Antimicrobial resistance in food-borne pathogens at the human-animal interface: Results from a large surveillance study in India.

Background: The burden of foodborne diseases and antimicrobial resistance carried by key foodborne pathogens in India is unknown due to a lack of an integrated surveillance system at the human-animal interface. Methods: We present data from the WHO-AGISAR (Advisory Group on Integrated Surveillance of Antimicrobial Resistance), India project. Concurrent human and animal sampling was done across a large area across north India. Community-acquired diarrhea cases (n = 1968) of all age groups were included. Cross-sectional sampling of stool/ intestinal contents (n = 487) and meat samples (n = 419) from food-producing animals was done at farms, retail shops, and slaughterhouses. Pathogens were cultured and identified, and antimicrobial susceptibility was performed. Results: Over 80% of diarrhoeal samples were obtained from moderate to severe diarrhea patients, which yielded EAEC (5%), ETEC (4.84%), EPEC (4.32%), and Campylobacter spp. (2%). A high carriage of EPEC (32.11%) and Campylobacter spp. (24.72%) was noted in food animals, but the prevalence of ETEC (2%) and EAEC (1%) was low. Atypical EPEC (aEPEC, 84.52%, p ≤0.0001) were predominant and caused milder diarrhea. All EPEC from animal/poultry were aEPEC. Overall, a very high level of resistance was observed, and the MDR rate ranged from 29.2% in Campylobacter spp., 53.6% in EPEC, and 59.8% in ETEC. Resistance to piperacillin-tazobactam, cefepime, ceftriaxone, and co-trimoxazole was significantly higher in human strains. In contrast, resistance to ciprofloxacin, aminoglycosides, and tetracycline was higher in animal strains, reflecting the corresponding usage in human and animal sectors. ESBL production was commoner in animal isolates than in humans, indicating high use of third-generation cephalosporins in the animal sector. C. hyointestinalis is an emerging zoonotic pathogen, first time reported from India. Conclusion: In one of the most extensive studies from India, a high burden of key foodborne pathogens with MDR and ESBL phenotypes was found in livestock, poultry, and retail meat.

Identification of Inhibitors for Flagellar Assembly Protein FliN of Uropathogenic Escherichia coli using Virtual Screening and Molecular Dynamics Simulation Study.

Escherichia coli (E. coli) is a gram-negative bacterial pathogen that poses a significant clinical and epidemiologic challenge. The selection pressure brought by the insufficient use of antibiotics has resulted in the emergence of multi-drug-resistant E. coli in the past ten years. Computational and bioinformatics methods for screening inhibitors have significantly contributed to discovering novel antibacterial agents. One possible target for novel anti-virulence drugs is motility. Motility inhibitors are generally effective at concentrations lower than those required for the antibacterial properties of traditional antibiotics, and they are likely to exert less selective pressure than current medicines. Motility may be essential for bacteria to survive, find nutrients, and escape unfavorable environments and biofilm formation. The FliN is a protein forming the bulk of the C ring of the flagella and is present in multiple copies (more than 100) in bacteria. Its absence in mammals makes it an attractive drug target for drug discovery. Two-thousand seven hundred seventy-eight natural compounds from the ZINC library were screened against FliN (PDB ID: 4YXB) using PyRx AutoDock Vina, and the top compounds were selected for secondary screening after sorting the results based on their binding energy. Based on interactional analysis, binding energy (- 7.78 kcal/mol), and inhibition constant (1.98 µM), ZINC000000619481 was the best inhibitor. This compound binds exactly as per the defined active site residues of the receptor protein. Also, molecular dynamics was performed. The eigenvalue of the selected complex was 1.241657e-05. There were no ADME properties outside of the specified range for the identified hit; it fitted exactly to the binding site of the FliN receptor well and was found to be stable in MD simulation studies. Further in vitro and in vivo studies are needed to confirm its anti-bacterial activity and use as a potential antimicrobial drug against urinary tract infections caused by E. coli.

Differentiation activates mitochondrial OPA1 processing in myoblast cell lines.

