Clinico-Radiological-Pathological Correlation of Visual Loss in COVID-Associated Rhino-Orbito-Cerebral Mucormycosis.

PURPOSE: To correlate the clinical, radiological, and histopathological features in Covid-associated Rhino-orbito-cerebral mucormycosis cases presenting with acute visual loss. DESIGN: Cross-sectional study. METHODS: Covid-associated Rhino-orbito-cerebral mucormycosis cases with unilateral visual loss, planned for exenteration, underwent orbital and ophthalmological ocular examination. The available radiological sequences, doppler ultrasonography and histopathology findings were correlated with clinical manifestations. RESULTS: The median age was 51 years and the male: female ratio was 3:1. All except one presented with unilateral ophthalmoplegia. The ocular media were hazy in 2 eyes. In 8 eyes, retinal changes were suggestive of occlusion of CRA (6), combined occlusion of CRA and central retinal vein (1), and myopic degeneration with hypertensive retinopathy (1). The contralateral eye showed retinal ischemic changes in one patient. Radiological imaging showed orbital apex involvement in the 10 affected eyes and one contralateral eye. Ipsilateral cavernous sinus thrombosis, diffusion restriction on MRI of optic nerve, internal carotid artery narrowing/thrombosis, and cortical watershed infarcts were seen in 8, 4, 4, and 2 cases, respectively. The blood flow in CRA and ophthalmic artery was absent or reduced in all the 10 affected eyes and in 1 contralateral eye. On histopathology, orbital fat necrosis, fungal hyphae, acute inflammation, granuloma formation, ischemic thrombosis of ophthalmic artery was observed in 10 specimens. CRA was patent in 9 and thrombosed in 1 eye. Optic nerve was ischemic in 8 and viable in 2 eyes. CONCLUSION: Acute visual loss in ROCM cases is associated with orbital apex involvement and thrombotic ischemia of ophthalmic artery. Cessation of flow in CRA possibly occurs secondary to ophthalmic artery thrombosis.

Genome-wide identification and characterization of NBS-encoding genes in Raphanus sativus L. and their roles related to Fusarium oxysporum resistance.

BACKGROUND: The nucleotide-binding site-leucine-rich repeat (NBS-LRR) genes are important for plant development and disease resistance. Although genome-wide studies of NBS-encoding genes have been performed in several species, the evolution, structure, expression, and function of these genes remain unknown in radish (Raphanus sativus L.). A recently released draft R. sativus L. reference genome has facilitated the genome-wide identification and characterization of NBS-encoding genes in radish. RESULTS: A total of 225 NBS-encoding genes were identified in the radish genome based on the essential NB-ARC domain through HMM search and Pfam database, with 202 mapped onto nine chromosomes and the remaining 23 localized on different scaffolds. According to a gene structure analysis, we identified 99 NBS-LRR-type genes and 126 partial NBS-encoding genes. Additionally, 80 and 19 genes respectively encoded an N-terminal Toll/interleukin-like domain and a coiled-coil domain. Furthermore, 72% of the 202 NBS-encoding genes were grouped in 48 clusters distributed in 24 crucifer blocks on chromosomes. The U block on chromosomes R02, R04, and R08 had the most NBS-encoding genes (48), followed by the R (24), D (23), E (23), and F (17) blocks. These clusters were mostly homogeneous, containing NBS-encoding genes derived from a recent common ancestor. Tandem (15 events) and segmental (20 events) duplications were revealed in the NBS family. Comparative evolutionary analyses of orthologous genes among Arabidopsis thaliana, Brassica rapa, and Brassica oleracea reflected the importance of the NBS-LRR gene family during evolution. Moreover, examinations of cis-elements identified 70 major elements involved in responses to methyl jasmonate, abscisic acid, auxin, and salicylic acid. According to RNA-seq expression analyses, 75 NBS-encoding genes contributed to the resistance of radish to Fusarium wilt. A quantitative real-time PCR analysis revealed that RsTNL03 (Rs093020) and RsTNL09 (Rs042580) expression positively regulates radish resistance to Fusarium oxysporum, in contrast to the negative regulatory role for RsTNL06 (Rs053740). CONCLUSIONS: The NBS-encoding gene structures, tandem and segmental duplications, synteny, and expression profiles in radish were elucidated for the first time and compared with those of other Brassicaceae family members (A. thaliana, B. oleracea, and B. rapa) to clarify the evolution of the NBS gene family. These results may be useful for functionally characterizing NBS-encoding genes in radish.

