Phthiriasis palpebrarum masquerading as blepharitis.

Pthiriasis palpebrarum, a rare condition caused by Phthirus pubis, can mimic blepharitis and manifest as intense itching, inflammation and eyelid redness. We describe a case of Pthiriasis palpebrarum in a young girl with right upper eyelid discomfort. A slit lamp examination revealed eggs on her eyelashes and adult lice on the eyelids' surface. Dermatology consultation confirmed the diagnosis and successful treatment followed. Family evaluation uncovered genital Phthiriasis pubis in her parents, who received appropriate treatment. This report emphasises the importance of accurate diagnosis and management of this masquerading condition by careful slit lamp and microscopic evaluation. It also highlights the significance of comprehensive family history and examination.

Design, synthesis and in vitro evaluation of novel thiazole-coumarin hybrids as selective and potent human carbonic anhydrase IX and XII inhibitors.

The coumarin is one of the most promising classes of non-classical carbonic anhydrase (CA, EC 4.2.1.1) inhibitors. In continuation of our ongoing work on search of coumarin based selective carbonic anhydrase inhibitors, a new series of 6-aminocoumarin based 16 novel analogues of coumarin incorporating thiazole (4a-p) have been synthesized and studied for their hCA inhibitory activity against a panel of human carbonic anhydrases (hCAs). Most of these newly synthesized compounds exhibited interesting inhibition constants in the nanomolar range. Among the tested compounds, the compounds 4f having 4-methoxy substitution exhibited activity at 90.9 nM against hCA XII isoform. It is noteworthy to see that all compounds were specifically and selectively active against isoforms hCA IX and hCA XII, with Ki under 1000 nM range. It is anticipated that these newly synthesized coumarin-thiazole hybrids (4a-p) may emerge as potential leads candidates against hCA IX and hCA XII as selective inhibitors compared to hCA I and hCA II.

Design, synthesis, and biological evaluation of 3-benzenesulfonamide-linked 3-hydrazinoisatin derivatives as carbonic anhydrase inhibitors.

A new series of isatin-linked benzenesulfonamide derivatives (9a-w) were synthesized using the tail approach and assayed for their inhibitory potency against four different human carbonic anhydrase (hCA) isoforms, hCA I, II, IX, and XII. Most of these synthesized compounds exhibited interesting inhibition potency against isoforms hCA I, IX, and XII in the nanomolar range and by taking the standard drug acetazolamide. The most potent compounds in the case of hCA I were 9c (435.8 nM) and 9s (956.4 nM), for hCA IX, 9a (60.5 nM), 9d (95.6 nM), 9g (92.1 nM), and 9k (75.4 nM), and for hCA XII, 9p (84.5 nM). However, these compounds showed more selectivity toward hCA IX over hCA I, II, and XII. Thus, these compounds can be further developed as potential lead molecules for the development of isoform-selective hCA IX inhibitors with further structural modifications.

Evaluation of Pertussis Disease in Young Infants in India: A Hospital-Based Multicentric Observational Study.

