The changing trend of fungal infection in invasive rhinosinusitis in the COVID era.

Background: SARS-COV virus operates as a significant risk factor for invasive fungal aspergillosis and mucormycosis. Successful management of this fulminant infection requires early recognition of the disease and aggressive medical or surgical interventions to prevent the high morbidity and mortality associated with the disease process. Aims and Objective of the Study: 1. To isolate and identify different species of fungi among acute rhinosinusitis patients. 2. To assess the association of risk factors causing fungal rhinosinusitis. 3. To assess the changing trend in fungal rhinosinusitis during the COVID era. Material and Methods: This is a retrospective observational study conducted from May 2020 to October 2022, attending the ENT department and relevant data were collected from the medical records department of ABVIMS and Dr RML Hospital, New Delhi, a Tertiary Care Referral Centre in India. The major risk factors studied were age, gender, COVID-19 infection and underlying diseases (such as diabetes mellitus, ischaemic heart disease, hypertension, malignancies, chronic kidney DISEASES, etc.); details of corticosteroid use of all patients were recorded in the datasheet. The pandemic data was divided into three distinct time periods/waves/eras, i.e., first, second, and third waves, each of which included ten months, to examine the changing trend in fungal rhinosinusitis in the pandemic era of COVID-19. Results: A total of 412 patients out of which 236 patients were clinically diagnosed with fungal sinusitis based on revised EORTC criteria. The most common site involved was the orbit with paranasal sinus and eye 86/236 (36.4%), followed by involvement of nasal and paranasal sinus alone 68/236 (28.8%). The most prevalent age range affected was 40 to 50 years. The most commonly associated comorbidity was diabetes mellitus (DM) in 176 (74.5%), followed by head and neck malignancies in 22 (9.32%) patients. Thirty-eight (50.6%) Rhizopus species and 18 (24%) Aspergillus flavus were the most common isolated fungal species on culture, followed by Mucor spp. 14 (18.6%) and Aspergillus fumigatus 5 (6.6%) in the period. In the second wave of COVID, there was a surge in Zygomycetes cases 36 (45%) and after the second wave, the Aspergillus cases increased by 14 (19%) during Jan-Oct 2022. Conclusion: With the continuing coronavirus pandemic, there is an unprecedented and discernible rise in the prevalence of acute invasive fungal sinusitis certainly a spike in cases of Aspergillus infection was observed, probably due to unprecedented usage of Amphotericin B for the treatment of mucormycosis during the third wave This underlines the importance of the need to tailor our treatment protocol as per the etiological agents hence the right antifungal drugs combined with urgent surgical procedures on a case-to-case basis may certainly increase the chances of survival.

Novel supramolecular luminescent metallogels containing Tb(iii) and Eu(iii) ions with benzene-1,3,5-tricarboxylic acid gelator: advancing semiconductor applications in microelectronic devices.

A novel strategy was employed to create supramolecular metallogels incorporating Tb(iii) and Eu(iii) ions using benzene-1,3,5-tricarboxylic acid (TA) as a gelator in N,N-dimethylformamide (DMF). Rheological analysis demonstrated their mechanical robustness under varying stress levels and angular frequencies. FESEM imaging revealed a flake-like hierarchical network for Tb-TA and a rod-shaped architecture for Eu-TA. EDX analysis confirmed essential chemical constituents within the metallogels. FT-IR, PXRD, Raman spectroscopy, and thermogravimetric analysis assessed their gelation process and material properties, showing semiconducting characteristics, validated by optical band-gap measurements. Metal-semiconductor junction-based devices integrating Al metal with Tb(iii)- and Eu(iii)-metallogels exhibited non-linear charge transport akin to a Schottky diode, indicating potential for advanced electronic device development. Direct utilization of benzene-1,3,5-tricarboxylic acid and Tb(iii)/Eu(iii) sources underscores their suitability as semiconducting materials for device fabrication. This study explores the versatile applications of Tb-TA and Eu-TA metallogels, offering insights for material science researchers.

Super-hydrophilic LaCoO3/g-C3N4 nanocomposite coated beauty sponge for solar-driven seawater desalination with simultaneous volatile organic compound removal.

