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Chryseobacterium spp., is non motile, non fermenter, Gram Negative Bacillus (GNB) showing enzymatic activity of catalase, oxidase, and indole production. Chryseobacterium spp. are found widely in the soil and aquatic milieu. It is also capable of surviving in chlorinated water, which can be attributed to the spread of infection in hospital settings hosting profusely immunosuppressed individuals. Newer diagnostic modalities like Matrix-Assisted Laser Desorption Ionisation-Time Of Flight-Mass Spectrometry (MALDI-TOF-MS) and Vitek-2 facilitate early identification and treatment can alleviate the infections caused by them. Present series discusses three cases of Chryseobacterium indologenes (C. indologenes) Urinary Tract Infection (UTI) Case 1-was a 61-year-old hypertensive and diabetic male patient diagnosed with renal failure with pyelonephritis. Case 2- was a female patient of 64-year-old with left upper ureteric calculus. Case 3-was a 31-year-old male patient having left mid ureteric calculus. All the patients were catheterised with a urinary catheter and developed UTI by C. indologenes. C. indologenes infection in UTI patients is uncommon but these cases of complicated UTIs demonstrate C. indologenes as a potential cause of UTI in hospitalised patients using invasive equipment like urinary catheters. As the organism was Multidrug-Resistant (MDR), appropriate antibiotic treatment and accurate identification can alleviate infection by this organism. [ABSTRACT FROM AUTHOR]

Introduction: Acinetobacter is a non fermenting, Gram negative bacillus, a causative pathogen of hospital-acquired infections due to its inherent Multidrug-Resistant (MDR) property. It is held responsible for the majority of nosocomial meningitis in patients undergoing neurosurgical procedures. Aim: To identify the clinical characteristics, drug-resistance and mortality rate among the patients suffering from meningitis caused by Acinetobacter baumannii. Materials and Methods: This retrospective, single-centre study was carried out in the Bacteriology section of the Department of Microbiology at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, from February 2019 to February 2022. A total of 150 Cerebrospinal Fluid (CSF) samples from routine bacterial culture-confirmed patients were included in the study. All clinical data were extracted from the Hospital Information System (HIS). All the isolates were identified by Matrix Assisted Laser Desorption/Ionisation-Time of Flight-Mass Spectrometry (MALDI-TOF-MS) assay and antibiotic sensitivity testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The study included 150 (7.55%) cases of culture-proven bacterial meningitis among 1986 CSF samples collected from February 2019 to February 2022. There were 45 (30.0%) cases of Acinetobacter meningitis. Thirty-five (77.8%) patients had undergone neurosurgical procedures for the removal of spaceoccupying lesions from the brain parenchyma. Forty-two (93.3%) isolates were resistant to amikacin and a cumulative resistance of almost 93.3-95.6% was observed among cephalosporins. Fluoroquinolone resistance was observed in 43 (95.6%) patients and carbapenem resistance was observed in 42 (93.33%) isolates. Overall, 12 (26.7%) succumbed to their infections. Conclusion: Acinetobacter meningitis causes delay in the recovery of the patient undergoing intracranial surgery, amounting to a delay in brain parenchyma healing in the case of neurosurgical patients. [ABSTRACT FROM AUTHOR]

Introduction: India is a major contributor to both maternal and neonatal death worldwide. Majority of these fatalities can be averted by adequate utilization of Antenatal care (ANC) services. Large scale surveys like National Family Health Survey follow hieratical characters in which subjects within the clusters are often correlated. The ordinary logistic model ignores this correlation and provide compromised estimate of effect size of predictors. Multilevel model that incorporates correlation is the appropriate method. Aim: To demonstrate the adequacy of multilevel logistic model over ordinary logistic model in hieratical data sets with ANC visits >4 and delivery assisted by Skilled Birth Attendant (SBA). Materials and Methods: This retrospective, cross-sectional study was conducted at the Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India, from October 2021 to March 2022. The data of 174607 women, who delivered the children within five years, obtained using cluster sampling, from country wide survey during 20th January 2015 to 4th December 2016 (India's National Family Health Survey-IV) was used. Firstly, the model adequacy of ordinary and multilevel logistic models was evaluated for ANC ≤4 visits and delivery assisted by SBA, the same data set of fourth round National Family Health Survey by considering the outcomes;. Thereafter, predictors of late or no registration of pregnancy were identified using three level logistic model. Results: Because of high Variance Partition Coefficients (VPC) at state and district levels, the multilevel model applied on components ANC ≥4 visits and delivery assisted by SBA suggested better accuracy of the multilevel logistic model (-2Log L=189334 for ANC ≥4 visits and 141148 for delivery assisted by SBA) than the ordinary logistic model (-2Log L=220268 for ANC ≥4 visits and 151978 for delivery assisted by SBA). For the late (registration in third trimester of pregnancy) or no registration of pregnancy, each predictor was found significantly associated in which the most important were women's education, child birth order, caste and wealth quintile. Conclusion: The present study concluded that multilevel logistic model in clustered design data was useful instead of individual level for more precise estimate of effect size of the predictors. [ABSTRACT FROM AUTHOR]

