Adrenal Crisis Secondary to COVID-19 Vaccination in a Patient With Hypopituitarism.

Background/objective: Adrenal crisis (AC) is an acute life-threatening condition that can occur in patients with primary or secondary adrenal insufficiency who are already receiving glucocorticoid replacement therapy or can be a first presentation of adrenal insufficiency. Vaccination with tetanus, diphtheria, and pertussis, influenza, and pneumococcal vaccines has been reported as a cause of AC. Here, we aimed to present a case of AC precipitated by COVID-19 messenger RNA vaccination in a patient with hypopituitarism.

Treatment of MRSA infections in India: Clinical insights from a Delphi analysis.

Purpose: International and Indian guidelines for the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections are available, but the local guidelines are not MRSA-specific. This study aimed to provide clinical insights for the treatment of MRSA infections in India.

Methods: We used a three-step modified Delphi method to obtain insights.

Legal age determined by a new threshold value of third molar maturity index in subjects with impacted mandibular third molars: An orthopantomographic study in south Indian adolescents.

Third molars are one of the few biological markers available for age estimation in juveniles, especially for the estimation of the 18-year-age threshold. Literature has indicated that impaction has an influence on the development of third molars, which could possibly result in age misclassifications. The present study is intended to identify an alternative cut-off value of the third molar maturity index (I3M) in impacted mandibular third molars and also to evaluate its applicability in estimating the major (≥ 18 years)/minor (< 18 years) status.

Incidental chest computed tomography findings in asymptomatic Covid-19 patients. A multicentre Indian perspective.

In December 2019, an unprecedented outbreak of pneumonia of unknown etiology emerged called COVID-19. A vast number of people affected by this disease are asymptomatic and yet contagious with up to 79% of COVID-19 infections reportedly caused by undocumented infections. Surprisingly, these asymptomatic subjects are also known to quietly harbor pneumonia changes on CT scans.

A comparative assessment of clinical, pharmacological and antimicrobial profile of novel anti-methicillin-resistant agent levonadifloxacin: Therapeutic role in nosocomial and community infections.

Staphylococcus aureus is of significant clinical concern in both community- and hospital-onset infections. The key to the success of S. aureus as a pathogen is its ability to swiftly develop antimicrobial resistance.

A universal stress protein in sequesters the cAMP-regulated lysine acyltransferase and is essential for biofilm formation.

Universal stress proteins (USPs) are present in many bacteria, and their expression is enhanced under various environmental stresses. We have previously identified a USP in that is a product of the gene and is a substrate for a cAMP-regulated protein lysine acyltransferase (KATms; MSMEG_5458). Here, we explored the role of this USP (USP) in and found that its gene is present in an operon that also contains genes predicted to encode a putative tripartite tricarboxylate transporter (TTT).

ORBIT: a New Paradigm for Genetic Engineering of Mycobacterial Chromosomes.

Two efficient recombination systems were combined to produce a versatile method for chromosomal engineering that obviates the need to prepare double-stranded DNA (dsDNA) recombination substrates. A synthetic "targeting oligonucleotide" is incorporated into the chromosome via homologous recombination mediated by the phage Che9c RecT annealase. This oligonucleotide contains a site-specific recombination site for the directional Bxb1 integrase (Int), which allows the simultaneous integration of a "payload plasmid" that contains a cognate recombination site and a selectable marker.

A Lysine Acetyltransferase Contributes to the Metabolic Adaptation to Hypoxia in Mycobacterium tuberculosis.

Upon inhibition of respiration, which occurs in hypoxic or nitric oxide-containing host microenvironments, Mycobacterium tuberculosis (Mtb) adopts a non-replicating "quiescent" state and becomes relatively unresponsive to antibiotic treatment. We used comprehensive mutant fitness analysis to identify regulatory and metabolic pathways that are essential for the survival of quiescent Mtb. This genetic study identified a protein acetyltransferase (Mt-Pat/Rv0998) that promoted survival and altered the flux of carbon from oxidative to reductive tricarboxylic acid (TCA) reactions.

Efficacy and Cost Comparison of Ertapenem as Outpatient Parenteral Antimicrobial Therapy in Acute Pyelonephritis due to Extended-spectrum Beta-lactamase-producing .

Outpatient parenteral antimicrobial therapy (OPAT) programs are becoming an increasingly popular trend in clinical practice as they offer several benefits to both patients and health-care setups. While OPAT is an established clinical practice in the Western world, the concept itself is alien to patients in India as they prefer the security of hospitals to receive antibiotics over OPAT. We evaluated the clinical response and cost comparison of ertapenem under OPAT versus inpatient settings in patients with extended-spectrum beta-lactamase (ESBL)-positive acute pyelonephritis (APN) given the increasing importance of optimizing both hospital beds and overall cost of patient care in India.

