Effectiveness, safety, and feasibility of outpatient parenteral antimicrobial therapy in a resource-limited setting: A pilot longitudinal study.

Background: Outpatient parenteral antimicrobial therapy (OPAT) offers a crucial method for administering intravenous/intramuscular antimicrobials outside of hospital settings, allowing patients to complete treatment safely while avoiding many hospital-acquired complications. This is a major boost or low-hanging fruit intervention in antimicrobial stewardship practices with multiple targets like decreasing hospital stays, its related complications, the economy, the burden on hospitals, However, resource-constrained countries like India practices rarely OPAT in an evidence-based way.

Aim: To evaluate the effectiveness, safety, and feasibility along with barriers and facilitators of OPAT practices in resource-poor settings, with a focus on its role in antimicrobial stewardship.

Different clinical profile of leptospirosis in a tertiary care Indian hospital: A Himalayan experience.

Background: Leptospirosis is a globally prevalent zoonotic disease with a significant burden in tropical and subtropical regions, including India. Despite its high fatality rate and endemic nature, the disease remains underreported in many areas, particularly in Northern India.

Aim: To analyze the demography, clinical presentation, complications, and mortality risk factors in presumptive leptospirosis patients admitted to a tertiary care hospital over the last 7 years from the Himalayan and Sub-Himalayan regions of Northern India.

Correct sepsis classification-A must for antimicrobial stewardship: A longitudinal observational study.

Background: Sepsis is a critical medical condition, and poses a substantial global health burden, with significant morbidity, mortality, and economic costs, particularly pronounced in low- and middle-income countries. Effective management of sepsis relies on early recognition and appropriate intervention, underscoring the importance of accurate classification to guide treatment decisions. The correct diagnosis will lead to effective antimicrobial stewardship practices.

Wrong diagnosis - Wrong antimicrobials: Rise in antimicrobial resistance in developing countries.

Antimicrobial resistance (AMR) is a growing global health crisis, disproportionately affecting developing countries. A key driver is the chain of wrong diagnosis leading to inappropriate antimicrobial use. Misclassification of infections-such as viral illnesses mistaken for bacterial infections-and failure to identify infection sources needing drainage or debridement result in unnecessary or ineffective antimicrobial therapy.

Chronic diarrhoea in a human immunodeficiency virus/acquired immunodeficiency syndrome patient: A case report.

Background: Chronic diarrhoea in people living with human immunodeficiency virus (PLHIV)/acquired immunodeficiency syndrome presents a diagnostic challenge, often resulting from opportunistic infections (OIs), malignancies, or disease progression itself. We present a case of an advanced human immunodeficiency virus (HIV) patient with chronic diarrhoea, significant weight loss, and antiretroviral therapy (ART) non-compliance, highlighting the diagnostic dilemma between HIV wasting syndrome, OIs, and malignancy.

Case Summary: A 36-year-old female, diagnosed with HIV five years ago on family screening, presented with three months of profuse watery diarrhoea, associated with crampy abdominal pain and weight loss (14 kg, 30% in 3 months).

Evaluating fever of unknown origin definitions in a tertiary care setting: Implications for diagnostic criteria revision.

Background: Fever of unknown origin (FUO) remains a diagnostic challenge and was originally defined in 1961. Its classic criteria include fever ≥ 38.3 °C (≥ 101 °F) on multiple occasions, fever lasting three weeks or longer, and a diagnosis after one week of inpatient evaluation.

Survival and quality-of-life in mucormycosis: a multicentric ambispective cohort study.

Objectives: We aimed to evaluate long-term survival and identify predictors of mortality among patients hospitalized with mucormycosis.

Methods: This prospective, multicentre cohort study included patients hospitalized for mucormycosis across 26 sites in India from March to July 2021. Follow-up data were collected at 1-, 3-, 6-, and 12-month intervals post-discharge through telephonic or in-person interviews with patients or caregivers.

Association of Markers of iron Metabolism with Mucormycosis: A Case Control Study.

Aim And Objective: To estimate the association of mucormycosis with markers of iron metabolism and to correlate levels of serum ferritin with stage of mucormycosis.

Materials And Methods: We conducted a case control study in hundred (50 cases and 50 controls) patients. Biopsy proven mucormycosis patients were taken as cases.

Emerging visceral leishmaniasis patients in mid Southern Himalayan region - A public health concern.

Background Objectives: Visceral Leishmaniasis (VL, Or Kala-azar) is a potentially lethal vector-borne disease caused by intracellular protozoa of the genus Leishmania, serve as the primary reservoir; traditionally endemic to Bihar, Jharkhand, West Bengal, and Eastern Uttar Pradesh of Indian states along river belts, has recently been observed in the past few years to a tertiary care teaching hospital located in Himalayan region (non-endemic, Uttarakhand). This study was done to identify the clinical features, demographics, complications and the risk factors involved in patients of non-endemic region a tertiary care hospital.

Methods: This retrospective study with present-day follow-up of all patients was done on VL patients who were admitted from Jan 2018 to Jan 2024.

Metronidazole-induced encephalopathy and polyneuropathy.

Though effective, metronidazole poses multiple side effects, especially with prolonged therapy or high dosage. Among these are metronidazole-induced peripheral neuropathy and encephalopathy, which are severely debilitating. We describe a middle-aged man with a liver abscess who was treated with metronidazole 2.

Antimicrobial prescription patterns in tertiary care centres in India: a multicentric point prevalence survey.