OBJECTIVES: To evaluate the incidence of laboratory-confirmed pertussis (LCP) among infants hospitalized with acute respiratory infections (ARIs) and meeting the Centers for Disease Control and Prevention (CDC)-recommended clinical case definition. METHODS: An investigator-initiated active surveillance for clinically suspected cases (CSCs) of pertussis screened infants aged ≤6 mo hospitalized with ARIs during January 2020-April 2022 at seven centers across India. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect Bordetella pertussis in nasopharyngeal swabs. Infants were classified as having 'LCP' or 'probable pertussis' (PP). RESULTS: Among 1102 screened infants, 400 participants met the CDC-2020 clinical case definition for pertussis. Of these, 34/400 (8.5%) had LCP and 46/400 (11.5%) had PP. The proportion of participants with LCP and PP was similar among infants aged 0-3 and 4-6 mo [LCP: 0-3 mo, 21/248 (~9%); 4-6 mo, 13/152 (~9%); PP: 0-3 mo, 30/248 (~12%); 4-6 mo, 16/152 (~11%)]. Cough illness lasted ≥2 wk in 3/34 (~9%) and 34/46 (~74%) participants with LCP and PP, respectively. Notably, 80% CSCs had neither LCP nor PP, and a respiratory pathogen apart from B. pertussis was detected in ~32%. Ventilation was required in 12 participants with LCP/PP. CONCLUSIONS: In this first study from India based on revised CDC guidelines, the incidence of LCP was 8.5%; cough illness was not a predominant feature. Infants below the age appropriate for vaccination are prone to pertussis-related hospital admissions, ICU care, and ventilation. Maternal immunization may be evaluated for neonatal protection, in addition to other strategies, to decrease disease burden in this highly vulnerable group. CLINICAL TRIAL REGISTRATION NUMBER: CTRI/2019/12/022449.

Describing the monthly variability of hospital-onset Clostridioides difficile during early coronavirus disease 2019 (COVID-19) using electronic health record data.

OBJECTIVE: To assess the relative risk of hospital-onset Clostridioides difficile (HO-CDI) during each month of the early coronavirus disease 2019 (COVID-19) pandemic and to compare it with historical expectation based on patient characteristics. DESIGN: This study used a retrospective cohort design. We collected secondary data from the institution's electronic health record (EHR). SETTING: The Ohio State University Wexner Medical Center, Ohio, a large tertiary healthcare system in the Midwest. PATIENTS OR PARTICIPANTS: All adult patients admitted to the inpatient setting between January 2018 and May 2021 were eligible for the study. Prisoners, children, individuals presenting with Clostridioides difficile on admission, and patients with <4 days of inpatient stay were excluded from the study. RESULTS: After controlling for patient characteristics, the observed numbers of HO-CDI cases were not significantly different than expected. However, during 3 months of the pandemic period, the observed numbers of cases were significantly different from what would be expected based on patient characteristics. Of these 3 months, 2 months had more cases than expected and 1 month had fewer. CONCLUSIONS: Variations in HO-CDI incidence seemed to trend with COVID-19 incidence but were not fully explained by our case mix. Other factors contributing to the variability in HO-CDI incidence beyond listed patient characteristics need to be explored.

Multicolor tunable emission through energy transfer in Dy3+/Ho3+ co-doped CaTiO3 phosphors with high thermal stability for solid state lighting applications.

The exploration of multicolor emitting phosphors with single phase is extremely important for n-UV chip excited LED/WLED's and multicolor display devices. In this paper, Dy3+, Ho3+ singly doped and Dy3+/Ho3+ co-doped CaTiO3 phosphor materials have been synthesized by solid state reaction method at 1473 K. The synthesized materials were characterized by XRD, FE-SEM, EDX, FTIR, PL and lifetime measurements. The PL emission spectra of Dy3+ doped CaTiO3 phosphors give intense blue and yellow emissions under UV excitation, while the PL emission spectra of Ho3+ doped CaTiO3 phosphor show intense green emission under UV/blue excitations. Further, to get the multicolor emission including white light, Dy3+ and Ho3+ were co-doped simultaneously in CaTiO3 host. It is found that alongwith colored and white light emissions, it also shows energy transfer from Dy3+ to Ho3+ with 367 nm and from Ho3+ to Dy3+ under 362 nm excitations. The energy transfer efficiency is found to be 67.76% and 69.39% for CaTiO3:4Dy3+/3Ho3+ and CaTiO3:3Ho3+/5Dy3+ phosphors, respectively. The CIE color coordinates, CCT and color purity of the phosphors have been calculated, which show color tunability from whitish to deep green via greenish yellow color. The lifetime of 4F9/2 level of Dy3+ ion and 5S2 level of Ho3+ ion is decreased in presence of Ho3+ and Dy3+ ions, respectively. This is due to energy transfer from Dy3+ to Ho3+ ions and vice versa. A temperature dependent photoluminescence studied of CaTiO3:4Dy3+/2Ho3+ phosphor show a high thermal stability (82% at 423 K of initial temperature 303 K) in the temperature range 303-483 K with activation energy 0.17 eV. The PLQY are 30%, 33% and 35% for CaTiO3:4Dy3+, CaTiO3:4Dy3+/2Ho3+ and CaTiO3:3Ho3+ phosphors, respectively. Hence, Dy3+, Ho3+ singly doped and Dy3+/Ho3+ co-doped CaTiO3 phosphor materials can be used in the field of single matrix perovskite color tunable phosphors which may be used in multicolor display devices, n-UV chip excited LED/WLED's and photodynamic therapy for the cancer treatment.

