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In this case, we focus on two innovations in the design of competitive discussions for a high stakes learning context. The designer created the intervention to provide learners first-hand discussion experiences despite large class sizes. It was a business communication course, and the large class sizes and group dynamics previously had inhibited constructive feedback and limited learner participation; however, the combination of a (1) time-constrained asynchronous CMC activity, along with (2) strategically selected smaller groups, created an interactive space that matched the designer's values of equity and inclusion that he wanted to bring to the design. The case chronicles a number of unforeseen consequences of logical design moves, and presents a multimodal re-conception of what it means to discuss in the context of modern business school.

Introduction Many patients suffered from rhino-orbital-cerebral mucormycosis during the coronavirus disease 2019 (COVID-19) pandemic in India. Diabetes is a known risk factor of COVID-19 infection and mucormycosis. Objective The present study was done to describe the clinical spectrum and histopathological findings of mucormycosis in COVID-19 patients and their outcomes. Methods A cross-sectional study was done over a period of two and half months. The biopsy samples or scrapings from sinonasal or periorbital tissue of 38 patients were analyzed. Hematoxylin & Eosin (H&E stain) slides were evaluated along with Grocott-Gomori methenamine–silver and Periodic acid–Schiff stains to highlight the fungal elements. Results The male to female ratio was 2.5:1, and the mean age of the subjects was 53 years old. A total of 68.4% (n = 26/38) of the patients had diabetes as a comorbidity, 84.2% (n = 32/38) had a history of steroid intake, and 55.3% (n = 21/38) were given supplemental oxygen during their treatment. The common presentations were nasal blockage, discharge, eye pain, headache, and altered mentation. The sites of biopsy were: nasal cavity 76.3% (n = 29/38), periorbital fat/orbit 21.1% (n = 8/38), maxillary sinus 15.8% (n = 6/38) and ethmoid sinus 13.2% (n = 5/38). In 76.3% (n = 29/38) cases, broad, irregular, nonseptate, and right-angle branching hyphae were seen on H&E-stained tissue sections. Conclusion COVID-19 led to various complications in individuals affected by it. Mucormycosis was one such lethal complication. An early diagnosis and prompt treatment is crucial to control the progression of the disease and improve outcomes. [ABSTRACT FROM AUTHOR]

Introduction There is ambiguity regarding usage of tranexamic acid for melasma in India, be it in its pre-administration evaluation, administration route, dosing or monitoring. Hence, we conducted this study to understand various tranexamic-acid prescribing patterns and provide practical guidelines. Materials and methods A Google-form-based questionnaire (25-questions) was prepared based on the key areas identified by experts from the Pigmentary Disorders Society, India and circulated to practicing dermatologists across the country. In rounds 2 and 3, the questionnaire was re-presented to the same group of experts and their opinions were sought. The results of the practitioners' survey were denoted graphically alongside, to guide them. Consensus was deemed when at least 80% of respondents chose an option. Results The members agreed that history pertaining to risk factors for thromboembolism, cardiovascular and menstrual disorders should be sought in patients being started on oral tranexamic-acid. Baseline coagulation profile should be ordered in all patients prior to tranexamic-acid and more exhaustive investigations such as complete blood count, liver function test, protein C and S in patients with high risk of thromboembolism. The preferred oral dose was 250 mg orally twice daily, which can be used alone or in combination with topical hydroquinone, kojic acid and sunscreen. Repeated dosing of tranexamic-acid may be required for those relapsing with melasma following initial tranexamic-acid discontinuation. Coagulation profile should ideally be repeated at three monthly intervals during follow-up, especially in patients with clinically higher risk of thromboembolism. Treatment can be stopped abruptly post improvement and no tapering is required. Limitation This study is limited by the fact that open-ended questions were limited to the first general survey round. Conclusion Oral tranexamic-acid provides a valuable treatment option for melasma. Frequent courses of therapy may be required to sustain results and a vigilant watch is recommended for hypercoagulable states during the course of therapy. [ABSTRACT FROM AUTHOR]

