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This paper presents the current status of Indian smart cities and examines their preparedness and response to the COVID-19 outbreak. The study focuses on implemented & ongoing projects under the Smart City Mission of the Government of India, which have contributed significantly to controlling the pandemic along with other channels. The study finds that modern cities in both developed and developing countries were not well-prepared to deal with the emergency situations and struggled in providing a satisfactory response during the pandemic. The analysis of primary and secondary data has shown that digital surveillance and movement control through integrated control command centers (ICCC) were the most useful projects in monitoring the COVID-19 cases. However, the lack of technology integration in smart cities hinders the effective usage of implemented projects. Thus, the study recommends integrated network-based applications that include healthcare, essential services, mobility, and movement across smart cities in India. The proposed framework is expected to provide the much-needed alignment at the policy, objective, and implementation levels of smart city framework designs. [ABSTRACT FROM AUTHOR]

Introduction: Six-min walk test (6MWT) is easy to use, the least expensive, and a quick measure of physical function and it reflects the capacity to perform our day-to-day activities hence quality of life can be assessed with 6MWT. This study was planned to assess the role of 6MWT in chronic respiratory disease patients and its association with spirometry-based functional grading at a rural tertiary care center of northern India. Materials and Methods: This was a hospital-based cross-sectional study done between December 2019 and July 2021. In this study, 110 patients were included as per inclusion and exclusion criteria. 6MWT and spirometry were conducted as per the American Thoracic Society/European Research Society recommendation using Spiropalm 6MWT and the association between 6MWT and spirometry was assessed. Results: A total of 110 chronic respiratory disease patients were included in the study. There were 69 (63%) males while 41 (37%) were females. Among study participants, chronic obstructive pulmonary disease patients were the most common 48 (43.6%) patients, followed by asthma 28 (25.5%), posttuberculosis sequelae patients 22 (20%), interstitial lung disease 9 (8.2%), and bronchiectasis 3 (2.7%) patients were found. There was a significant positive correlation of 6-min walk distance (6MWD) and % predicted 6MWD with spirometric parameters, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and there was a significant positive correlation of 6MWD with FEV1% (predicted) also. 6MWD and % predicted 6MWD negatively correlated with FEV1/FVC and association between 6MWD and FEV1/FVC was not statistically significant and between % predicted 6MWD and FEV1/FVC, it was found statistically significant. Conclusion: The 6MWD traveled by chronic respiratory disease patients was significantly lower than the predicted 6MWD and 6MWD correlated with spirometric variables well. Therefore, it can conclude that 6MWT is a useful alternative of spirometry in the management of chronic respiratory disease patients in resource-limited settings. [ABSTRACT FROM AUTHOR]

This article examines the influence of political proximity and cash-holding behavior of Indian firms on firm value and operating performance. Using a robust data set of political donations and connections for listed Indian firms around three general elections in India from 2009 to 2019, we find that firms with political connections show higher performance than their nonconnected peers. We also observe that politically connected Indian firms with higher cash holdings achieve substantially better valuations over time. Our results are robust and consistent after controlling for various factors. The article coincides with the introduction of electoral bonds through an amendment in Finance Bill 2017, which formalized the corporate financing of political parties and will likely strengthen the corporate-political linkages via more substantial donations. Overall, the article introduces political proximity/connection as a new indirect factor influencing firm performance. [ABSTRACT FROM AUTHOR]