Study of rhino-orbital-cerebral mucormycosis and its correlates during COVID-19 pandemic in a tertiary eye care institute of central India.

PURPOSE: To evaluate factors associated with the occurrence of ROCM in COVID-19 patients and to compare its related parameters and outcomes between active and recovered COVID-19 groups. METHODS: A total of 35 patients of ROCM associated with COVID-19 (active and post-COVID-19) were included. This is an ambispective study with retrospective medical records review for COVID-19 analysis and prospective assessments of ROCM-associated COVID-19 during the second wave of the COVID-19 pandemic. The demographic data, clinical parameters, and outcome were recorded on MS excel sheet, and various parameters were compared between active and recovered COVID-19 groups. RESULTS: ROCM in recovered COVID-19 group was higher (57.1%) as compared to active COVID-19 (42.9%) (P = 1.00). High occurrence of ROCM was seen in those who had a history of hospitalization due to severity of COVID-19 (n 33, 94.28%), oxygen support (77.14), and received systemic steroids (82.9%). The most common comorbidity was diabetes mellitus (82.9%), and new-onset hyperglycemia was noticed in 17.1% of patients. Exenteration (28.6%) was performed in severe cases who had stage IV ROCM, bilateral, and CNS involvement (RR = 7.2, 95% CI: 2.91 to 18.00). The risk of globe exenteration was 1.35 (0.7-2.29) times higher in recovered COVID-19 group, and mortality was 1.76 (0.72-3.36) times higher in active COVID-19 group. CONCLUSION: Monitored use of systemic steroids and the prompt management of hyperglycemia in COVID-19 patients are important factors for favorable outcomes with reference to globe salvage and life-saving in ROCM associated with COVID-19. Even recovered COVID-19 patients should be observed for persistent hyperglycemia and occurrence of ROCM.

Intense photoluminescence in CaTiO3:Sm3+ phosphors, effect of co-doping singly, doubly and triply ionized elements and their applications in LEDs.

In this work, Sm3+-doped and Sm3+/Li+/K+/Mg2+/Ba2+/Gd3+/Bi3+ co-doped CaTiO3 phosphors were synthesized by a solid-state reaction method at 1473 K. The phase of phosphors was identified to be orthorhombic with space group Pnma (62) by XRD measurements. The morphological properties of the prepared samples were studied by SEM measurements. The average crystallite and particle sizes were found to increase in the presence of modifiers and they follow the trend Li+ > Mg2+ > Gd3+ > K+ > Bi3+ > Ba2+. EDX measurements were used to verify the presence of Ca, Ti, O, Sm, K, Mg, Ba, Gd and Bi atoms in the prepared phosphor samples. The Sm3+ ion shows emission peaks at 564, 599 and 646 nm due to 4G5/2 → 6H5/2, 6H7/2 and 6H9/2 transitions upon 407 nm excitation, among which the peak situated at 599 nm has maximum emission intensity. Concentration quenching was observed above 2 mol% of Sm3+ ions in this host. However, the emission intensity of Sm3+ peaks can be enhanced using different modifier (Li+/K+/Mg2+/Ba2+/Gd3+/Bi3+) ions. It was found that the size (ionic radii) and charge compensation of the ion together play a dominant role. The enhancement is more after co-doping with smaller radius ions (Li+, Mg2+ and Gd3+), among which Li+ shows the largest enhancement. This is because ions of smaller size will be able to go closer to the activator ion and the charge imbalance causes a larger field. The CIE color coordinates, correlated color temperature (CCT) and color purity of the phosphors were calculated and show orange-red color emissions with a maximum color purity of ∼93% in the case of CaTiO3:2Sm3+/1.0Li+ phosphor. The lifetime value is increased in the presence of these ions. It is again maximum for the Li+ co-doped CaTiO3:2Sm3+ phosphor sample. Thus, the prepared phosphor samples are suitable sources for orange-red light.