Genome-Wide Identification, Evolution, and Comparative Analysis of B-Box Genes in Brassica rapa, B. oleracea, and B. napus and Their Expression Profiling in B. rapa in Response to Multiple Hormones and Abiotic Stresses.

The B-box zinc-finger transcription factors are important for plant growth, development, and various physiological processes such as photomorphogenesis, light signaling, and flowering, as well as for several biotic and abiotic stress responses. However, there is relatively little information available regarding Brassica B-box genes and their expression. In this study, we identified 51, 52, and 101 non-redundant genes encoding B-box proteins in Brassica rapa (BrBBX genes), B. oleracea (BoBBX genes), and B. napus (BnBBX genes), respectively. A whole-genome identification, characterization, and evolutionary analysis (synteny and orthology) of the B-box gene families in the diploid species B. rapa (A genome) and B. oleracea (C genome) and in the allotetraploid species B. napus (AC genome) revealed segmental duplications were the major contributors to the expansion of the BrassicaBBX gene families. The BrassicaBBX genes were classified into five subgroups according to phylogenetic relationships, gene structures, and conserved domains. Light-responsive cis-regulatory elements were detected in many of the BBX gene promoters. Additionally, BrBBX expression profiles in different tissues and in response to various abiotic stresses (heat, cold, salt, and drought) or hormones (abscisic acid, methyl jasmonate, and gibberellic acid) were analyzed by qRT-PCR. The data indicated that many B-box genes (e.g., BrBBX13, BrBBX15, and BrBBX17) may contribute to plant development and growth as well as abiotic stress tolerance. Overall, the identified BBX genes may be useful as functional genetic markers for multiple stress responses and plant developmental processes.

Integrating Omics and Gene Editing Tools for Rapid Improvement of Traditional Food Plants for Diversified and Sustainable Food Security.

Indigenous communities across the globe, especially in rural areas, consume locally available plants known as Traditional Food Plants (TFPs) for their nutritional and health-related needs. Recent research shows that many TFPs are highly nutritious as they contain health beneficial metabolites, vitamins, mineral elements and other nutrients. Excessive reliance on the mainstream staple crops has its own disadvantages. Traditional food plants are nowadays considered important crops of the future and can act as supplementary foods for the burgeoning global population. They can also act as emergency foods in situations such as COVID-19 and in times of other pandemics. The current situation necessitates locally available alternative nutritious TFPs for sustainable food production. To increase the cultivation or improve the traits in TFPs, it is essential to understand the molecular basis of the genes that regulate some important traits such as nutritional components and resilience to biotic and abiotic stresses. The integrated use of modern omics and gene editing technologies provide great opportunities to better understand the genetic and molecular basis of superior nutrient content, climate-resilient traits and adaptation to local agroclimatic zones. Recently, realizing the importance and benefits of TFPs, scientists have shown interest in the prospection and sequencing of TFPs for their improvements, cultivation and mainstreaming. Integrated omics such as genomics, transcriptomics, proteomics, metabolomics and ionomics are successfully used in plants and have provided a comprehensive understanding of gene-protein-metabolite networks. Combined use of omics and editing tools has led to successful editing of beneficial traits in several TFPs. This suggests that there is ample scope for improvement of TFPs for sustainable food production. In this article, we highlight the importance, scope and progress towards improvement of TFPs for valuable traits by integrated use of omics and gene editing techniques.

Red Chinese Cabbage Transcriptome Analysis Reveals Structural Genes and Multiple Transcription Factors Regulating Reddish Purple Color.

