Objective: Non-neoplastic, non-inflammatory cysts of the central nervous system (CNS) may cause symptoms as a result of changes in pressure, rupture or secondary inflammation. The cyst-related details, such as its age, site, cyst wall, and its contents, also provide an insight into their embryology and histogenesis. This paper reviews the clinic-pathological features of cysts of CNS. Methods: In this study, a prospective analysis of the cysts of CNS diagnosed between November 2019 and October 2023 who presented to our outpatient department and managed at Command Hospital Lucknow and Base Hospital Delhi Cantt were reviewed. Written informed consent was taken from all patients. Cystic degeneration in tumors or inflammatory lesions was excluded from the study. Results: There were 35 cysts in the study period of 04 years. Majority of intracranial cysts presented with signs of raised intracranial pressure. Patients with epidermoid cysts had additional cerebellar signs, visual disturbances and deafness. Cord compression is the main presentation of all spinal cysts. Conclusion: Cysts of CNS are usually maldevelopment in nature. A few are acquired. The radiological identification of these cysts and pathological confirmation is necessary for prognostic purposes.

Introduction: Dermatophytosis form approximately 15-75% of all the mycological infections. Dermatophytes are closely related keratinolytic fungi with ability to degrade keratin and invade the skin, hair and nails causing dermatophytosis. Aim: To evaluate the Minimum Inhibitory Concentration (MIC) of antifungal drug against the isolated dermatophytes by broth microdilution method. Materials and Methods: The present cross-sectional study was conducted in the Department of Microbiology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India. The duration of the study was August 2018-August 2020. A 10-20% KOH mount was prepared from the skin scrapings, nail clippings, and hair bits to look for fungal elements. The specimens were also inoculated on Mycosel media and Sabouraud Dextrose Agar (SDA) with chloramphenicol. The dermatophytes were identified on the basis of colony characteristics, Lacto Phenol Cotton Blue (LPCB) mount, nutritional requirement, temperature tolerance, urease production, and in-vitro hair perforation test. Antifungal susceptibility testing was done for all fungal isolates and performed by broth microdilution method. The descriptive statistics were reported as means with their Standard Deviation (SD). Data were statistically evaluated with International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics for Mac, Version 25.0., IBM Corp., Chicago IL. Results: In this study, the MIC range for all the 165 isolates for dermatophytes tested for antifungal susceptibility showed that itraconazole, terbinafine and voriconazole showed the lowest MIC range of 0.0019-0.5 μg/mL followed by griseofulvin and fluconazole at MIC range of 0.125-32 μg/mL. The MIC50 of itraconazole and terbinafine was seen lowest at 0.0313 μg/mL followed by voriconazole at 0.0625 μg/mL, griseofulvin at 0.25 μg/mL for all isolated dermatophytes. Highest MIC50 with 4 μg/ mL was found for fluconazole against T. mentagrophytes and T. violaceum. MIC90 of terbinafine, itraconazole and voriconazole was seen lowest at 0.25 μg/mL followed by griseofulvin at 1 μg/ mL for all isolated dermatophytes. Highest MIC90 of fluconazole was recorded at 16 μg/mL for all isolated dermatophytes. Conclusion: Highest MIC50 with 8 μg/mL was found for fluconazole against all isolated dermatophytes. MIC90 of terbinafine, itraconazole and voriconazole was seen lowest at 0.25 μg/mL followed by gresiofulvin at 1 μg/mL for all isolated dermatophytes. Highest MIC90 of fluconazole was recorded at 16 μg/mL for all isolated dermatophytes.

Introduction: Chronic suppurative otitis media (CSOM) is defined as a chronic inflammation of the middle ear and mastoid cavity, which presents with recurrent ear discharge or otorrhea through a tympanic perforation. Aim: The study aimed to compare the effectiveness of topical versus combined (systemic and topical) therapy in ciprofloxacin-sensitive CSOM (tubotympanic). Materials and Methods: A hospital-based prospective study of 100 patients aged >18 years with clinically diagnosed CSOM (tubotympanic type) was conducted. After aural toilet, patients were randomly assigned to one of the two treatment groups: Group A (topical ciprofloxacin ear drops) Group B (topical plus oral ciprofloxacin). These patients were received 1 week of treatment and followed up on day 3 and day 7. Statistical comparisons were performed using Chi-square test. Results: In this study, maximum numbers of patients were found in the age group of 20–29 years. Patients in Group A (topical ciprofloxacin ear drops) showed less side effects in comparison to Group B (topical plus oral ciprofloxacin). Forty-one (82%) patients showed improvement in Group A, whereas 43 (86%) patients in Group B. Conclusion: Topical ciprofloxacin drops were as effective as combined (oral plus topical ciprofloxacin) and that the addition of oral drug did not have any beneficial effect adding only to the side effects and to the cost of treatment.

