Abstract: Background: Premalignant endometrial lesions are clinically important because they represent precursor changes that may progress to endometrial carcinoma if not detected and managed in time. Obesity and diabetes mellitus are recognized metabolic risk factors that contribute to endometrial proliferation through hyperestrogenism, insulin resistance, and chronic inflammatory changes. Women with these conditions frequently present with abnormal uterine bleeding and may harbor underlying premalignant endometrial pathology.

Aim: To determine the prevalence of premalignant endometrial lesions in obese and diabetic women presenting to a tertiary care hospital and to assess their association with demographic, clinical, laboratory, and ultrasonographic factors.

Material and Methods: This hospital-based descriptive cross-sectional study was conducted on 110 women who were obese and/or diabetic and underwent endometrial evaluation at a tertiary care hospital. Women aged 18 years and above presenting with abnormal uterine bleeding, postmenopausal bleeding, menstrual irregularities, infertility with suspected endometrial pathology, or increased endometrial thickness on ultrasonography were included. Detailed clinical history, physical examination, laboratory investigations, ultrasonographic findings, and histopathological reports were recorded on a structured proforma. Endometrial samples were obtained by pipelle biopsy, dilatation and curettage, or endometrial curettage as clinically indicated. Histopathological findings were categorized into benign, premalignant, and malignant lesions.

Results: The mean age of the participants was 46.18 ± 9.24 years, and the mean body mass index was 35.86 ± 4.18 kg/m². Among the study population, 61.82% were diabetic and 43.64% were hypertensive. The most common presenting complaint was abnormal uterine bleeding (34.55%), followed by postmenopausal bleeding (21.82%). Histopathological examination revealed hyperplasia without atypia in 25.45%, atypical hyperplasia/endometrial intraepithelial neoplasia in 14.55%, and endometrial carcinoma in 5.45% of women. The overall prevalence of premalignant endometrial lesions was 40.00%. Significant associations were observed between premalignant lesions and age greater than 40 years, postmenopausal status, higher BMI, diabetes, longer duration of diabetes, hypertension, increased endometrial thickness, heterogeneous endometrial pattern, poor glycemic control, and postmenopausal bleeding.

Conclusion: Premalignant endometrial lesions were highly prevalent among obese and diabetic women in this study. Increasing age, obesity severity, diabetes-related factors, and abnormal sonographic findings significantly increased the risk of premalignant pathology. Early endometrial assessment in high-risk women, especially those presenting with abnormal uterine bleeding or postmenopausal bleeding, may facilitate timely diagnosis and help prevent progression to endometrial carcinoma.

Abstract: Background: Candida infections are a major global public health challenge due to their high rates of illness and death. Species of Candida rank among the most prevalent fungal pathogens globally, causing a wide spectrum of clinical manifestations in both immunocompetent and immunocompromised individuals. Although Candida species commonly exist as commensal organisms in healthy individuals, the global emergence of fluconazole-resistant strains has become a significant concern.

Material and Methods: This prospective cross-sectional study was carried out in the Mycology Laboratory, Department of Microbiology at a tertiary care hospital. Sabouraud’s dextrose agar was utilized for the isolation of Candida spp. and further confirmed by Gram staining and germ tube test. Speciation was done following conventional and CHROMagar differential media. Antifungal susceptibility testing was performed using the disk diffusion method in accordance with the guidelines of the Clinical and Laboratory Standards Institute (CLSI).

Results: A total of 250 Candida species isolates were identified, of which 71.20% were obtained from IPD patients and 28.80% from OPD patients. Most of the isolates were recovered from female patients (52.4%), whereas 47.6% were obtained from male patients. Among all the Antifungal agents tested, the highest sensitivity was observed to Amphotericin B (94.8%). followed by Micafungin (89.2%) and Caspofungin (88.8%) In contrast, Candida spp showed high resistance to Fluconazole (53.60%) followed by Voriconazole (43.60%) and Itraconazole (37.60%). Fluconazole resistance was observed in 53.6% of isolates. Candida albicans exhibited the highest resistance to fluconazole, followed by non-albicans Candida species.

Conclusion: Candida species are opportunistic pathogenic organisms. The prevalence of fluconazole resistance among Candida isolates is steadily rising. The inappropriate and over-the-counter use of antifungal agents has contributed to this issue. The rise of fluconazole-resistant Candida albicans and non-albicans Candida species highlights the importance of species identification and antifungal susceptibility testing in the diagnosis and management of Candida infections.

Abstract: Background: Candida infections are a major global public health challenge due to their high rates of illness and death. Species of Candida rank among the most prevalent fungal pathogens globally, causing a wide spectrum of clinical manifestations in both immunocompetent and immunocompromised individuals. Although Candida species commonly exist as commensal organisms in healthy individuals, the global emergence of fluconazole-resistant strains has become a significant concern.

Material and Methods: This prospective cross-sectional study was carried out in the Mycology Laboratory, Department of Microbiology at a tertiary care hospital. Sabouraud’s dextrose agar was utilized for the isolation of Candida spp. and further confirmed by Gram staining and germ tube test. Speciation was done following conventional and CHROMagar differential media. Antifungal susceptibility testing was performed using the disk diffusion method in accordance with the guidelines of the Clinical and Laboratory Standards Institute (CLSI).

Results: A total of 250 Candida species isolates were identified, of which 71.20% were obtained from IPD patients and 28.80% from OPD patients. Most of the isolates were recovered from female patients (52.4%), whereas 47.6% were obtained from male patients. Among all the Antifungal agents tested, the highest sensitivity was observed to Caspofungin (80.40%) and Micafungin (80.40%) followed by Amphotericin B (78.80%). In contrast, Candida spp showed high resistance to Fluconazole (53.60%) followed by Voriconazole (43.60%) and Itraconazole (37.60%). Fluconazole resistance was observed in 53.6% of isolates. Candida albicans exhibited the highest resistance to fluconazole, followed by non-albicans Candida species.

Conclusion: Candida species are opportunistic pathogenic organisms. The prevalence of fluconazole resistance among Candida isolates is steadily rising. The inappropriate and over-the-counter use of antifungal agents has contributed to this issue. The rise of fluconazole-resistant Candida albicans and non-albicans Candida species highlights the importance of species identification and antifungal susceptibility testing in the diagnosis and management of Candida infections.