The gendered dimensions of an ‘herbicide revolution’: a feminist analysis of herbicide adoption in central India

The present study investigated the occurrence of Vibrio spp. in commercially available frozen foods from Jabalpur, Madhya Pradesh, India. A total of 133 samples, including frozen vegetables, ready to cook snacks etc. were analyzed using standard microbiological procedure, prescribed by the Food Safety and Standards Authority of India. Following pre-enrichment, selective isolation was performed on thiosulfate citrate bile salts sucrose (TCBS) agar, and presumptive isolates were confirmed by colony morphology, Gram staining, and biochemical tests. Overall, 2.26% of the samples were positive for Vibrio spp. The detection of Vibrio in frozen food products indicates potential microbiological hazards and emphasizes the need for routine surveillance and improved food safety practices to protect public health.

This study was conducted to investigate the occurrence of Escherichia coli in frozen food stuffs sold in market of Jabalpur, Madhya Pradesh. Total 133 samples of frozen foods i.e.,frozen peas, beans frozen cut vegetables, frozen snacks, frozen corn and frozen cottage cheese etc. were collected.After pre-enrichment, the selective isolation for E. coli was performed on Eosin Methylene Blue (EMB) agar plates. In total, 17% frozen samples were found contaminated with E. coli. The presence of E. coli was confirmed by presence of green metallic sheen on EMB agar and presence of Gram-negative bacilli under microscope and other biochemical tests. Our study shows that frozen foods may predominantly harbor E. coli as pathogenic bacteria, although other pathogenic bacteria may also be present.

X-chromosome Short Tandem Repeats (X-STR) have been utilized in forensics and population genetics studies for more than two decades, particularly in cases involving complex kinship analysis, disaster victim identification, sexual assault, and incest. Nevertheless, the genetic landscape of India remains underexplored using X-STR markers. In the present study, blood samples of 420 unrelated participants (133 females and 287 males) were analyzed from the Brahmin community of Gujarat, India. For the amplification of X-STR loci, the Investigator® Argus X-12 QS Kit was utilized. 186 unique alleles were identified, suggesting high genetic diversity of the Brahmin population. Locus DXS10135 (PIC = 0.930) was the most polymorphic, and locus DXS7423 was the least polymorphic (PIC = 0.553). On analyzing the haplotype diversity, Linkage Group-1 (LG1) was found to have the highest haplotype diversity (0.997). Notably, LG1 was also the most informative and polymorphic linkage group (PIC = 0.994), preceded by LG4 (PIC = 0.989), LG2 (PIC = 0.988), and LG3 (PIC = 0.983). Based on the allelic and haplotype frequencies, the combined estimates for PDF, PDM, MECDesmarais, MECKishida, MECKruger, and MECDesmarais duo were ≥ 0.999, demonstrating high discriminatory power of all the loci. Furthermore, inter-population phylogenetic analysis revealed high genetic affinity of Gujarat's Brahmins with other populations of the Indian subcontinent, encompassing Madhya Pradesh's Bhil tribe and Punjab's Jat Sikh. The Gujarat Brahmins also have a shorter genetic distance with other South Asian populations, including the Bangladeshi population. This research indicates that the studied X-STR markers are highly polymorphic, offering significant insights for individual identification in forensics.

Despite growing coverage of health insurance among the Indian population, the indigenous (tribal) populations, who are socio-economically disadvantaged, are yet to be covered. This leaves many households vulnerable to out-of-pocket and catastrophic healthcare expenditures. The present study reports the prevalence of health insurance coverage and its associated factors among the tribal communities in India. A cross-sectional study was conducted across 19 tribal-dominated districts in 12 states of India. A sample of 35,870 households was selected using a multi-stage sampling method. A pre-tested, interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, healthcare access, health worker contact, and coverage under health insurance schemes. Andhra Pradesh and Uttarakhand states show higher proportions (~ 93%) of health insurance coverage, followed by Meghalaya (78%) and Assam (70%). In contrast, Himachal Pradesh (1%) and Madhya Pradesh (4%) have very poor health insurance coverage. Multiple logistic regression analysis reveals a significant geographical variation across states. Other variables, such as gender, age, tribe type, education, occupation, annual income, health worker's visit to the village, regular source of health care, and village type, were found to be significant factors associated with households having insurance coverage (p < 0.001). These study findings indicate considerable inter-state variation and persisting inequities in health insurance coverage among tribal populations. Strengthening awareness, enrolment support, and outreach through frontline health workers is essential to improve equitable coverage in these communities.

