India continues to have the persisting environmental problem of disposal of expired, unused, unwanted medicines. Since this has not been studied well, the exact repercussions, therefore, are not hitherto known fully. There are no laws in country worthy of handling this problem. The municipal corporations handling the waste have not been sensitized to it. The media are insensitive to it, and populations are disorganized to take up the issue. Hence, the environment continues to suffer and will end with higher complication of human life and environment.

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Background: Pseudomonas aeruginosa is emerging as a nosocomial pathogen by producing metallo-β-lactamases (MBLs) and acquiring resistance to many antimicrobial agents. The infections caused by metallo-beta-lactamases producing P. aeruginosa (MBL-PA) are associated with higher rates of mortality, morbidity, and overall healthcare costs. Aim: The aim of the study was to find the incidence of MBL in P. aeruginosa isolates and their antimicrobial resistance pattern. Material and Methods: A total of 180 non-duplicate P. aeruginosa isolates from various clinical specimens between April 2016 and March 2017 were subjected to susceptibility testing by disc diffusion test as per the Clinical and Laboratory Standards Institute guidelines 2015. Imipenem and meropenem resistant isolates were selected for the detection of MBL production by disc potentiation test and modified Hodge test. Results: Out of 180 isolates of P. aeruginosa, MBL was detected in 36 (20.00%) isolates. Resistance was significantly higher in the MBL-PA with 94.44% resistance to aztreonam followed by cefoxitin (91.66%), piperacilline/tazobactam and cefepime (80.55%). The prevalence of multidrug-resistant and possible extensively drug-resistant isolates was significantly higher among the MBL group as compared to that in the non-MBL group [50.00% vs. 11.11% and 5.55% vs. 0.69% (P = <0.05)]. None of the isolates were pan drug resistant. Conclusions: Increasing prevalence of MBL-PA producing isolates in hospital settings makes it important to perform routine detection of MBL strains for the purpose of infection control and for minimizing the adverse outcome of infection.

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Background: Antimicrobial resistance is a global health challenge with the increasing drug-resistant organisms even in community. Hence, there is a need for search of other alternatives to the antimicrobials which can replace or boost the activity of existing antimicrobials. Camellia sinensis (C. sinensis) is one of the most popular beverages worldwide and has been reported to demonstrate the antimicrobial activity against various pathogenic bacteria. Aim: The aim is to evaluate the antimicrobial property of green tea extract and its synergistic effect on antimicrobials showing resistance in clinical isolates. Materials and Methods: This cross-sectional, prospective, analytical study was conducted after due approval from the Institutional Ethics Committee. Green tea was procured and shade dried, and extraction was done by percolation and infusion method. The antimicrobial activities of these extracts were studied against standard strains and then on nonrepetitive clinical isolates from bacteriology laboratory showing resistance to the primary line of antimicrobials. Results: Our study showed antimicrobial action of green tea extract by percolation method against standard strain of Pseudomonas aeruginosa but not against Escherichia coli or Staphylococcus aureus. Minimum inhibitory concentration and minimum bactericidal concentration of green tea were found to be 12.5 μg/ml against standard strain of P. aeruginosa. The green tea extract exhibited synergistic activity against 21/30 clinical strains of nonfermenters tested from various clinical samples. No antibacterial action was found for extract prepared by infusion method against the standard American Type Culture Collection strains. Conclusion: C. sinensis could be explored as one of the alternatives or for synergistic action in combination with other antimicrobials for nonfermenters. Further investigation for potential toxicity and pharmacodynamic profile of the polyphenols is required.

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Introduction: Zika virus disease (ZVD) is a mosquito-borne arbovirus infection caused by Zika virus, a Flavivirus from the Flaviviridae family spread via a type of mosquito called Aedes mosquito, namely Aedes aegypti and Aedes albopictus which is also responsible for spreading diseases such as dengue, chikungunya, and yellow fever. Outbreaks of ZVD have been recorded in Africa, the Americas, Asia, and the Pacific. Materials and Methods: A cross-sectional study with complete enumeration was carried out among non-PG junior residents (JRs) of a tertiary care hospital of Delhi. Those who agreed to fill the questionnaire were included in the study after written consent. A self-administered, pretested, semistructured questionnaire, consisted of three sections, is used. Results: 125 (72.7%) participants had heard about ZVD, and almost 61% of participants believed A. aegypti to be the vector for transmission of ZVD. More than 80% of participants believed that ZVD outbreak is possible in India. The various reasons they quoted for the outbreak were environmental factors (50%), travel and immigration (16.3%), unawareness and unpreparedness (11.5%), host factors (9.6%), agent factors (6.4%), and easy transmission (4.7%). Approximately 90% of the study participants who have heard of ZVD knew that travel to the endemic area should be postponed. Participants with high level of knowledge according to knowledge score think that ZVD outbreak is possible in India in the future and they tried to gain more knowledge about ZVD. The results were found to be statistically significant. Conclusion: It can be concluded that the low knowledge among JR area is worrisome and a great deal of importance needs to be paid because health-care providers should be able to identify and screen potential patients to prevent further progression of this disease.

