Gender Preference for Auditory Versus Visual Routes for Memorization.

Objective: Memory is formed on the basis of sensory stimuli perceived. Vision and Auditory sense are the most common modes to form visual and auditory memory. This study was planned to find the preferred sense route for the formation of memory, between the two genders. Method: In the present cross sectional experimental study, 40 male and 40 female subjects between 18-20 years of age were tested for visual & auditory memory. Results: Results: The results suggested statistically significant higher scores of 'Memory Test' in women in comparison to men (F479 3.312, p=<0.001). The mean score for memory subtests was best for black & white pictures followed by colored pictures, visual words, visual digits, auditory digits and auditory words in that order in men, whereas in women, mean score was best for colored pictures followed by black & white pictures, auditory words, auditory digits, visual words and visual digits. Conclusion: It may be concluded that in men visual sense and in women auditory sense are more effectual for the formation of memory.

A quarantine process for the resolution of duodenoscope-associated transmission of multidrug-resistant Escherichia coli.

BACKGROUND: Because of their complex design, duodenoscopes have been long recognized to be difficult to fully disinfect and may play a role in transmission of bacteria between patients. Recent reports of duodenoscope-associated carbapenem-resistant enterobacteriaceae transmission have confirmed these suspicions. An outbreak of a multidrug resistant strain of Escherichia coli was recently reported at our institution. Herein we report the results of our investigation and the process improvements that we deployed in an effort to contain the outbreak. METHODS: A full investigation into the environment, endoscopists, infection control practices, high-level disinfection process as well as endoscopes was undertaken in conjunction with the local county health authority and the Centers for Disease Control and Prevention. Duodenoscopes were cultured and quarantined for 48 hours until negative cultures were obtained. Ergonomic changes were made to the endoscope reprocessing area, duodenoscopes were returned for routine maintenance, and surveillance cultures were obtained from all patients undergoing ERCP. RESULTS: Between November 2012 and August 2013, 32 patients were found to harbor 1 of 2 clonal strains of multidrug-resistant E coli, all of whom had undergone ERCP or duodenoscopy. A total of 1149 ERCPs were performed during this time period. Seven patients died within 31 days of the organism being identified in culture, 16 patients died overall by March 2015. The exact contribution of E coli to death is unclear because most patients had underlying late-stage malignancy or other severe medical comorbidities. No breach in high-level disinfection protocol or infection control practices was identified. The clonal strain of E coli was identified in culture on 4 of 8 duodenoscopes, 3 of which required critical repairs despite lack of obvious malfunction. The defect rate in high-level disinfection of duodenoscopes was 2% over a 1-year period. The implemented quality improvements, subsequent to which 1625 ERCPs have been performed, were successful in halting the outbreak. CONCLUSIONS: The existing manufacturer-recommended high-level disinfection protocols for duodenoscopes are inadequate. Although the ultimate solution may be a design change to the instrument, the timeline for such a change appears long and potentially difficult to exact. In the interim, a reliable method to ensure that bacterial pathogens are not present on the duodenoscope after high-level disinfection is needed.

An unusual presentation of Pseudomonas citronellolis bacteraemia and Campylobacter gastroenteritis infection in a human - a case report and literature review.

Introduction: Pseudomonas citronellolis is an unusual pathogen in humans and has not been extensively described in the scientific literature. Herein, we present a case of bacteremia and septic shock due to Pseudomonas citronellolis following Campylobacter species gastroenteritis in a patient with immunosuppression. Case Presentation: An 80-year-old man with myeloproliferative disorder on ruxolitinib presented with several days of worsening abdominal pain, which rapidly developed into septic shock with multi-organ failure and explosive diarrhea. Gram-negative bacilli observed on Gram staining of his blood culture broth were later identified as Pseudomonas citronellolis and Bacteroides thetaiotaomicron . Repeated abdominal imaging revealed no evidence of intestinal perforation or megacolon. In addition, stool PCR was positive for Campylobacter species. His clinical course improved after 14 days of meropenem with complete resolution of his symptoms and organ failure. Conclusion: P. citronellolis is a rare infection in humans. We postulate that Janus Associated Kinase (JAK) inhibition in myeloproliferative disorders heightened this patient's risk of bacterial translocation and severe illness in the setting of Campylobacter gastroenteritis. P. citronellolis may be identified more frequently as a pathogen in humans as more advanced diagnostic technologies become increasingly available in clinical microbiology.

