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Foodborne infection is one of the leading sources of infections spreading across the world. Foodborne pathogens are recognized as multidrug-resistant (MDR) pathogens posing a significant problem in the food industry and healthy consumers resulting in enhanced economic burden, and nosocomial infections. The continued search for enhanced microbial detection tools has piqued the interest of the CRISPR-Cas system and Nanoparticles. CRISPR-Cas system is present in the bacterial genome of some prokaryotes and is repurposed as a theragnostic tool against MDR pathogens. Nanoparticles and composites have also emerged as an efficient tool in theragnostic applications against MDR pathogens. The diagnostic limitations of the CRISPR-Cas system are believed to be overcome by a synergistic combination of the nanoparticles system and CRISPR-Cas using nanoparticles as vehicles. In this review, we have discussed the diagnostic application of CRISPR-Cas technologies along with their potential usage in applications like phage resistance, phage vaccination, strain typing, genome editing, and antimicrobial. we have also elucidated the antimicrobial and detection role of nanoparticles against foodborne MDR pathogens. Moreover, the novel combinatorial approach of CRISPR-Cas and nanoparticles for their synergistic effects in pathogen clearance and drug delivery vehicles has also been discussed., Competing Interests: 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., (© 2022 Published by Elsevier Ltd.)

Background The number of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is vastly underestimated. In this context, seroprevalence surveys are of utmost importance to assess the proportion of the population that has already developed antibodies against the virus and might potentially be protected against subsequent infection. Health care workers (HCWs) face a greater risk of developing SARS-CoV-2. Therefore, the present retrospective study was undertaken to estimate the prevalence of antibodies against SARS-CoV-2 among healthcare workers at a tertiary care institute in Uttarakhand, India. Material and methods Data were gathered from hospital records of 704 healthcare workers admitted to the coronavirus disease 2019 (COVID-19) unit and attended the COVID OPD of the tertiary care institute between July 15 to Aug 14, 2020. Result Out of the 704 recruited participants, 14 (1.99%) were seropositive for immunoglobulin G (IgG) antibodies against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive reverse transcription-polymerase chain reaction (RT-PCR)) was 4.40%. Conclusion The present study shows a low prevalence of SARS-CoV-2 IgG antibodies among health care workers. In addition, posting in COVID-19-positive areas was not associated with increased seropositivity. More studies are warranted to assess IgG/IgM antibodies against SARS-CoV-2 among those HCWs who are exposed to COVID-19 patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Saini et al.)

A novel 22π-aromatic sapphyrin isomer endowed with an acene moiety was designed and realised for the first time as a core-modified monothia analogue. This macrocycle exhibited absorption and emission in the near-infrared region. It was diprotonated under strongly acidic conditions and bound to anions like sapphyrin. It showed unusual coordination chemistry, acting as a neutral ligand and undergoing large out-of-plane deformation to bind Pd(II) ions.

Hypothyroidism is commonly associated with pericardial effusion, but it can be rarely complicated by cardiac tamponade. We report a case series of two patients who presented with shortness of breath and distension of the abdomen, progressing to generalized edema. Each of them was found to have cardiac tamponade at presentation and eventually diagnosed with hypothyroidism. They were managed by urgent pericardiocentesis followed by intermittent drainage of the collected pericardial effusion along with thyroxine replacement to which they responded. The presence of cardiac tamponade with bradycardia should raise a suspicion of a hypothyroid etiology. Early diagnosis and treatment of hypothyroidism are essential to prevent such complications., How to Cite This Article: Panda PK, Pattar S, Singh BO, Cheema T. Primary Hypothyroidism Presenting as Cardiac Tamponade. Indian J Crit Care Med 2022;26(5):655-657., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2022; The Author(s).)

Objective:  Pregnancy is a transient state of immunosuppression. The objective of this study was to ascertain whether pregnant women are more susceptible to coronavirus disease 2019 (COVID-19) than non-pregnant women and the impact of pregnancy on the severity of COVID-19 and associated morbidity and mortality., Methods:  A prospective observational study was performed at All India Institute of Medical Sciences (AIIMS) Rishikesh for a period of two months. A total of 42 and 33 COVID-19 positive women were included in the obstetric and non-obstetric cohorts respectively., Results:  Baseline characteristics were similar in both groups. Approximately 48% of the obstetric cohort had no COVID-19-related symptoms. Whereas, 100% of the non-obstetric cohort was symptomatic and had a significantly higher number of patients presenting with fever, cough, and breathlessness. The obstetric cohort had a significantly higher incidence of mild disease (p=0.009). In the obstetric cohort, the mean gestational age was 32.59 ± 2.57 weeks, with patients spread across all trimesters. Most of the patients with severe disease were in their second trimester. There was no difference in intensive care unit (ICU) admission, duration of ICU stay, duration of hospital stay, and mortality among both groups. A significantly smaller number of patients in the obstetric cohort required ventilatory support (p=0.0002). The maternal mortality rate was 16.67%. All of them had severe diseases requiring ICU admission. The cause of death was attributed to severe COVID pneumonia with septic shock in all cases. The mortality rate was comparatively higher (27.27%) in the non-obstetric group., Conclusion:  Pregnancy, unlike other immunocompromised conditions, does not seem to affect the prognosis of COVID-19 in terms of disease severity or mortality., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Khoiwal et al.)