Reddish purple Chinese cabbage (RPCC) is a popular variety of Brassica rapa (AA = 20). It is rich in anthocyanins, which have many health benefits. We detected novel anthocyanins including cyanidin 3-(feruloyl) diglucoside-5-(malonoyl) glucoside and pelargonidin 3-(caffeoyl) diglucoside-5-(malonoyl) glucoside in RPCC. Analyses of transcriptome data revealed 32,395 genes including 3345 differentially expressed genes (DEGs) between 3-week-old RPCC and green Chinese cabbage (GCC). The DEGs included 218 transcription factor (TF) genes and some functionally uncharacterized genes. Sixty DEGs identified from the transcriptome data were analyzed in 3-, 6- and 9-week old seedlings by RT-qPCR, and 35 of them had higher transcript levels in RPCC than in GCC. We detected cis-regulatory motifs of MYB, bHLH, WRKY, bZIP and AP2/ERF TFs in anthocyanin biosynthetic gene promoters. A network analysis revealed that MYB75, MYB90, and MYBL2 strongly interact with anthocyanin biosynthetic genes. Our results show that the late biosynthesis genes BrDFR, BrLDOX, BrUF3GT, BrUGT75c1-1, Br5MAT, BrAT-1, BrAT-2, BrTT19-1, and BrTT19-2 and the regulatory MYB genes BrMYB90, BrMYB75, and BrMYBL2-1 are highly expressed in RPCC, indicative of their important roles in anthocyanin biosynthesis, modification, and accumulation. Finally, we propose a model anthocyanin biosynthesis pathway that includes the unique anthocyanin pigments and genes specific to RPCC.

Numerical study of natural convection within a wavy enclosure using meshfree approach: effect of corner heating.

This paper presents a numerical study of natural convection within a wavy enclosure heated via corner heating. The considered enclosure is a square enclosure with left wavy side wall. The vertical wavy wall of the enclosure and both of the corner heaters are maintained at constant temperature, T c and T h , respectively, with T h > T c while the remaining horizontal, bottom, top and side walls are insulated. A penalty element-free Galerkin approach with reduced gauss integration scheme for penalty terms is used to solve momentum and energy equations over the complex domain with wide range of parameters, namely, Rayleigh number (Ra), Prandtl number (Pr), and range of heaters in the x- and y-direction. Numerical results are represented in terms of isotherms, streamlines, and Nusselt number. It is observed that the rate of heat transfer depends to a great extent on the Rayleigh number, Prandtl number, length of the corner heaters and the shape of the heat transfer surface. The consistent performance of the adopted numerical procedure is verified by comparison of the results obtained through the present meshless technique with those existing in the literature.

Comparative evaluation of dacryocystorhinostomy with retrograde intubation and conjunctivo-dacryocystorhinostomy.

OBJECTIVE: To compare the surgical outcomes of dacryocystorhinostomy with retrograde intubation and conjunctivo-dacryocystorhinostomy for the management of proximal mid-bicanalicular lacrimal obstruction. DESIGN: Randomized, controlled trial. METHODS: The study was conducted in 50 eyes of 50 adult patients with bicanalicular obstruction ≤ 6 mm from the punctum. The etiology, duration of symptoms, and Munk scores were recorded. Group A underwent dacryocystorhinostomy with retrograde intubation, and in group B, conjunctivo-dacryocystorhinostomy was performed. Success was defined as anatomic patency on syringing, a negative fluorescein dye disappearance test, and a Munk score < 2 twelve months postoperatively. RESULTS: There were 23 males and 27 females, 18-66 years of age, with a 6-month to 20-year duration of epiphora. The etiologies were idiopathic, trauma, and allergic conjunctivitis and ocular surface inflammation. In group A, the pseudopunctum was located medial to the diagnosed level of canalicular block by 1.28 ± 0.54 mm and 1.04 ± 0.88 mm in upper and lower canaliculi, respectively. Four post-traumatic cases required intervention following closure of the pseudopunctum, all being located ≥ 7 mm from the true punctum (p = 0.001). The complication rate was higher in group B than in group A (p = 0.001). At 12 months, the success rate was 100% in group A and 88% in group B (22 of 25; p = 0.74), with reduction in Munk scores from preoperative levels in both groups (p = 0.001). CONCLUSION: Dacryocystorhinostomy with retrograde intubation and conjunctivo-dacryocystorhinostomy have comparable success rates in the management of proximal mid-bicanalicular obstructions. Dacryocystorhinostomy with retrograde intubation has lower complication rates and does not require long-term maintenance of the bypass tube, unlike conjunctivo-dacryocystorhinostomy.

