"Tinea capitis caused by Microsporum canis: A case study of three family members in India, a non-endemic region.

INTRODUCTION: Tinea capitis, a common scalp infection primarily affecting children, is caused by keratinophilic dermatophytic fungi, notably Microsporum and Trichophyton species. Microsporum canis, primarily transmitted from cats and dogs to humans, is rarely reported in non-endemic regions like India. We report a cases involving three family members from Delhi, India, diagnosed with tinea capitis caused by Microsporum canis. The index case, a five-year-old boy, contracted the infection through contact with a cat, while his younger brother and sister acquired it through human-to-human transmission within the family. METHODS: Clinical examination, microscopic analysis, and molecular identification techniques confirmed the diagnosis. Antifungal susceptibility testing revealed sensitivity to itraconazole and terbinafine but resistance to griseofulvin. RESULTS: Treatment with oral terbinafine and topical ketoconazole cream led to successful outcomes for all three patients. Molecular typing confirmed clonality of the isolates, indicating human-to-human transmission. CONCLUSION: This case study underscores the significance of considering atypical sources of infection and human-to-human transmission in the diagnosis and management of tinea capitis caused by Microsporum canis in non-endemic regions. It emphasizes the necessity of thorough contact history assessment and appropriate antifungal therapy for effective control of the infection.

Diagnostic Utility of Galactomannan Enzyme Immunoassay in Invasive Aspergillosis in Pediatric patients with Hematological Malignancy.

OBJECTIVE: This study aims to determine the diagnostic utility of galactomannan enzyme immunoassay (GM EIA) in invasive aspergillosis (IA) in children with hematological malignancy (high risk population) in terms of sensitivity, specificity, negative predictive value (NPV) and positive predictive values (PPV) at various cut offs while validating the revised EORTC/MSG 2019 criteria in order to obtain the best cut-off. MATERIAL AND METHODS: For 100 pediatric patients, serum and respiratory samples were collected. Clinical, mycological workup (potassium-hydroxide mount, fungal culture) and GM EIA was done to classify proven, probable, and possible IA as per EORTC-MSG guidelines,2019. Sensitivity, specificity, PPV and NPV were calculated of GM indices at cut-off 0.5, 0.7 and 1, and validated with revised EORTC -MSG, 2019. RESULTS: Of 100 patients enrolled, 75 were diagnosed with ALL, 14 with AML, two with Hodgkin's, three had non-Hodgkin lymphoma, and six had undifferentiated leukemia. With routine mycological findings, 51 were classified as probable IA, 11 as possible IA, and 38 as no IA. Aspergillus flavus was the most prevalent on culture (56.9%, 29/51) followed by A. fumigatus (29%, 15/51) A. niger (7.8%, 4/51), A. terreus (3.9%, 2/51) and A. nidulans (2%, 1/51). GM EIA demonstrated sensitivity 82.3%, specificity 97.4%, PPV 98.1%, and NPV 77.1% at cut-off 0.67 when comparing probable/possible IA v/s no IA groups. The GM EIA had the best sensitivity (82.4%), specificity (81.8%), PPV (95.5%), and NPV (50%) at cut off 0.78 when the probable IA group was compared to the possible IA. Seven patients succumbed of whom 5 had GMI ≥ 2. CONCLUSION: This study deduces the optimal cut-off for serum GM EIA to be 0.67 obtained by ROC analysis when comparing possible and probable IA versus no IA and reinforces the definition of probable category of EORTC-MSG criteria, 2019. At 0.5 ODI the sensitivity (87.1%) and NPV (80.5%) are high, thus making it the most suitable cut-off for detecting true positive and ruling out IA respectively, in pediatric patients with hematological malignancy. GM EIA when performed adjunctive to clinico-radiological findings can prove to be screening, diagnostic and prognostic test for IA in pediatric hematological malignancy patients.

Spatial accessibility modeling to healthcare facilities in the case of health shocks of Midnapore municipality, India.

This research aims to identify the accessibility of the entire population, especially the slum population to existing healthcare facilities (HCF) as well as the slum neighborhoods having low geographic accessibility, and finally, to provide an analytical model for the people living in areas that are outside the coverage range of existing healthcare facilities (HCF) across the study area. Spatial data has been collected and used based on the road network, elevation, location of HCF, municipal boundary, slum point, and satellite images from various sources. Also, non-spatial data such as socioeconomic variables are collected from questionnaires survey within a particular period. The spatial analysis tool like as near, network analysis, and predictive analysis in the ArcGIS platform was used to examine geographic accessibility. The results of the spatial analysis show that the distribution of public healthcare facility centers in the study area has not been uniformly distributed. Across 84% of areas in the study area have sound spatial accessibility with traveling time coverage is about 12 min. However, 16% of areas have a traveling time of 12 to 30 min under low accessibility with existing slum neighborhoods. Therefore, the low spatial accessibility areas are demanding new healthcare facilities in the study area. The Analytical Hierarchy Process (AHP) is employed to find the most optimal and efficient locational suitability for building new healthcare facility centers. The finding of AHP analysis for site suitability of healthcare facilities revealed five major classes as most suitable (2%), suitable (5%), moderate (35%), poor (54%), and very poor (4%) in the study area. Moreover, the realistic framework of this study helps to measure geographic accessibility and suitability in any geographical area.