Aims: Antibodies against phosphorylcholine (anti-PC) are implicated as protection markers in atherosclerosis, cardiovascular disease (CVD), and other chronic inflammatory conditions. Mostly, these studies have been focused on IgM. In this study, we determined IgG, IgG1, and IgG2 anti-PC among 60-year-olds., Methods: Based on a 7-year follow-up of 60-year-olds (2,039 men and 2,193 women) from Stockholm County, we performed a nested case-control study of 209 incident CVD cases with 620 age- and sex-matched controls. Anti-PC was determined using ELISA. We predicted the binding affinity of PC with our fully human, in-house-produced IgG1 anti-PC clones (i.e., A01, D05, and E01) using the molecular docking and molecular dynamics simulation approach, to retrieve information regarding binding properties to PC., Results: After adjustment for confounders, IgG and IgG2 anti-PC showed some significant associations, but IgG1 anti-PC was much stronger as a protection marker. IgG1 anti-PC was associated with an increased risk of CVD below 33rd, 25th, and 10th percentile and of stroke below 33rd and 25th, and of myocardial infarction (MI) below 10th percentile. Among men, a strong association with stroke was determined below the 33rd percentile [HR 9.20, CI (2.22-38.12); p = 0.0022]. D05 clone has higher binding affinity followed by E01 and A01 using molecular docking and further have been confirmed during the course of 100 ns simulation. The stability of the D05 clone with PC was substantially higher., Conclusion: IgG1 anti-PC was a stronger protection marker than IgG anti-PC and IgG2 anti-PC and also separately for men. The molecular modeling approach helps in identifying the intrinsic properties of anti-PC clones and atomistic interactions with PC., Competing Interests: JF was named as inventor on patents related to Phosphorylcholine. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Samal, Panda, Vikström, Leander, de Faire, Ahuja and Frostegård.)

Background: In newly diagnosed neurocysticercosis (NCC) with seizures, the choice of anti-seizure medication (ASM) seems to be arbitrary due to a lack of comparative studies. Although oxcarbazepine (OXC) is often considered efficacious for focal seizures in NCC, due to adverse effects, newer ASMs like levetiracetam (LCM) and lacosamide are also being explored., Methods: This study was performed by case record review of children with newly diagnosed solitary viable parenchymal NCC aged 4-18years who received lacosamide and OXC at least for 12 weeks between August 2019 and April 2021, from a prospective registry of a tertiary care teaching hospital in north India. Seizure control, electroencephalographic abnormalities, resolution of inflammatory granulomas and adverse effects were compared between two arms at 12 and 24 weeks., Results: Total 31 (8.3 ± 4.7 years, 19 boys) and 72 (8.6 ± 4.2 years, 43 boys) completed at least 12 weeks follow-up in LCM and OXC groups, out of which 2 and 51 completed at least 24 weeks follow-up in LCM and OXC groups, respectively. The occurrence of breakthrough seizure was comparable in both arms at 12 and 24 weeks (1/31 and 2/22 in lacosamide group vs. 2/72 and 4/51 in OXC group, p = 0.66 and 0.59, respectively). Patients receiving OXC had more frequent treatment-emergent adverse events (p = 0.0001) and four patients required discontinuation due to severe adverse events (SAEs), while none in the lacosamide group had SAEs., Conclusions: Lacosamide appears to be efficacious and safe for achieving seizure freedom in patients with solitary viable parenchymal neurocysticercosis., (© The Author(s) [2022]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Molecular electronic devices based on few and single-molecules have the advantage that the electronic signature of the device is directly dependent on the electronic structure of the molecules as well as of the electrode-molecule junction. In this work, we use a two-step approach to synthesise functionalized nanomolecular electronic devices (nanoMoED). In first step we apply an organic solvent-based gold nanoparticle (AuNP) synthesis method to form either a 1-dodecanethiol or a mixed 1-dodecanethiol/ ω -tetraphenyl ether substituted 1-dodecanethiol ligand shell. The functionalization of these AuNPs is tuned in a second step by a ligand functionalization process where biphenyldithiol (BPDT) molecules are introduced as bridging ligands into the shell of the AuNPs. From subsequent structural analysis and electrical measurements, we could observe a successful molecular functionalization in nanoMoED devices as well as we could deduce that differences in electrical properties between two different device types are related to the differences in the molecular functionalization process for the two different AuNPs synthesized in first step. The same devices yielded successful NO 2 gas sensing. This opens the pathway for a simplified synthesis/fabrication of molecular electronic devices with application potential., (Creative Commons Attribution license.)

The purpose of the study is to evaluate the antidiabetic and hyperlipidemic potential of stem bark extract of Premna spinosa (Lamiaceae), by using streptozotocin (STZ)-nicotinamide (NA)-induced diabetic and triton-induced hyperlipidemic models in albino rats. The blood glucose, total cholesterol, and triglyceride levels were determined in STZ-NA-induced diabetic and triton-induced hyperlipidemic rats, as per the respective protocols. It was found that there is the dose dependent and significant reduction in foregoing parameters on the administration of extract from Premna spinosa stem bark at the doses of 200, 400, and 800 mg/kg body weight to diabetic and hyperlipidemic rats. From these observed results it may be inferred that the stem bark of Premna spinosa possesses remarkable antidiabetic and antihyperlipidemic properties., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Advanced Pharmaceutical Technology & Research.)

Purpose: An indolent nature, with a high risk of local recurrence along with the potential for distant metastases, makes the relatively rare adenoid cystic carcinomas (ACCs) of the head-and-neck region, a unique entity. In the base of skull (BOS) region, these cancers require radiation doses as high as 70-72 GyE in proximity to critical structures. Proton therapy (PT) confers physical and radiobiological advantages and local control at 2-5 years exceeding 80% in most series, compared with below 60% with photon-based techniques. We report a case series of ACCs of the BOS, treated with image-guided, intensity-modulated PT (IMPT)., Materials and Methods: During 2019-2020, we treated six patients with skull-base ACC IMPT with on-board, cross-sectional image guidance. Dosimetric data, toxicity, and early outcomes were studied, and a comparative review of literature was done., Results: Three patients underwent PT/proton-photon treatment for residual/inoperable lesions and three patients underwent reirradiation for recurrent lesions. The prescription was 70 GyE in 31-35 fractions, and 95% of the clinical target volume (CTV) received 98% of the prescribed dose in five of the six patients. Grade 3 mucositis and skin reactions were noted in two patients and one patient, respectively. Five of the six patients were controlled locally at a median follow-up of 15 months., Conclusion: The radiobiological and physical characteristics of PT help to deliver high doses with excellent CTV coverage in skull-base ACCs, adjacent to critical neurological structures., Competing Interests: None