Alterations in retrobulbar haemodynamics in thyroid eye disease.

PURPOSE: To study the orbital perfusion parameters of ophthalmic artery (OA) and central retinal artery (CRA) in inactive TED and the changes following surgical decompression. METHODS: Non-randomised clinical trial. 24 inactive moderate-to-severe TED orbits of 24 euthyroid cases underwent surgical decompression and examined again at 3 months. The peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of OA and CRA were evaluated using colour doppler imaging and normative database was established using 18 healthy controls. RESULTS: The mean age was 39.38 ± 12.56 years and male: female ratio was 1: 1.18. Intraocular pressure was higher, and CRA-PSV, CRA-RI, OA-PSV, and OA-EDV were lower in TED in comparison to heathy orbits. The CRA-PSV, CRA-EDV, OA-PSV, and OA-EDV negatively correlated with proptosis and duration of thyroid disease. The area under curve of OA-PSV (95% CI:0.964-1.000, p < 0.001) and OA-EDV (95% CI:0.699-0.905, p < 0.001) helped in differentiating TED orbits from HC, and in predicting the severity of disease. Post decompression, CRA-PSV, CRA-EDV, OA-PSV, and OA-EDV improved, with decrease in CRA-RI and OA-RI in both lipogenic and MO. CONCLUSIONS: The orbital perfusion is reduced in inactive TED. The changes in OA flow velocities can help in differentiating inactive TED from healthy orbits and progression of TED. Sequential orbital CDI of OA and CRA can serve as an objective tool for case selection and monitoring response to surgical decompression.

Duplication of the gallbladder: Case report of a rare biliary malformation.

Duplication of the gall bladder is a rare anatomic variation. The incidence is approximately 1 in 4000 in literature. Preoperative identification of such anomaly and its various types is very important since it can avoid damage to possible vascular and biliary aberrant anatomy during surgery. My case is a 29-year-old male patient with a complaint of epigastric pain which was on and off type. An abdominal ultrasonogram showed multiple calculi in the gallbladder lumen with normal wall thickness and no evidence of intra or extra-hepatic biliary tree dilatation. Another cystic structure was noted adjacent to it with no intraluminal pathology. Magnetic resonance cholangiopancreatography revealed the duplication of the gallbladder and a common cystic duct for both the cavities draining into a common hepatic duct. Multiple filling defects were noted within one of the cavities. The patient was discharged and advised to follow-up. Two months later the patient presented with an episode of acute cholecystitis which was managed by laparoscopic cholecystectomy. Preoperative radiological identification of this anatomic variation helps in planning the surgery accordingly and can prevent perioperative complications.

End Stage Renal Disease among Patients Undergoing Haemodialysis at a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Chronic kidney disease is defined as structural or functional damage of the kidney persisting for three or more months. Studies have shown hypertension and diabetes as the leading causes of chronic kidney disease. The aim of this study is to find out the prevalence of end-stage renal disease patients undergoing haemodialysis in a tertiary care hospital. Methods: This was a descriptive cross-sectional study conducted among 96 patients undergoing haemodialysis from February 13, 2021 to April 4, 2021 in the hemodialysis unit of a tertiary care centre after receiving ethical clearance from the Institutional Review Committee (Reference number: 354). Convenience sampling was done and all patients older than 18 years who were on maintenance haemodialysis on an outpatient basis were included in the study. Data were collected using a self-administered questionnaire. Data were analysed using the Statistical Package for the Social Science version 22.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data and mean with standard deviation for continuous data. Results: Among 96 patients undergoing haemodialysis, the prevalence of end-stage renal disease was 83 (86.45%) (79.60-93.30 at 95% Confidence Interval). The most common underlying condition was hypertensive nephropathy in 34 (40.96%) patients, followed by both hypertensive and diabetic nephropathy in 26 (31.33%) patients. Conclusions: The prevalence of end-stage renal disease in our study was higher when compared to similar studies conducted in similar settings. Early diagnosis and adequate treatment of hypertension and diabetes could be crucial to reducing the prevalence of the end-stage renal disease. Keywords: chronic kidney failure; chronic renal insufficiency; end stage renal disease; hemodialysis; Nepal.

