Abstract: Background: Physical growth pattern and nutritional status using anthropometric measures are the key inputs to understand general health condition of the population even in micro level communities like tribal communities in India. In order to find out the present condition of physical growth pattern and nutritional status in such communities in a tribal dominated state with increasing impact of globalization and modernization, this present cross-sectional study was conceptualized to assess the physical growth patterns and nutritional status by using anthropometric measures among the Apatani and the Nyishi tribal children in Arunachal Pradesh, India through a comparative way. Methods: A total of 442 children (240 boys and 202 girls) aged 5 to 15 years living in rural areas of Lower Subarnasiri (the Apatani tribe) and Kamle (the Nyishi tribe) districts of Arunachal Pradesh, India were considered for the present analysis. The international standards were used to collect height and weight and other anthropometric data to understand physical growth patterns. BMI for age percentiles were calculated and used for nutritional status categorization. Results: The results revealed that the height (cm), weight (kg), Waist Circumference (cm), Hip Circumference (cm) and Mid Upper Arm Circumference (cm) showed a gradual increase over the age in both Apatani and Nyishi children. The maximum increase of anthropometric measures was observed between 10 and 13 years of age in both the groups but Apatani children were slightly taller and heavier than the Nyishi children. Apatani children had higher percentage of overweight and obesity compared to Nyishi children i.e. 12.6% and 9.5%, respectively. It may be due to the modification of traditional dietary pattern and regular consumption of fast food. Conclusions: Therefore, the Apatani tribal children were heavier and taller compared to Nyishi counterparts. Besides, both the undernutrition as well as overnutrition problem were observed among studied children, perhaps correlated with rapid alternation from traditional food consumption towards fast food and less physical activities in their early age.
Key words: BMI for age, children, height, weight, nutritional status, tribe, Arunachal Pradesh, India

Abstract: In community-based studies, mid-upper arm circumference (MUAC) appears to be a superior predictor of childhood under nutrition than many other anthropometric indicators. This study aimed to evaluate the nutritional status of children aged 2-5 years using mid-upper arm circumference (MUAC) cut-off values recommended by the World Health Organization in 2007. The present study was a cross-sectional study carried out in randomly selected 44 ICDS canters in Maynaguri Block, Jalpaiguri District, West Bengal, India. Children aged 24 – 60 months (Boys - 499 and Girls - 522) from three (Rajbanshi, Nama Shudra, Nashya Seikh) ethnic communities. Significant age variation was found among boys (F = 14.777; p< 0.001) and girls (9.465; p< 0.001). The overall percentage of moderate and severe undernourished girls (moderate – 25.67%; severe – 5.75%) is higher than the boys (moderate – 24.85 %; severe – 5.41%). Chi-square analysis shows a statistically significant relationship of under nutrition with age, birth weight, ethnicity, birth order, number of siblings, bath place, fuel of cooking, income level and Asia-specific maternal BMI level. Comparison with international studies reveals that the prevalence of under nutrition in the present study is higher than the children of Malaysia, Cameroon, Nepal, Nigeria and Pakistan. In the context of India, the present study reported a higher prevalence of under nutrition than the children of Midnapur South 24 Pargana of West Bengal, children of Odisha and Bihar.
Key words: Mid-upper arm circumference, Preschool, under nutrition, Z score, Socio-economic, Socio-demographic

Abstract: Background/Objectives: Increased longevity and declining fertility have increased the number of older population globally. Several factors make older population vulnerable to malnutrition. The purpose of this study was to find out predictors of Chronic Energy Deficiency (CED) of geriatric subjects. Materials and Methods: This study was conducted on 616 urban subjects (? 60 years) by adopting community based cross sectional design. Socioeconomic characteristics of the subjects was obtained by interviewing them using interview schedule. Their weight and height were recorded following standard technique. A subject with Body Mass Index <18.5 kg/m² was considered as victim of CED. Data analysis was done using SPSS version 22.0. For inferential purpose Adjusted Odds Ratios and 95% Confidence Interval were computed. Results: In all 44.8% subjects had CED. Age, religion, literacy status, and Socio Economic Status emerged as predictors of CED. Adjusted Odds Ratio (AOR) for CED was 4.05 (95% CI: 1.52- 10.77) in > 80 years and 2.20 (95%CI: 1.4-4.43) in 70-79 years age group. AOR for Muslims was 2.16 (95%CI: 1.31-3.56) for CED. Taking educational status intermediate and above as reference AOR for CED for illiterate and just literate was 2.53(95% CI: 1.10-5.81) and for primary plus middle was 2.42(95%CI 1.08-5.44). For subjects from lower socio economic status AOR was 1.74(95%CI: 1.02-2.96). Conclusion: Age, religion, literacy status and socioeconomic status were predictors of CED in geriatric subjects.
Key words: Body Mass Index, Chronic Energy Deficiency, Nutritional indices, Nutritional status, Urban geriatric subjects.