Staphylococcus aureus is one of the common causes of Healthcare-associated infection. Staphylococcus colonizes the anterior nares of the nose and tends to disseminate and secondarily colonize several other body sites including the skin and the gut. Colonized hospital personnel may be an important factor in dissemination. Staphylococcus aureus to patients and vice-versa. Mupirocin is an excellent topical anti-staphylococcal antimicrobial agent used for eradicating nasal carriage. Resistance to Mupirocin is a threat for future use of this drug in eliminating nasal carriage of Staphylococcus aureus. Thus, this study was conducted to determine the rate of Mupirocin resistance among Staphylococcus aureus isolated from nasal swabs of Health care workers (HCWs) of Operation Theatres (OTs) and Intensive Care Units (ICUs). A single nasal swab was collected from both the anterior nares of participating health care workers of ICU and OT once at the end of their shift. Antibiotic susceptibility testing of Staphylococcus aureus to various antibiotics was done by Kirby-Bauer disk diffusion method using CLSI guidelines. High and low-level Mupirocin resistance was determined. Among 282 nasal swabs collected, Staphylococcus aureus was isolated in 62 samples. Of Staphylococcus aureus 19 came out to be Methicillin-resistant (MRSA) and the remaining 43 Methicillin sensitive (MSSA). Mupirocin resistance was seen in 3 MRSA strains and 1 MSSA strain. Thus, overall 4/62 (6.5%) strains were MupR strains. Mupirocin is the most effective antibiotic used against colonization of Staphylococcus aureus in anterior nares. Resistance to this antibiotic is thus an alarm as well as a matter of great concern. Necessary steps, policies and guidelines need to be framed to stop the spread of this resistance.

Objective: Acute disc herniation (DH) is a common cause of low back pain (LBP). It ranks fifth in the category of diseases in terms of cost of hospital care. It has higher indirect costs due to absenteeism from work and disability than any other disease. The present study was performed to assess the clinical outcomes of non-surgically treated LBP patients after 6 months of follow-up. Methods: The present study was prospective study which was performed on 450 lumbar radicular patients visiting the neurosurgery outpatient department having clinical signs and symptoms of acute lumbar DH of less than 3 month duration. Their diagnosis was confirmed by magnetic resonance imaging. The patients were treated conservatively during 6 months. Pain and disability were assessed by visual analog scale (VAS) and Oswestry disability questionnaire, respectively. Results: About 135 (30%) female and 315 (70%) male participated in the study. During the follow-up period, 27 (06%) patients (21 male and 6 female) showed poor response to conservative treatment and motor weakness and underwent surgical intervention. A significant improvement in the VAS Score was seen after 6 months of conservative treatment than initial evaluation of patients (3.12±1.84, 7.1±1.43, p=0.00). Furthermore, significant improvement in disability score of patients was seen in follow-up period (25.82±16.92, 53.66±17.66; p=0.00). Conclusion: Results of our study showed that conservative treatment in patients of acute lumbar DH have significant improvement in pain relief and disability without any notable side effect.

Chronic Suppurative Otitis Media (CSOM) is commonly encountered chronic inflammation of middle ear as well as the mastoid cavity due to dysfunction of Eustachian tube followed by microbial infection. Fungal infection in CSOM is now a major otolarynological problem in India not only in children but in adults too. Excessive use of steroids, antibiotics, cytotoxic chemotherapies and immunosuppressive diseases has increased the incidence of otomycosis in recent years. To define the aetiology of clinically diagnosed otomycosis. To isolate and identify fungal agents and their association with different factors (age, sex, predisposing factors). A total of 100 clinically diagnosed patients of CSOM with suspicion of otomycosis were included in the study. Patients where passing swab is difficult as with canal stenosis were excluded. Samples were taken using sterile swabs and studied for microbial profile. Male to female ratio in study was 1.6:1. The most common fungi isolated in CSOM cases was Aspergillus fumigatus followed by Aspergillus niger. Other fungus isolated were Aspergillus flavus, Penicillium species, Mucor species and Candida species. 04 samples showed mixed growth of Aspergillus species and Candida species. In our study we concluded that Aspergillus complex was most commonly isolated fungi in CSOM cases.

