Baseline findings of a multicentric ambispective cohort study (2021-2022) among hospitalised mucormycosis patients in India.

In India, the incidence of mucormycosis reached high levels during 2021-2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March-July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent, trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire. At baseline, we recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness or swelling of the face were the commonest symptoms (73.3%). Liposomal Amphotericin B was the commonest drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9% but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high. This cohort study could enhance our understanding of the disease's clinical progression and help frame standard treatment guidelines.

Effect of Needling at Selected Acupuncture Points (GB39, BL17, LR13) on Hemoglobin Levels in Anemia: a Randomized Placebo Controlled Study.

Iron deficiency anemia (IDA) is an important public health issue in India. This study was performed to determine the impact of acupuncture at the GB39, BL17, and LR13 points on hemoglobin levels, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW) in people with IDA. One hundred women with IDA were randomly allocated to the acupuncture group (AG) or placebo control group (PCG). For 30 minutes per day, daily for 2 weeks, the AG received acupuncture at GB39, BL17, and LR13, while the PCG received needling at non-acupuncture points. Outcomes were assessed before and after the intervention. We found a significant increase (p < 0.001) in hemoglobin level (AG 10.39-11.38 g/dl, effect size 0.785; PCG 10.58-10.40 g/dl, effect size 0.191), MCH (AG 25.69-27.50 fl, effect size 0.418; PCG 27.43-27.23 fl, effect size 0.058), and RDW (AG 15.12-16.41 fl, effect size 0.626; PCG 14.91-14.94 fl, effect size 0.017) in the AG compared to the PCG. Results suggest that needling at the GB39, BL17, and LR13 acupuncture points is more effective in treating people with IDA than needling at non-acupuncture points.

A user-friendly web portal for analyzing conformational changes in structures of Mycobacterium tuberculosis.

Initiation of the Tuberculosis Structural Consortium has resulted in the expansion of the Mycobacterium tuberculosis (MTB) protein structural database. Currently, 969 experimentally solved structures are available for 354 MTB proteins. This includes multiple crystal structures for a given protein under different functional conditions, such as the presence of different ligands or mutations. In depth analysis of the multiple structures reveal that subtle differences exist in conformations of a given protein under varied conditions. Therefore, it is immensely important to understand the conformational differences between the multiple structures of a given protein in order to select the most suitable structure for molecular docking and structure-based drug designing. Here, we introduce a web portal ( http://bmi.icmr.org.in/mtbsd/torsion.php ) that we developed to provide comparative data on the ensemble of available structures of MTB proteins, such as Cα root means square deviation (RMSD), sequence identity, presence of mutations and torsion angles. Additionally, torsion angles were used to perform principal component analysis (PCA) to identify the conformational differences between the structures. Additionally, we present a few case studies to demonstrate this database. Graphical Abstract Conformational changes seen in the structures of the enoyl-ACP reductase protein encoded by the Mycobacterial gene inhA.