Search

Introduction: Muscle fatigue is often experienced by athletes and in work settings. Excessive fatigue can lead to injury and musculoskeletal disorders. Surface electromyography (EMG) is typically used to detect and ultimately prevent fatigue during isometric movement. The application of EMG to fatigue detection in dynamic movement requires, however, a secondary confirmation of fatigue based on physiological measures. Our objective was to determine if muscle oxygenation derived via near-infrared spectroscopy (NIRS) was correlated with relevant EMG indicators of neuromuscular fatigue and whether observed correlations were related to the fatigue process. Methods: Bilateral electromyograms from three upper leg muscles and the tissue oxygenation index (TOI) of the vastus lateralis muscle were recorded in sixteen non-disabled individuals during cycle ergometry to volitional exhaustion. Six EMG activity features were extracted and the Pearson correlation coefficient between each feature and TOI was determined. Results: The EMG root mean square, spectral standard deviation, second spectral moment, and zero-crossing rate (ZC) were strongly correlated with TOI. The time course of ZC and the correlation of this feature with TOI suggest that there could be a relation between muscle oxygenation and fatigue. Conclusion: Future work should use the knowledge gained in this study to investigate whether NIRS can be used to verify the onset of fatigue as detected by EMG.

The Compressed Baryonic Matter (CBM) experiment is one of the major scientific pillars of the Facility for Antiproton and Ion Research (FAIR). The physics programme of CBM is centred around the exploration of the QCD phase diagram and nuclear matter equation-of-state in the region of high baryon densities. The respective rare probes will be accessed by using nucleus-nucleus collisions in the energy range √sNN = 2.9 - 4.9 GeV at peak interaction rates of up to 10 MHz and a trigger-less data acquisition scheme. This article reviews CBM physics goals with the experimental observables. The progress and current status of the comprising detector sub-systems, including their performance in FAIR Phase-0 experiments will also be presented.

Image segmentation is a common use case of image processing. It enables a wide variety of activities, from self-driving cars to traffic systems that are capable of governing them. Most state of the art models like Mask R-CNN and other transformer-based models perform well but have very high inference times. Therefore in this paper, a novel model architecture is proposed that can run on consumer grade hardware while giving near real time image segmentation. This is done by creating masks on regions of interest proposed by a lightweight object detection algorithm that is the YOLOv4. Such an algorithm allows for image segmentation in near-real time for resource constrained environments as compared to other state of the art models that have high inference times are unsuitable for deployment in said environments.

The CBM experiment at the Facility for Antiproton and Ion Research (FAIR) aims to explore the QCD phase diagram in the region of high net-baryon densities using nucleus-nucleus collisions ($\sqrt{s_{NN}}$ = 2.9 - 4.9 GeV). CBM will be utilizing peak interaction rates of up to 10 MHz and an advanced triggerless data acquisition scheme to provide it with an unique access to rare physics probes required to accomplish CBM's physics goals. This contribution will summarise CBM's progress in terms of its physics performance simulations and the status of the comprising detector sub-systems, including their involvement in FAIR Phase-0 activities., Comment: 6 pages, 4 figures, Quark Matter 2022, submitted to Acta Physica Polonica B

The COVID-19 pandemic is a global health crisis that poses a great challenge to the public health system of affected countries. Safe and effective vaccines are needed to overcome this crisis. Here, we develop and assess the protective efficacy and immunogenicity of an inactivated SARS-CoV-2 vaccine in rhesus macaques. Twenty macaques were divided into four groups of five animals each. One group was administered a placebo, while three groups were immunized with three different vaccine candidates of BBV152 at 0 and 14 days. All the macaques were challenged with SARS-CoV-2 fourteen days after the second dose. The protective response was observed with increasing SARS-CoV-2 specific IgG and neutralizing antibody titers from 3rd-week post-immunization. Viral clearance was observed from bronchoalveolar lavage fluid, nasal swab, throat swab and lung tissues at 7 days post-infection in the vaccinated groups. No evidence of pneumonia was observed by histopathological examination in vaccinated groups, unlike the placebo group which exhibited interstitial pneumonia and localization of viral antigen in the alveolar epithelium and macrophages by immunohistochemistry. This vaccine candidate BBV152 has completed Phase I/II (NCT04471519) clinical trials in India and is presently in phase III, data of this study substantiates the immunogenicity and protective efficacy of the vaccine candidates., SARS-CoV-2 vaccines are needed to fight the pandemic. Here, authors show protective efficacy and immunogenicity of the inactivated SARS-CoV-2 vaccine BBV152 in rhesus macaques. This vaccine is currently in clinical development.