Role of cystatin C and calprotectin as potential early prognostic biomarkers in COVID-19 patients admitted to a dedicated COVID care facility.

Background: The COVID-19 pandemic has claimed millions of lives. A tool for early prediction of severity and mortality risk is desirable for better utilization of health care facilities. Several biomarkers like D-dimer, lactate dehydrogenase (LDH), C-reactive protein (CRP) and some recently explored biomarkers like serum cystatin C and serum calprotectin have been proposed as prognostic markers of COVID-19, but their role as prognostic markers is so far undefined. The present work attempted to investigate the possible role of serum cystatin C and serum calprotectin as prognostic tools to predict severity and outcome ahead of time. Material and Methods: This observational cohort study was carried out on 95 COVID-19 patients admitted to a dedicated COVID care facility from mid-October 2020 to January 2021. Serial estimations of serum cystatin C and serum calprotectin levels were done and assessed for significant difference between severe (NEWS 2 score ≥5) and non-severe (NEWS 2 score <5) groups, survivors and deceased and on the basis of comorbidities at each time points. Survival analysis was done based on the optimal thresholds for severity and mortality, calculated from the receiver operating characteristic (ROC). Result: The results showed that median cystatin C levels were significantly higher on the first day in the severe group (P < 0.001) and in patients with cardiovascular disease (P < 0.05), chronic lung disease (P = 0.009) and among patients who died (P < 0.05). It remained raised on day 3 in severe (P < 0.05) and deceased (P < 0.05) group. Serum calprotectin levels were significantly higher in patients with chronic lung disease (P = 0.008) and in those who died (P < 0.05). Conclusion: Serum cystatin C could be used as a tool for early prognosis and therapeutic decision-making for COVID-19 patients. Serum calprotectin seems to be a better marker of critical illness.

Variability in serum electrolytes in different grades of depression.

The present study was planned to assess the variation in serum electrolytes in patients of major depression. A total of 100 patients of 35-45 yrs of age (68 males and 32 females) of depression were compared with the age matched healthy volunteers. Severity of depression was assessed by DSM IV criteria and were graded into mild, moderate and severe depression. In all the subjects serum electrolytes (Na+, K+, Mg++ and Ca++) were assessed quantitatively. All the depression patients were having higher level of Na+, K+, and Ca++ and lower level of Mg++. Multivariate analysis showed that different grades of depression influences statistically significantly levels of serum Mg++ and Ca++ (F(2,98) for Mg++ = 4.88, P value = 0.001 and F(2,98) for Ca++ = 5.97, P value = 0.004). No statistically significant difference was observed for Na+ and K+ although their values were higher (within normal limit) in comparison to that of control group. Multiple comparison revealed highly statistically significant difference between the levels of serum Ca and Mg individually between mild and moderate depression (S V(mild & mod) for Ca++; Mg++ = 7.1; 7.4) moderate & severe depression (SV(mod & severe) for Ca++; Mg++ = 6.82; 6.92) and mild & severe depression patients (SV(mild & severe) for Ca++; Mg++ = 7.46; 7.73) with critical value = 6.36. These results indicated the disbalance in the level of serum electrolytes especially of Ca and Mg in accordance with the severity of depression.

Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19.