Background: Carbapenems have the broadest activity spectra of any β-lactam antibiotic and are often the most appropriate agents for use in the treatment of infections caused by multi resistant gram negative bacteria. The recent worldwide emergence and dissemination of carbapenemase-producing Gram negative rods that are resistant to carbapenems is a significant concern with respect to patient care and infection control strategies. Hence this study was undertaken to study the magnitude of carbapenem resistance among routine clinical isolates of family Enterobacteriaceae so as to guide the clinicians in selection of appropriate antimicrobial chemotherapies and infection control measures.Methods: The present study was conducted in the Department of Microbiology over a period 18 months from January 2017 to July 2018. All the clinical isolates of Enterobacteriaceae were screened for carbapenem resistance as per CLSI guidelines. Such strains were then subjected to phenotypic confirmation of carbapenemase production by the Modified Hodge test. All isolates that gave a positive screening test were further evaluated for metallo-β-lactamase production. The technique used was the Combined Disk Test using a combination of Imipenem and Imipenem-EDTA.Results: Out of the 400 total clinical isolates of Enterobacteriaceae isolated in the laboratory,57 were found to be Meropenem resistant (14.25%) and were labelled 'Carbapenem resistant Enterobacteriaceae" or CRE. Modified Hodge test (MHT) performed on the 57 carbapenem resistant isolates showed 41 (71.93%) isolates to be carbapenemase enzyme producers. Combined disc test (CDT) conducted on the 57 isolates of CRE detected Metallo-β-lactamase (MBL) enzyme production in 39 isolates (68.42%).Conclusions: Since there is a high prevalence of carbapenemase resistance in our setting hence we need to be cautious with the indiscriminate use of broad spectrum antimicrobials, more so, the carbapenems.

Background: Acute febrile illness is a common presenting complaint during the rainy season. Rains predispose to both water and vector borne diseases. Co-infection of dengue with malaria, leptospirosis, typhoid, scrub typhus and other arboviral diseases can occur in endemic areas. Such dual infections are difficult to diagnose and create a diagnostic dilemma for the treating physician. Here in this study authors attempt to find out rates of concurrent dengue and typhoid infection.Methods: This retrospective study was done between August to November 2017. 403 patients presenting with acute febrile illness were studied. Diagnosis of dengue was done by rapid card test detecting NS1 antigen, IgM and IgG antibodies. Serodiagnosis of Salmonella infection was done by tube Widal test.Results: : Out of 403 febrile sera samples tested 154 (38.2%) were positive for dengue (either NS1 antigen or IgM antibodies or both), 71(17.6%) were positive for Widal test O and H titres ≥1:160) and 28 (6.9%) were positive for both dengue as well as Salmonella (Widal test).Conclusions: Acute febrile illnesses with diagnostic dilemma may be seen in cases of co-infection. Only better clinical judgement and right choice of laboratory tests can diagnose these diseases timely and prevent fatal outcomes.

Background: To evaluate the in-vitro antifungal activity of various essential plant oils against yeast species.Methods: The present study was a prospective study conducted in Department of Microbiology along with Department of Pharmacology at Tertiary care teaching hospital. Various clinical samples from ICU patients were inoculated on Sabourauds Dextrose Agar (SDA) in accordance with the standard methods. Yeast isolates were recovered and identified as per standard recommended procedure. The antifungal activity of plant oils against these isolated yeasts was determined using disc diffusion method. The results were interpreted as <9mm-inactive, 9-12mm-partially active, 13-18mm-very active. Fluconazole and Itraconazole were taken as control drugs.Results: The various yeast isolated were C. albicans, C. tropicals, C. krusei, C. glabrata, C. gulliermondi, C. keyfr, Cryptococcus and Tricosporon. Among essential plant oils, Cinnamon oil and clove oil showed high activity against all isolated yeast species. Olive oil showed least antifungal activity. Fluconazole was resistant in all yeast isolates, while Itraconazole was sensitive to all yeast isolates. Sensitivity of cinnamon and clove oil was statistically significant than Itraconazole.Conclusions: To conclude present study shows the potential of essential plant oils as newer therapeutic alternatives to antifungal drugs. These may be used in combination with antifungal agents to overcome drug resistance, adverse effects and in shortening the long-term treatment with antifungal drugs. Thus, these essential plant oils can be used in future as antifungal agents in azoles resistant strains.

