The triazole-scaffold plays a crucial role as a specific and selective detection of Fe³⁺ ion in biological and environmental systems. These probes provide an efficient molecular platform for sensing of Fe³⁺ ion at ultra-low concentrations and bio-imaging applications. The N-rich triazole ring facilitate strong metal-ligand complexation and induces photo-induced electron transfer (PET)-based fluorescence quenching upon Fe³⁺ binding. The spectroscopic analyses (UV-vis absorption, fluorescence emission) revealed the 1:1 stoichiometry ratio and complex formation followed by distinct “turn-Off” and “turn-On” response, as well as bathochromic and hypsochromic shifts indicative of charge transfer effect. These probes exhibit ultralow detection limits, high selectivity, excellent cell permeability and good biocompatibility enabling real-time Fe³⁺ visualization. Overall, this review highlights that trizaole-scaffold-based sensor provide a versatile, cost-effective and reliable platform for environmental and biomedical applications.

Introduction: Kawasaki Disease (KD) is acute febrile, systemic vasculitis.In majority of cases, KD remains underdiagnosed as it is predominantly based on clinical criteria. Kawasaki disease mainly occur in young children below 5 years.Coronary artery aneurysm (CAA) is one of the most dreaded complication of   KD. The illness is very rarely seen in infants younger than 2 months.  Case Report:  An unusual presentation of KD in an infant as early as 60 days, was investigated, received immunoglobulins and aspirin, but due to delay in diagnosis developed CAA and had prolongrd derangement of lab parameters. Conclusion: We need to consider KD even in an infant with a case of prolonged fever so that CAA complication can be prevented.

Background: The study was conducted to evaluate the association between Central Macular Thickness (CMT) & Duration of diabetes in Patients of Type 2 Diabetes Mellitus present at Ophthalmology OPD of Tertiary Care center. Material & methods: This was a cross-sectional study on type 2 diabetes patients conducted in the department of ophthalmology, Indira Gandhi Medical College Shimla (H.P) for a period of one year. Patients who fulfilled the inclusion criteria were interviewed regarding the duration of diabetes mellitus and treatment history. A complete ophthalmologic examination including Central Macular Thickness (CMT) was performed to all patients. Results: A total of 260 eyes from 130 patients (87 males, 43 females; mean age 56.88±8.26 years) were included in this study. The mean duration of DM was 8.87±2.34 years (range, 1-25 years). In the present study, CMT in right eye ranged from 189–751 μm with mean value of 260.41±101.66. CMT in left eye ranged from 180–561 μm with mean value of 255.69±88.89. A statistically significant and positive correlation was observed between CMT in right eye and duration of diabetes (ANOVA test; p = 0.000). A statistically significant and positive correlation was also observed between CMT in left eye and duration of diabetes (ANOVA test; p = 0.009). Conclusion: Present study concluded that there was statistically significant and positive correlation between CMT and duration of diabetes in both eyes among Patients of Type 2 Diabetes Mellitus present at Ophthalmology OPD.

