Weather-related changes in the dehydration of respiratory droplets on surfaces bolster bacterial endurance.

HYPOTHESIS: The study shows for the first time a fivefold difference in the survivability of the bacterium Pseudomonas Aeruginosa (PA) in a realistic respiratory fluid droplet on fomites undergoing drying at different environmental conditions. For instance, in 2023, the annual average outdoor relative humidity (RH) and temperature in London (UK) is 71 % and 11 °C, whereas in New Delhi (India), it is 45 % and 26 °C, showing that disease spread from fomites could have a demographic dependence. Respiratory fluid droplet ejections containing pathogens on inanimate surfaces are crucial in disease spread, especially in nosocomial settings. However, the interplay between evaporation dynamics, internal fluid flow and precipitation and their collective influence on the distribution and survivability of pathogens at different environmental conditions are less known. EXPERIMENTS: Shadowgraphy imaging is employed to study evaporation, and optical microscopy imaging is used for precipitation dynamics. Micro-particle image velocimetry (MicroPIV) measurements reveal the internal flow dynamics. Confocal imaging of fluorescently labelled PA elucidates the bacterial distribution within the deposits. FINDINGS: The study finds that the evaporation rate is drastically impeded during drying at elevated solutal concentrations, particularly at high RH and low temperature conditions. MicroPIV shows reduced internal flow under high RH and low temperature (low evaporation rate) conditions. Evaporation rate influences crystal growth, with delayed efflorescence and extending crystallization times. PA forms denser peripheral arrangements under high evaporation rates and shows a fivefold increase in survivability under low evaporation rates. These findings highlight the critical impact of environmental conditions on pathogen persistence and disease spread from inanimate surfaces.

A single-centre prospective study comparing efficacy and safety of apremilast with cyclosporine in moderate to severe atopic dermatitis.

BACKGROUND: Apremilast regulates several pro-inflammatory signals involved in atopic dermatitis (AD). METHODS: A randomized, open-labelled study was conducted at a tertiary care centre in India. Fifty patients with AD of >1 year duration were randomly assigned in a 1:1 ratio to receive either apremilast (30 mg twice daily after initial titration) or cyclosporine (5 mg/kg/day) for 24 weeks, followed by a 12-week follow-up period. Primary outcome was mean percentage change in Eczema Area and Severity Index (EASI) from baseline to week 24. Secondary outcome measures were proportion of patients achieving EASI 75, EASI 90, ≥2-point improvement in Investigator's Global Assessment (IGA), SCORing Atopic Dermatitis (SCORAD) 75 at week 24 and percentage of patients experiencing ≥1 adverse effect (AEs). RESULTS: Mean percentage change in EASI (standard deviation) was -67.79% [22.44] in the apremilast treatment group and -83.06% [21.20] in the cyclosporine treatment group (p < 0.05). At week 24, 52.38% of patients in the apremilast group and 78.26% in the cyclosporine group achieved EASI 75 (p < 0.05); 14.29% in the apremilast group and 52.17% in the cyclosporine group achieved EASI 90 (p < 0.05) and 80.95% in the apremilast group and 82.60% patients achieved ≥2 point reduction in IGA (p > 0.05). 57.14% of patients achieved SCORAD 75 in the apremilast group and 69.56% in the cyclosporine group (p > 0.05). Mean time taken to achieve EASI 75 in the apremilast group was 4.50 ± 4.62 weeks, while it was 3.96 ± 3.43 weeks in the cyclosporine group (p > 0.05). Incidence of AEs was 28.57% in the apremilast group and 21.74%) in the cyclosporine group. CONCLUSIONS: Apremilast demonstrated lesser efficacy in comparison to cyclosporine; it has the advantage of a favourable safety profile and requires no laboratory monitoring.

Lysinibacillus macroides-mediated control of cellulose-producing morphotype of Salmonella.

BACKGROUND: Soil-dwelling human pathogens like Salmonella are transmitted by fresh produce such as tomato, spinach, onion and cabbage. With >2600 serovars, it is difficult to classify the good plant colonizers from the non-colonizers. Generally, soil microbiota are classified as autochthonous or zymogenous organisms, based on their ability to survive in soil. However, such information for soil-dwelling human pathogens is not available Thus there is a need to classify these organisms for designing a strategy to prevent their outbreak. Moreover, soil harbours a plethora of microbes, which can be screened for competitive organisms to control such human pathogens. RESULTS: In this study, we examined whether the morphotype based on the attachment factors (e.g., cellulose and curli fimbri) of Salmonella was important for its colonization of roots. Secondly, we tracked the location of the bacteria in the plant cell. Interestingly, most of the epidermal cells occupied by Salmonella showed propidium iodide-positive nuclei. As an extension of the study, a screening of competitive rhizospheric bacteria was performed. One isolate, identified as Lysinibacillus macroides, was able to inhibit the biofilm of Salmonella and subsequently reduced its colonization on roots. CONCLUSION: Based on this study, we classified the Rdar (red, dry and rough) morphotypes as good plant colonists. The ability to colonize and subsequent kill the live plant cell throws light on the zymogenous life cycle of soil-dwelling Salmonella. Additionally, Lysinibacillus macroides served as a biocontrol agent by reducing the burden of Salmonella in various vegetables. Such organisms can further be explored to prevent contamination of the food chain. © 2022 Society of Chemical Industry.