Vaccines remain the key protective measure to achieve herd immunity to control the disease burden and stop COVID-19 pandemic. We have developed and assessed the immunogenicity and protective efficacy of two formulations (1mg and 2mg) of ZyCoV-D (a plasmid DNA based vaccine candidates) administered through Needle Free Injection System (NFIS) and syringe-needle (intradermal) in rhesus macaques with three dose vaccine regimens. The vaccine candidate 2mg dose administered using Needle Free Injection System (NFIS) elicited a significant immune response with development of SARS-CoV-2 S1 spike region specific IgG and neutralizing antibody (NAb) titers during the immunization phase and significant enhancement in the levels after the virus challenge. In 2 mg NFIS group the IgG and NAb titers were maintained and showed gradual rise during the immunization period (15 weeks) and till 2 weeks after the virus challenge. It also conferred better protection to macaques evident by the viral clearance from nasal swab, throat swab and bronchoalveolar lavage fluid specimens in comparison with macaques from other immunized groups. In contrast, the animals from placebo group developed high levels of viremia and lung disease following the virus challenge. Besides this, the vaccine candidate also induced increase lymphocyte proliferation and cytokines response (IL-6, IL-5).The administration of the vaccine candidate with NFIS generated a better immunogenicity response in comparison to syringe-needle (intradermal route). The study demonstrated immunogenicity and protective efficacy of the vaccine candidate, ZyCoV-D in rhesus macaques.

The COVID-19 pandemic is a global health crisis that has severely affected mankind and posed a great challenge to the public health system of affected countries. The availability of a safe and effective vaccine is the need of the hour to overcome this crisis. Here, we have developed and assessed the protective efficacy and immunogenicity of an inactivated SARS-CoV-2 vaccine (BBV152) in rhesus macaques (Macaca mulata). Twenty macaques were divided into four groups of five animals each. One group was administered a placebo while three groups were immunized with three different vaccine candidates at 0 and 14 days. All the macaques were challenged with SARS-CoV-2 fourteen days after the second dose. The protective response was observed with increasing SARS-CoV-2 specific IgG and neutralizing antibody titers from 3rd-week post-immunization. Viral clearance was observed from bronchoalveolar lavage fluid, nasal swab, throat swab, and lung tissues at 7 days post-infection in the vaccinated groups. No evidence of pneumonia was observed by histopathological examination in vaccinated groups, unlike the placebo group which showed features of interstitial pneumonia and localization of viral antigen in the alveolar epithelium and macrophages by immunohistochemistry. Data from this study substantiate the immunogenicity of the vaccine candidates and BBV152 is being evaluated in Phase I clinical trials in India (NCT04471519).

Aim: The objective was to do a comparative study and to evaluate the outcome in overall acceptance for correction of residual facial deformity with autogenous graft versus porous polyethylene implants. Materials and Methods: A total of 16 patients in the age group of ≥15 years irrespective of sex, caste, religion, and socioeconomic status presenting with signs and symptoms of residual facial deformities and who were declared fit for surgery were included in the study. The study patients were further divided into two groups, of eight each. Deformity correction using autogenous grafts was performed in Group A and using high-density polyethylene (HDPE) alloplastic implants was performed in Group B. During the follow-up period, patients' and doctor rating of overall acceptance between autogenous and alloplastic (HDPE) bone grafts was recorded on 100-mm visual analog scale (VAS) on the 2nd day and 7th day and at 3, 6, and 12 weeks. Results: The unpaired t-test is used for evaluation. VAS score at all the follow-up periods above stated was significantly higher in alloplastic group than in the autogenous group for both in patients and doctor evaluation. Conclusion: From the present study, it can be concluded that porous HDPE implants are an effective alternative to autogenous grafts in accordance of overall acceptance for correction of residual facial deformity when proper case selection, exclusion of negative prognostic factors, and meticulous surgical procedure are followed.

Aspergillus species cause a wide spectrum of clinical infections. Although Aspergillus fumigatus and Aspergillus flavus remain the most commonly isolated species in aspergillosis, in the last decade, rare and cryptic Aspergillus species have emerged in diverse clinical settings. The present study analyzed the distribution and in vitro antifungal susceptibility profiles of rare Aspergillus species in clinical samples from patients with suspected aspergillosis in 8 medical centers in India. Further, a matrix-assisted laser desorption ionization–time of flight mass spectrometry in-house database was developed to identify these clinically relevant Aspergillus species. β-Tubulin and calmodulin gene sequencing identified 45 rare Aspergillus isolates to the species level, except for a solitary isolate. They included 23 less common Aspergillus species belonging to 12 sections, mainly in Circumdati , Nidulantes , Flavi , Terrei , Versicolores , Aspergillus , and Nigri . Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) identified only 8 (38%) of the 23 rare Aspergillus isolates to the species level. Following the creation of an in-house database with the remaining 14 species not available in the Bruker database, the MALDI-TOF MS identification rate increased to 95%. Overall, high MICs of ≥2 μg/ml were noted for amphotericin B in 29% of the rare Aspergillus species, followed by voriconazole in 20% and isavuconazole in 7%, whereas MICs of >0.5 μg/ml for posaconazole were observed in 15% of the isolates. Regarding the clinical diagnoses in 45 patients with positive rare Aspergillus species cultures, 19 (42%) were regarded to represent colonization. In the remaining 26 patients, rare Aspergillus species were the etiologic agent of invasive, chronic, and allergic bronchopulmonary aspergillosis, allergic fungal rhinosinusitis, keratitis, and mycetoma.

