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Predicting a person's chronological age (CA) from visible skin features using artificial intelligence (AI) is now commonplace. Often, convolutional neural network (CNN) models are built using images of the face as biometric data. However, hands hold telltale signs of a person's age. To determine the utility of using only hand images in predicting CA, we developed two deep CNNs based on 1) dorsal hand images (H) and 2) frontal face images (F). Subjects (n = 1454) were Indian women, 20-80 years, across three geographic cohorts (Mumbai, New Delhi and Bangalore) and having a broad variation in skin tones. Images were randomised: 70% of F and 70% of H were used to train CNNs. The remaining 30% of F and H were retained for validation. CNN validation showed mean absolute error for predicting CA using F and H of 4.1 and 4.7 years, respectively. In both cases correlations of predicted and actual age were statistically significant (r(F) = 0.93, r(H) = 0.90). The CNNs for F and H were validated for dark and light skin tones. Finally, by blurring or accentuating visible features on specific regions of the hand and face, we identified those features that contributed to the CNN models. For the face, areas of the inner eye corner and around the mouth were most important for age prediction. For the hands, knuckle texture was a key driver for age prediction. Collectively, for AI estimates of CA, CNNs based solely on hand images are a viable alternative and comparable to CNNs based on facial images., (© 2024 The Authors. Experimental Dermatology published by John Wiley & Sons Ltd.)

Background: Sudden upsurge in cases of COVID-19 Associated Mucormycosis (CAM) following the second wave of the COVID-19 pandemic was recorded in India. This study describes the clinical characteristics, management and outcomes of CAM cases, and factors associated with mortality., Methods: Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2., Results: A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1%), literate (n = 261, 77.7%), and employed (n = 224, 66.7%). The commonest presenting symptoms in our cohort of patients were oro-facial and ophthalmological in nature. The median (Interquartile Range; IQR) interval between COVID diagnosis and admission due to mucormycosis was 31 (18, 47) days, whereas the median duration of symptoms of CAM before hospitalization was 10 (5, 20) days. All CAM cases received antifungal treatment, and debridement (either surgical or endoscopic or both) was carried out in the majority of them (326, 97.02%). Twenty-three (6.9%) of the enrolled CAM cases expired. The odds of death in CAM patients increased with an increase in HbA1c level (aOR: 1.34, 95%CI: 1.05, 1.72) following adjustment for age, gender, education and employment status., Conclusion: A longer vigil of around 4-6 weeks post-COVID-19 diagnosis is suggested for earlier diagnosis of CAM. Better glycemic control may avert mortality in admitted CAM cases., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Learning environment in any medical college is found to be important in determining student's academic success. The study was undertaken to know and compare the perceptions of educational environment of undergraduate and postgraduate medical students, find out the problem areas and their remedies at Calcutta National Medical College and Hospital, Kolkata. In the present study, Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to undergraduate (n = 278) and postgraduate (n = 43) student and the scores were compared using a non-parametric test. Among the two groups, the undergraduate students were found to be more satisfied with the learning environment at Calcutta National Medical College and Hospital (as indicated by their higher DREEM score) compared to the postgraduate students. There was insignificant difference in perception among male and female students. The study revealed that both groups of students perceived the learning environment positively. Nevertheless, the study also reflected problematic areas of learning environment in this medical college which generates an idea of adopting some remedial measures in the form of small group learning and problem based learning where there is enough scope of student-teacher interaction and practical exposure.

The incidence of cryptococcal infection is high in developing countries such as India. Cryptococcal meningitis is considered rare in immunocompetent patients and is mainly a disease of immunocompromised patients. Prognosis in immunocompetent patients is generally considered good. We report a fatal case of cryptococcal meningitis in an immunocompetent male caused by Cryptococcus neoformans var. grubii. Whether the patient is immunocompromised or immunocompetent, the outcome of the disease can be severe unless the disease is diagnosed early in the course of illness.

Present study was an attempt to study the prevalence of nonfermenter and its antibiotic susceptibility pattern at CSM Medical University, Lucknow. All the isolates and samples were selected from clinical specimens received in Bacteriology section, P.G. Depart of Microbiology, for culture. The observation were made on the nonfermenter isolates that can be isolated from clinical specimen using simple Laboratory media e.g. Blood Agar & Mac Conkey agar. All relevant history & information were recorded from the subjects. A total of 8340 specimen were screened for a period of one year. The prevalence of nonfermenters came to be 19.09% among all isolates. Most of spp. belongs to oxidase+ve group (77%). P. aeruginosa was found to be most common isolate (53%). Overall sensitivity profile for ciprofloxacin was 60%, P/T 58% & Amikacin 56%. Sensitivity of imepenem was 60% for multi-resistant isolates. The most resistant isolate was Sachrolytic Acinetobacter spp. The knowledge of synergism between drugs in context to different isolates may aid in effective therapy for these isolates.