Abstract: Introduction: Blood culture is a proven gold standard method for the identification of causative agents of bloodstream infections. Prompt identification (ID) and antimicrobial susceptibility testing (AST) of organisms causing blood stream infections has a significant impact on the morbidity and mortality associated with these infections. The need to circumvent the slow turnaround time of conventional gold standard methods has paved way for the rapid automated systems. In this regard the automated identification aid in rapid diagnosis/treatment of bacterial pathogens. Aims: Evaluation of automated system Vitek-2 compact system with conventional blood culture method for the identification of organisms causing neonatal septicaemia. Materials and Methods: In this hospital-based retrospective study conducted in the Department of Microbiology in a tertiary care hospital, New Delhi. A total of 170 non duplicate isolates of both Gram Positive and Gram-Negative organisms recovered from blood samples were included. Organisms were processed on the Vitek-2 compact system and simultaneously from conventional method (ID) for comparison. Descriptive statistics was used for the presentation and comparison of data and appropriate statistical charts were used to present the data. Results: Concordant identification (ID) results of Vitek-2 compact system were seen with all the isolates of S. aureus, S. epidermidis, S. pneumonia, E. faecalis and E. faecium. Discordant results of Vitek-2 were noticed with S. hominis (5 isolates of the organism misidentified as S. epidermidis). Conclusion: The organisms having slow metabolic rates and late lactose fermenters (S. hominis) are prone to errors by the Vitek-2 compact system; hence need to be reconfirmed with other possible method.
Key words: VITEK-2 compact system, Bac T/ALERT, Blood culture, Neonatal septicaemia.

Abstract: Purpose: Sample rejection is an important quality indicator pertaining to the preanalytical phase of a laboratory workflow and has a wide range of implications. This study is aimed to determine causes of blood sample rejection, identify areas with maximum rejects and assess impact of targeted training on the same. Methods: A prospective analytical cross-sectional study was conducted in a diagnostic laboratory of a tertiary care hospital. Blood samples collected for clinical biochemistry and hematology tests were monitored for rejections. The study was divided into three phases, in Phase I, rejection rates were monitored without any targeted training, in phase II training was given to phlebotomists in areas of rejection. In phase III, targeted training was omitted to determine effect of stopping the same, however routine training sessions continued. An evaluation of efficacy of training interventions was performed by comparing specimen rejection rates and patterns. Results: The overall rejection rate was 0.43%. Maximum rejections were seen from general wards in all phases. Hemolyzed and clotted samples comprised the vast majority (64.65 % in phase I, 68.72 % in second phase and 69.28% in the third phase) of the total rejections. There was significant reduction in rejections during the training phase, but the effect was seen dwindling when upon cessation of training. Conclusion: Sample rejection rates were significantly reduced upon targeted training. However, challenge lied in maintaining sustainability of reduced rejection rates. The findings mandate reviewing and redesigning processes of training periodically in sites of phlebotomy for optimizing quality assurance practices.
Key words: Preanalytical phase, Quality Indicators, Blood specimen, Quality, Risk Management

Abstract: Introduction: Enterococci are major cause of health care associated infections and are resistant to commonly used antibiotics like cephalosporins. The study aims to find the proportion and characteristics of Enterococcus faecium isolates among the enterococcal infections at a tertiary care hospital. Methods and Material: A prospective cohort study was conducted in a tertiary care hospital in Mangalore, Karnataka for a period of 6 months from June to November 2023. The enterococci were isolated and identified and tested for antibiotic susceptibility by the standard methods. Results: Among the 132 enterococcal strains isolated from the clinical samples, 68 (51.51%) were E. faecalis and 61(46.21%) were E. faecium. E. faecium was significantly isolated more from the urine samples and from the inpatients. Also, the resistance to ampicillin (57.4% vs 14.7%), high level gentamicin (54.1% vs 36.8%), nitrofurantoin (37.7% vs 8.8%) and vancomycin (11.5% vs 1.5%) was significantly more among the E. faecium isolates, compared to the E. faecalis isolates. Resistance to linezolid was not found in the current study. Conclusion: In the present study, E. faecium strains were isolated in higher proportion compared to other studies. Therefore, there is an emergent need to combat this increase in E. faecium infections and the associated antibiotic resistance by scrutinising and encouraging appropriate antibiotic use in the hospitals and community.
Key words: Enterococcus faecium, Enterococci, antibiotic resistance, VRE