Mitochondrial optic atrophy-1 (OPA1) plays key roles in adapting mitochondrial structure to bioenergetic function. When transmembrane potential across the inner membrane (Δψm) is intact, long (L-OPA1) isoforms shape the inner membrane through membrane fusion and the formation of cristal junctions. When Δψm is lost, however, OPA1 is cleaved to short, inactive S-OPA1 isoforms by the OMA1 metalloprotease, disrupting mitochondrial structure and priming cellular stress responses such as apoptosis. Previously, we demonstrated that L-OPA1 of H9c2 cardiomyoblasts is insensitive to loss of Δψm via challenge with the protonophore carbonyl cyanide chlorophenyl hydrazone (CCCP), but that CCCP-induced OPA1 processing is activated upon differentiation in media with low serum supplemented with all-trans retinoic acid (ATRA). Here, we show that this developmental induction of OPA1 processing in H9c2 cells is independent of ATRA; moreover, pretreatment of undifferentiated H9c2s with chloramphenicol (CAP), an inhibitor of mitochondrial protein synthesis, recapitulates the Δψm-sensitive OPA1 processing observed in differentiated H9c2s. L6.C11 and C2C12 myoblast lines display the same developmental and CAP-sensitive induction of OPA1 processing, demonstrating a general mechanism of OPA1 regulation in mammalian myoblast cell settings. Restoration of CCCP-induced OPA1 processing correlates with increased apoptotic sensitivity. Moreover, OPA1 knockdown indicates that intact OPA1 is necessary for effective myoblast differentiation. Taken together, our results indicate that a novel developmental mechanism acts to regulate OMA1-mediated OPA1 processing in myoblast cell lines, in which differentiation engages mitochondrial stress sensing.

Selective adhesion of nitrogen-containing toxic gasses on hexagonal boron phosphide monolayer: a computational study.

CONTEXT: Various toxic gasses are being released into the environment with the increasing industrialization. However, detecting these gasses at low concentrations has become one of the main challenges in environmental monitoring and protection. Thus, developing sensors with high performance to detect toxic gasses is of utmost significance. For this purpose, researchers have introduced 2D materials thanks to their unique electronic qualities and large specific surface area. Within this piece of research, a hexagonal boron phosphide monolayer (h-BPML) is employed as the substrate material. The adhesion behavior of ambient nitrogen-containing toxic gasses, i.e., N2O, NH3, NO2, and NO, onto the h-BPML is investigated through DFT computations. The adhesion energy values for gasses NO and NO2 were calculated to be - 0.509 and - 0.694 eV on the h-BPML, respectively. Meanwhile, the absorbed energy values for gasses NH3 and N2O were found to be - 0.326 and - 0.119 eV, respectively. The recovery time, DOS, workfunction, and Bader charges were computed based on four optimal adhesion structures. After the absorption of NO on the h-BPML, the value of workfunction of a monolayer decreased from 1.54 to 0.47 eV. This amount of decrease was the greatest among the other gasses absorbed. By comparing the investigated parameters, it can be concluded that the h-BPML has a greater tendency to interact with NO gas compared to other gasses, and it can be proposed as a sensor for NO gas. METHOD: Within this piece of research, the sensitivity of the h-BPML to four nitrogenous toxic gasses, namely, N2O, NH3, NO2, and NO, was investigated using the DFT with HSE06 hybrid functional by using GAMESS software. For this purpose, we computed the DOS, workfunction, and the Bader charges for the four adhesion systems with most stability.

Tailoring ZnS nanostructures through precipitation-cum-hydrothermal synthesis for enhanced wastewater purification and antibacterial treatment.

This study presents a novel blend of synthesis techniques for shape-controlled ZnS nanoparticles. Zinc sulfide (ZnS) nanoparticles with distinct morphologies cauliflower-like microstructures (∼4.5 µm) and uniform nanospheres (200-700 nm) were synthesized through an innovative blend of precipitation and hydrothermal techniques. Capping with polyvinylpyrrolidone (PVP) significantly decreased crystallite size (3.93 nm-2.36 nm), modulated the band gap (3.57 eV-3.71 eV), and dramatically influenced morphology, highlighting the novelty of shape-controlled synthesis and its impact on optoelectronic and functional properties. X-ray diffraction confirmed crystallinity and revealed the size-controlling influence of PVP. UV-vis spectroscopy suggested potential tuning of optical properties due to band gap widening upon PVP capping. Field-emission scanning electron microscopy (FESEM) unveiled distinct morphologies: cauliflower-like microstructures for ZnS and uniform nanospheres (200-700 nm) for PVP-ZnS. Both structures were composed of smaller spherical nanoparticles, demonstrating the role of PVP in promoting controlled growth and preventing agglomeration. High-resolution transmission electron microscope (HRTEM) images depicted that the majority of nanoparticles maintain a spherical shape, though slight deviations from perfect sphericity can be discerned. Fourier-transform infrared (FTIR) spectroscopy confirmed that successful PVP encapsulation is crucial for shaping nanospheres and minimizing aggregation through steric hindrance. Photocatalytic activity evaluation using methylene blue (MB) dye degradation revealed significantly faster degradation by PVP-ZnS under ultraviolet (UV) irradiation (within 60 min as compared to 120 min for ZnS), showcasing its superior performance. This improvement can be attributed to the smaller size, higher surface area, and potentially optimized band gap of PVP-ZnS. Additionally, PVP-ZnS exhibited promising antibacterial activity against S. aureus and P. aeruginosa, with increased activity at higher nanoparticle concentrations.

