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We present here a case of multidisciplinary management of a 20-year-old pregnant woman who presented with sudden paraplegia attributed to a large paraspinal tumor. Magnetic resonance imaging (MRI) revealed compressive dorsal myelopathy due to an extramedullary tumor. Given the urgency of her symptoms and pregnancy status, a multidisciplinary team decided to proceed with surgery while avoiding radiation exposure (eg, O/C-arm). Intraoperative point-of-care ultrasound (POCUS) was utilized for tumor localization and surgical guidance, facilitating successful gross total excision with minimal risk to the fetus. Postoperative recovery was uneventful, with improvement in muscle strength and preservation of the pregnancy. Beyond tumor localization, POCUS offers additional benefits in assessing maternal hemodynamics and detecting potential complications. This case highlights the utility of POCUS as a radiation-free theranostic imaging modality in pregnant patients with spinal tumors, enhancing safety in surgery and optimizing outcomes for both mother and fetus.

Long before the Dobbs decision, abortion was a fraught topic in communication classes. Post-Dobbs, the disincentives to discussing abortion intensified as a slew of state legislative actions-imposed restrictions not only on abortion access, but also on anything that might be construed as support for abortion. The purpose with this essay is to begin thinking through the pedagogical implications not only of the Dobbs decision, but of the state laws restricting how abortion is discussed, particularly by those teaching at state institutions. Further, the authors make the case for why professors should be teaching about abortion despite precarity.

Multidrug-resistant yeast Candida auris is a serious threat to public health with documented survival in various hospital niches. The dynamics of this survival benefit and its trade off with drug resistance are still unknown for this pathogen. In this study we investigate the oxidative stress response (OSR) in fluconazole-resistant C. auris and compare its relative fitness with fluconazole-susceptible strains. A total of 351 C. auris clinical isolates (61 fluconazole-susceptible and 290 fluconazole-resistant) were screened for stress tolerance by spot assay and 95.08 % fluconazole-susceptible isolates were hyper-resistant to oxidative stress while majority (94.5 %) fluconazole-resistant isolates had lower oxidative tolerance. Expression of Hog1 and Cta1 gene transcript levels and cellular catalase levels were significantly higher in fluconazole-susceptible isolates and a corresponding higher intracellular reactive oxygen species level (iROS) was accumulated in the fluconazole-resistant isolates. Biofilm formation and cell viability under oxidative stress revealed higher biofilm formation and better viability in fluconazole-susceptible isolates. Fluconazole-resistant isolates had higher basal cell wall chitin. On comparison of virulence, the % cytotoxicity in A549 cell line was higher in fluconazole-susceptible isolates and the median survival of the infected larvae in G. mellonella infection model was higher in fluconazole-resistant (5; IQR:4.5–5 days) vs. fluconazole-susceptible C. auris (2; IQR:1.5–2.5 days). All organisms evolve with changes in their environmental conditions, to ensure an optimal balance between proliferation and survival. Development of tolerance to a certain kind of stress example antifungal exposure in yeast can leads to a compensatory decrease in tolerance for other stresses. This study provides useful insights into the comparative fitness and antifungal susceptibility trade off in C. auris. We report a negative association between H2O2 tolerance and fluconazole susceptibility. Using in-vitro cell cytotoxicity and in-vivo survival assays we also demonstrate the higher virulence potential of fluconazole-susceptible C. auris isolates corroborating the negative correlation between susceptibility and pathogen survival or virulence. These findings could also be translated to clinical practice by investigating the possibility of using molecules targeting stress response and fitness regulating pathways for management of this serious infection.

Gliosarcoma (GSM) is a rare and aggressive type of brain tumour with limited treatment options and a poor prognosis. The present case series aimed to provide further insights into the clinical features, treatment outcomes, and prognosis of GSM. Medical records of 12 histologically confirmed cases of GSM were analysed from 2018 to 2022, revealing a male predominance and a median age of 54 years. The most common symptoms were headache and vomiting due to raised intracranial pressure. All patients underwent maximal safe resection followed by concurrent chemoradiation and adjuvant chemotherapy with Temozolomide (TMZ). Kaplan-Meier analysis showed a median Progression-free Survival (PFS) and overall survival of 8 and 12 months, respectively. The study revealed that the optimal treatment for primary GSM remains a therapeutic dilemma due to the rarity of the disease and the heterogeneity of the patient population and treatment regimens employed. The present study provides valuable insights into the clinical presentation and management of primary GSM in India and highlights the need for further research to improve outcomes for these patients.