Introduction: Posterior circulation stroke (PCS) is often diagnosed late and long-term outcomes have not been described in South India. We wished to study clinical features, long-term outcomes, and independent predictors of the same. Materials and Methods: We conducted a prospective cohort study in PCS patients from January 2014 to May 2017. Morbidity and mortality at discharge, at 3 months and 6 months was studied. Univariate and multivariate analysis of predictors of poor outcome as well as the survival analysis was computed. Results: We recruited 291 PCS during the study period; prevalence of PCS among all strokes was 12.9% in 2014. The mean age was 53.34 years (standard deviation 13.34). Young strokes constituted 28.8%. The common comorbidities were hypertension 72%, diabetes mellitus 52.6%, smoking 38.5%, and dyslipidemia 32.6%. The common presenting symptoms were giddiness 79%, unsteadiness 75.35%, ataxia 56%, motor deficits 48.8% and nausea and vomiting 43%. Most were Ischemic strokes (86.5%); 10.3% gave a history of preceding TIAs. Common arteries involved were posterior cerebral 45%, posterior inferior cerebellar 38%, and basilar artery 19.2%. Among ischemic strokes, large artery atherosclerosis was 50.8%. Dysphagia was seen in 32.6% and sepsis in 19.2%; post stroke pain in 23%, followed by cognition decline in 10.3%. Bad outcome (modifies Rankins score 4-6) was 16.8% at discharge, 16.4% at 1 month, 14.4% at 3 months, and 13.8% at 6 months. Independent predictors of bad outcomes at 6 months were baseline National Institute of Health Stroke Scale (NIHSS) score (Odds ratio [OR] 1615.59 confidence interval [CI] 27.64-94447.7), invasive ventilation (OR 7.77 CI 1.57-38.43), sepsis (OR 17.22 CI 1.45-204.08), and basilar artery involvement (OR 19.98 CI 1.67-238.81). Baseline NIHSS scores between 0 and 5 suggest a good outcome while scores more than 13 suggest a bad outcome at 6 months. At 6 months, half are unemployed. Conclusions: The prevalence, clinical features, and comorbidities were also similar to previous studies. There was good survival at 6 months. NIHSS score is useful in predicting poor outcomes. [ABSTRACT FROM AUTHOR]

We evaluate investors' learning from past fund performance and subsequent capital allocation decisions in mutual funds in an emerging market setup. We find that investors in India learn more about funds' ability to generate excess returns from past funds'-family performances. We explore two possible channels, common skill effect and negative correlation effects, through which investors observe fund-family performance and its impact on future fund flows. We observe that fund-family performance dominates individual fund performance when the common skill effect is stronger than the negative correlation effect. Our findings suggest that investors can use fund-family resources to understand funds' alpha-generating skills. Overall, our result highlights the new learning perspective of Indian fund investors. [ABSTRACT FROM AUTHOR]

Background: Although sepsis is a well-known cause of in-hospital mortality, data on long term outcomes are scarce. Aim: This study aims to estimate the cumulative 5-year mortality among patients with infection requiring admission. Methods: This was a cohort study done in tertiary care center in South India, with recruitment of those admitted with an infection between January 1st, 2009 and July 31st, 2014 in a medical unit. The patients were followed up by telephonic call or case record review. Kaplan-Meier survival curve was plotted and Cox-proportional hazard model was used as multivariable analysis to identify the independent risk factors of long-term mortality. Results: One thousand four hundred and fifty three patients were followed up in this cohort study. The mean survival by Kaplan-Meier survival analysis was 3.78 years (95% confidence interval [CI] 3.33, 4.22) in quick sepsis-related organ failure assessment (qSOFA) score positive patients and 6.07 years (95% CI 5.73, 6.41) in qSOFA negative patients which was statistically significant by the log-rank test. The cumulative 1-year mortality was 44.9% and 21.8% for qSOFA score of 2 or more and nonsepsis patients, respectively. The median survival of qSOFA score of 2 or more patients was 0.75 years (95% CI 0-2.1 years). The mortality among sepsis patients at discharge, 1 year, 5 and 8 years was 38.2%, 44.9%, 47.4%, and 47.8%, respectively. Cox regression analysis showed age hazard ratio (HR) 1.02 (1.01, 1.04), male gender 1.45 (1.03, 2.04), >qSOFA score HR 1.89 (1.32, 2.72), Charlson Comorbidity Index HR 1.29 (1.14, 1.46), respiratory tract infection HR 1.81 (1.10, 2.95), and inotrope requirement HR 3.24 (1.98, 5.29) were the independent predictors of long-term mortality. Conclusions: The median survival of patients with possible infection with qSOFA score of 2 or more patients was 0.75 years (95% CI 0-2.1 years). Older age, male gender, qSOFA score of 2 or more, Charlson Comorbidity Index, respiratory tract infection, and inotrope requirement HR 3.24 were the independent predictors of long-term mortality. [ABSTRACT FROM AUTHOR]