An updated study of the relationship between bacterial infections and women's immune system, focusing on bacterial compositions with successful pregnancy.

Genital tract infections can cause a variety of harmful health outcomes, including endometritis, bacterial vaginosis, and pelvic inflammatory disease, in addition to infertility. Anaerobic bacteria, such as Gardnerella vaginalis, Megasphaera spp., and Atopobium vaginae, are more commonly identified in cases of bacterial vaginosis than lactobacilli. It is unknown how the microorganisms that cause pelvic inflammatory diseases and endometritis enter the uterus. Both prospective and retrospective research have connected pelvic inflammatory disorders, chronic endometritis, and bacterial vaginosis to infertility. Similar to bacterial vaginosis, endometritis-related infertility is probably caused by a variety of factors, such as inflammation, immune system recognition of sperm antigens, bacterial toxins, and a higher risk of STDs. Preconception care for symptomatic women may include diagnosing and treating pelvic inflammatory disease, chronic endometritis, and bacterial vaginosis before conception to optimize the results of both natural and assisted reproduction.

Synthesis and Biological Evaluation of Amino Acid and Peptide Conjugates of 5-Bromovaleric Acid.

BACKGROUND: Among various carboxylic acid derivatives, valeric acid or pentanoic acid is found to be widely distributed in nature. It is a straight-chain alkyl carboxylic acid containing five carbon atoms. Due to the therapeutic value of valeric acid, it is used as a versatile nucleus in the pharmaceutical field. Valeric acid derivatives are associated with a broad spectrum of biological activities, like anticonvulsant, antiplatelet, antidiabetic, and plant growth activities. AIM: It has previously been revealed that peptide derivatives of carboxylic acids are accountable for enhanced antimicrobial activity. Therefore, it was hypothesized that coupling peptides with valeric acid would increase the antimicrobial properties of the target compounds. So, the objective of the present study was to synthesize peptide derivatives of 5-bromovaleric acid and evaluate their antibacterial and antifungal activities. METHODS: 5-bromovaleric acid was synthesized by the reaction of cyclopentanone and hydrogen peroxide in the presence of copper bromide and sodium bromide. Additionally, 5-bromovaleric acid was coupled with amino acid methyl esters, dipeptides, tripeptides, and tetrapeptides in the presence of dicyclohexylcarbodimide (DCC) and N-methylmorpholine (NMM) as a base under continuous stirring for 36 hours to produce its peptide derivatives. RESULTS: The results obtained showed that 5-bromovaleric acid possesses more potent antibacterial activity than N-terminal 5-bromovaleric acid conjugates of selected di-, tri, and tetra peptide Cterminal methyl esters against ciprofloxacin as a standard. The selected dipeptide and tripeptide Nterminal 5-bromovaleric acid-conjugated C-terminal methyl ester derivatives were more active than the selected tetrapeptide methyl ester analogue. Using fluconazole as a reference, the antifungal efficacy of 5-bromovaleric acid against C. albicans and A. niger declined as it was combined with C-terminal methyl esters of selected dipeptides, tripeptides, and tetrapeptides. CONCLUSION: The novel selected peptide derivatives had less antibacterial and antifungal action than the parent 5-bromovaleric acid. Antibacterial and antifungal investigations showed that 5- bromopentanoic acid peptide derivatives might impair antimicrobial efficacy. Further, attaching 5- bromopentanoic acid to di, tri, and tetra peptides did not boost their antibacterial potential.

Hand hygiene compliance of respiratory physiotherapists: An analysis of trends over eight years including the COVID-19 pandemic period.

