Quality of comprehensive assessment among severely ill TB patients referred after triaging in southern India.

To reduce TB deaths, Tamil Nadu, a southern Indian state, implemented the first state-wide differentiated TB care strategy starting April 2022. Triage-positive severely ill patients are prioritised for comprehensive assessment and inpatient care. Routine program data during October-December 2022 revealed that documentation of total score after comprehensive assessment was available in only 39%, possibly indicating poor quality of comprehensive assessment. We confirmed this using operational research. The case record form to record comprehensive assessment was used only in 26% and among these, the completeness and correctness in filling out the form were sub-optimal. There is a clear need to enhance the quality of comprehensive assessments.

Depuis avril 2022, le Tamil Nadu, un État du sud de l'Inde, a mis en œuvre la première stratégie de soins différenciés pour la TB à l'échelle de l'État afin de réduire le nombre de décès dus à la TB. Les personnes gravement malades ayant obtenu un résultat positif au triage sont prioritaires pour une évaluation complète et des soins hospitaliers. Les données du programme de routine entre octobre et décembre 2022 ont révélé que la documentation du score total après l'évaluation complète n'était disponible que dans 39% des cas, ce qui pourrait indiquer une mauvaise qualité de l'évaluation complète. Nous l'avons confirmé par le biais d'une recherche opérationnelle. Le formulaire de dossier pour enregistrer l'évaluation complète n'a été utilisé que dans 26% des cas et, parmi ceux-ci, l'exhaustivité et l'exactitude du remplissage du formulaire n'étaient pas optimales. Il est manifestement nécessaire d'améliorer la qualité de l'évaluation complète.

Competency of peripheral health workers in detection & management of common syndromic conditions under surveillance, North 24 Parganas, West Bengal, India, 2016: a cross-sectional study.

BACKGROUND: Competency of peripheral health workers in the detection and management of common syndromic conditions is crucial as they are the first point of contact for the majority of the Indian population. METHODS: We measured the competency of auxiliary nurse midwives (ANMs), and factors associated with inadequate competency, in the detection and management of common conditions-diarrhoea, acute respiratory tract infection, fever, malaria-through a cross-sectional study using condition specific validated clinical vignettes and structured questionnaires. RESULTS: Out of 272 selected ANMs, 68% (95% CI 62-74%) were adequately competent. Factors independently associated with inadequate competency were unavailability of essential drugs in preceding month [adjusted odds ratio (AOR) = 1.95; 95% CI 1.1-3.5] and ever trained in integrated management of childhood illness (AOR = 2.4; 95% CI 1.4-4.1). CONCLUSION: More than two third of the peripheral health workers were adequately competent to detect and manage common conditions. Ensuring uninterrupted drug availability and improved quality in service trainings might facilitate competency levels.

Combinatorial treatment of acute spinal cord injury with ghrelin, ibuprofen, C16, and ketogenic diet does not result in improved histologic or functional outcome.

Because of the complex, multifaceted nature of spinal cord injury (SCI), it is widely believed that a combination of approaches will be superior to individual treatments. Therefore, we employed a rat model of cervical SCI to evaluate the combination of four noninvasive treatments that individually have been reported to be effective for acute SCI during clinically relevant therapeutic time windows. These treatments included ghrelin, ibuprofen, C16, and ketogenic diet (KD). These were selected not only because of their previously reported efficacy in SCI models but also for their potentially different mechanisms of action. The administration of ghrelin, ibuprofen, C16, and KD several hours to days postinjury was based on previous observations by others that each treatment had profound effects on the pathophysiology and functional outcome following SCI. Here we showed that, with the exception of a modest improvement in performance on the Montoya staircase test at 8-10 weeks postinjury, the combinatorial treatment with ghrelin, ibuprofen, C16, and KD did not result in any significant improvements in the rearing test, grooming test, or horizontal ladder. Histologic analysis of the spinal cords did not reveal any significant differences in tissue sparing between treatment and control groups. Although single approaches of ghrelin, ibuprofen, C16, and KD have been reported to be beneficial after SCI, our results show that the combination of the four interventions did not confer significant functional or histological improvements in a cervical model of SCI. Possible interactions among the treatments may have negated their beneficial effects, emphasizing the challenges that have to be addressed when considering combinatorial drug therapies for SCI.

