Phenotypic Detection of ESBL, AmpC, MBL, and Their Co-occurrence among MDR Isolates.

 Emergence of extended-spectrum beta-lactamases (ESBLs), AmpC β-lactamases, and metallo-β lactamases (MBL), and their co-existence among members of pose newer diagnostic and therapeutic challenges. The present study examines the ESBL, AmpC, and MBL production by various phenotypic methods and their co-occurrence among the multidrug-resistant (MDR) clinical isolates.  Four hundred non-repetitive clinical isolates were collected from the Central Referral Hospital, Sikkim.

Domperidone-induced dystonia: a rare and troublesome complication.

Domperidone is a commonly prescribed antiemetic drug but its side effects are rarely seen. Extrapyramidal side effects are a very rare complication of the drug occurring in 1/10,000 population. They usually occur in infants and very young children due to a poorly developed blood-brain barrier.

Phytobezoar leading to gastric outlet obstruction in a patient with diabetes.

Gastroparesis is a condition which results in delayed gastric emptying without gastric outflow tract obstruction. Gastrointestinal involvement in diabetes can present in various forms such as oesophageal dysmotility, gastro-oesophageal reflux disease, gastroparesis, enteropathy, non-alcoholic fatty liver disease and glycogenic hepatopathy. Gastroparesis is the most common gastric motility disorder complicating long-standing diabetes.

Pancreatitis in scrub typhus: a rare complication.

Scrub typhus is a zoonosis transmitted by a trombiculid mite which introduces bacteria of Orientia tsutsugamushi by its bite. The acute febrile illness is characterised by eschar at the site of the bite with maculopapular rashes and local and/or generalised lymphadenopathy. The disease is endemic in the tsutsugamushi triangle.