BACKGROUND: Respiratory physiotherapists (RPs) are an integral part of healthcare workers delivering care to intubated patients. Our study aimed to evaluate the effect of awareness campaigns on hand hygiene (HH) compliance among RPs. METHOD: An observational single-center study was conducted between 2015 and 2022 in different ICU types in both adult and paediatric settings. The hand hygiene compliance rates were monitored prospectively and the quality improvement interventions included various hand hygiene campaigns and awareness sessions with RPs. Compliance was calculated as a percentage of events over total opportunities observed. RESULTS: There was a significant increase in compliance rates for all five moments of HH (p-value: <0.05). Overall, mean compliance rate in ICUs was significantly higher than wards for Moment 1 (p-value: 0.0045), Moment 4 (p-value: 0.0372) and Moment 5 (p-value: 0.0036) by 24.2%, 22.7% and 21.5% respectively. Also, paediatric ICUs had higher HH compliance than adult ICUs for Moment 1 (87.5% vs 61.1%; p-value: 0.0459) and Moment 4 (93.7% vs 79.3%; p-value: 0.0255). A significant increase in HH compliance was observed in post-COVID-19 period compared to pre-COVID-19 period with respect to Moment 1, 2 and 5. CONCLUSION: This study adds to the almost non-existent literature on this important category of healthcare workers working in respiratory ICUs. Our results project an increase compliance after the HH awareness programmes over the years among RP which is critical to prevent spread infection by multidrug resistant organisms among the hospitals.

Seasonal distribution and upsurge of respiratory viruses among indigenous tribes with ILI and SARI in a far-flung Car Nicobar Island.

BACKGROUND: Respiratory viral illnesses among children are a prominent cause of morbidity and mortality in the developing world. The aim of this study is to understand the seasonal pattern and surge of respiratory viruses among the Nicobarese tribe. METHODS: Respiratory specimens were collected from both ARI and SARI cases attended the BJR district hospital in Car Nicobar Island, India, between 2021 and 2022. Respiratory viruses were identified from the specimens by using the qRT-PCR assay. Meteorological parameters were collected and evaluated using Microsoft Excel and SPSS 21. The significant association between the surge of respiratory viruses and each climatic parameter was evaluated. RESULTS: In this hospital-based cross-sectional study, 471 ILI cases were enrolled, and 209 of these were positive for respiratory viral infections. Of these respiratory virus infections, 201 (96.2%) were infected with a single respiratory virus infection, and 8 (3.8%) had mixed viral infections. Fever, cough, and chills were the most common symptoms of respiratory illness among this indigenous population. There was a significant link between respiratory viruses and influenza-like illness in children (below 5 years and 6 to 15 years). CONCLUSION: This prevalence study revealed that viral respiratory infections were more common in children than adults. Among these respiratory viruses, respiratory syncytial virus A (RSV) and influenza B virus were predominantly reported among tribal children up to age five years. In the year 2021, these viruses were recorded frequently during the winter season. Climate factors such as high humidity, high precipitation, moderate temperature, and moderate rainfall are found to be correlated with respiratory viral infections. This study implicates important information for preventing a further outbreak of respiratory viral infections in Car Nicobar Island.

Investigation of Earth-Abundant Metal Salts for the Inhibition of Asphalt-Derived Volatile Organic Compounds.

Asphalt is used globally in construction for roads, pavements, and buildings; however, as a fossil-derived material, it is known to generate volatile organic compounds (VOCs) upon exposure to heat and light that can be harmful to human health. Several heterogeneous strategies have been reported for the inhibition of these VOCs; however, the direct use of inexpensive, accessible Earth-Abundant metals has not been extensively explored. In this study, simple metal salts are examined for their coordination capability toward asphalt-derived VOCs. From UV-visible (UV-vis) spectroscopic studies, FeCl3 emerged relative to other metal salts (metal = Mn, Co, Ni, Cu, Zn) as a promising candidate for the adsorption and retention of Lewis basic compounds. Coordination of an example oxygen-containing VOC, benzofuran (Bf), to Fe yielded a paramagnetic semi-octahedral complex Fe(Bf)3Cl3. Evaluation by thermal gravimetric analysis (TGA) coupled to infrared spectroscopy (IR) demonstrated that the complex was stable up to 360 °C. Spectroscopic evaluation demonstrated the stability of the complex upon visible light irradiation and in the presence of a variety of organic pollutants. The potential application of Fe was demonstrated by subjecting biochar to FeCl3 followed by the addition of Bf. It was discovered that this Fe-rich biochar was successful at adsorbing Bf suggesting the possibility of introducing Fe to biochar late-stage in processing to deter asphalt degradation and VOC emissions. An understanding of the binding and stability of Fe salts to VOCs provides insight into how a sustainable infrastructure can be achieved.

