Availability of adequate water and access to sanitation is essential to life, health, dignity, and considered as a fundamental human right. Ongoing conflict in Syria has resulted in the displacement of millions of people into the neighboring countries which has put tremendous pressure on already limited water resources. This limited water supply (which is also related to the poor sanitation) has increased the risk of water-borne diseases in the refugee population. Further, this increased demand of water and gap in supply has the potential to increase the tension between refugee population and local population. In the present article, we review the role of water, water needs, challenges to supply adequate water, and the effect of water needs and supply on the displaced and host population in the region.

Background: A 45 year old male was admitted with jaundice, abdominal pain and respiratory distress. He had history of chronic alcoholism. Materials and Methods: Blood tests revealed a raised leucocyte count of 19000/microlitre, high levels of bilirubin, amylase and lipase. Radiological investigations including chest x-ray, USG, CECT, and MRI gave findings of cholelithiasis, pancreatic pseudocyst, left sided pleural effusion and left lower lobe collapse. MRCP diagnosed choledocholithiasis. Pseudocyst fluid was aspirated and sent for culture and sensitivity. Results: Culture yielded pure growth of capsulated gram positive diplococci resembling Streptococcus pneumoniae. However, it was bile-insoluble and hence pure colonies were sent for confirmation by Vitek-2. Vitek-2 confirmed it to Streptococcus mitis sensitive to erythromycin, levofloxacin, linezolid and vancomycin. The patient responded to the antibiotics after surgery and was discharged. Conclusion: Streptococcus mitis is considered to be an oral commensal, sometimes causing infective endocarditis. However, as it contains almost all the virulence factors carried by it's close relative S. pneumoniae, and also can masquerade itself to the latter morphologically and biochemically to a great extent, it seems to walk a thin line between being a harmless commensal and a virulent pathogen. This incidence of infecting a pancreatic pseudocyst should make a microbiologist alert of considering a probability of it's increasing pathogenicity range.

Introduction: HIV/AIDS is a spectrum of disorders ranging from primary infection to the advanced disease, characterized by opportunistic infection and neoplasms. It is a chronic disease, which is prevalent in a significant number of population throughout the world and as well as in India. Approximately 10% of total people living with HIV/AIDS of India live in the state of West Bengal both in rural and urban area. This study was done to see the difference in socioeconomic status and demographic variation in the HIV patients, who were enlisted for the treatment in the antiretroviral treatment (ART) center of Murshidabad district of West Bengal. Methods: It was a cross-sectional and observational study conducted in the ART center of Murshidabad Medical College and Hospital from October 2014 to January 2017. The enlisted HIV/AIDS patients of ART center of Murshidabad district were included in this study after obtaining written consent from each patient. The data were analyzed by Microsoft Excel format. Results and Conclusion: A total of 822 HIV/AIDS patients were included in this ART center-based survey. The results showed that the incidence of HIV infection varies with the age, sex, literacy, occupation, and socioeconomic status. The incidence of infection was more in the sexually active male, illiterate, unemployed, and low socioeconomic status due to the lack of proper knowledge, abnormal behavioral pattern, and migration to distant places for employment.

Background: Pathologies of Helicobacter pylori infection show distinct regional patterns and are unclassified for Northern Ghana. Materials and Methods: Demographic and clinical data of 1580 patients who underwent upper gastrointestinal endoscopy (Tamale Teaching Hospital) were assessed. Results: The prevalence of H. pylori infection was 73.4%. Patients 31-50 years-old and >50 years-old had significantly more positive H. pylori tests than the ≤30 year-olds (odds ratios [ORs] [95% confidence interval [CIs]: 8.6 [6.637-11.22] and 6.1 [4.609-8.203]; both, P< 0.0001). Presenting symptoms were epigastric pain (67.3%), abdominal pain (21.5%), hematemesis (7.6%), and dysphagia (2.0%). H. pylori was diagnosed in 72.5% of patients with duodenal ulcers and 77.0% with gastric ulcer (n = 444). Gastric ulcer was significantly associated with H. pylori (OR [95% CI]: 1.3 [1.01-1.69], P= 0.042), and gastritis showed a positive but not statistically significant association. Conclusions: In Northern Ghana, H. pylori infection is associated with gastritis, gastric ulcer, and duodenal ulcer and is most common in middle-aged adults (31-50 years old).

Background: Youth princess' knowledge, attitudes, and beliefs toward exclusive breastfeeding are still low. Aims: This research would like to develop exclusive breastfeeding modules for princess youth in rural and urban areas. Methodology: This research uses a quasi-experiment design and implemented in urban and rural areas. Each consisted of intervention and control groups with samples (n = 127 and n = 104), while in rural areas (n = 126 and n = 103). The intervention group received learning with the Module plus Lecture Method (MLM), while the control group received the Learning Methods Module (LMM). Intervention was given to each school for 90 min. Knowledge, attitudes, and beliefs on exclusive breastfeeding are measured before and after intervention by questionnaire. Data analysis was performed using paired samples t-test and Friedman test. Results: The participants were aged between 15 and 16 years (67.6%), the birth order in the family was the first to second (61.3%), whereas the number of siblings was three to four (60.9%) and the 74.8% were Bugis. Seen increased knowledge, attitudes, and beliefs on exclusive breastfeeding after the intervention (P < 0.05) in all study groups. There was no difference in the increase in group knowledge in urban areas after the intervention P = 0.738. While rural areas, there is a difference in the increase in knowledge of MLM and LMM group P = 0.000. In addition, there was no difference in the improvement of attitudes and beliefs in all groups in the study area P > 0.05. Conclusions: LMM plus lecture and module learning methods can improve the knowledge, attitude, and belief of adolescent girls to exclusive breastfeeding. There is no visible difference between group receiving modules plus lectures and modules alone in urban areas. For rural areas, the group received a module plus lecture well than the module group alone on knowledge (P < 0.05), while attitudes and beliefs did not differ all groups in the study area.