Transethnic analysis of psoriasis susceptibility in South Asians and Europeans enhances fine-mapping in the MHC and genomewide.

Because transethnic analysis may facilitate prioritization of causal genetic variants, we performed a genomewide association study (GWAS) of psoriasis in South Asians (SAS), consisting of 2,590 cases and 1,720 controls. Comparison with our existing European-origin (EUR) GWAS showed that effect sizes of known psoriasis signals were highly correlated in SAS and EUR (Spearman ρ = 0.78; p < 2 × 10-14). Transethnic meta-analysis identified two non-MHC psoriasis loci (1p36.22 and 1q24.2) not previously identified in EUR, which may have regulatory roles. For these two loci, the transethnic GWAS provided higher genetic resolution and reduced the number of potential causal variants compared to using the EUR sample alone. We then explored multiple strategies to develop reference panels for accurately imputing MHC genotypes in both SAS and EUR populations and conducted a fine-mapping of MHC psoriasis associations in SAS and the largest such effort for EUR. HLA-C*06 was the top-ranking MHC locus in both populations but was even more prominent in SAS based on odds ratio, disease liability, model fit and predictive power. Transethnic modeling also substantially boosted the probability that the HLA-C*06 protein variant is causal. Secondary MHC signals included coding variants of HLA-C and HLA-B, but also potential regulatory variants of these two genes as well as HLA-A and several HLA class II genes, with effects on both chromatin accessibility and gene expression. This study highlights the shared genetic basis of psoriasis in SAS and EUR populations and the value of transethnic meta-analysis for discovery and fine-mapping of susceptibility loci.

Role of intrastromal vancomycin in recalcitrant corneal abscess after phacoemulsification.

Side port infection and corneal abscess after cataract surgery can produce devastating outcomes. Topical antibacterial drugs are the mainstay in management of these cases. Although intrastromal antifungal agents are an established modality for fungal keratitis, such use of antibacterial agents is rarely reported due to better pharmacokinetic profile of antibacterial agents.We report a case of methicillin-resistant Staphylococcus aureus corneal abscess following phacoemulsification that responded to intrastromal vancomycin injection in addition to conventional therapy.This case of postphacoemulsification corneal abscess highlights the importance of postoperative hygiene practices, use of anterior segment optical coherence tomography for monitoring these patients and use of intrastromal vancomycin as an adjunct to topical and systemic therapy.

The relationship between pelvic organ prolapse and short birth intervals in a rural area of Nepal.

BACKGROUND: Pelvic organ prolapse (POP) is one of the main contributors to reproductive health problems that affect women's quality of life. Previous studies have reported the risk factors and prevalence of POP. The aim of this study is to examine the association between POP and short birth intervals in a rural area of Nepal. METHODS: A cross-sectional study was conducted in Panchapuri municipality, located in Surkhet District of Karnali Province in Nepal. A questionnaire was used to collect information on POP, birth intervals, and other known confounding factors, such as age and parity. Multiple logistic regression analysis was used to examine the association between minimum birth intervals and POP. RESULTS: The study recruited 131 women. The prevalence of POP was 29.8%. The mean (SD) of maternal age was 32.3 (0.7) years. The median parity was 2, with a range of 2-6 children. More than half (64.9%) of the women reported a minimum birth interval of less than 2 years. Maternal age at birth, minimum birth interval, parity, and latest birth interval were significantly associated with POP in univariate analyses. After adjusting for the potential confounding factors such as age and occupation, the minimum birth interval was significantly associated with POP [AOR = 3.08, 95% CI 1.04-9.19]. CONCLUSION: The prevalence of POP was high in this rural area of Nepal. Age, parity, occupation, and minimum birth interval were significantly associated with POP.