Itraconazole (ITZ) has been the mainstay of oral antifungal treatment for the current epidemic of recalcitrant dermatophytosis (RD) in India. Recently, a newer formulation of ITZ, super bioavailable itraconazole (SUBA-ITZ), is made available in the market by many pharmaceutical companies. It is important for dermatologists to understand the pharmacokinetic properties of SUBA-ITZ vis-a-vis conventional pellet formulation to use it effectively and safely. Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) has established a special interest group for recalcitrant dermatophytosis (SIG-RD) to strengthen research, continuing medical education, and industry collaboration on the subject. This position statement on SUBA-ITZ by SIG-RD is an attempt to address current pieces of evidence and the position of this new formulation in the management of RD. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) in developing countries constitute a high risk for patients acquiring infection by multidrug-resistant organisms (MDROs). The rise in antimicrobial resistance (AMR) threatens the effective prevention and treatment of an increasing range of infections. The present study analyzed the local trends of AMR in Gram-negative isolates of ICU patients from a tertiary care facility in North India. Methods: This retrospective study was conducted over 5 years (January 2018–December 2022). All bacterial isolates from patients admitted to ICU during the study period were included in the study, and their AMR pattern was analyzed. In addition, sensitivity trends of different antimicrobials against the common Gram-negative bacteria were analyzed, and AMR trends were analyzed over the study period. Results: Klebsiella spp. was the most common isolate in samples received from ICU. A rise of carbapenem-resistant microorganisms was observed over the study period. Escherichia coli and Klebsiella spp. showed around 10% and a 17% decrease in susceptibility to carbapenems, respectively. In contrast, a marked 29% decrease in sensitivity to carbapenems was observed in Acinetobacter spp. Conclusion: The inception of integrated stewardship measures has shown a rising trend in susceptibility and is the need of the hour to prevent the spread of MDROs. Surveillance studies help us understand the impact of AMR in hospitals and help plan prevention programs. [ABSTRACT FROM AUTHOR]

Background: Impact of COVID-19 pandemic has been immense. An innocent casualty of this disaster is medical education and training. Dermatology, which primarily deals with out-patient services, medical and surgical interventions, and in-patient services, was one of the worst hit. The National Medical Commission of India has implemented competency-based medical education (CBME) in Dermatology, Venereology, and Leprosy since 2019. The new curriculum relies on acquiring practical and procedural skills, training skills in research methodology, professionalism, attitude, and communication. Objectives: The study was undertaken to understand the implications of the COVID-19 pandemic on postgraduate dermatology CBME training in India. Materials and Methods: A questionnaire-based survey was carried out on postgraduate dermatology teachers and residents in India after obtaining ethics committee approval. An online semi-structured English questionnaire was administered by Google Forms. The calculated sample size was 366 dermatology faculty and 341 postgraduate students. Validity (Content validity ratio (CVR) ≥0.56) and reliability (Cronbach's alpha coefficient 0.7249) of the questionnaire were determined. Results: Among the 764 responses received, 51.4% reported that their institutes were converted to exclusive COVID hospitals. Domains of dermatology education affected were procedural training (n = 655), bedside clinical teaching (n = 613), outpatient department-based clinical teaching (n = 487), bedside laboratory procedures (n = 463), research activities (n = 453), histopathology (n = 412), and theory classes (n = 302). To keep up with the teaching-learning process, online platforms were mostly utilized: Zoom Meeting (n = 379), Google Meet (n = 287), and WhatsApp Interaction (n = 224). Teaching during ward rounds was significantly more affected in exclusively COVID institutes than non-exclusive COVID institutes (P < 0.001). Psychomotor skill development suffered a major jolt with 26.7% of respondents reporting a standstill (P < 0.001). Communication skills among students suffered due to social distancing, mask, and poor attendance of patients. According to 23.84% of respondents, formative assessment was discontinued. Conclusion: Online seminars, journal clubs, and assessments have been incorporated during the pandemic. Online modalities should be used as a supplementary method as psychomotor skills, communication skills, research work, and bedside clinics may not be replaced by the e-learning. [ABSTRACT FROM AUTHOR]

Introduction: There has been a sudden, unexplained surge in dermatophytoses in India since past 5 years. T. rubrum being the most common etiological agent isolated from clinically diagnosed lesions of cutaneus dermatophytosis. It has a significantly higher capacity of transmission than other anthropophilic dermatophytes. Aim and Objective: To study the Antifungal Susceptibility Pattern, Molecular Profiling and its Sequencing Analysis of Trichophyton rubrum isolated from human Sample. Material and Methods: This was a a prospective study carried out in the Department of Microbiology at Rama Medical College Hospital and Research Centre Mandhana, Kanpur for a period of 1 year i.e, March 2017 to March 2018. A total of 375 clinically suspected cases of superficial fungal infection were collected with proper informed consent. Dermatophytosis was confirmed in cases by direct microscopy and culture methods. Antifungal drug susceptibility profiles, MIC of isolates were 50 90 determined using the broth microdilution method according to the CLSI guidelines. The DNA isolation was done using the Qiagen DNA extraction kit followed by the PCR. The sequencing methods were used for the genetic analysis of virulence gene for the confirmation. Results: Out of the total of 375 clinically suspected cases of superficial fungal infection 31 isolates of Trichophyton rubrum were studied. The ratio of Male were more 27 (87%) as compared to the Female 4 (12.9% ). The maximum number of isolates was found in the Skin 28 (90.3%) followed by the Nail 3 (9.6%). The ITZ was most sensitive toward T. rubrum than KTZ, TBF, and FCZ. The molecular characterization for the detection of 18s gene was performed which was confirmed by the Sequencing Analysis. Conclusion: Antifungal resistance against T. rubrum is increasing over the last few decades due to genetic diversity in the fungal genome. The molecular identification is a gold standard technique for the identification of T. rubrum allowing important factor in providing fungal infection prevention and treatment approaches. [ABSTRACT FROM AUTHOR]