Rhynchosia suaveolens (L.f.) DC. was reported for the first time from the Vidarbha region of Maharashtra. It is rediscovered after 144 years from Maharashtra. Previously, this species was recorded only from the southern part of India. In the present article detailed description, illustration, digital photographs, and relevant notes are provided to facilitate its easy identification. [ABSTRACT FROM AUTHOR]

Fruit rot disease (FRD) in arecanut has appeared in most of the arecanut growing regions of India in the last few decades. A few comprehensive studies on the management of FRD under field conditions have examined various treatment combinations for disease control and yield response analysis. This study aimed to compare the control efficiencies and yield responses of treatments applied over multiple locations and compute the probable returns of investment (ROIs) for treatment costs. Data were gathered from 21 field trials conducted across five main arecanut growing regions of India in the period 2012–2019. The collected data were subjected to analysis with a multivariate (network) meta-analytical model, following standard statistical protocols. The quantitative, synthesized data were evaluated for the estimated effects of disease pressure (DPLow ≤ 35% of FRDInc in the treatments > DPHigh), mean disease control efficiencies (treatment mean, C), and yield responses (R) corresponding to the tested treatments. Based on disease control efficacy, the evaluated treatments were grouped into three efficacy groups (EGs): higher EGs were observed for the Bordeaux mixture (C, 81.94%) and its stabilized formulation (C, 74.99%), Metalaxyl + Mancozeb (C, 70.66%), while lower EGs were observed in plots treated with Biofight (C, 29.91%), Biopot (C, 25.66%), and Suraksha (C, 29.74%) and intermediate EGs were observed in plots to which microbial consortia (bio-agents) had been applied. Disease pressure acted as a significant moderator variable, influencing yield response and gain. At DPLow, the Bordeaux fungicide mixture (102%, 22% of increased yield) and Metalaxyl + Mancozeb (77.5%, +15.5%) exhibited higher yield responses, with absolute arecanut yield gains of 916.5 kg ha−1 and 884 kg ha−1, while, under DPHigh, Fosetyl-AL (819.6 kg ha−1) showed a yield response of 90.5%. To ensure maximum yield sustainability, arecanut growers should focus on the spraying of fungicides (a mixture of different active ingredients or formulations or products) as a preventative measure, followed by treating palms with either soil microbial consortia or commercial formulations of organic fungicides. [ABSTRACT FROM AUTHOR]

To understand the spatio-temporal dynamics and the effect of climate on fruit rot occurrence in arecanut plantations, we evaluated the intensity of fruit rot in three major growing regions of Karnataka, India for two consecutive years (2018 and 2019). A total of 27 sampling sites from the selected regions were monitored and the percentage disease intensity (PDI) was assessed on 50 randomly selected palms. Spatial interpolation technique, ordinary kriging (OK) was employed to predict the disease occurrence at unsampled locations. OK resulted in aggregated spatial maps, where the disease intensity was substantial (40.25–72.45%) at sampling sites of the Malnad and coastal regions. Further, Moran's I spatial autocorrelation test confirmed the presence of significant spatial clusters (p ≤ 0.01) across the regions studied. Temporal analysis indicated the initiation of disease on different weeks dependent on the sampling sites and evaluated years with significant variation in PDI, which ranged from 9.25% to 72.45%. The occurrence of disease over time revealed that the epidemic was initiated early in the season (July) at the Malnad and coastal regions in contrary to the Maidan region where the occurrence was delayed up to the end of the season (September). Correlations between environmental variables and PDI revealed that, the estimated temperature (T), relative humidity (RH) and total rainfall (TRF) significantly positively associated (p = 0.01) with disease occurrence. Regression model analysis revealed that the association between Tmax, RH1 and TRF with PDI statistically significant and the coefficients for the predictors Tmax, RH1 and TRF are 1.731, 1.330 and 0.541, respectively. The information generated in the present study will provide a scientific decision support system, to generate forecasting models and a better surveillance system to develop adequate strategies to curtail the fruit rot of arecanut. [ABSTRACT FROM AUTHOR]

