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The primary function of nasal packs is to modulate the bleeding, prevent adhesions and obstruction, with least discomfort to the subjects without risking secondary infection. However, both packing and removal of the pack is an unpleasant experience, with the latter being extremely painful. Therefore the need of the hour is a dressing which prioritizes subject comfort without compromising other desired nasal pack properties. Twenty subjects were enrolled in this interventional, open label study. The subjects had 10 hospital visits, starting from baseline (Visit 1) to postoperative day 28 (Visit 10), at regular intervals. The proportion of the population with postoperative pain alleviation and bleeding control failure (within 10 min) were the main objectives. Within 10 min of VELNEZ administration, all 20 participants got their bleeding under control. With VELNEZ, the painful nasal pack removal method was totally avoided because it was biodegradable. No moderate/severe pain, infection and adhesions were reported in any of the subjects, but few subjects reported moderate obstruction until Visit 3 (Discharge Day). In the present study, for participants undergoing nasal surgery, VELNEZ proved to be a secure and reliable nasal pack. Trial Registration: CTRI/2021/09/036437, prospectively registered. [ABSTRACT FROM AUTHOR]

The word library comes from the Latin word liber which translates to “book.” This study has taken library synonymous with books-textbooks, journals, reference books—all conventional methods of gaining knowledge. There has been a rapid decline in the use of traditional methods, including bedside teaching, owing to the new, digital sources of learningwhich has been precipitated by the deadly pandemic of coronavirus disease-2019 (COVID-19) among various other reasons. This research is focused on drawing conclusions regarding learning from actual, physical books, traditional classroom teaching, and the newonset era of digital learning. Digital learning has grown tremendously through the unfortunate COVID-19. [ABSTRACT FROM AUTHOR]

Metastasis is the hallmark of malignancy but the spread to brain is an exceedingly rare occurrence for oral cancer. Two of our patients who underwent definitive surgery for oral cancer developed manifestations of Central nervous system (CNS) involvement within 7 days of surgery, one with seizures and other with cranial nerve palsies (3rd and 7th ), who were otherwise symptom free for CNS involvement preoperatively. These cases highlight the need for thorough metastasis workup including CNS. [ABSTRACT FROM AUTHOR]

Aim: The aim is to analyze various possible etiological factors for the sudden outbreak of mucormycosis. Methods: A prospective observational study involving consecutive individuals with proven mucormycosis was undertaken at a tertiary care teaching hospital in North India from May 2021 to July 2021. A total of 88 patients with mucormycosis were studied for the demographic profile, COVID-19 status, various risk factors, COVID-19 immunization status, clinical staging of disease, and outcome of patients. Results: Out of 88 patients, 54 (61%) were males and 34 (39%) were females. The mean age of male patients was 50.5 ± 13.8 and female patients was 52.1 ± 14.1. Most of the patients were in stage two, i.e., 45 (51.1%) and 26 (29.5%) in stage three of the disease. Past history of diabetes was present in 49 (55%) patients. Forty-one (46.6%) patients had documented Reverse Transcription Polymerase Chain Reaction (RTPCR) reports in favor of COVID-19 and others had clinical features consistent with COVID-19. Only 1% of patient took COVID-vaccination. Of the total 88 patients, 42 (47%) were on oxygen therapy, 72 (81%) had history of blood transfusion, and 48 (54%) were given steroids. Conclusions: No conclusive etiological factor was identified although few recommendations are suggested for prevention, early diagnosis, and prompt management of mucormycosis in hospitalized COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: In April and May 2021, India faced massive second wave of COVID-19 pandemic and then became the hotspots of mucormycosis across globe. Hence, we planned the first analysis of mucormycosis in Uttar Pradesh. Aim and Objectives: co The objectives were to explore the epidemiology, vaccination status, clinical features, microbiological findings, treatment of mucormycosis and outcome. Material and Methods: This was an observational study of mucormycosis at tertiary care centre of Agra, Uttar Pradesh, India from 20 May 2021 to 15 July 2021. Results: 98 patients' data with mucormycosis was analyzed. Patients had median age of 55 years. COVID-19 infection was present in 69.4% of participants and diabetes mellitus was present as underlying co-morbid condition in more than 85% of patients. 91.8 % of cases were unvaccinated with steroid consumption in almost 60% of patients. R. arrhizus was among the most common agent while we found less commonly reported fungi like R.homothallicus, Apophysomyces, Cunninghamella. 41.8% of cases were successfully treated and 16.3% of cases expired. Conclusion: Diabetes mellitus was labeled as major predisposing factor and most patients were unvaccinated. Awareness about fungal infections, rigorous monitoring of chronic diseases, judicious use of drugs, early diagnosis and prompt treatment is decisive for better outcome. [ABSTRACT FROM AUTHOR]

