A cross-sectional study of the mental health burden among COVID-19 survivors.

Introduction: Coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on mental health, including stress, anxiety, and depression. This study aimed to assess the incidence and severity of mental health issues among individuals diagnosed with COVID-19 infection. Methods: A semi-structured proforma for socio-demographic and clinical parameters was used to collect cross-sectional hospital-based data of subjects who tested positive for COVID-19 infection. The Modified Fatigue Impact Scale (MFIS), Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS) were used to assess the presence of physical, psychological, and cognitive symptoms. The presence of anxiety, depression, and stress was based on the cut-off scores for HADS-A (≥8), HADS-D (≥8), and PSS (≥14), respectively. Results: A total of 101 patients comprising 39 (38.6%) males were recruited. Compared to nuclear families, we observed that patients living in joint families had significantly greater severity scores for fatigue [MFIS (p = 0.04)], anxiety [HADS-A (p = 0.004)], depression [HADS-D (p = 0.004)], and stress [PSS (p = 0.02)]. Based on the cut-off scores, we found that 44 (43.6%) patient had anxiety, 41 (40.6%) had depressive, and 72 (71.3%) had moderate to high stress symptoms, respectively. We also observed significantly greater fatigue and anxiety scores, that is, MFIS (p = 0.008) and HADS-A (p = 0.03) in those who received oxygen therapy compared to those who did not. The subjects who received corticosteroids were older (p = 0.01) and had significantly higher stress scores [PSS (p < 0.001)]. The study showed that patients who were assessed more than 3 months post-COVID-19 infection had higher fatigue and depression scores; however, the difference did not reach statistical significance (MFIS P = 0.058; HADS P = 0.059). Conclusion: Our study confirms that COVID-19 infection can cause various adverse mental health issues. Mitigating the hazardous effects of COVID-19 pandemic on mental health should be a top priority for public health to prevent long-term complications.

A Community-Based Pancreatic Cancer Screening Study in High-Risk Individuals: Preliminary Efficacy and Safety Results.

INTRODUCTION: Pancreatic cancer (PC) screening recommendations have been based on studies performed solely at high-volume academic centers. To make PC screening more widely available, community-based efforts are essential. We implemented a prospective PC screening study in the community of Fairfield County, CT, and report our early safety and efficacy results. METHODS: Eligible individuals were enrolled into an investigator-initiated study and underwent a baseline and 3 annual magnetic resonance imagings/magnetic resonance cholangiopancreatographies (MRIs/MRCPs) with gadolinium, biannual blood donations for biobanking, and assessments for anxiety and depression. All MRIs were presented at a multidisciplinary board to determine whether further investigation was warranted. RESULTS: Seventy-five individuals have been enrolled and 201 MRIs performed over a 2.6-year average length of follow-up. Abnormal pancreatic findings (predominantly small cysts) were detected in 58.7% of the participants. Among these, 6.7% underwent endoscopic ultrasound, with 1 case complicated by postprocedural pancreatitis. One surgical resection was performed on a 4.7-cm intraductal papillary mucinous neoplasm with a focus on low-grade pancreatic intraepithelial neoplasia. One incidental finding of fibrosing mediastinitis was detected. Anxiety and depression scores decreased over the course of this study from 21.4% to 5.4% and 10.7% to 3.6%, respectively. DISCUSSION: This preliminary report supports the feasibility of performing MRI/magnetic resonance cholangiopancreatographies-based PC screening as part of a clinical trial in a community setting. A longer follow-up is needed to better assess safety and efficacy. To the best of our knowledge, this is the first report from a community-based PC screening effort ( clinicaltrials.gov ID: NCT03250078).

A review on Arthrobacter sp. lipase: A versatile biocatalyst for the kinetic resolution to access enantiomerically pure/enriched compounds.

Over the last few years, there has been a dramatic increase in the number of reports related to Arthrobacter sp. lipase (ABL:MTCC No. 5125) catalyzed kinetic resolution performed in biphasic media. A strain displaying esterase/lipase activity and designated as ABL was isolated, during the course of a screening program at Indian Institute of Integrative Medicine, Jammu. Considerable research has shown that reactions catalyzed by ABL are more selective than many commercial lipases. Since new applications of this lipase are emerging, there is a great need to provide all the relevant information exclusively. This review article is an attempt to cover all the relevant reports based on isolation, purification, immobilization, and application of ABL in the biopharmaceutical sector.

Quality of life in patients of corrosive esophageal stricture treated with endoscopic dilatation.

BACKGROUND AND AIM: Caustic ingestion is associated with long-term sequelae in the form of esophageal and/or gastric cicatrization requiring endoscopic or surgical intervention. Quality of life (QoL) and disability in patients with caustic-induced sequelae is less explored. METHODS: In this prospective study, we included consecutive patients with symptomatic caustic-induced esophageal stricture undergoing endoscopic dilatation. QoL was measured using the World Health Organization Quality of Life questionnaire (WHOQoL-BREF). Disability was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Subjective dysphagia score was calculated by Likert scale. RESULTS: A total of 42 patients were included in the study; 25 (59.5%) patients were male. Patients had poor WHOQoL-BREF and WHODAS scores compared to normality data in all domains of the scores among both the genders. A majority (66.7%) of patients had a current psychiatric diagnosis, with the most common being mood disorder (50%) followed by suicidality (45.2%). Males had a higher prevalence of a previous psychiatric diagnosis compared to females, while females had a higher prevalence of suicidality. Dysphagia score had strong correlation with the WHOQoL (r = -0.66; P < 0.01) and WHODAS (r = 0.71; P < 0.01). CONCLUSION: Patients with esophageal stricture due to caustic ingestion on long-term endoscopic dilatation have poor QoL, high prevalence of psychological morbidity, and disability.

