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Introduction: Foot covering was one of the first things made by our primitive ancestors. Shoes have played an important role in human culture throughout history. Shoemakers and their health have attracted less attention than the shoes themselves. Musculo-skeletal problems were explored in this study to find out the prevalence and associated factors among the workers of the shoe making community in Kolkata, West Bengal. Methods: The study was done where shoemakers of the study area were considered and basic information on socio-economic status, demographic characteristics, pattern of musculo-skeletal morbidities. Community based cross-sectional study design was adopted and data collection was done through observation, interview and clinical examination. Results: This study found high prevalence (45.6%) of musculo-skeletal ailments among the shoe making workers and among all the ailments considered, most of them were suffering from ‘pain in limb joints’ (34.3%) followed by ‘low back pain’ (32.9%) and ‘neck pain’ (31.5%). Chi-square for linear trend analysis showed increasing odds ratio from 1 to 11.16 when the total duration of work for the shoemakers increased from less than 5 years to more than 21 years which was also statistically significant (χ2 = 21.82; p < 0.01). Similar trend was observed where odd ratio increased from 1 to 2.95 when daily working hours increased from less than 9 hours to more than 12 hours. (χ2 = 2.95; p < 0.09). Conclusion: Our study concluded high prevalence of musculo-skeletal ailments among shoe making workers and those are in increasing in linear trend analysis.

Background: During the recent pandemic, the number of patients with influenza-like symptoms had considerably increased in fever clinics of hospitals leading to queuing and increased patient dissatisfaction. Aims and Objectives: A time-motion study was therefore designed to evaluate the time taken at different service delivery points in the fever clinic and patient satisfaction regarding service delivery time. Materials and Methods: An institutional cross-sectional observational study was conducted at the fever clinic of Midnapore Medical College and Hospital for 1 month. A total of 200 patients were selected by systematic random sampling from the fever clinic outdoors and their movement was recorded and satisfaction assessed. Results: Most patients visited the clinic during the start of the week and in the first half of the day. The total mean time required from entry to exit was 9089 s±143.0. The maximum time was spent waiting time in the fever clinic entry queue followed by that at the pharmacy. The minimum time required was at the nursing table followed by a doctor’s consultation. The maximum meantime for movement between two stations was between station 5 (laboratory investigation station) and station 6 (pharmacy), that is, 1144 s±183.6. The majority of the study population was not satisfied with the time management in the fever clinic whereas only 18.0% of the participants were fully satisfied. Conclusion: Identifying the loopholes and formulating an effective time management strategy can help deliver better patient care as well as boost patient satisfaction.

Background: Effective vaccination is a successful tool for controlling COVID-19 pandemic, along with other preventive measures. Both intention to get vaccinated and barrier to vaccination played important role in COVID vaccination drive. Aims and Objectives: The present study was conducted to assess awareness, acceptance, and hesitancy about COVID-19 vaccine among the residents of rural and urban area and to assess the factors related to their attitude. Materials and Methods: A descriptive cross-sectional survey was conducted among the adult residents of urban and rural area over 6 months. Total sample size was 400. Simple random sampling technique was adopted to recruit the study participants after obtaining informed verbal consent. This process was continued until the desired number of sample size was attained. Data were compiled after collection and analysis was done. Results: Rural population had significantly higher knowledge of coronavirus and urban population knew prevention of coronavirus infection more. Correct knowledge of COVID vaccine availability was higher among rural people but higher knowledge of vaccine related information was among urban population. Sources of information were mainly from mass media. Vaccine acceptance was more among urban population, but apprehension was significantly higher among urban residents. Higher proportion of urban people was motivated significantly by the healthcare workers as well as self-motivated than their rural counterpart. Conclusion: Targeted interventions could be developed for increasing awareness of disease and availability of COVID-19 vaccines. Population-based vaccination program can decline the trend of the pandemic in long term.

We report a unique intraoperative finding of an additional double left atrial appendage (LAA) during an arterial switch operation with ventricular septal defect closure in a 4-month-old girl. Immediately after the procedure, a prolapsing mass within the left atrium (LA) on the transesophageal echocardiogram raised concerns of a possible thrombus. The LAA was clearly visible with a pressure monitoring line which was put intraoperatively. To investigate further, cardiopulmonary bypass was resumed, and the heart was arrested and explored. There was an appendage-like structure, separate from the one that had the pressure monitoring line, which was inverted inside. It was pulled out from outside clearly establishing a double LAA. This report illustrates an example of a diagnostic dilemma caused by a double atrial appendage which was invaginated into LA masquerading as a mass or thrombus.

Secondary erythrocytosis occurs in cyanotic heart disease as a physiological response to chronic hypoxia, and this leads to hyperviscosity and various complications of the same. Microvascular stasis due to hyperviscosity results in symptoms including headache, fatigue, paraesthesia, and loss of vision. An important and dreadful feature of hyperviscosity is overt thrombosis in organ systems, resulting in cerebrovascular accident and myocardial infarction. Limited body iron store in a state of secondary erythrocytosis brings forth iron-deficient microcytic red cells; these being more rigid and less deformable than normocytic cells, further aggravate vascular occlusion. The management of hyperviscosity syndrome starts with intravenous hydration and correction of latent iron deficiency. However, therapeutic phlebotomy may be employed as a rescue measure if symptoms persist despite correction of dehydration and anemia. We present a series of four patients with uncorrected cyanotic congenital heart disease who presented with a spectrum of features of hyperviscosity and discuss pathophysiology, clinical features, and management of hyperviscosity in detail.