Meditation-A Slippery Slope for Psychosis: A Case Series With Review of Evidence.

ABSTRACT: The practice of meditation has been traditionally viewed as a self-regulatory approach that aids in psychological well-being. Over the last decade, mindfulness-based meditation has gained a separate therapeutic significance in various mental health conditions. There has also been considerable understanding of the adverse effects of meditation over the years. Despite this, there is still underreporting of the altered behavioral presentations arising possibly because of intensive and unguided meditation practices. We present two cases of meditation-related psychosis with different clinical presentations. The write-up highlights the need for tailoring the meditation practices after evaluation of mental state of the individuals and early detection of "at-risk" mental states. There should be regular screening of emergence of any unwanted effects during the course of meditation and the guides should be able to detect the early warning signs of psychosis.

In vivo versus in silico assessment of potentially pathogenic missense variants in human reproductive genes.

Infertility is a heterogeneous condition, with genetic causes thought to underlie a substantial fraction of cases. Genome sequencing is becoming increasingly important for genetic diagnosis of diseases including idiopathic infertility; however, most rare or minor alleles identified in patients are variants of uncertain significance (VUS). Interpreting the functional impacts of VUS is challenging but profoundly important for clinical management and genetic counseling. To determine the consequences of these variants in key fertility genes, we functionally evaluated 11 missense variants in the genes ANKRD31, BRDT, DMC1, EXO1, FKBP6, MCM9, M1AP, MEI1, MSH4 and SEPT12 by generating genome-edited mouse models. Nine variants were classified as deleterious by most functional prediction algorithms, and two disrupted a protein-protein interaction (PPI) in the yeast two hybrid (Y2H) assay. Though these genes are essential for normal meiosis or spermiogenesis in mice, only one variant, observed in the MCM9 gene of a male infertility patient, compromised fertility or gametogenesis in the mouse models. To explore the disconnect between predictions and outcomes, we compared pathogenicity calls of missense variants made by ten widely used algorithms to 1) those annotated in ClinVar and 2) those evaluated in mice. All the algorithms performed poorly in terms of predicting the effects of human missense variants modeled in mice. These studies emphasize caution in the genetic diagnoses of infertile patients based primarily on pathogenicity prediction algorithms and emphasize the need for alternative and efficient in vitro or in vivo functional validation models for more effective and accurate VUS description to either pathogenic or benign categories.

Side-Chain Modification in Conjugated Polymer Frameworks for the Electrocatalytic Oxygen Evolution Reaction.