Background: Alzheimer’s disease (AD) is a neurodegenerative disease characterized by beta-amyloid (Aβ) deposition and increased acetylcholinesterase (AchE) enzyme activities. Indole 3 carbinol (I3C) and diindolylmethane (DIM) are reported to have neuroprotective activities against various neurological diseases, including ischemic stroke, Parkinson’s disease, neonatal asphyxia, depression, stress, neuroinflammation, and excitotoxicity, except for AD. In the present study, we have investigated the anti-AD effects of I3C and DIM. Methods: Docking and molecular dynamic studies against AchE enzyme and network pharmacological studies were conducted for I3C and DIM. I3C and DIM’s neuroprotective effects against self and AchE-induced Aβ aggregation were investigated. The neuroprotective effects of I3C and DIM against Aβ-induced neurotoxicity were assessed in SH-S5Y5 cells by observing cell viability and ROS. Results: Docking studies against AchE enzyme with I3C and DIM show binding efficiency of −7.0 and −10.3, respectively, and molecular dynamics studies revealed a better interaction and stability between I3C and AchE and DIM and AchE. Network pharmacological studies indicated that I3C and DIM interacted with several proteins involved in the pathophysiology of AD. Further, I3C and DIM significantly inhibited the AchE (IC50: I3C (18.98 µM) and DIM (11.84 µM)) and self-induced Aβ aggregation. Both compounds enhanced the viability of SH-S5Y5 cells that are exposed to Aβ and reduced ROS. Further, I3C and DIM show equipotential neuroprotection when compared to donepezil. Conclusions: Our findings indicate that both I3C and DIM show anti-AD effects by inhibiting the Aβ induced neurotoxicity and AchE activities.

Key Clinical Message Early recognition and treatment of Multisystem Inflammatory Syndrome in Children (MIS‐C) within the context of COVID‐19 infection is crucial for improved outcomes. Prompt intervention with IVIG and steroids leads to significant improvement in a severe case of MIS‐C. Clinicians should be vigilant for MIS‐C symptoms and initiate timely management. Abstract We report a case involving a fourteen‐year‐old male with COVID‐19 infection who developed multisystem inflammatory disease. A previously healthy child presented with a history of 10 days of fever and cough, along with diarrhea, and vomiting for 3 days. His COVID‐19 infection was confirmed through Polymerase Chain Reaction (PCR), and the laboratory values were remarkable for high levels of C‐reactive protein, D‐dimers, B‐type natriuretic peptide (BNP), and troponin I. He developed circulatory shock on the second day of the presentation and needed inotropic support. Steroids and intravenous immunoglobulin (IVIG) were started in light of Multisystem Inflammatory Syndrome in Children (MIS‐C), which improved his condition. Thus, during the management of COVID‐19 infection, early detection and a careful clinical characterization for MIS‐C are essential.