Background: Urinary incontinence (UI) affects 30–45% of postmenopausal women in India, yet evidence from nurse-led pelvic floor muscle training (PFMT) interventions in Indian primary healthcare settings remains scarce. Objective: To evaluate the effectiveness of a structured 12-week nurse-led PFMT programme on UI severity and pelvic floor muscle strength among postmenopausal women. Methods: A prospective, single-blind, parallel-group randomised controlled trial was conducted at community and primary health centres affiliated with Index College of Nursing, Indore, Madhya Pradesh. One hundred and twenty postmenopausal women (aged 45–70 years) with self-reported UI were randomised to the intervention group (n = 60; structured PFMT) or control group (n = 60; usual care). Primary outcome: UI severity (ICIQ-UI SF). Secondary outcomes: pelvic floor muscle strength (Modified Oxford Scale) and sustainability at 6 months. Results: At 12 weeks, the intervention group demonstrated significantly lower ICIQ-UI SF scores compared to controls (7.68 ± 3.81 vs. 13.70 ± 3.40; t = −9.123, p &lt; .001, Cohen's d = 1.67). Pelvic floor strength improved by 1.52 ± 0.51 Oxford grades versus 0.42 ± 0.29 in controls (p &lt; .001, d = 2.65). Benefits were sustained at 6-month follow-up (ICIQ-UI SF: d = 1.83). The intervention was effective across stress (p &lt; .001), mixed (p &lt; .001), and urgency (p = .023) UI subtypes. Conclusion: Nurse-led PFMT significantly reduces UI severity and strengthens pelvic floor muscles in Indian postmenopausal women. These findings support the integration of PFMT into primary healthcare nursing practice.

Road dust resuspension represents a significant yet inadequately quantified contributor to urban particulate matter (PM) pollution in Indian non-attainment cities. This study aims to quantify road dust emissions and characterize the elemental composition of road dust in Ujjain, Madhya Pradesh-a city designated as non-attainment under India's National Clean Air Programme (NCAP), through systematic field measurements, traffic surveys, and chemical characterization. During October 2023, road dust samples were collected at 11 strategically chosen sites that represent a variety of traffic densities with the help of the U.S. EPA-standardized protocols. The silt loading values showed that there was significant spatial heterogeneity of 4.3g/m2 at Malkhamba Statue and 15.2g/m2 at Piplinaka Chauraha with a city average of 8.4 ± 3.6g/m2 (coefficient of variation (CV) = 43%). Extensive traffic surveys were recorded in terms of vehicle make-up in five categories with daily traffic volumes of 15,800 to 57,655 vehicles. The bcity-wide estimates of 132.37 tons/day PM10 and 32.03 tons/day PM2.5 were found by the use of the U.S. EPA AP-42 emission methodology. Ujjain Ring Road was the largest emitter of the total measured emissions 41.34 tons/day PM10. Wavelength dispersive X-ray fluorescence (WD-XRF) analysis revealed a dual-source structure: predominant crustal elements (Fe: 19.21%, Si: 14.2%) from soil and agricultural dust and traffic-related heavy metals (Zn, Cu, Ni, Cr, V) from non-exhaust vehicle emissions. Three high-emission hotspots Ujjain Ring Road, Aagar Naka, and Hari Fatak collectively account for 59.7% of the collected city-wide road dust emissions, underscoring the importance of spatially targeted mitigation strategies for air quality management in non-attainment cities.