A field experiment was conducted to study the impact of different nitrogen (N) management options on the nutrient uptake, biomass carbon sequestration and yield of maize-wheat system in reclaimed sodic soil of the Trans-Gangetic Plains of India. Seven N management treatments – T1 [100% recommended dose of N (RDN) + 10 t ha−1 farm yard manure (FYM)]; T2 (100% RDN); T3 (75% RDN + 25% N through FYM); T4 (50% RDN + 50% N through FYM), T5 (25% N through FYM); T6 (50% N through FYM) and T7 (control; No N) were tested. Maximum nutrient uptake, biomass carbon sequestration and yield of maize-wheat system were reported in 100% RDN + FYM treatment. Total biomass carbon sequestration and yield were significantly higher by 47.8% and 30.4%, respectively in 100% RDN + FYM as compared to control treatment. However, 100% RDN + FYM was statistically at par with the 100% RDN, 75% RDN + 25% N through FYM, and 50% RDN + 50% N through FYM treatments for both these variables. Nutrient uptake, total carbon sequestration and yield in 50% N through FYM and 25% N through FYM were insignificantly higher as compared to control, but significantly lower than the 100% RDN treatment. Results indicated that the addition of FYM with RDN increased the nutrient uptake, biomass carbon sequestration and yield of maize-wheat system. Higher biomass carbon sequestration and sustainability to maize and wheat cropping system is need of the hour in the study area. [ABSTRACT FROM AUTHOR]

Background: Dysphagia is a disorder of swallowing and/or feeding. It is associated with malnutrition, dehydration, pulmonary pneumonia and increased mortality. Timely assessment and management of dysphagia carried out by speech and language pathologist is necessary. Speech Language Pathologist (SLP) evaluates and treats patients with dysphagia by using dysphagia therapy, postural changes, swallowing maneuvers and recommends texture modified dysphagia diet. Objective: The aim of the present study was to explore the level of awareness medical practitioner have regarding dysphagia and speech and language pathologist's role in dysphagia. Methodology: A non-experimental, descriptive survey was conducted for the purpose of this research. Information was gathered by mean of a self-designed questionnaire. The data was collected from Sumandeep Vidhyapeeth University, Vadodara, Gujarat. The sample of the study consists of 100 medical practitioners (60 males and 40 females) working in different department, in which speech and language services were available and speech and language pathologists were accessible fulltime. Results: The data analysis was carried out with SPSS version 17.0 for windows. The score obtained by the participants were shows that medical practitioners do not have adequate knowledge regarding the assessment and management of patients who suffer from eating and drinking difficulties. Conclusion: On the basis of the present research, it was concluded that medical practitioners lack in their knowledge and understanding of basic dysphagia assessment and management practices. Their lack of awareness of SLP role results in decrease SLP referrals. [ABSTRACT FROM AUTHOR]

Obesity is a major health problem of excessive adipose tissue accumulation in body which leads to problem in Asian countries like India as a result of rapidly changing life style which involves consumption of calorie rich food with lack of physical activities. While the complication of obesity such as cardiovascular disease, diabetes and osteoarthritis are well known, but less emphasis is traditionally placed on the effects of obesity on the respiratory system. Obesity is responsible for lessening the lung volume and capacities by reducing both lung and chest wall acquiescence and also there is an increase in resistance to outflow of air through the airways. Purpose of present study is to establish a relationship between Forced Vital Capacity and Body Mass Index (BMI). The present study was undertaken in department of Physiology in NetajiSubhash Chandra Bose Medical College, Jabalpur MP in year 2018. The subjects comprised of both male and female 50 individuals came to Physiology department for Pulmonary function test from other departments of the college. After explaining and training the subjects Spirometry of all individuals was done by Computerised Spirometer in well ventilated room, after written consent in Department of Physiology. Tools used in present study were chi square, t-test etc. [ABSTRACT FROM AUTHOR]