Low- and middle-income countries (LMICs) represent a diverse group of regions with varied cancer presentation. Drug development and accessibility across these regions have primarily been dependent on the trials initiated and conducted across high-income countries. Representation of LMIC regions in these trials in terms of study population has been minimal, leading to inequitable distribution of optimal and affordable cancer care. In spite of many challenges, LMICs have now increasingly been able to contribute to anticancer drug development. The opportunities present in LMICs must be explored and used in conjunction with due collaborative efforts from high-income countries, health care planners, and regulatory agencies. Global drug development trials should not only factor in suitable representation of LMICs but also design studies with pragmatic objectives and endpoints so that the trial results lead to equitable and affordable cancer care. Strengthening collaboration between cancer researchers from LMICs and high-income countries and empowering the local investigator with adequate resources will help remove current disparities.

Presently, nanocarriers (NCs) have gained huge attention for their structural ability, good biocompatibility, and biodegradability. The development of effective NCs with stimuli-responsive properties has acquired a huge interest among scientists. When developing drug delivery NCs, the fundamental goal is to tackle the delivery-related problems associated with standard chemotherapy and to carry medicines to the intended sites of action while avoiding undesirable side effects. These nanocarriers were able of delivering drugs to tumors through regulating their pH, temperature, enzyme responsiveness. With the use of nanocarriers, chemotherapeutic drugs could be supplied to tumors more accurately that can equally encapsulate and deliver them. Material carriers for chemotherapeutic medicines are discussed in this review keeping in viewpoint of the structural properties and targeting methods that make these carriers more therapeutically effective, in addition to metabolic pathways triggered by drug-loaded NCs. Largely, the development of NCs countering to endogenous and exogenous stimuli in tumor regions and understanding of mechanisms would encourage the progress for tumor therapy and precision diagnosis in future., (© 2022. The Author(s).)

Transfection of tumor suppressor miRNAs such as miR-34a, miR-449a, and miR-16 with DNA damage can regulate apoptosis and senescence in cancer cells. miR-16 has been shown to influence autophagy in cervical cancer. However, the function of miR-34a and miR-449a in autophagy remains unknown. The functional and persistent G1/S checkpoint signaling pathways in HeLa cells via these three miRNAs, either synergistically or separately, remain a mystery. As a result, we present a synthetic Boolean network of the functional G1/S checkpoint regulation, illustrating the regulatory effects of these three miRNAs. To our knowledge, this is the first synthetic Boolean network that demonstrates the advanced role of these miRNAs in cervical cancer signaling pathways reliant on or independent of p53, such as MAPK or AMPK. We compared our estimated probability to the experimental data and found reasonable agreement. Our findings indicate that miR-34a or miR-16 may control senescence, autophagy, apoptosis, and the functional G1/S checkpoint. Additionally, miR-449a can regulate just senescence and apoptosis on an individual basis. MiR-449a can coordinate autophagy in HeLa cells in a synergistic manner with miR-16 and/or miR-34a., (© 2022. The Author(s).)

We have designed and synthesized 3,6,13,16-tetrapropylporphycene for the first time as its alkyl analogue from ethyl 4-propyl-1 H -pyrrole-2-carboxylate. The substituent effect was found to be more intense than reported positional isomeric tetrapropylporphycenes. The freebase porphycene exhibited moderate fluorescence and complexation ability with divalent metal ions, including Zn(II), which displayed an enhanced emission quantum yield (∼30%). The Pd(II) complex and freebase β-tetrabromoporphycene generated singlet oxygen efficiently (75 and 51%, respectively) and, hence, may find application as potential photosensitizers in photodynamic therapy.

Introduction: Breast carcinoma (BC) is one of the most frequent causes of cancer-related death among women, which is due to the poor response to conventional therapy. There are several complications associated with monotherapy for cancer, such as cytotoxicity to normal cells, multidrug resistance (MDR), side effects, and limited applications. To overcome these challenges, a combination of chemotherapy and immunotherapy (monoclonal antibodies, anticancer vaccines, checkpoint inhibitors, and cytokines) has been introduced. Drug delivery systems (DDSs) based on nanotechnology have more applications in BC treatment owing to their controlled and targeted drug release with lower toxicity and reduced adverse drug effects. Several nanocarriers, such as liposomes, nanoparticles, dendrimers, and micelles, have been used for the effective delivery of drugs., Areas Covered: This article presents opportunities and challenges in BC treatment, the rationale for cancer immunotherapy, and several combinational approaches with their applications for BC treatment., Expert Opinion: Nanotechnology can be used for the early prognosis and cure of BC. Several novel and targeted DDSs have been developed to enhance the efficacy of anticancer drugs. This article aims to understand new strategies for the treatment of BC and the appropriate design of nanocarriers used as a combinational DDS.

Dinaphthoporphycene (DNP) has emerged as a versatile ligand undergoing large out-of-plane distortion to form a cis-bimetallic complex with Pd(II) using Pd(OAc) 2 and out-of-plane monometallic complexes with Pd(acac) 2 and PtCl 2 (PhCN) 2 . Herein, we are finally able to synthesize the in-core complex with Pd(II) using PdCl 2 (PhCN) 2 or PdCl 2 . The crystal structure shows the palladium ion resides slightly above the N4-core, with the Pd(II) dimensionally dissenting with the typical square planarity displayed by the reported in-core DNP complexes with Ni(II) and Cu(II) ions. The deformed complex displays a blue shift in the absorption spectra compared to DNP and its metallo-derivatives. PdDNP exhibits a moderate singlet oxygen generation ability (18%).