Background: Almost half of India's children under 3 years of age are undernourished and at risk for illness and death. Poor complementary feeding practices contribute substantially to the problem. Promoting appropriate feeding practices is critical for ensuring child survival, health, and nutrition. Nutrition education is a feasible intervention and has the potential to help achieve the Millennium Goals, provided it is implemented appropriately. However, in existing programs, education is too generalized and based on information transfer., Objective: To develop and implement a need-based, situation-specific education program for mothers to bring about changes in complementary feeding practices, with emphasis on the quantity and nutritional quality of complementary feeds., Methods: Four hundred fourteen mothers or caregivers from five slums in Mumbai participated in a 3-month intervention study. Gaps in complementary feeding practices were identified at baseline. Education was given by trained fieldworkers, first to groups of 8 to 10 mothers or caregivers using innovative modules and demonstrations, followed by weekly monitoring and reinforcement. A simple checklist was used at each follow-up to assess impact, identify practices not adopted, and provide further inputs. Data collected at three follow-ups were compared with baseline and analyzed by SPSS using the chi-square test, the t-test, and ANOVA to assess whether feeding practices of the mothers or caregivers were altered favorably., Conclusions: The intervention process used in this study, the modules used, and the use of the checklist as a monitoring tool were successful in favorably changing complementary feeding practices. Incorporation of these in existing Growth Monitoring and Promotion programs would help to improve child nutrient intakes and thus reduce the prevalence of undernutrition.

Background: Japanese encephalitis is associated with high rates of mortality and disabling sequelae. To date, no specific antiviral has proven to be of benefit for this condition. We attempted to determine the efficacy of oral ribavirin treatment for reducing early mortality among children with Japanese encephalitis in Uttar Pradesh, India., Methods: Children (age, 6 months to 15 years) who had been hospitalized with acute febrile encephalopathy (a < or =2-week history of fever plus altered sensorium) were tested for the presence of immunoglobulin M antibodies to Japanese encephalitis virus with commercial immunoglobulin M capture enzyme-linked immunosorbent assay. Children with positive results were randomized to receive either ribavirin (10 mg/kg per day in 4 divided doses for 7 days) or placebo syrup through nasogastric tube or by mouth. The primary outcome was early mortality; secondary outcome measures were early (at hospital discharge; normal or nearly normal, independent functioning, dependent, vegetative state, or death) outcome, time to resolution of fever, time to resumption of oral feeding, duration of hospitalization, and late outcome (> or =3 months after hospital discharge). The study was double-blind, and analysis was by intention to treat., Results: A total of 153 patients were enrolled during a 3-year period; 70 patients received ribavirin, and 83 received placebo. There was no statistically significant difference between the 2 groups in the early mortality rate: 19 (27.1%) of 70 ribavirin recipients and 21 (25.3%) of 83 placebo recipients died (odds ratio, 1.10; 95% confidence interval, 0.5-2.4). No statistically significant differences in secondary outcome measures were found., Conclusions: For the dosage schedule used in our study, oral ribavirin has no effect in reducing early mortality associated with Japanese encephalitis., Trial Registration: ClinicalTrials.gov identifier: NCT00216268 .

Background: Japanese encephalitis is a disease that affects the rural poor in Asia. In August-September 2005, a severe epidemic of Japanese encephalitis occurred in Uttar Pradesh, one of India's poorest states., Methods: Children admitted to the King George Medical University hospital (Lucknow, Uttar Pradesh, India) with acute febrile encephalopathy (defined as fever plus encephalopathy of

The study was conducted in 4140 clinical samples sent to Microbiology department from different department of G.M. and associated hospitals. The samples included 2270 urine, 960 pus, 300 blood, 210 sputum, 180 CSF, 20 intercostal drainage tubes and 150 other swabs like vaginal and urethral, conjunctival smear 30, 10 ascitic fluids and 10 gastric aspirates. Apart from this, 30 specimens were collected from hospitals environment, like linen and trolley. From clinical samples, 43 acinetobacter strains (1.04%) were isolated. 17 strains (0.41%), were from pus, 12 (0.28%), from respiratory tract, 1, was (0.02%) from intercostal drainage secretions, urine 9 (0.22%), blood 1 (0.2%) and CSF 3 (.72%). From environmental samples, 7 strains (23.33%) were isolated. All the isolated strains were identified by routine biochemical tests. They were preserved in 1 % agar media for characterization. Characterization was done on the basis of growth at 37 degrees c, 41 degrees c and 44 degrees c, hemolysis, gelatin hydrolysis, acid from glucose, utilization of citrate, L-phenyl alanine, malonate, B-alanine, L-arginine, L-ornithine and L-aspartate. Among species identified Acinetobacter baumannii was 30 (69.67%), from clinical specimens and 5 (71.42%) from environment, Acinetobacter lwoffi was 10 (23.25%) from clinical specimen and 2 from environmental specimen, Acinetobacter hemolyticus was 3 (6.97%) and none from the environment. All the strains were resistant to penicillin. The sensitivity pattern showed gentamycin 64% sensitive, cotrimaxazole 42% cefotoxin 32% ciprofloxacine 26% and tetracycline 16%.