Effect of infestation stage, form and treatment on fragment count in flour

Call number: LD2668 .T4 1979 S23Master of Scienc

Assessment of maternal and child health (MCH) practices with a focus on Janani Suraksh Yojana (JSY)

Background Janani Suraksha Yojana (JSY) is a safe motherhood intervention encompassing conditional cash transfer scheme initiated under National Rural Health Mission (NRHM).Objective A rapid appraisal was conducted to assess selected maternal and child health (MCH) practices among rural mothers in a block of Haryana with a focus on JSY. Methodology Using stratified random sampling, 6 health subcentre area in a rural block of Haryana were selected and all available JSY (n=72) mothers with their child in age-group of 6-11 months were covered. Similar numbers of non-JSY (n=76) mother were also contacted by the investigators using pre-designed, pre-tested semi-structure interview schedule. Results Out of 148 mothers, majority (77.02%) were in the age-group of 20-24 years; overall 52.02% [45.83% (JSY) vs. 57.89% (non-JSY)] had completed atleast 9 years of schooling; all (100%) JSY beneficiaries belonged to affirmative group (OBC/SC) but only 38.89% of them possessed BPL-card; a total of 68 (45.94%), 62 (41.89%) and 18 (12.16%) mothers had one, two & three living children respectively and 93% women were home-maker. Higher proportion of non-JSY (72.36%) viz. JSY (54.16%) mothers had institutional delivery (p<0.05). Pre-lacteal feed was administered to 60% of newborn while 95% received colostrum; however only 32.43% were initiated on breast-milk within first hour of birth inspite of all being normal vaginal deliveries. Nearly 91.66% of JSY and 22.36% of non-JSY mothers were aware of the financial scheme (p<0.05); only 20.83% JSY mothers received money within one-month of delivery; 47.22% of mothers spent money either on themselves or child care while amongst rest it got utilized within general family pool

Key diffusion mechanisms involved in regulating bidirectional water permeation across E. coli outer membrane lectin

Capsular polysaccharides (CPSs) are major bacterial virulent determinants that facilitate host immune evasion. E. coli group1 K30CPS is noncovalently attached to bacterial surface by Wzi, a lectin. Intriguingly, structure based phylogenetic analysis indicates that Wzi falls into porin superfamily. Molecular dynamics (MD) simulations further shed light on dual role of Wzi as it also functions as a bidirectional passive water specific porin. Such a functional role of Wzi was not realized earlier, due to the occluded pore. While five water specific entry points distributed across extracellular &periplasmic faces regulate the water diffusion involving different mechanisms, a luminal hydrophobic plug governs water permeation across the channel. Coincidently, MD observed open state structure of "YQF" triad is seen in sugar-binding site of sodium-galactose cotransporters, implicating its involvement in K30CPS surface anchorage. Importance of Loop 5 (L5) in membrane insertion is yet another highlight. Change in water diffusion pattern of periplasmic substitution mutants suggests Wzi's role in osmoregulation by aiding in K30CPS hydration, corroborating earlier functional studies. Water molecules located inside β-barrel of Wzi crystal structure further strengthens the role of Wzi in osmoregulation. Thus, interrupting water diffusion or L5 insertion may reduce bacterial virulence

Factors Associated with Tuberculosis and Rifampicin-Resistant Tuberculosis amongst Symptomatic Patients in India: A Retrospective Analysis

Background Tuberculosis remains a major public health challenge for India. Various studies have documented different levels of TB and multi-drug resistant (MDR) TB among diverse groups of the population. In view of renewed targets set under the End TB strategy by 2035, there is an urgent need for TB diagnosis to be strengthened. Drawing on data from a recent, multisite study, we address key questions for TB diagnosis amongst symptomatics presenting for care: are there subgroups of patients that are more likely than others, to be positive for TB? In turn, amongst these positive cases, are there factors—apart from treatment history—that may be predictive for multi-drug resistance? Methods We used data from a multi-centric prospective demonstration study, conducted from March 2012 to December 2013 in 18 sub-district level TB programme units (TUs) in India and covering a population of 8.8 million. In place of standard diagnostic tests, upfront Xpert MTB/RIF testing was offered to all presumptive TB symptomatics. Here, using data from this study, we used logistic regression to identify association between risk factors and TB and Rifampicin-Resistant TB among symptomatics enrolled in the study. Results We find that male gender; history of TB treatment; and adult age compared with either children or the elderly are risk factors associated with high TB detection amongst symptomatics, across the TUs. While treatment history is found be a significant risk factor for rifampicin-resistant TB, elderly (65+ yrs) people have significantly lower risk than other age groups. However, pediatric TB cases have no less risk of rifampicin resistance as compared with adults (OR 1.23 (95% C.I. 0.85–1.76)). Similarly, risk of rifampicin resistance among both the genders was the same. These patterns applied across the study sites involved. Notably in Mumbai, amongst those patients with microbiological confirmation of TB, female patients showed a higher risk of having MDR-TB than male patients. Conclusion Our results cast fresh light on the characteristics of symptomatics presenting for care who are most likely to be microbiologically positive for TB, and for rifampicin resistance. The challenges posed by TB control are complex and multifactorial: evidence from diverse sources, including retrospective studies such as that addressed here, can be invaluable in informing future strategies to accelerate declines in TB burden

