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Background: Secondary bacterial infections during COVID-19 hospitalization have been reported in about 6–15% of patients. Aims: To study the secondary bacterial infections that affected the COVID-19 patients during their hospitalisation and to unearth the bacteriological profile of samples obtained after their demise.Settings and Design: This prospective study was carried out at a COVID-19 dedicated, apex tertiary care centre in North India from July 2020 to April 2021.Methods and Materials: Samples of 268 patients were considered for the study. Nasopharyngeal swab specimen, blood, and tissue (lung) were collected from the deceased body as early as possible and processed. Statistical Analysis: Statistical analyses were performed using STATA version 11.1 (Stata Corp., College Station, TX, USA). Results: A total of 170 samples were received from patients before their death, which included blood, urine, respiratory samples, pus, and cerebrospinal fluid. Forty-four pathogens were isolated, which consisted of Acinetobacter baumannii (43.1%), Klebsiella pneumoniae (36.3%), Escherichia coli (11.3%), and Pseudomonas aeruginosa (4.5%), Enterococcus faecium (4.5%). Two hundred fifty-eight samples were collected from the deceased bodies wherein the nasopharyngeal sample was highest, followed by tissue and blood. A total of 43 pathogens were isolated among them which included A. baumannii (44.1%), followed by K. pneumoniae (25.5%), E. coli (20.9%), P. aeruginosa (6.97%) and Enterobacter cloacae (2.3%). All these isolates were highly resistant to antimicrobials. Conclusions: In our study, bacterial profiles in antemortem and postmortem samples were found to be similar, suggesting that resistant pathogens may be the cause of mortality in COVID-19 infected hospitalised patients.

Background: Picture-naming tests (PNTs) evaluate linguistic impairment in dementia due to semantic memory impairment, impaired lexical retrieval or perceptual deficits. They also assess the decline in naming impairment at various stages of dementia and mild cognitive impairment (MCI) that occurs due to progressive cognitive impairment. With the increasing numbers of people with dementia globally, it is necessary to have validated naming tests and norms that are culturally and linguistically appropriate. Aims: In this cross-sectional study we harmonized a set of 30 images applicable to the Indian context across five languages and investigated the picture-naming performance in patients with MCI and dementia. Methods & Procedures: A multidisciplinary expert group formed by the Indian Council of Medical Research (ICMR) collaborated towards developing and adapting a picture naming test (PNT) known as the ICMR-PNT in five Indian languages: Hindi, Bengali, Telugu, Kannada and Malayalam. Based on cross-cultural adaptation guidelines and item-wise factor analysis and correlations established separately across five languages, the final version of the ICMR-PNT test was developed. A total of 368 controls, 123 dementia and 128 MCI patients were recruited for the study. Psychometric properties of the adapted version of the ICMR-PNT were examined, and sensitivity and specificity were examined. Outcomes & Results The ICMR-PNT scores in all languages combined were higher in controls compared with patients with dementia and MCI (F[subscript 2], [subscript 615] = 139.85; p < 0.001). Furthermore, PNT scores for MCI was higher in comparison with patients with dementia in all languages combined (p < 0.001). The area under the curve across the five languages ranged from 0.81 to 1.00 for detecting dementia. There was a negative correlation between Clinical Dementia Rating (CDR) and ICMR-PNT scores and a positive correlation between Addenbrooke's Cognitive Examination--III (ACE-III) and ICMR-PNT scores in control and patient groups. Conclusions & Implications: The ICMR-PNT was developed by following cross-cultural adaptation guidelines and establishing correlations using item-wise factor analysis across five languages. This adapted PNT was found to be a reliable tool when assessing naming abilities effectively in mild to moderate dementia in a linguistically diverse context.

Background Expansion of the testing capacities for severe acute respiratory syndrome-coronavirus-2 is an important issue in the face of ever-increasing case load. So, there is need of point-of-care diagnostic tests in the existing laboratory capacities for early treatment, isolation, and clinical decision making, especially in resource limited settings. Materials and Methods This prospective cohort study was conducted at Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi. Nasopharyngeal samples and blood samples were collected for antigen and antibody testing. Rapid antigen test was performed as per the kit's instructions. The performance of the kit was compared with the gold standard reverse transcription polymerase chain reaction (RT-PCR) testing. Results Eighty-eight out of 110 patients tested positive by RT-PCR for coronavirus disease 2019 in last 48 to 72 hours were included in the study. Overall, the sensitivity of combined antibody test was 52%, antigen test 26%, and combined sensitivity of both antigen and antibody was 72.7%, respectively. Conclusion The combo kit needs to be used with caution in low prevalence settings, where cases may be missed.

