Coronavirus disease 2019 (COVID‐19) has been shown to be associated with a lot of neurological complications, of whom Guillain‐Barre syndrome (GBS) is an important post‐infectious consequentiality. More than 220 patients with GBS have been reported thus far. We intend to share our experience with five patients of GBS where one of them had severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in the cerebrospinal fluid (CSF). This is the first‐ever report demonstrating the presence of SARS‐CoV‐2 in the CSF of an adult patient; a similar occurrence has recently been described in a pediatric patient. We wish to emphasize the fact that commonly GBS occurs as a result of a post‐infectious process but in a few cases where the symptoms of COVID‐19 and GBS occur concurrently, corresponding to the viremic phase, separate pathogenesis needs to be thought of. This para‐infectious nature is exemplified by the presence of virus in the cerebrospinal fluid of one of our patients. We review the neuroinvasive potential of SARS‐Cov‐2 in this regard and draw parallels with Cytomegalovirus, Zika virus, and Human Immunodeficiency virus‐associated occurrences of GBS.

Amoxicillin possess antimicrobial activity against major pathogens in orofacial odontogenic infections, but β-lactamase production has restricted the effectiveness of amoxicillin against the resistant strains of Staphylococcus aureus, Bacteroides, Prevotella and Porphyromonas. For the management of orofacial infections, the use of amoxicillin/clavulanate and clindamycin is recommended because of stability against β-lactamases.

BackgroundMobile health (mHealth) has the potential to solve human resource issues in the health care sector. mHealth is of particular interest in developing countries, where widespread mobile networks and access to devices are connecting people like never before.ObjectiveThe aim of this paper was to review published and unpublished literature, field projects, and pilot studies on mHealth usage in overcoming shortage of human health resources in developing countries.MethodsA narrative literature review was undertaken using an iterative approach in extracting literature focused on mHealth and human health resources of low-income countries, especially India. The present review has undertaken comprehensive coverage of the work on related field projects that have been either published, accepted for publication, or pilot tested.ResultsThis review presented the use of mHealth across various dimensions of primary health care, including data collection, disease surveillance, health education, supervision, monitoring, and feedback. Field studies of fast, error-free data collection and transmission using mHealth were also documented. New apps for supervision, monitoring, and utilization of innovative health education tools were documented in the current review. Practical limitations of mHealth and challenges set forth in developing countries included issues of data security, cost constraints, health provider privacy, and technical barriers.ConclusionsIn the present review, we have documented a few mHealth projects that contribute to the proficient use of human resources. These projects pave the path for the efficient utilization of mHealth, offering solutions to emerging human resource challenges and simultaneously revamping the health care delivery in resource-limited settings.

Background: Breast cancer is a heterogeneous disease comprising of distinct biological subtypes with many targeted prognostic biomarkers having therapeutic implications. However, no specific targeted therapy for triple negative breast cancer has been discovered to date and hence further research is needed. Aim: The aim and objectives of the present study were to examine the prevalence of triple negative breast cancer (TNBC) in North-East India and to compare the clinicopathological parameters in two study groups defined by immunohistochemistry (IHC) -"TNBC" and "Others". Materials and Methods: We carried out a retrospective study in a cohort of 972 patients diagnosed with invasive breast carcinoma in the Department of Pathology, Dr. B. Borooah Cancer Institute, a Regional Cancer Centre for treatment and research, Guwahati, for a period of 3 years and 10 months from January 2010 to October 2013. Based on IHC findings, patients were divided into two groups -"TNBC" and "Others". All relevant clinicopathological parameters were compared in both. TNBC were defined as those that were estrogen receptor (ER), progesterone receptor (PR), and HER2/neu negative while those positive for any of these markers were defined as "Others". Results: In this study, out of total 972 cases 31.9% (310 cases) were defined as TNBC and 662 cases (68.1%) as "Others" based on IHC markers. Compared to the "Others" category, TNBC presented at an early age (mean 40 years), were associated with high grade large tumours and high rate of node positivity, IDC NOS being the most common histological subtype in TNBC. Conclusions: TNBC accounts for a significant portion of breast cancers in this part of India and commonly present at younger age and tend to be large high grade tumours.