Interfacial solar steam generation (ISSG) is emerging as a promising, environment-friendly solution for fulfilling freshwater and energy demands. However, a critical challenge for ISSG lies in the presence of harmful volatile organic compounds (VOCs) in the feedwater which are co-evaporated with water, leading to more enriched concentration in condensed water. Herein, lanthanum cobaltate-graphitic carbon nitride (LaCoO3/g-C3N4, LCO/g-CN) nanocomposite decorated beauty sponge (LCO/g-CN@BS) is proposed as an efficient photothermal/photocatalytic material for solar-driven seawater desalination and simultaneous VOC degradation. The hydrophobic surface of the beauty sponge after LCO/g-CN coating becomes super-hydrophilic, ensuring sufficient water supply and our LCO/g-CN@BS delivers an evaporation rate of 1.94 kg m-2 h-1 under 1 sun irradiation. This LCO/g-CN@BS shows excellent seawater desalination capacity with a self-cleaning ability when employed for saltwater purification for a salt (NaCl) concentration as high as 15 wt%. Moreover, fast photocarrier transfer between LCO and g-CN leads to enhanced photocatalytic degradation of over 90% of phenol simultaneously, which is about 60% for only an LCO-based beauty sponge. This work presents a promising approach to combining novel nanocomposites with microporous structures for efficient solar desalination, offering simultaneous VOC degradation.

Visible light-mediated ring-ablative functionalization of oxazoles: oxidative azidation and demethylative amination.

Photochemical functionalization of alkoxyoxazoles with trimethylsilyl azide and N,N-dimethylanilines is described. These C-N bond forming reactions proceed with concomitant oxidative ring-opening assisted by organic dyes as photocatalyst and molecular oxygen, providing access to novel chemical space. Unusual demethylative C-N bond formation in the case of N,N-dimethylanilines establishes a new reactivity pattern for these precursors.

Improving Quality Metrics with a Day-only Skin Abscess Protocol: Experience from Australia.

BACKGROUND: Skin abscesses are a common emergency presentation often requiring incision and drainage; however, issues with theatre access lead to delays in management and high costs. The long-term impact in a tertiary centre of a standardised day-only protocol is unknown. The aim was to evaluate the impact of day-only skin abscess protocol (DOSAP) for emergency surgery of skin abscesses in a tertiary institution in Australia and to provide a blueprint for other institutions. METHODS: A retrospective cohort study analysed several time periods: Period A (July 2014 to 2015, n = 201) pre-DOSAP implementation, Period B (July 2016 to 2017, n = 259) post-DOSAP, and Period C (July 2018 to 2022, n = 1,625) prospectively analysed four 12-month periods to assess long-term utilisation of DOSAP. Primary outcomes were length of stay and delay to theatre. Secondary outcome measures included theatre start time, representation rates and total costs. Statistical analysis using nonparametric methods was used to analyse the data. RESULTS: There was a significant decrease in ward length of stay (1.25 days vs. 0.65 days, P < 0.0001), delay to theatre (0.81 days vs. 0.44 days, P < 0.0001) and theatre start time before 10AM (44 cases vs. 96 cases, P < 0.0001) after implementation of DOSAP. There was a significant decrease in median cost of admission of $711.74 after accounting for inflation. Period C reported 1,006 abscess presentations successfully managed by DOSAP over the four-year period. CONCLUSION: Our study demonstrates the successful implementation of DOSAP in an Australian tertiary centre. The ongoing utilisation of the protocol demonstrates the ease of applicability.

Microfluidic Salinity Gradient-Induced All-Day Electricity Production in Solar Steam Generation.

Synergistic generation of freshwater and electricity using solar light would be an ideal solution for global freshwater challenges and energy demands. Recently, interface solar steam generation has been considered one of the promising cost-effective alternatives for freshwater generation. Here, we have systematically maintained the salinity gradient within two-legged paper-based microfluidic channels to transport wastewater from the reservoir to the evaporator surface and generate electricity all-day-long. Flowing seawater (3.5 wt % NaCl) on one leg and tap water on the other of the water-conducting channels connected to a conical evaporator, we achieved an average open-circuit voltage (VOC) of 150 mV and a short-circuit current of 6.5 µA across each channel along with a water evaporation efficiency of 88%. As the VOC depends only on the ion concentration gradient within the channel in the direction perpendicular to the water flow, the electricity generation persists throughout the day and can be tuned by varying the salinity. Increasing the salt concentration of the seawater to 20 wt %, the VOC increased to 250 mV in a single channel. In an evaporator connected with four such channels, we achieved a maximum output power density of 9.9 mW m-2 in a series combination without sacrificing the evaporation rate. Furthermore, removing agglomerated salt from the evaporator surface, we harvested salt at a rate of 0.33 kg m-2 h-1. Therefore, our approach provides an alternative way of freshwater generation, salt harvesting, and all-day-long electricity production simultaneously.

