Evaluation of hospital environment for presence of Mucorales during COVID-19-associated mucormycosis outbreak in India - a multi-centre study.

BACKGROUND: An unprecedented rise in the number of COVID-19-associated mucormycosis (CAM) cases has been reported in India. Myriad hypotheses are proposed for the outbreak. We recently reported uncontrolled diabetes and inappropriate steroid therapy as significant risk factors for the outbreak. However, Mucorales contamination of hospital environment was not studied. AIM: To perform a multi-centre study across India to determine possible Mucorales contamination of hospital environment during the outbreak. METHODS: Eleven hospitals from four zones of India representing high to low incidence for mucormycosis cases were included in the study. Samples from a variety of equipment used by the patients and ambient air were collected during May 19th, 2021 through August 25th, 2021. FINDINGS: None of the hospital equipment sampled was contaminated with Mucorales. However, Mucorales were isolated from 11.1% air-conditioning vents and 1.7% of patients' used masks. Other fungi were isolated from 18% of hospital equipment and surfaces, and 8.1% of used masks. Mucorales grew from 21.7% indoor and 53.8% outdoor air samples. Spore counts of Mucorales in air were significantly higher in the hospitals of North and South zones compared to West and East zones (P < 0.0001). Among Mucorales isolated from the environment, Rhizopus spp. were the most frequent genus. CONCLUSION: Contamination of air-conditioning vents and hospital air by Mucorales was found. Presence of Mucorales in these areas demands regular surveillance and improvement of hospital environment, as contamination may contribute to healthcare-associated mucormycosis outbreaks, especially among immunocompromised patients.

Holoentropy enabled-decision tree for automatic classification of diabetic retinopathy using retinal fundus images.

Diabetic retinopathy (DR) is the most common diabetic eye disease. Doctors are using various test methods to detect DR. But, the availability of test methods and requirements of domain experts pose a new challenge in the automatic detection of DR. In order to fulfill this objective, a variety of algorithms has been developed in the literature. In this paper, we propose a system consisting of a novel sparking process and a holoentropy-based decision tree for automatic classification of DR images to further improve the effectiveness. The sparking process algorithm is developed for automatic segmentation of blood vessels through the estimation of optimal threshold. The holoentropy enabled decision tree is newly developed for automatic classification of retinal images into normal or abnormal using hybrid features which preserve the disease-level patterns even more than the signal level of the feature. The effectiveness of the proposed system is analyzed using standard fundus image databases DIARETDB0 and DIARETDB1 for sensitivity, specificity and accuracy. The proposed system yields sensitivity, specificity and accuracy values of 96.72%, 97.01% and 96.45%, respectively. The experimental result reveals that the proposed technique outperforms the existing algorithms.

Improving performance of microbial fuel cell while controlling methanogenesis by Chaetoceros pretreatment of anodic inoculum.

Loss of substrate due to methanogenesis reduces Coulombic efficiency (CE) of the microbial fuel cell (MFC) significantly. Hexadecatrienoic acid present in the marine algae Chaetoceros inhibits the growth of methanogenic archaea. Influence of Chaetoceros pre-treated mixed anaerobic sludge on the electrogenic activity of MFC was evaluated. A MFC inoculated with Chaetoceros pre-treated mixed anaerobic sludge demonstrated maximum CE of 45.18%, with volumetric power density of 21.43W/m(3) and current density of 93A/m(3). Cyclic voltammetry indicated higher electron discharge on the anode surface due to suppression of methanogenesis. Tafel analysis also showed a higher exchange current density and a lower Tafel slope and charge transfer resistance, indicating advantage of this pre-treatment method in reducing the cell internal losses. A 60% reduction in specific methanogenic activity was observed in anaerobic sludge pre-treated with Chaetoceros; emphasizing significance of this pretreatment for suppressing methanogenesis and its utility for enhancing electricity generation in MFC.

Comparison of oxygen and hypochlorite as cathodic electron acceptor in microbial fuel cells.

Effect of oxygen and sodium hypochlorite (NaOCl) as cathodic electron acceptors on performance of a clayware microbial fuel cell (MFC) was evaluated in this study. Maximum power density of 6.57 W/m(3) was obtained with NaOCl as catholyte, which is about 9 times higher than oxygen being used as an electron acceptor. Voltammetry and Tafel analysis further supported the faster reduction kinetics lead to increase in power output and reduction in internal resistance of MFC operated with NaOCl as an electron acceptor. Using NaOCl as catholyte, higher exchange current density of 10.91 and 11.52 mA/m(2) and lower charge transfer resistance of 0.58 and 0.56 kΩ m(2) was observed for anode and cathode, respectively. Higher organic matter removal of about 90% with 25% Coulombic efficiency was achieved using NaOCl as catholyte. Higher internal resistance, lower cathode potential and slow reduction kinetics deteriorated performance of MFC using oxygen as cathodic electron acceptor.

