Dengue, Chikungunya, and Zika: The Causes and Threats of Emerging and Re-emerging Arboviral Diseases.

The recent emergence and re-emergence of viral infections transmitted by vectors, Zika, chikungunya, dengue, and others, is a cause for international concern. Here, we provide a summary of the current understanding of the transmission, clinical features, diagnosis, global burden, and the likelihood of future epidemics by these viruses. Arboviruses transmitted by mosquitoes are challenging to diagnose and can have surprising clinical complications. Dengue, chikungunya, and Zika are the most important diseases caused by arboviruses worldwide, especially in tropical and subtropical regions. These are transmitted to humans by day-biting Aedes aegypti and Aedes albopictus mosquitoes. In India, the increase in the incidence of dengue and chikungunya cases is primarily linked to the dissemination of Aedes aegypti. A rapid and accurate diagnosis is paramount for effectively controlling dengue outbreaks. As there is no vaccination or specific treatment available for these viruses, vector control is the only comprehensive solution available.

Fungal otitis externa and tympanic membrane perforation.

Introduction: Otomycosis is a fungus-causing superficial infection of the external auditory canal that is common in otolaryngology practice. Though it is a worldwide infection, but is more prevalent in warm and humid regions. There has been rise in the occurrence of otomycosis in the last few years because of the extensive usage of antibiotic eardrops. Other influencing reasons for the occurrence of otomycosis is swimming, an immunocompromised host (e.g.: DM, AIDs) pregnancy, post-canal wall down mastoidectomy, tympanic membrane perforation, hearing aids and self-inflicted injuries. Methods: Approval from the institutional ethics committee and penned informed agreement from all patients involved in the examination were obtained. 40 patients were included in the study, starting from 1stAugust to 30th September 2021, which emphasized on otomycosis infection with central tympanic membrane perforation. Physical findings such as whitish ear discharge and the presence of hyphae in the EAC, the ear drum, the middle ear mucosa were used to diagnose otomycosis. Result: 20 patients of patched group and 20 patients of non-patched group did not visit for follow up. Data here is for patients who followed-up for 3 weeks. Any significant observation regarding statistical variation in the age, size of perforation, mycological analysis and pure tone audiometry among the two groups were not seen. Conclusion: To conclude, we state that treatment with clotrimazole solution in patched group is safe in managing otomycosis with tympanic membrane perforation. Otomycosis is a fungus causing surface infection of the external auditory canal that otolaryngologists routinely diagnose by medical examination. In acute otomycosis, overgrowth of the fungus in the external auditory canal is due to increased humidity.

Microvasular Free Flap Reconstruction in Head and Neck Surgery: Complication and Outcome of 80 Flaps.

Head and neck carcinoma can prompt destroying cosmetic and functional deformities with resultant mental, physical and nourishing burden. Regardless of ongoing advances in medication and surgical procedure, the general endurance for patients with head and neck malignant growth has stayed still for as long as 35 years. This endurance rate has prompted the foundation of the standards of tumor extraction with most extreme tissue saving and more up to date endoscopic laser-helped methods for auto-digestive region malignant growths targeting diminishing operational morbidity without influencing the general endurance. This retrospective and prospective study contained 80 patients who went through miniature vascular free flap remaking following a significant head and neck oncosurgery procedure from 01/01/2017-to-31/12/2019. Three kinds of free flaps were fundamentally utilized. The current study was directed to assess the clinical result in patients going through miniature vascular free flap reproduction and to decide the viability after head and neck onco-surgical procedure method. Despite the fact that miniature vascular free flaps are today viewed as cutting edge in head and neck remaking after composite resection with predominant effective and stylish rebuilding, it is as yet not basic in India at numerous focuses. This retrospective and prospective study were conducted for a time of 3 years to know the clinical result, decide the adequacy and assess the occurrence and reasons for pre- and post-surgical intricacies in patients going through miniature vascular free flap recreation after head and neck onco-surgical procedure method. It was inferred that the free flaps were dependable in accomplishing effective reproduction of the head and neck following an effective onco-surgical procedure methodology. Despite the fact that there is a critical loss of delicate tissue and bone however after an effective acknowledgment of free flap, close to ordinary anatomical and physiological capacities can be accomplished in larger part of the patients. The frequency of complexities was straightforwardly related to the co-morbidity level and specialist's working experience.

An Epidemiological Analysis of SARS-CoV-2 Genomic Sequences from Different Regions of India.