Background: Systemic steroids are the cornerstone of therapy in allergic bronchopulmonary aspergillosis(ABPA) but are associated with adverse effects. Itraconazole(ITZ) is proposed as an effective yet safer alternative. Aims: To evaluate the effectiveness of ITZ in comparison to systemic steroids in the management of ABPA. Methods: ABPA patients diagnosed between 2010-16 were administered oral ITZ or deflazacort(DFZ) and were followed every 3 months with serial total and specific IgE antibodies, chest x-ray; symptom control, time to remission, exacerbations and time to exacerbations were noted. Results: 172 patients were enrolled, 45 received ITZ(group A) and 106 received DFZ(group B). Both groups were homogenous with regards to their baseline characteristics (P 0.9999) achieved remissions and at a similar time (7.7±0.7 vs 7.5±0.4months respectively;P=0.77). Also, an equal number exacerbated (57.5 vs 51.7% respectively;P=0.57) within 6 months (4.4±0.7 vs 5.7±0.5 respectively;P=0.13) after stopping therapy. However patients in group A suffered more exacerbations (1.2±0.1 vs 1.05±0.03months;P=0.048) subsequently. Conclusions: ITZ and DFZ are equally effective in ABPA when administered for a similar duration to effect a disease remission. While neither drug is superior in preventing or delaying exacerbations of the disease, steroids may have the advantage of producing lesser subsequent exacerbations in comparison to ITZ.

Solena amplexicaulis, commonly called as the creeping cucumber, belongs to the family Cucurbitaceae. Traditional it is used as astringent, appetizer, carminative, cardiotonic, digestive, diuretic, expectorant, invigorating, purgative and stimulant. Plant also having antioxidant antidiabetic and antibacterial action. The leaves showed potent anti-inflammatory activity.The present study was carried out to establish physico-chemical parameters along with preliminary phytochemical screening of petroleum ether, chloroform, methanolic and aqueous extracts of Solena amplexicaulis leaf . Preliminary phytochemical screening of various extracts revealed the presence of carbohydrate, alkaloids, flavonoids, sterols, phenolic & tannins compounds. The physico-chemical parameters such as total, water soluble, acid insoluble and sulphated ash (2.2, 1.9, 1.17 and 1.3%w/w respectively) and loss on drying (10.0 %w/w), extractive values foaming and swelling index were studied. These studies will be helpful in developing standards for quality, purity and sample identification of this plant. Keyword: Standardization, Solena amplexicaulis, physicochemical and phytochemical.

Methods that effectively assess and train dynamic seated balance are critical for enhancing functional independence and reducing risk of secondary health complications in the elderly and individuals with neuromuscular impairments. The objective of this research was to devise and validate a portable tool for assessing and training dynamic seated balance. An instrumented wobble board was designed and constructed that (1) elicits multidirectional perturbations in seated individuals, (2) quantifies seated balance proficiency, and (3) provides real-time, kinematics-based vibrotactile feedback. After performing a technical validation study to compare kinematic wobble board measurements against a gold-standard motion capture system, 15 nondisabled participants performed a dynamic sitting task using the wobble board. Our results demonstrate that the tilt angle measurements were highly accurate throughout the range of wobble board dynamics. Furthermore, the posturographic analyses for the dynamic sitting task revealed that the wobble board can effectively discriminate between the different conditions of perturbed balance, demonstrating its potential to serve as a clinical tool for the assessment and training of seated balance. Vibrotactile feedback decreased the variance of wobble board tilt, demonstrating its potential for use as a balance training tool. Unlike similar instrumented tools, the wobble board is portable, requires no laboratory equipment, and can be adjusted to meet the user's balance abilities. While future work is warranted, obtained findings will aid in effective translation of assessment and training techniques to a clinical setting, which has the potential to enhance the diagnosis and prognosis for individuals with seated balance impairments.

Following balance impairments, effective assessment and training of dynamic sitting balance are critical for enhancing functional independence. The objective of this study was to construct and test an instrumented wobble board that elicits multidirectional perturbations in seated individuals, quantifies balance proficiency, and provides vibrotactile feedback. The wobble board was equipped with an inertial measurement unit, eight vibrating tactors, and a microprocessor. The accuracy of the kinematic measurements was confirmed in a technical validation study. One healthy participant performed an assessment and training task using the wobble board. Future work will evaluate the efficacy of the portable device in assessing and enhancing sensorimotor function during dynamic sitting.

Background: Invasive aspergillosis (IA) is now recognized in immunocompetent patients too with outbreaks known to occur in hospitals during civil work Aims: To identify characteristics and outcomes of patients who developed IA and correlate aerial spore counts and molecular types of Aspergillus isolates with possible role of civil work in nosocomial infection Methods: Patients diagnosed in 2010-16 were enrolled. Clinical data and outcome were noted. Those with nosocomial infection, defined as IA diagnosed 2days after admission served as cases. Annual incidence of IA and spore counts were calculated. Environmental and clinical Aspergillus isolates were characterized by microsatellite typing (STR) to determine possible source of infection Results: IA was observed in 50cases. Civil work was done in 2011,2014-16. Incidence of IA correlated with greater spore counts (r=0.942). COPD was commonest risk factor. None were immunocompromised. Further, 77% of those admitted required ICU care. Cases stayed longer in wards than controls(12.4±9.4vs0.8±0.8days, p=0.000) before diagnosing IA and received therapy later(7.8±7.8vs3.3±3.5days, p=0.011). 64.4% patients succumbed to IA. Both groups were similar in terms of age, sex, risk factors, serology, radiology, treatment outcomes Although no environmental A. Fumigatus isolate shared the same STR type as patient isolates, similar STR types were observed among patients suggesting common source of infection Conclusion: Civil work in augments Aspergillus spore count, increasing the incidence of IA in admitted immunocompetent patients with prolonged fungal exposure. No difference is seen in the natural history of IA with respect to source of infection.