Two-Year Follow-up of Isolated Epileptiform Discharges in Autism: An Endophenotypic Biomarker?

Context: A significant subset of autistic children exhibit abnormal isolated epileptiform discharges (IEDs) in the absence of clinical epilepsy. The etiological significance of such IEDs is under much debate.

Aims: The aim is to study the relationship between IEDs with risk factors, clinical severity, behavioral problems, and social-quotient and follow-up for the occurrence of new seizures.

Cyclical Vomiting Syndrome: Psychiatrist's View Point.

Cyclical vomiting syndrome (CVS) is an idiopathic functional disorder characterized by recurrent episodes of nausea and vomiting separated by symptom-free intervals. Even though initially described in children, it is seen in all age groups. Exact etiology is not known.

Nitric oxide prevents a pathogen-permissive granulocytic inflammation during tuberculosis.

Nitric oxide contributes to protection from tuberculosis. It is generally assumed that this protection is due to direct inhibition of Mycobacterium tuberculosis growth, which prevents subsequent pathological inflammation. In contrast, we report that nitric oxide primarily protects mice by repressing an interleukin-1- and 12/15-lipoxygenase-dependent neutrophil recruitment cascade that promotes bacterial replication.

Statistical analysis of genetic interactions in Tn-Seq data.

Tn-Seq is an experimental method for probing the functions of genes through construction of complex random transposon insertion libraries and quantification of each mutant's abundance using next-generation sequencing. An important emerging application of Tn-Seq is for identifying genetic interactions, which involves comparing Tn mutant libraries generated in different genetic backgrounds (e.g.

Forensic psychiatry in India: Past, present, and future.

Forensic psychiatry is a subspecialty of psychiatry, in which scientific and clinical expertise is applied to legal issues in legal contexts embracing civil, criminal, correctional, or legislative matters. Forensic psychiatry is still in an infant stage in India and other developing countries. Law is the sanctioning discipline, and Psychiatry is the therapeutic discipline.

xCT increases tuberculosis susceptibility by regulating antimicrobial function and inflammation.

The physiological functions of macrophage, which plays a central role in the pathogenesis of tuberculosis, depend on its redox state. System xc-, a cystine-glutamate transporter, which consists of xCT and CD98, influences many ROS-dependent pathways by regulating the production of the antioxidant glutathione. xCT's ability to alter this critical host redox balance by increasing the glutathione synthesis aspect of phagocyte physiology suggested that it might influence tuberculosis pathogenesis.

Fine-tuning of Substrate Affinity Leads to Alternative Roles of Mycobacterium tuberculosis Fe2+-ATPases.

Little is known about iron efflux transporters within bacterial systems. Recently, the participation of Bacillus subtilis PfeT, a P1B4-ATPase, in cytoplasmic Fe(2+) efflux has been proposed. We report here the distinct roles of mycobacterial P1B4-ATPases in the homeostasis of Co(2+) and Fe(2+) Mutation of Mycobacterium smegmatis ctpJ affects the homeostasis of both ions.

Joubert syndrome with autism in two siblings: A rare presentation.

Joubert syndrome is a rare autosomal recessive disorder with partial or complete agenesis of cerebellar vermis. This syndrome is identified mainly by the presence of molar tooth sign in magnetic resonance imaging of the brain since it has a varied phenotypic presentation. Of the 200 cases reported so far in the literature, only three reports show the presence of autistic symptoms in siblings suggesting a link between the cerebellar vermis and autistic spectrum disorders.

Mental Illness and Nullity of Marriage: Indian Perspective.

Marriage is a social institution that formalizes and stabilizes the union between a man and wife. At times, either of the parties undergoing the contract of marriage may ask it be declared null and void. Psychiatrists and legal experts may be called in to provide opinion whether such a marriage should be annulled.

X-linked adrenoleukodystrophy presenting as attention deficit hyperactivity disorder.

X-linked adrenoleukodystrophy (X-ALD) is one the leukodystrophies causing a progressive decline in neurological function mainly affecting the children. The most common symptoms are changes in behavior, including social withdrawal or aggression, poor memory or poor scholastic performance. Here, we present a 7-year-old boy who presented with symptoms of inattention and hyperactivity and later turned out to be a case of X-ALD.

The Oxidative Stress Network of Mycobacterium tuberculosis Reveals Coordination between Radical Detoxification Systems.

M. tuberculosis (Mtb) survives a hostile environment within the host that is shaped in part by oxidative stress. The mechanisms used by Mtb to resist these stresses remain ill-defined because the complex combination of oxidants generated by host immunity is difficult to accurately recapitulate in vitro.

The story of a girl with weeping blood: Childhood depression with a rare presentation.

Ms. V, a 10-year-old girl was referred to Child Psychiatry Department with complaints of bleeding from eyes for last 3 months. Bleeding was spontaneous, recurrent, painless, and self-limited.