Comprehensive data on early prognostic indicators in patients with mild COVID-19 remains sparse. In this single center case series, we characterized the initial clinical presentation in 180 patients with mild COVID-19 and defined the earliest predictors of subsequent deterioration and need for hospitalization. Three broad patient phenotypes and four symptom clusters were characterized, differentiated by varying risk for adverse outcomes. Among 14 symptoms assessed, subjective shortness of breath (SOB) most strongly associated with adverse outcomes (odds ratio (OR) 21.3, 95% confidence interval (CI): 2.7-166.4; p < 0.0001). In combination, SOB and number of comorbidities were highly predictive of subsequent hospitalization (area under the curve (AUC) 92%). Additionally, initial lymphopenia (OR 21.0, 95% CI: 2.1-210.1; p = 0.002) and male sex (OR 3.5, 95% CI: 0.9-13.0; p = 0.05) were associated with increased risk of poor outcomes. Patients with known comorbidities, especially multiple, and those presenting with subjective SOB or lymphopenia should receive close monitoring and consideration for preemptive treatment, even when presenting with mild symptoms.

Gender based alteration in color perception.

Human beings are able to perceive hundreds of shades of color which depends on the three types of cone system and various ratios of stimulation in response to different wavelengths. Perceptually and cognitively, men and women may experience appearance of color differently. Therefore, this study was planned to assess and compare color vision in male and female subjects. This study was carried out in the department of Physiology, SGRRIM&HS, Dehradun on 60 ocular healthy subjects (equal number of males and females) of 17-22 years of age group. The task was to match 22 test color strips with 2 shade charts of different colors. Total number of correct answers and total time taken in matching all the test color strips with the shade charts was recorded in both the sexes and analyzed. The results of this study showed that overall, females gave more correct responses (P < 0.001) and also took less time (P < 0.01) than males. Color wise also, females gave more correct responses especially for red (P < .001) and green color (P < 0.01). The conclusion states that the females can see more shades of colors than males.

Salt preference: age and sex related variability.

Salt preference was assessed in 60 adults of 18-21 yrs of age (30 males and 30 females) and in 60 children of 7-12 yrs of age (30 boys and 30 girls). Subjects rated the preference on Likert scale for popcorns of five salt concentrations (OM, 1M, 2M, 3M and +3M). Statistical analysis using Two way ANOVA revealed statistically significant effect of age and sex on salt preference (F4,100 = 15.027, P < 0.01) and One Way ANOVA revealed statistically significant sex difference in salt preference of adults (F4,50 = 16.26, P < 0.01) but no statistically significant sex difference in salt preference of children (F4,50 = 4.08, P > 0.05). Dietary experiences during development and more physical activity in children may be responsible for higher salt preference in children while finding no sex variability in children favours the role of sex hormones in salt preference of male and females.

Salt preference across different phases of menstrual cycle.

It is well established that women experience food craving for particular foods and gain weight in relation to phases of menstrual cycle. In this study, the preference for different concentrations of salt sprayed on bland popcorn was assessed in 55 healthy women (age 18 to 22 yrs). Salt solutions of 0, 1, 2, 3 and +3 molar strength were used. Samples of sprayed popcorn were consumed in random order and preference marked on a Likert scale. It was observed that women preferred unsalted popcorn in the menstrual phase more than in the luteal phase. The preference for salted popcorn was most during the luteal phase and was proportionate to the strength of the salt solution used. Statistical analysis revealed significant differences in the preference rating between the menstrual phase and the other two phases. There was no significant difference in preference between the luteal and follicular phases.

Endoscopic retrograde cholangiopancreatography-associated AmpC Escherichia coli outbreak.