In modern era, with tremendous competition, long working hours and more demanding workstyle, nearly every profession is associated with some or the other health hazards. These may develop and progress rapidly or in a gradual way but ultimately add up unwanted morbidities and in long run affects the production and work output. Unfortunately, doctors and other health professionals who look after the health of society, are not the exceptions to this rule and depending upon their specialty, they have to face some or the other health issues. This article highlights some important though underestimated health issues among radiologists and some remedies. It aims to sensitize radiologists about such health issues so that they can take timely remedial measures before it is really late.

The small airways, once regarded as the silent zone in the air conducting system of the lungs are now known to be one of the initial sites of involvement in diseases like asthma and Chronic Obstructive Pulmonary Disease (COPD). Identification of the involvement of distal airways in these diseases is often difficult to assess, clinically as well as by conventional pulmonary function tests and therefore, usually remains undiscovered in early stages. Early recognition of their involvement in asthma and COPD and timely management may reduce long term morbidity in these conditions. This article aims to highlight the relatively lesser recognized facts about small airways involvement in asthma and COPD and role of imaging and newer modalities for detection.

Item does not contain fulltext Filamentous basidiomycetes (BM) are common environmental fungi that have recently emerged as important human pathogens, inciting a wide array of clinical manifestations that include allergic and invasive diseases. We reviewed 218 reported global cases of BM fungi. The most common etiologic agent was Schizophyllum commune in 52.3% (114/218) of the cases followed by Hormographiella aspergillata (n = 13; 5.9%), Ceriporia lacerata (n = 11; 5%), and, rarely, Volvariella volvacea, Inonotus tropicalis, Irpex lacteus, Phellinus undulates, Perenniporia species, Bjerkandera adusta, Sporotrichum pruinosum, Phanerochaete steroids, and Cyclomyces tabacinus. These fungi are present in the environment as gilled mushrooms, shelf fungi, and bracket fungi. However, in clinical settings, they usually present as nonsporulating white moulds that are difficult to identify. Moreover, the GenBank database of these fungi is limited. Regarding the country-wise distribution of cases, Japan topped the list with about 43% (n = 94) of globally reported cases, followed by India (57; 26%), the United States (4%), Austria (3.2%), Iran (3.2%), France (2.8%), and the remaining one-third from 16 other countries. The respiratory tract was the most commonly afflicted site (n = 71), with the majority of the cases (42; 59.1%) being allergic in etiology and comprising 34 cases of allergic bronchopulmonary mycosis. Also, B. adusta has been implicated in a recently described clinical entity, that is, fungus associated chronic cough, reported exclusively from Japan. BM fungi-incited diseases are currently underdiagnosed due to lack of awareness and expertise, warranting comprehensive epidemiological and susceptibility studies to determine their prevalence and to predict a more appropriate therapy.

Contains fulltext : 137490.pdf (Publisher’s version ) (Closed access) Candida auris is a recently described rare agent of fungemia. It is notable for its antifungal resistance. A total of 15 C. auris isolates, originating from seven cases of fungemia, three cases of diabetic gangrenous foot, and one case of bronchopneumonia from a tertiary care hospital in south India, were investigated. All of the 15 isolates were identified by sequencing and 14 of these along with 12 C. auris isolates previously reported from two hospitals in Delhi, north India, two each from Japan and Korea were genotyped by amplified fragment length polymorphism (AFLP). In vitro antifungal susceptibility testing (AFST) was done by the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. Candida auris isolates were misidentified as Candida haemulonii by VITEK. All were resistant to fluconazole [geometric mean minimum inhibitory concentration (MIC) 64 mug/ml] and 11 isolates were resistant to voriconazole (MIC >/=1 mug/ml). Forty-seven percent of the C. auris isolates were resistant to flucytosine (MIC >/=64 mug/ml) and 40% had high MIC (>/=1 mug/ml) of caspofungin. Breakthrough fungemia developed in 28.6% of patients and therapeutic failure in 4 (66.7%) patients. Interestingly, the 26 Indian C. auris isolates from north and south India were clonal and phenotypically and genotypically distinct from Korean and Japanese isolates. The present study demonstrates that C. auris is a potential emerging pathogen that can cause a wide spectrum of human mycotic infections. The prevalence of a C. auris endemic clonal strain resistant to azoles and other antifungals in Indian hospitals with high rates of therapeutic failure in cases of fungemia is worrisome.