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Workers involved in battery manufacturing or recycling factories are occupationally exposed to high concentrations of lead. In humans, lead can cause a wide range of biological effects depending upon the level and duration of exposure. The purpose of this study was to find out the blood lead levels (BLL) in occupationally exposed workers involved in battery industry in Delhi NCR region and to study whether lead affected the vitamin D (vit D) and calcium metabolism. For this study 100 occupationally lead-exposed battery workers (LEBW) and 100 non-lead exposed controls (NLEC) were recruited. BLL were measured using inductively coupled plasma optical emission spectrometer (ICP-OES) technique while ELISA was performed to quantify the serum vit D levels in the study subjects. Routine biochemical parameters were measured by chemistry autoanalyzers. Statistical analysis was done using appropriate statistical tools. Results showed that BLL were significantly higher in LEBW as compared to NLEC (p \ 0.0001). Serum vitamin D, calcium and phosphorus levels were significantly decreased in battery workers as compared to controls (p \ 0.005). Spearman's rank correlation analysis showed significant negative correlation of BLL with serum Vitamin D and calcium levels. Significant positive correlation was observed between BLL and duration of lead exposure. Weak negative correlation was also observed between BLL and vit D even after adjusting for smoking status. In conclusion, this study demonstrated that higher BLL significantly alters the vit D and calcium metabolism.

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Introduction: The coronavirus disease (COVID-19) pandemic has surfaced as a public health emergency and the world has witnessed the evolution of unprecedented measures for slowing down the disease progression and reducing the morbidity/mortality associated with the disease. In such scenario healthcare workers assume the most vital and the most vulnerable responsibilities. Aim: To investigate the awareness of undergraduate students of pre-final and final year, interns and postgraduate students in Shyam Shah Medical College, Rewa, MP towards COVID-19 and the sources on which the respondents depend for acquiring information through a web based questionnaire. Materials and Methods: This was a cross-sectional study, conducted from 25th April to 1st May 2020 based on a close-ended, time bound, online questionnaire containing 16 questions based on aetiology, mode of transmission, risk factors, signs, symptoms, treatment and prevention of COVID-19. It was administered to a total of 320 students of which final respondents were 183 (112 undergraduate students and 71 post graduate students and interns) as a Google form through a cross platform messaging application namely WhatsApp. Data about the information sources and the perceived reliability of the respondents on them was also obtained. The filled information was evaluated and the collected data was presented as frequencies and percentages. Awareness was graded as good when the respondents were able to answer more than 75% (>12) questions correctly, average when they answered >50% and ≤75% (9-12) answers correctly and poor when they could answer ≤50% (≤8) questions correctly. Continuous variables were presented as mean±SD. Student’s Independent t-test was performed to compare the mean awareness level of both groups. A p-value of less than 0.05 was considered statistically significant. Results: Out of a total of 320 students to whom the questionnaire was sent, 183 participated in the survey (response rate=57.1%). The study revealed a good awareness level of the respondents towards COVID-19 (mean score >12) in both the groups (undergraduate/postgraduate). The percentage of correct answers for entire study population for awareness related questions was 82.24%. The difference in awareness level between undergraduate students in comparison to interns and postgraduate students was found to be statistically significant (p<0.001). The respondents obtained maximum information from the official government websites (mean=3.6) and had maximum confidence on the same for the credibility of data (mean=3.9). Conclusion: The awareness level of the students was found to be good. To cope up with this new emerging infectious disease, the health care workers must remain updated with all recent developments. Comprehensive educational programs focused on field epidemiology, infection control practice and public health are the need of the hour.