Perception, practices and understanding of teenage pregnancy among the adolescent girls in India: A scoping review protocol.

Introduction: Teenage pregnancy is a subject of concern among adolescents. Inadequate knowledge and misperceptions about pregnancy are major contributing factors to teenage pregnancy. Without a proper understanding, adolescents are involved in unsafe sexual practices, which results in pregnancy. So, perception and understanding are important aspects to explore among adolescents. In this planned scope review, all eligible studies will be identified around the perception, practices, and understanding of teenage pregnancy among married and unmarried adolescent girls. Methods: The Arksey and O'Malley (2005) scoping review framework and the Joanna Briggs Institute Reviewers' Manual (2015) will be used for the planned scoping review. The population, concept, and context strategy (PCC) will be used to develop the research question, search strategy, and eligibility criteria. Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA ScR) will be used for the findings of the study. For the literature search, authors will use Google Scholar, PubMed, and ResearchGate electronic databases with specific words such as "teenage", "adolescence", "pregnancy", "perception", "knowledge", "awareness" and "abortion". Result: The planned scoping review will be helpful in addressing the lack of adolescent misperception, malpractices, and misunderstandings regarding teenage pregnancy. It can provide detailed information about teenage pregnancy in the Indian context. Conclusion: The evidence synthesis and gap analysis will be helpful in suggesting insights into the issue of teenage pregnancy, which will be helpful in future policies and programs.

Female sexual dysfunction-knowledge, attitude, practices, and barriers encountered by medical fraternity across the country: A web-based cross-sectional study.

Introduction: Sexual dysfunction in women is common yet often remains underdiagnosed due to the lack of adequate training and experience of the doctors to manage female sexual dysfunctions. This study was done to assess the knowledge and attitude of medical professionals toward female sexual dysfunction and the various practices and barriers they encounter while managing women with sexual dysfunction. Materials and Methods: A web-based cross-sectional study was done using the snowball sampling method. A well-structured, self-administered, and pre-validated questionnaire containing 27 items was administered through social media. Data was collected and evaluated to assess their knowledge, practices they follow, and barriers encountered while managing female sexual dysfunction. Results: A total of 513 doctors participated in the study. Out of all, only 11.1% of the doctors were often seeing patients with sexual dysfunction. Loss of desire (44%), painful intercourse (33%), lack of lubrication (18%), and anorgasmia (5%) are common symptoms with which women present. The majority of doctors (78.9%) were comfortable in starting a conversation, over half (52.6%) were confident in making a diagnosis, and 51.3% were confident in providing sexual counseling. Yet, only 11.1% were routinely screening women for sexual dysfunctions, and 33.8% were providing counseling regarding sexual issues. Lack of time (31.6%), lack of adequate training (57.3%), unavailability of effective treatment (11.9%), patient discomfort (60.62%), and patient's reluctance to seek treatment (15.8%) were the barriers encountered by doctors. When assessed for knowledge, around 30.9% had excellent knowledge (≥75th percentile) about female sexual dysfunction. Conclusion: Sexual dysfunction among women is an important health issue that significantly affects the social, mental, and physical well-being of those suffering from it. Screening for sexual dysfunction should be done routinely in day-to-day clinical practice to improve the overall quality of life of a couple.

Comparative evaluation of self-pressurized Air-Q® and Proseal™ LMA® in patients undergoing elective surgery under general anaesthesia: A randomized clinical trial.

Background and Aims: Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery. Material and Methods: The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated. Results: All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar. Conclusions: Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.

Awareness among Pediatricians Regarding National Telemedicine Guidelines during the COVID-19 Pandemic: A Survey.