Introduction: Surgical intervention serves as the primary treatment modality for operable oral cavity cancer. However, patients with locally advanced disease or unfavourable prognostic factors often require adjuvant Radiotherapy (RT) with or without concurrent Chemotherapy (CT). Advanced radiation techniques, such as Intensity-Modulated Radiotherapy (IMRT), have shown potential in minimising radiation-related toxicities while ensuring effective tumour control. Aim: To assess common late toxicities, namely xerostomia, dysphagia, and hoarseness, in patients with postoperative Squamous Cell Carcinoma (SCC) of the oral cavity, who received adjuvant RT or concurrent Chemo-Radiotherapy (CRT) utilising IMRT with a Simultaneous Integrated Boost (SIB) approach. Materials and Methods: A retrospective cohort study was conducted in the Department of Radiotherapy at IMS, BHU, Varanasi, Uttar Pradesh, India, from June 2018 to December 2021. Study was done using the medical records of 62 patients with SCC of the oral cavity and received adjuvant radiation by the IMRT technique with or without concurrent CT. Late toxicities were evaluated according to the Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0). Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 28.0, and a logistic regression model was used to establish the association between Organ-At-Risk (OAR) doses and the development of late toxicities. Results: The median age of the study participants was 45 years (range: 25-68), and 95.2% (n=59) of the patients were male. A total of 62 patients (59 male, 3 female) were included. The median follow-up duration was 21.5 months. At two years, the cumulative incidence of xerostomia, dysphagia, and hoarseness was 28.5% (n=8), 21.4% (n=6), and 28.5% (n=8), respectively. Logistic regression showed that both the D mean of >26 Gy to the contralateral parotid (HR=4.32; 95% CI, 1.03- 18.05; p=0.045) and the D mean of >26 Gy to the contralateral Submandibular Gland (SMG) (HR=6.41; 95% CI, 1.48-27.81; p=0.013) were significantly associated with the incidence of xerostomia. The D mean of >47 Gy to the pharyngeal constrictors (HR=17.89; 95% CI, 3.15-101.62; p=0.001) and the D mean of >50 Gy to the larynx (HR=5.77; 95% CI, 1.82-18.24; p=0.003) had a significantly high risk of dysphagia and hoarseness, respectively. Conclusion: Adjuvant IMRT resulted in acceptable rates of late toxicities in oral cancer. Doses to the contralateral parotid and SMGs, pharyngeal constrictors, and larynx had a significant impact on late xerostomia, dysphagia, and hoarseness, respectively

Exposure to general anesthetics can adversely affect brain development, but there is little study of sedative agents used in intensive care that act via similar pharmacologic mechanisms. Using quantitative immunohistochemistry and neurobehavioral testing and an established protocol for murine sedation, we tested the hypothesis that lengthy, repetitive exposure to midazolam, a commonly used sedative in pediatric intensive care, interferes with neuronal development and subsequent cognitive function via actions on the mechanistic target of rapamycin (mTOR) pathway. We found that mice in the midazolam sedation group exhibited a chronic, significant increase in the expression of mTOR activity pathway markers in comparison to controls. Furthermore, both neurobehavioral outcomes, deficits in Y-maze and fear-conditioning performance, and neuropathologic effects of midazolam sedation exposure, including disrupted dendritic arborization and synaptogenesis, were ameliorated via treatment with rapamycin, a pharmacologic mTOR pathway inhibitor. We conclude that prolonged, repetitive exposure to midazolam sedation interferes with the development of neural circuitry via a pathologic increase in mTOR pathway signaling during brain development that has lasting consequences for both brain structure and function.

Herein, comparative studies were conducted on different species of Pleurotus mushroom (Pleurotus osteratus, Pleurotus eryngii, Pleurotus sajor caju, Pleurotus florida, and Pleurotus roseus), extracted in two different solvent systems: dichloromethane (DCM)-ethanol (Et) with the ratio of 1 : 1 (v/v) and 50% (v/v) ethanol. Comparably, 50% (v/v) ethanolic crude extract had a considerably higher extraction yield and total phenolic, carbohydrate, and protein content. Owing to a high total phenolic yield, 50% (v/v) ethanolic crude extract had better ability to scavenge 2,2-diphenyl-1-picryl-hydrazyl-hydrate and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid radical. Contrarily, DCM-Et crude extract showed strong cytotoxic potential against the human breast cancer cell line (MD-MBA-231) and murine skin cancer cell line (B16F10). High-performance thin layer chromatography based methods were developed and validated as per the International Council for Harmonisation Q2(R1) for the determination of ergosterol. Ergosterol content in DCM-Et crude extract correlates with its cytotoxic potential., Author(s): Singh Shreya [sup.1] , Debadatta Mohapatra [sup.1] , Gaurav Gopal Naik [sup.1] , Yamini Bobde [sup.2] , Balaram Ghosh [sup.2] , Alakh N Sahu [sup.1] Author Affiliations: (1) grid.467228.d, [...]

We retrospectively reviewed consecutive cases of mucormycosis reported from a tertiary-care center in India to determine the clinical and mycologic characteristics of emerging Rhizopus homothallicus fungus. The objectives were ascertaining the proportion of R. homothallicus infection and the 30-day mortality rate in rhino-orbital mucormycosis attributable to R. homothallicus compared with R. arrhizus. R. homothallicus accounted for 43 (6.8%) of the 631 cases of mucormycosis. R. homothallicus infection was independently associated with better survival (odds ratio [OR] 0.08 [95% CI 0.02–0.36]; p = 0.001) than for R. arrhizus infection (4/41 [9.8%] vs. 104/266 [39.1%]) after adjusting for age, intracranial involvement, and surgery. We also performed antifungal-susceptibility testing, which indicated a low range of MICs for R. homothallicus against the commonly used antifungals (amphotericin B [0.03–16], itraconazole [0.03–16], posaconazole [0.03–8], and isavuconazole [0.03–16]). 18S gene sequencing and amplified length polymorphism analysis revealed distinct clustering of R. homothallicus.