Summary The Ustilaginomycetous basidiomycete yeast, Pseudozyma aphidis has recently been implicated in potentially fatal disorders ranging from subcutaneous mycoses to disseminated infections. Till date a solitary case of P. aphidis fungaemia in a paediatric patient has been reported. We present a case of fungaemia due to P. aphidis in a rhesus factor-isoimmunised, low-birth-weight neonate. The isolate was identified by sequencing the D1/D2 domain of the LSU region. Antifungal susceptibility of the isolate revealed susceptibility to amphotericin B, voriconazole, itraconazole, isavuconazole and posaconazole. It had high minimum inhibitory concentrations of fluconazole and was resistant to flucytosine and echinocandins. Consequently, the patient was successfully treated with intravenous amphotericin B. Although the source of infection could not be traced, as the neonate developed fungaemia on the first day of life, it could possibly be from the maternal urogenital tract or intrahospital transmission. A review of previously published cases revealed that risk factors for invasive Pseudozyma spp. infections were similar to those previously reported for non-albicans Candida spp. Pseudozyma species are underreported due to the difficulty of identifying this rare yeast pathogen by commercial identification systems. Considering that Pseudozyma spp. cause invasive fungal infections globally and are resistant to flucytosine, fluconazole and echinocandins, this pathogen assumes a greater clinical significance.

A new clonal strain of Candida auris is an emerging etiologic agent of fungemia in Delhi, India. In 12 patients in 2 hospitals, it was resistant to fluconazole and genotypically distinct from isolates from South Korea and Japan, as revealed by M13 and amplified fragment length polymorphism typing.

Considering the growing need to identify alternative bio-nutritional sources, wild edible leaves consumed in forest zone of Uttarakhand, India were evaluated for their nutritive value in order to prioritize edible wild plant suitable for domestication. The result showed significance of wild plant species as important source of nutrient for rural poor people. The nutritional value of leaves of wild plant Urtica ardence were evaluated in terms of protein, carbohydrate, fat, fiber content, vitamin content, reducing sugars and minerals. Urtica ardence had a significant level of above nutrients and therefore was identified as promising specie for promotion as backyard planting especially farming systems suffering from crop loss, food shortage and chronic malnutrition.

Schizophyllum commune ( n = 30) showed lowest geometric mean MICs of isavuconazole (0.19 μg/ml), itraconazole (0.2 μg/ml), voriconazole (0.24 μg/ml), and amphotericin B (0.29 μg/ml) and high geometric mean MICs of fluconazole (19.39 μg/ml) and flucytosine (17.28 μg/ml). Five cases (of 8) of allergic bronchopulmonary mycosis that were treated with itraconazole had no recrudescence after 6 to 24 months of follow-up. One case each of invasive pulmonary mycosis and fungal ball were treated successfully with voriconazole and itraconazole.

Nonsporulating molds (NSMs), especially basidiomycetes, have predominantly been reported as human pathogens responsible for allergic and invasive disease. Their conventional identification is problematic, as many isolates remain sterile in culture. Thus, inconclusive culture reports might adversely affect treatment decisions. The clinical significance of NSMs in pulmonary mycoses is poorly understood. We sequenced the internal transcribed spacer (ITS) region and D1/D2 domain of the larger subunit (LSU) of 52 NSMs isolated from respiratory specimens. The basidiomycetes were the predominant NSMs, of which Schizophyllum commune was the most common agent in allergic bronchopulmonary mycosis (ABPM), followed by Ceriporia lacerata in invasive fungal disease. Porostereum spadiceum , Phanaerochaete stereoides , Neosartorya fischeri , and Marasmiellus palmivorus were the other molds observed. Application of ITS and LSU region sequencing identified 92% of the isolates. The antifungal susceptibility data revealed that all basidiomycetes tested were susceptible to amphotericin B and resistant to caspofungin, fluconazole, and flucytosine. Except for 3 isolates of S. commune and a solitary isolate of M. palmivorus , all basidiomycetes had low MICs for itraconazole, posaconazole, and voriconazole. Basidiomycetes were isolated from patients with ABPM, invasive pulmonary mycosis/pneumonia, or fungal balls. In addition, the majority of the basidiomycetes were isolated from patients with chronic respiratory disorders who were sensitized to one of the basidiomycetous fungi and demonstrated precipitating antibodies against the incriminating fungi, indicating an indolent tissue reaction. Thus, isolation of basidiomycetes from the lower respiratory tract could be significant, and it is important to monitor these patients in order to prevent subsequent lung damage.

