ObjectiveTo assess the feasibility of using a remote sensing model as a free messaging application tool in the preventive screening of oral potentially malignant disorders in a rural area of India.DesignAn observational cross‐sectional study.SettingPrimary care setting in Udupi District, Karnataka, South India.ParticipantsOne‐hundred and thirty‐one individuals with a mean (SD) age of 37.34 (11.31) years, of whom 64.1% and 35.9% were men and women, respectively.InterventionsClinical oral examination followed by photo capture of five areas of the patients' mouth.Main outcome measuresReliability measures for the use of a photo messaging service in diagnosing oral potentially malignant disorders, as compared to the clinical examination.ResultsWhen lesions were categorised as normal and abnormal, the reliability (kappa) between the diagnoses, based on photo messaging and clinical oral examination, was 0.68 and 0.67 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.5% and 99.04%, respectively, whereas the specificity was 72% and 64%, respectively. When the agreement between photo messaging and clinical oral examination for an exact diagnostic match was assessed, the reliability (kappa) was 0.59 and 0.55 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.1% and 98.7%, respectively, whereas the specificity was 64% and 52% respectively.ConclusionThere was a substantial agreement between the diagnosis based on clinical examination and WhatsApp image for both the examiners, when the lesions were dichotomised as normal and abnormal, but slightly reduced when assessed for the exact diagnostic match. Screening for oral potentially malignant disorders using photo messaging can serve as an effective adjunct and a potential cost‐effective tool in a low‐resource setting.

Background Candida auris is an emerging multidrug‐resistant pathogen in intensive care settings (ICU). During the coronavirus disease 19 (COVID‐19) pandemic, ICU admissions were overwhelmed, possibly contributing to the C. auris outbreak in COVID‐19 patients. Objectives The present systematic review addresses the prevalence, underlying diseases, iatrogenic risk factors, treatment and outcome of C . auris infections in COVID‐19 patients. Methods MEDLINE, Scopus, Embase, Web of Science and LitCovid databases were systematically searched with appropriate keywords from 1 st January 2020 to 31 st December 2021. Results A total of 97 cases of C. auris were identified in COVID‐19 patients. The prevalence of C. auris infections in COVID‐19 patients was 14%. The major underlying diseases were diabetes mellitus (42.7%), hypertension (32.9%), and obesity (14.6%), followed by the iatrogenic risk factors such as a central venous catheter (76.8%%) intensive care unit (ICU) stay (75.6%), and broad‐spectrum antibiotic usage (74.3%). There were no significant differences in underlying disease and iatrogenic risk factors among C. auris non‐candidemia/colonisation and C. auris candidemia cases. The mortality rate of the total cohort is 44.4%, whereas, in C. auris candidemia patients, the mortality was 64.7%. Conclusion This study shows that the prevalence of C. auris infections remains unchanged in the COVID‐19 pandemic. Hospital‐acquired risk factors may contribute to the clinical illness. Proper infection control practices and hospital surveillance may stop future hospital outbreaks during the pandemic.

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Fungemia due to Saccharomyces species are reported in considerable numbers, and the increase is attributed to using Saccharomyces boulardii probiotics in clinical settings. The present systematic review addresses the underlying diseases and risk factors in Saccharomyces fungemia patients, along with the treatment and outcome of the disease. MEDLINE, Scopus, Embase and Web of Science databases were searched systematically with appropriate keywords from June 2005 to March 2022. This review identified 117 Saccharomyces fungemia cases; 108 cases were included in the analysis. Saccharomyces fungemia is commonly seen in patients treated with S. boulardii probiotics (n = 73, 67.6%), and 35 (32.4%) patients did not receive probiotic therapy. The underlying disease and risk factors significantly associated with S. boulardii probiotic associated fungemia were intensive care unit stay (n = 34, 31.5%), total parenteral nutrition or enteral feeding (n = 32, 29.6%), patients with gastrointestinal symptoms such as diarrhoea (n = 23, 21.3%), and diabetes mellitus (n = 14, 13.0%). In patients without probiotic therapy, immunosuppression (n = 14, 13.0%), gastrointestinal surgery (n = 5, 4.6%) and intravenous drug use (n = 5, 4.6%) were the significant risk factors for Saccharomyces fungemia. The all-cause mortality rate of the total cohort is 36.1%. No significant variation in the mortality rate is observed between S. boulardii probiotic treated (n = 29, 26.9%) and untreated patients (n = 10, 9.3%). In conclusion, S. boulardii probiotic therapy in debilitated critical care patients may have contributed to increased Saccharomyces fungemia cases. Further, clinicians should be vigilant in preventing S. boulardii fungemia in patients with prophylactic probiotic therapy.