The present work investigates the efficiency of Paecilomyces variotii upon degrading Reactive Black dye which has been termed a recalcitrant variety of synthetic dye. In this research, initially a predominant fungal species, Paecilomyces variotii was isolated from the tannery effluent sample. The study was carried out by assessing the ability of fungi to decolorize the dye under various parameters like pH (5,7 and 9), Temperature (7°C, 30°C, and 45°C), Dye concentration (200, 300, and 400 mg/L) for different incubation or exposure time interval (3, 5 and 7 days). From the experimental study, it was found that Paecilomyces variotii showed a maximum percentage of dye decolorization at 7°C at pH 9 with 75%, at 30°C at pH 7 with 85%, at 45°C at pH 5 with 82% and a maximum period of incubation with 7 days in 200 mg.L-1 concentration. This result conveys that the strength of Paecilomyces variotii in decolorizing the synthetic dye is effective at a moderate temperature with neutral pH for maximum exposure time. So Paecilomyces variotii could be a good candidate of choice for the biodegradation of various synthetic dyes when manipulated wisely. Also, the result sparks a positive attribute toward decreasing industrial wastewater pollution.

Head-fixed behavioral experiments in rodents permit unparalleled experimental control, precise measurement of behavior, and concurrent modulation and measurement of neural activity. Here, we present OHRBETS (Open-Source Head-fixed Rodent Behavioral Experimental Training System; pronounced ‘Orbitz’), a low-cost, open-source platform of hardware and software to flexibly pursue the neural basis of a variety of motivated behaviors. Head-fixed mice tested with OHRBETS displayed operant conditioning for caloric reward that replicates core behavioral phenotypes observed during freely moving conditions. OHRBETS also permits optogenetic intracranial self-stimulation under positive or negative operant conditioning procedures and real-time place preference behavior, like that observed in freely moving assays. In a multi-spout brief-access consumption task, mice displayed licking as a function of concentration of sucrose, quinine, and sodium chloride, with licking modulated by homeostatic or circadian influences. Finally, to highlight the functionality of OHRBETS, we measured mesolimbic dopamine signals during the multi-spout brief-access task that display strong correlations with relative solution value and magnitude of consumption. All designs, programs, and instructions are provided freely online. This customizable platform enables replicable operant and consummatory behaviors and can be incorporated with methods to perturb and record neural dynamics in vivo.

Endogenous ochronosis/Alkaptonuria is a rare, genetic metabolic disease presenting with cutaneous hyperpigmentation, disabling arthropathy, and homogentisic aciduria. The dermoscopic features of this entity have a good correlation with the histopathological findings, and its knowledge can facilitate early diagnosis to decrease long-term morbidity and improve the quality of life.

AIM: The main aim of this study was to evaluate functional disability in patients with cervical radiculopathy. Our second aim was to compare neck disability between males and females. METHODS: The study included 35 participants of both sexes, in which 21 were female and 14 male. We have used three scales for the evaluation of neck disability: (1) Cervical radiculopathy Impact Scale (CRIS), (2) Neck Pain and Disability (NPAD) Scale, and (3) Copenhagen Neck Functional Disability (CNFD) Scale. RESULTS: The mean scores of CRIS were 14.35 ± 15.59 in males and 33.22 ± 17.58 in females. The NPAD Scale scores were 14.35 ± 15.59 in males and 33.22 ± 17.58 in females. The mean scores of the CNFD Scale were 7.92 ± 5.56 in males and 13.50 ± 5.61 in females. All three scales showed a significant difference between the scores of the two genders, indicating more disability in female patients as compared with the male patients. CONCLUSION: Our results showed 26.22% and 25.88% disability as per CRIS and Neck Pain and Disability Scale, respectively. We found mild-to-moderate disability in our subjects according to the CNFD Scale. The study concluded that females have more disability in cervical radiculopathy as compared to males.