Introduction: Caesarean Section (CS) despite being one of the most commonly performed surgeries in the world has a wide variation in its techniques. To improve the outcomes of CS through rectification of the surgical techniques, it is imperative to assess the current practices amongst the obstetricians and analyse the rationale behind their surgical preferences. Aim: To assess the surgical techniques used for primary CS by obstetricians and review them with respect to the current evidence. Materials and Methods: The present descriptive, questionnairebased, cross-sectional study was carried out in the Department of Obstetrics and Gynaecology, Mayo Institute of Medical Sciences, Barabanki, Lucknow, Uttar Pradesh, India, in the month of May 2020. A total of 400 Obstetricians possessing diploma or degree in the speciality performing CS and willing to participate in the study were included. A pretested questionnaire majorly focused on the various surgical techniques of primary CS, performed by the obstetricians, was distributed online. A total 203 respondents completed the questionnaire and their response was recorded. Analysis of Variance (ANOVA), Independent samples t-test and Pearson's correlation coefficients were used to analyse the data. Results: Majority (n=140, 68.96%) of the respondents were between 25-40 years of age. In the study population, 8 (3.94%) were male respondents and 195 (96.06%) were female respondents. experience of <5 years. The most consistently used technique was the creation of bladder flap (187, 92.11%), while the least common was use of vertical incision (6, 2.9%) for opening the abdomen. There was a huge variation in the method of opening of the abdomen with 117 (57.6%) of obstetricians using blunt versus 86 (42.36%) using sharp dissection. The blunt extension of uterine incision was significantly associated with the increasing years of practice, whereas the preference to use Pfannensteil incision was significantly associated with the younger obstetricians. Conclusion: There was heterogeneity and variation in the CS techniques being practiced by the obstetricians. These varied practices were the result of surgeon preferences, their training and difficulty in unlearning the long used surgical techniques. These are bound to continue until strong evidence-based guidelines for the techniques of CS are formulated. [ABSTRACT FROM AUTHOR]

Aerococcus viridans is a rare Gram positive microorganism identified largely as environmental or skin contaminants. With the advent of an increase in the immunosuppressed population due to diabetes, the use of steroids and the Coronavirus Disease 2019 (COVID-19) pandemic, this bacteria caused a variety of infections like bacteraemia, urinary tract infections, and endocarditis. The use of Matrix-Assisted Laser Desorption Ionisation Time-of-Flight Mass-Spectrometry (MALDI-TOF MS), a unique technique of microorganism identification, has placed Aerococci among human pathogens, capable of causing infection among immunocompromised patients. The present case was of a 48-year-old female presented with dry cough, high-grade fever associated with chills and rigors, and generalised body ache and weakness for the past one week. She was a known case of bronchial asthma. She tested positive for COVID-19 and over the course of hospital stay, her BACTEC blood culture performed due to high fever which flagged positive indicated her as a case of Aerococcus viridans bacteraemia. Despite of all the efforts she developed respiratory distress followed by an episode of asystole following which she could not be revived. [ABSTRACT FROM AUTHOR]

Achromobacter xylosoxidans subspecies denitrificans flourishes in presence of oxygen, commonly isolated from aquatic milieu. It is rarely implicated as the causative agent of endocarditis. It is not known to cause virulent infections in patients but causes severe infections in immunosuppressed patients with underlying co-morbidities. Present report is first case of Achromobacter xylosoxidans prosthetic valve endocarditis from India. This case report accounts for a 47-year-old man, suffering from Rheumatic Heart Disease (RHD), who presented to the cardiology emergency with chief complaints of remitting type high-grade fever for years years followed by persistent fever for 10 days. On echocardiography and positively flagged BACTEC blood culture reports was diagnosed as a case of Achromobacter xylosoxidans subspecies denitrificans bacteraemia and prosthetic aortic valve endocarditis. Antibiotics were started according to the susceptibility testing but the patient could not complete the course of treatment as he developed dyspnoea and cardiac arrest following which he could not be resuscitated. [ABSTRACT FROM AUTHOR]

With an increasing number of COVID-19 cases and a lack of definitive treatment, there is an increasing burden on already stressed health care sector in India.The patients that require medical and surgical intervention need to be triaged and provided with adequate treatment. India has a major chunk of head and neck malignancy in the world attributable to tobacco use. These patients when diagnosed early have a fair survival rate. Health personals bear the responsibility to provide early and adequate treatment to these patients and at the same time, need to follow all measures to contain the spread of the virus. The present review highlights the various issues and newer guidelines in the management of head and neck malignancy patients during the COVID pandemic. The current review aims to present a comprehensive outlook of the updated evidence base available from PUBMED and other search engines. In India, treatment of head and neck malignancy patients are severely affected at this time of COVID-19, due to the long waiting period, delayed diagnosis, limited dedicated centres for head and neck cancer.The pandemic had diverted resources and manpower leading to potentially poor outcome of the head and neck malignancy patients. Triage policy, safety precautions for health care staff is the need of the hour and should be imbibed in regular practice. [ABSTRACT FROM AUTHOR]