Background: Stormy course has been reported among hospitalized adults with covid-19 in high- and middle-income countries. To assess clinical outcomes in consecutively hospitalized patients with mild covid-19 in India we performed a study. Methods: We developed a case registry of successive patients admitted with suspected covid-19 infection to our hospital (n=501). Covid-19 was diagnosed using reverse transcriptase polymerase chain reaction (RT-PCR). Demographic, clinical, investigations details and outcomes were recorded. Descriptive statistics are presented. Results: Covid-19 was diagnosed in 234 (46.7%) and data compared with 267 (53.3%) negative controls. Mean age of covid-9 patients was 35.1+16.6y, 59.4% were <40y and 64% men. Symptoms were in less than 10% and comorbidities were in 4-8%. History of BCG vaccination was in 49% cases vs 10% controls. Cases compared to controls had significantly greater white cell (6.96+1.89 vs 6.12+1.69x109 cells/L) and lower lymphocyte count (1.98+0.79 vs 2.32+0.91x109 cells/L). No radiological and electrocardiographic abnormality was observed. All these were isolated or quarantined in the hospital and observed. Covid-19 patients received hydroxychloroquine and azithromycin according to prevalent guidelines. One patient needed oxygen support while hospital course was uncomplicated in the rest. All were discharged alive. Conversion to virus negative status was in 10.2+6.4 days and was significantly lower in age >40y (9.1+5.2) compared to 40-59y (11.3+6.1) and >60y (16.4+13.3) (p=0.001). Conclusions: This hospital-based registry shows that mildly symptomatic or asymptomatic young covid-19 patients have excellent prognosis.

Aim: To find out the prevalence of Lower Respiratory Tract Infection (LRTI) such as bacterial, fungal, mycobacterial infections etc. in patients with productive cough of duration less than 15 days and to rule out the patients having previous history of tuberculosis or having treatment of tuberculosis. Materials and Methods:Outdoor and Indoor patients of Department of Medicine and Chest & TB, SRG hospital and Jhalawar Medical College, Jhalawar were included. After sample collection the specimens were sent to the Microbiology department, for processing of Gram staining, Acid fast staining, KOH mount and bacteriological culture and sensitivity.

Herpes Zoster is a common viral disorder, occurs due to reactivation of latent Varicella Zoster Virus (VZV) usually in adults or elderly patients, usually confined to a single dermatome. Herpes zoster duplex is a rare but well established entity which is simultaneous, occurring of herpes zoster at two different non contiguous dermatomes, can be unilateralis or bilateralis. Here we are reporting two cases of herpes zoster duplex bilateralis, in case-1 lesions occurs in two different distant dermatomes while in case-2 it appeared in a single dermatome but both sides were involved. Both the patients were healthy immuno-competent male.

Background & objectives Presence of cardiovascular (CV) risk factors enhance adverse outcomes in COVID-19. To determine association of risk factors with clinical outcomes in India we performed a study. Methods Successive virologically confirmed adult patients of COVID-19 at a government hospital were recruited at admission and data on clinical presentation and in-hospital outcomes were obtained. The cohort was classified according to age, sex, hypertension, diabetes and tobacco use. In-hospital death was the primary outcome. Logistic regression was performed to compared outcomes in different groups. Results From April to September 2020 we recruited 4645 (men 3386, women 1259) out of 5103 virologically confirmed COVID-19 patients (91.0%). Mean age was 46±18y, hypertension was in 17.8%, diabetes in 16.6% and any tobacco-use in 29.5%. Duration of hospital stay was 6.8±3.7 days, supplemental oxygen was in 18.4%, non-invasive ventilation in 7.1%, mechanical ventilation in 3.6% and 7.3% died. Unadjusted and age-sex adjusted odds ratio(OR) and 95% confidence intervals(CI) for in-hospital mortality, respectively, were: age ≥60y vs <40y, OR 8.47(95% CI 5.87–12.21) and 8.49(5.88–12.25), age 40-59y vs <40y 3.69(2.53–5.38) and 3.66(2.50–5.33), men vs women 1.88(1.41–2.51) and 1.26(0.91–1.48); hypertension 2.22(1.74–2.83) and 1.32(1.02–1.70), diabetes 1.88(1.46–2.43) and 1.16(0.89–1.52); and tobacco 1.29(1.02–1.63) and 1.28(1.00–1.63). Need for invasive and non-invasive ventilation was greater among patients in age-groups 40–49 and ≥60y and hypertension. Multivariate adjustment for social factors, clinical features and biochemical tests attenuated significance of all risk factors. Conclusion Cardiovascular risk factors, age, male sex, hypertension, diabetes and tobacco-use, are associated with greater risk of in-hospital death among COVID-19 patients.

Introduction: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the use of macrolide lincosamide-streptogramin B (MLSB) antibiotics to treat such infections. Aim: To assess the prevalence of phenotypic expression of inducible resistance for clindamycin due to expression of erm genes, in clinical isolates of Methicillin resistant Staphylococcus aureus from various clinical samples using modified D test. Materials and Methods: A total of 101 Methicillin resistant Staphylococcus aureus (MRSA) strains were included for induction tests which utilize closely approximated erythromycin, clindamycin and azithromycin discs (modified D test); the flattening or indentation of the clindamycin zone of inhibition adjacent to the erythromycin and / or azithromycin disk indicates inducible MLSB (macrolide lincosamide-streptogramin B) resistance. Results: Among the 101 clinical isolates, 37 (36.63%) isolates shows D test positive using Erythromycin, Clindamycin and Azithromycin combination. Inducible resistance to clindamycin using azithromycin was found in 5.94% isolates which was the major achievement of the study, which will be confirmed by genotyping in future. Conclusion: D-test should be performed on all MRSA isolates, to avoid erroneous reporting resulting in treatment failure, a partial modification in the D test can be made using azithromycin as it was helpful in our study, must be confirmed using genotyping.