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During surge of COVID-19-associated mucormycosis (CAM), we identified five cases of CAM where two different species of Mucorales were isolated. All had history of diabetes mellitus and presented with clinical features suggesting rhino-orbital mucormycosis. The patients grew different species from their nasal scraping/biopsy samples, Rhizopus arrhizus, R. homothallicus (n = 2); R. homothallicus, Lictheimia corymbifera (n = 1); R. arrhizus, Mucor spp (n = 1); and L. corymbifera, Apophysomyces variabilis (n = 1). All patients underwent surgical and medical (liposomal amphotericin B) treatment. All, except one growing A. variabilis and L. corymbifera survived. Mixed infection by more than one Mucorales in CAM is unique and warrants epidemiological investigation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Aerosols are potential supplier of nutrients to the surface water of oceans and can impact biogeochemical processes particularly in the remote locations. The nutrient data from atmospheric supply is poorly reported from the Indian Ocean region. In this study, we present atmospheric nutrients such as reactive nitrogen species (Nitrate, Ammonium, Organic nitrogen), micro-nutrients (e.g. Fe, Mn and Cu) concentration along with mineral dust in the aerosol samples collected over meridional transect during summer (April-May 2018) and monsoon (June-July 2019) months. A significant spatial variation of dust was observed during summer (0.6-22.8 μg m -3 ) and monsoon (2.8-25.1 μg m -3 ) months with a decreasing trend from north to south. Dust as well as other nutrient species shows a general north to south decreasing trend, however, no such trend was seen in the soluble trace elements (TEs) concentration. Anthropogenic species like NH 4 + and nss-K + were found below detection limit during monsoon campaign. The fractional solubility (in percentage) of Fe, Mn and Cu were estimated by measuring their concentration in ultrapure water leach which averaged around 0.99 ± 1.12, 31.0 ± 14.9 and 31.1 ± 25.4, respectively during summer and 0.09 ± 0.08, 6.0 ± 8.9, 16.7 ± 9.6, respectively, during monsoon period. Correlation of soluble Fe with total Fe and total acidic species suggest varying dust sources is an important controlling factor for the fraction solubility of Fe with negligible contribution from the chemical processing. However, a significant correlation was observed between total acid and fractional solubility of Mn and Cu suggest role of chemical processing in enhancement of their solubility. Dry deposition flux of aeolian dust was estimated for both campaign using Al concentration and relatively higher fluxes were observed for summer (12.6 ± 8.4 mg·m -2 ·d -1 ) and monsoon (8.7 ± 8.4 mg·m -2 ·d -1 ) months as compared to model based estimates reported in the literature. Contrastingly, estimated deposition flux of soluble Fe from both campaign displays relatively lower values as compared to model based results which underscores a need for re-evaluation of biogeochemical models with real-time data., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Artificial intelligence (AI) has become a prominent technique for medical diagnosis and represents an essential role in detecting brain tumors. Although AI-based models are widely used in brain lesion segmentation (BLS), understanding their effectiveness is challenging due to their complexity and diversity. Several reviews on brain tumor segmentation are available, but none of them describe a link between the threats due to risk-of-bias (RoB) in AI and its architectures. In our review, we focused on linking RoB and different AI-based architectural Cluster in popular DL framework. Further, due to variance in these designs and input data types in medical imaging, it is necessary to present a narrative review considering all facets of BLS., Approach: The proposed study uses a PRISMA strategy based on 75 relevant studies found by searching PubMed, Scopus, and Google Scholar. Based on the architectural evolution, DL studies were subsequently categorized into four classes: convolutional neural network (CNN)-based, encoder-decoder (ED)-based, transfer learning (TL)-based, and hybrid DL (HDL)-based architectures. These studies were then analyzed considering 32 AI attributes, with clusters including AI architecture, imaging modalities, hyper-parameters, performance evaluation metrics, and clinical evaluation. Then, after these studies were scored for all attributes, a composite score was computed, normalized, and ranked. Thereafter, a bias cutoff (AP(ai)Bias 1.0, AtheroPoint, Roseville, CA, USA) was established to detect low-, moderate- and high-bias studies., Conclusion: The four classes of architectures, from best-to worst-performing, are TL > ED > CNN > HDL. ED-based models had the lowest AI bias for BLS. This study presents a set of three primary and six secondary recommendations for lowering the RoB., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Management of sphenoid lateral recess (SLR) cerebrospinal fluid (CSF) leaks present a challenge because of the location and requiring complete visualization of the defect for a successful repair. The endoscopic endonasal transpterygoid approach (EETPA) is considered the gold standard in addressing these defects. We lay out our experience in implementing this approach with plasma ablation., Methods: This is a case series of 11 diagnosed patients of SLR CSF leaks who underwent plasma ablation-assisted EETPA