Synthesis of Tritylones via Cascade Reaction of Arynes with 5-Ethoxyoxazoles.

A cascade reaction involving arynes and 5-ethoxyoxazoles has been developed toward the synthesis of 9-alkyl/aryl tritylones. 5-Ethoxyoxazoles undergo a [4 + 2] cycloaddition reaction with arynes followed by retro-[4 + 2] cycloaddition, a second intermolecular [4 + 2] cycloaddition reaction, and hydrolytic ring cleavage to generate substituted tritylones in good yields. The conversion of tritylone products to a series of spirocyclic anthrone derivatives has been demonstrated. The reaction is expeditious, exhibits wide scope, and employs readily available starting materials.

Narrow-Bandgap LaMO3 (M = Ni, Co) nanomaterials for efficient interfacial solar steam generation.

Photothermal water evaporation provides a pathway towards a promising solution to global freshwater scarcity. Synergistic integration of functions in a material in diverse directions is a key strategy for designing multifunctional materials. Lanthanum-based perovskite complex oxides LaMO3 (M = Ni and Co) have narrow band gaps with a high absorption coefficient. These functionalities have not been appropriately explored for photothermal energy conversion. Here, we synthesized nanostructured metallic LaNiO3 and semiconducting LaCoO3 and used them to design interfacial solar steam generators. Effective light absorption capability over the entire solar spectrum of these materials leads to a photothermal efficiency of the order of 83% for both materials. Using a cone-shaped 3D interfacial steam generator with a LaNiO3 absorber, we achieved an evaporation rate of 2.3 kg m-2 h-1, corresponding to solar vapor generation efficiency of over 95%. To the best of our knowledge, this evaporation rate is higher than any oxide-based interfacial solar steam generator reported so far. Furthermore, we have also shown an effective way of using such evaporators for long-term seawater desalination.

Unmasking Dipole Character of Acyl Ketene Dithioacetals via a Cascade Reaction with Arynes: Synthesis of Benzo[b]thiophenes.

An unusual strategy toward novel substituted benzo[b]thiophenes has been developed. The generation of arynes in the presence of acyl ketene dithioacetals resulted in a cascade reaction involving [3 + 2] cycloaddition, and a dealkylative arylation of a thioether moiety to afford 2,3-disubstuted benzo[b]thiophenes. This route represents an expeditious approach to benzothiophenes that employs acyl ketene dithioacetals as dipoles.

Risk factors associated with hypertensive disorders of pregnancy within an urban indigenous population in south western Sydney.

BACKGROUND: The prevalence of hypertensive disorders of pregnancy (HDP) in Australia's urban indigenous women is unknown. AIM: To explore the risk factors associated with HDP for a cohort of urban indigenous women in South-Western Sydney, Australia. METHODS: This study was conducted in partnership with the Tharawal Aboriginal Medical Service. Women (18-45 years) were recruited at the clinic and community events. The quantitative questionnaire included obstetric history, personal and family history of hypertension. Anthropometric measurements and blood pressure were conducted. Rates were compared with Australian Bureau of Statistics (ABS) national rates. RESULTS: Eighty-three participants completed the questionnaire. The rate of ever having HDP in a pregnancy was 36.1%. The overall ABS rate was 9.8% and for indigenous women, 14%. The mean maternal age at first pregnancy was 20.8 years (SD 3.7 years). The mean body mass index (BMI) of the sample population (n = 81) was 32.2 kg/m2 (SD 9.5 kg/m2 ) and BMI was not related to HDP (P = 0.197). Of those questioned, 25.3% had an individual history and 63.9% had a family history of hypertension. The effect of family history of hypertension (P = 0.020) (odds ratio (OR) 4.29; 95% confidence interval (CI); 1.42-12.93) and individual history of hypertension (P < 0.001) (OR 15.69; 95% CI; 4.50-54.76) were associated with HDP. CONCLUSION: There was a higher rate of HDP in urban indigenous women compared to the national indigenous prevalence. The family history, or individual history of hypertension was the most significant risk factors and BMI was not identified as a risk factor for HDP in this population.

Eco-friendly PEG-based controlled release nano-formulations of Mancozeb: Synthesis and bioefficacy evaluation against phytopathogenic fungi Alternaria solani and Sclerotium rolfsii.