Fertigation in rice-based cropping systems is catching up the attention of farmers for producing high yield of crops and improved fertilizer use efficiency. As fertigation with different combinations of irrigation and nitrogen (N) levels can interact with depth of rooting system of different crops as well as soil tillage, this study was carried out in 2017 in the fourth year of on an on-going long-term experiment initiated in the summer (Kharif) season of 2014 to understand the effect of fertigation on soil organic carbon pools and yield in zero-till direct-seeded rice-based cropping systems. The experiment was laid out in a split plot design with three levels of fertigation as main plots: N @ 20 kg ha−1 in rice through fertigation followed by 200 mm irrigation in post rice crops (W1), N @ 40 kg ha−1, in rice through fertigation followed by 300 mm irrigation in post rice crops (W2), N @ 60 kg ha−1, in rice through fertigation followed by 400 mm irrigation in post rice crops (W3). The sub-plot treatments consisted of zero till direct seeded durum wheat, barley, chickpea, linseed, lentil and lathyrus crops after rice. The rice crop was also under zero till direct seeded cultivation system. The highest grain yield of rice was observed in the rice-lathyrus cropping system with treatment W3 where N was applied in three equal splits, first being basal application and the two subsequent applications through surface inline drip irrigation. Both in surface and sub-surface soil layers, soil carbon stock, carbon pools and aggregate associated carbon were found to be more in the legume based cropping systems and with W3 fertigation regime than in other cereal based cropping systems. The grain yield was found negatively and highly significantly correlated with less labile pool (r=-0.63**) whereas very labile pool was positively significantly correlated with labile (r = 0.89**), less labile (r = 0.53**) and non-labile (r = 0.91**) pools of carbon. Overall, fertigation levels influenced the crop yield and soil organic matter in zero-till direct-seeded rice-based cropping systems. [ABSTRACT FROM AUTHOR]

Psoriasis is a multisystem disorder with a significant impact on the quality of life (QoL) of the patient. QoL in psoriasis is influenced by epidemiological factors, the type and extent of the disease, and underlying comorbidities. Various tools have been developed to assess the QoL in patients with psoriasis, namely psoriasis specific, skin specific, generic QoL, and mixed measures. In this review, we present a concise overview of the different indices and the pros and cons of various tools to assess the impact of psoriasis on patients. [ABSTRACT FROM AUTHOR]

The wonder fruit pomegranate (Punica granatum , family Lythraceae) is one of India's economically important fruit crops that can grow in different agro-climatic conditions ranging from tropical to temperate regions. This study reports high-quality de novo draft hybrid genome assembly of diploid Punica cultivar "Bhagwa" and identifies its genomic features. This cultivar is most common among the farmers due to its high sustainability, glossy red color, soft seed, and nutraceutical properties with high market value. The draft genome assembly is about 361.76 Mb (N50 = 40 Mb), ∼9.0 Mb more than the genome size estimated by flow cytometry. The genome is 90.9% complete, and only 26.68% of the genome is occupied by transposable elements and has a relative abundance of 369.93 SSRs/Mb of the genome. A total of 30,803 proteins and their putative functions were predicted. Comparative whole-genome analysis revealed Eucalyptus grandis as the nearest neighbor. KEGG-KASS annotations indicated an abundance of genes involved in the biosynthesis of flavonoids, phenylpropanoids, and secondary metabolites, which are responsible for various medicinal properties of pomegranate, including anticancer, antihyperglycemic, antioxidant, and anti-inflammatory activities. The genome and gene annotations provide new insights into the pharmacological properties of the secondary metabolites synthesized in pomegranate. They will also serve as a valuable resource in mining biosynthetic pathways for key metabolites, novel genes, and variations associated with disease resistance, which can facilitate the breeding of new varieties with high yield and superior quality. [ABSTRACT FROM AUTHOR]