HLA-DRB1 is the major genetic risk factor for visceral leishmaniasis (VL). We used SNP2HLA to impute HLA-DRB1 alleles and SNPTEST to carry out association analyses in 889 human cases and 977 controls from India. NetMHCIIpan 2.1 was used to map epitopes and binding affinities across 49 Leishmania vaccine candidates, as well as across peptide epitopes captured from dendritic cells treated with crude Leishmania Ag and identified using mass spectrometry and alignment to amino acid sequences of a reference Leishmania genome. Cytokines were measured in peptide-stimulated whole blood from 26 cured VL cases and eight endemic healthy controls. HLA-DRB1*1501 and DRB1*1404/DRB1*1301 were the most significant protective and risk alleles, respectively, with specific residues at aa positions 11 and 13 unique to protective alleles. We observed greater peptide promiscuity in sequence motifs for 9-mer core epitopes predicted to bind to risk (*1404/*1301) compared with protective (*1501) DRB1 alleles. There was a higher frequency of basic amino acids in DRB1*1404/*1301-specific epitopes compared with hydrophobic and polar amino acids in DRB1*1501-specific epitopes at anchor residues pocket 4 and pocket 6, which interact with residues at DRB1 positions 11 and 13. Cured VL patients made variable, but robust, IFN-γ, TNF, and IL-10 responses to 20-mer peptides based on captured epitopes, with peptides based on DRB1*1501-captured epitopes resulting in a higher proportion (odds ratio 2.23, 95% confidence interval 1.17-4.25, p = 0.017) of patients with IFN-γ/IL-10 ratios > 2-fold compared with peptides based on DRB1*1301-captured epitopes. Our data provide insight into the molecular mechanisms underpinning the association of HLADRB1 alleles with risk versus protection in VL in humans. [ABSTRACT FROM AUTHOR]

Considering the contemporary interests of water-free reverse micelles (RMs) in the field of organic reaction medium and potential drug delivery carrier, we synthesized two different classes of ionic liquids (ILs), protic N-methyl-2-pyrrolidonium hexanoate, [NMP][Hex] and aprotic choline hexanoate, [Chl][Hex] and subsequently incorporated them in a mixture of polyoxyethylene (20) sorbitan monooleate (Tween-80) and cyclohexane. In order to understand the differential nature of interinterionic interaction of two ILs, we performed DFT calculations on pure ILs to correlate with experimental results. The formation of IL-in-oil RMs was confirmed from phase behavior and DLS studies. Interestingly, [NMP][Hex]-based systems showed a larger monophasic region and droplet size along with higher shear viscosity compared to [Chl][Hex]-based systems. Stronger interaction between [NMP]+ and Tween-80 due to their protic nature might be the driving force for such observations which supported the resonance stabilization energy [E(2)] and charge population analysis by NBO calculation. Smaller E(2) values along with lesser NBO charges on atoms involved in H-bonding in pure [NMP][Hex] than [Chl][Hex] corroborated with the experimental observations. This primary hypothesis was further confirmed from FTIR and time-resolved fluorescence studies. These systems showed efficient thermal stability. Taking all of the results together, we anticipate that these RMs could be used as efficient delivery systems and for nanomaterial synthesis. [ABSTRACT FROM AUTHOR]

Schwannoma, a benign tumor, arise from schwann cells of myelin sheath; occur anywhere in the body but commonly occur on flexor aspect of extremities. Nasal septum being the rarer site. We report a case of nasal septum schwannoma in an 18-year-old female presented with intermittent epistaxis and progressively increasing nasal obstruction for 2-year duration. The differential diagnosis of juvenile angiofibroma, pyogenic granuloma, and pleomorphic adenoma was made and complete surgical excision was done. Histopathological examination revealed ciliated stratified columnar epithelium, underlying tumor area with two distinct patterns, mainly hypercellular and few hypocellular areas. The cells have spindle shaped pointed basophilic nuclei with abundant eosinophilic cytoplasm. Overall feature was suggestive of nasal septum schwannoma. For confirmation, immunohistochemical staining with S-100 was done and tumor was found positive. Herein, we report the clinicopathological features of nasal septum schwannoma in an 18-year-old female. [ABSTRACT FROM AUTHOR]