Spatial analysis and modelling for primary healthcare site selection in Midnapore town, West Bengal.

Unprecedented and chaotic growth of cities results in reducing open spaces and water bodies, worsening infrastructure facilities and changes in ecological morphology. This unregulated growth of the urban population led to uneven distribution of urban amenities, facilities and healthcare services. Considering this, the study aimed to draw attention to the existing spatial pattern of healthcare facility centres as well as to find out the possible sites for the provision of healthcare facility centres in the municipal ward (micro-scale) of Midnapore town. This prototype study was conducted using Analytical Hierarchy Process (AHP) and Ordinary Least Square (OLS) evaluation model based on various criteria through Arc GIS environment. The findings indicate that the spatial distribution patterns of existing public healthcare centres were significantly dispersed. Weights based on a set of criteria were calculated by AHP and OLS algorithm and generated suitability evaluation maps classified from 1 (poor suitable) to 4 (most suitable). According to the employed criteria in this study unveil those existing hospitals and primary healthcare centres have not been located in the appropriate locations. The model is found to be valid for the given study area and there is no significant difference between AHP and OLS results. Further, it can be used for preparing the suitability map for the other areas with similar geo-environmental conditions for the proviso of healthcare services as well as will be most effective in preventing disease progression and reducing healthcare inequality on a large scale. Supplementary Information: The online version contains supplementary material available at 10.1007/s10708-021-10528-w.

Bioleaching of Al from spent fluid catalytic cracking catalyst using Aspergillus species.

Bioleaching uses biodegradable organic acids, thereby making the process environmental friendly as compared to chemical leaching. In this work, bioleaching of aluminium (Al) metal from spent catalyst was investigated by using three Aspergillus strains (A. niger, A. foetidus, and A. carbonarius). Bioleaching was performed in batch culture mode at different loading densities of spent catalyst (i.e., 0.4%, 0.8% and 1.2% (w/v)). The highest Al leaching efficiency of 88.43% was obtained at 0.8% ((w/v)) catalyst loading using A. foetidus, further increase in the catalyst loading decreased the efficiency. In addition to this, molasses was used as a carbon source (low-cost) at various concentrations for bioleaching of spent catalyst and the results were found to be significant at 40 g/L sugar concertation with 60% bioleaching efficiency. Overall, this study indicates that A. foetidus have the potential for leaching of Al from spent catalysts. Therefore, present research findings suggested that, instead of using mineral acids, organic acids (biodegradable) usage for metal leaching process is highly reliable and eco-friendly as well.

Urban flood mitigation planning for Guwahati: A case of Bharalu basin.

Guwahati, the capital city of Assam and the gateway to the seven north-eastern Indian states, is located in the Brahmaputra valley-one of the most flood prone regions of the world. The city receives an average annual rainfall of 1688 mm and is highly vulnerable towards frequent urban floods because of uncontrolled dumping of solid waste and siltation have choked the natural water channels. This coupled with the absence of an integrated drainage network and rapid urbanisation causes floods in many parts of the city, after a quick downpour. Bharalu river is the main natural water channel of the city and Bharalu basin is the most vulnerable one. The present paper is an attempt to plan for urban flood mitigation, by designing an integrated drainage network for the Bharalu basin which includes the low-lying urbanized areas bordered by the Guwahati-Shillong Road, the Radha Gobindo Baruah Road and the Rajgarh Road. Data regarding land use, flood level, rainfall, urban pattern and vulnerability towards urban flood were collected from available literature, field survey to find highest water level for 11.4 km road stretch, expert opinion survey from 18 experts and feedback from 77 community elders who have been residing in the city since the 1980s. The Bharalu basin is divided into seven drainage blocks and storm run-off has been calculated based on the inputs. Seven different trapezoidal drainage sections were designed to form an integrated drainage network which is 'self-healing' to a certain extent. This can serve as a template for the other catchment basins and to design a drainage network for the entire Guwahati city, thereby reducing urban flood hazard to a significant extent. The study illustrates the necessity of an urban flood mitigation planning approach in sub-Himalayan urban settlements such as Guwahati.

CNS depressive role of aqueous extract of Spinacia oleracea L. leaves in adult male albino rats.

Treatment with Spinacia oleracea extract (SO; 400 mg/kg body weight) decreased the locomotor activity, grip strength, increased pentobarbitone induced sleeping time and also markedly altered pentylenetetrazole induced seizure status in Holtzman strain adult male albino rats. SO increased serotonin level and decreased both norepinephrine and dopamine levels in cerebral cortex, cerebellum, caudate nucleus, midbrain and pons and medulla. Result suggests that SO exerts its CNS depressive effect in PTZ induced seizure by modulating the monoamines in different brain areas.