The study explores the intersectionality of caste, class, and gender in relation to the socio-economic empowerment of married women in Chennai's urban slums. Despite India's strides toward gender equality, the socio-economic empowerment of marginalized women remains an on-going challenge, particularly in urban slum areas where caste and class inequalities persist. This research delves into how these intersecting identities influence married women's access to education, employment, and healthcare, alongside their overall sense of agency and decision-making power within their households and communities. The study works a mixed-methods approach, utilizing both quantitative surveys and qualitative interviews to gain a comprehensive understanding of the experiences of married women in Chennai's urban slums. Through this methodology, the research captures the nuances of how caste and class structures intersect to shape these women's socio-economic realities. Quantitative data from a sample size of 300 women provides insight into education levels, employment rates, household income, and access to healthcare, while qualitative interviews with a subset of participants illuminate the personal narratives and challenges faced due to caste and class-based discrimination. Preliminary findings indicate that caste continues to play a significant role in limiting economic opportunities and social mobility, with lower-caste women experiencing greater barriers compared to their higher-caste counterparts. Additionally, class disparities further compound these issues, as limited financial resources restrict access to education and healthcare services. Gender norms and expectations within these communities often confine married women to domestic roles, thus hindering their economic participation and independence. The study aims to shed light on the specific obstacles to socio-economic empowerment faced by married women in Chennai's urban slums. The findings will contribute to a deeper understanding of the intersectionality of caste, class, and gender, ultimately providing policy recommendations for targeted interventions that can enhance the socio-economic standing and agency of marginalized women in urban slum areas. [ABSTRACT FROM AUTHOR]

The participation of women in political spheres, particularly at local governance levels, is a critical factor in advancing gender equality and promoting inclusive decision-making. However, patriarchal norms continue to pose significant barriers to women's political involvement, particularly for married women, who often face additional societal expectations and constraints. This study explores the political participation and representation of married women in Chennai's local governance, aiming to uncover the socio-cultural dynamics that shape their involvement and to understand the extent to which patriarchal structures influence their political agency. The research studies both formal and informal factors that affect the political engagement of married women. It takes into account legislative frameworks, including the reservation of seats for women in local governance as mandated by India's Constitution (73rd and 74th Amendments), and the socio-cultural norms that often hinder their active participation. The study adopts a mixed-methods approach, combining quantitative data collection through surveys with married women in local governance roles with qualitative interviews to gain deeper insights into their lived experiences. Furthermore, the study explores the inter-sectionalist of caste, class, and religion, examining how these factors compound the barriers that married women face in political engagement. Preliminary findings indicate that despite the constitutional mandate for women's representation in local governance, patriarchal norms deeply rooted in family and community structures continue to constrain the political participation of married women. Many face opposition from family members, particularly spouses, and are often expected to prioritize domestic responsibilities over political careers. Additionally, there is evidence of systemic bias within political institutions, where male counterparts often undermine or marginalize the voices of married women leaders. Cultural expectations surrounding gender roles also discourage women from pursuing active political participation, as they are often perceived as less capable of handling governance responsibilities compared to men. [ABSTRACT FROM AUTHOR]

Byline: Sheetal. Goyal, K. Darshini, Dinesh. Sharma, Saraswathi. Nashi, Faheem. Arshad, V. Vandana, Suvarna. Alladi Sir, Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a rare autosomal dominant [...]

Summary: Although a plethora of research articles on AI methods on COVID-19 medical imaging are published, their clinical value remains unclear. We conducted the largest systematic review of the literature addressing the utility of AI in imaging for COVID-19 patient care. By keyword searches on PubMed and preprint servers throughout 2020, we identified 463 manuscripts and performed a systematic meta-analysis to assess their technical merit and clinical relevance. Our analysis evidences a significant disparity between clinical and AI communities, in the focus on both imaging modalities (AI experts neglected CT and ultrasound, favoring X-ray) and performed tasks (71.9% of AI papers centered on diagnosis). The vast majority of manuscripts were found to be deficient regarding potential use in clinical practice, but 2.7% (n = 12) publications were assigned a high maturity level and are summarized in greater detail. We provide an itemized discussion of the challenges in developing clinically relevant AI solutions with recommendations and remedies. The bigger picture: During the COVID-19 pandemic, medical imaging (CT, X-ray, ultrasound) has played a key role in addressing the magnified need for speed, low cost, ubiquity, and precision in patient care. The contemporary digitization of medicine and rise of artificial intelligence (AI) induce a quantum leap in medical imaging: AI has proven equipollent to healthcare professionals across a diverse range of tasks, and hopes are high that AI can save time and cost and increase coverage by advancing rapid patient stratification and empowering clinicians.This review bridges medical imaging and AI in the context of COVID-19 and conducts the largest systematic review of the literature in the field. We identify several gaps and evidence significant disparities between clinicians and AI experts and foresee a need for improved, interdisciplinary collaboration to develop robust AI solutions that can be deployed in clinical practice.The key challenges on that roadmap are discussed alongside recommended solutions.

