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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]

Introduction: Mucormycosis is a fatal fungal infection, which is rare but commonly affects immunocompromised patients. Coronavirus disease 2019 (COVID-19) patients who were immunocompromised, due to comorbid conditions, such as hematological malignancy and diabetes mellitus (DM), and patients on immunosuppressive therapy such as steroid therapy were the important host for mucormycosis infection. Aim: This study aimed to study the clinicopathological correlation of mucormycosis in post-COVID-19 patients. Material and Methods: The study was a retrospective study conducted in the Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over four months from April 2021 to July 2021, and clinically diagnosed mucormycosis cases were included in this study. Clinical details, histology slides, and blocks were reviewed, and the data were analyzed. Three- to four-micrometer sections were taken from the blocks and stained with hematoxylin and eosin, and two more slides were made for each case for periodic acid-Schiff (PAS) and Grocott methenamine silver (GMS) staining. Result: In this study, the maximum cases were above the fifth decade of life. Males were more commonly affected than females with a male-to-female ratio of 2.09:1. Of the total of 65 cases, 46 (70.77%) cases were positive for mucormycosis and 19 (29.23%) cases were negative on histopathological examination and special stain PAS and GMS. A significant correlation was found between mucormycosis-positive cases on steroid therapy and oxygen supply during the treatment for COVID-19 with P-values of 0.001 and 0.027, respectively. Conclusion: For COVID-19 patients with altered glycemic control, receiving steroid therapy and oxygen supply poses a significant threat to the development of mucormycosis. [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]

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]

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]

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]

In an attempt to increase the stability and water uptake capacity of water-in-oil (W/O) microemulsions, here we study the physicochemical behavior of a series of protic ionic liquid based water/oil microemulsions, wherein solute amounts of biocompatible tetramethylguanidinium cation-based ionic liquids (ILs) are added to the aqueous phase of water-in-oil (W/O) microemulsions. FTIR and time-resolved fluorescence measurements showed an increased water uptake in these reverse micellar droplets, compared to conventional W/O microemulsions of similar compositions. Dynamic light scattering and differential scanning calorimetric measurements suggested greater thermal stability of the droplets in presence of the ILs. NMR and FTIR measurements and ab initio calculations explained these findings by showing an extended hydrogen bonding network between interfacial water and protic IL ions and strong electrostatic associations between the surfactant headgroups and IL anions. Our results pave the way for potential applications of protic ionic liquids in emulsion and microemulsion science and technology. [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]

Ionic liquids (ILs) have shown great potential in the dissolution and stability of biomolecules when a low-to-moderate quantity of water is added. Hence, determining the thermophysical properties and understanding these novel mixtures at the molecular level are of both fundamental and practical importance. In this context, here we report the synthesis of two nontoxic guanidinium cation based ILs, tetramethylguanidinium benzoate [TMG][BEN] and tetramethylguanidinium salicylate [TMG][SAL], and present a detailed comparison of their thermophysical properties in the presence of water. The results show that the [TMG][SAL]/water mixtures have higher density and higher apparent molar volume, but a lower viscosity and higher compressibility than the [TNG][BEN]/water mixtures. The measured viscosity and compressibility data are explained from ab initio quantum mechanical calculations and liquid-phase molecular dynamics simulations, where salicylate anions of denser [TMG][SAL]/water were found to exist as isolated ions due to intramolecular H-bonding. On the contrary, intermolecular H-bonding among the benzoate anions and their strong tendency to form an extended H-bonding network with water made [TMG][BEN]/water solutions more viscous and less compressible. This study shows the importance of probing these emerging solvents at the molecular-to-atomic level, which could be helpful in their optimal usage for task-specific applications. [ABSTRACT FROM AUTHOR]