Conjugated polymer frameworks (CPFs) have recently sparked tremendous research interest due to their broad potentials in various frontline application areas such as photocatalysis, sensing, gas storage, energy storage, etc. These framework materials, without sidechains or functional groups on their backbone, are generally insoluble in common organic solvents and less solution processable for further device applications. There are few reports on metal-free electrocatalysis, especially oxygen evolution reaction (OER) using CPF. Herein, we have developed two triazine-based donor-acceptor conjugated polymer frameworks by coupling a 3-substituted thiophene (donor) unit with a triazine ring (acceptor) through a phenyl ring spacer. Two different sidechains, alkyl and oligoethylene glycol, were rationally introduced into the 3-position of thiophene in the polymer framework to investigate the effect of side-chain functionality on the electrocatalytic property. Both the CPFs demonstrated superior electrocatalytic OER activity and long-term durability. The electrocatalytic performance of CPF2, which achieved a current density of 10 mA/cm2 at an overpotential (η) of 328 mV, is much superior to CPF1, which reached the same current density at an overpotential of 488 mV. The porous and interconnected nanostructure of the conjugated organic building blocks, which allowed for fast charge and mass transport processes, could be attributed to the higher electrocatalytic activity of both CPFs. However, the superior activity of CPF2 compared to CPF1 may be due to the presence of a more polar oxygen-containing ethylene glycol side chain, which enhances the surface hydrophilicity, promotes better ion/charge and mass transfer, and increases the accessibility of the active sites toward adsorption through lower π-π stacking compared to hexyl side chain present in CPF1. The DFT study also supports the plausible better performance toward OER for CPF2. This study confirms the promising potentiality of metal-free CPF electrocatalysts for OER and further sidechain modification to improve their electrocatalytic property.

Age-related cataract - Prevalence, epidemiological pattern and emerging risk factors in a cross-sectional study from Central India.

Purpose: To study the epidemiological pattern, prevalence, types, and correlates of age-related cataracts in a tertiary care center in central India. Methods: This hospital-based single-center cross-sectional study was conducted on 2,621 patients diagnosed with cataracts for 3 years. Data pertaining to demography, socio-economic profile, cataract grading, cataract types, and associated risk factors were evaluated. Statistical analysis using unadjusted odds ratio (OR) and multivariate logistic regression was performed, with P-value <0.05 considered significant with the power of the study being 95%. Results: The commonest age group affected was 60-79 years, closely followed by the 40-59 years age group. The prevalence of nuclear sclerosis (NS), cortical (CC), and posterior subcapsular cataract (PSC) was found to be 65.2% (3,418), 24.6% (1,289), and 43.4% (2,276), respectively. Among mixed cataracts, (NS + PSC) had the highest prevalence of 39.8%. Smokers were found to have 1.17 times higher odds of developing NS than non-smokers. Diabetics had 1.12 times higher odds of developing NS cataracts and 1.04 times higher odds of developing CC. Patients with hypertension showed 1.27 times higher odds of developing NS and 1.32 times higher odds of developing CC. Conclusion: The prevalence of cataracts in the pre-senile age group (<60 years) was found to have increased significantly (35.7%). A higher prevalence of PSC (43.4%) was found in studied subjects, as compared to the data of previous studies. Smoking, diabetes, and hypertension were found to have a positive association with a higher prevalence of cataracts.

Exploration of seryl tRNA synthetase to identify potent inhibitors against leishmanial parasites.

Aminoacyl-tRNA synthetases are crucial enzymes for cellular protein metabolism and have been considered as an attractive target for development of new antimicrobials. In the current study, seryl tRNA synthetase of Leishmania donovani (LdSerRS) and its mutants were purified and characterized through biochemical and structural methods. Purified LdSerRS was found to be enzymatically active and exhibited more alpha helices in secondary structure. The enzymatic activity of purified protein was observed as highest near physiological temperature and pH. Mutation in ATP binding residues (R295 and E297) demonstrated reduction in the affinity for cofactor with no significant deviation in secondary structure. In vitro inhibition studies with ureidosulfocoumarin derivatives helped to identify Comp 5l as a specific inhibitor for leishmanial SerRS that showed lesser potency towards purified HsSerRS. The identified compound presented competitive mode of inhibition for LdSerRS and also revealed druglikeness along with very low toxicity for human macrophages. Structural analysis of protein and ligand complex depicted the binding of Comp 5l into the cofactor binding site of LdSerRS with high affinity succeeded by validation employing molecular dynamics simulations. Altogether, our study presents a promising scaffold to explore small molecules to target the enzymatic activity of leishmanial SerRS to develop the specific therapeutics.