Objective: The objective of this study is to delineate the characteristics and outcome of Pediatric Inflammatory Multisystem Syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARSCoV2) infection (PIMS-TS) in Eastern Indian settings. Materials and Methods: We conducted a prospective observational multicentric study from May 2020 to August 2020, collecting data on clinical profile, investigation findings, and outcome of the children aged 1 month–12 years admitted with the features of coronavirus disease 2019 (COVID-19) related hyperinflammation satisfying criteria for PIMS-TS from three tertiary care hospitals of Kolkata. Results: A total of 38 patients fulfilling the criteria of PIMS-TS were recruited. The median age of the study population was 5 years (1.9–8 years). Gastrointestinal symptoms were present in 33 (86.6%) of patients. Nasopharyngeal swab for COVID-19 reverse transcriptase-polymerase chain reaction was positive in 19 (50%) of patients, and immunoglobulin G antibody against COVID-19 was found in 12 (66.6%) of patients, whereas 19 (50%) of patients had a positive contact history of SARS-Co-V2 exposure. The features of Kawasaki, like illness with coronary changes, were seen in 12 (32%) cases, whereas myocarditis with ejection fraction

Transcatheter closure of patent ductus arteriosus (PDA) is now the standard of care with some exceptions. Best treatment for peripheral pulmonary artery (PA) stenosis in small children is still debatable. Surgical augmentation, balloon dilatation, and stenting are the available options with each having its own risks and limitations. Here, we are reporting complete transcatheter management of three cases of congenital rubella syndrome who had PDA and left branch PA stenosis by device closure and stent placement, with successful outcome in two cases and complication, leading to surgery in one. We also share our understanding of case selection for a better outcome.

The biosynthesis of cholesterol, an essential component of higher eukaryotic membranes, was worked out by Konrad Bloch (and Feodor Lynen) in the 1960s and they received the Nobel Prize around that time in recognition of their pioneering contributions. An elegant consequence of this was a hypothesis proposed by Konrad Bloch (the Bloch hypothesis) which suggests that each subsequent intermediate in the cholesterol biosynthesis pathway is superior in supporting membrane function in higher eukaryotes relative to its precursor. In this review, we discuss an autosomal recessive metabolic disorder, known as Smith-Lemli-Opitz syndrome (SLOS), associated with a defect in the Kandutsch-Russell pathway of cholesterol biosynthesis that results in accumulation of the immediate precursor of cholesterol in its biosynthetic pathway (7-dehydrocholesterol) and an altered cholesterol to total sterol ratio. Patients suffering from SLOS have several developmental, behavioral and cognitive abnormalities for which no drug is available yet. We characterize SLOS as a manifestation of the Bloch hypothesis and review its molecular etiology and current treatment. We further discuss defective Hedgehog signaling in SLOS and focus on the role of the serotonin1A receptor, a representative neurotransmitter receptor belonging to the GPCR family, in SLOS. Notably, ligand binding activity and cellular signaling of serotonin1A receptors are impaired in SLOS-like condition. Importantly, cellular localization and intracellular trafficking of the serotonin1A receptor (which constitute an important determinant of a GPCR cellular function) are compromised in SLOS. We highlight some of the recent developments and emerging concepts in SLOS pathobiology and suggest that novel therapies based on trafficking defects of target receptors could provide new insight into treatment of SLOS.

Previous work from us and others has suggested that cholesterol is an important lipid in the context of the organization of the actin cytoskeleton. However, reorganization of the actin cytoskeleton upon modulation of membrane cholesterol is rarely addressed in the literature. In this work, we explored the signaling crosstalk between cholesterol and the actin cytoskeleton by using a high-resolution confocal microscopic approach to quantitatively measure changes in F-actin content upon cholesterol depletion. Our results show that F-actin content significantly increases upon chronic cholesterol depletion, but not during acute cholesterol depletion. In addition, utilizing inhibitors targeting the cholesterol biosynthetic pathway at different steps, we show that reorganization of the actin cytoskeleton could occur due to the synergistic effect of multiple pathways, including prenylated Rho GTPases and availability of membrane phosphatidylinositol 4,5-bisphosphate. These results constitute one of the first comprehensive dissections of the mechanistic basis underlying the interplay between cellular actin levels and cholesterol biosynthesis. We envision these results will be relevant for future understating of the remodeling of the actin cytoskeleton in pathological conditions with altered cholesterol.

In this study, we have specifically blocked a key step of sphingolipid (SL) biosynthesis in Candida glabrata by disruption of the orthologs of ScIpt1 and ScSkn1. Based on their close homology with S. cerevisiae counterparts, the proteins are predicted to catalyze the addition of a phosphorylinositol group onto mannosyl inositolphosphoryl ceramide (MIPC) to form mannosyl diinositolphosphoryl ceramide (M(IP)2C), which accounts for the majority of complex SL structures in S. cerevisiae membranes. High throughput lipidome analysis confirmed the accumulation of MIPC structures in ΔCgipt1 and ΔCgskn1 cells, albeit to lesser extent in the latter. Noticeably, ΔCgipt1 cells showed an increased susceptibility to azoles; however, ΔCgskn1 cells showed no significant changes in the drug susceptibility profiles. Interestingly, the azole susceptible phenotype of ΔCgipt1 cells seems to be independent of the ergosterol content. ΔCgipt1 cells displayed altered lipid homeostasis, increased membrane fluidity as well as high diffusion of radiolabeled fluconazole (3H-FLC), which could together influence the azole susceptibility of C. glabrata. Furthermore, in vivo experiments also confirmed compromised virulence of the ΔCgipt1 strain. Contrarily, specific functions of CgSkn1 remain unclear.