Synthetic fertilizer and herbicides encompass the largest share in nutrient and weed management on food grain crops that create serious environmental issues. Integrated nutrient and non-chemical weed management approaches may help to reduce the chemical load in the environment, maintaining higher weed control efficiency and yield. A field experiment was conducted for two consecutive monsoon seasons during 2015 and 2016 in farm fields to develop a profitable and sustainable rice production system through integrated nutrient and weed management practices. A varied combination of nutrients either alone or integrated with chemical and non-chemical weed management were tested on transplanted rice in a factorial randomized block design with three replications. The results showed that the integration of concentrated organic manures with chemical fertilizer effectively inhibited weed growth and nutrient removal. Integration of nutrient and weed management practices significantly enhanced 9% biomass growth, 10% yield of the rice crop along with 3–7% higher nutrient uptake. Brassicaceous seed meal (BSM) and neem cake also had some influence on weed suppression and economic return. Thus, the integrated nutrient and weed management practices in rice cultivation might be an effective way to achieve economic sustainability and efficient rice cultivation in eastern India. Shortages of farmyard manure and vermicompost could be supplemented by BSM and neem cake in the integrated module. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has changed the approach of dermatologists, with respect to management of numerous conditions, vitiligo being one of them. However, there is a lack of consensus on how to deal with patients of vitiligo, as we battle this pandemic. Aim: To conduct a questionnaire-based survey, amongst expert dermatologists; in order to understand the impact of COVID-19 on the management of vitiligo. Materials and Methods: An online semi-structured English questionnaire was prepared and the link was circulated among 50 pan-Indian expert dermatologists, through various platforms (snowball sampling). Confidentiality and anonymity were strictly maintained. Responses were analyzed at the end of the study and a consensus statement was generated. Results: 42.22% of the respondents believed that teleconsultation is adequate for the diagnosis and management of most cases of vitiligo. 64.44% were found to be comfortable in prescribing oral medications, even during the COVID-19 pandemic; of which 62% would prefer to prescribe systemic steroids; followed by 17%, 11%, 7%, and 3% who would prefer cyclosporine, azathioprine, mycophenolate mofetil, and methotrexate, respectively. 64.44% respondents would recommend phototherapy in their office and 80% would prefer home-based phototherapy (PUVAsol or handheld NBUVB devices). 86.67% would prefer to stop the oral immunosuppressive drugs, till the COVID-19 RTPCR positive patients are tested negative. Limitations: The results are based on a survey of a small albeit selected group of dermatologists who decided on the currently available information on COVID-19. The same may change depending on the nature of further available information on the virus and its effect on how we manage the patients. Conclusions: Cases for initial consultation may be seen physically, and those for follow-up may be scheduled for teleconsultation. Topical therapy may be used without any hesitation. Phototherapy may be best advised with either PUVAsol or home-based phototherapy units (handheld NBUVB devices). With regards to systemic immunosuppressives, oral minipulse therapy may be preferable in view of lesser requirement of monitoring. Surgery for vitiligo should be performed only if the psychological well-being is severely affected. [ABSTRACT FROM AUTHOR]

Introduction: As regard to all pandemics, the current COVID-19 pandemic, could also have been better managed with prudent use of preventive measures coupled with rapid diagnostic tools such as rapid antigen tests, but their efficacy is under question because of projected lower sensitivity as compared to Real Time Reverse Transcriptase Polymerase Chain Reaction, which although considered gold standard has its own limitations. Methodology: A prospective, single centre study was carried out to evaluate the performance of Standard Q COVID-19 Ag, a rapid immunochromatographic assay for antigen detection, against TrueNat, a chip-based, point-of-care, portable, Real-Time PCR analyzer for diagnosis of COVID-19; on 467 nasal swab samples from suspected subjects at a fever clinic in North India in month of July 2020. Results: Of the 467 specimens tested, TrueNat showed positive result in 29 (6.2%), majority of whom were asymptomatic (72.4%) while 4/29 (13.9%) had influenza like illness and 2/29 (6.8%) presented with severe acute respiratory illness. Compared to TrueNat, Rapid antigen test gave concordance for 26 samples, while for 2 samples the result was false positive; giving an overall sensitivity of 89.7% (95% CI = 72.6-97.8) and a specificity of 99.5%, indicating strong agreement between two methods. Conclusion: Community prevalence plays an important role is choosing the laboratory test and result interpretation. Rapid antigen detection tests definitely have a big role to play, especially in resource limited setting, for early diagnosis as well as for source control to halt the spread. [ABSTRACT FROM AUTHOR]