Controlled release (CR) nano-formulations of Mancozeb (manganese-zinc double salt of N,N-bisdithiocarbamic acid), a protective fungicide, have been prepared using laboratory-synthesized poly(ethylene glycols) (PEGs)-based functionalized amphiphilic copolymers without using any surfactants or external additives. The release kinetics of the developed Mancozeb CR formulations were studied and compared with that of commercially available 42% suspension concentrate and 75% wettable powder. Maximum amount of Mancozeb was released on 42nd day for PEG-600 and octyl chain, PEG-1000 and octyl chain, and PEG-600 and hexadecyl chain, on 35th day for PEG-1000 and hexadecyl chain, on 28th day for PEG-1500 and octyl chain, PEG-2000 and octyl chain, PEG-1500 and hexadecyl chain, and PEG-2000 and hexadecyl chain in comparison to both commercial formulations (15th day). The diffusion exponent (n value) of Mancozeb in water ranged from 0.42 to 0.62 in tested formulations. The half-release (t1/2) values ranged from 17.35 to 35.14 days, and the period of optimum availability of Mancozeb ranged from 18.54 to 35.42 days. Further, the in vitro bioefficacy evaluation of developed formulations was done against plant pathogenic fungi Alternaria solani and Sclerotium rolfsii by poison food technique. Effective dose for 50% inhibition in mgL-1 (ED50) values of developed formulations varied from 1.31 to 2.79 mg L-1 for A. solani, and 1.60 to 3.14 mg L-1 for S. rolfsii. The present methodology is simple, economical, and eco-friendly for the development of environment-friendly CR formulations of Mancozeb. These formulations can be used to optimize the release of Mancozeb to achieve disease control for the desired period depending upon the matrix of the polymer used. Importantly, the maximum amount of active ingredient remains available for a reasonable period after application. In addition, the developed CR formulations were found to be suitable for fungicidal applications, allowing use of Mancozeb in lower doses.

Comparative whole-genome analysis of clinical isolates reveals characteristic architecture of Mycobacterium tuberculosis pangenome.

The tubercle complex consists of closely related mycobacterium species which appear to be variants of a single species. Comparative genome analysis of different strains could provide useful clues and insights into the genetic diversity of the species. We integrated genome assemblies of 96 strains from Mycobacterium tuberculosis complex (MTBC), which included 8 Indian clinical isolates sequenced and assembled in this study, to understand its pangenome architecture. We predicted genes for all the 96 strains and clustered their respective CDSs into homologous gene clusters (HGCs) to reveal a hard-core, soft-core and accessory genome component of MTBC. The hard-core (HGCs shared amongst 100% of the strains) was comprised of 2,066 gene clusters whereas the soft-core (HGCs shared amongst at least 95% of the strains) comprised of 3,374 gene clusters. The change in the core and accessory genome components when observed as a function of their size revealed that MTBC has an open pangenome. We identified 74 HGCs that were absent from reference strains H37Rv and H37Ra but were present in most of clinical isolates. We report PCR validation on 9 candidate genes depicting 7 genes completely absent from H37Rv and H37Ra whereas 2 genes shared partial homology with them accounting to probable insertion and deletion events. The pangenome approach is a promising tool for studying strain specific genetic differences occurring within species. We also suggest that since selecting appropriate target genes for typing purposes requires the expected target gene be present in all isolates being typed, therefore estimating the core-component of the species becomes a subject of prime importance.

Synthesis of 2-aryl/heteroaryloxazolines from nitriles under metal- and catalyst-free conditions and evaluation of their antioxidant activities.

The synthesis of structurally diverse 2-aryl/heteroaryloxazolines from nitriles and aminoalcohols has been achieved under metal- and catalyst-free conditions in good to excellent yields. An array of functional groups are well-tolerated, thus, allowing the introduction of many important biologically active motifs such as azoles, ring-fused azoles, saturated heterocyclics, and amines in 2-aryloxazoline scaffolds. An evaluation of the antioxidant properties using the DPPH (diphenyl picryl hydrazyl) assay method shows the pyrrole-functionalized 2-aryloxazoline to be the best antioxidant among all the synthesized 2-aryl/heteroaryloxazolines.

Multicentric aggressive mammary fibromatosis with cytological features and review of literature.