repair by a single surgeon between 2011 and 2020 at our institution. Outcomes in terms of surgical field grade on the Wormald 11-point grading scale, postoperative complications, healing on nasal endoscopy and imaging, and surgical success rate were assessed., Results: The etiology was spontaneous leak in 10 (90.9%) patients and secondary to temporal lobe abscess and/or meningitis in one (9.09%). Three (27%) patients were previously operated elsewhere by the transsphenoidal route, which we reoperated by this technique. As per Wormald grading, grade 1 field in 3 (27.27%), grade 2 in 6 (54.5%), and grade 3 in 2 cases (18.18%) were noted. Complications occurred in 3 patients (27%) in the form of dry eye (9%), meningitis (9%), and transient CSF rhinorrhea in the immediate postoperative period (9%). Repair sites were well healed on follow-up nasal endoscopy and imaging. The surgical success rate was 100%., Conclusions: Plasma ablation-assisted EETPA allows for a uninostril approach to the SLR, easy accessibility, and better visualization with a bloodless field, which allows appropriate repair, thus minimizing complications and preventing recurrence., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The cavernous sinus is a complex structure susceptible to a wide variety of vascular, neoplastic and inflammatory pathologies. Vascular pathologies include ICA aneurysms, carotid-cavernous fistulas, cavernous sinus thrombosis, and cavernous hemangioma. Neoplasms that involve the cavernous sinus include pituitary adenoma, meningioma, schwannoma, lymphoma, perineural tumor spread, metastases, and direct tumor invasion. Infectious and inflammatory diseases include Tolosa-Hunt syndrome, sarcoidosis, granulomatosis with polyangiitis, IgG-4 related disease and invasive fungal infections. In this article, we review the clinical and imaging findings of a number of pathologies involving the cavernous sinus, focusing on key features that can narrow the differential diagnosis and, in some cases, support a particular diagnosis., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Sediment collected from the estuarine mangroves of the Zuari estuary and Cumbharjua canal were analyzed to assess the concentration, contamination and bioavailability of metals. Mangrove pneumatophores were also analyzed to understand the metal bioaccumulation in mangrove plants. The results indicated the variation of metal concentrations in sediment along the estuary was attributed to changing hydrodynamic conditions, type of sediment and metal sources. Further, speciation studies revealed that Fe, Cr, Co, Ni, Cu and Zn were mainly of lithogenic origin and less bioavailable while high Mn content in the sediment raised concerns over its potential mobility, bioavailability and subsequent toxicity. The mangrove plants exhibited difference in metal accumulation due to variations in sediment parameters and metal availability, in addition to difference in plant species and tissue physiology that affect metal uptake. Moreover, the mangrove plants reflected the quality of the underlying sediment and can be used as a potential bio-indicator tool., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Metals are non-degradable in the aquatic environment and play a vital role in estuarine biogeochemistry but could also be detrimental to associated biota. A comparative evaluation of the trace metal concentrations (Fe, Mn, Zn, Cu, Ni, and Co) was carried out in the Zuari estuary, Goa during the post-monsoon season of 2013 at six locations, each representing three mangrove and three mudflat regions. In addition, fractionation of trace metals in sediments was performed to provide information on the mobility, distribution, bioavailability and toxicity. Special attention was paid to the marine mollusks viz. bivalves and gastropods that are extensively used as bio-indicators in coastal pollution. Considering the percentage of metals in the sequentially extracted fractions, the order of mobility from most to least bioavailable forms was Mn > Zn > Cu > Ni > Co > Fe. Mn maintained high bioavailability (average around 60%) in Fe-Mn oxide and carbonate bound forms indicating that Mn is readily available for biota uptake. The bioavailability of Fe was on an average of around 6% whereas other metals like Cu, Zn, Ni and Co were around 19% to 34%. When the bioavailable values were compared with standard Screening Quick Reference Table (SQUIRT), Zn showed higher toxicity level and bioavailability in the lower estuary. On the basis of calculated Bio Sediment Accumulation Factors (BSAF's), overall trend in bioaccumulation was in the order of Cu > Zn > Mn > Ni > Co > Fe. Metal Pollution Index (MPI) computed was higher for gastropods than bivalves., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Two sediment cores collected from a mudflat sedimentary environment of Swarna estuary (S3) and Gurpur estuary (MF6), representing the middle estuarine region, Karnataka, India, were investigated to understand bioavailability of metals and their toxicity. The subsamples were analyzed for sand, silt, clay, organic carbon and total metal concentration of Aluminum (Al), Iron (Fe), Manganese (Mn), Nickel (Ni), Zinc (Zn), Copper (Cu), Cobalt (Co) and Chromium (Cr) at 2 cm intervals. Sediments (average) are relatively coarser in Gurpur estuary whereas silt, clay, organic carbon along with the studied metals (except Mn and Cu) is noted to be higher in the Swarna estuary. Significant correlations were observed of Al, Fe with finer