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Cervical cancer is more common in countries and regions with poor facilities, and they are often not well equipped with high-end equipment required for diagnosis. By way of this article, we would like to demonstrate with three case reports the use of minimal and available technology for documentation in screening and prevention of cervical cancer in clinics having basic facilities. The mobile camera is commonly available with clinicians/technicians these days. It can be used for capturing pictures of the cervix if colposcope is not available or for clicking microscopic pictures of Papanicolaou smears or histology slides to document abnormalities when inbuilt cameras are not functional or not available.

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Abdominal wall implantation malignancy or scar recurrence following laparotomy or laparoscopy is a rare and untoward occurrence. We present here a case series of five patients who developed scar malignancies, of which four patients underwent open abdominal surgery while the other had laparoscopic surgery.

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Accidental and unnoticed ingestion of foreign bodies (FBs) is not very uncommon. Most of such FBs pass through the gastrointestinal tract uneventfully and only on rare instances cause obstruction or perforation. We present here a case of unnoticed ingested plastic FB in an 11-month-old male child. The baby was presented to us with the complaint of acute intestinal obstruction. The plastic FB appeared as a radiopaque ring in the plain erect abdominal X-ray. The patient was managed by only sodium phosphate enema, which expelled the FB out through the anus.

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Introduction: Stool-based immunochromatographic test (ICT) requires validation for use in regional setups. Hence, this study was carried out to evaluate the diagnostic performance of a newly developed ICT kit (Pylori-Strip/Pylori K-Set, Corisbio). Materials and Methods: This was a prospective analytical study on patients who underwent upper gastrointestinal endoscopy. The combination of histology and urease was used as gold standard. Stool specimens were subjected to immunochromatographic stool antigen test using Corisbio stool antigen kit. The diagnostic performance of cassette and dipstick method and combination both was compared to the gold standard. Correlation of test efficacy with endoscopic, histological, and demographic parameters was carried out. Results: A total of 143 patients were included in the study. The diagnostic performance of cassette method and dipstick method was sensitivity, 73.3% (22/30) and 73.3% (22/30); specificity, 97.3% (110/113) and 98.23% (111/113); positive predictive value (PPV), 88% (22/25) and 91.66% (22/24); negative predictive value (NPV), 93.22% (110/118) and 93.27% (111/119); and overall accuracy, 92.3% (132/143) and 93% (133/143), respectively, when compared with the gold standard. The combination of the tests had a sensitivity of 73.3% (22/30), specificity of 97.3% (110/113), PPV of 88% (22/25), NPV of 93.22% (110/118), and accuracy of 92.3% (132/143). The diagnostic performance of the kit was unaffected by various demographic, endoscopic, or histological characteristics. Conclusions: The stool-based ICT is rapid and noninvasive diagnostic test with a high specificity, PPV and NPV, and overall accuracy. However, as the sensitivity is low, it should be primarily used as a rapid office test to determine eradication of Helicobacter pylori.

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Introduction: Diabetes mellitus (DM) type 2 (T2) is a metabolic disorder characterized by insulin resistance and affecting protein metabolism. There has been a great interest in the proteomic analysis of plasma and serum for the identification and characterization of protein biomarkers of different diseases. Materials and Methods: For the protein identification, one of the most important developments and technologies is the proteomics. In this work, the levels of protein biomarkers specific to T2 DM using sodium dodecyl sulfate polyacrylamide gel electrophoresis were identified and characterized. Results: Patients suffering from DM and normal healthy controls were recruited for this study. Biochemical and proteins biomarker assay were done. Some proteins were up and down-regulated in the samples of diabetes as compared to control. Conclusion: Assessment of the levels of biomarkers can aid early diagnosis and as well cure of T2DM.

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The physiology of sports embodies a wide and diverse range of scientific interests. It is a recent outlet emanating from the discipline of exercise physiology that encompasses application of the concepts of exercise physiology to training athletes and enhancing sports performance. Sports physiology, a field that was once pursued almost exclusively in research laboratories and cardiac rehabilitation programs, is now commonly applied in comprehensive sports medicine clinics. Cardiorespiratory fitness is one of the most important parameters of physical fitness of an individual. This can be evaluated by assessing aerobic capacity (VO_2max) and heart rate variability indices signifying the cardiac autonomic sympathovagal regulation. Both of these parameters derived from cardiorespiratory fitness assessment have been found sensitive to training effects in team sports players, thus of relevance in sports physiology.

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