E. coli Group 1 Capsular Polysaccharide Exportation Nanomachinary as a Plausible Antivirulence Targetin the Perspective of Emerging Antimicrobial Resistance

Bacteria evolving resistance against the action of multiple drugs and its ability to disseminate the multidrug resistance trait(s) across various strains of the same bacteria or different bacterial species impose serious threat to public health. Evolution of such multidrug resistance is due to the fact that, most of the antibiotics target bacterial survival mechanisms which exert selective pressure on the bacteria and aids them to escape from the action of antibiotics. Nonetheless, targeting bacterial virulence strategies such as bacterial surface associated polysaccharides biosynthesis and their surface accumulation mechanisms may be an attractive strategy, as they impose less selective pressure on the bacteria. Capsular polysaccharide (CPS) or K-antigen that is located on the bacterial surface armors bacteria from host immune response. Thus, unencapsulating bacteria would be a good strategy for drug design, besides CPS itself being a good vaccine target, by interfering with CPS biosynthesis and surface assembly pathway. Gram-negative Escherichia coli uses Wzy-polymerase dependent (Groups 1 and 4) and ATP dependent (Groups 1 and 3) pathways for CPS production. Considering E. coli as a case in point, this review explains the structure and functional roles of proteins involved in Group 1 Wzy dependent CPS biosynthesis, surface expression and anchorage in relevance to drug and vaccine developments

Use of Xpert MTB/RIF in Decentralized Public Health Settings and Its Effect on Pulmonary TB and DR-TB Case Finding in India

Background Xpert MTB/RIF, the first automated molecular test for tuberculosis, is transforming the diagnostic landscape in high-burden settings. This study assessed the impact of up-front Xpert MTB/RIF testing on detection of pulmonary tuberculosis (PTB) and rifampicin-resistant PTB (DR-TB) cases in India. Methods This demonstration study was implemented in 18 sub-district level TB programme units (TUs) in India in diverse geographic and demographic settings covering a population of 8.8 million. A baseline phase in 14 TUs captured programmatic baseline data, and an intervention phase in 18 TUs had Xpert MTB/RIF offered to all presumptive TB patients. We estimated changes in detection of TB and DR-TB, the former using binomial regression models to adjust for clustering and covariates. Results In the 14 study TUs, which participated in both phases, 10,675 and 70,556 presumptive TB patients were enrolled in the baseline and intervention phase, respectively, and 1,532 (14.4%) and 14,299 (20.3%) bacteriologically confirmed PTB cases were detected. The implementation of Xpert MTB/RIF was associated with increases in both notification rates of bacteriologically confirmed TB cases (adjusted incidence rate ratio [aIRR] 1.39; CI 1.18-1.64), and proportion of bacteriological confirmed TB cases among presumptive TB cases (adjusted risk ratio (aRR) 1.33; CI 1.6-1.52). Compared with the baseline strategy of selective drug-susceptibility testing only for PTB cases at high risk of drug-resistant TB, Xpert MTB/RIF implementation increased rifampicin resistant TB case detection by over fivefold. Among, 2765 rifampicin resistance cases detected, 1055 were retested with conventional drug susceptibility testing (DST). Positive predictive value (PPV) of rifampicin resistance detected by Xpert MTB/RIF was 94.7% (CI 91.3-98.1), in comparison to conventional DST. Conclusion Introduction of Xpert MTB/RIF as initial diagnostic test for TB in public health facilities significantly increased case-notification rates of all bacteriologically confirmed TB by 39% and rifampicin-resistant TB case notification by fivefold

Monthly Pattern and Distribution of Births in a Teaching Institution of Northern India

Background: Seasonality in frequency of birth is a world-wide phenomenon that reflect behavioral and biological determinant of reproduction. Aim: To assess pattern of birth occurring in a medical college hospital according to calendar months. Materials and Methods: Log books of delivery room were retrieved and all singleton live births occurring in each month for the calendar years 2002-2009 (8-year) was extracted. Data collection was carried out by the investigators during the period February-April 2010 and data management using software statistical package. Analysis was carried out by calculating average birth per month for the period under study and standard index as well as quarter-wise details was also tabulated. Result: It was observed that there was a progressive rise in total number of births occurring in the hospital from 5840 (avg. 486.66/month) from the year 2002 to 8205 (avg. 683.75/month) in 2009. Maximum birth occurred during the months of August (avg. 774/month) followed by September (avg. 735/month) and October (avg. 705/month) respectively and least in the month of April (avg. 445/month) with a P&lt;0.05. Quarter (q) wise distribution showed maximum birth during q3 (July-September=30%) followed by q4 (October- December=27%), q2 (April-June=22%) and q1 (January-March=21%) respectively. Conclusion: It can be concluded that peak birth in the months of August-September-October as observed in present study implying that there is increased conception during the winter months of December-January-February. Within study limitations, findings may facilitate advocacy, counseling, planning and delivery of family welfare service in a more efficient and effective manner particularly related to mobilization of human resource, inventory control, logistics, streamlining family planning services at institutional and community level keeping in mind the monthly pattern of hospital deliveries. Keywords: Behavior, communication, conception, delivery, demography, family planning, fertility, human resource, months, pattern, reproduction, seasonality, tim