Perception of health care students towards lectures as a teaching and learning method in the COVID era - A multicentric cross-sectional study from India.

The sudden precipitation of the pandemic forced undergraduates to take refuge at home, deserting the campus. Consequently, the age-old classroom in person teaching-learning (T-L) method shifted and lessons had to be conducted online. In previous decades, archetypical classroom lectures survived a lot of criticism in the face of the quasi-passive nature of T-L  methodology. There are very few studies that reflect undergraduate students' perceptions of lectures. This study aimed to evaluate undergraduate students' perceptions of lectures using an online questionnaire with 13 items, which was circulated to undergraduate students of medical, physiotherapy, and nursing courses in three settings at different locations of private and public health schools. There was a total of 877 responses. The surveyed students were in favor of lectures and considered them indispensable for undergraduate learning. They preferred it as a kind of organized learning through the teacher's own experiences. Our study suggests that it is not the 'lecture' that requires mending but possibly teachers require better training, application of effective audio-visual aids, and innovative techniques to sustain students' interest in the class.

Dysbiotic Lesional Microbiome With Filaggrin Missense Variants Associate With Atopic Dermatitis in India.

Background: Atopic Dermatitis (AD) has been associated with the loss of function (LoF) mutations in Filaggrin (FLG) gene and increase in relative abundance of specific microbes in the lesional skin, predominantly in Caucasians. Our study aims to determine, in Indian AD patients, (a) the prevalence of FLG LoF and missense mutations, and (b) the nature and extent of dysbiosis and altered microbial pathways with and without mutations in FLG. AD patients (n = 34) and healthy controls (n = 54) were recruited from India in this study and shotgun sequencing was carried out in a subset of samples with adequate microbiome DNA concentration. Host DNA from the same subset of samples was subjected to FLG coding region sequencing and host-microbiome association was estimated. Results: The prevalence of FLG LoFs that are associated with AD globally were significantly lesser in our cases and controls (8.6%, 0%) than those reported in Europeans (27%, 2.6%). Staphylococcus aureus was present only on AD skin [abundance in Pediatric AD: 32.86%; Adult AD: 22.17%], but not on healthy skin on which Staphylococcus hominis (Adult controls: 16.43%, Adult AD: 0.20%; p = 0.002), Cutibacterium acnes (Adult controls:10.84%, Adult AD: 0.90%; p = 0.02), and Malassezia globosa (Adult controls: 8.89%, Adult AD: 0.005%; p = 0.001) were significantly more abundant. Microbial pathways mostly associated with skin barrier permeability, ammonia production and inflammation (Arginine and Proline metabolism, Histidine Metabolism and Staphylococcus aureus infection) were significantly enriched on AD skin metagenome. These pathways are also reported to impair antimicrobial peptide activity. Among AD patients with missense single nucleotide polymorphisms harboring "potentially damaging" alleles in FLG gene, damaging allele dosage was significantly (p < 0.02) positively correlated with relative abundance of phylum_Proteobacteria up to order_Pseudomonadales and negatively correlated with phylum_Firmicutes up to species_Staphylococcus aureus. Conclusion: Our study has provided evidence that host DNA profile is significantly associated with microbiome composition in the development of AD. Species and strain level analysis showed that the microbial pathways enriched in AD cases were mostly found in MRSA strains. These evidences can be harnessed to control AD by modulating the microbiome using a personalized strategy. Our findings on the association of FLG genotypes with the microbiome dysbiosis may pave the way for a personalized strategy to provide a more effective control of AD.

Clinico-epidemiological study of leprosy in an urban area of West Bengal.

A cross-sectional study was carried out at Naihati municipal area in West Bengal to study the prevalence and some epidemiological factors in transmission of leprosy. Side by side, the validity of WHO operational classification was also tested by using slit skin smear examination as gold standard. A group of trained paramedical workers, supervised by epidemiologist conducted house to house survey work. Experienced dermatologist and neurologist examined suspected cases. Overall prevalence of leprosy were 9.9 per 10000, of which 53% were new cases. Epidemiologically manual workers, living in slums and unhygienic surroundings had significantly higher risk of developing leprosy. Sensitivity and specificity of WHO operational classification (> 5 skin lesion= MB) was found to be quite high (sensitivity 85.9% and specificity 83.3%) in this study. However addition of > 2 nerve lesions to this criteria increase sensitivity to 90.1% without much affecting the specificity (79.8%).

A case of Mayer-Rokitansky-Kuster-Hayser syndrome with absence of the right thumb.

A 14-year-old feminine adolescent, presented with congenital absence of right thumb, scoliosis, severe anemia, primary amenorrhea without secondary sexual characteristics, except for normally developed breasts. In the genital area, there was a pair of ill developed labia majora fused at upper end with a whirling pattern containing inside the urethral opening. The lower end of genitalia had loose skin folds containing adequate amounts of rugae with a raphe, mimicking the texture of scrotal skin. There was no vaginal orifice. Diagnostic work-up included routine hematological studies, skeletal radiography, renal ultrasonography, and renal scan to demonstrate possible association between the congenital genitourinary and skeletal anomalies. Ultrasound imaging studies confirmed that she had structures close to uterus with hematometra, but vagina and ovary were not found. Sonologically, the left kidney could not be visualized. Renal scan confirmed agenesis of the left kidney and hypoplastic, parenchymally insufficient, right kidney. Cytogenetic karyotyping revealed a 46, XX karyotyping and the presence of Barr chromatin body. Based on the clinical examination and investigations, a diagnosis of Mayer-Rokitansky-Kuster-Hauser syndrome was established with associated limb and skeletal deformities.