Introduction:Comminuted patellar fractures constitute approximately 55% of all operatively managed patellar fractures and pose a persistent challenge for orthopedic surgeons. Comparative functional outcome data from India, particularly from central India, remain sparse.Objectives:The objective of the study was to evaluate and compare the functional outcomes of tension band wiring (TBW), modified TBW (MTBW), cannulated screw TBW, and modified cerclage wiring (MCW) in the surgical management of comminuted patellar fractures.Materials and Methods:This prospective observational study enrolled 63 cases of comminuted patellar fractures at Government Bundelkhand Medical College, Sagar, Madhya Pradesh, from August 2022 to April 2024. Of these, 46 underwent surgical management. Functional outcomes were assessed using the Böstman clinical grading score at 1, 3, 6, and 12 weeks post-operatively. Fisher’s exact test was applied for intergroup comparisons (significance threshold: P < 0.05).Results:Mean patient age was 42.2 ± 15.4 years; 76.1% were male. Road traffic accidents were the predominant injury mechanism (69.6%). TBW was the most frequently performed procedure (43.5%). At 12 weeks, 39.1% achieved excellent and 47.9% achieved good Böstman scores. MTBW yielded the highest proportion of excellent results (56.3%). Complications occurred in 15.2% of cases, predominantly in the TBW group. No statistically significant differences were observed across modalities (P = 0.443).Conclusion:All four modalities yielded satisfactory outcomes in comminuted patellar fractures. MTBW demonstrated numerically superior excellent outcomes; MCW showed the lowest complication rate. Fixation choice should be individualized to fracture morphology and surgeon expertise.

Tracing rare earth elements distribution and enrichment mechanism in phosphorites of the Paleoproterozoic Bijawar Group in Mardeora Mine, Chattarpur district, Madhya Pradesh (M.P.), India

e13599 Background: The principal challenges in cancer care are the affordability, accessibility, and availability of an adequately trained oncology workforce. In central India, a structured model of cancer care delivery was initiated in 2014 across 12 districts. This model is currently being scaled up to achieve nationwide coverage. We present how cancer care services achieved large-scale expansion through the optimization of existing health system infrastructure, systematic capacity building, task sharing, and the development of an alternative oncology workforce. Methods: Each district is served by a state-owned comprehensive district hospital, which provides free general medical services. An oncology capacity-building program targeting medical officers and nursing personnel was implemented, leading to the establishment of dedicated oncology units in each district hospital. In 2014, this program started with 12 districts. Now, it has grown to 200 districts in eight Indian states. The training methodology, documentation protocols, follow-up training procedures, and support mechanisms were standardized at all sites. A key feature of the program was the provision of continuous (24 × 7) professional backup to the entire oncology workforce. Simultaneously, the district-level essential medicines list was revised to include essential anticancer drugs. Results: In total, more than 200 districts participated, with over 296 physicians and 542 nurses trained (Table 1). The training program was complemented by on-site supervisory visits that included cancer-related service delivery activities in each district, short-term continuing medical education (CME) courses, and participation in scientific conferences. State-level WhatsApp groups facilitated routine communication and case-based discussions to support ongoing clinical decision-making. This implementation model contributed to health system strengthening through broad-based adoption, enhanced resilience during crises, and integration into governmental structures. Conclusions: The challenges of ensuring affordable and accessible cancer care have been substantially addressed through the district cancer care model. The Government of India has adopted it for national implementation. This model has the potential to alleviate financial toxicity and reduce the overall economic burden associated with cancer care and it addresses critical shortages in the oncology workforce. Thus, the district cancer care model may serve as a foundational framework for health systems worldwide. Training of oncology workforce. S.no Name of State Doctors Staff Nurse Year of Training 1 Madhya pradesh 90 240 2014 2 Odisha 28 56 2015 3 Rajasthan 33 66 2016 4 Gujarat 19 36 2017 5 Uttar Pradesh 15 30 2017 6 Himachal Pradesh 44 22 2017 7 Bihar 16 42 2017 8 Chattisgarh 45 44 2017 9 Haryana 6 6 2025 Total 296 542

India has a glorious history in iron smelting through indigenous methods. Many tribal communities including Agaria tribe in India have a rich cultural heritage and renowned for their mastery in the art of iron smelting and metal working for centuries, which has been passed away through generations. The people related to this tribe have indigenous methods and techniques of craft work and iron smelting which were developed a long back by their ancestors. The indigenous iron smelters and craftsmen tribal community, live in the adjoining areas of Madhya Pradesh and Chhattisgarh. Over generations, this tribe preserved it’s unique skills and knowledge in the area of producing iron and related products. At present, the tribe is gradually leaving their traditional methods of iron smelting due to the development of modern iron and steel plants. However, the Agaria tribe has made important contributions to iron metallurgy that ought to be preserved. This review seeks to unearth the outstanding contributions of the Agaria Tribe to the ancient Indian ironworking traditions, shedding light on their technological innovations, and the lasting impact on the subcontinent's history. The Agaria tribe's contributions to iron metallurgy, including their origin and character, belief of magic iron and rituals, and production of high-quality iron products have been discussed. The challenges faced by the Agaria tribe in the modern world and the need to preserve their traditional knowledge and skills are also listed. Further, the indigenous techniques of the Agaria tribe for iron smelting and the scientific analysis of their iron products have also been presented in this study. By understanding and preserving their native knowledge, this study throws light on their contributions to India’s cultural diversity and the sustainability of their age-old craft.