Contraceptive efficacy of a novel spermicidal microbicide used with a diaphragm: a randomized controlled trial.

OBJECTIVE: Women need products that protect against both pregnancy and sexually transmitted infections, including human immunodeficiency virus (HIV). The acid buffering gel is a nondetergent spermicide that may provide this dual protection by reinforcing normal vaginal acidity to inactivate both sperm and acid-sensitive sexually transmitted pathogens. The objective of this study was to assess the gel's contraceptive effects, safety, and acceptability. METHODS: We conducted a multicenter, randomized, double-masked, noninferiority study at 11 centers, comparing 621 women who used an acid buffering gel plus diaphragm with 300 women who used a nonoxynol-9 spermicide plus diaphragm for 6 months. A double-masked study extension followed 234 women for an additional 6 months of use. RESULTS: The 6-month pregnancy rate per hundred women was 10.1% (95% confidence interval [CI] 7.1-13.1%) for acid buffering gel and 12.3 (95% CI 7.7-16.9) for nonoxynol-9 spermicide users. The difference in rates was -2.2% with a 95% CI -7.7 to 3.3%. Consistent and correct use 6-month pregnancy rates were 4.7% for acid buffering gel and 6.1% for nonoxynol-9 spermicide users, calculated from those cycles where diary entries indicated such use. Adverse events and acceptability were similar between the two groups. Pregnancy probabilities were similar between groups participating in the 12-month study extension. CONCLUSION: An acid buffering gel used with a diaphragm is a safe, acceptable contraceptive with efficacy comparable to that of a common commercial spermicide with diaphragm. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.ClinicalTrials.gov, NCT00065858 LEVEL OF EVIDENCE: I.

Intradiploic primary epithelial inclusion cyst of the skull.

Intradiploic inclusion cyst of the skull presenting as a calvarial defect is fairly uncommon in the neuroscience practice. They are benign in nature, slow to grow, and clinically difficult to differentiate from other causes of calvarial defects. We present a case of a healthy 55-year-old woman who presented clinically for an asymptomatic lump over the right parieto-occipital region of the scalp of 4-month duration. The radiological features were suggestive of presence of a large intradiploic solitary cyst and additional multiple lytic defects with sclerotic borders, destroying the underlying bone. The gross and histomorphological features of the right parieto-occipital craniectomy specimen received were pathognomic of an intradiploic primary epithelial inclusion cyst of the skull bone. The importance of its benign nature, embryogenic origin, and differentiation from other cystic lesions with similar histology is stressed. We report this case for its unique histomorphology and first of its kind in the Indian literature.

Prevalence of diabetes in various habitats of West Bengal, India.

The epidemiological profile data were collected for diabetes mellitus from the people living in three habitats (rural, industrial and urban) having considerable difference in their lifestyle and socio-economic status. Every 5th (occasionally 4th or 6th) member from each habitat was sampled; no restriction regarding age was kept during screening; OGTT (oral glucose tolerence test) was performed 2 hours after 75 g glucose, in those whose FBS (fasting blood sugar) was >90 mg/dl. Diagnosis of diabetes mellitus was ascertained, if the FBS was >120 mg/dl and/ or postglucose value was >200mg/dl. The per cent prevalence (among all aged people) of diabetes mellitus in rural, industrial and urban habitats were found to be: 1.66 +/- 0.58 (male 1.99 +/- 0.88, female 1.3 +/- 0.75); 3.00 +/- 0.74 (male 3.17 +/- 1.04, female 2.80 +/- 1.04) and 4.8 +/- 0.98 (male 5.31 +/- 1.43, female 4.27 +/- 1.32) respectively.

Prevention of type 2 diabetes in the prediabetic population.

Prevention of diabetes has been tried by several groups with varying degree of success. Prediabetic population are the ideal target for the purpose. In this study, prediabetic subjects are selected from the high-risk groups, like those having obesity, family history of diabetes, past history of gestational diabetes, hypertension, dyslipidaemia; and are included in the study when their fasting plasma glucose was found to be below 110 mg/dl and 2 hours postglucose (75g) plasma glucose remained between 110 and 200 mg/dl. After giving advice for lifestyle changes to all for a period of 3 months, those who had their blood glucose values in the impaird glucose tolerance (IGT) range were given either metformin, rosiglitazone or acarbose, the rest continued with diet and exercise only. Total follow-up period was 3 years. All groups maintained blood sugar in the euglycaemic range till the end of the 3-year period.

Mason diabetes--report of a family.

A 48-year-old Hindu housewife was presented with increased appetite, thirst, frequency of micturition, weakness, cramps in the legs, tingling in the fingers, decline in bladder-bowel control and dimness of vision. She was a patient of diabetes. On investigations and history, she was diagnosed as a case of type 2 diabetes transmitted in three generations as an autosomal dominant trait.