Obesity and cardiovascular complications are the two pandemic which plays a crucial role in the pathophysiology of type 2 diabetes mellitus. Loss of weight and increased cardiovascular risk are becoming the hurdles for the diabetic population. The tremendous hike in the rate of obesity is one of the main reasons for the increased cases of diabetes mellitus and hence, obesity becomes a high-risk factor for diabetes. Glucagon-like peptide-1 (GLP-1) agonists were initially developed for the treatment of diabetes mellitus but was found to be effective not only for the glycemic control but also for the weight loss. Hence this review article aims to assess the clinical efficacy of GLP-1 agonists in the management of weight loss, and also discusses the detailed insights of FDA approved drugs used in weight management, and discuss the mechanisms by which GLP-1 agonist, used in weight loss therapy. It also discusses the role of dual co-agonist in the treatment of obesity. This literature survey has been done by searching term “GLP-1 agonist, diabetes, obesity, novel drug targets” in the PubMed, Scopus, Embase, and web of science databases. Then, the search is further narrowed by including the articles having recent updates only and then further it is narrowed by excluding the animal studies and including only the clinical studies. This article is purely based on the published clinical data obtained from various clinical trials. Based on the previous studies and clinical trials, it has been observed that GLP-1 agonists such as liraglutide and semaglutide are more efficacious drug than other approved drugs in weight management therapy and have advantage of improving the blood glucose profile and reduces the cardiovascular risk also. It is also found that dual gastric inhibitory polypeptide (GIP)/GLP-1 agonists is regarded as the more effective in treating obesity than the GLP-1 agonist alone.

Background: The increasing prevalence of female pattern hair loss (FPHL) is an alarming concern. There are many studies on FPHL in the world literature but there is a dearth of Indian data on the same. Aims and objectives: The present study aims to ascertain the demographic variables and clinical features of FPHL in Western India and its association with metabolic syndrome (MetS) to add over and above the existing data. Materials and Methods: Ninety females who were diagnosed with FPHL were included after approval of the institutional ethics committee. Demographic details, detailed history, and clinical features were noted, following which a few blood investigations for diagnosis of MetS were advised and evaluated. Results: Our study population's age ranged from 17 to 65 years, with the mean age of 34.7 ± 1.3 years. According to the Basic and Specific (BASP) classification, The basic pattern prevalence as found in our study was 46.7% for M type, 35.6% for L type, and 17.7% for C type. The FPHL severity score revealed that 82 (91.1%) had advanced disease at presentation. Prevalence of MetS was found to be 34.4% and had a significant correlation with age of onset in years (p=0.041) and severity score (p=0.013) implying that it leads to an early onset and greater severity of FPHL. Conclusion: FPHL is increasingly common among Indian women, who frequently present with a bitemporal recession of the hairline. Calculation of the female pattern hair loss severity index (FPHL-SI) can help in the categorization of patients and assessment of prognosis. MetS should be actively looked for in patients of FPHL and managed accordingly.

Colorectal cancer (CRC) is a prevalent and potentially fatal disease categorized based on its high incidences and mortality rates, which raised the need for effective diagnostic strategies for the early detection and management of CRC. While there are several conventional cancer diagnostics available, they have certain limitations that hinder their effectiveness. Significant research efforts are currently being dedicated to elucidating novel methodologies that aim at comprehending the intricate molecular mechanism that underlies CRC. Recently, microfluidic diagnostics have emerged as a pivotal solution, offering non-invasive approaches to real-time monitoring of disease progression and treatment response. Microfluidic devices enable the integration of multiple sample preparation steps into a single platform, which speeds up processing and improves sensitivity. Such advancements in diagnostic technologies hold immense promise for revolutionizing the field of CRC diagnosis and enabling efficient detection and monitoring strategies. This article elucidates several of the latest developments in microfluidic technology for CRC diagnostics. In addition to the advancements in microfluidic technology for CRC diagnostics, the integration of artificial intelligence (AI) holds great promise for further enhancing diagnostic capabilities. Advancements in microfluidic systems and AI-driven approaches can revolutionize colorectal cancer diagnostics, offering accurate, efficient, and personalized strategies to improve patient outcomes and transform cancer management.