Nuevo método espectrofotométrico para la estimación de olmesartán medoxomilo en forma de dosificación comprimido usando la solubilización isotrópica / Novel Spectrophotometric Method for Estimation of Olmesartan Medoxomil from its Tablet Dosage Form Using Hydrotropic Solubilization

Objetivo: La estimación cuantitativa de fármacos poco solubles en agua implica el uso de disolventes orgánicos. En la presente investigación, se emplea la solubilización hidrotrópica para mejorar las solubilidades acuosas fármacos poco solubles en agua como el olmesartán medoxomilo dosificado en comprimido. Material y Métodos: Este método emplea acetato sódico 0,05 M como agente solubilizante hidrotrópico, mostrando el olmesartán medoxomilo una absorbancia máxima a 256 nm. La solución de acetato 0.05 M no muestra ninguna interferencia con la longitud de onda de muestreo. El agente hidrotrópico y los aditivos utilizados en la elaboración de los comprimidos no interfieren en el análisis. Resultados y conclusiones: El fármaco obedece a la Ley de Beer en el intervalo de concentraciones 2-14 mg / ml con un de coeficiente de correlación de 0,9987. El método desarrollado fue validado estadísticamente siguiendo las directrices ICH Q2B (R1). El análisis estadístico demostró que el método era sencillo y rápido para la estimación de olmesartán medoxomilo y se puede utilizar para análisis de rutina de olmesartán medoxomilo en laboratorios de control de calidad (AU)

Aim: Quantitative estimation of poorly water-soluble drugs involves use of organic solvents. In the present investigation, hydrotropic solubilization is employed to enhance the aqueous solubilities of poorly water-soluble drugs like Olmesartan Medoxomil in tablet dosage forms.Material and methods: This method utilizes 0.05 M Sodium acetate solution as hydrotropic solubilizing agent Where Olmesartan Medoxomil shows maximum absorbance at 256 nm. The 0.05 M Sodium acetate solution does not show any interference with the sampling wavelength. The hydrotropic agent and additives used in the manufacture of tablets did not interfere in the analysis. Results and Conclusion: The drug obeys the Beer’s Law in the concentration range 2-14 μg/ml with correlation coefficient value of 0.9987. The developed reliable method was validated statistically following ICH Q2B (R1) guidelines. Statistical analysis proved that the method was simple and rapid for the estimation of Olmesartan Medoxomil and can be used for routine analysis of Olmesartan Medoxomil in quality control laboratories. The ex vivo mucoadhesion time of patches ranged between 109 min (FA10) to 126 min (FB14). The ex vivo mucoadhesive force was in the range of 0.278 to 0.479 Kg.m.s-2. The in vitro drug release studies revealed that formulation FA8 released 84% and FB16 released 99.01% of drug in 140 min (AU)

Column chromatographic separation of lead(II) using poly [dibenzo-18-crown-6] in L-ascorbic acid.

A column chromatographic separation method has been developed for separation of Lead(II) using poly[dibenzo-18-crown-6]. The separation was carried out in L-ascorbic acid medium. The adsorption of Lead(II) was quantitative from 1 x 10(-2) M to 1 x 10(-7) M L-ascorbic acid. The capacity of poly [dibenzo-18-crown-6] for Lead (II) was found to be 0.530 +/- 0.01 mmol/g of crown polymer. Lead(II) was separated from commonly associated metal ions such as Mg(II), Co(II), Ni(II), Cd(II), Mn(II) Th(IV) and U(VI) and other associated metal ions in binary as well as in multicomponent mixtures. The sorption of Lead was carried out in presence of various ions to ascertain the tolerance limits of individual. The method was extended for the determination of Lead in real samples. The method is simple, rapid and selective having good reproducibility (approximately +/- 2%).

Differential induction, purification and characterization of cold active lipase from Yarrowia lipolytica NCIM 3639.

The production, purification and characterization of cold active lipases by Yarrowia lipolytica NCIM 3639 is described. The study presents a new finding of production of cell bound and extracellular lipase activities depending upon the substrate used for growth. The strain produced cell bound and extracellular lipase activity when grown on olive oil and Tween 80, respectively. The organism grew profusely at 20 °C and at initial pH of 5.5, producing maximum extracellular lipase. The purified lipase has a molecular mass of 400 kDa having 20 subunits forming a multimeric native protein. Further the enzyme displayed an optimum pH of 5.0 and optimum temperature of 25 °C. Peptide mass finger printing reveled that some peptides showed homologues sequence (42%) to Yarrowia lipolytica LIP8p. The studies on hydrolysis of racemic lavandulyl acetate revealed that extracellular and cell bound lipases show preference over the opposite antipodes of irregular monoterpene, lavandulyl acetate.

Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes.

Individual studies indicate that kidney transplantation is associated with lower mortality and improved quality of life compared with chronic dialysis treatment. We did a systematic review to summarize the benefits of transplantation, aiming to identify characteristics associated with especially large or small relative benefit. Results were not pooled because of expected diversity inherent to observational studies. Risk of bias was assessed using the Downs and Black checklist and items related to time-to-event analysis techniques. MEDLINE and EMBASE were searched up to February 2010. Cohort studies comparing adult chronic dialysis patients with kidney transplantation recipients for clinical outcomes were selected. We identified 110 eligible studies with a total of 1 922 300 participants. Most studies found significantly lower mortality associated with transplantation, and the relative magnitude of the benefit seemed to increase over time (p < 0.001). Most studies also found that the risk of cardiovascular events was significantly reduced among transplant recipients. Quality of life was significantly and substantially better among transplant recipients. Despite increases in the age and comorbidity of contemporary transplant recipients, the relative benefits of transplantation seem to be increasing over time. These findings validate current attempts to increase the number of people worldwide that benefit from kidney transplantation.

Rhinocerebral mucormycosis in a pregnant woman with diabetic ketoacidosis.

Rhinocerebral mucormycosis (RCM) is a rare but often fatal condition characterized by aggressive necrotizing infection originating from nose and spreading to paranasal sinuses, orbit and central nervous system. Although Fungi and spores of mucorales show minimal intrinsic pathogenicity towards normal persons, they can initiate fulminant infections in patients with underlying debilitating conditions. A case of RCM in a pregnant woman with diabetic keto-acidosis successfully treated by supportive care, amphotericin B and surgery is reported.

Pyrethroid resistance and mechanisms of resistance in field strains of Helicoverpa armigera (Lepidoptera: Noctuidae).

Pyrethroid resistance was found in 54 field strains of Helicoverpa armigera collected between 1995 and 1999 from 23 districts in seven states of India. LD50 values of the field strains ranged from 0.06 to 72.2 microg/larva with slopes of 0.5-3.1. Resistance was highest in regions where pyrethroid use was frequent (four to eight applications per season). Resistance to deltamethrin was exceptionally high with resistance ratios of 13,570 and 27,160 in two strains collected during February 1998 in central India. Resistance to cypermethrin, fenvalerate and cyhalothrin also was high with resistance ratios of >1,000 in four strains collected from central and southern India. Resistance ratios were below 100 in >50% of the strains tested. Pyrethroid resistance was high in strains collected from the districts in Andhra Pradesh where a majority of the cotton farmer suicide cases in India were reported. Resistance to pyrethroids appeared to have increased over 1995-1998 in most of the areas surveyed. Studies carried out through estimation of detoxification enzyme activity and synergists indicated that enhanced cytochrome p450 and esterase activities were probably important mechanisms for pyrethroid resistance in field strains. Pyrethroid nerve insensitivity also was found to be a major mechanism in some parts of the country where the use of pyrethroids was high. The information presented illustrates the importance of proper insect management programs to avoid the consequences associated with improper insecticide use.

Carbamate and organophosphate resistance in cotton pests in India, 1995 to 1999.

Monitoring for organophosphate and carbamate resistance was carried out on five major insect pests of cotton collected from 22 cotton-growing districts across India. Resistance was monitored in Helicoverpa armigera (Hübner) and Pectinophora gossypiella (Saunders) for the period 1995-1999 and for Spodoptera litura (Fabricius), Earias vittella (Fabricius) and Bemisia tabaci (Gennadius) in a survey conducted during the 1997-98 cropping season. Of the 53 field strains of H. armigera, only four were found to exhibit resistance to quinalphos, the highest 15-fold, whereas all 16 field strains tested were found to be resistant to monocrotophos. Similarly, out of 40 field strains tested, only eight were found to express appreciable resistance to methomyl. Resistance in P. gossypiella to quinalphos was high in the majority of the strains tested. Of the seven strains of E. vittella tested, two strains from northern India exhibited > 70-fold resistance to monocrotophos. Of the 11 S. litura strains tested, only four were found to exhibit resistance factors of 10 to 30-fold to quinalphos and monocrotophos. All of the B. tabaci field strains exhibited resistance to methomyl and monocrotophos and susceptibility to triazophos. Practical implications for pest control resulting from the observed patterns of cross-resistance between quinalphos, monocrotophos and methomyl are discussed.