Abstract: Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) has been known as an infectious pathogen worldwide since 1960. The epidemiological distribution of MRSA may have shifted due to outbreaks reported from several nations, making it more challenging to differentiate among CA-MRSA and HA-MRSA. It is currently important to develop a strain-based explanation for HA and CA-MRSA due to its distinct epidemiology, genetic profile, antibiogram, and quantifiable features. The study aimed to distinguish CA and HA-MRSA by Staphylococcal Cassette Chromosome mec (SCCmec) typing. Materials and Method: The study involved a total of 381 S. aureus isolates, which were processed in the department of Microbiology, JSS Hospital, Mysore. All isolates were confirmed as MRSA, initially by disk diffusion method using cefoxitin 30µg and oxacillin 1μg disk and later by using PCR technique for the detection of mecA-gene. All mecA-gene positive samples were amplified for SCCmec typing by multiplex PCR for detection of SCCmec type I, II, III, IVa, IVb, IVc, IVd, V and XI respectively. Results: PCR confirmed a total of 66% isolates as mecA-positive MRSA. Multiplex PCR method revealed only 53% isolates were SCCmec-typeable. The mainstream of the isolates belonged to SCCmec type IV (53.48%) and type V (44.18%), followed by type III (9.30%), type II (3%) and type I (1.16%) respectively. The study also demonstrated the presence of multiple SCCmec types in 10.46% of MRSA isolates. Staphylococcal cassette chromosome recombinase (ccr) typing determined only 43% of isolates were typeable. Conclusion: The study found that hospital-associated SCCmec type IV and type V were the most circulating strains in our healthcare setting. The research identified a few MRSA isolates with diverse SCCmec types. The presence of CA-MRSA infection in in-patients and HA-MRSA infection in out-patients were also recognised. The situation indicates the spreading of hospital-acquired strains into the community and vice versa, necessitating the molecular characterisation of MRSA isolates in order to administer the appropriate antibiotic medication.
Key words: CA-MRSA, HA-MRSA, SCCmec typing, ccr-typing, Multiplex PCR

Abstract: Objective: The present study aims to assess pregnancy-associated plasma protein-A (PAPP-A) and beta human chorionic gonadotropins (β-hCG) as predictive markers to diagnose Gestational Diabetes Mellitus (GDM) in the first trimester of pregnancy in a population of India. Material and Methods A retrospective observational study was conducted, wherein the cohort of 975 pregnant women were enrolled. All the patients had first trimester aneuploidy screen and 171 pregnancies were diagnosed with GDM during pregnancy. Glucose challenge or tolerance test was carried out in each trimester for detection of GDM. Results The incidence of GDM was 17.4% in the cohort. The PAPP-A value (1.2 ± 0.69 vs 1.39 ± 0.80), age (30.1 ± 3.8 vs 28.4 ± 3.7 (years)), and Body Mass Index (24.09 ± 5.1 vs 21.71 ± 4.04) were significantly different in GDM group and non-GDM group respectively. The Receiver Operating Characteristic (ROC) curve provided the value of 0.57 as an area under the curve for the exclusion of GDM. A cutoff value of PAPP-A ≤0.95 MoM was found to have a sensitivity of 45% and a 70% specificity value for the diagnosis of GDM. The β-hCG values were statistically identical between GDM and non-GDM groups. Conclusion: This study demonstrates that PAPP-A MoM is inversely proportionate to GDM. The low normal value is associated with GDM. Hence, it can be a part of the early screening GDM tool but not sufficient as an individual screening test. Hence, glucose tolerance test is recommended for diagnosis of GDM. Pregnancies with GDM have decreased β-hCG, however, it was not significant.
Key words: Gestational diabetes mellitus, Beta - Human Chorionic Gonadotropins, Pregnancy Associated Plasma Protein -A, First-trimester aneuploidy screening