Colorimetric assays for quantitative analysis and screening of epoxide hydrolase activity.

Focusing on directed evolution to tailor enzymes as usable biocatalysts for fine chemistry, we have studied in detail several colorimetric assays for quantitative analysis of epoxide hydrolase (EH) activity. In particular, two assays have been optimized to characterize variants issued from the directed evolution of the EH from Aspergillus niger. Assays described in this paper are sufficiently reliable for quantitative screening of EH activity in microtiter plates and are low cost alternatives to GC or MS analysis. Moreover, they are usable for various epoxides and not restricted to a type of substrate, such as those amenable to assay by UV absorbancy. They can be used to assay EH activity on any epoxide and to directly assay enantioselectivity when both (R) and (S) substrates are available. The advantages and drawbacks of these two methods to assay EH activity of a large number of natural samples are summarized.

Operationalisation of surveillance of communicable diseases in Chandigarh.

Weekly reports of listed communicable diseases from various departments and centres of Government Medical College, Chandigarh, involved in clinical care and laboratory diagnosis, compiled and forwarded by Department of Community Medicine, sub-nodal centre under National Surveillance Programme for Communicable Diseases (NSPCD), to Anti- Malaria-cum-Nodal Officer, NSPCD were analysed for a period of one year Out of 14,082 cases of various communicable diseases 9166 (64.62%) were of Acute Respiratory Infections (ARI), 3586 (25.78%) of Acute Diarrhoeal Diseases (ADDs) and 576 (4.10%) of Pulmonary Tuberculosis. The proportion of ARI appeared higher among females while that of other diseases was higher among males. Most cases of ARI (76.5%) and Pneumonia (3.09%) reported in winter, ADDs (38.89%) and Pulmonary Tuberculosis (4.68%) in summer and Typhoid (1.57%) and Viral Hepatitis (1.23%) in monsoon season. No significant gender predilection was seen. Overall reporting of communicable diseases seen to be significantly more during winter and summer compared to monsoon season, with specific seasonal trends demonstrated by various morbidities.

A spectrophotometric method to assay epoxide hydrolase activity.

The Aspergillus niger epoxide hydrolase activity was assayed by spectrophotometric using (rac) p-nitrostryrene oxide (pNSO) as substrate. Both the substrate (pNSO) and the reaction product, p-nitrostryrene diol (pNSD), had a strong absorbance in UV at 280 nm. The assay was based on the measure of the pNSD absorbance of the water phase after extraction of the non-reacted pNSO with a solvent. Among the five solvents tested, chloroform was selected since it extracted more than 99% of the epoxide and only 32% of the produced diol. This extraction yield was independent of the diol and epoxide concentrations and it was fairly reproducible. Using different enzyme amounts, the reaction kinetics were linear for the first 10 min corresponding to degrees of conversion less than 5% for the epoxide. Two controls were run simultaneously, one with the substrate alone (epoxide hydrolysis and non-complete extraction) and one with the enzyme alone (enzyme absorbance at 280 nm). The resulting DeltaOD/min was linear with the amount of enzyme added within a large range from 2 to 80 microg of the EH preparation. The new spectrophotometric assay correlates well with the previous HPLC assay and could be used routinely for an easy and fast evaluation of EH activity. The kinetic parameters of (rac) pNSO hydrolysis by A. niger epoxide hydrolase could be easily determined and K(M) (1.1 mM) compared well with that previously reported (1.0 mM).

H107, a new aminoglycoside anti-Pseudomonas antibiotic produced by a new strain of Spirillospora.