Background: Asymptomatic Leishmania donovani infections outnumber clinical presentations, however the predictors for development of active disease are not well known. We aimed to identify serological, immunological and genetic markers for progression from L. donovani infection to clinical Visceral Leishmaniasis (VL). Methods: We enrolled all residents >2 years of age in 27 VL endemic villages in Bihar (India). Blood samples collected on filter paper on two occasions 6–12 months apart, were tested for antibodies against L. donovani with rK39-ELISA and DAT. Sero converters, (negative for both tests in the first round but positive on either of the two during the second round) and controls (negative on both tests on both occasions) were followed for three years. At the start of follow-up venous blood was collected for the following tests: DAT, rK39- ELISA, Quantiferon assay, SNP/HLA genotyping and L.donovani specific quantitative PCR. Results: Among 1,606 subjects enrolled,17 (8/476 seroconverters and 9/1,130 controls) developed VL (OR 3.1; 95% CI 1.1–8.3). High DAT and rK39 ELISA antibody titers as well as positive qPCR were strongly and significantly associated with progression from seroconversion to VL with odds ratios of 19.1, 30.3 and 20.9 respectively. Most VL cases arose early (median 5 months) during follow-up. Conclusion: We confirmed the strong association between high DAT and/or rK39 titers and progression to disease among asymptomatic subjects and identified qPCR as an additional predictor. Low predictive values do not warrant prophylactic treatment but as most progressed to VL early during follow-up, careful oberservation of these subjects for at least 6 months is indicated. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has targeted elimination of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) by 2020. Despite distinctive decline seen in the number of VL cases in ISC, there is still a quest for development of a diagnostic test which has the utility for detection of active infection and relapse cases and as a test of cure. The present study validated the sensitivity and specificity of SYBR Green I based closed tube LAMP assay reported by us for diagnosis of VL. Methodology: The validation study was carried out at two endemic sites in India, located at Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna and Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), Varanasi. Standard operating protocols were provided at the two sites for applying LAMP assay on confirmed VL cases. The diagnostic accuracy of LAMP assay was evaluated by Receiver operator curve (ROC) analysis. Furthermore, a simplified LAMP assay based on direct blood lysis, DBL-LAMP, was developed and verified for its diagnostic accuracy. Principal findings: A total of 267 eligible participants were included in the study which comprised of 179 VL cases and 88 controls. Sensitivity and specificity of the LAMP assay were 98.32% (95% C.I– 95.2–99.7%) and 96.59% (95% C.I.-90.4–99.3%), respectively. ROC curve analysis depicted no significant difference between area under curve (AUCROC) for LAMP assay and rK39 RDT, indicative of LAMP as an excellent diagnostic test. DBL-LAMP assay, performed on 67 VL and 100 control samples, yielded a sensitivity of 93.05% (95% C.I- 84.75–97%) and specificity of 100% (95% C.I.- 96.30–100%). Conclusions/Significance: The validated closed tube LAMP for diagnosis of VL will provide impetus to the ongoing VL elimination programme in ISC. The assay based on direct blood lysis promotes its scope for application in field settings by further reducing time and cost. [ABSTRACT FROM AUTHOR]

Choline carboxylates are an important class of bio-derived ionic liquids (ILs) having potential applications in the pharmaceutical sector. Therefore, detailed knowledge of the physicochemical properties of this class of ILs and their mixtures with biomolecules is highly desired with a focus on sustainability and environmental impact. In view of this, a series of surface-active ILs (SAILs) based on choline carboxylates, viz. choline laurate ([Chl][Lau]) and choline palmitate ([Chl][Pal]), were synthesized. Various techniques such as surface tension measurements, conductivity measurements, dynamic light scattering (DLS), and rheology were employed to get detailed information about their self-assembly and viscoelastic behaviours in aqueous medium. A set of surface and thermodynamic parameters of these SAILs in water was determined, which revealed the superior surface activity of [Chl][Pal] compared to [Chl][Lau]. Ab initio and natural bond orbital (NBO) calculations manifested larger binding and hydrogen-bonding energies of [Chl][Lau]–water compared to [Chl][Pal]–water. Consequently, it is more difficult for [Chl][Lau] to self-aggregate in water. The steady-state and oscillatory rheological measurements demonstrated notable differences in solution viscosities in these systems. The size of the micellar aggregates was significantly affected by the hydrophobicity of carboxylate anions and concentration of SAILs. Finally, the interactions of these SAILs with bovine serum albumin (BSA) were systematically investigated in aqueous medium. The quenching effect of these SAILs on tryptophan moieties of BSA along with the information on the secondary structural conformation was monitored through fluorescence and circular dichroism techniques to understand the binding strength and mechanism. Understanding the aggregation behaviour and molecular level interactions of choline carboxylate SAILs with BSA is required to explore their potential applications in biotechnology. [ABSTRACT FROM AUTHOR]

Granular Cell Tumour (GCT) of nasal and paranasal area is an extremely rare entity, while the most common site is the tongue in oral cavity. GCT was first time described by Abrikossoff in 1926, which occurs in 3rd to 5th decades of life and most frequently involving the head and neck region. Abrikossoff in 1926, first time described GCT, to be derived from smooth muscle and gave the term myoblastomas, also known as Abrikossoff's tumours. Schwann cell origin of GCT was demonstrated on immunohistochemistry through positive S100 protein identification. Herein, the authors report a case of GCT arising from right nasal vestibule in a 28-year-old female who presented with swelling since three months. On gross examination, the specimen revealed firm red and white pieces of tissue measuring 0.8x0.8x0.5cm. Diagnosis was made by histopathological examination which was confirmed by PAS special stain and S100 immunohistochemistry. Author also abridge the clinical information, microscopic features, treatment and patient status after follow-up. This case is believed to be the 7th reported case of GCT as primary lesion at this location. [ABSTRACT FROM AUTHOR]