Dioctophyma renale commonly known as "giant kidney worm' is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India.

Blastoschizomyces capitatus is an arthrospore filamentous fungus. Lung infection by Blastoschizomyces can develop as an opportunistic infection in patients with underlying conditions especially when there is immunosuppression including neutropenia. However, it can occur in non-neutropenic patients with solid organ transplant and patients whose local pulmonary defenses are altered by chronic underlying lung pathology. We report here a case of pulmonary infection by B. capitatus in an old tuberculosis patient.

Background: Tuberculosis is a significant cause of morbidity and mortality in the Indian subcontinent. A major challenge to clinical microbiology is the detection of Mycobacterium tuberculosis as accurately as possible. Objective: Tthe most important tool in the diagnosis of tuberculosis is direct microscopic examination of appropriately stained specimens for acid- fast bacilli and the gold standard for diagnosing tuberculosis is MTB convention culture on L-J media So, the present study was undertaken to compare smear microscopy by Z – N staining with conventional culture on L-J media, in cases of clinically suspected Pulmonary Tuberculosis and Extra Pulmonary Tuberculosis. Methods: 279 samples were processed within 24 hours of receipt. Samples from non-sterile sites were subjected to decontamination by the modified Petroff’s method. Sterile samples were directly processed as per conventional methods. Smear microscopy was done by Z- N staining and culture was done on L- J media. A control organism in the form of M. tuberculosis H37Rv was also tested with each batch of clinical isolates. Result: Results of smear microscopy and conventional culture of pulmonary and extra pulmonary specimens were compared. 22 and 14 more cases were detected by culture as compared to smear in case of pulmonary and extra pulmonary specimens respectively.Conclusion: From this study we can state that direct microscopic examination of appropriately stained Pulmonary and Extra Pulmonary specimens for acid fast Bacilli is an important tool in the diagnosis of tuberculosis. The Technique is simple, inexpensive and fast .However many Paucibacillary cases may be missed on smear microscopy. Thus specimens from all suspected cases of Pulmonary and Extrapulmonary Tuberculosis should be subjected to conventional culture on LJ media. This is the Gold Standard for Diagnosing Tuberculosis.

Balantidium coli is the only ciliated protozoan which is known to infect human and nonhuman primates. Route of infection is faecal-oral route. It is actively motile and causes mostly asymptomatic infections, or it may develop dysentery which is similar to that which is caused by Entamoeba histolytica. Here, we are describing a case of an accidental finding of B.coli in the urine of a patient who presented with acute renal failure, based on its characteristic morphology and motility which were seen on light microscopy. This is the third case of Urinary Balantidiosis which has been reported from India.

During the current investigation, 51 bacterial isolates/mutants of Azotobacter chroococcum, Azospirillum spp. and Gluconacetobacter diazotrophicus were tested for antifungal activity against three fungal pathogens, namely Rhizoctonia solani cotton, Rhizoctonia solani rice and Fusarium oxysporum tomato using a dual-culture technique under laboratory conditions. Ten isolates/mutants were found to be inhibitory against R. solani cotton, six against R. solani rice and twelve against F. oxysporum tomato. Nearly 50% of the isolates/mutants were siderophore positive. The antimicrobial substance was found to be extracellular and proteinaceous in nature, but in some strains it was found to be associated with other complex material also. Almost all the positive isolates/mutants showed production of antibiotic and antifungal compounds. On the basis of this study, in vitro results under laboratory conditions were reproduced in pot experiments in the greenhouse and chosen isolates/mutants of A. chroococcum were found to be effective biocontrol agents against R. solani cotton (disease index 16.7%) and R. solani rice (2.5%) in cotton crop, whereas in guar, the crop disease index was 2.5% against R. solani cotton, 13.3% against R. solani rice and 0% against F. oxysporum tomato in tomato crop compared with their respective checks.