Background: The study was conducted to evaluate the correlation between Central Macular Thickness (CMT) and Best Corrected Visual Acuity (BCVA) in Patients of Type 2 Diabetes Mellitus present at Ophthalmology OPD of Tertiary Care center. Material and methods: This was a cross-sectional study on type 2 diabetes patients conducted in the department of ophthalmology, Indira Gandhi Medical College Shimla (H.P) for a period of one year. Patients who fulfilled the inclusion criteria were interviewed regarding the duration of diabetes mellitus and treatment history. A complete ophthalmologic examination including Central Macular Thickness (CMT) and Visual Acuity were performed to all patients. Results:  A total of 260 eyes from 130 patients (87 males, 43 females; mean age 56.88±8.26 years) were included in this study. The mean duration of DM was 8.87±2.34 years (range, 1-25 years). In the present study, CMT in right eye ranged from 189–751 μm with mean value of 260.41±101.66. CMT in left eye ranged from 180–561 μm with mean value of 255.69±88.89.  Among 130 study subjects best corrected visual acuity of right eye was 6/9 or better in 68.5% (n = 89), between 6/12–6/24 in 20.0% (n = 26), between 6/36–6/60 in 8.5% (n = 11) and worse than 6/60 in 3.1% (n = 4). Best corrected visual acuity of left eye was 6/9 or better in 67.7% (n = 88) subjects, between 6/12–6/24 in 20.8% (n = 27), between 6/36–6/60 in 7.7% (n = 10) and worse than 6/60 in 3.8% (n = 5). Increased CMT in right eye significantly correlated with decreased best corrected visual acuity in the same eye which was found to be statistically significant with a ‘p’ value of <0.01. Increased CMT in left eye significantly correlated with decreased best corrected visual acuity in the same eye which was found to be statistically significant with a ‘p’ value of <0.01. Conclusion: Present study concluded that Increased CMT was significantly correlated with decreased BCVA in both eyes among Patients of Type 2 Diabetes Mellitus present at Ophthalmology OPD.

We read with interest the review article by Wan et al. about the neurological complications of COVID-19 and its mechanisms of infection by SARS-CoV-2 [1]. It was concluded that SARS-CoV-2 may enter the brain via pathways other than invasion of the olfactory nerve, inflammatory responses disrupting the blood-brain-barrier (BBB), or infection of vascular endothelial cells [1]. The study is appealing but raises concerns and comments. The main shortcoming of the review is that the number of neurological complications after SARS-CoV-2 infections is incomplete. The authors did not consider various central nervous system (CNS) disorders, such as cerebellitis, ventriculitis, cerebral vasculitis, giant cell arteritis, transverse myelitis, optic neuritis, hypophysitis, cerebral vasoconstriction syndrome, pontine myelinolysis, and venous sinus thrombosis (VST) as manifestations of neuro-COVID. Missing are also some manifestations of neuro-COVID in the peripheral nervous system (PNS), such as cranial neuritis, myasthenia, myasthenic syndrome, and Parsonage-Turner syndrome. The various pathophysiological models according to which the virus allegedly enters the brain are nice but unsupported by real world data. For example, in almost all patients with SARS-CoV-2 associated GBS, SARS-CoV-2 could not be detected within the cerebro-spinal fluid (CSF) [2], suggesting that the virus not necessarily needs to invade the CNS to cause CNS damage. We do not agree with the statement that “cerebro-vascular disease is characterised by damage to brain tissue due to intra-cranial blood circulation disturbances” [1]. Cerebro-vascular disease may also derive from damage to extra-cranial arteries, from cardiac abnormalities, and even from disease of the peripheral veins in case of a patent foramen ovale. The cardiac origin of cerebro-vascular disease is crucial to encounter as the heart can be affected by the SARS-CoV-2 infection as well and may secondarily lead to cerebro-vascular disease. Cardiac abnormalities that have been reported in SARS-CoV-2 infected so far include endocarditis, which is usually secondary due to infectious agents other than SARS-CoV-2, myocarditis, which is usually immune-mediated and responds to immune-suppressive treatment [3], and Takotsubo syndrome, a stress-related transient heart failure. All these conditions may be complicated by intra-ventricular thrombus formation and thus a risk of cardio-embolism.