One of the canonical features of the current outbreak of dermatophytosis in India is its unresponsiveness to treatment in majority of cases. Though there appears to be discordance between in vivo and in vitro resistance, demonstration of in vitro resistance of dermatophytes to antifungals by antifungal susceptibility testing is essential as it may help in appropriate management. The practical problem in the interpretation of antifungal susceptibility testing is the absence of clinical breakpoints and epidemiologic cutoff values. In their absence, evaluation of the upper limit of a minimal inhibitory concentration of wild type isolates may be beneficial for managing dermatophytosis and monitoring the emergence of isolates with reduced susceptibility. In the current scenario, most of the cases are unresponsive to standard dosages and duration of treatment recommended until now. This has resulted in many ex-cathedra modalities of treatment that are being pursued without any evidence. There is an urgent need to carry out methodical research to develop an evidence base to formulate a rational management approach in the current scenario. [ABSTRACT FROM AUTHOR]

The worldwide spread of COVID-19 caused a nationwide lockdown in India from 24 March 2020 and was further extended up to 3 May 2020 to break off the transmission of novel Coronavirus. The study is designed to assess the changes in air quality from the pre-lockdown period to the during lockdown period in Kolkata and Howrah municipal corporation, West Bengal, India. GIS-based techniques include the spatial and temporal distribution of pollutants using interpolation method, and on the other hand, statistical methods like analysis of variance (ANOVA) was applied to determine the mean differences two phases and correlation matrix helps to understand the changing association of the pollutants in pre- and during lockdown phases. Significant correlations have been found among the pollutants, ANOVA (Two-Way) has shown the significant mean difference of NAQI between the two phases, F(1,611) = 465.723, p < 0.0001; pairwise comparison for Ballygunge has shown the highest mean difference 108.194 at p < 0.0001 significant level between lockdown and pre-lockdown phase. Significant positive correlation has been found between PM2.5, PM10 (0.99*); PM2.5, NO2 (0.81*); PM10, NO2 (0.81*); CO, NO2 (0.77*) and some negative correlations have also been found between O3, NO (− 0.15); O3 and NH3 (− 0.36) in the pre-lockdown phase. The reduction amount of mean concentration from the pre-lockdown phase to during lockdown of the main pollutants like PM2.5, PM10 and NO2 are ~ 58.71%, ~ 57.92% and ~ 55.23%. Near Rabindra Bharati University constant emission of PM2.5, 10 and NO2 have been recorded due to the nearby Cossipore thermal power station. [ABSTRACT FROM AUTHOR]

Background: Given the all-encompassing foothold of COVID-19, it is plausible that the pandemic would have a long-lasting impact on medical training programs, including dermatology. We conducted a survey amongst the residents of dermatology (across India) to assess the impact of COVID-19 pandemic on their teaching and education programs. Materials and Methods: An online semi-structured English questionnaire was prepared on the Google-forms platform and the link was circulated among the residents. The questionnaire comprised of five sections (demographic details, impact on clinical training, procedural training, academic curriculum, and research activities). Appropriate statistical tests were carried out to analyze the data obtained. Results: Three-hundred and seventy-eight responses were taken into consideration. A majority of the respondents (63.5%) were engaged in both COVID-19-related duties and departmental work (out-patient and in-patient duty). Around two-thirds of the trainees (65.1%) claimed a reduction in patient footfall (greater than 50% compared to pre-COVID times). Sixty-nine percent reported a decline of more than 50% in in‑patient admission; 47.6% felt that the discontinuity in patient care had severely affected their residency training; 50.8% highlighted that no procedures were being performed in their department; 54.5% opined that academic activities were relatively unhampered as regular seminars were being conducted through online web-based applications; and 65.1% of the trainees were not able to devote any time to their thesis-related work. Conclusion: Since the after‑effects of this pandemic will last long, it is advisable that residents and faculties adapt themselves to web-based learning programs in the academic curriculum so that the training of the future consultants does not get jeopardized. Our survey, being the first of its kind in dermatology, will throw some light on the perspective of residents and the way forward to combat the untoward consequences on their training programs. [ABSTRACT FROM AUTHOR]

Trichophyton (T.) mentagrophytes now accounts for an overwhelming majority of clinical cases in India, a new "Indian genotype" (T. mentagrophytes ITS genotype VIII) having been isolated from skin samples obtained from cases across a wide geographical distribution in this country. The conventional diagnostic methods, like fungal culture, are, however, inadequate for diagnosing this agent. Thus, molecular methods of diagnosis are necessary for proper characterization of the causative agent. The shift in the predominant agent of dermatophytosis from T. rubrum to T. mentagrophytes, within a relatively short span of time, is without historic parallel. The apparent ease of transmission of a zoophilic fungus among human hosts can also be explained by means of mycological phenomena, like anthropization. [ABSTRACT FROM AUTHOR]