Background Itraconazole (ITZ) is an alternative to steroids in the treatment of allergic bronchopulmonary aspergillosis (ABPA) but therapeutic drug monitoring (TDM) is warranted due to erratic absorption and early relapse. Aim To correlate serum ITZ levels with clinical outcomes in ABPA. Methods ITZ capsules 400mg/day for 6 months were administered as monotherapy to 30 consecutive patients in stage 4/5 of ABPA between Jan913 to Jun913. High-performance liquid chromatography was done on serum samples collected after 2-4 weeks to measure concentrations of ITZ and its active metabolite hydroxy-ITZ (OHITZ); ITZ levels of >2mg/L were considered adequate. Total and Aspergillus species specific IgE, leucocyte count (TLC), eosinophil count (AEC) and precipitins were recorded before and thereafter. Any relapse was noted till 2 years. Results Mean serum concentration of ITZ and OHITZ was 0.79±0.2 and 1.2±0.3mg/L respectively. Total IgE (9.9±1.4 vs 6.5±1.2×10 3 IU/mL), specific IgE (42.98±3.9 vs 34.1±4.8KUA/L), TLC (10.6±0.6 vs 9.7±0.7×10 3 cells/µL) and AEC (1.0±0.1 vs 0.6±0.09×10 3 cells/µL) reduced significantly. Remission was achieved in 64% but 52% relapsed after 3months. Serum ITZ and OHITZ levels correlated negatively with total IgE, specific IgE, TLC, AEC, relapse and time to relapse but only those between ITZ (r=0.049) and OHITZ (r=0.039) with duration to relapse were significant. Adequacy of ITZ and OHITZ significantly related with remissions(P=0.039). Conclusion ITZ monotherapy is effective in treating ABPA therefore TDM should be routinely undertaken. Adequate serum drug levels imply remissions but do not correlate well with markers of disease severity. Relapse may be prevented by prolonged drug use.

Background: Chronic pulmonary aspergillosis (CPA) is still under-diagnosed in high tuberculosis (TB) burden areas like India where similar clinical presentation and disregard for underlying risk factors lead to its misdiagnosis as the latter. Aim: To evaluate patient characteristics and treatment outcomes in CPA patients Methods: Consecutive patients with a differential diagnosis of CPA enrolled from Jan. 2012-Dec. 2013 were administered oral itraconazole (ITZ) or voriconazole. Weight, BMI, haemoglobin (Hb), total leucocyte count (TLC), specific IgG, precipitins, CRP, sputum fungus and radiology were followed till 2 years after the end of treatment. Negative specific IgG was taken as end-point of therapy. Results: CPA was diagnosed in 24(70.5%) patients including 10 CCPA, 9 CNPA, 3 CFPA and 2 simple aspergilloma. Mean age was 47.2±10.9years. Average 2.1 risk factors were present per patient; TB was the commonest risk factor (29.3%) but ABPA, sarcoidosis and diabetes mellitus were significantly associated with development of CPA. Cavitation was noted in 29% and aspergilloma in 12%. Specific IgG and serum precipitins were raised in 79% and CRP 92%. A. fumigatus was isolated in 80%. Both drugs exerted similar but significant improvements in weight (51.8±7 vs 56.3±8 Kg), BMI (18.7±3.1 vs 20.3±3.0 Kg/m 2 ), Hb (11.3±1.9 vs 12.3±1.7 g/dL), TLC (10.2±3.1 vs 7.9±2.6×10 3 /µL), precipitins and specific IgG (69.1; 26.5-84.2 vs 29.6; 0-39.3 MgA/L). Two cases on ITZ relapsed at 12 months; no deaths were reported. Conclusions: CPA should be investigated in patients with multiple risk factors. Triazole antifungals are effective in treatment. Specific IgG titers can be used to assess disease activity and response to treatment.

Aspergillus is a large genus of saprophytic fungi which are present everywhere in the environment. However, in persons with underlying weakened immune response this innocent bystander can cause fatal illness if timely diagnosis and management is not done. Chest infection is the most common infection caused by Aspergillus in human beings. Radiological investigations particularly Computed Tomography (CT) provides the easiest, rapid and decision making information where tissue diagnosis and culture may be difficult and time-consuming. This article explores the crucial role of CT and offers a bird's eye view of all the radiological patterns encountered in pulmonary aspergillosis viewed in the context of the immune derangement associated with it.

Several high energy physics and neutrino physics experiments worldwide require large-size RPCs to cover wide acceptances. The muon tracking systems in the Iron calorimeter (ICAL) experiment in the India based Neutrino Observatory (INO), India and the near detector in Deep Underground Neutrino Experiment (DUNE) at Fermilab are two such examples. A single gap bakelite RPC of dimension 240 cm × 120 cm, with gas gap of 0.2 cm, has been built and tested at Variable Energy Cyclotron Centre, Kolkata, using indigenous materials procured from the local market. No additional lubricant, like oil has been used on the electrode surfaces for smoothening. The chamber is in operation for > 365 days. We have tested the chamber for its long term operation. The leakage current, bulk resistivity, efficiency, noise rate and time resolution of the chamber have been found to be quite stable during the testing peroid. It has shown an efficiency > 95% with an average time resolution of ~ 0.83 ns at the point of measurement at ~ 8700 V throughout the testing period. Details of the long term performance of the chamber have been discussed.