BACKGROUND: We identified an outbreak of AmpC-producing Escherichia coli infections resistant to third-generation cephalosporins and carbapenems (CR) among 7 patients who had undergone endoscopic retrograde cholangiopancreatography at hospital A during November 2012-August 2013. Gene sequencing revealed a shared novel mutation in a bla CMY gene and a distinctive fumC/ fimH typing profile. OBJECTIVE: To determine the extent and epidemiologic characteristics of the outbreak, identify potential sources of transmission, design and implement infection control measures, and determine the association between the CR E. coli and AmpC E. coli circulating at hospital A. METHODS: We reviewed laboratory, medical, and endoscopy reports, and endoscope reprocessing procedures. We obtained cultures from endoscopes after reprocessing as well as environmental samples and conducted pulsed-field gel electrophoresis and gene sequencing on phenotypic AmpC isolates from patients and endoscopes. Cases were those infected with phenotypic AmpC isolates (both carbapenem-susceptible and CR) and identical bla CMY-2, fumC, and fimH alleles or related pulsed-field gel electrophoresis patterns. RESULTS: Thirty-five of 49 AmpC E. coli tested met the case definition, including all CR isolates. All cases had complicated biliary disease and had undergone at least 1 endoscopic retrograde cholangiopancreatography at hospital A. Mortality at 30 days was 16% for all patients and 56% for CR patients. Two of 8 reprocessed endoscopic retrograde cholangiopancreatography scopes harbored AmpC that matched case isolates by pulsed-field gel electrophoresis. Environmental cultures were negative. No breaches in infection control were identified. Endoscopic reprocessing exceeded manufacturer's recommended cleaning guidelines. CONCLUSION: Recommended reprocessing guidelines are not sufficient.

Comparison of the Verigene Clostridium difficile, Simplexa C. difficile Universal Direct, BD MAX Cdiff, and Xpert C. difficile assays for the detection of toxigenic C. difficile.

We compared the Verigene Clostridium difficile test (Nanosphere, Northbrook, IL, USA), the Simplexa C. difficile Universal Direct (Focus Diagnostics, Cypress, CA, USA), the BD MAX Cdiff (Becton Dickinson, Franklin Lakes, NJ, USA), and the Xpert C. difficile (Cepheid, Sunnyvale, CA, USA) assays for the detection of toxigenic C. difficile. One hundred and ninety deidentified, remnant diarrheal specimens were included in this study. After resolution of discordant results by toxigenic culture, the Xpert C. difficile assay displayed the highest sensitivity (100%), with a specificity of 98.8%. The sensitivity and specificity were 95.2% and 99.4% and 87% and 100% for the Verigene CDF and Simplexa Universal Direct assays, respectively. Finally, the BD MAX assay showed a sensitivity of 87% and a specificity of 98.8%. Despite differences in the overall performance of these assays, these results support the routine use of these platforms for the detection of toxigenic C. difficile in the clinical laboratory.

Gender based variation in cognitive functions in adolescent subjects.

BACKGROUND: Cognition can be defined as all mental activities that are involved in acquisition, processing, storage and retrieval of information. PURPOSE: There is paucity of the data related to cognitive function amongst healthy adolescent age group which limits our ability to distinguish and compare cognitive changes that occur across the adult lifespan in female and male subjects separately and can provide some help to understand dementia related conditions. METHODS: Cognitive function was assessed in 100 healthy subjects of each sex of 17-20 years by using 'Montreal Cognition Assessment Test', a 10 minutes: 30-points test which is used in assessing a wide range of cognitive abilities on 7 subscales : 1) Visuospatial Skills, 2) Language, 3) Memory, 4) Attention, 5) Mathematical ability, 6) Abstraction, and 7) Orientation. RESULTS: Overall score (Male: 25.16 ± 1.8, Female: 25.72 ± 1.8) of cognition functions was statistically significantly higher in female adolescents (p=<0.02). However male subjects showed higher score in Mathematical ability. CONCLUSION: There are variations in the cognitive functions in male and female individuals and neuroanatomical and physiological differences contribute to these variations.

Native valve endocarditis due to Gordonia polyisoprenivorans: case report and review of literature of bloodstream infections caused by Gordonia species.

We report the first case of endocarditis caused by Gordonia polyisoprenivorans and concisely review the English literature regarding bloodstream infections caused by Gordonia species.