Background: Bacillus (B.) cereus is widely distributed in different environments including hospitals and health centers that considered one of the highly resistant organisms to various antimicrobial agents. This investigation aimed to detect the incidence of B. cereus in hospital environments and their antibiotic susceptibility profile. Materials and methods: A total of 114 swaps were collected from different places in the hospital and divided into two groups, floors 56 (49%) and equipment 58 (51%). Swabs cultured on blood agar, bacteria were identified according to the morphological characteristics and microscopic examination that confirmed by Bacillus ChromoSelect Agar. The antibiotics susceptibility test was carried out by following the Kirby Bauer method by using 7 antibiotics from various classes. Results: From 114 specimens, 48 (42%) were positive for B. cereus. Antibiotic sensitivity test revealed highest resistance for ampicillin 33/48 (68.8%), cephalexin 31/48 (64.6%), and imipenem 25/48 (52.1%), and highest sensitive for ciprofloxacin 42/48 (87.5%) and gentamycin 40/48 (83.3%). The high positive correlation between cephalexin and ampicillin (r = 0.78, p = 0.001), tetracycline and ciprofloxacin (r = 0.64, p = 0.001), and no correlation between cephalexin and gentamycin (r = –0.063, p = 0.67). Conclusion: This study revealed a high prevalence of B. cereus in hospital floors and equipment with high resistance to various antibiotics including β-lactams and tetracycline. The monitoring of hospital environments is an important tool in the prevention of hospital-associated infection by B. cereus.

Introduction: The COVID-19 pandemic was a global threat that affected the economy as well as the health system of our country. Most of the rural areas and outside the urban areas were beyond the proper availability and accessibility of all health services. In this situation, technologies such as telemedicine service played an important role. These telehealth services tried to recover the health system at minimum cost-effectiveness and covered a major part of the population. Telemedicine physicians could reduce the burden on secondary hospitals and advise on the emergency conditions of the patients. The guidelines should be revised to address the weaknesses and establish an ongoing system of evaluation to permit future improvements in the health system. Telemedicine technologies will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of forms, and these practice guidelines will be a key factor for handling emergency health conditions in the future. Materials and methods: It was a record-based, cross-sectional study done in the Telemedicine Center at IPGMER, Kolkata, from 1st January to 31st January, 2022. Patients were interrogated by simple questionnaires over the telephone. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for COVID-19 antibody-positive or suspected COVID-19-positive patients was included in the study. Patients related to vaccines or enquiring other health-related problems were excluded. Result: In 92 patients, the mean age was 48.75 ± 4 and there were about equal no. of male and female patients. Among comorbidities, a number of hypertensive, chronic obstructive pulmonary disease (COPD), and diabetes mellitus were more. The duration of symptoms is more in these comorbid patients. Among antibiotics, azithromycin was the most prescribed. The percentage of encounters with antibiotics was much higher than the World Health Organization (WHO) standard. The percentage of drugs from the essential drug list was about the same as the WHO standard. The average consultation time was lower than 7 minutes of the WHO standard. Discussion: This study showed that comorbidities like hypertension, diabetes mellitus, COPD, etc., affected the duration and severity of COVID-19 symptoms. There were overuses of antibiotics as well as other drugs more than WHO indicators but consultation time was less than WHO indicators. More patients were satisfied with this service than in previous studies.

Background: Bronchial asthma, characterized by airway inflammation and hyperresponsiveness, affects millions worldwide, with a significant prevalence in India. Despite effective treatments with inhalation drugs, nonadherence to hand-held devices poses a substantial challenge, leading to uncontrolled symptoms and increased healthcare burden. Aims and objectives: This study aims to investigate the reasons for nonadherence to hand-held inhalation devices in bronchial asthma treatment, identify barriers, and propose strategies for improvement through various intervention approaches. Materials and methods: This qualitative study was conducted at a tertiary medical college in Bihar, India, included 229 patients with uncontrolled bronchial asthma. Data collection involved in-depth interviews (IDIs) and subsequent interventions targeting identified barriers, such as patient education, supply assurance, and behavioral interventions. Data analysis involved transcription, coding, and categorization of interview responses using qualitative research standards. Results: Analysis revealed multifaceted challenges contributing to nonadherence, including treatment costs, inhaler availability, lack of treatment response, and motivational issues. Following interventions, 15% of patients became symptom free, while 40% showed improvement. The study highlighted the importance of interventions in addressing adherence barriers and improving patient outcomes. Conclusion: Despite the challenges, proper interventions targeting identified barriers showed promising results in enhancing bronchial asthma treatment adherence and improving patient conditions. Further research with larger samples and longer follow-up periods is warranted to refine treatment strategies and deepen the understanding of adherence behavior in bronchial asthma patients.

Background: Cutaneous adverse drug reactions (CADR) are being frequently reported. However, there is a paucity of epidemiological data in the Indian setting. We aimed to determine the frequency of cutaneous ADR in our setup, identify the causative drug(s), and evaluate their treatment response. Materials and methods: We included the retrospective data of 40 patients with cutaneous drug reactions. Available history including medication history was taken and causality was determined. Descriptive statistics were used for data analysis. Results: The most common offending drugs were antimicrobials followed by non-steroidal anti-inflammatory drugs (NSAIDs)/DMARDs. Among antimicrobials, fluoroquinolones were the commonest culprit. The maculopapular rash was the commonest manifestation seen in 50% of cases followed by fixed drug eruption (FDE) in 15% of total cases. Three cases of Stevens–Johnson Syndrome (SJS) were noted in our study. Levofloxacin was the offending drug in one case and rest two cases were due to cephalosporins. Conclusion: Awareness is needed about the common causative agents of CADR, and these drugs must not be prescribed irrationally. Detailed medication history and clinico-pharmacological evaluation are extremely important for approaching any patient with CADR.

