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Background: The emergence of antimicrobial-resistant bacteria has become a public threat, creating a burden on medical care in hospitals. Carbapenem-resistant organisms are a source of both community-acquired and healthcare-acquired infection that poses a substantial hazard to public health. This study aimed to conclude the prevalence of carbapenem resistance gram-negative bacteria from a clinical specimen at Index Medical College -Indore. Methodology: This study was conducted in the Department of Microbiology, at Index Medical College, Indore, between January 2020 and January 2022.The isolates were subjected to antimicrobial susceptibility tests by Kirby Bauer’s disk diffusion test. Most of the isolates were resistant to beta-lactam drugs, cephalosporin’s and aminoglycosides. These isolates were further confirmedby phenotypic detection usingthe Modified Hodge test, Modified carbapenem Inactivation, Combined disc diffusion test and Double Disk Synergy. Results: The percentage distribution of health-associated infection show highest resistance in both urinary tract and respiratory tract infection, followed by skin & soft tissue infection and least in septicemia and other health associated infection. Highest percentage of resistance was seen in the age group between 21-30 and the least in less than 10 years with a statistical significance of p-value=.00001. The most common isolates recover was E.coli in Enterobacterals and in Non fermenter it was Pseudomonas aeruginosa and Acientobacter. The sensitivity of MHT, mCIM, CDDT, and DDST within CI 95% were 74%, 95%, 84%, and 95% respectively. The overall prevalence of carbapenem resistance is 17.75%. Conclusion: The production of carbapenemase is the major mechanism underlying carbapenem resistance around the world and represents a great health concern. More knowledge is needed to control resistant genes and resistant organisms and their dissemination. There is an urgent need for global collaboration to plan valid strategies to prevent the spread of carbapenemase and the development of new antimicrobial molecules.

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Background: Globally, there are around 50 million Alzheimer's disease sufferers worldwide, a number that is expected to double every five years and reach 152 million by 2050. Traditional drugs for cognitive impairment are only palliative and do not cure the disease. Alzheimer's disease is characterised by memory and language loss, as well as difficulties with visual orientation and greater executive function. Aim: The present study aimed to examine various causes, mechanisms, and roles of different herbal components in the treatment of Alzheimer’s disease. Discussion: Since ancient times, several different plants have been utilised to improve memory and treat various dementia-related issues. These anti-AD plants include a wide taxonomic range due to acetyl choline esterase inhibition, antioxidant capacity, neuroprotection, mitochondrial energy restoration, and/or precipitated protein clearance. Secondary metabolites of these medicinal plants may be used to treat AD. AADvac1 is an active vaccination that stimulates an immune response by attacking numerous critical epitopes in pathogenic tau variants, thereby preventing tau aggregation and reducing the development of neurofibrillary tangles. Conclusion: Herbal plants are widely used because of their perceived effectiveness, safety, and low cost. To summarise, the evidence supporting the use of herbal components is promising, but more work is needed.

Aims: Nosocomial infections are the leading cause of mortality. ESKAPE organisms are the primary causes of nosocomial infection as these organisms are more or less carbapenem resistant. This study aimed to isolate and identify the etiological agents responsible for causing nosocomial infection and determine the carbapenemase producing organism by phenotypic and genotypic detection. Study Design: The study design is cross-sectional study. Place and Duration of Study: The study was conducted in the Department of Microbiology, at Index Medical College, Indore, between January 2020 and January 2022. Methodology: Total of 246 samples was collected from the patients who develop symptoms after 48- 72 hrs of hospitalization. Samples were processed for identification of etiological agents. Gram negative organisms were selected and further identified for carbapenemase enzyme. Screening was done by Kirby Bauer disc diffusion test and further confirmed by Modified Hodge test, Combined Disc test, Double Disc Synergy Diffusion test and Carbapenem Inactivation method. Genotypic detection was done by using multiplex polymerase chain reaction for KPC, NDM and OXA-48 gene. Results: Out of 107-gram-negative organisms, 19 (17.75%) were carbapenem resistant. Among 19 carbapenem resistant GNR, 13% MHT, 15% CCDT, 17% DDST and 17% mCIM were positive. The sensitivity and specificity of MHT, CCDT, DDST, mCIM were 74%/100, 84%/100,95%/100 and 95%/100respectively. The genotypic detection shows highest percentage of blaNDM 74% which is followed by bla OXA-48 31% and blaKPC 26%. Conclusion: Hospitals have become the hotspot for various microorganism causing nosocomial infections and are getting carbapenem resistance due to irrational use of antibiotics. Antimicrobial stewardship is one of the effective measures that minimize the resistance. Proper universal precaution can also minimize, spread of resistance in organism. If the last resort drug gets resistant, then it could be challenging for the clinician to treat their patients. Hospitals should have regular HAI meeting and release of antibiogram to know the pattern of these notorious organisms invading infection.