Genotypic analyses and antimicrobial resistance profiles of Campylobacter jejuni from crows (Corvidae) of United States and India reflect their respective local antibiotic burdens.

AIM: The study examined the hypothesis that crow-borne Campylobacter can function as environmental reservoirs and indicators of antibiotic resistance (AR) determinants circulating in a human population. METHODS AND RESULTS: Two species of crows from Washington (WA), United States, and Kolkata, India, respectively, were examined for their ability to carry antibiotic resistant Campylobacter. Campylobacter jejuni was the only species isolated by selective agar plating from crow faecal samples. Disk diffusion method used to compare the AR profile of the isolates showed tetracycline (TET) resistance to be the most prevalent (27%) among WA isolates, followed by ciprofloxacin (CIP; 24%). Among Kolkata isolates, nalidixic acid resistance was most common (36%), followed by CIP (27%). The AR profile demonstrated by crow isolates of WA reflects those reported by the US National Antimicrobial Resistance Monitoring System for human isolates (2007-2011), where resistance to TET was most prevalent (≈45%), followed by quinolones (≈24%). The Kolkata crow isolates reflected the AR profile of human clinical isolates from India, where 97% resistance was shown to quinolones, followed by TET (18%). Multilocus sequence typing of 37 isolates, including 11 water isolates from the crow roost area, showed 24 different sequence types (STs). Seventeen of these were previously found in wild birds, 2 in human diarrhoea, 4 in poultry and 8 in environmental water. One isolate was found in both water and faeces, though from different sites within WA. CONCLUSIONS: The results indicate that crows most likely acquire the AR from anthropogenic sources. Although they are colonized by specific STs, rarely isolated from humans, they can facilitate the spread of AR. SIGNIFICANCE AND IMPACT OF THE STUDY: By studying two areas in different continents, this research demonstrates that Campylobacter borne by crows can function as environmental reservoirs and indicators of AR determinants that circulate in a human population. This information will be of importance to scientists from the medical and poultry industries.

Confronting the uncommon: Cholecystitis and cholangitis in a young adult arising from a bilobed gallbladder with subvesicle duct - A case report and review of literature.

INTRODUCTION AND IMPORTANCE: Bilobed gallbladder is a rare congenital anomaly characterized by the duplication of the gallbladder. It presents a unique challenge for surgeons due to its infrequency and the potential for perioperative complications. Anatomical variations, including the presence of the subvesicle duct of Luschka, should be suspected in these cases. CASE PRESENTATION: In our case report, we present the clinical details of a **23-year-old male** who presented with symptoms of acute cholecystitis and cholangitis. Preoperative imaging revealed a bilobed gallbladder, and incidentally, intraoperative evidence of the subvesicle duct/duct of Luschka was also observed during a successful laparoscopic cholecystectomy. Importantly, the patient experienced no postoperative complications. CLINICAL DISCUSSION: This case highlights considering bilobed gallbladder as a differential diagnosis in patients with cholecystitis or cholangitis is crucial. Surgeons should be vigilant about this anomaly when evaluating patients with gallbladder-related symptoms. CONCLUSION: We understand precise imaging plays a pivotal role in guiding surgical planning. Detecting bilobed gallbladder preoperatively allows for better assessment of biliary structures and helps prevent bile leaks during surgery. Although rare, awareness of bilobed gallbladder and its associated anatomical variants is essential for optimal patient management and successful surgical outcomes. Surgeons should remain attentive to such anomalies to ensure safe and effective procedures.

Auditory Deficits in Employees of Business Process Outsourcing (BPO): Need to Take Preventative Action.

The present study aimed to explore auditory deficits in full-time call center workers. A total of sixty participants participated, which was divided into two groups, viz. experimental group and control group. The complete audiological test battery was performed. On comparing the groups, significant differences were obtained for both ears while analyzing the TEOAEs, PTA1, and PTA2 (high-frequency audiometry). From the results, it can be delineated that BPO employees are at risk for sensorineural hearing loss following continuous noise exposure. We conclude that this type of hearing loss may be considered an iceberg, and to overcome all the issues related to noise exposure, all BPO employees should undergo periodic audiological, psychological, and health screening.

Predictability of Nailfold Capillaroscopic Score in Diagnosing Retinopathy in Patients with Type 2 Diabetes Mellitus and its Utility as a Non-Invasive Tool for Differentiating from those Not Having Retinopathy: A Pilot Observational Cross-Sectional Analytical Study.

Background: Diabetes mellitus (DM) is a chronic hyperglycaemic state associated with microvascular structural alterations. Nailfold capillaroscopy (NFC) is an in vivo study of microvascular circulation. Aims and Objectives: This study aimed to investigate the diameters of capillary loops and morpho-structural changes using a handheld dermatoscope in patients with type 2 DM (T2DM) with and without diabetic retinopathy (DR) and to establish nailfold capillary changes and NFC score as a non-invasive method to identify microvascular complication in T2DM patients. Material and Methods: A cross-sectional observational study was conducted in AIIMS Rishikesh for 6 months from August 2022 to February 2023. Our study participants were 100 adults more than 18 years of age diagnosed with T2DM, based on the American Diabetes Association (ADA) criteria. All patients were evaluated thoroughly for the presence of microvascular complications in the form of retinopathy. Based on this, they were divided into two groups-group 1 (T2DM with retinopathy) and group 2 (T2DM without retinopathy). Both groups were further subdivided into three subgroups based on haemoglobin A1c (HbA1c): the first group with HbA1c <7%, the second group with HbA1c 7-8.9% and the third group with HbA1c >=9%. For all the study participants, a detailed NFC was done for all 8 fingernails (excluding the thumb), using a handheld dermatoscope. Abnormal capillary shapes (ACS) were recorded by semi-quantitative score (NFC score). Results: A significant association was seen in capillary density (loops/mm) (5.83 ± 0.72 in the DR group and 6.3 ± 0.89 in the no-DR group) (P value = 0.005), capillary density (loops/3 mm) (P value = 0.005), total number of microhaemorrhages/3 mm (P value < .0001), total number of giant capillaries/3 mm (P value = 0.0004), total number of avascular areas/3 mm (P value = 0.0005), enlarged capillaries/3 mm (P value = 0.002), tortuous capillaries/3 mm (P value < .0001), abrogated/bushy capillaries/3 mm (P value = 0.004), number of fingers involved excluding the thumb (P value < .0001) and total nailfold capillaroscopic score (P value < .0001) between the two groups, one with DR and another without DR. Furthermore, the proportion of patients with abnormal nailfold capillaroscopic findings, abnormal NFC score, was significantly higher in patients with DR as compared to patients without DR (51.85% vs 4.35%, respectively) (P value < 0.0001). Conclusion: Our results suggest that NFC could possibly be used as an adjunctive tool in diabetics for diagnosing or monitoring microvascular complications with total NFC score being the significant predictor of DR at a cut-off point of >0 with the area under the curve (AUC) of 0.745 for correctly predicting DR.