This study explores the potential of green infrastructure as a sustainable solution for urban development in Khargone, Madhya Pradesh. As a growing town facing environmental stress and rapid urbanization, Khargone presents an opportunity to integrate ecological networks into planning practices. The research assesses existing green assets, identifies gaps, and proposes strategic interventions such as urban forests, green corridors, and water - sensitive design. Through spatial analysis, stakeholder inputs, and sustainability indicators, the study highlights how green infrastructure can enhance climate resilience, ecological health, and quality of urban life. The findings aim to inform future planning frameworks for small and mid - sized Indian cities.

Accurate discrimination of mosquito vectors is essential for entomological surveillance in India, where multiple Anopheles, Aedes and Culex species transmit malaria, lymphatic filariasis and arboviral diseases. However, routine species identifications are challenged by cryptic and morphologically similar taxa. Furthermore, population genetic information of major mosquito vectors remains elusive. A total of 265 adult mosquitoes representing 21 species from four mosquito genera and one non-mosquito dipteran genus ( Chironomus ) used as an outgroup, were collected from indoor and outdoor resting habitats in selected districts of Madhya Pradesh and Chhattisgarh. Mosquitoes were identified morphologically using standard keys and a mobile identification application. Subsets of specimens representing major genera and putative vector and non-vector taxa were subjected to PCR amplification and sequencing of the cox1 and ITS2 genes that are known to be genetic barcodes for mosquitoes. DNA sequences of these two genes were analyzed for inter- and intra-specific divergence, and phylogenetic clustering and genetic diversity. The cox1 marker showed 100% amplification success and reliably separated most species and genera, although it failed to fully resolve certain closely related taxa, particularly within Anopheles and culicine groups. In contrast, ITS2 amplification success was lower (~50%) but provided complementary resolution for selected species complexes that clarified ambiguous morphological assignments and improved discrimination of selected species complexes in combination with cox1 . Phylogenetic analyses recovered largely congruent species-level clustering across both markers, highlighting both the strengths and limitations of each marker for operational surveillance. Furthermore, mitochondrial diversity analyses revealed high haplotype diversity in Anopheles species with limited genetic differentiation between populations, suggesting weak population structure. The combined use of morphology with cox1 and ITS2 sequencing enhances species identification and phylogenetic resolution in diverse mosquito vectors. While cox1 serves as a robust primary barcode for routine surveillance, ITS2 provides additional resolution for cryptic taxa., However, population genetic inferences based on mitochondrial data alone should be interpreted cautiously. These findings support the strengthening of molecularly informed vector surveillance pipelines and backup more precise, evidence-based vector control in endemic settings.

Cotton (Gossypium hirsutum L.) is a vital cash crop in India's rainfed Central Zone, facing challenges from low productivity, erratic rainfall, and biotic (sucking pests, diseases) and abiotic (drought) stresses. While Bt cotton varieties with the Bacillus thuringiensis (Bt) gene have reduced bollworm losses, the need persists for high-yielding, stable varieties with broader tolerance. This study evaluates the newly released Bt cotton variety NH 1901 Bt (BG I), bred for rainfed regions of Maharashtra, Gujarat, and Madhya Pradesh. Evaluated over three years (2020-21 to 2022-23) in multi-location trials under the All India Coordinated Research Project (AICRP) on Cotton, NH 1901 Bt achieved a weighted mean seed cotton yield of 1474kg/ha-a 17.32% increase over the Zonal Bt check (Suraj Bt, 1256kg/ha) and 20.71% over the non-Bt check (NH 615, 1221kg/ha). Beyond yield, NH 1901 Bt showed robust tolerance to Bacterial Blight and Alternaria Leaf Spot, plus notable resistance to sucking pests, addressing post-Bt era concerns. It also offers superior fibre quality: Upper Half Mean length of 25.23mm, strength of 25.47g/tex, and Micronaire of 4.17µg/inch, ideal for medium-staple cotton.NH 1901 Bt's consistent performance and broad-spectrum tolerance make it a reliable, high-yielding choice for resource-poor farmers, bolstering sustainable cotton production and the regional economy.

