sociodemographic profile of the distress callers, their psychosocial concerns, the interventions provided by the service provider, and whether the service users were satisfied with the intervention(s) or not. Method: It was a cross-sectional study done during the period of lockdown (7-24 April 2020). All the callers who called the helpline were screened for anxiety, depression, suicidal thoughts (when required), and the psychosocial issues which they were facing were explored. They were provided the psychological intervention(s) at the appropriate time, and they were asked to rate their experience at the end. Results: A total of 239 callers used the tele-counselling services. The majority of callers were male (79.1%). Most of the callers were between 19-35 years of age group (66.5%), married (52.5%), and graduates (31%). Two-thirds of the callers called to seek guidance for their own issues and one-third for their relatives or friends. Callers had anxiety (46%), depressive disorder (8.3%), and depressive symptoms not qualifying for depressive disorder (14%), and suicidal thoughts (5.44%). The commonest intervention provided to the callers was supportive (77.8%), followed by psychoeducation (30.5%), cognitive behaviour therapy (24.7%), relaxation (23.6%) and behaviour therapy (13.4%). Most of the callers utilised more than one type of therapy. Overall, most of the callers were satisfied and appreciated the tele-counselling services. Conclusion: The findings could help in formulating psychological interventions to improve the mental health of vulnerable groups in the post-COVID-19 period to reduce psychiatric morbidity and mortality.

Postpartum depression and associated risk factors: a descriptive study in tertiary care teaching hospital

Background: Postpartum depression is a mood disorder that can affect women after childbirth which may cause feeling of extreme sadness, anxiety, and exhaustion that may lead to hamper of daily care activities for themselves and others. Aim: To determine presence of depression and associated risk factors among postnatal mothers. Methods and material: Fifty postnatal mothers, aged between 18-44 years were selected from the Department of Obstetrics and Gynaecology, Gauhati Medical College Hospital (GMCH), Guwahati, Assam, India. The presence of postpartum depression and maternal bonding with baby were assessed by using the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Bonding Instrument. Results: The prevalence of postpartum depression among mothers was 26%. Prevalence was found higher among the Muslim postnatal mothers. ‘Confidence and anxiety’ and ‘aggression to baby’ were found more significant which adversely affected bonding with their babies. Conclusions: Postpartum depression was found in a high number of mothers and it adversely affected bonding to their babies.

Generic Drug: Prescriber’s Perspective

Objective: Knowledge of doctors and their understanding of generic drugs could facilitate in recognizing potential barriers to larger generic medicine prescriptions. Hence, the primary objective of this study was focused to explore knowledge, attitude, and practice (KAP) of doctors toward generic medicines. Methods: It is a cross-sectional questionnaire-based study. The study participants are the doctors working in the hospital during the study period (2016–2017). The questionnaire designed for this study comprised of thirty-five questions related to the knowledge, attitude, and practice (KAP) of generic medicine and about demographic details of the participants. Results: A total of 86 questionnaires were distributed among the health care professionals and the response rate is 37%. The majority of doctors who participated in this survey perceived that generic medicine is effective, safe and need to have the same active component, dose and bioequivalent as the brand name medicines. Most of the doctors (72%) were of the view that generic drugs were manufactured in poor quality than branded medicines. More than three-quarters of doctors (78%) prescribed generic drugs. Conclusion: Majority of the participants had an honest angle about the efficaciousness and safety of generic and though they sometimes prescribe generic medicine, however a high range of doctors (72%) were of the opinion that generic was of poorer quality than brand medicine. To have a better understanding of the generic drug, the doctor must be well informed about the generics during their academic career resulting in savings to healthcare budgets.

Intra-psychic disarray of gender identity and sexual orientation: in the process of coming out as transsexual

The present paper takes a step towards understanding the confusion that a transgender individual undergoes, while coming in terms with one抯 gender identity. Here, we will be presenting a case study with few anecdotes to put forward concepts of negotiation, self-understanding, and disclosure. We will refer to the individual as 慼im� as the person identifies himself as a male and is in the process of transition. Here, we have introduced the coming out process as a one-way and two-way process.

Duration Dependent Antiapoptotic Efficacy Of Camellia Sinensis (GREEN Tea) On Streptozotocin Induced Diabetes Linked Testicular Hypofunction In Albino Rat: Genomic And Flow Cytometric Assessment

Objective: The study has been conducted to search out the threshold duration of treatment of ethyl acetate fraction of methanolic extract of leaves of Camellia sinensis (L.) Kuntze at the dose of 100 mg/kg body weight for the management of diabetes-induced testicular impairment in streptozotocin-induced diabetic rat in a duration dependent fashion. Methods: In this respect, the glycemic, androgenic, oxidative stress sensors, gene expression of testicular androgenic key enzymes along with apoptotic markers were evaluated in a duration dependent way (14, 28 and 56 d). Results: A significant correction was noted in the levels of glycated haemoglobin (HbA1C), testicular thiobarbituric acid reactive substances (TBARS), conjugated diene (CD), sperm viability, sperm mitochondrial status, serum testosterone, and genomic expression of testicular Δ5, 3β-hydroxysteroid dehydrogenase (HSD), 17β-HSD, Bax, Bcl-2 after treatment for different duration with the said fraction in diabetic groups in compare to respective vehicle-treated diabetic group without any toxicity induction in general. Thin layer chromatography (TLC) study of the fraction showed two spots with retention factors (Rf) of 0.78 and 0.51. Conclusion: The results showed that 28 d treatment was threshold duration of treatment for the correction of diabetes-induced testicular impairment.