HIV-1 Vpu targets the host cell proteins CD4 and BST-2/Tetherin for degradation, ultimately resulting in enhanced virus spread and host immune evasion. The discovery and characterization of small molecules that antagonize Vpu would further elucidate the contribution of Vpu to pathogenesis and lay the foundation for the study of a new class of novel HIV-1 therapeutics. To identify novel compounds that block Vpu activity, we have developed a cell-based ‘gain of function’ assay that produces a positive signal in response to Vpu inhibition. To develop this assay, we took advantage of the viral glycoprotein, GaLV Env. In the presence of Vpu, GaLV Env is not incorporated into viral particles, resulting in non-infectious virions. Vpu inhibition restores infectious particle production. Using this assay, a high throughput screen of >650,000 compounds was performed to identify inhibitors that block the biological activity of Vpu. From this screen, we identified several positive hits but focused on two compounds from one structural family, SRI-41897 and SRI-42371. We developed independent counter-screens for off target interactions of the compounds and found no off target interactions. Additionally, these compounds block Vpu-mediated modulation of CD4, BST-2/Tetherin and antibody dependent cell-mediated toxicity (ADCC). Unfortunately, both SRI-41897 and SRI-42371 were shown to be specific to the N-terminal region of NL4-3 Vpu and did not function against other, more clinically relevant, strains of Vpu; however, this assay may be slightly modified to include more significant Vpu strains in the future.

Background: This study was conducted to calculate the pulmonary arterial obstruction index (Qanadli index), evaluate its usefulness in patients with pulmonary thromboembolism, study the correlation between the pulmonary arterial obstruction index and right ventricular dilatation in patients with pulmonary thromboembolism, and investigate the correlation between the pulmonary artery obstructive index and right ventricular dysfunction in patients with pulmonary embolism. Methods: This was a hospital based cross-sectional study conducted among 50 patients who presented with pulmonary thromboembolism to the Department of Radiodiagnosis and Imageology, Kurnool Medical College, Kurnool, over a period of two years from November 2018 to November 2020, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: Dyspnea and chest pain were present in 78% and 40% of the patients respectively. The maximum number of patients had an obstructive pulmonary index. Thrombus in the RT main pulmonary artery was present in 24 % of patients. LT main pulmonary artery in 18%. RT upper lobe segmental artery involved in 50%, RT middle lobe segmental artery in 72%, RT lower lobe segmental artery in 74%. LT upper lobe segmental artery involved in 36%, LT middle lobe segmental artery in 56%, LT lower lobe segmental artery in 62%. RT lung was involved more than LT lung. RV dilation measured in terms of relation to right and left ventricular measurements, RV/LV > 1 was present in 40%, <1 in 60%. RV dilatation was present in 20 patients out of 50. Out of 20 patients, 19 had a pulmonary artery obstructive index >45%; only one had a pulmonary artery obstructive index <45%. RV dysfunction was present in 19 cases. 15 patients had a pulmonary artery obstructive index >50%; four patients had a pulmonary artery obstructive index <50%. Conclusion: The specific index (the CT obstruction index) to quantify vascular obstruction in helical CT appears simple and reproducible. The CT obstruction score has considerable clinical and imaging impact, enabling accurate diagnosis, risk stratification, and patient selection for more aggressive treatment. There is a strong correlation between OI, RV dilatation, and RVD. [ABSTRACT FROM AUTHOR]

It is important to emphasize that the presence of intrahepatic or extrahepatic biliary stenotic foci in an HIV-positive patient with low CD4 count suggests a possibility of AIDS-associated cholangiopathy, which may be an indicator of progression of the disease. It presents with a clinical variable presentation, although right upper quadrant pain and fever accompanied by an elevated serum alkaline phosphatase (ALP) level are the most common manifestations. We present a case of a young female patient diagnosed with AIDS cholangiopathy as evidenced by clinical features, altered liver function profile indicating obstructive jaundice, classical imaging features on USG, MRI and MRCP, and very low CD4 count.