Background: Hepatocellular carcinoma (HCC), the most frequent primary liver malignancy, ranks as the sixth leading cause of incidence and the third leading cause of cancer-related mortality worldwide, with a heavy healthcare burden in Asian countries. Epidemiological data from India remain limited and are predominantly based on studies conducted in urban settings; therefore, we aimed to assess the demographic characteristics, analyze the etiological spectrum, and identify changing trends in the etiology of HCC in Central India. Methods: A prospective analysis of patients presented with HCC from January 2022 to December 2024, conducted in the State Cancer Institute NSCB Medical College, Jabalpur, Madhya Pradesh, a tertiary cancer care centre in Central India. Patient data and details were collected and analysed prospectively. Results: We conducted a study from January 2022 to December 2024, enrolling a total of 48 patients. The majority were male, with a mean age of 55-58 years. A substantial proportion had a history of alcohol consumption (42%) and tobacco use (46%). Overall, hepatitis B (HBV) (47.92%) emerged as the predominant etiological agent among cases with known risk factors. Most patients presented to our institute with advanced-stage disease (Stage III or IV). The advanced stage at presentation resulted in many patients being unsuitable for curative treatment. Conclusions: The incidence of HCC is low among all cancers, but it carries a high mortality rate. Alcohol consumption and viral hepatitis were the most common causes. The disease is more common in individuals above 40 years of age, particularly in males.

Dengue fever is a vector borne viral disease common in tropical and subtropical climates. The present study reports the comprehensive molecular characterization of dengue virus (DENV) serotypes and genotypes from the central part of the Indian state, Madhya Pradesh, during 2023. In the retrospective study, 2442 suspected DENV cases were collected from January to December 2023 and were further analyzed using non-structural protein 1 (NS1) and IgM ELISA to determine seroprevalence. Samples collected within ≤5 d of onset of fever were included for serotyping and genotyping. Phylogenetic analysis was done using partial envelope (E) gene sequences. Of 2442 samples, 231 were DENV positive, including 13 NS1 positive and 218 IgM ELISA positive cases. Among these, 61 samples (13 NS1 positive and 48 IgM positive within ≤5 d of fever) were subjected to PCR. 16 (26.2%) samples tested positive for DENV by PCR and were sequenced, of which 12 cases belonged to DENV-2, while four were DENV-1. Phylogenetic analysis showed that DENV-2 (cosmopolitan genotype, lineage 4) was predominant, followed by DENV-1 (genotype III [GIII]). These findings demonstrate that DENV-2 cosmopolitan lineage 4, and DENV-1 GIII in central part of India during 2023.

BackgroundSpinal anaesthesia is widely preferred for elective caesarean sections because of its rapid onset and safety advantages. However, sympathetic blockade frequently results in maternal hypotension, which may compromise uteroplacental perfusion. Despite preventive measures, hypotension remains common, and reliable preoperative predictors of haemodynamic instability are limited.ObjectiveThis study aimed to assess maternal mean arterial pressure (MAP) changes following spinal anaesthesia, determine the incidence and temporal pattern of hypotension, and examine the association between early MAP decline (ΔMAP) and vasopressor requirement.MethodsThis prospective observational study included 100 parturients undergoing elective caesarean section under spinal anaesthesia at the Department of Obstetrics and Gynaecology and Anaesthesia at the associated hospital of Government Medical College, Datia, Madhya Pradesh, India. Demographic and obstetric characteristics were recorded. Haemodynamic parameters were measured at baseline and at serial intervals up to 120 minutes. Hypotension was defined as systolic blood pressure <90 mmHg or a ≥20% reduction from baseline. The primary outcome was the change in MAP (ΔMAP) within the first 30 minutes. Serial comparisons and multivariable logistic regression analyses were performed to evaluate temporal trends and associations.ResultsThe mean age was 27.4 ± 4.6 years, and the baseline MAP was 91.9 ± 3.8 mmHg. Hypotension occurred in 78 (78%) participants, and 34 (34%) required vasopressors. MAP declined significantly at five and 10 minutes post-spinal (p ≤ 0.003), indicating early haemodynamic compromise, followed by recovery after 15 minutes. The mean reduction from baseline to minimum MAP was 20.3 mmHg (p < 0.001). Age, BMI, gravidity, and baseline MAP were not significantly associated with hypotension. Greater reductions in MAP (ΔMAP) were significantly associated with vasopressor requirement (adjusted odds ratio (OR) 3.6, 95% confidence interval (CI) 1.90-6.78; p < 0.001).ConclusionsSpinal anaesthesia is associated with frequent early hypotension. Greater declines in MAP were associated with increased vasopressor use, reflecting the severity of haemodynamic compromise rather than an independent predictive factor. These findings provide descriptive insights into perioperative haemodynamic patterns in routine clinical practice.