Ferritin is a known inflammatory biomarker in COVID-19. However, many factors and co-morbidities can confound the level of serum ferritin. This current metaanalysis evaluates serum ferritin level in different severity levels in COVID-19. Studies evaluating serum ferritin level in different clinical contexts (COVID-19 vs. control, mild to moderate vs. severe to critical, non-survivor vs. survivor, organ involvement, ICU and mechanical ventilation requirement) were included (total 9 literature databases searched). Metaanalysis and metaregression was carried out using metaphor "R" package. Compared to control (COVID-19 negative), higher ferritin levels were found among the COVID-19 patients [SMD -0.889 (95% C.I. -1.201, -0.577), I 2  = 85%]. Severe to critical COVID-19 patients showed higher ferritin levels compared to mild to moderate COVID-19 patients [SMD 0.882 (0.738, 1.026), I 2  = 85%]. In meta-regression, high heterogeneity was observed could be attributed to difference in "mean age", and "percentage of population with concomitant co-morbidities". Non-survivors had higher serum ferritin level compared to survivors [SMD 0.992 (0.672, 1.172), I 2  = 92.33%]. In meta-regression, high heterogeneity observed could be attributed to difference in "mean age" and "percentage of male sex". Patients requiring ICU [SMD 0.674 (0.515 to 0.833), I 2  = 80%] and mechanical ventilation [SMD 0.430 (0.258, 0.602), I 2  = 32%] had higher serum ferritin levels compared to those who didn't. To conclude, serum ferritin level may serve as an important biomarker which can aid in COVID-19 management. However, presence of other co-morbid conditions/confounders warrants cautious interpretation., Competing Interests: Declaration of competing interest Nil., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The key to bacterial virulence relies on an exquisite balance of signals between microbe and hosts. Bacterial toxin-antitoxin (TA) system is known to play a vital role in response to stress adaptation, drug resistance, biofilm formation, intracellular survival, persistence as well as pathogenesis. In the present study, we investigated the role of Hha-TomB TA system in regulating virulence of Salmonella enterica serovar Typhimurium (S. Typhimurium) in a host model system, where we showed that deletion of hha and tomB genes displayed impaired cell adhesion, invasion, and uptake. The isogenic hha and tomB mutant strain was also found to be deficient in intracellular replication in vitro, with a highly repressed Salmonella Pathogenicity Island-2 (SPI-2) genes and downregulation of Salmonella Pathogenicity Island-1 (SPI-1) genes. In addition, the Δhha and ΔtomB did not show acute colitis in C57BL/6 mice and displayed less dissemination to systemic organs followed by their cecal pathology. The TA mutants also showed reduction in serum cytokine and nitric oxide levels both in vitro and in vivo. However, the inflammation phenotype was restored on complementing strain of TA gene to its mutant strain. In silico studies depicted firm interaction of Hha-TomB complex and the regulatory proteins, namely, SsrA, SsrB, PhoP, and PhoQ. Overall, we demonstrate that this study of Hha-TomB TA system is one of the prime regulating networks essential for S. Typhimurium pathogenesis. 1. Role of Hha-TomB toxin-antitoxin (TA) system in Salmonella pathogenesis was examined. 2. The TA mutants resulted in impaired invasion and intracellular replication in vitro. 3. The TA mutants displayed alteration in SPI-1 and SPI-2 regulatory genes inside host cells. 4. Mutation in TA genes also limited systemic colonization and inflammatory response in vivo., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature.)

Purpose  Lennox-Gastaut syndrome (LGS) is one of the most difficult to treat childhood-onset epileptic encephalopathies. There is growing evidence that lacosamide is safe and efficacious in patients and adults with refractory epilepsy. However, the evidence regarding the efficacy of lacosamide in LGS is controversial so far. We aimed to evaluate the efficacy and tolerability of lacosamide in patients with LGS. Methods  We conducted a systematic review on MEDLINE, EMBASE, COCHRANE CENTRAL, Google Scholar, and Web of Science, collating all available literature till July 31, 2020. The qualitative review included case reports, case series, and both controlled/uncontrolled trials as well as retrospective studies, but for determining pooled estimates, we only included studies with a sample size of 5 or more. The primary outcome was the efficacy of lacosamide in patients with LGS. Clinical variables related to efficacy and adverse events attributed to lacosamide were extracted from each publication. The pooled estimate of variables related to these parameters was performed using a random-effect model. Results  Of the 68 items identified by the search, 14 were reviewed as full-text. Eleven articles including two prospective and six retrospective studies fulfilled eligibility criteria and described outcomes in 81 patients (42 adults, 39 children, 60% male, range-1.4-61 years). On average, 35.2%, 27.9%, 7.3%, and 29.4% patients had > 50% reduction, < 50% reduction, no change, and worsening of seizure frequency, respectively. Although 36% of patients had adverse events like somnolence, behavioral abnormalities including irritability, aggressiveness, nausea, tremor, memory problems, dizziness, gastrointestinal discomfort, vomiting, and weight loss, no serious adverse events were noted. Conclusion  The evidence available in the current literature is not sufficient to support or refute the use of lacosamide in patients with LGS. Although it is one of the possible therapeutic options worth exploring in patients with LGS, caution is still necessary, as there are reports of worsening of seizure frequency in some patients., Competing Interests: Conflict of Interest None declared., (Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Concern for public health has been growing with the increasing volume of cases of COVID-19 in India. To combat this pandemic, India has implemented nationwide lockdowns, and unlocking phases continue with certain restrictions in different parts of the country. The lockdown has required people to adopt social-distance measures to minimize contacts in order to reduce the risks of additional infection. Nevertheless, the lockdown has already impacted economic activities and other dimensions of the health of individuals and society. Although many countries have helped their people through advanced welfare protection networks and numerous support aids, several emerging economies face specific difficulties to adapt to the pandemic due to vulnerable communities and scarce resources. However, certain lower-income countries need more rigorous analysis to implement more effective strategies to combat COVID-19. Accordingly, the current systematic review addresses the impacts of the COVID-19 pandemic and lockdowns in India in relation to health and the economy. This work also provides further information on health inequalities, eco-nomic and social disparities in the country due to the COVID-19 pandemic and lockdowns and also contributes pragmatic suggestions for overcoming these challenges. These observations will be useful to the relevant local and national officials for improving and adopting novel strategies to face lockdown challenges.