Analysis Of Fatty Acids From Oil Of Green Tea (CAMELLIA Sinensis L) By Gas Chromatography Coupled With Flame Ionization Detector And Its Anticancer And Antibacterial Activity In Vitro

Objective: Tea is a widely consumed beverage worldwide. The effect of green tea is mainly due to its high polyphenols-(-) epigallocatechin-3-gallate (EGCG) content in the culture of cancer cell and bacterial cells. The present work was carried out to investigate the efficacy of green tea oil (GTO) against cancer cells and bacterial cells. Methods: In this study green tea oil was prepared from green tea for different experiment and determination of fatty acids profile from green tea oil. In the present study, peripheral blood lymphocyte (PBL) was chosen as human peripheral blood lymphocytes and blood cancer MCF-7 cells were chosen as human cancer cells. To fulfill our aims and also to evaluate the activity of this phytomedicine against normal lymphocytes and cancer cells the cell samples were divided into 26 experimental groups in the following ways. Each Petri dish contains 2 X 105 cells. Results: GTO shows a potent anticancer agent but nontoxic to normal cells. The GTO decreases the reduced glutathione (GSH) level and increase the oxidized glutathione (GSSG) level significantly (P<0.05) in MCF-7 cells. But in lymphocytes the GSH level and GSSG level were almost the same with the control group but doxorubicin (DOX) significantly decreased the GSH and increase the GSSG level. Green tea oil treatment causes generation of reactive oxygen species (ROS) in MCF-7 cells revealed by DCFH2DA staining. Agar diffusion test shows the GTO is effective against multi-drug resistant bacteria. Conclusion: This phytomedicine has a potent anticancer activity without damaging the normal lymphocytes. So, this drug can be used for further treatment of anticancer and antibacterial.

Construction and validation of logMAR visual acuity charts in seven Indian languages

Purpose: The evaluation of visual impairment requires the measurement of visual acuity with a validated and standard logMAR visual acuity chart. We aimed to construct and validate new logMAR visual acuity chart in Indian languages (Hindi, Bengali, Telugu, Urdu, Kannada, Malayalam, and Assamese). Methods: The commonly used font in each language was chosen as the reference and designed to fit the 5 � 5 grid (Adobe Photoshop). Ten letters (easiest to difficult) around median legibility score calculated for each language based on the results of legibility experiment and differing by 10% were selected. The chart was constructed based on the standard recommendations. The repeatability of charts was tested and also compared with a standard English Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart for validation. Results: A total of 14 rows (1.0 to -0.3 logMAR) with five letters in each line were designed with the range of row legibility between 4.7 and 5.3 for all the language charts. Each chart showed good repeatability, and a maximum difference of four letters was noted. The median difference in visual acuity was 0.16 logMAR for Urdu and Assamese chart compared to ETDRS English chart. Hindi and Malayalam chart had a median difference of 0.12 logMAR. When compared to the English chart a median difference of 0.14 logMAR was noted in Telugu, Kannada, and Bengali chart. Conclusion: The newly developed Indian language visual acuity charts are designed based on the standard recommendations and will help to assess visual impairment in people of these languages across the country.

Tea Seed: A Review

Tea (Camellia sinensis (L.) O. Kuntz) is one of the most economically essential beverage crops in all over the world and is considered to be the national drink. Tea seeds are borne in capsules, each containing one to three seeds. Seed is a means for reproduction and always possess variation within groups of seedlings. In nature, variability has an essential role in the production of the crop with quality and quantity. Tea seeds are recalcitrant and shown to lose viability very fast which makes their storage and transportation. In North East India, tea flowers from October to mid-February. Seed development right from flower bud initiation to maturity required 18 months. During seed maturation, the storage of carbohydrates in cotyledons continuously increases, and finally around 30% starch accumulates in tea seed cotyledons. Moreover, flower buds are a strong sink and approximately 46 percent of total photo-assimilates absorbed by developing flower bud. Tea seeds are planted in rows at a depth of about 1.5 cm. The macropile is usually pointed downward or parallel to the ground surface. Product diversification and value addition is currently an area of great interest. The oil extracted from tea seed has almost similar properties of olive and groundnut oils. High-quality detergent, soap, cream and hair oils can be made from tea seed oil.

Coagulase‑negative staphylococci causing blood stream infection at an Indian tertiary care hospital: Prevalence, antimicrobial resistance and molecular characterisation.