Abstract: Introduction: In hospitalized patients, candidemia accounts for considerable morbidity and mortality. Knowledge of local species epidemiology and antifungal susceptibility is important when considering therapy. This study was performed to speciate Candida isolates from inpatients admitted with blood stream infections in our hospital and to assess their risk factors. Materials and Methods: This present study of 2 years' duration was performed from April 2022 to March 2024. BacT/Alert aerobic culture bottle (bioMérieux, France) was used for all routine blood cultures and incubated for 5 days at 37°C. Any blood culture growing yeast was identified by Gram stain and MALDI-TOF MS (Bruker Daltonics). Disk diffusion method was used for antifungal susceptibility testing and test was performed according to clinical laboratory standard institute (CLSI) guidelines. Results: About 132 Candida isolates from blood were isolated in 2 years. Predominance of males (59%) was noted with the median age of 52 years. Majority were non- albicans Candida (81.06 %) with C. tropicalis (31.81%) and C. auris (13.63%). Susceptibility to fluconazole and voriconazole was 100% for both C. albicans and C. tropicalis isolates. Fluconazole resistance of 11.77% and 100% was observed in C. parapsilosis and C. auris isolates respectively. Conclusion: The predominance of non-albicans Candida with increasing fluconazole resistance and isolation of C. auris as the third most common non-albicans Candida species in this study is of concern. Accurate identification of non-albicans Candida specially C. auris and strict infection control policies should be in place to combat the spread of C. auris in the hospital.
Key words: Candidemia, Non-albicans Candida, Candida auris, MALDI-TOF

Abstract: Background: Rosai-Dorfman disease (RDD), or Sinus histiocytosis with massive lymphadenopathy, is a rare idiopathic disorder characterized by histiocytic proliferation. While lymph node involvement is predominant, extranodal manifestations pose diagnostic challenges, and only limited cases involving the breast have been reported. Methods: We present a series of RDD cases, including two in cervical nodes, one in perisplenic and aortocaval nodes, one in retroperitoneal nodes, one in the breast, and one in the nasopharynx. Clinical and histopathological features are examined to enhance our understanding of this complex disorder. Discussion: Comparison with literature reveals RDD predominantly affecting young and middle-aged individuals, with nodal involvement more prevalent than extranodal. Clinical and imaging challenges in extranodal cases underscore the importance of accurate diagnosis through histopathological and immunohistochemical analyses. Successful outcomes with various treatment modalities reaffirm the manageable nature of RDD. Conclusion: This series contributes to understanding RDD's varied clinical presentations, diagnostic intricacies, and successful management outcomes. Increased awareness, especially regarding rare extranodal involvements such as the breast, is crucial for accurate diagnosis and optimal therapeutic interventions.
Key words: Rosai-Dorfman disease, Sinus histiocytosis, lymphadenopathy, extranodal

Abstract: Thyroid inclusions or Ectopic thyroid tissue in cervical lymph nodes is a unique and intriguing phenomena that defies direct embryological explanation. In the lateral neck, thyroid ectopies account for just 1-3% of all cases. Despite its low frequency, this occurrence could make treatment decisions very difficult because it is rarely possible to discriminate between ectopic thyroid tissues and metastatic carcinomas in lymph nodes, especially in orthotopic thyroid tumors that are not clearly visible. We report a case of 64 years old male presenting with swelling in the anterior aspect of neck for 20 years. Patient underwent total thyroidectomy with bilateral neck node dissection. Histology revealed papillary carcinoma thyroid, with bilateral neck nodes showing benign thyroid inclusions.
Key words: Ectopic thyroid tissues, Thyroid inclusions.

Abstract: Synovial sarcoma of larynx is a rare type of mesenchymal malignancy which constitutes 8.5% of sarcomas in soft tissue .Synovial sarcoma usually occur in the lower extremities of young adults, it can also occur in other parts of the body, including the head and neck region, chest, and abdomen. Its occurrence in the larynx is particularly rare. In head and neck region soft tissue sarcoma constitutes only 1%. Among them 10% was synovial sarcoma . In this report, we present a case of synovial sarcoma that originated in the larynx and unfortunately recurred.
Key words: Synovial sarcoma, Larynx, Mesenchymal tissue, Cranial-Cervical region