Purpose: To study the clinical presentation, mycological profile, and risk factors of fungal keratitis (FK) cases presenting at two tertiary-care centers, one each at North (Chandigarh) and Northeast (Assam) India, and to compare the spectrum of fungi recovered from the clinical and environmental samples at both locations. Methods: All patients with suspected FK were enrolled from both the centers between January 2018 and December 2019. Corneal samples were collected and processed as per standard laboratory protocols. Demographic details and clinical and mycological profiles were noted in all patients. Environmental sampling from the soil, air, and the vegetative matter was performed from both locations and neighboring districts. Results: Of the 475 suspected cases, 337 (71%) were diagnosed as FK (median age: 50 years; 77.2% males). The presence of diabetes, hypertension, blurred vision, and corneal discoloration was significantly higher in patients with FK compared to those without FK. Aspergillus sp. (52.1%) and Fusarium sp. (47.61%) were the predominant etiological agents isolated from cases in North and Northeast India, respectively. FK due to melanized fungi was associated with diabetes, trauma with animal tail, and corneal discoloration. A similar spectrum of fungi was seen in environmental and clinical samples in both the regions. Conclusion: The difference in etiological agents of FK and environmental fungal isolates in North and Northeast India highlights the need to identify the ecological niche of potential fungal pathogens. Prospective, multicenter studies, systematic environmental sampling, and the evaluation of the differences in causative agents and clinical presentation of FK from different parts of the country can substantially improve our understanding of its region-specific clinico-epidemiological profile.

IntroductionAntimicrobial susceptibility testing (AST) is used to determine the susceptibility of an organism to antibiotics. The determination of susceptibility is based on MIC breakpoints and is provided by EUCAST and CLSI. Likewise, phenotypic classification criteria developed by CDC/ECDC are used for the classification of pathogens into susceptible, multidrug-resistant, extremely drug-resistant, or totally drug-resistant categories. Whole-genome sequencing (WGS)-based diagnosis is now supplementing existing gold-standard microbiology methods for rapid and more precise AST, and therefore, EUCAST recommended quality criteria to assess whole-genome sequence for reporting the same. In this study, these three global standards, MIC breakpoints, phenotypic classification, and genome quality, are applied to the largest publicly available data for Acinetobacter baumannii (AB), the most critical priority pathogen identified by WHO.Materials and MethodsThe drug sensitivity profile and genomes for isolates of AB were obtained from PATRIC and evaluated with respect to AST standards (CLSI and EUCAST). Whole genome quality assessment and antimicrobial resistance mapping is performed with QUAST and ABRicate, respectively. Four in-house methods are developed for mapping standards and are integrated into a Galaxy workflow based system, Galaxy-ASIST. Analysis of the extent of agreement between CLSI 2022 and EUCAST 2022 for antibiotics was carried out using Cohen’s kappa statistics.Results and DiscussionAn automated pipeline, Galaxy-ASIST, is designed and developed for the characterization of clinical isolates based on these standards. Evaluation of over 6,500 AB strains using Galaxy-ASIST indicated that only 10% of the publicly available datasets have metadata to implement these standards. Furthermore, given that CLSI and EUCAST have different MIC breakpoints, discrepancies are observed in the classification of resistant and susceptible isolates following these standards. It is, therefore, imperative that platforms are developed that allow the evaluation of ever increasing phenotypic and genome sequence datasets for AST. Galaxy-ASIST offers a centralized repository and a structured metadata architecture to provide a single globally acceptable framework for AST profiling of clinical isolates based on global standards. The platform also offers subsequent fine mapping of antimicrobial-resistant determinants. Galaxy-ASIST is freely available at https://ab-openlab.csir.res.in/asist.

