Emergence of a genotype I lineage 1 variant avian infectious bronchitis virus in Assam, India

Background: Infectious bronchitis (IB) is an acute and highly contagious viral disease of poultry affecting chicken of all ages. The causative agent IB virus (IBV) is a Gammacoronavirus within the family Coronaviridae. Viral genetic mutations and recombination events particularly in the spike protein (S1) of IBV constantly give rise to emerging IBV variants. Vaccination is considered as the most reliable approach for IBV control, but current vaccines have been found to be ineffective due to constant emergence of new variant viruses. Objective(s): The objective of our study was to detect IBV genotypes prevalent in Assam, India. Material(s) and Method(s): Oro-pharyngeal swabs and tissue samples from unvaccinated broiler chickens showing respiratory symptoms were tested using RT-PCR targeting the N gene of IBV. The virus was isolated from infected swab/tissue samples in 9 days old specific pathogen free embryonated chicken eggs through allantoic cavity route. Phylogenetic studies were done based on the S1 gene of IBV. Results and Conclusion(s): Clinically, the birds showed gasping and tracheal rales. Necropsy revealed distended ureters. Virus was isolated and identified by curling and dwarfing of the dead embryos and further confirmed by RT-PCR. Positive PCR amplicons were sequenced and phylogenetic analysis clustered the IBV isolate from Assam with genotype I lineage 1 IBV prototype sequence belonging to Beaudette and Mass 41 strains but the isolate exhibited a relatively high degree of sequence divergence with reference strains. Our findings suggest that the IBV isolate might have emerged from recombination with the local circulating virus or vaccine strains. This will have important implications for IB prevention strategies.

Deep COVID-19 Face Mask Detection in Public Using Transfer Learning

Ahstract- The face mask is necessary for crowded places to control the pernicious effect of Corona Virus (COVID-19). The government officials of various countries have mandated the usage of face masks in public places. However, inspecting unmasked people in crowded areas is very tough. To solve this issue, the research demonstrates the automatic detection of masked faces from the images using transfer learning. In the proposed works, the pre-trained models ResNet34 and ResNet50 have been used on the MAFA data set to analyze the accuracy of face mask detection. Experimental testing evaluated 91.74% accuracy for ResNet34 whereas ResNet50 outperformed and achieved 92.3% accuracy. However, the training loss is found to be minimum in Resnet50 as compared to Resnet34. © 2022 IEEE.

Assessing the impact of COVID-19 on visual acuity for diabetic macular edema patients treated with aflibercept in the UK

Purpose : Assessing the impact of COVID-19 on visual acuity (VA) in eyes treated for Diabetic Macular Edema. Methods : Anonymized data from 21 UK centers were extracted from Medisoft for eyes receiving treatment with aflibercept and with VA data in the pre-COVID baseline period (01/10/19 to 30/03/20, N=3,248). Comparisons for period 1 (01/04/20 to 30/09/20, N=2,077)-lockdown following RCOphth Medical Retinal Management Plan, period 2 (01/10/20 to 30/03/21, N=1,850)-intermittent lockdown and period 3 (01/04/21 to 30/09/21, N=1,111;20 centers)-easing of COVID-19 restrictions. VA change was compared for baseline VA, <7 vs. ≥7 injections before period 1 and for eyes losing ≥5 ETDRS letters in period 1. Results : The mean change in VA for eyes with a baseline VA of ≤35 letters, was +4.9, +2.5 and +1.7 letters from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For baseline VA of 36-55 letters, +0.6, +1.7 and -0.2 letters, from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For baseline VA of 56-75 letters, +1.9, zero and -0.5 letters, from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For baseline VA of >75 letters, -4.3, -0.5 and zero letters, from baseline to period 1, period 1 to 2 and period 2 to 3, respectively. For eyes receiving <7 injections before period 1, the mean change in VA was -1.9 letters (N=1,335) from baseline to period 1, +0.5 letters (N=992) from period 1 to 2 and +0.1 letters (N=592) from period 2 to 3. For ≥7 injections before period 1, the mean change in VA was -3.4 letters (N=742) from baseline to period 1, -0.4 letters (N=515) from period 1 to 2 and -1.1 letters (N=303) from period 2 to 3. For eyes losing ≥5 letters before period 1, the mean change in VA when receiving ≥1 injection in period 2 was +3.9 letters (N=283) from period 1 to 2 and -0.1 letters (N=140) from period 2 to 3. For eyes not retreated in period 2, the mean change in VA was -2.9 letters (N=162) from period 1 to 2 and zero letters (N=73) from period 2 to 3. Conclusions : Visual gain between time periods was more likely for lower baseline vision. For eyes with <7 or ≥7 injections before period 1, the mean VA change was a loss in vision in the first period with little change in later periods. For eyes with ≥5 letter loss in period 1, subsequent visual gain was more likely if treatment continued.