Respiratory tract infections are globally responsible for one-third of infectious disease–associated mortality, accounting for 4.3 million annual deaths. Among these, fungal infections of the respiratory tract are largely unrecognized, and the true burden is elusive [1]. Despite treatment, most invasive fungal infections are associated with high mortality rates of >50% [2]. In general, fungal infections of the respiratory tract are considered synonymous with invasive pulmonary infections caused by Aspergillus spp. and in some centers by Mucorales. However, over the last decade, a number of uncommon filamentous fungi, such as Scedosporium, Fusarium, Penicillium, melanized moulds, and basidiomycetes, have emerged as etiological agents of well-characterized respiratory disorders. It is therefore that the term “respiratory mycosis” has now broadened to include not just invasive disease but also lesser-recognized entities such as fungal ball, severe asthma with fungal sensitization (SAFS), fungus-associated chronic cough (FACC), allergic bronchopulmonary mycosis (ABPM), and allergic fungal rhinosinusitis (AFRS) [3–6]. Notably, both FACC and SAFS have recently been recognized as distinct clinical entities [7,8]. The former manifests as chronic intractable cough in response to pharyngeal colonization by filamentous basidiomycetes, which has been associated with allergic sensitization [7]. The latter, on the other hand, is a reference to poorly controlled asthma, despite optimal management, with evidence of fungal sensitization (short of being labelled ABPM) [6]. Aspergillus spp. are considered to be the major culprit of SAFS, although a range of other fungi, such as Alternaria and Cladosporium spp., are also involved [8]. Both conditions respond favourably to oral antifungal agents, thereby proving a definite role of fungi [9,10]. Moreover, new pathophysiological associations hitherto unknown, such as fungal sensitization and ABPM in patients with chronic obstructive pulmonary disease (COPD), are unfolding [11,12]. Further, emergence of resistance in filamentous fungi to azole antifungal drugs used as mainstay of therapy is another challenging scenario witnessed in the last two decades. This emerging problem is primarily attributed to the widespread usage of azole fungicides in the environment for agricultural and material preservation practices [13]. Here, we aim to provide an overview of the ever-expanding spectrum of human respiratory mycoses and the fungi involved, excluding Aspergillus and Mucorales.

We report Schizophyllum commune as the aetiological agent of one case each of allergic broncho-pulmonary mycosis (ABPM) and pulmonary fungal ball, and present a literature review. The fungus was characterised by clamp connections, hyphal spicules, and formation of basidiocarps with basidiospores. The phenotypic identification was confirmed by sequencing of the ITS region. To-date, ABPM and pulmonary fungal ball to S. commune have been reported exclusively from Japan and North America respectively. Of the 71 globally reported cases due to S. commune, 45 (63%) were bronchopulmonary, 22 (31%) sinusitis and 4 extrapulmonary. Taken together, cases of bronchopulmonary disease and sinusitis numbered 67 (94%), indicating the respiratory tract as the primary target of disease. Concerning the country-wise distribution, Japan topped the list with 33 cases (46%), followed by Iran - 7 cases (10%), U.S.A. - 6 cases (9%), and a lower prevalence of 1.4-6% for the remaining 12 countries. The preponderance of the disease in Japan may be attributed to its greater awareness vis-a-vis that in other countries rather than to any geographical/climatic factors. We believe that the burden of S. commune-incited disease is currently underestimated, warranting comprehensive prospective studies to determine its prevalence.

Item does not contain fulltext A rare case of allergic bronchopulmonary mycosis (ABPM), caused by Alternaria alternata, is reported in an immunocompetent resident of Delhi. Her complaints included a generalized, urticarial skin rash and occasional pain in the right lower chest. Her differential count showed eosinophils, 22%; absolute eosinophil count (AEC), 2400 cells/mul; and total IgE, 4007 IU/ml. The computerised tomogram (CT) scan of her thorax showed an enhancing lesion with surrounding ground glass haziness in the right lower lobe. Histopathologic examination of the resected lung revealed a necrotizing granulomatous inflammation, parenchymal infiltration by eosinophils, lymphocytes, neutrophils, plasma cells and some exudative bronchiolitis suggestive of ABPM. Observation of KOH wet mounts of repeat sputum and BAL samples demonstrated the presence of septate, brownish hyphae and cultures of these specimens yielded A. alternata (identified by sequencing of the ITS region). Her serum showed a three-fold higher specific IgE to A. alternata antigens than control levels, and the type I cutaneous hypersensitivity response to antigens of A. alternata was strongly positive. She was treated successfully with oral glucocorticoids and itraconazole. To our knowledge, ABPM due to Alternaria alternata has not been reported previously. 01 november 2012

Ceratocystis adiposa known as phytopathogen of conifers has not been recognized so far as a human pathogen. Herein, we report for the first time a case of allergic fungal rhinosinusitis due to C. adiposa. The fungus was identified by sequencing internal transcribed spacer of rDNA and D1/D2 of larger subunit region.

The influence of various polymers on the release rate of Diclofenac Sodium from enteric coated tablets was investigated in an attempt to formulate a delayed release solid dosage forms. Prepared the conventional diclofenac sodium tablets by wet granulation method (non-aqueous) using granulating fluid (isopropyl alcohol). Developed the aqueous coating formula using shacryl and non-aqueous coating formula using HPMCP and optimized the best aqueous coating formula. Coating was performed in a mini coating pan at 107 rpm using low-pressure air atomized liquid spray techniques. Comparative dissolution, disintegration and antiulcer studies were performed on the best products and marketed products. The Comparative antiulcer studies were performed on wister albino rats using conventional, dummy and enteric-coated tablets.