Dermatophytosis has attained unprecedented dimensions in recent years in India. Its clinical presentation is now multifarious, often with atypical morphology, severe forms and unusually extensive disease in all age groups. We hesitate to call it an epidemic owing to the lack of population-based prevalence surveys. In this part of the review, we discuss the epidemiology and clinical features of this contemporary problem. While the epidemiology is marked by a stark increase in the number of chronic, relapsing and recurrent cases, the clinical distribution is marked by a disproportionate rise in the number of cases with tinea corporis and cruris, cases presenting with the involvement of extensive areas, and tinea faciei. [ABSTRACT FROM AUTHOR]

Background: Elderly population is vulnerable to develop a multitude of dermatological diseases, owing to comorbidities and polypharmacies. Objective: To know the prevalence of dermatological conditions in elderly patients attending outpatient department, determine the pattern and relative frequency of skin diseases, and find the relation with associated comorbidities. Materials and Methods: We performed a cross-sectional study on 250 patients, aged ≥60 years. Clinical diagnosis was done, followed by appropriate investigations when required. Descriptive data was analyzed on the parameters of range, mean ± S.D., frequencies, etc., Continuous variables were analyzed using unpaired t-test/Mann–Whitney U test and categorical data by Fisher's exact test/Chi-square test. Statistical software Medcalc version 10.2.0.0 for Windows vista was used. P value =0.05 was considered statistically significant. Results: 250 patients were evaluated, 164 males (65.5%) and 86 females (34.4%). Mean age was 67.87 ± 7.29 years. Commonest disease category was infection (30%), followed by dermatitis (29.6%), papulo-squamous (18.4%), and immunobullous (6.4%). Difference in acute and chronic disease was significant (P = 0.0001). 30% had infections; fungal (50.66%), bacterial (32%), and viral (17.33%). 74 patients had dermatitis (29.6% of study population). Commonest systemic disease was hypertension (23.2%), followed by diabetes mellitus (19.6%). Association of diabetes mellitus was significant (P = 0.0014), more in infective dermatoses (P = 0.0007). All had signs of aging; idiopathic guttate hypomelanosis (51.2%), xerosis (45.2%), seborrheic keratosis (42.6%), cherry angioma (33.2%), senile acne (6.6%). Photoaging was noted as wrinkling (98.8%), freckles (35.6%), purpura (10.8%), telangiectasia (5.6%). People involved in outdoor activity had higher Glogau scale (3.01 ± 0.69) compared to those indoors (2.44 ± 0.74), statistically significant difference (P = 0.001). Conclusion: Our study is the first of its kind, in Eastern India, where we evaluated and explored the disease pattern and extent of geriatric dermatoses among patients attending dermatology OPD of a tertiary care hospital. [ABSTRACT FROM AUTHOR]

SDRIFE (symmetrical drug related intertriginous and flexural exanthem) is a benign self‐limiting adverse drug reaction (ADR) primarily affecting the intertriginous, gluteal and flexural regions symmetrically in the absence of systemic involvement. It is considered to be a variant of baboon syndrome. Pathogenesis is poorly understood but is thought to be result of a delayed hypersensitivity response after exposure to the drug. Commonly implicated drugs are beta‐lactam antibiotics. With the rising incidence of dermatophytosis in the Indian subcontinent, the use of oral anti fungals has become rampant. SDRIFE due to itraconazole has been rarely reported in literature. We hereby present a series of 12 patients presenting with SDRIFE due to itraconazole, which is by far the largest reported in existing literature. This case series highlights the importance of identifying these cutaneous adverse drug reactions in a setting where itraconazole is commonly being used. [ABSTRACT FROM AUTHOR]

False smut disease of rice caused by Ustilaginoidea virens, is an emerging threat to rice cultivation worldwide due to its detrimental effects on grain yield and quality. False smut disease severity was 4.44‒17.22% during a roving survey in Kharif 2016 in the four different rice ecosystems of Karnataka, India. Further, 15 pathogen isolates representing four different ecosystems were studied for their virulence and morphometric diversity. Among the 15 strains studied, most virulent strains Uv-Gvt was selected for whole genome sequencing in Illumina NextSeq 500 platform using 2 × 150 bp sequencing chemistry. The total assembled genome of Uv-Gvt was 26.96 Mb, which comprised of 9157 scaffolds with an N50 value of 15,934 bp and 6628 protein-coding genes. Next, the comparative genomic study revealed a similar gene inventory as UV-8b and MAFF 236576 strains reported from China and Japan, respectively. But, 1756 genes were unique to Uv-Gvt strain. The Uv-Gvt genome harbors 422 putative host–pathogen interacting genes compared to 359 and 520 genes in UV-8b and MAFF 236576 strains, respectively. The variant analysis revealed low genetic diversity (0.073‒0.088%) among U. virens strains. Further, phylogenetic analysis using 250 single copy orthologs genes of U. virens revealed a distinct phylogeny and an approximate divergence time. Our study, report the genomic resource of rice false smut pathogen from India, where the disease originated, and this information will have broader applicability in understanding the pathogen population diversity. [ABSTRACT FROM AUTHOR]