Importance: Invasive fungal infections have recently become a public health problem, particularly in India following the second wave of coronavirus disease 2019 (COVID-19). India harbors the world's largest population of patients suffering from diabetes. What prompted the sudden spike of mucormycosis infections in the COVID pandemic needs investigation., Objective: To determine if COVID-19 infection prompted the spike in invasive fungal infections in diabetic population. To determine the long-term outcome of COVID-associated mucormycosis. To determine if COVID-19 infection causes diabetes mellitus transiently., Design: The study was a prospective cohort study comprising patients suffering from mucormycosis. The study was planned from 20 May 2021, until 30 November 2022, to investigate the long-term follow-up (1 year) of mucormycosis patients., Setting: The study setting was a referral hospital., Participants: All the consecutive patients admitted to this hospital for treatment of mucormycosis were included in the study who consented to it. Intervention(s) (for clinical trials) or exposure(s) (for observational studies): All patients suffering with mucormycosis underwent treatment at this hospital with surgery and injectable systemic antifungal drugs alongside diabetes management., Main Outcome(s) and Measure(s): Primary outcome measurement was in the form of survival with cure of mucormycosis. Hypothesis being tested was formulated during data collection., Results: The data of 98 participants was collected, but analysis was done after excluding the case of cutaneous mucormycosis (infant patient). Mean age for patients was 55.5 years, varying from 28 to 88 years. In our study, 63.3% of patients with mucormycosis were males and 37.8% were females, of which 55.7% (34) and 58.3% (21) were known diabetics, respectively. Previous history of diabetes mellitus was identified as an underlying comorbid condition in 56.7% of patients, while the rest were diagnosed with new-onset diabetes mellitus. Sugar levels ranged (on admission) from 112 to 494 mg/dL (median 212 mg/dL) for known diabetics and from 132 to 356 mg/dL (median 204 mg/dL) for newly diagnosed diabetics. Other comorbidities included hypertension (19.5%), ischemic heart disease (8.2%), chronic renal illness (3.09%), and one case (1.03%) of postoperative renal cell carcinoma (disease-free). The majority of cases (91.8%) were not vaccinated for COVID-19, while only two patients reported a history of vaccination with two doses, and six others had received only a single dose. At the 1-year follow-up, 57.7% of cases were disease-free, 30.9% had expired, and 11.3% were lost to follow-up. The mean glycated hemoglobin (HbA1c) at the time of admission was found to be statistically significant when compared between known diabetics and newly diagnosed ones [confidence interval (CI)-95%, p ≤ 0.01]. A total of seven patients from the newly diagnosed diabetic group no longer required medicines for diabetes at the end of 1 year (CI-95%, p ≤ 0.01)., Conclusions and Relevance: Diabetes mellitus, particularly with poor glycemic control, was the single most important factor associated with and predictor of outcome. Contrary to the popular hypothesis, industrial oxygen and oxygen masks were not the reasons for the mucormycosis pandemic. Additionally, immunization against COVID provided protection not only from severe COVID but also from COVID-associated mucormycosis. It is recommended that patients with mucormycosis be followed for longer periods as a few patients could be suffering from transient diabetes, particularly against the backdrop of a pandemic., (© Journal of the Association of Physicians of India 2024.)

Context: Pulse oximetry is one of the most revolutionary methods used to monitor the patients in the clinical setting, particularly intensive care and anesthesia. We usually use the index or middle finger to measure SpO 2 values, but little is known about the inter-digital differences that exist between the fingers., Aim: We aim to compare the peripheral capillary oxygen saturation among fingers of both hands. A total of 93 healthy volunteers aged between 18 and 50 years participated in the study., Materials and Methods: Their SpO 2 values were recorded from each finger with at least 1 minute of resting interval. Their blood pressure, heart rate, and body temperature were recorded as well., Result: A total of 930 measurements were obtained from 93 volunteers. The highest average SpO 2 value of right-handed volunteers was measured from the left little finger (98.48 ± 0.62) of right-handed volunteers, and it was statistically significant when compared with the right ring finger, right little finger, left thumb, left index, left middle finger, and left ring finger. The highest average SpO 2 from left-handed volunteers was obtained from the right index finger, but it was statistically insignificant., Conclusion: We assume ethnic and climatic differences to play a role in contradictory results noted from previous studies conducted, and this needs to be investigated further. It is recommended that multiple readings may be obtained from other fingers as well before coming to any conclusion as inter-finger variability cannot be ignored., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Family Medicine and Primary Care.)

Background: Lifestyle disorders are on rise world over. Also, the role of doctors as leaders in propagating healthy lifestyles needs to get a reality check. Aims and Objectives: This study aimed to investigate the prevalence of lifestyle disorders, eating habits, nutrition patterns, and lifestyle of doctors by assessing health-related behaviours considering gender and other relevant demographic parameters. The objectives of the present study are to find out the relationship of lifestyle disorders among doctors and to study lifestyle disorders and related behaviour among male and female doctors and other subgroups., Materials and Methods: Online survey was conducted using Googledoc in June to August 2021. Descriptive statistical analysis has been carried out in the present study. The student's t-test (two tailed, independent) has been used., Results: About 50% rated a happiness quotient of 7 and 8. Surgeons had more diabetes and hypertension than physicians. Prevalence of hypertension was more in self-employed males versus males in job. About two-third participants scored ≥ 80% on healthy lifestyle score., Conclusion: Our results call for a well-thought strategy to overcome the financial and technological hindrances to accurately identify health risk factors and plan corrective interventions. A healthy lifestyle both in terms of diet and exercise should be incorporated into the schedules of doctors., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Mid-life Health.)