Background: Pain from the lateral aspect of the elbow was first described in 1873, and has since then been given different names such as tennis elbow (TE), lateral epicondylitis, epicondylosis, epicondylalgia and lateral elbow pain. The most frequently used term is probably TE, implying a relationship with repetitive mechanical load while using a forceful grip, as in playing tennis. Lateral epicondylitis is an inflammatory condition that occurs at the origin of the common extensor tendon of forearm over the lateral epicondyle. It is the commonest chronic disabling painful condition of the elbow. It causes symptoms in 1% to 3% of the general population. It is common in people whose occupation requires frequent rotatory motion of the forearm like carpenter, gardener, computer workers and knitting workers. The age of onset of lateral epicondylitis is between 35 and 50 years with an equal male to female sex ratio. The dominant upper limb is most commonly affected. Aim: To study the correlation between NRS, DASH and Oxford scores after percutaneous tenotomy in patients with chronic tennis elbow. Methodology: A hospital-based prospective study conducted at department of Orthopaedics, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, HP, India for a duration of 1 year (2019-20).All patients of tennis elbow (>6 months duration) consenting to be part of the study during the study duration were enrolled in the study. Results: In our study, there were a total of 47 patients, with history of chronic tennis elbow for more than 6 months duration, enrolled for the study with lost to follow up of 2 patients at 6^th month onwards. There were 24 males and 23 females. Patients' age ranged from 29-65 years with mean age of 47±9.8 years. 33 patients had tennis elbow of right side while 10 had problem on left side. 4 patients presented with difficulty on both sides. As per NRS score, at 9^th month, there were 15 patients with excellent score, 24 with good and 4 with fair score. 2 patients had poor outcome after 9^th month. As per DASH score after 9 months, 15 patients had excellent outcome and 24 had good outcome. Fair outcome was observed in 4 patients and poor in 2 patients. Conclusion: Many treatment modalities are available to address this subgroup patients with tennis elbow, Percutaneous Tenotomy has proven to be a reliable treatment method which has given sustained and improved outcomes without requirement of any additional modality  of treatment /medication option.

Background: Pain from the lateral aspect of the elbow was first described in 1873, and has since then been given different names such as tennis elbow (TE), lateral epicondylitis, epicondylosis, epicondylalgia and lateral elbow pain. The most frequently used term is probably TE, implying a relationship with repetitive mechanical load while using a forceful grip, as in playing tennis. Lateral epicondylitis is an inflammatory condition that occurs at the origin of the common extensor tendon of forearm over the lateral epicondyle. It is the commonest chronic disabling painful condition of the elbow. It causes symptoms in 1% to 3% of the general population. It is common in people whose occupation requires frequent rotatory motion of the forearm like carpenter, gardener, computer workers and knitting workers. The age of onset of lateral epicondylitis is between 35 and 50 years with an equal male to female sex ratio. The dominant upper limb is most commonly affected. Aim: To study the Clinico-epidemiological profile of patients with chronic tennis elbow undergoing percutaneous tenotomy. Methodology: A hospital-based prospective study conducted at department of Orthopaedics, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, HP, India for a duration of 1 year (2019-20).All patients of tennis elbow (>6 months duration) consenting to be part of the study during the study duration were enrolled in the study. Results: In our study, there were a total of 47 patients, with history of chronic tennis elbow for more than 6 months duration, enrolled for the study with lost to follow up of 2 patients at 6^th month onwards. There were 24 males and 23 females. Patients' age ranged from 29-65 years with mean age of 47±9.8 years. 33 patients had tennis elbow of right side while 10 had problem on left side. 4 patients presented with difficulty on both sides. As per NRS score, at 9^th month, there were 15 patients with excellent score, 24 with good and 4 with fair score. 2 patients had poor outcome after 9^th month. As per DASH score after 9 months, 15 patients had excellent outcome and 24 had good outcome. Fair outcome was observed in 4 patients and poor in 2 patients. Conclusion: Many treatment modalities are available to address this subgroup patients with tennis elbow, Percutaneous Tenotomy has proven to be a reliable treatment method which has given sustained and improved outcomes without requirement of any additional modality of treatment /medication option.

Quality assurance (QA) is the total process whereby the quality of laboratory reports can be guaranteed. The term quality control covers that part of QA, which primarily concerns the control of errors in the performance of tests and verification of test results. All materials, equipment and procedures must be adequately controlled. Culture media must be tested for sterility and performance. Each laboratory must have standard operating procedures (SOPs). Quality assurance (QA) of pre-analytical, analytical and post-analytical stages of microbiological procedures should be incorporated in SOPs. The laboratory must be well lit with dust-free air-conditioned environment. Environmental conditions should be monitored. Supervisory and technical personnel should be well qualified. The laboratory should participate in external and internal quality assurance schemes.