The success of telemedicine depends on awareness among doctors on how to implement it. We aimed to assess knowledge about national telemedicine guidelines in pediatricians during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study of pediatricians across India was conducted through a structured online questionnaire containing 16 marks. The mean knowledge score (KS) was calculated. Participants were divided into two groups: poor KS (KS <8) and good KS (KS ≥8). The association between factors and KS was assessed using univariate analysis. A total of 503 pediatricians participated (private sector: 80.7% and public sector: 19.3%). Most (61%) belonged to the age group of 31-50 years and were males (75%). The minimum educational qualification was a Doctor of Medicine (MD) in 57% of cases. Despite work experience of more than 5 years in most (70%) of the cases, very few had provided teleconsultation before the pandemic (13.9%). The mean KS was 10.60 ± 2.8, that is, 66.25%. The minimum KS was 1 (6.25%), and the maximum was 16 (100%). Assam, Chandigarh, Himachal Pradesh, Jharkhand, Odisha, Sikkim, and Tamil Nadu showed higher knowledge than other states, although no significant difference was found. The majority (89.1%) had good KS, which is significantly higher among private practitioners as compared to public practitioners. There was no association between KS and age, gender, qualification, and work experience. Pediatricians have good information regarding telemedicine guidelines in India; however, training programs will further empower doctors working in the public sector.

Malnutrition and Anemia Among Particularly Vulnerable Tribal Groups of Odisha, India: Needs for Context-Specific Intervention.

Background: As undernutrition and anemia persist to be prevalent in India, the socioeconomically disadvantaged groups continue to take the greater brunt. Odisha is home to the largest number of particularly vulnerable tribal groups (PVTGs) in India. The study aimed to provide a comprehensive report on the undernutrition and anemia status of all the PVTGs of Odisha. Methods: A community-based cross-sectional study was conducted among (N = 1461, 683 males and 779 females) 13 PVTGs spread across 12 districts of Odisha from August 2018 to February 2019. Results: Among the under-five children, the prevalence of underweight was observed in 75.26%, stunting in 55.42%, and wasting in 60.00% and all forms of undernutrition were higher among girls. Among children and adolescents belonging to the age group of 5 to 19 years, the prevalence of thinness was 46.7%. In individuals above the age of 20, the prevalence of underweight among males was 37.7% and females was 44.3% and severe anemia was present in 36.5% of females and 35.8% of males. Women in the reproductive age have a higher prevalence of anemia. Conclusion: The study shows that undernutrition and anemia remain high in the PVTGs, especially among the under-five children and women in the reproductive age. As the country heads toward fulfilling Sustainable Development Goals (SDG) by 2030, national and state health policies need to be designed and implemented, giving special focus to these vulnerable groups.

Aetiological profile of acute encephalitis syndrome in Assam, India, during a 4-year period from 2019 to 2022.

Acute encephalitis syndrome (AES) is a major public health concern in India as the aetiology remains unknown in the majority of cases with the current testing algorithm. We aimed to study the incidence of Japanese encephalitis (JE) and determine the aetiology of non-JE AES cases to develop an evidence-based testing algorithm. Cerebrospinal fluid (CSF) samples were tested for Japanese encephalitis virus by ELISA and polymerase chain reaction (PCR). Multiplex real-time PCR was done for Dengue, Chikungunya, West Nile, Zika, Enterovirus, Epstein Barr Virus, Herpes Simplex Virus, Adenovirus, Cytomegalovirus, Herpesvirus 6, Parechovirus, Parvovirus B19, Varicella Zoster Virus, Scrub typhus, Rickettsia species, Leptospira, Salmonella species, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Plasmodium species and by ELISA for Mumps and Measles virus. Of the 3173 CSF samples, 461 (14.5%) were positive for JE. Of the 334 non-JE AES cases, 66.2% viz. Scrub typhus (25.7%), Mumps (19.5%), Measles (4.2%), Parvovirus B19 (3.9%) Plasmodium (2.7%), HSV 1 and 2 (2.4%), EBV and Streptococcus pneumoniae (2.1% each), Salmonella and HHV 6 (1.2% each) were predominant. Hence, an improved surveillance system and our suggested expanded testing algorithm can improve the diagnosis of potentially treatable infectious agents of AES in India.

Comparative Study of Ki-67 Labeling Index Quantification by Eye-rolling, Manual Count, and Digital Image Analysis; An Approach with Caution.