Overexpression of EcDREB2A transcription factor from finger millet in tobacco enhances tolerance to heat stress through ROS scavenging.

An extreme temperature regime beyond desired level imposes significant stress in crop plants. The low and high temperature stresses are one of the primary constraints for plant development and yield. Finger millet, being a climate resilient crop, is a potential source of novel stress tolerant genes. In this study, functional characterization of finger millet DREB2A gene in different abiotic stress conditions was done. This novel EcDREB2A transcription factor isolated from finger millet is a truncated version of DREB2A gene compared to previously reported DREB genes from other plant species. The overexpression of EcDREB2A in transgenic tobacco exhibits improved tolerance against heat stress 42 °C for up to 7 days, by altering physiology and biochemical means. However, same transgenic lines were unable to provide tolerance to 200 mM NaCl and 200 mM Mannitol stress. Under heat stress conditions, increased seed germination with improved lateral roots, fresh and dry weight relative to wild type (WT) was observed. The EcDREB2A transgenics exposed to heat stress showed improved rate of stomatal conductance, chlorophyll and carotenoids contents, and other photosynthesis parameters compared to WT plants. EcDREB2A overexpression also resulted in increased antioxidant enzyme activity (SOD, CAT, GR, POD and, APX) with decreased electrolyte leakage (EL), H2O2, and malondialdehyde (MDA) content than WT plants under heat stress. Quantitative real time expression analysis demonstrated that all eight downstream genes were significantly upregulated in transgenic plants only after heat stress. Our data provide a clear demonstration of the positive impact of overexpression of EcDREB2A providing heat stress tolerance to plants.

Clinical Presentation and Management Strategies in Intraorbital Foreign Bodies.

The authors present a retrospective, observational case study of seven patients, who presented with retained Intra-Orbital Foreign Bodies (IOrbFBs) following penetrating orbital injury at a tertiary eye hospital over a period of one year. Cases were reviewed for epidemiological features, mechanism of injury, nature of foreign body, clinical features, imaging modality, associated complications, management outcomes, and the final prognosis. The mean age of presentation was 27.43 years. Amongst the seven patients, two were children (aged <10 years). The male : female ratio was 4 : 3. Of the seven retained IOrbFBs, two were plastic, two wooden, and three metallic in nature (one gunshot injury, one ball projectile (commonly referred to as BB) injury, and one with knife). Two out of seven had no light perception at presentation. The periocular location of the foreign bodies was inferior in 4 cases and medial in 3 cases. Computed Tomography scan confirmed the diagnosis in five cases and Magnetic Resonance Imaging (MRI) was diagnostic in one. Surgical intervention was done in five cases, and two cases were managed conservatively. The authors conclude that favourable outcome can be achieved even without surgical removal in cases of inert metallic/inorganic IOrbFBs. The properties of plastic FBs can frequently render them invisible on imaging, or they may mimic chronic inflammatory conditions like tuberculosis. Long-standing wooden IOrbFBs evade identification radiologically due to prolonged hydration. The ultimate choice of intervention must be individualised, weighing the risks of retention against the risk of iatrogenic damage.

Optimizing nutrient use efficiency, productivity, energetics, and economics of red cabbage following mineral fertilization and biopriming with compatible rhizosphere microbes.