Introduction: Blood Stream Infections (BSI) in Intensive Care Unit (ICU) patients at initial stages are acute infections which might even become life threatening. In developing countries, increasing antimicrobial resistance and emergence of Extended Spectrum Beta-Lactamases (ESBL) and carbapenemase has also added an extra burden on physicians. Aim: To study the prevalence of emergence of ESBL and carbapenemase producing Gram Negative Bacteria (GNB) causing BSI in ICU patients. Materials and Methods: The present cross-sectional study was conducted on 1537 blood samples which were received in duration of two years from 2018 to 2020 in the Department of Microbiology, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Haryana, India from various ICUs. A 5-7 mL of blood was aseptically added to BACTEC bottles and bottles after proper labeling were inserted into the machine and incubated upto five days. 0.1 mL of broth from positively flagged bottles was cultured on Blood and MacConkey Agar. These plates were incubated at 37o C for 24 hours and processed as per standard microbiological procedures. Data was entered locally and calculated on the Microsoft Excel database. Results: Among 1537 samples, 263 (17.11%) samples were flagged positive by BACTEC system. On culture out of 263 samples, 51 (19.40%) were Gram Positive Cocci (GPC), 21 (07.98%) were Candida spp. and 191 (72.62%) were GNB. Among 191 Gram negative isolates, Escherichia coli 64 (33.51%) was the predominant organism followed by Klebsiella spp. 60 (31.41%). For all gram negative isolates, meropenem was the most sensitive drug followed by imipenem. Tigecycline (81.25%) was the second most effective drug against Acinetobacter baumannii. ESBL detection was done by Combine Disc Test on 124 samples (Escherichia coli and Klebsiella spp.) which showed Klebsiella spp. 25(20.16%) as the highest ESBL producing organism The rate of carbapenemase producer was 20 (10.45%) among all the gram negative isolates. Conclusion: For BSI in ICU patients, culture and sensitivity along with screening for prevalence of ESBL and carbapenemase producers should be done prior to starting antibiotics

Systemic therapy is one of the most significant cancer treatments. However, drug resistance often appears and has become the primary cause of cancer therapy failure. Regulation of drug target, drug metabolism and drug efflux, cell death escape (apoptosis, autophagy, et al.), epigenetic changes, and many other variables are complicatedly involved in the mechanisms of drug resistance. In various types of cancers, long non-coding RNA H19 (lncRNA H19) has been shown to play critical roles in tumor development, proliferation, metastasis, and multiple drug resistance as well. The efficacy of chemotherapy, endocrine therapy, and targeted therapy are all influenced by the expression of H19, especially in breast cancer, liver cancer, lung cancer and colorectal cancer. Here, we summarize the relationship between lncRNA H19 and tumorigenesis, and illustrate the drug resistance mechanisms caused by lncRNA H19 as well. This review may provide more therapeutic potential targets for future cancer treatments.

IntroductionRecently, India witnessed an unprecedented surge of coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) cases. In addition to patient management issues, environmental Mucorales contamination possibly contributed to the outbreak. A recent study evaluated environment contamination by Mucorales in the hospital setting. However, a considerable number of CAM patients were never admitted to a hospital before the development of the disease. The present study, therefore, planned to evaluate Mucorales contamination of patients’ residences.MethodsThe residential environment of 25 patients with CAM living in north India was surveyed. Air samples were collected from indoor and immediate outdoor vicinity of the patients’ residence and cultured on Dichloran Rose–Bengal Chloramphenicol (DRBC) agar with benomyl for selective isolation of Mucorales. Surface swab samples were also collected from the air coolers fitted in those residences and cultured on DRBC agar. The isolates were identified by phenotypic and genotypic methods. Amplified fragment length polymorphism (AFLP) was employed to evaluate the genetic relatedness of the environmental and patients’ clinical isolates.ResultsThe median spore count (mean ± SD, cfu/m3) of Mucorales in the air of patients’ bedrooms was significantly higher than in the air in other rooms in those residences (3.55 versus 1.5, p = 0.003) or the air collected directly from the front of the air cooler (p < 0.0001). The Mucorales spore count in the environment did not correlate with either ventilation of the room or hygiene level of the patients’ residences. Rhizopus arrhizus was isolated from the environment of all patients’ residences (n = 25); other Mucorales species isolated were Cunninghamella bertholletiae (n = 14), Rhizopus microsporus (n = 6), Rhizopus delemar (n = 6), Syncephalastrum racemosum (n = 1), Lichtheimia corymbifera (n = 1), and Mucor racemosus (n = 1). Genetic relatedness was observed between 11 environmental isolates from the patients’ bedrooms and respective clinical isolates from patients.DiscussionThe study supported the view that the patients might have acquired Mucorales from the home environment during the post-COVID-19 convalescence period. Universal masking at home during patients’ convalescence period and environmental decontamination could minimize exposure in those susceptible patients.