Hepatopathy in Scrub Typhus: Clinical Presentation, Association With Morbidity and Impact on Outcome.

INTRODUCTION: Acute liver injury accompanies tropical fevers like scrub typhus. This study was undertaken to evaluate liver injury in scrub typhus and its association with the disease severity. METHODS: This was a single-centre prospective, observational study on in-patients of scrub typhus from north India. All patients were categorized on basis of elevation of transaminases as having normal or abnormal liver function. Those with hepatopathy were sub-categorized as having mild, moderate, severe or very severe liver injury. RESULTS: Liver dysfunction was present in 76/109 of the patients and was significantly associated with eschar, clinically discernible hepatomegaly and splenomegaly. Shock, renal and respiratory insufficiency, need for intensive care and oxygen supplementation were also significantly associated with hepatopathy. Duration of hospitalization and mortality were comparable in patients with/without liver injury; however delayed defervescence (6.2+3.8 vs. 4.5+2.5 days; p=0.025) was observed with hepatopathy. Icterus (p=0.001), hepatomegaly (p=0.015), thrombocytopenia (p<0.001) and raised erythrocyte sedimentation rate (ESR) (p=0.003) were significantly observed with increasing grade of liver injury.  Conclusion: Liver dysfunction and its increased severity in scrub typhus did not translate into increased morbidity and/or poor outcomes.

A case series of 2,4 diethylamine poisoning - what the future holds for us.

2,4-Diethylamine (2,4-D) is a chlorphenoxy herbicide widely used in north India, marketed as 'Sohna' and 'Zura'. Multi-organ dysfunction and mortality is high in cases of accidental or suicidal ingestion owing to the lack of any antidote. We report a case series of 2,4-D poisoning from a single tertiary centre of north India managed with variable outcomes.

The COVID-19 pandemic and the future of telecommuting in the United States.

This study focuses on an important transport-related long-term effect of the COVID-19 pandemic in the United States: an increase in telecommuting. Analyzing a nationally representative panel survey of adults, we find that 40-50% of workers expect to telecommute at least a few times per month post-pandemic, up from 24% pre-COVID. If given the option, 90-95% of those who first telecommuted during the pandemic plan to continue the practice regularly. We also find that new telecommuters are demographically similar to pre-COVID telecommuters. Both pre- and post-COVID, higher educational attainment and income, together with certain job categories, largely determine whether workers have the option to telecommute. Despite growth in telecommuting, approximately half of workers expect to remain unable to telecommute and between 2/3 and 3/4 of workers expect their post-pandemic telecommuting patterns to be unchanged from their pre-COVID patterns. This limits the contribution telecommuting can make to reducing peak hour transport demand.

A database of travel-related behaviors and attitudes before, during, and after COVID-19 in the United States.

The COVID-19 pandemic has impacted billions of people around the world. To capture some of these impacts in the United States, we are conducting a nationwide longitudinal survey collecting information about activity and travel-related behaviors and attitudes before, during, and after the COVID-19 pandemic. The survey questions cover a wide range of topics including commuting, daily travel, air travel, working from home, online learning, shopping, and risk perception, along with attitudinal, socioeconomic, and demographic information. The survey is deployed over multiple waves to the same respondents to monitor how behaviors and attitudes evolve over time. Version 1.0 of the survey contains 8,723 responses that are publicly available. This article details the methodology adopted for the collection, cleaning, and processing of the data. In addition, the data are weighted to be representative of national and regional demographics. This survey dataset can aid researchers, policymakers, businesses, and government agencies in understanding both the extent of behavioral shifts and the likelihood that changes in behaviors will persist after COVID-19.

The potential stickiness of pandemic-induced behavior changes in the United States.

Human behavior is notoriously difficult to change, but a disruption of the magnitude of the COVID-19 pandemic has the potential to bring about long-term behavioral changes. During the pandemic, people have been forced to experience new ways of interacting, working, learning, shopping, traveling, and eating meals. A critical question going forward is how these experiences have actually changed preferences and habits in ways that might persist after the pandemic ends. Many observers have suggested theories about what the future will bring, but concrete evidence has been lacking. We present evidence on how much US adults expect their own postpandemic choices to differ from their prepandemic lifestyles in the areas of telecommuting, restaurant patronage, air travel, online shopping, transit use, car commuting, uptake of walking and biking, and home location. The analysis is based on a nationally representative survey dataset collected between July and October 2020. Key findings include that the "new normal" will feature a doubling of telecommuting, reduced air travel, and improved quality of life for some.

Dermoscopy of a rare case of linear syringocystadenoma papilliferum with review of the literature.

Syringocystadenoma papilliferum (SCAP) is a benign hamartomatous tumor arising from pluripotent cells with either apocrine or eccrine differentiation. We report a rare case of de novo linear SCAP in a 12-year-old female child with lesions over the chest along with the dermoscopic findings.

Disseminated cutaneous fusariosis in human immunodeficiency virus-infected patient and dramatic response with oral itraconazole.

Fusarium species are known to cause disseminated cutaneous lesions in immunocompromised patients. Some cases of fusariosis are reported in patients infected with the human immunodeficiency virus. There are two reports in such patients with systemic comorbidities like lymphoma, neutropenia and infective port-a-catheter. Another reported patient had systemic fusariosis, without skin involvement. Diagnosis and treatment of cutaneous fusariosis is difficult and resistance to antifungals is a problem. Our patient was at an advanced human immunodeficiency virus infection stage with disseminated cutaneous fusariosis, without any systemic involvement, who responded completely to oral itraconazole.