Resistive Plate Chamber (RPC) is a type of gaseous detector having excellent time and position resolutions. VECC is involved in the R&D of indigenously developed bakelite RPCs. The largest size of bakelite RPC developed in India is \(100\,{\text {cm}} \times 100\,{\text {cm}}\). We present here the test results of a bakelite sample along with the cosmic ray test results of a bakelite RPC (\(30\,{\text {cm}} \times 30\,{\text {cm}} \times 0.2\,{\text {cm}}\)) fabricated at VECC. The steps taken towards the development of a large size (\(240\,{\text {cm}} \times 120\,{\text {cm}} \times 0.2\,{\text {cm}}\)) bakelite RPC have also been discussed.

A large (240 cm $\times$ 120 cm $\times$ 0.2 cm) oil-free High Pressure Laminate (HPL), commonly referred as "bakelite", Resistive Plate Chamber (RPC) has been developed at VECC-Kolkata using locally available P-302 OLTC grade HPL. The chamber has been operated in streamer mode using Argon, Freon(R134a) and Iso-butane in a ratio of 34:57:9 by volume. The electrodes and glue samples have been characterised by measuring their electrical parameters like bulk resistivity and surface resistivity. The performance of the chamber has been studied by measuring the efficiency, its uniformity and stability in detection of cosmic muons. Timing measurement has been performed at a central location of the chamber. The chamber showed an efficiency $>$95$\%$ and time resolution ($\sigma$), at the point of measurement, $\sim$0.83 ns at 9000V. Details of the material characterisation, fabrication procedure and performance studies have been discussed., Comment: Accepted for publication in JINST

Atopic patients with chronic obstructive pulmonary disease (COPD) demonstrate more severe symptoms than their non-atopic counterparts. Also, Aspergillus hypersensitivity is known in COPD. However, allergic sensitisation to non-Aspergillus fungi has never been studied in COPD patients. To evaluate the prevalence of fungal sensitisation and its impact on the clinical presentation and outcome of COPD patients. Sensitisation to 17 fungi was studied in 55 COPD patients through skin prick tests, fungus-specific IgE, precipitating antibodies, total IgE and eosinophil counts. The clinical symptoms of patients were monitored thorough a patient-administered questionnaire. Overall, 5.4% (n = 3) of COPD patients were fungus sensitive. The sensitisation was noted to Alternaria alternata and Schizophyllum commune in two patients each, whereas another was sensitive to A. tamarii, Rhizopus spp. and Aspergillus fumigatus. Eosinophils were higher in fungus-sensitised patients (P = 0.001 vs. 0.003). No differences were noted in the clinical presentation of patients sensitised to fungi compared to those not sensitised to fungi or non-atopic. Although low, fungal sensitisation occurs in COPD but it is not limited to Aspergilli alone. Fungus-sensitised patients exhibit greater eosinophilia, implying more severe inflammation. Thus, such patients should be followed up regularly to recognise clinical worsening or development of ABPM.

Purpose Diagnosis of extrapulmonary tuberculosis (EPTB) poses serious challenges. A careful selection of appropriate gene targets is essential for designing a multiplex-polymerase chain reaction (M-PCR) assay. Materials and methods We compared several gene targets of Mycobacterium tuberculosis, including IS6110, devR, and genes encoding MPB-64 (mpb64), 38kDa (pstS1), 65kDa (hsp65), 30kDa (fbpB), ESAT-6 (esat6), and CFP-10 (cfp10) proteins, using PCR assays on 105 EPTB specimens. From these data, we chose the two best gene targets to design an M-PCR. Results Among all gene targets tested, mpb64 showed the highest sensitivity (84% in confirmed cases and 77.5% in clinically suspected cases), followed by IS6110, hsp65, 38kDa, 30kDa, esat6, cfp10, and devR. We used mpb64+IS6110 for designing an M-PCR assay. Our M-PCR assay demonstrated a high sensitivity of 96% in confirmed EPTB cases and 88.75% in clinically suspected EPTB cases with a high specificity of 100%, taking clinical diagnosis as the gold standard. Conclusion These M-PCR results along with the clinical findings may facilitate an early diagnosis of EPTB patients and clinical management of disease.

Penicillium species are ubiquitously present in the environment and are usually considered as laboratory contaminants or non-pathogenic. Among Penicillium species Penicillium marneffei is the only dimorphic member, which is an established agent of invasive mycoses in immunocompromised and immunocompetent patients [1, 2]. However, invasive fungal infections due to Penicillium species other than P marneffei such as Penicillium chrysogenum [3, 4], Penicillium citrinum [5], Penicillium decumbens [3, 6], Penicillium piceum [7, 8], Penicillium commune [9], and Penicillium purpurogenum [3] have also been rarely reported. The reduced susceptibility of these species to voriconazole, which is often the first-line therapy for invasive mold infections, is particularly worrisome [10, 11]. In this study, we report 3 rare cases of opportunistic fungal infection caused by voriconazole-resistant Penicillium oxalicum in patients with acute myeloid leukemia (AML), diabetes mellitus (DM), and chronic obstructive pulmonary disease (COPD), while on voriconazole therapy for 3–6 weeks.