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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.

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.

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.

There are very few acoustic studies reflecting on the localization of speech function within the different loci of the cerebellum. Task based performance profile of subjects with lesion in different cerebellar loci is not reported. Also, the findings on nonfocal cerebellar lesions cannot be generalized to lesions restricted to the cerebellum. Hence, this study was undertaken to reflect upon the differential performance if any of subjects with lesions in different cerebellar loci based on phonatory and diadochokinetic (DDK) tasks. The aims and objectives of this study were to see the pattern of phonatory and DDK measures in dysarthria due to lesions in different cerebellar loci. The study aimed to see if there is a task based localization of speech within the cerebellum. Findings and implications of this study are discussed. (Contains 4 tables and 8 graphs.)

Cerebellum plays an important role in speech motor control. Various tasks like sustained phonation, diadochokinesis and conversation have been used to tap the speech timing abilities of dysarthric clients with cerebellar lesion. It has recently been proposed that not all areas of the cerebellum may be involved in speech motor control; especially aspects concerned with timing of speech events. In the present study, the timing of articulatory movements in three clients with lesions restricted to different cerebellar loci was investigated. A relational speech timing paradigm was used to investigate initial syllable vowel duration (ISVD) in these three clients. The findings were compared with 15 age and gender matched controls. The results suggest that subjects with cerebellar right hemispheric cerebellar lesion showed reduced preservation of relational timing measures as compared to cerebellar vermis lesion i.e. midline structures and cerebellar left cerebellar hemispheric lesion, thus indirectly suggesting a differential loci specific control in cerebellum for relational speech timing.

Introduction: Mucoid degeneration and Ganglion cysts arising from the posterior cruciate ligament (PCL) of the knee are rare. The aetiology, clinical features and Magnetic resonance imaging (MRI) appearance of PCL mucoid degeneration and intercondylar ganglion cyst are discussed. Case Report: We present a 36 year-old male patient who presented with chronic right knee pain for the duration of 5-6 months. No evidence of ligament instability on clinical examination was found. A diagnosis of PCL mucoid degeneration and intercondylar ganglion cyst was made on MRI. Conclusion: Mucoid degeneration and ganglion cyst involving PCL are uncommon lesions and represents the spectrum of same pathology. MR imaging is sensitive, specific, accurate and noninvasive, while providing multiplanar imaging and superior identification of the anatomical and morphological relationship of the synovial tissue to the surrounding structures, an additional intra-articular lesions can also be detected. Keywords: Ganglion cyst, mucoid degeneration, intercondylar, posterior cruciate ligament.

Delayed recovery/awakening/ emergence can occur under anaesthesia and is multifactorial, could be drug or non drug related. Similarly, we report a case of delayed recovery in a 68-year-old patient, for laparoscopic cholecystectomy, a known case of hypertension, bronchial asthma and hypothyroidism. Preoperatively, she was optimised for her medical disorders; however, she had delayed recovery from general anaesthesia. The delayed recovery, often, would be expected in a case of hypothyroidism, however in our patient it was found to be associated with inadvertent hypokalemia.

This commentary describes how a grassroot-led partnership initiated by members of the organisations World Federation of NeuroRehabilitation and Collaboration of Aphasia Trialists is addressing the marginalisation of people with aphasia, through education and knowledge exchange related to communication partner training of health professionals. A partnership between academics and healthcare professionals across Austria, Denmark, Egypt, Ireland, Greece, India, Serbia and the United Kingdom was established in 2020. Through bimonthly online sessions in 2021–2022 a Danish communication partner training program was introduced while six teams adapted and translated the training and its materials to their local contexts. A collaborative partnership enabled multiple translations of an existing communication partner training program for healthcare professionals working with people with aphasia to support a sustainable delivery model that is linguistic and culturally sensitive. This commentary paper focusses on Sustainable Development Goal (SDG) 17 and also addresses SDG 10. [ABSTRACT FROM AUTHOR]

Carotid endarterectomy(CEA) is being increasingly performed under regional anaesthesia supplemented with sedation, the world over. Deep or superficial cervical plexus blocks or a combination of both have been found to be equally effective. Various imaging modalities like fluoroscopy, computed tomography (CT), CT-fluoroscopy, ultra-sound etc have been used to increase the success rates of the technique and to reduce the rate of complications associated with the block. These are especially useful given the varying landmarks quoted by various authors as also inter-individual differences in anatomy. We present a case report of how fluoroscopy aided us in administering cervical plexus block.

This current study investigates the effect of blending bio-lubricant with commercial lubricant on physico-chemical and tribological properties. The synthesis of TMP and PE ester are optimized to obtain 100% long chain tetra-esters and extreme care was taken during preparation of bio-lubricant to lessen deterioration of physio-chemical properties by blending with commercial oil. SM grade commercial petrol engine oil was blended with Tri-methylolpropane (TMP) ester, Penta-erythritol (PE) ester derived from Calophyllum-inophyllum in 10, 15, 20 and 25% v/v. The tests for anti-wear, anti-friction and extreme pressure properties are conducted on the sample oils on a four-ball wear tester. The friction coefficient and wear of bio-lubricant – commercial oil blends have decreased significantly up to 20% blending percentage. In the extreme pressure test, there is a substantial improvement in the weld load and marked improvement in the load wear index signifying the better load-bearing capacity of commercial oil – bio-lubricant blends. A synergy between bio-lubricant and additives in the commercial oil was found from a metallographic examination of worn balls after the EP test. The optimum volume percent of blend was found to be 15% PE blend and 10% TMP blend for optimum overall performance. [ABSTRACT FROM AUTHOR]