Antimicrobial susceptibility testing (AST) is a laboratory procedure performed by medical technologists to identify which antimicrobial regimen is specifically effective for individual patients. On a larger scale, it aids in the evaluation of treatment services provided by hospitals, clinics, and national programs for the control and prevention of infectious diseases. Clinical laboratories currently employ several methods depending on the laboratory test menu that they provide. These approaches include the disk diffusion and minimum inhibitory concentration (MIC) methods. Commercial systems also became available across health centers and hospital facilities, utilizing both phenotypic and genotypic characterization of bacterial resistance. While routine antimicrobial susceptibility testing for gram-positive (e.g., Staphylococcus aureus) and gram-negative bacteria (e.g., Pseudomonas aeruginosa) are commonly available in peripheral laboratories, drug susceptibility testing (DST) for Mycobacterium tuberculosis is usually carried out within more complex facilities like reference laboratories. Despite the differences in the techniques for susceptibility tests, all laboratories must be critical on each step of the sampling and testing process so that test results are obtainable with consistently high levels of accuracy and reliability. In this article, we elaborate the importance of AST, Standardization of Antimicrobial Sensitivity Testing (AST) Methods, Various types of AST including Disk Diffusion Method (Kirby Bauer method and Stokes method), Dilution methods (Broth dilution method and Agar dilution method), Epsilometer test and Automated Antimicrobial Susceptibility Test Systems (Vitek 2 systems, The MicroScan WalkAway system and The Phoenix system).

We read with interest the article by Xie et al. about a 51yo female with nuclear inclusion disease (NID) due to a GGC expansion of 118 repeats in NOTCH2NLC detected upon a repeat-primed PCR [1]. The patient manifested phenotypically with migraine, lactic acidosis, and a stroke-like lesion (SLL) in the right occipito-temporal area at age 51y [1]. A mitochondrial disorder (MID) was considered as a differential but excluded upon sequencing of the mitochondrial DNA (mtDNA) and application of a gene panel for mutations in nuclear DNA (nDNA) located genes involved in mitochondrial function and morphology [1]. It was concluded that a NID should be considered as a differential of migraine and a SLL and that hyperintensity on diffusion weighted imaging (DWI) and cortical enhancement could be a biomarker of NID [1]. The study is appealing but raises concerns which should be extensively discussed۔We do not agree that a MID was entirely excluded as long it is unknown which nDNA genes were actually screened for pathogenic variants by means of the mitochondrial gene panel. SLLs have been reported in association with POLG1, LIG3, CACNA1A, MYORG, TTC19, MRM2, FASTKD2, ADCK3, GJB1, CSF1R, ARCA2, and COQ4 variants [2,3,4,5,6,7,8,9,10]. Pathogenic variants in these genes should be excluded before attributing the stroke-like lesion (SLL), the morphological equivalent of a SLE, to NIG. Arguments for a MID in the index patient are the elevated serum lactate, the abnormal lactate stress test, the reduced tendon reflexes suggesting neuropathy or myopathy, the SLL on MRI, and the history of migraine. We should be told if other phenotypic features of a MID, such as short stature, hypoacusis, sicca syndrome, cardiomyopathy, diabetes, or renal insufficiency were also present in the index patient. Since MIDs are usually multisystem disease, we should be informed about the results of investigations of organs potentially affected in MIDs. A further argument for the presence of a SLL in the index patent is the dynamic expansion of the left parieto-occipital lesion within three months [1]. Since SLL usually regress over time, we should be informed about the outcome of the SLL. Regarding the diagnosis SLL, DWI, and TIRM are not sufficient. A SLL is additionally characterised by a hyperintensity on perfusion weighted images (PWI), by a hypointensity on oxygen extraction MRI (OEF-MRI), and by hypometabolism on FDG-PET or SPECT [11,12]. Missing is the electroencephalography (EEG). Since SLLs can be triggered by seizures it is crucial to exclude or confirm the presence of epileptiform discharges.