Pigmented basal cell carcinoma diagnosed in a dental setup: Report of a case with review of the literature.

Pigmented basal cell carcinoma is a rare variant of basal cell carcinoma, with only a limited number of reported cases. Because of its similar clinical presentation, it is often over-diagnosed as malignant melanoma. Along with case presentation, the clinical, microscopic features, and differential diagnosis are discussed in this case report.

Expansion microscopy: A revolution in diagnostic pathology.

Expansion microscopy (ExM) is a recent discovery in diagnostic pathology and microbiology that promotes a physical magnification of the tissue specimen instead of optical magnification. It not only improves the resolution of the specimen but also enhances the diagnostic precision, and permits nanoscale imaging of the specimen. Optical microscopy is routinely used in histopathology and microbiology for ages. Due to its simplicity, compatibility with different types of specimens, and ease of operation it is accepted by pathologists. ExM and its variants have been widely tested in different types of tissue specimens and microbiological specimens and yielded brilliant results.

Imprints of COVID-19 lockdown on the surface water quality of Bagmati river basin, Nepal.

COVID-19 pandemic has caused profound impacts on human life and the environment including freshwater ecosystems globally. Despite the various impacts, the pandemic has improved the quality of the environment and thereby creating an opportunity to restore the degraded ecosystems. This study presents the imprints of COVID-19 lockdown on the surface water quality and chemical characteristics of the urban-based Bagmati River Basin (BRB), Nepal. A total of 50 water samples were collected from 25 sites of BRB during the monsoon season, in 2019 and 2020. The water temperature, pH, electrical conductivity, total dissolved solids, dissolved oxygen (DO), and turbidity were measured in-situ, while the major ions, total hardness, biological oxygen demand (BOD), and chemical oxygen demand (COD) were analyzed in the laboratory. The results revealed neutral to mildly alkaline waters with relatively moderate mineralization and dissolved chemical constituents in the BRB. The average ionic abundance followed the order of Ca2+ > Na+ > Mg2+ > K+ > NH4+ for cations and HCO3-> Cl- > SO42- > NO3- > PO43- for anions. Comparing to the pre-lockdown, the level of DO was increased by 1.5 times, whereas the BOD and COD were decreased by 1.5 and 1.9 times, respectively during the post-lockdown indicating the improvement of the quality water which was also supported by the results of multivariate statistical analyses. This study confirms that the remarkable recovery of degraded aquatic ecosystems is possible with limiting anthropic activities.

Intestinal Carriage of Extended-Spectrum ß-Lactamase- (ESBL-) Possessing Escherichia coli and Klebsiella Species among Nepalese Health Science and Non-Health Science Students.

Infections due to extended-spectrum ß-lactamase- (ESBL-) producing Gram-negative bacteria have led to increased mortality, morbidity, and economic burden worldwide. These bacteria can colonize the healthy intestine of human beings and can disseminate in communities and hospital. This study aimed to investigate the prevalence of fecal carriage of ESBL-producing Escherichia coli and Klebsiella species among health science (HS) and non-health science (NHS) students. This descriptive cross-sectional study was conducted on 104 HS and 104 NHS students in which one stool sample from each student was collected and processed for bacterial culture and sensitivity testing according to standard bacteriological procedures. Each morphotype was identified and characterized phenotypically. The antimicrobial sensitivity profile of bacterial isolates was determined by the Kirby-Bauer disk diffusion technique. ESBL production was tested by combination disk method as recommended by the Clinical and Laboratory Standards Institute. Out of 208 stool samples, E. coli and Klebsiella spp. were recovered from 203 (86.8%) and 31 (13.2%) stool samples, respectively. Among those 234 isolates, 69 were positive for ESBL which included E. coli (n = 66, 95.7%) and Klebsiella spp. (n = 3, 4.3%). Fifty (42.4%) out of 118 isolates from HS students and 19 (16.4%) out of 116 from NHS students were colonized by ESBL-producers. Compared to non-ESBL producers, a higher number of ESBL-producing isolates were resistant to ciprofloxacin (14.5% vs. 1.8%, p < 0.001), cotrimoxazole (59.4% vs. 16.4%, p < 0.001), and amikacin (10.1% vs 4.2%, p < 0.001). All E. coli and Klebsiella species isolates were susceptible to meropenem. The prevalence of fecal carriage of ESBL-producing bacteria was higher in HS students; however, there was a considerable number of these strains colonizing NHS students as well. This "iceberg phenomenon" of asymptomatic carriage of ESBL-producing pathogens might act as a source of infection in both the community and hospitals. Therefore, surveillance of carriage of drug-resistant bacteria should be performed regularly.