Cutaneous Adverse Drug Reactions to Targeted Chemotherapeutic Drugs: A Clinico-Epidemiological Study.

BACKGROUND: Targeted chemotherapeutic drugs have led to a remarkable improvement in the survival of cancer patients but also have resulted in the increased incidence of uncommon but specific muco-cutaneous adverse effects. AIMS: This study aimed to highlight the spectrum of such cutaneous adverse drug reactions and to derive a causal association. MATERIALS AND METHODS: A hospital-based, descriptive study was carried out in the dermatology outpatient department between August 2016 and July 2018, on patients referred from the state cancer institute, who developed muco-cutaneous lesions after the initiation of targeted chemotherapeutic drugs. RESULTS: A total of 80 patients, 59 (74%) males and 21 (26%) females of mean age 45.83 ± 16.37 years (range 4-70 years) developed one or more uncommon albeit specific muco-cutaneous adverse effects. Among them, papulopustular and acneiform eruptions were found in 21 patients (26.25%), and PRIDE complex was seen in 3 patients. Sixteen patients (20.00%) developed palmar-plantar erythrodysesthesia, 8 patients (10%) developed lichenoid drug eruption, and 5 patients (6.25%) developed flagellate dermatitis. Twenty-two (27.5%) patients showed nail changes, the most common, being melanonychia. CONCLUSION: There has been a paradigm shift in the management of both hematopoietic and solid cancers with the advent of targeted chemotherapeutic drugs leading to an increase in uncommon and specific drug reactions. Early recognition of these decreases morbidity, improves quality of life, and allows continuation of the life saving chemotherapy.

Hair casts.

Hair casts or pseudonits are circumferential concretions, which cover the hair shaft in such a way that, it could be easily removed. They are thin, cylindrical, and elongated in length. We present an unusual case of an 8-year-old girl presenting with hair casts. Occurrence of these is unusual, and they may have varied associations. This patient was suffering from developmental delay. It is commonly misdiagnosed as and very important to differentiate from pediculosis capitis.

Goldenhar syndrome: a report of 3 cases.

We report here 3 cases with the classic signs of Goldenhar syndrome in the form of multiple accessory tragi, bilateral ocular dermoids, mandibular hypoplasia (micrognathia), and facial microsomia. One of the patients also had vitiligo, which is yet to be reported as an association.

Pharmaceutical standardization of Jala Shukti Bhasma and Mukta Shukti Bhasma.

Shukti is an important component of Sudha Varga, which is considered as the latest class in the field of Rasa Shastra. Two types of Shukti have been mentioned in Rasa Shastra texts i.e. Jala Shukti and Mukta Shukti according to the availability. In present study, an attempt has been made to develop a standard manufacturing procedure (SMP) of Jala Shukti Bhasma and Mukta Shukti Bhasma. Five batches of Jala Shukti Bhasma and Mukta Shukti Bhasma were prepared and standardization was attempted by maintaining batch manufacturing records of individual batches. During pharmaceutical procedures like Shodhana, Bhavana, Marana, etc. due care of temperature, its duration, percentage of weight gain or loss and the cost factor of the end product, etc. were considered. The average weight loss observed was 12.08 g i.e. 2.42% and 14.62 g i.e. 2.92% during Jala Shukti and Mukta Shukiti Shodhana respectively. Average weight loss found was 38.94 g i.e. 7.79% in Jala Shukti Bhasma while in Mukta Shukti Bhasma, it was 35.24 g i.e. 7.05%. At the end of the pharmaceutical procedure, it was found that Mukta Shukti Bhasma is 2.8 times costlier than Jala Shukti Bhasma.

A study of autologous melanocyte transfer in treatment of stable vitiligo.

BACKGROUND: Replenishing melanocytes selectively in vitiliginous macules by autologous melanocytes is a promising treatment. With expertise in culturing melanocytes, it has now become possible to treat larger recipient areas with smaller skin samples. AIM: To study the extent of repigmentation after autologous melanocyte transplantation in patients with stable vitiligo. METHODS: The melanocytes were harvested as an autologous melanocyte rich cell suspension from a donor split thickness graft. Melanocyte culture was performed in selected cases where the melanocyte cell count was insufficient to meet the requirement of the recipient area. These cells were then transplanted to the recipient area that had been superficially dermabraded. RESULTS: An excellent response was seen in 52.17% cases with the autologous melanocyte rich cell suspension (AMRCS) technique and in 50% with the melanocyte culture (MC) technique. CONCLUSION: Autologous melanocyte transplantation can be an effective form of surgical treatment in stable but recalcitrant lesions of vitiligo.