Background: Poisoning represents a significant public health concern globally, with varying epidemiology based on regional socioeconomic conditions, cultural practices, and healthcare accessibility. This study aimed to elucidate the patterns, demographics, and outcomes of different types of poisoning in a peripheral tertiary care hospital in India. Materials and methods: A retrospective, record-based observational study was conducted over 12 months, including 66 patients with poisoning, excluding drug abuse, insect, and snakebites. Demographics and clinical data were analyzed using SPSS, and confidentiality was maintained in line with ethical standards. Results: The study found a female predominance in poisoning cases (77%), with a mean patient age of 28.2 years. Organophosphate (OP) poisoning was most common (45.45%), followed by kerosene (10.47%) and unidentified drug poisoning (9.30%). The overall mortality was 10.6 and 7.5% of patients were referred to a higher-level center for advanced care. Conclusion: The prevalence of OP and kerosene poisoning underscores the need for increased public awareness and improved storage and handling practices. The higher incidence among females and significant referral rates to Tertiary Care Centers indicate a need for targeted preventive strategies and improved primary care management.

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, a neurological sensorimotor disorder characterized by irresistible restlessness and urge to move mainly the legs, often accompanied by unpleasant sensations. It is more common in the elderly. It can be primary or idiopathic and secondary to various systemic conditions like iron deficiency anemia, type 2 diabetes mellitus, vitamin B12 deficiency, uremia, radiculopathy, etc. Restless legs syndrome is a clinical disorder without any specific biological marker which affects sleep hygiene, and quality of life and compromises working hours of patients. It is frequently encountered but often overlooked. If properly diagnosed in appropriate time, it can be easily managed.

Background: The pattern of poisoning in India varies with socioeconomic status as well as region. A thorough understanding of the demographics and management of poisoning cases is essential for the development of well-informed policies, targeted interventions, and effective public awareness campaigns. The indiscriminate practice of self-medication in developing countries like India often leads to cases of overdosing, which poses a significant alarm. The present study aimed to explore poisoning cases in a tertiary care setup and determine the prevalence of self-medication-related overdosing as a cause of poisoning. Materials and methods: This cross-sectional observational study included emergency admission cases of poisoning in whom demographic data including age and gender were noted. Information on the type and cause of poisoning were noted based on clinical records and history elicitation from patients or their caregivers. In the case of drug overdose-related poisoning cases, the chemical nature of the drug and the mode of the drug procurement were probed. Data were analyzed statistically. Results: The study observed that the age group of less than 20 years was the most vulnerable, while the age group of more than 70 years was the least vulnerable. Females were most affected. Among the types of poisoning observed, accidental (49%) and suicidal (48%) intent were almost the same. About 2.55% of cases were homicidal. Drugs were most commonly the causative agents (39%). Among the drug-causing poisonings, self-medication-related overdose was as high as 40.98%. Among the various causative agents, sedatives-hypnotics were the most common causative drugs, including alprazolam, chlordiazepoxide, diazepam, and zolpidem. This was followed by antihistaminics, antitussives, and antihypertensives. On the contrary, prescription drugs were responsible for 59.01% of drug poisoning cases. Conclusion: The healthcare system including the healthcare professionals and various government programs must come forward to educate the masses regarding the hazards of self-medication. This will impart knowledge and understanding of the self-medication practices and will curb the associated menace.

Introduction: Schistosomiasis, also known as bilharziasis is a parasitic disease caused by blood flukes (Trematode worms) of the genus Schistosoma. Schistosomiasis is prevalent in tropical and subtropical areas, especially in poor communities without access to safe drinking water and a lack of sanitary facilities. It is rare in the Indian subcontinent. Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory condition. It is considered to be the prototype disease of neutrophilic dermatoses. Case description: Here we report a case of urinary schistosomiasis along with sweets syndrome in a case of 56 years old male residing at Digha, West Bengal. Although it is very rare in our country, it is probably the second case report of schistosomiasis in India after Maharashtra. Again, schistosomiasis complicated by sweet syndrome was never been reported worldwide. Conclusion: This case report should aware the physician treat any patient with fever with hematuria, particularly living in the coastal area and/or history of travel to the coastal area in our country or abroad.

Background: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a rare autoimmune disease associated with varied manifestations like rapidly progressive dementia (RPD) and other neuropsychiatric manifestations. Case description: A 65-year-old female presented with subacute onset rapidly progressive memory loss and behavioral disturbances along with extrapyramidal symptoms for 3 months. Her MRI brain and EEG showed no significant findings. On further evaluation, her anti-TPO levels and antithyroglobulin levels were found to be significantly elevated. Other causes of RPD were ruled out. The patient showed a dramatic improvement after administering steroids. Conclusion: Given the reversibility of clinical manifestations, SREAT should be considered in the differential diagnosis when evaluating such a clinical picture, and treatment with steroids should not be delayed if the diagnosis is considered. This case report highlights the importance of early identification and treatment with steroids for autoimmune causes of RPD.