Background: Linguistic typology plays an important role in identifying clinical markers of language deficits that characterise Primary Progressive Aphasia (PPA). The current International criteria to diagnose PPA were primarily developed for English. Typological characteristics of Indian languages however differ from English in their morpho‐syntactic complexity, a flexible‐word order, richer morphology, 'pro‐drop' languages with absence of prepositions and transparent orthography. We aimed to develop a novel test in Kannada (Dravidian) and Hindi (Indo‐Aryan) to identify language deficits in Indian language speakers with PPA. Method: The speech‐language test systematically developed for Kannada and Hindi consisted of unique tasks for syntax, semantics, phonology, motor speech and working memory. Participants underwent assessment of cognition and language with Addenbrooke's Cognitive Examination‐III, Western Aphasia Battery‐Revised and Indian Semantic Memory Battery (ISMB) in addition to the novel test. Results: Of 26 patients with PPA (Kannada 13, Hindi 13), 15 had non‐fluent variant (nfvPPA), 8 semantic variant (svPPA) and 3 logopenic variant (lvPPA). On the novel test, PPA had higher phonological, motor speech, syntactic and semantic errors compared to 60 controls. nfvPPA had higher phonological, motor speech and syntactic errors and lesser semantic errors compared to svPPA. Semantic and working memory errors discriminated between nfvPPA and svPPA. On qualitative analysis, 5 patients of nfvPPA had significant apraxia of speech. The other 10 had a unique syntactic profile: agrammatism was not prominent in their spontaneous speech and picture description. Sentences were relatively fluent, complete and sufficient for functional communication. The consistent abnormality observed was a reduction in overall length of utterance. Agrammatisms such as inappropriate use of case markers were restricted to specific tests of syntax. svPPA patients had increased verbal output and prominent paragrammatisms. Testing for surface dyslexia was not relevant due to the orthographic transparency of Indian languages. Conclusion: The novel language test for evaluation of Indian speakers of PPA revealed unique findings for diagnosis of nfvPPA. Reduction in length of utterances and lack of prominent agrammatism was a consistent clinical marker and owes itself to morpho‐syntactic complexity of Indian languages. Our study emphasises the need to account for linguistic typology in diagnosis of PPA. [ABSTRACT FROM AUTHOR]

Cerebrovenous sinus thrombosis (CVT) is a rare neurological condition which is difficult to diagnose because of the varied neurological presentation. The pattern of speechlanguage findings and recovery patterns in CVT can be quite different from those seen associated with arterial stroke. In converse to arterial stroke, scarce information exists on the natural history and long-term prognosis of CVT. This is particularly true with respect to the pattern of speech and language deficits associated with this condition. The present study profiles the speech-language and recovery patterns in seven patients with cerebrovenous sinus thrombosis. [ABSTRACT FROM AUTHOR]

The perceptual method of classifying dysarthria is considered the "gold standard" for clinically differentiating the types of dysarthria. Darley et al.,[l] pioneered the use of perceptual classification system to identify clusters of salient perceptual characteristics in speech that are associated with lesions in the central and peripheral nervous system. This system is also popularly referred to as the "Mayo Clinic Dysarthria Research"[1] Many researchers who investigate the acoustic and physiologic bases of dysarthrias also use the perceptual classification system. The present study attempts to analyse the perceptual speech characteristics in dysarthria associated with lesions in different cerebellar loci. [ABSTRACT FROM AUTHOR]

The article discusses findings on phonatory and laryngeal characteristics in the acoustic and perceptual studies on ataxic dysarthria. It indicate inconsistency in the phonatory deviations due to underlying dysmetria in subjects with focal cerebellar lesions. It details the laryngeal measures in increased long and short term pitch and loudness fluctuations in ataxic dysarthria.

The article discusses the advantages and challenges in the adaptation and standardization of Cognitive Linguistic Quick Test in Kannada (CLQT-K). It compares the factors affecting language cognition and proficiency in both monolinguals and bilinguals in terms of vocabulary acquisition and language fluency. It emphasizes the role of aging in many cognitive linguistic changes in the semantic knowledge and functional levels.

Cerebellum plays an important role in speech motor control. Various tasks like sustained phonation, diadochokinesis and conversation have been used to tap the speech timing abilities of dysarthric clients with cerebellar lesion. It has recently been proposed that not all areas of the cerebellum may be involved in speech motor control; especially aspects concerned with timing of speech events. In the present study, the timing of articulatory movements in three clients with lesions restricted to different cerebellar loci was investigated. A relational speech timing paradigm was used to investigate initial syllable vowel duration (ISVD) in these three clients. The findings were compared with 15 age and gender matched controls. The results suggest that subjects with cerebellar right hemispheric cerebellar lesion showed reduced preservation of relational timing measures as compared to cerebellar vermis lesion i.e. midline structures and cerebellar left cerebellar hemispheric lesion, thus indirectly suggesting a differential loci specific control in cerebellum for relational speech timing. [ABSTRACT FROM AUTHOR]