Fibromatosis is a fibroblastic lesion composed of uniform fibroblasts and collagen with an infiltrative growth pattern but lacking malignant cytological features. It is a rare entity and is even more unusual when found in the breast. Multicentricity in fibromatosis has been reported in 10% cases. Multicentricity in breast cancer has been defined as the presence of two or more tumor foci within different quadrants of the same breast. Considering this definition of multicentricity for fibromatosis, we herein report a case of recurrent multicentric aggressive mammary fibromatosis and its cytological features with review of literature because of limited literature of (FNAC) in mammary fibromatosis.

A study of cervical intraepithelial neoplasia in pregnancy.

OBJECTIVE: To find the incidence of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) in pregnant women and compare Pap smear with the HPV DNA test in detecting HPV infection. MATERIALS AND METHODS: Hundred antenatal women, irrespective of gestational age, were enrolled as subjects in this prospective pilot study for blood investigations, wet mount examination of cervical discharge, Pap smear, and high-risk HPV DNA detection of cervical scrape by PCR. Women showing abnormality in Pap smear and/or those who were high-risk HPV DNA positive were subjected to colposcopy. RESULTS: The incidence of HPV-positive pregnant women was 18 %. Koilocytosis on Pap smear was observed in six women. Three high-risk HPV DNA-positive women showed changes consistent with CIN 1 on colposcopy. CONCLUSIONS: The HPV DNA test is the most sensitive and reliable in detecting HPV infection as compared to Pap smear, but considering the cost of PCR, Pap smear screening of all antenatal women was recommended.

Prevalance of ABO and Rhesus Blood Groups in Blood Donors: A Study from a Tertiary Care Teaching Hospital of Kumaon Region of Uttarakhand.

UNLABELLED: Backround: ABO and Rhesus (Rh) blood group antigens are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly for the immunologic safety of blood during transfusion. AIMS: This study is aimed to determine the distribution pattern of the ABO and Rh blood groups among blood donors in Kumaon region of Uttarakhand and compare it with other data from similar studies within the India and all over the world. DESIGN: It is a retrospective study carried out at blood bank of Shushila Tewari Hospital of Government Medical College, Haldwani from January 2012 to December 2013. MATERIALS AND METHODS: The study was conducted on 12,701 blood donors. ABO and Rh typing was done using slide agglutination method with antisera ABO and Rh (Tulip diagnostics ltd). Doubtful cases were confirmed by tube agglutination method and reverse grouping using known pooled A and B cells. The age group and sex of donors, frequency of ABO and Rh blood groups were reported in simple percentages. RESULTS: The predominant donors belonged to age group between 18-35years (84.28%). Male donors were more than female donors, ratio being 352:1. Replacement donors (99.71%) were much more than voluntary donors (0.91%). The most common blood group was B (32.07%) and least common being AB (10.53%). Blood group 'O' and 'A' had same frequency. The prevalence of Rhesus positive and negative distribution in the studied population was 94.49% and 5.51% respectively. Blood group frequency with respect to ABO and Rhesus positive was found to be shown by formula B> O>A >AB. The frequency for ABO and Rhesus negative was given by the formula B>A>O>AB. CONCLUSION: Knowledge of frequencies of the different blood groups is very important for blood banks and transfusion service policies that could contribute significantly to the National Health System.

Draft Genome Sequence of Multidrug-Resistant Mycobacterium tuberculosis Clinical Isolate OSDD515, Belonging to the Uganda I Genotype.

We describe the genome sequencing and analysis of a clinical isolate of the multidrug-resistant Mycobacterium tuberculosis Uganda I genotype (OSDD515) from India.

Draft Genome Sequence of a Multidrug-Resistant Clinical Isolate of Mycobacterium tuberculosis Belonging to a Novel Spoligotype.

We describe the genome sequencing and analysis of a multidrug-resistant (MDR) clinical isolate of Mycobacterium tuberculosis, strain OSDD105 from India, belonging to a novel spoligotype.

Draft Genome Sequence of an Extensively Drug-Resistant Mycobacterium tuberculosis Clinical Isolate of the Ural Strain OSDD493.

We describe the genome sequencing and analysis of a clinical isolate of Mycobacterium tuberculosis belonging to the Ural strain OSDD493 from India.

Draft Genome Sequence of a Clinical Isolate of Multidrug-Resistant Mycobacterium tuberculosis East African Indian Strain OSDD271.

We describe the genome sequencing and analysis of a clinical isolate of Mycobacterium tuberculosis East African Indian (EAI) strain OSDD271 from India.