Conventional agricultural practices and rising energy crisis create a question about the sustainability of the present-day food production system. Nutrient exhaustive crops can have a severe impact on native soil fertility by causing nutrient mining. In this backdrop, we conducted a comprehensive assessment of bio-priming intervention in red cabbage production considering nutrient uptake, the annual change in soil fertility, nutrient use efficiency, energy budgeting, and economic benefits for its sustainable intensification, among resource-poor farmers of Middle Gangetic Plains. The compatible microbial agents used in the study include Trichoderma harzianum, Pseudomonas fluorescens, and Bacillus subtilis. Field assays (2016-2017 and 2017-2018) of the present study revealed supplementing 75% of recommended NPK fertilizer with dual inoculation of T. harzianum and P. fluorescens increased macronutrient uptake (N, P, and K), root length, heading percentage, head diameter, head weight, and the total weight of red cabbage along with a positive annual change in soil organic carbon. Maximum positive annual change in available N and available P was recorded under 75% RDF + P. fluorescens + B. subtilis and 75% RDF + T. harzianum + B. subtilis, respectively. Bio-primed plants were also higher in terms of growth and nutrient use efficiency (agronomic efficiency, physiological efficiency, apparent recovery efficiency, partial factor productivity). Energy output (26,370 and 26,630 MJ ha-1), energy balance (13,643 and 13,903 MJ ha-1), maximum gross return (US $ 16,030 and 13,877 ha-1), and net return (US $ 15,966 and 13,813 ha-1) were considerably higher in T. harzianum, and P. fluorescens treated plants. The results suggest the significance of the bio-priming approach under existing integrated nutrient management strategies and the role of dual inoculations in producing synergistic effects on plant growth and maintaining the soil, food, and energy nexus.

Rhino-Orbito-Cerebral-Mucormycosis During the COVID-19 Second Wave in 2021 - A Preliminary Report from a Single Hospital.

PURPOSE: To list the clinico-epidemiological profile and possible risk factors of COVID-19 associated rhino-orbital-cerebral mucormycosis (CA-ROCM) patients presenting to a COVID dedicated hospital during the second wave of COVID-19 in India. PATIENTS AND METHODS: A cross-sectional, single-center study was done on 60 cases of probable CA-ROCM based on clinical features and supportive diagnostic nasal endoscopic findings and/or radiologic findings. Patients with recent or active COVID-19 were included. The demographic profile, clinical features, possible risk factors and diagnostic workup (microbiological, pathological and radiological) were analysed to identify the triggering factors for CA-ROCM. RESULTS: The age of patients ranged from 29 to 75 years and male-female ratio was 3:1. The duration between the first positive COVID report and onset of CA-ROCM was 0 to 47 days. Forty-nine (81.66%) patients had a recent COVID infection and 11 (18.33%) had active COVID infection at presentation. Thirty-five patients (58%) had ocular/orbital involvement at presentation. In the affected eye, 10 had no perception of light and in the rest visual acuity ranged from log MAR 0 to +1.5. Ocular manifestations were ptosis (29), ophthalmoplegia (23), periocular tenderness and edema (33), proptosis (14), black discoloration of eyelids (3), facial palsy (3), endophthalmitis (4), retinal artery occlusion (8), disc edema (4) and disc pallor (5). Twenty-two (25%) patients had neither received steroids nor oxygen. Thirty patients (50%) were managed with oxygen while 38 patients (63.3%) with systemic steroids. The most common risk factor was diabetes in 59 patients. The average glycosylated hemoglobin (HbA1c) was 10.31 ± 2.59%. Systemic Amphotericin B was started in all the patients. Radical surgical debridement was performed in 12 patients and the remaining were planned. CONCLUSION: SARS-CoV-2 variant with accompanying glycaemic dysregulation was found to be the triggering factor for the epidemic of CA-ROCM.

Role of Chromohysteroscopy in Evaluation of Endometrial Pathology Using Methylene Blue Dye.