The current study investigated inter-annual growth, biomass production, carbon storage, and sequestration in Eucalyptus tereticornis plantation of different age (1–8 years) in North-west India. Nondestructive sampling using the allometric equation assessed aboveground and belowground biomass of E. tereticornis plantations. The growth, biomass accumulation, and CO2 assimilation followed the log-normal distribution with age of the plantation. At early stages, E. tereticornis showed rapid growth and within six months 1.4-time increment in DBH and height of one-year tree. Total carbon stock in E. tereticornis increased from 18.7–20.6 Mg C ha−1 in 1-year to 91.8–96.2 Mg C ha−1 after 8-year of planting. The soil organic carbon in 0–15 cm depth showed 34.8% increment in 8 years of plantation cycle highlighting the significance of litter input. Terrestrial C sequestration in the matured plantation (8 years) varied from 85.3 to 88.7 Mg C ha−1 during September 2012 and March 2013, respectively. Total carbon stock (plant+soil) in 8-year plantation ranges from 114.1 to 118.8 Mg C ha−1. Results confirm that E. tereticornis based plantation forestry offers a low-cost strategy for carbon sequestration besides increasing farm income. [ABSTRACT FROM AUTHOR]

Prosopis species is a multipurpose N-fixing leguminous tree that grows naturally in semi-arid and arid environments. These trees are reported to ameliorate and rehabilitate salt-affected soils through its diverse inputs and tolerance to high salinity. However, scanty and scattered information is available on reclamation capacity and soil ecology transformations of different Prosopis spp. under different soil depths. The first aim of this study was to examine changes in soil properties under different Prosopis spp. (of 12 years old plantations) at the research farm, ICAR-Central Soil Salinity Research Institute, Karnal, Haryana, India. The second aim was to determine the most influential soil properties that accounted for the most variation in the Prosopis spp. plantation. The results indicated that irrespective of different Prosopis spp. Plantation, soil pH, electrical conductivity (EC), bulk density, the concentration of Na+, HCO3− and CO3− decreased significantly whereas, mineral N (NO3––N and NH4+–N), soil organic C (SOC), soil carbon stock, microbial biomass C (MB-C) and the concentration of K+ increased significantly. The highest reduction in EC value was noticed under P. juliflora (64.5%) followed by P. chilensis (61.5%) and P. articulata (59.8%) as compared to the control (barren land). Prosopis juliflora increased the MB-C, averaged across the soil depth by 14.8% and 27.5% over P. alba and P. articulata, respectively. MB-C averaged across the Prosopis spp. decreased with increased soil depth and remarkable influence was observed up to 75 cm of soil depth. The magnitude of increase in SOC content and soil carbon stock was higher under P. alba followed by P. juliflora than rest of the Prosopis spp. in the surface (0–15 cm) than sub-soil (15–105 cm) layers. With the predicted increase in area under salt-affected soils due to climate change and anthropogenic reasons, it is crucial to develop the management practices and technologies particularly bio-amelioration which will not only reclaim salt-affected soils but also increase the carbon content to restore the fertility of these soils. [ABSTRACT FROM AUTHOR]

Pledging of personally held common stock is widespread in India, where pledging often serves as lender collateral for large shareholder and promoter personal debt acquisitions. This practice is exacerbated by high ownership concentrations in India, as promoters, often firm founders, control, on average, 51% of their firms' equity. We examine promoter stock pledging impacts on stock volatility, capital investment decisions, and firm performance, using a sample of 1,452 Indian firms. We find that pledging relatively large proportions of outstanding shares and substantial proportions of shares held by promoters exacerbates stock volatility, fosters lower risk capital investments, adversely affects firm values, and impedes longer‐term performance. [ABSTRACT FROM AUTHOR]