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions, which are mainly caused by drugs; and these are usually associated with high degree of morbidity and mortality. Recently, two detailed guidelines were published on the management of SJS/TEN, Indian guidelines and UK guidelines. Still, there is no consensus on the management of SJS/TEN. In this article, our aim is to conceptualize the management aspect of SJS/TEN considering Indian setup. Early discontinuation of all medicines, supportive measures (hydration, electrolytes, and care of denuded skin), corticosteroids and cyclosporine has been found to be useful. Oral provocation test is reserved for patients, who undergo complete remission and this is to be done after hospitalization, under strict vigilance. As there is no consensus, the treatment should be individualized on case to case basis. [ABSTRACT FROM AUTHOR]

Background & objectives: Treatment of serious life threatening infections due to multi-drug resistant pathogens presents a difficult challenge due to the limited therapeutic options. Therefore, we studied the in vitro susceptibility of tigecycline, a new glycylcycline with promising broad spectrum of activity against Gram positive and Gram negative bacteria at a tertiary care hospital in north India. Methods: A total of 75 multi-drug resistant isolates of methicillin resistant Staphylococcus aureus (21), vancomycin resistant enterococci (14), vancomycin resistant Streptococcus spp. (3), extended spectrum lactamase producing Gram negative bacteria (11) and multi-resistant Acinetobacter spp. (26) were tested for tigecycline susceptibility by the E- test and disc diffusion methods. An additional 83 multi-resistant Gram negative clinical isolates were screened by disc diffusion method alone. Results: All the isolates of MRSA, VRE, vancomycin resistant Streptococcus spp. and ESBL producing enteric bacteria were sensitive to tigecycline by the E-test and disc diftusion methods. However, only 42 per cent of Acinetobacter spp. were found to be sensitive to tigecycline by the E-test method. Interpretation & conclusions: In conclusion, tigecycline was found to be highly effective against Gram-positive bacteria and Gram-negative members of Enterobacteriaceae, but a high prevalence of resistance in members of Acinetobacter spp. is worrisome. [ABSTRACT FROM AUTHOR]

Wilt disease affecting pomegranate crops results in rapid soil-nutrient depletion, reduced or complete loss in yield, and crop destruction. There are limited studies on the phytopathogen Fusarium oxysporum prevalence and associated genomic information with respect to Fusarium wilt in pomegranate. In this study, soil samples from the rhizosphere of different pomegranate plants showing early stage symptoms of wilt infection to an advanced stage were collected from an orchard situated in Karnataka, India. A whole metagenome sequencing approach was employed to gain insights into the adaptations of the causative pathogen F. oxysporum. Physicochemical results showed a drop in the pH levels, N, Fe, and Mn, and increase in electrical conductivity, B, Zn, Cl, Cu was observed in the early and intermediate stage samples. Comparative abundance analysis of the experimental samples ESI and ISI revealed an abundance of Proteobacteria phyla Achromobacter sp. 2789STDY5608625, Achromobacter sp. K91, and Achromobacter aegrifaciens and Eukaryota namely Aspergillus arachidicola, Aspergillus candidus, and Aspergillus campestris. Functional pathway predictions implied carbohydrate binding to be significant (p < 0.05) among the three experimental samples. Microbiological examination and whole microbiome analysis confirmed the prevalence of F. oxysporum in the soil samples. Variant analysis of F. oxysporum revealed multiple mutations in the 3IPD gene with high impact effects. 3-Isopropylmalate dehydratase and carbohydrate-active enzymes could be good targets for the development of antifungals that could aid in biocontrol of F. oxysporum. The present study demonstrates the capabilities of the whole metagenome sequencing approach for rapid identification of potential key players of wilt disease pathogenesis wherein the symptomatology is complex. [ABSTRACT FROM AUTHOR]

Increasing productivity of maize while decreasing production costs and maintaining soil health are emerging challenges for the rice–maize system in South Asia. A range of integrated nutrient and weed management practices were tested in winter maize for their effects on yield, profitability, and soil health. The nutrient management treatments were a partial substitution of nitrogen with bulky (Farmyard manure; vermicompost) and concentrated organic manures (Brassicaceous seed meal, BSM; neem cake), whereas weed management practices compared chemical controls only versus an integrated approach. The N supplementation through BSM diminished the weed growth by reducing weed N uptake, and enhanced the maize crop uptake of nutrients. As compared to the sole chemical approach, atrazine-applied pre-emergence followed by hoeing reduced weed density by 58 and 67% in years 1 and 2, respectively. The N supplementation through BSM resulted in the maximum yield of maize grain (6.13 and 6.50 t ha−1 in year 1 and year 2, respectively) and this treatment increased yield in year 2 compared to N application through synthetic fertilizer. Hoeing in conjugation with herbicide enhanced the maize grain yield by 9% over herbicide alone. The maximum net return and economic efficiency were achieved with the application of BSM for N supplementation, together with the integrated weed management practice. [ABSTRACT FROM AUTHOR]