sediments and most of the trace metals in both the cores indicating a mainly lithogenic source. Further, metal speciation analysis carried out for Fe, Mn, Ni, Zn, Cu, Co and Cr on selected samples of both the cores indicated that Fe was largely associated with the residual fraction with 93 ± 0.5% in Gurpur and 84 ± 6% in Swarna estuary. The concentration of studied metals in the residual fraction in the sediments of Gurpur estuary was in the order Mn(90 ± 5%)>Cr(85 ± 1%)>Ni(72 ± 5%)>Zn(69 ± 3%)>Cu(57 ± 5%)>Co(55 ± 2%) and; Cr(80 ± 7%)>Mn(77 ± 10%)>Ni(76 ± 7%)>Zn(67 ± 10%)>Cu(67 ± 10%)>Co(50 ± 7%) in Swarna estuary. When the total (bulk) metals were compared with the Sediment Quality Values (SQV) following Screening Quick Reference Table (SQUIRT), Co values of both the cores fell above Apparent Effect Threshold (AET) values. When the sum of the average bioavailable fractions in sediments was considered, Co values exceeded the AET in core S3 (Swarna estuary). When the variations are viewed with depth, bioavailability of Mn, Ni, Cu and Co in Gurpur estuary indicated anthropogenic addition in recent years whereas in Swarna estuary most of the studied metals showed diagenetic remobilization and diffusion to the water column from surface sediments. Metal speciation study indicated no harm to the aquatic life, except of Co, in Swarna estuary wherein it posed a high risk of toxicity to organisms associated with the sediments., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Metal speciation studies were carried out on three intertidal core sediments of the industrially impacted Dudh creek located along west coast of India. Metals indicated a drastic increase in the bioavailable fraction towards the surface of the cores, suggesting an increase in anthropogenic metal input in recent years as compared to the past. Also, when compared with Vaitarna estuary and Khonda creek of Thane district, the speciation of metals in Dudh creek sediments was observed to have been highly modified in recent years. High concentrations of metals associated with bioavailable fractions therefore suggested a risk of toxicity to sediment associated biota of Dudh creek., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The present study investigated the concentration, distribution and speciation of metals (Fe, Mn, Cu, Pb, Co, Zn and Cr) in sediments of Mumbai region. Pearson's correlation matrix and cluster analyses showed good association of metals with grain size and organic matter. Factor analysis applied to the speciation data helped to identify the role of different sediment fractions in metal retention. The environmental risks of metals, evaluated by sediment quality guidelines, revealed some contamination in the region. However, the Individual and Global Contamination Factors and the Risk Assessment Code, suggested low risk to the aquatic environment, except of Mn in the creek sediments., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Present study provides results of trace metal distribution in mangrove sediment cores collected from macro-tidal Khonda and Dudh creeks of Northern Maharashtra coast, India. Most of the metals showed significant higher addition in Dudh creek (core DC) as compared to Khonda creek (core KC). However, Khonda creek sediments did show anthropogenic enrichment of Mn, Zn and Ni, while Dudh creek sediments showed anthropogenic enrichment of almost all the studied metals. Large difference in metal concentration between the two creeks was attributed to their proximity to industries. The higher Mn, Zn and Ni content in Khonda creek was mainly attributed to addition from domestic and agricultural wastes. While high deterioration of Dudh creek sediments was the outcome of addition from industrial effluents., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The transmembrane P-glycoprotein that functions as a drug-efflux transporter coded by ATP-binding cassette, subfamily B, member 1/Multidrug Resistance 1 (ABCB1/MDR1) gene is considered relevant to drug absorption and elimination, with access to the central nervous system. Effects of three ABCB1 single nucleotide polymorphisms (SNPs) in genotypic and haplotypic combination have been evaluated in a south Indian population for risk of pediatric medically refractory epilepsy. The study included age and sex matched medically refractory (N=113) cases and drug responsive epilepsy patients (N=129) as controls, belonging to the same ethnic population recruited from a tertiary referral centre, of Karnataka, Southern India. The genotype frequencies of SNPs c.1236C>T, c.2677G>T/A, and c.3435C>T were determined from genomic DNA of the cases and controls by PCR- RFLP and confirmatory DNA sequencing. 256 normal population samples of the same ethnicity were genotyped for the three loci to check for population stratification. Results indicate that there was no statistically significant difference between allele and genotype frequencies of refractory and drug responsive epilepsy patients. The predicted haplotype frequencies of the three polymorphisms did not show significant difference between cases and controls. The results confirm earlier observations on absence of association of ABCB1 polymorphisms with medically refractory epilepsy.

We describe a 27-year-old woman who presented with classical symptoms and signs of left atrial myxoma. Histopathological studies of the excised tumor mass, however, revealed it to be choriocarcinoma. This is the first report of such a presentation of choriocarcinoma.