Introduction: Recent years have seen a rise of coagulase‑negative staphylococci (CoNS) from common contaminants to agents of nosocomial blood stream infections (BSI’s). Molecular typing and establishing a correlation with antibiotic resistance is essential particularly in countries like India where genotyping studies for drug‑resistant CoNS are sparse. Methods: A prospective study was done over 18 months, wherein 42,693 blood samples were received, and 59 patients with BSI due to CoNS were evaluated. The isolates recovered were identified by a biochemical test panel and matrix‑assisted laser desorption ionization – time of flight mass spectrometry followed by antimicrobial susceptibility testing by Kirby–Baur disc diffusion method and E‑test strips. Staphylococcal chromosomal cassette mec (SCCmec) element was characterised by multiplex polymerase chain reaction for all methicillin‑resistant (MR) isolates. Results: The majority of CoNS isolated were constituted by Staphylococcus haemolyticus (47.5%) followed by Staphylococcus epidermidis (33.9%), Staphylococcus hominis (11.86%), Staphylococcus cohnii (5.08%) and Staphylococcus warneri (1.69%). Among all isolates 57.6% were MR with statistically significant higher resistance versus methicillin sensitive‑CoNS. This difference was significant for erythromycin (76% vs. 44%, P = 0.011), rifampicin (50% vs. 12%, P = 0.002) and amikacin (26.5% vs. 4%, P = 0.023), ciprofloxacin (64.7% vs. 20%, P = 0.001) and cotrimoxazole (55.9% vs. 20%, P = 0.006). SCCmec type I was predominant (61.8%, P = 0.028) and exhibited multidrug resistance (76.2%). Coexistence of SCCmec type I and III was seen in 8.82% MR isolates. Conclusion: CoNS exhibit high antimicrobial resistance thereby limiting treatment options. The presence of new variants of SCCmec type in hospital‑acquired CoNS may predict the antibiotic resistance pattern. This is the first evaluation of the molecular epidemiology of CoNS causing BSI from India and can serve as a guide in the formulation of hospital infection control and treatment guidelines.

Molecular characterisation of antimicrobial resistance in Pseudomonas aeruginosa and Acinetobacter baumannii during 2014 and 2015 collected across India.

Background: Surveillance of antimicrobial resistance (AMR) is of great importance. Pseudomonas aeruginosa and Acinetobacter baumannii are important pathogens and emergence of resistance in these have increased the morbidity and mortality rates. This surveillance study was initiated by the Government of India ‑ Indian Council of Medical Research. The aim of this study is to determine the antimicrobial susceptibility profile and to characterise the enzyme mediated antimicrobial resistance such as extended spectrum beta‑lactamases (ESBLs) and carbapenemases among multidrug‑resistant (MDR) P. aeruginosa and A. baumannii. Materials and Methods: A multi‑centric study was conducted from January 2014 to December 2015 with a total number of 240 MDR P. aeruginosa and 312 MDR A. baumannii isolated from blood, cerebrospinal fluid, respiratory, pus, urine and intra‑abdominal infections. Kirby–Bauer disc diffusion was done to determine the antimicrobial susceptibility profile. Further, MDR isolates were characterised by multiplex polymerase chain reaction to determine the resistance genes for ESBLs and carbapenemases. Results: Among the ESBLs, blaVEB (23%), blaTEM (5%) and blaSHV (0.4%) in P. aeruginosa and blaPER (54%), blaTEM (16%) and blaSHV (1%) in A. baumannii were the most prevalent. Likewise, blaVIM (37%), blaNDM (14%), blaGES (8%) and blaIMP (2%) in P. aeruginosa and blaOXA‑23like (98%), blaOXA‑58like (2%), blaNDM (22%) and blaVIM (3%) in A. baumannii were found to be the most prevalent carbapenemases. blaOXA‑51like gene, intrinsic to A. baumannii was present in all the isolates tested. Conclusion: The data shown highlight the wide difference in the molecular mechanisms of AMR profile between P. aeruginosa and A. baumannii. In P. aeruginosa, plasmid‑mediated mechanisms are much lesser than the chromosomal mediated mechanisms. In A. baumannii, class D oxacillinases are more common than other mechanisms. Continuous surveillance to monitor the trends in AMR among MDR pathogens is important for implementation of infection control and to guide appropriate empirical antimicrobial therapy.

Declining trends of Syphilis seroprevalance among antenatal clinic cases and STD clinic cases in a tertiary care centre: From January 2002 to December 2012.

Syphilis affects nearly 1.36 million pregnant women, majority of these cases being concentrated in the developing countries. We aimed at analysing the 11 years’ trends in syphilis seroprevalence in antenatal clinics (ANC) and STD clinic cases. Laboratory data of syphilis cases from 2002-2012 were retrospectively analysed. Out of the total 73642 cases, 393 (0.53%) tested positive for Syphilis. A statistically signifi cant decline in syphilis prevalence was found in both ANC and STD clinic cases. The efforts of various interventional programs should continue to make the screening and treatment facilities readily accessible to continue the decline in syphilis seropositivity.