The impact of COVID-19 on visual acuity for nAMD patients treated with aflibercept in the UK

Purpose : To assess the impact of COVID-19 on eyes treated for neovascular AMD. Methods : Anonymized data from 21 UK centers were extracted from Medisoft for patients receiving treatment with aflibercept and VA data in the pre-covid baseline (01/10/19 to 31/03/20 n=8,313). Comparisons were made for period 1 (01/04/20 to 30/09/20 n=4,011)-lockdown following RCOphth Medical Retinal Management Plan during COVID-19, period 2 (01/10/20 to 31/03/21 n=4,551)-intermittent lockdown following updated RCOphth COVID-19 guidelines, and period 3 (01/04/21 to 30/09/21 n=2,630)-easing COVID-19 restrictions. VA change was compared for baseline VA, <7 vs. ≥7 injections before period 1 and for eyes losing ≥5 letter in period 1. Results : The mean change in VA for eyes with a baseline VA of ≤35 ETDRS letters was +0.7, +0.1 and -1.6 letters, 36-55 letters was -3.0, -1.2 and -1.3 letters, 56-75 letters was -2.1, -1.1 and -1.5, and >75 letters was -4.3, -0.7 and -0.4 letters in periods 1, 2 and 3 respectively. The median VA change was zero letters for all baseline VA groups and time periods except for the >75 letter group in period 1 (median 2 letter loss). The mean change in VA from baseline for eyes with <7 injections before period 1, was -2.0, -0.6 and -1.2 letters from 2,083, 2,465 and 1,420 eyes in periods 1, 2 and 3, and ≥7 injections before period 1, was -2.9 from 1,928 eyes in period 1 and -1.3 letters from 2,086 and 1,210 eyes in periods 2 and 3. For both groups and time periods the median VA change was zero letters. For eyes that lost ≥5 ETDRS letters before period 1 the mean change in VA for eyes receiving no injections was +2.3 letters (n=155) and -3.5 letters (n=107), 1-3 injections was +1.4 letters (n=740) and -1.3 letters (n=340), and >3 injections was +2.3 letters (n=199) and -0.8 letters (n=122) in periods 2 & 3 respectively. The median VA change was zero letters for all time periods and injection number groups except for >3 injection eyes in period 2 (median 3 letter gain) and no injection eyes in period 3 (median 1 letter loss). Conclusions : In period 1, a small VA loss was experienced by many eyes dependent on baseline VA. Similar VA changes were present for eyes receiving <7 and ≥7 injections before period 1. For eyes that lost ≥5 ETDRS letters during period 1, many had visual gain with more improvement linked to receiving more injections in period 2, falling back in period 3.

Lockdown loss - An unfortunate conundrum in fungal diagnosis during COVID time

Background:Mucormycosis is uncommon among individuals with no underlying risk factors. In children a subcutaneous maxillofacial presentation is common with entomophthoromycosis. Establishing the correct etiology is essential as ther- apeutic management differs for entomophthoromycosis and mucormycosis. In this background establishing diagnosis in a 13 year old patient presenting with a maxillofacial swelling with erosion was a challenge. Methods:A 13 year old male child presented with a 3 year history. It progressed from dry discharging lesions on right side of the face to flattening of the dorsum of the nose and currently regurgitation of fluids from the nose after inges- tion. Biopsy from the facial lesions, middle meatus and anterior ethmoid were received for fungal culture. Results:KOH – calcofluor examination of samples revealed aseptate fungal hyphae. In view of the clinical presentation and the preliminary microscopic finding, a diagnosis of entomophthoromycosis, probably basidiobolomycosis was made. However the colony morphology on SDA and the preliminary LPCB was not suggestive of basidiobolomycosis. Final identification as M. circinelloides was established based on slide culture and confirmed by sequencing at PGIMER. What confused the diagnosis even further was reporting by pathologists as broad septate fungal hyphae with granulom- atous reaction. Empirical therapy with itraconazole was based on the preliminary microbiological diagnosis. He was dis- charged on oral itraconazole pending final microbiological confirmation. Unfortunately he was lost to follow up due to COVID. Conclusions:Establishing etiology and timely intervention, medical and/or surgical are key to the successful recovery of patients with deep fungal infections. It involves a team effort.