Spirillospora spp. (strain 719) has been the source of several antibiotics. One of these designated H107 is produced as a trace. Compared with other antibiotics produced by the same strain, it was obtained only from the broth filtrate after precipitation with acetic acid followed by extraction with n-butanol. It was a water soluble metabolite active against Gram-negative bacteria and especially Pseudomonas spp., and was identified as an aminoglycoside compound. This is the first report of aminoglycoside anti-Pseudomonas production by Spirillospora.

Cardiovascular responses to microinjections of excitatory amino acids into the area postrema of the rat.

Although, area postrema (AP) as been implicated in the regulation of cardiovascular function, there is no consensus regarding the type of responses elicited by stimulation of this brain structure. Microinjections (50 nl) of smaller concentrations of excitatory amino acid receptor agonists (e.g., NMDA, KA and trans-ACPD, 10 microM each) into the AP elicited pressor and tachycardic responses in unanesthetized decerebrate as well as urethane-anesthetized rats. Microinjections of higher concentrations (e.g., 50 microM NMDA) of excitatory amino acids (EAAs) into the AP elicited an initial pressor and tachycardic response which was followed by a depressor and bradycardic response; when high concentrations of NMDA were microinjected into the AP, enough concentration may have reached the nucleus tractus solitarius (nTS) to elicit depressor and bradycardic responses. Alternatively, high concentrations of NMDA may excite known projections from AP to the nTS.

Cardiovascular responses to microinjections of glutamate into the nucleus tractus solitarii of unanesthetized supracollicular decerebrate rats.

In anesthetized rats, microinjections of excitatory amino acids (EAAs) into the nucleus tractus solitarii (nTS), in a region located immediately rostral to the calamus scriptorius (CS), have been generally reported to elicit depressor and bradycardic responses. On the other hand, in conscious freely moving rats, similar microinjections have been reported to elicit pressor and bradycardic responses. These divergent results have been attributed to the effect of anesthetics. A reinvestigation of the effects of EAAs into the nTS in unanesthetized animals became necessary in order to resolve this controversy. The microinjection technique used in freely moving conscious rats suffers from several technical limitations; for example, microinjections cannot be delivered stereotaxically. In order to avoid these limitations, the present experiments were carried out in unanesthetized supracollicular decerebrate rats. A systematic mapping of nTS in these rats, using microinjections of the solutions of EAAs in artificial cerebrospinal (aCSF) fluid, confirmed that depressor and bradycardic responses are elicited from all the sites in the nTS extending from the CS to a level about 1 mm rostral to it. Pressor responses were elicited by microinjections of l-glutamate (l-Glu) only from the chemoreceptor projection site (a region of the commissural subnucleus, 0.1-0.5 mm caudal to the CS, 0-0.5 mm lateral to the midline and 0.4-0.5 mm deep from the medullary surface). The pressor responses elicited from the aforementioned site were accompanied with bradycardia; this response may be due to diffusion of l-Glu to the dorsal motor nucleus of vagus because the bradycardia disappeared when the depth of the microinjection was reduced to 0.3, instead of 0.5 mm, from the dorsal medullary surface. When urethane was administered intravenously in unanesthetized decerebrate rats, the responses to microinjections of l-Glu remained unchanged, i.e., depressor and bradycardic responses were elicited from all the sites in the nTS extending from the CS to a level about 1 mm rostral to it and pressor and tachycardic responses were elicited from the chemoreceptor projection site. These observations indicated that there is no anesthetic-induced qualitative alteration of the cardiovascular responses to microinjections of EAAs into the nTS.

A new species of Pythium isolated from the Burgundy region in France.

Pythium nodosum sp. nov. has been isolated from a soil sample taken in the Burgundy region in France. The fungus has spherical to variously shaped proliferating sporangia, smooth-walled oogonia which are crowded with different antheridial branches making a complicated knot around the former, and aplerotic oospores. Morphological and reproductive aspects of Pythium nodosum as well as the PCR of the internal transcribed spacer (ITS1) of the ribosomal nuclear DNA coupled with restriction fragment length polymorphism analysis are described here. The nucleotide sequences of ITS1 encoding 5.8S rRNA is also given.