Infective endocarditis (IE) is a significant cause of morbidity and mortality. Underlying congenital heart disease and acquired valvular disease significantly increases the IE risk, which is still prevalent in developing countries. Gram-negative organism related IE prevalence appears to be rising with limited data on their presentation and outcomes. This study hopes to shed further light on this subject. This retrospective cross-sectional study occurred in a tertiary care center in South India. A retrospective cross-sectional study performed in a single tertiary care center in South India. All patients with IE from 2006 to 2016 were included in this study. The details of clinical presentation, laboratory investigations, clinical course, microbiology, and outcomes were obtained. Patients fulfilling the modified Duke's criteria and a culture-proven diagnosis of gram-negative IE were eligible for inclusion. A total of 27 patients were enrolled from Jan 2006 to Dec 2016, among whom 78% were male. Prior structural heart disease was common in our cohort (41%) with renal (55%) and embolic (51%) complications being the most common systemic complications. A comparison of mortality with survivors found that congenital and acquired structural heart disease had a higher risk of mortality. Non-fermenting GNB accounted for 52% of the cohort, with Pseudomonas accounting for 19%. E. coli was the most common bacilli isolated, constituting 37% of the cohort. Assessment of risk factors for adverse outcomes found that renal dysfunction and intravascular device were significant with multivariate-logarithmic analysis showing renal dysfunction as an independent risk factor. In-hospital mortality in this series was 30%. In conclusion, gram-negative IE was more prevalent among males. Underlying structural heart disease was the most common risk factor associated with the disease. Renal dysfunction and embolic complications were the most common complications in this cohort. E. coli and NFGNB accounted for 70% of the offending organisms. In-hospital mortality was similar to patients with IE secondary to common organisms. The presence of renal dysfunction was an independent risk factor for an adverse outcome. [ABSTRACT FROM AUTHOR]

Fruit rot disease (FRD) of arecanut, caused by Phytophthora meadii , is an important fruit disease of this palm tree that resulted in huge economic losses to the growers in India. In recent years, the control of this disease has become a prime factor in the management of arecanut plantations. Though prophylactic sprayings of Bordeaux mixture (1%) along with other older fungicides are useful in reducing the disease severity. Hence, there is an urgent need for new generation molecules to combat FRD under field conditions. The present investigation was aimed at evaluating newer oomycete-specific fungicides in in-vitro on different life stages of Phytophthora and in-vivo through a Bunch Spraying System (BSS) from ground level. The pathogen was isolated, identified, and characterized from varied regions and one virulent isolate from each region was used. Out of the 11 fungicides tested, EC 50 for mycelial inhibition among isolates was lowest in Famoxadone + Cymoxanil. Similarly, the lowest EC 50 for sporangial production was recorded in Iprovalicarb + Propineb, Famoxadone + Cymoxanil, and Kresoxymethyl ranging from 210.70 to 517.87 mg mL_1. The most effective fungicide for inhibition of zoospore release was Dimethomorph + Mancozeb which ranged from 406.81 to 565.80 mg mL_1. Bunch spraying of fungicides such as Bordeaux mixture (1%), mandipropamid (0.5%), fosetyl-Al (0.3%), and a combination of metalaxyl-mancozeb (0.2%) from ground level had a significant (P < 0.05) effect against FRD. These fungicides were found most effective in reducing the disease up to an extent of 65–70% and which in turn increased the dry nut yield by 75–95% when applied twice compared to untreated control. However, a semi-systemic fungicide mandipropamid could be a potential alternative to the Bordeaux mixture for effective control of FRD under field conditions. • New-generation oomycete-specific fungicides were evaluated in-vitro and in-vivo. • Semi-systemic Mandipropamid could be a potential alternative to BM in FRD control. • Spraying of fungicides reduced 65–75% of disease with increased dry nut yield. • Bunch spraying system could be adopted in arecanut to realize better FRD control. [ABSTRACT FROM AUTHOR]

Rodenticides such as yellow phosphorus are highly toxic compounds which are commonly used for pest control. Reports of yellow phosphorus poisoning from tropical nations is scanty. In this retrospective study, we report the clinical features, mortality and predictors of mortality among nine patients at a tertiary care centre in south India. Yellow phosphorus consumption was common among a younger age group of patients. The mean duration of presentation after consumption was five days. The most common clinical manifestations seen were abdominal pain and vomiting followed by a depressed sensorium. Features of acute liver failure including coagulopathy were seen in all patients. Despite all patients receiving supportive therapy, a poor outcome or death resulted in the majority. Early referral to a tertiary care centre, meticulous monitoring and supportive measures are key elements of patient management as there are no specific antidotes available at present. Increase in public and physician awareness to the toxin and implementation of preventive policies is of utmost importance. [ABSTRACT FROM AUTHOR]