BACKGROUND: Chromohysteroscopy is expected to help in diagnosing subtle endometrial pathologies which could be missed on conventional hysteroscopy and also help in targeting biopsy from endometrium. OBJECTIVE: To study staining pattern of endometrium in patients undergoing chromohysteroscopy and to evaluate and compare the histopathology of chromohysteroscopy-guided endometrial biopsy with conventional endometrial sampling. METHOD: This was a cross-sectional study conducted during the period of 18 months in Department of Obstetrics and Gynaecology, ESI PGIMSR, New Delhi, India, from September 2016 to February 2018. Totally, 60 women with complaints of infertility, failed intrauterine insemination (IUI), recurrent spontaneous abortions (RSA), heavy menstrual bleeding (HMB), intermenstrual bleeding (IMB) and postmenopausal bleeding (PMB) meeting inclusion criteria were evaluated and enrolled in the study. In patients with normal looking endometrium on hysteroscopy, methylene blue dye was administered through the hysteroscopic inlet. Tissue samples were obtained from stained areas followed by blind endometrial sampling immediately. The results of chromohysteroscopy-guided biopsy from light- and dark-blue-stained areas and blind biopsy were compared. RESULTS: Mean age of the study group was 37 years, with mean BMI of 24 kg/m2. There were 24 cases of HMB, 9 of IMB, 7 of PMB, 15 of infertility, 2 of failed IUI and 3 with RSA. On chromohysteroscopy, 39(65%) cases showed light-stained endometrium (group I) and 21(35%) showed dark-stained endometrium (group II). Comparison was done between histopathology obtained through chromohysteroscopy and blind endometrial sampling. The diagnostic accuracy of chromohysteroscopy-guided endometrial biopsy in evaluation of endometrial pathology was 86.67% with sensitivity of 91.67%, specificity of 85.41%, PPV of 61.12% and NPV of 97.61% (P <0.001). CONCLUSION: Chromohysteroscopy was able to detect endometrial pathology which was missed on conventional hysteroscopy and detected more cases of endometrial pathology than blind endometrial sampling.

The membrane tethered transcription factor EcbZIP17 from finger millet promotes plant growth and enhances tolerance to abiotic stresses.

The occurrence of various stresses, as the outcome of global climate change, results in the yield losses of crop plants. Prospecting of genes in stress tolerant plant species may help to protect and improve their agronomic performance. Finger millet (Eleusine coracana L.) is a valuable source of superior genes and alleles for stress tolerance. In this study, we isolated a novel endoplasmic reticulum (ER) membrane tethered bZIP transcription factor from finger millet, EcbZIP17. Transgenic tobacco plants overexpressing this gene showed better vegetative growth and seed yield compared with wild type (WT) plants under optimal growth conditions and confirmed upregulation of brassinosteroid signalling genes. Under various abiotic stresses, such as 250 mM NaCl, 10% PEG6000, 400 mM mannitol, water withdrawal, and heat stress, the transgenic plants showed higher germination rate, biomass, primary and secondary root formation, and recovery rate, compared with WT plants. The transgenic plants exposed to an ER stress inducer resulted in greater leaf diameter and plant height as well as higher expression of the ER stress-responsive genes BiP, PDIL, and CRT1. Overall, our results indicated that EcbZIP17 improves plant growth at optimal conditions through brassinosteroid signalling and provide tolerance to various environmental stresses via ER signalling pathways.

Isolation and expression analysis of EcbZIP17 from different finger millet genotypes shows conserved nature of the gene.

Basic leucine zipper (bZIP) transcription factors comprise one of the largest gene families in plants. They play a key role in almost every aspect of plant growth and development and also in biotic and abiotic stress tolerance. In this study, we report isolation and characterization of EcbZIP17, a group B bZIP transcription factor from a climate smart cereal, finger millet (Eleusine coracana L.). The genomic sequence of EcbZIP17 is 2662 bp long encompassing two exons and one intron with ORF of 1722 bp and peptide length of 573 aa. This gene is homologous to AtbZIP17 (Arabidopsis), ZmbZIP17 (maize) and OsbZIP60 (rice) which play a key role in endoplasmic reticulum (ER) stress pathway. In silico analysis confirmed the presence of basic leucine zipper (bZIP) and transmembrane (TM) domains in the EcbZIP17 protein. Allele mining of this gene in 16 different genotypes by Sanger sequencing revealed no variation in nucleotide sequence, including the 618 bp long intron. Expression analysis of EcbZIP17 under heat stress exhibited similar pattern of expression in all the genotypes across time intervals with highest upregulation after 4 h. The present study established the conserved nature of EcbZIP17 at nucleotide and expression level.