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic of 2019 forced widespread use of face coverings as a mandatory step towards reducing infection by the virus. The face mask acts as a barrier for transmission of infected aerosols among its user and surrounding people. This has propelled pace of research and development of face masks around the world. This short review is an effort to present advances in materials and designs used for face masks. Details available in scientific literature and company brochures have been accessed and the use of nanomaterials and designs for the new generation of face masks have been discussed. Special attention was given to the face masks based on electrospun nanofiber-based membrane materials due to their nano-sized pores, light weight, and high filtration efficiency; therefore, they are commercially viable and popular among various products available in the market. Incorporation of metal organic framework (MOFs) and graphene have opened avenues to more advanced/multi-functional, reusable, and high capacity adsorption filtration membranes. Rapid prototyping/3-dimensional (3-D) printing techniques have been applied to shorten the time of manufacture of face masks. This review is expected to be very helpful for engineers, scientists, and entrepreneurs working on development of novel face masks required in plenty during this pandemic period., Competing Interests: Conflict of interestThe authors declare no competing interests., (© Qatar University and Springer Nature Switzerland AG 2022.)

Competing Interests: There are no conflicts of interest.

Background: With the looming threat of recurrent waves of coronavirus disease-2019 (COVID-19) in the presence of mutated strains, it is of paramount importance to understand the demographic and clinical attributes of COVID-19 related mortalities in each pandemic wave. This could help policy makers, public health experts, and clinicians to better plan preventive and management strategies to curb COVID-19 related mortality., Materials and Methods: This was a hospital record-based, retrospective cross-sectional descriptive study, at a tertiary care hospital in Rishikesh, India. The study included all deceased patients between March 2020 and January 2021 (first wave) who had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) and were hospitalized. The study was done to describe demography, clinical presentation, laboratory parameters, treatment given, and associated complications of all COVID-19 deaths., Result: Out of 424 mortalities, 298 (70.38%) were males and 126 (29.62%) were females. Mean age of patients was 55.85 ± 16.24 years, out of which 19.5% were less than 45 years old, 33.6% were 45-60 years old, and 41.8% were more than 60 years old. Comorbidity in the form of type II diabetes mellitus was present in 41.4% [95% CI (41.4-51.1)], hypertension in 39.8% [95% CI (35.1-44.6)], and coronary artery disease (CAD) in 15.2% [95% CI (11.8-18.8)]. At the time of presentation, shortness of breath was present in 73.6% [95% CI (69.1-77.7)], fever in 64.92% [95% CI (60.1-69.4)], and cough in 46.1%, [95% CI (41.1-50.8)]. Deranged laboratory parameters were lymphopenia in 90.2% [95% CI (86.8-92.7)], transaminitis in 59.7% [95% CI (54.8-64.3)], and hypercreatinemia in 37.7% [95% CI (33.1-42.5)]. Complications manifested were acute respiratory distress syndrome (ARDS) in 78.3% [95% CI (74-82.1)] and shock in 54.7% [95% CI (49.8-59.5)]. Median time duration between onset of symptom and hospital admission was 5 days (interquartile range (IQR) = 3-5 days) and median length of hospital stay was 9 days (IQR = 4-14 days)., Conclusion: During the first pandemic wave, COVID-19 related mortality was 2.37 times higher among males, 2.14 times in the age group >60 than <45 years. The most common associated comorbidities (>40%) were type II diabetes mellitus and hypertension. The most common associated symptoms (>60%) were shortness of breath and fever. Lymphopenia was seen in >90% cases while liver involvement in 60% and kidney in 38% cases. Median hospital stay was doubled the prehospital illness., How to Cite This Article: Tendulkar P, Pandey P, Panda PK, Bhadoria AS, Kulshreshtha P. Descriptive Epidemiology of COVID-19 Deaths during the First Wave of Pandemic in India: A Single-center Experience. Indian J Crit Care Med 2022;26(1):71-75., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2022; The Author(s).)

Background and Aims: COVID-19 vaccines are now accessible to all Indian citizens. Infection with COVID-19, on the other hand, continues to spread constantly. Our study aimed to determine the number of persons who had COVID-19 infections despite receiving the recommended number of doses of the COVID-19 vaccination at AIIMS Rishikesh, a tertiary care facility in Uttarakhand, India., Methods: We analysed meticulously preserved data regarding COVID-19 vaccination, COVID-19 infection, clinical symptoms, and RT-PCR testing among all HCWs in our healthcare institution from 16 January 2021 to 30th June 2021., Results: During this period, 5273 (90.3%) HCWs received two doses of the COVID-19 vaccine, while 566 (9.7%) received only one dose. 628 HCWs (10.8%) were BBV152 recipients and 5211 (89.2%) were AZD1222 (ChAdOx1-S) recipients. 423 HCWs (7.2%, confidence interval of 95% - 13.8, 22.0) reported COVID-19 infections. 274 (5.19% of total vaccinated HCWs) breakthrough infections and 149 non-breakthrough COVID-19 infections were reported in HCWs who had previously received a single dose of the COVID-19 vaccination., Conclusion: Viral infections, especially breakthrough infections, following adequate vaccination, are a cause for concern, but there is a lack of data on these infections in the actual world. Therefore, the primary focus of research should be on the emergence of illness in India following the completion of a full vaccine course., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Renovation of host erythrocytes is vital for pathogenesis by Plasmodium falciparum. These changes are mediated by parasite proteins that translocate beyond the parasitophorous vacuolar membrane in an unfolded state, suggesting protein folding by chaperones is imperative for the functionality of exported proteins. We report a type IV P. falciparum heat-shock protein 40, PF11&#95;0034, that localizes to the cytoplasmic side of J-dots and interacts with the erythrocyte cytoskeleton, and therefore named eCiJp (erythrocyte cytoskeleton-interacting J protein). Recombinant eCiJp binds to the human heat-shock protein 70 HsHSPA1 and promotes its ATPase activity. In addition, eCiJp could suppress protein aggregation. Our data suggest that eCiJp recruits HsHSPA1 to the host erythrocyte cytoskeleton, where it may become involved in remodeling of the erythrocyte cytoskeleton and/or folding of exported parasite proteins., (© 2021 Federation of European Biochemical Societies.)

