Noonan syndrome is a RASopathy with variable clinical expression. Prenatal suspicion is often based on ultrasound findings such as increased nuchal fold. Increased nuchal fold on prenatal ultrasound led to genetic evaluation and identification of a pathogenic MAPK1 variant in the foetus. Segregation analysis revealed the same mutation in the phenotypically normal mother also. The neonate after birth was clinically normal with no structural abnormalities. This case highlights the importance of prenatal markers and demonstrates that Noonan syndrome may be present without classical phenotypic features.
Extended and improper mask use may lead to increased bacterial contamination of the mask surface, highlighting the need to better understand patterns of microbial load and persistence on masks in clinical settings. This study aims to investigate the bacterial contamination in face masks used by healthcare workers (HCWs), identify the predominant bacterial species, and evaluate factors contributing to contamination. A cross-sectional study was conducted among 400 HCWs in secondary and tertiary hospitals in a metropolitan Indian city. Data was collected through interviews on demographics and hygiene. Mask and indoor air samples were analysed using conventional cultures and the Automated VITEK-2 for identification. Bacterial contamination was found in 84.5
Background: Allergic conjunctivitis (AC) affects 10–20% of the Indian population, necessitating cost-effective treatment strategies. Aims and Objectives: We aimed to evaluate the comparison between the pharmacoeconomic profiles of olopatadine hydrochloride 0.1% and bepotastine besilate 1.5% eye drops in the management of AC. Materials and Methods: This prospective and comparative study was conducted involving patients aged 18–60 years, who were randomly assigned to receive olopatadine (Group A) or bepotastine (Group B) over a 2-week treatment period. Symptom severity scores were recorded at baseline and on day 14. The average cost-effectiveness ratio (ACER) was calculated from the perspective of healthcare payers, incorporating direct drug costs and clinical outcomes. Results: Two treatment arms demonstrated comparable clinical efficacy, with no statistically significant differences in symptom resolution (P>0.05). Complete alleviation of symptoms was observed in both cohorts. However, olopatadine exhibited superior cost-effectiveness, reflected in lower ACER values (median 0.12; range 0.09–0.16) compared to bepotastine (median 0.19; range 0.14–0.24). Analysis of brand-level pricing revealed substantial variability, with daily costs for olopatadine ranging from INR 9 to INR 16 and for bepotastine from INR 13 to INR ₹22. The most cost-efficient brands were olopatadine Brand 5 (ACER 0.09023) and bepotastine Brand 4 (ACER 0.13207). Conclusion: While both olopatadine 0.1% and bepotastine 1.5% were equally effective in treating AC, olopatadine demonstrated greater cost-efficiency and more consistent pricing across brands. These findings support the preferential use of olopatadine as a first-line therapeutic agent in resource-constrained settings, highlighting the importance of generic formulations and competitive pricing in optimizing healthcare resource allocation.
ABSTRACT Background Moxifloxacin is a key component of current MDR-TB therapy regimens. The choice to include it in therapy at standard or higher doses is based on the lack or presence of resistance mutations conferring low-level or high-level resistance to moxifloxacin, as detected by the Line probe assay (LPA). Due to inherent phenotypic and genotypic discordance, such resistance must be reconfirmed phenotypically using liquid culture and drug susceptibility testing (LC-DST) at critical concentration and clinical breakpoint of the drug. This takes several weeks, delaying the therapeutic decision. The current study intends to shorten this time by performing phenotypic DST directly on sputum samples. Methods A cross-sectional study was conducted for 18 months from October 2023 to April 2025, in which smear positive sputum samples that were resistant to Rifampicin or Isoniazid or both were subjected to Direct Moxifloxacin DST, irrespective of patient characteristics. Results obtained by Direct DST were compared against Indirect LC-DST as the gold standard as well as with LPA to evaluate the diagnostic accuracy and time savings with direct DST. Results Direct DST exhibited high accuracy of 98.18%, high sensitivity (90.91%), high specificity (98.99%), excellent concordance (98.18%) and almost perfect agreement (kappa value - 0.901) when compared to Indirect DST. It saved an average of 10 ± 3.20 days over Indirect DST to obtain the valid results. Similar performance was also observed in comparison to LPA with good sensitivity (90.91%), specificity (98.99%) and accuracy (98.18%). Significant discordance was however noted in classification of resistance by both direct and indirect DST compared to LPA. Few error rates and minimal cost advantages were some of the disadvantages of Direct-DST. Conclusion Direct DST demonstrated excellent performance characteristics, making it a reliable and rapid alternative to the gold standard, saving significant time in guiding therapeutic decisions for effective patient management.
A vital component of health and well-being is mental health. While the medical profession has historically been a highly desired career in Indian society, it is also known for being demanding, often negatively impacting students’ physical and mental health. This study aims to determine prevalence of depression, anxiety, and stress and factors associated with these mental health conditions among undergraduate medical students at a Medical College in West Bengal. An observational cross-sectional study was conducted from April to September 2023 among 240 MBBS students. A pre-designed, semi-structured questionnaire, including the Depression, Anxiety and Stress Scale-21 (DASS-21), was used to collect data. Multivariable logistic regression analysis was performed to identify significant associations between the mental health conditions and various factors. The study found a high prevalence of depression (58.3