Background and Objective: An accurate Ki-67 labeling index assessment is critical for managing a few tumors, like breast carcinomas and neuroendocrine tumors. We aimed to determine the degree of agreement between digital image analysis (DIA) and eye-rolling assessment (EE) and DIA and manual count (MC) for Ki-67 LI scoring. Methods: A total of 120 cases (both tru-cut biopsies and resected specimens) were selected during the study period from the institutional database, wherein the Ki-67 labeling index was performed. The selected cases were divided into two groups, i.e., breast neoplasms and other neoplasms. The correlation between DIA and EE and DIA and MC for Ki-67 LI scoring was calculated in both groups. Results: A total of 113 cases were analyzed for Ki-67 LI by three different methods (EE, MC, and DIA); 7 cases were rejected due to poor image quality. Ki-67 LI scoring by DIA and EE was highly correlated in both study groups with a Spearman's rank correlation coefficient of 0.809 (P=0.01) and 0.904 (P=0.01), respectively. Correlation between DIA and MC methods was also found to be almost perfect in both study groups with a Spearman's rank correlation coefficient of 0.974 (P=0.01) and 0.955 (P=0.01), respectively. Conclusion: ImmunoRatio is a free web-based digital image analysis application that can be used for Ki-67 LI assessment with considerable reliability and reproducibility. Yet, it carries a few limitations and demands a careful approach and final confirmation by an expert.

Analysing the Impact of Resistant Starch Formation in Basmati Rice Products: Exploring Associations with Blood Glucose and Lipid Profiles across Various Cooking and Storage Conditions In Vivo.

Common cooking methods were used to prepare basmati rice products, including boiling 1 (boiling by absorption), boiling 2 (boiling in extra amount of water), frying, and pressure cooking. The cooked rice was held at various temperatures and times as follows: it was made fresh (T1), kept at room temperature (20-22 °C) for 24 h (T2), kept at 4 °C for 24 h (T3), and then reheated after being kept at 4 °C for 24 h (T4). The proximate composition, total dietary fibre, resistant starch (RS), and in vitro starch digestion rate of products were examined. The effect of RS on blood glucose and lipid profiles was measured in humans and rats, including a histopathological study of the liver and pancreas in rats. The basmati rice that was prepared via boiling 1 and stored with T3 was found to be low in glycaemic index and glycaemic load, and to be high in resistant starch. Similarly, in rats, the blood glucose level, cholesterol, triglycerides, and LDL were reduced by about 29.7%, 37.9%, 31.3%, and 30.5%, respectively, after the consumption of basmati rice that was prepared via boiling 1 and stored with T3. Awareness should be raised among people about the health benefits of resistant starch consumption and the right way of cooking.

Influence of ß-lactam pharmacodynamics on the systems microbiology of gram-positive and gram-negative polymicrobial communities.

Objectives: We sought to evaluate the pharmacodynamics of ß-lactam antibacterials against polymicrobial communities of clinically relevant gram-positive and gram-negative pathogens. Methods: Two Enterococcus faecalis isolates, two Staphylococcus aureus isolates, and three Escherichia coli isolates with varying ß-lactamase production were evaluated in static time-killing experiments. Each gram-positive isolate was exposed to a concentration array of ampicillin (E. faecalis) or cefazolin (S. aureus) alone and during co-culture with an E. coli isolate that was ß-lactamase-deficient, produced TEM-1, or produced KPC-3/TEM-1B. The results of the time-killing experiments were summarized using an integrated pharmacokinetic/pharmacodynamics analysis as well as mathematical modelling to fully characterize the antibacterial pharmacodynamics. Results: In the integrated analysis, the maximum killing of ampicillin (Emax) against both E. faecalis isolates was ≥ 4.11 during monoculture experiments or co-culture with ß-lactamase-deficient E. coli, whereas the Emax was reduced to ≤ 1.54 during co-culture with ß-lactamase-producing E. coli. In comparison to monoculture experiments, culturing S. aureus with KPC-producing E. coli resulted in reductions of the cefazolin Emax from 3.25 and 3.71 down to 2.02 and 2.98, respectively. Two mathematical models were created to describe the interactions between E. coli and either E. faecalis or S. aureus. When in co-culture with E. coli, S. aureus experienced a reduction in its cefazolin Kmax by 24.8% (23.1%RSE). Similarly, ß-lactamase-producing E. coli preferentially protected the ampicillin-resistant E. faecalis subpopulation, reducing Kmax,r by 90.1% (14%RSE). Discussion: ß-lactamase-producing E. coli were capable of protecting S. aureus and E. faecalis from exposure to ß-lactam antibacterials.