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of external ophthalmomyiasis caused by the larvae of a sheep nasal botfly, Oestrus ovis, for the first time from Meerut city in Western Uttar Pradesh, India. A 25-year-old farmer presented with severe symptoms of conjunctivitis. The larvae, 3 in number, were observed in the bulbar conjunctiva, and following removal the symptoms of eye inflammation improved within a few hours. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on high prevalence of carbapenem resistant Pseudomonas aeruginosa at a tertiary care centre of north India.

Coconut (Cocos nucifera L.), an important source of vegetable oil, nutraceuticals, functional foods, and housing materials, provides raw materials for a repertoire of industries engaged in the manufacture of cosmetics, soaps, detergents, paints, varnishes, and emulsifiers, among other products. The palm plays a vital role in maintaining and promoting the sustainability of farming systems of the fragile ecosystems of islands and coastal regions of the tropics. In this study, we present the genome of a dwarf coconut variety "Chowghat Green Dwarf" (CGD) from India, possessing enhanced resistance to root (wilt) disease. Utilizing short reads from the Illumina HiSeq 4000 platform and long reads from the Pacific Biosciences RSII platform, we have assembled the draft genome assembly of 1.93 Gb. The genome is distributed over 26,855 scaffolds, with ∼81.56% of the assembled genome present in scaffolds of lengths longer than 50 kb. About 77.29% of the genome was composed of transposable elements and repeats. Gene prediction yielded 51,953 genes, which upon stringent filtering, based on Annotation Edit Distance, resulted in 13,707 genes, which coded for 11,181 proteins. Among these, we gathered transcript level evidence for a total of 6828 predicted genes based on the RNA-Seq data from different coconut tissues, since they presented assembled transcripts within the genome annotation coordinates. A total of 112 nucleotide-binding and leucine-rich repeat loci, belonging to six classes, were detected. We have also undertaken the assembly and annotation of the CGD chloroplast and mitochondrial genomes. The availability of the dwarf coconut genome shall prove invaluable for deducing the origin of dwarf coconut cultivars, dissection of genes controlling plant habit and fruit color, and accelerated breeding for improved agronomic traits. [ABSTRACT FROM AUTHOR]

Background: The diagnosis and treatment monitoring of hepatitis C is quite challenging. The screening test, i.e. antibody assay, is unable to detect acute cases, while the gold standard hepatitis C virus (HCV) reverse transcriptase polymerase chain reaction (RTPCR) assay is not feasible in resource-limited countries such as India due to high cost and infrastructure requirement. European Association for the Study of the Liver and World Health Organization have approved a new marker, i.e. HCV core antigen (HCVcAg) assay, as an alternative to molecular assay. In this study, we have evaluated HCVcAg assay for diagnosis and treatment monitoring follow-up in Indian population infected with hepatitis C., Methods: Blood specimen of 90 clinically suspected cases of acute hepatitis C were tested simultaneously for anti-HCV antibody assay via ELISA (enzyme-linked immunoassay), HCVcAg assay by chemiluminescence immune assay (CLIA) and HCV RTPCR VL (viral load) assay. Thirty-four HCV RTPCR positive patients were further enrolled in treatment monitoring group whose blood samples were tested at the beginning of treatment, two weeks, four weeks and 12 weeks via HCV core Ag assay and HCV RTPCR Viral Load assay., Results: Considering HCV RTPCR as gold standard, diagnostic performance of HCV core Ag assay and anti-HCV antibody assay was evaluated. The sensitivity and specificity of HCV core Ag assay were higher than that of anti-HCV Antibody assay, i.e. 88.3% and 100% vs. 23.3% and 83.3%, respectively. The overall diagnostic accuracy of HCV core Ag assay was 92.20%. Among treatment follow-up group, HCV core Ag levels correlated well with HCV viral load levels, at the beginning of treatment (baseline) till 12 weeks showing highly significant Spearman rank correlation coefficient of > 0.9 with HCV viral load levels., Conclusions: HCV core Ag assay is a cost-effective, practically feasible substitute of HCV RTPCR viral load assay for diagnosis as well as long duration treatment monitoring of hepatitis C infection in resource-limited settings., (© 2024. Indian Society of Gastroenterology.)