The number of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) cases is increasing in India. This study looks upon the geographic distribution of the virus clades and variants circulating in different parts of India between January and August 2020. The NPS/OPS from representative positive cases from different states and union territories in India were collected every month through the VRDLs in the country and analyzed using next-generation sequencing. Epidemiological analysis of the 689 SARS-CoV-2 clinical samples revealed GH and GR to be the predominant clades circulating in different states in India. The northern part of India largely reported the 'GH' clade, whereas the southern part reported the 'GR', with a few exceptions. These sequences also revealed the presence of single independent mutations-E484Q and N440K-from Maharashtra (first observed in March 2020) and Southern Indian States (first observed in May 2020), respectively. Furthermore, this study indicates that the SARS-CoV-2 variant (VOC, VUI, variant of high consequence and double mutant) was not observed during the early phase of virus transmission (January-August). This increased number of variations observed within a short timeframe across the globe suggests virus evolution, which can be a step towards enhanced host adaptation.

Hepatitis B and C Viruses, Their Coinfection and Correlations in Chronic Liver Disease Patients: A Tertiary Care Hospital Study.

INTRODUCTION: There has been a rapid increase in the cases of viral hepatitis in Malwa region of Punjab. Quantification of seroprevalence of hepatitis B virus (HBV)/hepatitis C virus (HCV) and their coinfection among liver disease patients in tertiary care settings is needed to know the associated disease burden. AIM: The aim of this study is to analyze the seroprevalence of HBV, HCV, their coinfection, and implications in liver disease patients. MATERIALS AND METHODS: This prospective study was conducted from June 2015 to August 2015 on a total of 100 chronic liver disease (CLD) patients. Venous blood samples were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies by performing required serological tests using sandwich ELISA technique and solid-phase immunochromatography. RESULTS: Out of 100 cases, 80 (80%) were male and 20 (20%) were female with mean age of 47.44 ± 14.56 years. Out of 100 cases of hepatic disorders, 26 were HBsAg positive and 40 were anti-HCV positive. Majority of the HBsAg-positive cases had alcohol as a risk factor (27%) and were diagnosed with cirrhosis (38.5%). Maximum number of anti-HCV-positive cases had blood transfusion as risk factor (30%) and were diagnosed with cirrhosis (45%). Out of total 62 seropositive cases, 4 had coinfection of HBV and HCV. Coinfected patients did not demonstrate greater risk of developing cirrhosis or progressing to hepatocellular carcinoma than mono-infected patients. CONCLUSION: HBV and HCV are the major causes of CLD at the place of study. Patients with dual HBV and HCV infection do not have greater risk of developing cirrhosis or progressing to HCC than mono-infected patients.

Antibiotic susceptibility profiles of non-fermenting gram-negative Bacilli at a Tertiary Care Hospital in Patiala, India.

BACKGROUND: Non-fermenting Gram-negative bacilli (NFGNB) have emerged as a major cause of healthcare-associated infections and are innately resistant to many antibiotics. AIM: The aim of this study was to determine the prevalence of NFGNB isolated from various clinical specimens and evaluate their antimicrobial susceptibility profiles. MATERIALS AND METHODS: This retrospective study was done at our Department of Microbiology from December 2015 to December 2016. NFGNB were isolated from a variety of clinical specimens, plated on blood agar and MacConkey agar and incubated at 37°C for 18-24 h under aerobic conditions. Appropriate biochemical tests were done to identify the organisms isolated. Antibiotic susceptibility test was performed using the modified Kirby-Bauer disc diffusion method using commercially available discs on Mueller-Hinton agar. Data was analyzed using SPSS IBM version 20. RESULTS: Out of 19065 clinical samples, cultures were positive in 1854 samples. Out of 1854 culture-positive samples, 216 (11.6%) yielded NFGNB. Pseudomonas aeruginosa was the most common NFGNB, isolated in 190/216 (87.96%) samples, followed by Acinetobacter baumannii (17/216, 7.87%). Overall, most of the NFGNB isolates were susceptible to polymyxin B (88.4%), imipenem (82.9%) and cefoperazone + sulbactam (50.9%), and a total of 11 (64.71%) multidrug-resistant A. baumannii (MDRAB) strains were isolated in the study. CONCLUSION: Our study showed a significantly high prevalence of NFGNB. Isolation of multidrug-resistant P. aeruginosa and MDRAB in the present study raises the concern of rapidly emerging antibiotic resistance in this group of bacteria in our region.