Perceptual, Aerodynamic and Acoustic Evaluation of Vocal Characteristics in Subjects With Obesity.

INTRODUCTION: Obesity has tripled since 1975 and affects health across many domains. Increasing body mass index increases the risk to the obese subject of many non-communicable diseases. The study evaluated the perceptive, aerodynamic, and acoustic parameters that characterize the voice of the obese population. METHODOLOGY: Eighty adult subjects (40 participants in each obese and control group) aged 18-50 years were enrolled. The perceptual voice analysis was performed using the Consensus Auditory Perceptual Evaluation of Voice. The aerodynamic and acoustic voice analyses were performed using the MIR Spiro lab instrument and Doctor's Speech software. A digital stopwatch was also used to measure maximum phonation time. RESULTS: Statistical analysis revealed a significant difference (P-value <0.05 and t value >2) between two groups on acoustic parameters, specifically Normalized noise energy and fundamental frequency tremor (F0 tremor). Normalized noise energy and fundamental frequency tremor were greater in the obese group. Moreover, maximum phonation time and expiratory reserve volume were significantly reduced in the obese group. DISCUSSION AND CONCLUSION: Results of the present study showed poor voice quality and reduced expiratory reserve volume in obese individuals. This could be credited to the adverse effects of accrued adipose on the functioning of the laryngeal and respiratory systems. Increasing body mass index escalates the risk to the obese subjects of many non-communicable diseases.

Seropositivity For Viral Markers in Patients Undergoing Cataract Surgery Diagnosed Unexpectedly

Background: To find the prevalence of unexpected seropositive viral markers in the patients undergoing cataract surgery.Material & Methods:It was a longitudinal observational study. Total1180 cataract patients were studied. Patients were discovered unexpectedly positive for hepatitis B antigen, hepatitis C, human immunodeficiency virus during preoperative screening for cataract surgery. HBV and HCV patients were referred for medicine opinion and operated after treatment and clearance. HIV patients were referred to ART center for further management.Results:During the study period 1180 patients, 504 males and 676 females were studied. 34 patients work positive for HIV, twelve patients were positive for hepatitis B and 50 patients were found positive for HCV. The patients accidentally found positive were 18/34 for HIV, 6/12 for hepatitis B and 32/50 for hepatitis C.Conclusions:We concluded that preoperative screening should be done for viral markers before every cataract surgery to prevent spread of such infections. Mass immunization against hepatitis B should be done among health care workers.

Assessment of Effect and Safety of Ripasudil (0.4%) in patients of Primary Open Angle Glaucoma / Ocular Hypertension

Background: The aim is to evaluate the intraocular pressure-lowering efficacy and tolerability of Ripasudil (0.4%) ophthalmic solution in patients of primary open-angle glaucoma/ocular hypertension.Material & Methods:In this prospective, interventional, single-arm, open-label study, 50 patients of POAG/ocular hypertension attending the Outpatient Department of Ophthalmology, Government Medical College, Patiala were included.Results:Mean value of numerical change in IOP at four weeks, at eight weeks, at twelve weeks in IOP were 3.61 � 2.05, 3.98 � 1.47, 4.44 � 1.53 respectively. Among side effects, conjunctival hyperemia, blepharitis, and allergic conjunctivitis were reported among 62%, 10%, and 8% of the subjects at four weeks. Final results after 12 weeks showed that only conjunctival hyperemia was reported as a side effect among 16% of the subjects. Conclusions:Our present study showed significant IOP-lowering effects and safety of ripasudil (0.4%) over 12 weeks in patients with primary open-angle glaucoma/ocular hypertension. For the treatment of glaucoma and OHT, ripasudil is regarded as a possible second-line choice in spite of the high occurrence of conjunctival hyperemia.

Design and development of paclitaxel-loaded bovine serum albumin nanoparticles for brain targeting.

Bovine serum albumin (BSA) nanoparticles loaded with paclitaxel (PTX) were prepared using a desolvation technique. A 32 full factorial design (FFD) was employed to formulate nanoparticles. Nanoparticles were characterized for particle size by photon correlation spectroscopy and surface morphology by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Encapsulation efficiency, zeta potential and particle yield were also determined. Response surface linear modelling (RSLM) was used to predict the optimal formulation. Various models were applied to determine the release mechanism from PTX nanoparticles. The effect of drug-polymer ratio on the release profile of formulations was observed and was applied to determine the suitability of the predicted optimal formulation. A preliminary study to determine the feasibility of targeting the prepared nanoparticles to brain was also carried out using mice as in vivo models.