Leaf blight and corm rot caused by Phytophthora colocasiae are the most devastating diseases of taro. Fourteen P. colocasiae isolates collected from different states of India were characterised for mating type, metalaxyl fungicide sensitivity and aggressiveness on taro. These organisms were identified as P. colocasiae based on morphological characteristics, internal transcribed spacer (ITS) sequence homology and pathogenicity to taro plants. Ribosomal DNA (rDNA) ITS regions of P. colocasiae isolates were examined, and compared with additional Phytophthora species. All isolates of P. colocasiae fell within a single cluster in phylogenetic trees, regardless of their geographic origins. These isolates were more closely related to Phytophthora capsici. All isolates except the isolate collected from Sikkim state of India (98-111) were sensitive to metalaxyl at 100 ppm and it was also scored for causing higher average foliar disease and tuber rot ratings. Isolates tested exhibited four growth patterns in cultures: cottony, rosaceous, petaloid and stellate. P.colocasiae isolates, including an IISR isolate (PC-73), with cottony growth pattern did not grow at 36°C. The mean oospore diameter of A1 mating type isolates was greater than that of A2 mating type isolates. Six of 14 isolates tested produced chlamydospores in V8-CaCO3 liquid medium. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the feasibility of a telephone call as an acceptable method of following up patients with cerebrovascular accidents in South India.

Neem oil has widespread use in Indian subcontinent due to its many bioactive properties. Azadirachtin, an active ingredient, is implicated in causing the effects seen in neem oil poisoning. Neem oil poisoning is rare in adults. This report highlights the toxicity associated with neem oil poisoning in an elderly male. The patient presented with vomiting, seizures, metabolic acidosis, and toxic encephalopathy. The patient recovered completely with symptomatic treatment. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) treatment fails to achieve sustained virological response at 12 weeks (SVR12) in 5–10 % and requires retreatment with second-line drugs. We report our experience of sofosbuvir/velpatasvir/voxilaprevir use for HCV retreatment in a small cohort of difficult-to-treat Indian patients. We reviewed our HCV databases to identify the patients who had failed to achieve SVR12 after treatment with sofosbuvir in combination with either daclatasvir, ledipasvir, or velpatasvir with/without ribavirin on one or more occasions. Participants were excluded if they had (i) decompensated cirrhosis, (ii) HIV coinfection or (iii) chronic kidney disease, or (iv) prior organ transplantation. All the participants were treated with sofosbuvir/velpatasvir/voxilaprevir plus ribavirin for 12 weeks. Treatment outcome was categorized as successful or failure if HCV RNA was undetectable or detectable at SVR12, respectively. Fifteen patients (male 67 %; genotype-3 80 %) were included in the analysis. Ten (67 %) had cirrhosis. Five, eight, and two participants had previously failed one, two, and three courses of pegylated-interferon free, sofosbuvir containing direct acting antiviral (DAA) regimens respectively. Fourteen participants had failed to at least one course of the sofosbuvir/velpatasvir combination. Fourteen patients achieved SVR12, and one patient was lost to follow-up. Treatment was successful in 100 % and 93.3 % of per-protocol (PP) and intention to treat (ITT) analyses, respectively. Sofosbuvir/velpatasvir/voxilaprevir combination is an effective second-line therapy in India for difficult-to-treat HCV patients. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Tuberculous meningitis (TBM) remains common in developing countries. Cerebrovascular infarct (CI) in TBM occurs in 15%-57% of patients. Literature regarding the predictors of central nervous system (CNS) infarct in patients with TBM is scanty, and the outcome of these events is unknown. The aim of this study is to evaluate the predictors of CI among patients with TBM at a tertiary care center in South India and to compare the impact of CI on the prognosis and outcomes in terms of mortality and morbidity., Methods: All patients who were confirmed to have TBM and CNS infarcts/stroke were included in this study retrospectively. Forty-six patients had appropriate imaging, and they were enrolled in the study as cases. Patients without infarct were matched with age and sex as controls. Details of the course of the disease, the extent of CNS involvement, and treatment were compared between the two arms., Results: The mean age of patients with and without infarct was similar. The presence of basal meningeal inflammation, hydrocephalus, focal neurological deficit, and cranial nerve palsy, was higher in patients with infarct. Independent predictors of infarcts in a patient with TBM were Medical Research Council (MRC) staging of II or more, presence of focal neurological deficit, cranial nerve palsy, and presence of hydrocephalus, meningeal enhancement on neuroimaging. Presences of infarcts were independently associated with a higher odds ratio of 2.58 for poor outcome, 4.48 for a longer duration of hospital stay, and odds ratio of 8.85 for the requirement of multiple hospitalizations., Conclusion: CI involvement in TBM has higher morbidity, with longer stay, recurrent admission., Competing Interests: None