Competing Interests: Srinivas ChilukuriEmployment: Apollo Proton Cancer CenterLeadership: Optimus Oncology Private LimitedStock and Other Ownership Interests: Optimus Oncology Private LimitedHonoraria: AstraZenecaConsulting or Advisory Role: Varian Medical SystemsSpeakers' Bureau: AstraZeneca Pankaj Kumar PandaEmployment: Apollo Proton Cancer Centre, Apollo Hospitals Enterprise LimitedTravel, Accommodations, Expenses: Reliance Life Sciences Rakesh JalaliEmployment: Apollo Proton Cancer Centre, Apollo Hospitals Enterprise LimitedHonoraria: Cipla LimitedNo other potential conflicts of interest were reported.

Background: The COVID-19 pandemic has resurfaced in India as a hardhitting second wave. This study aims to compare the clinical profile of the first wave (April-June 2020) and the second wave (March-May 2021) of the severe acute respiratory syndrome coronavirus-2 pandemic (SARS-CoV-2) in a single tertiary care center in India., Methods: In this retrospective observational study, we examined the demographic profile, symptoms at presentation, severity of illness, baseline investigations, treatments received, underlying comorbidities, and outcomes of the COVID-19 patients belonging to the first (W1) and the second wave (W2) of the pandemic in India., Results: The age group affected most in the W2 is 50.5 (17.7) versus 37·1 (16·9) years for W1. The baseline oxygen saturation is lower in W2, being 84·0 (13·4) % compared with 91·9 (7·4) % in W1 [SpO2 < 90% OR 14.3 (6.1-33), P < 0.0001]. 70.2 % of the cases belonged to the severe category in W2 compared to 37.5% in W1. W2 has worse outcomes. Incidence of acute respiratory distress syndrome (ARDS) [48.7% v/s 6.45%; OR 15.4 (6.5-35.7), P<0.0001], Acute Kidney Injury (AKI) [18% v/s 2.4%; OR 6 (1.7- 22.2), P = 0.005], Acute Liver Injury (transaminitis) [12.8% v/s 6.4%, OR 7.3 (3.7- 14.3), P < 0.0001], and deaths (29% v/s 9.6%, standardized mortality ratio 3.5) is higher in W2. Similarly, the CT severity score for W2 [29.5 (6.7)] was higher than W1 [23·2 (11·5), P < 0.05]. The proportion of patients requiring oxygen [81.8% v/s 11.2%; OR 125 (40-333.3), P < 0.0001], high flow nasal cannula (HFNC) (11.4% v/s 5.6%), Non- Invasive Ventilation (NIV) (41.2% v/s 1.5%), invasive ventilation [24.5% v/s 0.9%; OR 22.72 (2.94-166.6), P = 0.003], as well as ICU/HDU admissions [56.4% v/s 12.0%; OR 10.5 (5.3-21.2), P < 0.0001] was higher for W2 as compared with W1. Cough, invasive ventilation, inotrope requirement, and ARDS are significantly related to higher mortality in the W2 than W1., Conclusion: Higher age, oxygen requirement, ventilator requirement, ICU admission, and organ failure are more prevalent in the admitted COVID-19 cases during the second wave that hit India than in the first wave and are associated with more fatalities. Strategy for another wave should be planned accordingly., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Competing Interests: There are no conflicts of interest.

Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Neuro-ophthalmic features are a known association in tuberculosis, especially common in central nervous system tuberculosis (CNS-TB). They are mostly the result of the visual pathway and/or ocular motor and other cranial nerve involvement. Furthermore, toxic optic neuropathy and paradoxical response to anti-tubercular drugs (ATT) are also not uncommon. The etiopathogenesis is by the complex interplay of various factors like exudates, vasculitis, arachnoiditis, presence of tuberculomas, hydrocephalus, brain infarcts and/or immune-mediated reaction. The entity often poses a diagnostic dilemma for the ophthalmologists/neuro-ophthalmologists and may lead to irreversible vision loss. The presence of neuro-ophthalmic features not only affect the visual outcome but are also predictors of systemic morbidity of the disease. Therefore, understanding and knowledge about this entity are necessary for the comprehensive management of the disease. While various forms of TB including CNS-TB have been well-dealt with in literature, little is discussed specifically about the neuro-ophthalmic manifestations of tuberculosis. Therefore, the purpose of this review is to highlight current understanding of the types of neuro-ophthalmic involvement in tuberculosis, its etiopathogenesis, diagnosis and management., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Introduction  Triclofos and melatonin are commonly used oral sedatives in children for obtaining a sleep electroencephalogram (EEG) record. There has been no systematic review till now to compare the efficacy and safety of these two medications. Objectives  The review intended to compare the efficacy of oral triclofos and melatonin in children <18 years of age for inducing adequate sedation for obtaining a sleep EEG record. We also attempted to compare the adverse effects, impact on EEG record, the yield of epileptiform abnormalities, and sleep onset latency in both groups. Methods  A systematic search was conducted on "MEDLINE/PUBMED, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Web of Science, and Google Scholar" till November 30, 2020, with the following keywords/the Medical Subject Headings (MESH) terms while searching: "sleep EEG," "electroencephalogram," "triclofos," "melatonin" OR "ramelteon" AND "epilepsy," "seizure," OR "convulsion." ROB 2.0 and ROBINS-I tool was used to determine the risk of bias. To assess heterogeneity in studies, Higgins and Thompson's I 2 method was utilized. When I 2 was more than 50%, a random effects model was utilized and a fixed-effect model was used for other parameters. To assess the presence of publication bias, Egger's test was used. Results  For describing the efficacy of triclofos in 1,284 and melatonin in 1,532 children, we selected 16 articles. The indirect comparison between the pooled estimate of all children receiving individual medications revealed comparable efficacy in obtaining successful sleep EEG record with a single dose (90 vs. 76%, p  = 0.058) and repeat dose ( p  = 0.054), detection of epileptiform abnormalities ( p  = 0.06), and sleep onset latency ( p  = 0.06), but more proportion of children receiving triclofos had adverse effects ( p  = 0.001) and duration of sleep was also higher with triclofos ( p  = 0.001). Conclusion  Efficacy of triclofos and melatonin are comparable in inducing sleep for recording EEG in children, although triclofos is more likely to cause adverse effects. However, the level of evidence is low for this conclusion and the weak strength of recommendation for the results of this review is likely to change in the future after completion of controlled trials exploring these two medications., Competing Interests: Conflict of Interest None declared., (Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Plasma is regularly alluded to as the fourth form of matter. Its bounty presence in nature along with its potential antibacterial properties has made it a widely utilized disinfectant in clinical sciences. Thermal plasma and non-thermal (or cold atmospheric) plasma (NTP) are two types of plasma. Atoms and heavy particles are both available at the same temperature in thermal plasma. Cold atmospheric plasma (CAP) is intended to be non-thermal since its electrons are hotter than the heavier particles at ambient temperature. Direct barrier discharge (DBD), atmospheric plasma pressure jet (APPJ), etc. methods can be used to produce plasma, however, all follow a basic concept in their generation. This review focuses on the anticipated uses of cold atmospheric plasma in dentistry, such as its effectiveness in sterilizing dental instruments by eradicating bacteria, its advantage in dental cavity decontamination over conventional methods, root canal disinfection, its effects on tooth whitening, the benefits of plasma treatment on the success of dental implant placement, and so forth. Moreover, the limitations and probable solutions has also been anticipated. These conceivable outcomes thus have proclaimed the improvement of more up-to-date gadgets, for example, the plasma needle and plasma pen, which are efficient in treating the small areas like root canal bleaching, biofilm disruption, requiring treatment in dentistry., Competing Interests: 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., (© 2021 The Authors.)

Contact electrification (triboelectrification) has been a long-standing phenomenon for 2600 years. The scientific understanding of contact electrification (triboelectrification) remains un-unified as the term itself implies complex phenomena involving mechanical contact/sliding of two materials involving many physico-chemical processes. Recent experimental evidence suggests that electron transfer occurs in contact electrification between solids and liquids besides the traditional belief of ion adsorption. Here, we have illustrated the Density Functional Theory (DFT) formalism based on a first-principles theory coupled with temperature-dependent ab initio molecular dynamics to describe the phenomenon of interfacial charge transfer. The model captures charge transfer dynamics upon adsorption of different ions and molecules on AlN (001), GaN (001), and Si (001) surfaces, which reveals the influence of interfacial charge transfer and can predict charge transfer differences between materials. We have depicted the substantial difference in charge transfer between fluids and solids when different ions (ions that contribute to physiological pH variations in aqueous solutions, e.g. , HCl for acidic pH, and NaOH for alkaline pH) are adsorbed on the surfaces. Moreover, a clear picture has been provided based on the electron localization function as conclusive evidence of contact electrification, which may shed light on solid-liquid interfaces., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background and Purpose: The healthcare system in India collapsed during the second wave of the COVID-19 pandemic. A fungal epidemic was announced amid the pandemic with several cases of COVID-associated mucormycosis and pulmonary aspergillosis being reported. However, there is limited data regarding mixed fungal infections in COVID-19 patients. Therefore, we present a series of ten consecutive COVID-19 patients with mixed invasive fungal infections (MIFIs)., Materials and Methods: Among COVID-19 patients hospitalized in May 2021 at a tertiary care center in North India, 10 cases of microbiologically confirmed COVID-19-associated mucormycosis-aspergillosis (CAMA) were evaluated., Results: All patients had diabetes and the majority of them were infected with severe COVID-19 pneumonia (6/10, 60%) either on admission or in the past month while two were each of moderate (20%) and mild (20%) categories of COVID-19; and were treated with steroid and cocktail therapy. The patients were managed with amphotericin-B along with surgical intervention. In total, 70% of all CAMA patients ( Rhizopus arrhizus with Aspergillus flavus in seven and Aspergillus fumigatus complex in three patients) survived., Conclusion: The study findings reflected the critical importance of a high index of clinical suspicion and accurate microbiological diagnosis in managing invasive dual molds and better understanding of the risk and progression of MIFIs among COVID-19 patients. Careful scrutiny and identification of MIFIs play a key role in the implementation of effective management strategies., (Copyright: © Current Medical Mycology.)