Recognizing intrapancreatic accessory spleen via EUS: Interobserver variability.

BACKGROUND AND OBJECTIVE: Accessory spleen (AS) may be encountered as an intrapancreatic lesion on EUS. This can look similar to other pancreatic pathologies and may lead to unnecessary interventions. The goal of this study was to evaluate the accuracy of EUS in distinguishing intrapancreatic AS (IPAS) from other pancreatic lesions. MATERIALS AND METHODS: Twelve sets of endoscopic images of the spleen and various pancreatic lesions confirmed on histology or cytology were gathered. Ten endosonographers were asked to characterize and identify the lesions. The responses were analyzed via Excel and the interobserver agreement was analyzed using Gwet's agreement coefficient statistic via Stata I/C v15. RESULTS: In our sample, the interobserver agreement was 0.37 (-+1-1; 0-0.2 poor, 0.2-0.4 fair, 0.4-0.6 moderate, 0.6-0.8 substantial, and 0.8-1.0 almost perfect) for determining whether or not the pancreatic lesion is IPAS. The reviewers were able to correctly determine IPAS endosonographically with a sensitivity of 77%, specificity of 74%, and positive and negative predictive values of 50% and 92%, respectively. CONCLUSION: There is a moderate-to-substantial interobserver agreement in describing the sonographic characteristics of the pancreatic lesions, such as the shape, echogenicity compared to spleen, echotexture, and border of the lesions. However, the interobserver agreement is only fair when deciding if the pancreatic lesion is an IPAS. The similar profile of IPAS and pancreatic neuroendocrine tumor could confound the diagnosis of IPAS, thus contributing to the decreased interobserver agreement. This study demonstrates that EUS criteria alone are not accurate for IPAS diagnosis. Fine-needle aspiration (FNA) may be required for a confirmatory diagnosis.

Aerococcus Viridans: A Rare Pathogen Causing Urinary Tract Infection.

Aerococci are Gram-positive cocci with colony morphology similar to viridans streptococci. Most often these isolates in clinical samples are misidentified and considered insignificant. However, with the use newer techniques like Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass-Spectrometry (MALDI-TOF MS), aerococci have been recognized as significant human pathogens capable of causing a diverse spectrum of infections. Among the different species of aerococci, Aerococcus urinae is the most common agent causing Urinary Tract Infection (UTI) followed by A. sanguinocola. Aerococcus viridans (A. viridans) have been reported rarely in urinary tract infections. The antimicrobial resistance in aerococci in terms of its intrinsic resistance and evolving resistance to penicillin and vancomycin has raised the concern for better understanding of this pathogen. We recently encountered two cases of nosocomial UTI caused by A. viridans which are being reported here.

Psilostachyin, acetylated pseudoguaianolides and their analogues: preparation and evaluation of their anti-inflammatory potential.

Naturally occurring acetylated pseudoguaianolides and psilostachyin including their analogues were synthesized. The structure of semi-synthetic psilostachyin was also confirmed by X-ray crystallography. The anti-inflammatory potential of all the derivatives has been evaluated through in vitro expression of TNF-α, IL-1ß and IL-6 in murine neutrophils.

Entrapment and kinetic resolution of stabilized axial and equatorial conformers of spiro-ß-lactams.

The facile synthesis of the stabilized axial and equatorial conformers of spiro-ß-lactams was achieved via entrapment of cyclohexanone imines (Schiff bases) with acetoxyacetyl chloride in a [2 + 2]-cycloaddition reaction followed by their kinetic resolution. The immobilization of the racemic substrates on an inert solid support significantly reduced the reaction time and improved the enantioselectivity of conformers during kinetic resolution. The mechanism of the formation of the spiro-ß-lactams was explored using B3LYP/6-31+G* level quantum chemical calculations.

Admission hyperglycemia and length of hospital stay in patients with diabetes and heart failure: a prospective cohort study.

The authors assessed the relationship between glycemia and length of hospital stay (LOS) in a prospective cohort study of patients with diabetes mellitus and heart failure (HF). Of 212 patients with acute HF exacerbation, 119 (56%) also had diabetes. The mean age of the cohort was 63+/-0.87 years, and the mean body mass index was 29.3 kg/m2. Diabetic patients had significantly longer LOS compared with the nondiabetics (5.0+/-0.29 vs 3.4+/-0.19; P<.001). In patients with diabetes, the mean glycated hemoglobin A1c was 8.3%, admission blood glucose (BG) was 169+/-7.7 mg/dL, and average BG was 196+/-8.1 mg/dL. After adjusting for age, sex, weight, hypertension, renal function, and anemia, LOS was significantly correlated with admission BG (r=0.31; P<.001) and average BG (r=0.34; P=.001). In patients with acute HF exacerbation, diabetes significantly prolonged LOS. Hyperglycemia correlated with LOS.