Background & Objectives: Dengue fever (DF) is a common cause of acute febrile illness. Skin involvement is seen in more than half of the patients. This study was aimed to compare the clinical profile and outcome in DF patients with or without skin involvement., Methods: This study included all the patients with DF from the acute febrile illness database of a tertiary care health centre in south India. These patients were further subgrouped into SP and SN (skin involvement positive and negative) based on the presence and absence of skin rash. Differences in clinical presentation, laboratory parameters, disease course, morbidity and outcome among patients with DF with or without skin rash were recorded and analysed statistically., Results: In total 387 patients (>16 yr) with DF were enrolled into the study. Among these 55 patients had evidence of skin rash. Presence of history of overt bleeding (OR = 4.96, p = 0.027) including gum bleeding (OR = 1.17, p = 0.23), epistaxis (OR = 5.52, p = 0.04), and haematuria (OR = 6.41, p = 0.01) were more among patients with SP as compared to SN. The SP patients were found to have lower levels of platelets during the disease course. Patients with SP had a higher percentage of platelet transfusion which was statistically significant. There was no difference in organ dysfunction and mortality among both the groups., Interpretation & Conclusion: Cutaneous involvement, though common, is not pathognomonic and can help in dengue diagnosis. Adult patients with skin rash can develop worsening thrombocytopenia requiring platelet transfusion. However, there are limited data to suggest that such patients have a worse outcome and higher mortality., Competing Interests: None

Background: Dematiaceous moulds are pathogenic microorganisms and act as etiological agents of mycoses with different degrees of severity in humans and animals. These moulds also cause loss of food crops and storage food products. The information regarding antimicrobial efficacy of the plant preparations on these moulds is scanty. The present study reveals phytochemical characterization and the effect of bark and leaf extracts of Indian spice plant, Cinnamomum zeylanicum (Cz), against the growth of two species of dematiaceous moulds, Alternaria solani and Curvularia lunata., Methods: Cz bark and leaf samples were sequentially extracted in different solvents using Soxhlet apparatus. Phytochemical analyses of extracts were done as per standard protocols. The antifungal bioassay of extracts was done by hanging drop technique. The inhibition of fungal spore germination was monitored under influence of three different concentrations of extracts., Results: The lowest test concentration (50 microg/ml) of extracts of Cz bark prepared into acetone and that of Cz leaf into petroleum ether and ethanol exhibited complete inhibition (100%) of spore germination in both the moulds. At 100 microg/ml concentration all the extracts showed about 50 to 100% inhibition. However, the treatment of the spores of the two fungal species with highest concentration (500 microg/ml) of bark and leaf extracts in all the solvents showed 100% fungicidal activity as it completely arrested the germination of spores. Relatively lower activity of aqueous extracts at 50 and 100 microg/ml concentrations suggests that the antifungal ingredients present in Cz bark and leaf are more soluble in organic solvents than water., Conclusion: The results demonstrated that the Cz bark and leaves contain certain fungicidal constituents exhibiting potential antimould activity against A. solani and C. lunata.