Background: Quality of life (QoL) is significantly compromised among patients undergoing hemodialysis duetophysical, psychological, and social burdens. Nurse-led educational interventions may improve patient-centeredoutcomes. Objective: To evaluate the effectiveness of a nurse-led structured educational intervention on quality of life among patients undergoing hemodialysis. Methods: A quasi-experimental one-group pre-test and post-test design was conducted among 60 patients undergoing hemodialysis in selected hospitals of Madhya Pradesh, India. Quality of life was assessed usingtheWHOQOL-BREF scale. Statistical analysis included paired t-test and Pearson correlation. Results: The mean QoL score improved significantly from 48.6 ± 7.5 (pre-test) to 72.4 ± 6.9 (post-test). The difference was statistically highly significant (t = 11.92, p &lt; 0.001). A moderate positive correlation (r =0.62, p&lt; 0.001) was observed between self-care practices and quality of life. Conclusion: Nurse-led structured educational intervention significantly improves quality of life among hemodialysis patients.

[This retracts the article DOI: 10.7759/cureus.106307.].

Background: The rise in antimicrobial resistance, particularly among Gram-negative bacilli (GNB), poses a significant threat to global public health. Colistin, a polymyxin antibiotic, has re-emerged as a last-resort treatment against multidrug-resistant Gram-negative bacilli (MDR-GNB). However, increasing colistin resistance has become a major concern, especially in clinical settings where treatment options are limited.Aim: To estimate the prevalence of colistin resistance among MDR-GNB and to compare the performance of three phenotypic methods, broth microdilution (BMD), colistin broth disk elution (CBDE), and colistin agar test (CAT), for detecting colistin resistance.Methods: This observational study was conducted over a period of one year at a tertiary care hospital in Gwalior, Madhya Pradesh. A total of 100 MDR-GNB isolates were included as a convenience sample during the study period, which was considered adequate to estimate colistin resistance and evaluate the diagnostic performance of the testing methods.The isolates were screened for colistin susceptibility using BMD (gold standard), CBDE, and CAT as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Diagnostic performance, including sensitivity, specificity, and categorical agreement, was assessed for CBDE and CAT in comparison with BMD.Results: Among 100 MDR Gram-negative isolates, Klebsiella pneumoniae (41%), Escherichia coli (35%), Acinetobacter baumannii (13%), and Pseudomonas aeruginosa (11%) were identified. Susceptibility to imipenem was highest in E. coli (20/35; 57.1%), followed by P. aeruginosa (6/11; 54.5%) and A. baumannii (7/13; 53.8%), while K. pneumoniae showed lower susceptibility (13/41; 31.7%). Resistance to ciprofloxacin was observed in 100% of K. pneumoniae, P. aeruginosa, and A. baumannii, and 94.3% (33/35) of E. coli. Resistance to third-generation cephalosporins ranged from 81.8% to 100%.Colistin resistance by BMD was 4% (4/100), with resistance detected in K. pneumoniae (3/41; 7.3%) and A. baumannii (1/13; 7.7%). The CBDE method showed 100% sensitivity, 98.96% specificity, and 99% categorical agreement with BMD, whereas the CAT demonstrated lower sensitivity (75%) and a higher very major error rate (25%).Conclusion: The emergence of colistin-resistant MDR-GNB emphasizes the urgent need for accurate and accessible susceptibility testing. While BMD remains the reference standard, CBDE offers a practical and reliable alternative for routine laboratory use. Regular surveillance and rational use of colistin are essential to curb the spread of resistance and preserve the efficacy of this critical antimicrobial agent.