Background: Antimicrobial resistance (AMR) poses a global health threat, emphasizing the need for Point Prevalence Surveys (PPS) to understand antibiotic use and resistance. This study assesses antibiotic use patterns and resistance in tertiary care hospitals across India to inform AMR interventions.

Methods: This cross-sectional survey was conducted over two weeks between May and August 2023 in eight Indian tertiary care hospitals.

Repurposing Efavirenz, the HIV Antiretroviral Drug for Chikungunya Virus Infection.

Chikungunya virus (CHIKV) has frequently recurred in recent decades, causing outbreaks worldwide in tropical and subtropical regions. The re-emergence of CHIKV poses a substantial risk to human health, as no efficacious drugs are currently available to curb new outbreaks. Here, the anti-CHIKV activity of efavirenz was investigated by cell culture-based antiviral assays in different relevant cell lines.

Intractable Pruritus as Initial Presentation of Cytomegalovirus -Tuberculosis Coinfections.

Coinfection of cytomegalovirus (CMV) and Mycobacterium tuberculosis presenting with acquired perforating dermatosis is a rare occurrence and remains poorly described in the literature. A man in his 40s, a farmer and chronic smoker, who was partially treated for tuberculosis, presented with a history of fever, weight loss, cough, generalized lymphadenopathy, severe pruritus, and skin lesions. Imaging findings suggested tuberculosis, which was confirmed by sputum examination.

Dengue fever complicated with bilateral Psoas hematoma and superadded infection: A case report.

Dengue hemorrhagic fever (DHF) typically presents with various bleeding manifestations such as epistaxis, gum bleeding, and gastrointestinal bleeding. However, spontaneous large muscle hematoma formation is a rare complication. This case report discusses a patient with DHF who developed bilateral psoas muscle hematomas, a very uncommon presentation.

Disruption of Molecular Interactions between the G3BP1 Stress Granule Host Protein and the Nucleocapsid (NTD-N) Protein Impedes SARS-CoV-2 Virus Replication.

The Ras GTPase-activating protein SH3-domain-binding protein 1 (G3BP1) serves as a formidable barrier to viral replication by generating stress granules (SGs) in response to viral infections. Interestingly, viruses, including SARS-CoV-2, have evolved defensive mechanisms to hijack SG proteins like G3BP1 for the dissipation of SGs that lead to the evasion of the host's immune responses. Previous research has demonstrated that the interaction between the NTF2-like domain of G3BP1 (G3BP1) and the intrinsically disordered N-terminal domain (NTD-N) of the N-protein plays a crucial role in regulating viral replication and pathogenicity.

Primary Sjogren's syndrome presenting as hypokalaemic periodic paralysis and acute pancreatitis.

Renal tubular acidosis is a well-known consequence of primary Sjogren's syndrome (pSS), but a rare manifestation similar to acute pancreatitis in pSS. Here, we discuss the case of a woman in her 50s, who presented to a tertiary care hospital with recurrent episodes of sudden-onset weakness in all four limbs, recurrent vomiting and epigastric pain. She had non-anion gap metabolic acidosis with hypokalaemia and was diagnosed with pSS with hypokalaemic periodic paralysis.

Modeling the relative influence of socio-demographic variables on post-acute COVID-19 quality of life.

Importance: Post-acute sequelae of SARS-CoV-2, referred to as "long COVID", are a globally pervasive threat. While their many clinical determinants are commonly considered, their plausible social correlates are often overlooked.

Objective: To compare social and clinical predictors of differences in quality of life (QoL) with long COVID.

Pseudomonas and aspergillus symbiotic coinfections in a case of chronic obstructive pulmonary disease and diabetes mellitus.

Coinfection of Pseudomonas and Aspergillus has not been previously reported in patients with chronic obstructive pulmonary disease (COPD). A middle-aged, thinly built woman (Body Mass Index: 18.1 kg/m²) who smokes bidi (a type of tobacco) and has a history of exposure to open log fires for cooking, has been suffering from COPD for the last 4 years.

Community-acquired multidrug-resistant pneumonia, bacteraemia, and infective endocarditis: A case report.

Background: The prevalence of multidrug-resistant (MDR) bacteria has increased globally, with extensive drug-resistant (XDR) bacteria posing a threat to patients.

Case Summary: This case report describes a young man admitted for suspected tropical fever infections who experienced rapid deterioration in health. Despite negative results for tropical fever infections, he had neutrophilic leucocytosis, acute kidney injury, and chest imaging findings suggestive of bilateral consolidations.

Baseline findings of a multicentric ambispective cohort study (2021-2022) among hospitalised mucormycosis patients in India.

In India, the incidence of mucormycosis reached high levels during 2021-2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge.

Burkholderia-associated polymyositis.

A diagnosis of polymyositis can readily be made when there is a typical history of proximal muscle weakness together with clinical findings, and there is corroboratory evidence in the form of elevated creatine kinase lactate dehydrogenase, aldolase, and serum glutamic-oxaloacetic transaminase (aspartate aminotransferase). A muscle biopsy usually helps in making the confirmatory diagnosis. A female in her 50s presented with non-healing multiple deep necrotic ulcers with muscle weakness.

Study on good clinical practices among researchers in a tertiary healthcare institute in India.

Background: Good clinical practice (GCP) is put in place to protect human participants in clinical trials as well as to ensure the quality of research. Non-adherence to these guidelines can produce research that may not meet the standards set by the scientific community. Therefore, it must be ensured that researchers are well-versed in the GCP.