Background: The novel disseminated intravascular coagulation (DIC) score (platelet count, prolonged prothrombin time, D-dimer, and fibrinogen) and sepsis-induced coagulopathy (SIC) score (platelet count, international normalized ratio, and sequential organ failure assessment score) are markers of coagulopathy, which, for the first time, are explored in line with the coronavirus disease-2019 (COVID-19) disease outcomes. The correlation of D-dimer with these findings is also studied., Materials and Methods: A retrospective analysis of hospital-based records of 168 COVID-19 patients was done. Data including D-dimer, routine investigations, DIC, and SIC scorings (all within 3 days of admission) were collected and correlated with the outcomes. The study was conducted in a tertiary care center catering to North India's population., Results: Higher DIC score (1.59 ± 1.18 vs 0.96 ± 1.18), SIC score (1.60 ± 0.89 vs 0.63 ± 0.99), and D-dimer titers (1321.33 ± 1627.89 vs 583·66 ± 777.71 ng/mL) were significantly associated with severe COVID-19 disease ( p <0.05). DIC score and SIC score ≥1, and D-dimer ≥1315 ng/mL for severe disease; DIC score ≥1, SIC score ≥2, and D-dimer ≥600 ng/mL for pulmonary embolism (PE); and DIC score and SIC score ≥1, and D-dimer level ≥990 ng/mL for mortality were the respective cutoff values we found from our study., Conclusion: Higher DIC scores, SIC scores, and D-dimer values are associated with severe COVID-19 disease, inhospital mortality, and PE risk. They can serve as easily accessible early markers of severe disease and prioritize hospital admissions in the presently overburdened scenario and may be used to develop prognostic prediction models., How to Cite This Article: Kapoor M, Panda PK, Saini LK, Bahurupi Y. Disseminated Intravascular Coagulation Score and Sepsis-induced Coagulopathy Score in Prediction of COVID-19 Severity: A Retrospective Analysis. Indian J Crit Care Med 2021;25(12):1357-1363., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)

The spread of coronavirus disease, 2019, has affected several countries in the world including Asian countries. The occurrences of COVID infections are uneven across countries and the same is determined by socioeconomic situations prevailing in the countries besides the preparedness and management. The paper is an attempt to empirically examine the socioeconomic determinants of the occurrence of COVID in Asian countries considering the data as of June 18, 2020, for 42 Asian countries. A multiple regression analysis in a cross-sectional framework is specified and ordinary least square (OLS) technique with heteroscedasticity corrected robust standard error is employed to obtain regression coefficients. Explanatory variables that are highly collinear have been dropped from the analysis. The findings of the study show a positive significant association of per capita gross national income and net migration with the incidence of total COVID-19 cases and daily new cases. The size of net migration emerged to be a potential factor and positive in determining the total and new cases of COVID. Social capital as measured by voters' turnout ratio (VTR) in order to indicate the people's participation is found to be significant and negative for daily new cases per million population. People's participation has played a very important role in checking the incidence of COVID cases and its spread. In alternate models, countries having high incidence of poverty are also having higher cases of COVID. Though the countries having higher percentage of aged populations are more prone to be affected by the spread of virus, but the sign of the coefficient of this variable for Asian country is not in the expected line. Previous year health expenditure and diabetic prevalence rate are not significant in the analysis. Therefore, people-centric plan and making people more participatory and responsive in adhering to the social distancing norms in public and workplace and adopting preventive measures need to be focused on COVID management strategies. The countries having larger net migration and poverty ratio need to evolve comprehensive and inclusive strategies for testing, tracing, and massive awareness for sanitary practices, social distancing, and following government regulation for management of COVID-19, besides appropriate food security measures and free provision of sanitary kits for vulnerable section., (© 2020 John Wiley & Sons Ltd.)

Competing Interests: There are no conflicts of interest.

Objective: Several studies have demonstrated a shift in the spectrum of infective endocarditis (IE) in the developed world. We aimed to investigate whether demographic and microbiologic characteristics of IE have changed in India., Design: A retrospective analysis of patients with in north India between 2010 and 2020., Methods: The clinical and laboratory profiles of 199 IE admitted to an academic hospital patients who met the modified Duke criteria for definite IE were analysed., Results: The mean age was 34 years, and 84% were males. The main predisposing conditions were injection drug use (IDU) (n = 71, 35.7%), congenital heart disease (n = 46, 21.6%), rheumatic heart disease (n = 25, 12.5%), and prosthetic device (n = 19, 9.5%). 17.1% of patients developed IE without identified predispositions. Among 64.3% culture-positive cases, the most prevalent causative pathogens were Staphylococcus aureus (46.1%), viridans streptococci (7.0%), enterococci (6.0%), coagulase-negative staphylococci (5.5%), gram negative bacilli (5.5%), polymicrobial (5.5%), and Candida (1.0%). The tricuspid (30.3%), mitral (25.6%), and aortic (21.6%) valves were the most common sites of infection, and 60.3% had large vegetations (>10 mm). Systemic embolization occurred in 55.3% of patients at presentation. Cardiac surgery was required for 13.1%. In-hospital mortality was 17.1% and was associated with prosthetic devices (p-value, 0.001), baseline leucocytosis (p-value, 0.036) or acute kidney injury (p-value, 0.001), and a microbial etiology of gram negative bacilli or enterococci (p-value, 0.005)., Conclusion: IDU is now the most important predisposition for IE in India, and S. aureus has become the leading cause of native valve endocarditis with or without IDU., (Copyright © 2021 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)

Although vaccination represents the most promising way to stop or contain the coronavirus disease 2019 (COVID-19) pandemic and safety and effectiveness of available vaccines were proven, a small number of individuals who received anti-SARS-CoV-2 vaccines developed a prothrombotic syndrome. Vaccine-induced immune thrombotic thrombocytopenia (VITT) can be triggered by the adenoviral vector-based vaccine, whereas lipid nanoparticle-mRNA-based vaccines can induce rare cases of deep vein thrombosis (DVT). Although the main pathogenic mechanisms behind this rare phenomenon have not yet been identified, both host and vaccine factors might be involved, with pathology at least in part being related to the vaccine-triggered autoimmune reaction. In this review, we are considering some aspects related to pathogenesis, major risk factors, as well as peculiarities of diagnosis and treatment of this rare condition., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Competing Interests: There are no conflicts of interest.