Development of Novel Indole-3-sulfonamide-heteroaryl Hybrids as Carbonic Anhydrase Inhibitors: Design, Synthesis and in-vitro Screening.

BACKGROUND: Carbonic anhydrases (CAs, EC 4.2.1.1) catalyze the reversible hydration of carbon dioxide to bicarbonate and a proton. Inhibition of isoforms IX and XII has induced potent anticancer effects. OBJECTIVE: A series of indole-3-sulfonamide-heteroaryl hybrid (6a-y) was synthesized and screened for the inhibition of human (h) hCA isoforms I, II, IX, and XII. METHODS: The synthesis of target compounds (6a-y) was carried out in multistep starting from 5-nitro indole as starting material by using classical reported reaction conditions. The steps involved are N-Alkylation Chlorosulfonation, amination, reduction, and finally amidation reaction. RESULTS: Amongst all the compounds (6a-y) synthesized and screened, 6l was found to be active against all the screened hCA isoforms, with Ki ranging 8.03 µM, 4.15 µM, 7.09 µM, and 4.06 µM respectively. On the other hand, 6i, 6j, 6q, 6s, and 6t were highly selective against tumor-associated hCA IX, and 6u was selective against both hCA II and hCA IX with moderate inhibitory activities under the range of 100 µM. These compounds showed good activity against the tumor-associated hCA IX and might be developed as future drug leads for anticancer drug discovery. CONCLUSION: These compounds may be useful as starting points for the design and development of more selective and potent hCA IX and XII inhibitors.

Intracameral Drug Delivery: A Review of Agents, Indications, and Outcomes.

An intracameral (IC) injection directly delivers the drug into the anterior chamber of the eye. This targeted drug delivery technique overcomes the ocular barriers and offers a high therapeutic concentration of medication at the desired site and consequently better clinical outcomes. IC drug delivery is a safe and effective modality with many advantages over topical delivery. These include excellent bioavailability, reduced systemic risk, and minimal ocular toxicity. Agents delivered via IC injection have shown promising results against infection, inflammation, ocular hypertension, and neovascularization. Current literature shows that IC antibiotics, including cefuroxime, vancomycin, and moxifloxacin, are routinely used for prophylaxis of endophthalmitis. Other drugs available for IC use are steroids, anesthetics, mydriatics, miotics, antivascular endothelial growth factor, antiglaucoma, and alkylating agents. Introduction of sustained-release devices containing dexamethasone or Bimatoprost in anterior chamber via IC route has the potential in treating ocular inflammation and raised intraocular pressure. The complications such as hemorrhagic occlusive retinal vasculitis and toxic anterior segment syndrome have been documented with IC prophylaxis but are rare. In this review, we provide an overview of available IC drugs, their pharmacokinetics, the spectrum of activity, dosage and preparation, prophylactic and therapeutic usage, clinical efficacy, and safety profiles.

PET radiotracers and fluorescent probes for imaging human carbonic anhydrase IX and XII in hypoxic tumors.

Positron emission tomography (PET) and fluorescent imaging play a pivotal role in medical diagnosis, biomedical oncologic research, and drug development process, which include identification of target location, target engagement, but also prove on mechanism of action or pharmacokinetics of new drug candidates. PET estimates physiological changes at the molecular level using specific radiotracers containing a short-lived positron emitting radionuclide such as fluorine-18 or carbon-11, whereas fluorescent imaging techniques use fluorescent probes labeled with suitable drug candidates for detection at the molecular level. The human carbonic anhydrase (hCA) isoforms IX and XII are overexpressed in hypoxic cancer cells, promoting tumor growth by regulating extra/intracellular pH, ferroptosis, and metabolism, being recognized as promising targets for anticancer theranostic agents. In this review, we have focused on PET radiotracers as well as fluorescent probes for diagnosis and treatment of tumors expressing hCA IX and hCA XII.