The present study was done to detect the antibiotic resistance in S. pneumoniae. One hundred twenty S. pneumoniae isolates from clinical specimens and 50 from nasopharyngeal sites were subjected to antimicrobial susceptibility testing by Kirby Bauer disk diffusion method and minimum inhibitory concentration (MIC) determination for penicillin and cefotaxime non-susceptible isolates. A total of 22 isolates (18.3%) from clinical sites and eight (16%) from nasopharyngeal sites showed decreased susceptibility to penicillin by oxacillin disk diffusion test. MICs of 26 of these resistant strains ranged from 0.12-1 µg/mL (intermediate resistance) by broth dilution and E test. Only four isolates, two from sputum and two from nasopharyngeal swabs, showed MIC of 2 µg/mL (complete resistance). However, MIC of two cefotaxime resistant isolates (by disk diffusion) was in the susceptible range (0.5 µg/mL). Highest antimicrobial resistance was seen to cotrimoxazole (55.2%) and tetracycline (61.2%). Antimicrobial resistance to cotrimoxazole and tetracycline was much more in clinical isolates than colonizing isolates. Multi-drug resistant phenotype was detected in 76.9% (20 of 26) of isolates that were intermediately sensitive to penicillin and 50% (2 of 4) of penicillin resistant isolates (co-resistant to tetracycline and cotrimoxazole). Routine screening for antibiotic susceptibility is recommended for clinical isolates of pneumococci. Strains with reduced susceptibility to penicillin should be subjected to MIC determination to detect relative resistance or true resistance as such strains are associated with increased virulence.The choice of antibiotics should be guided by the prevalence of local resistance patterns of pneumococci.

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The report highlights the occurrence of basal cell carcinoma in a native Indian with oculo-cutaneous albinism, an association not frequently encountered. The clinical and histopathological features, which assisted to form the diagnosis, are outlined. A high degree of suspicion and timely recognition of the potentially aggressive neoplasm, under this unusual circumstance, is the key to its diagnosis.

Background: Coronavirus (Covid-19) pandemic can be referred to as a life-threatening war where every country is fighting with an invisible untold enemy. Realizing the disease severity and managing the prevention is crucial in current situations. Hence, it is time to follow the lockdown protocol until the situation improves worldwide. Method: We have searched all the possible validated resources such as WHO, governmental data-sharing portal, news media, blogs, and existing empirical studies. We identified the significant inputs from social media platforms provided by healthcare entrepreneurs, clinicians, and interrelated different domain experts. Here we qualitatively narrated an in-depth understanding of the phenomena and proposed a few steps to deal with the mental burden in developing country context. Result: There must be some effective strategy to reduce the mental burden and availability of the health consultancy services continuously to deal with such vulnerable situations. Telehealth is one such solution in a developed country where the healthcare system is well equipped to offer such services. Conclusions: Here, we have presented a few proposed steps that can be adapted/practiced dealing with a similar situation in developing and densely populated nation like India. This approach may help to deal with such emergencies and challenges for healthcare management in lockdown conditions.