QI initiative to improve utilization of centchroman: a non-steroidal contraceptive

Background: The nonsteroidal contraceptive centchroman is manufactured in India. It was included in family welfare programme in April 2016 by the Ministry of Health and Family Welfare, Government of India. However, national statistics indicated its low utilization at all levels of healthcare. Objective was to identify the reasons for underutilization of centchroman in the family planning clinic, and in the postpartum period, and to implement corrective measures to improve its utilization at a tertiary hospital.Methods: The study was conducted in the department of obstetrics and gynecology at a tertiary care hospital from September 2019 to January 2022. A quality improvement action team was constituted to undertake root cause analysis. Important corrective factors were insufficient focused counselling for centchroman as contraceptive, insufficient sensitization of doctors and nurses, inconsistent supply of tablets, lack of clarity about side effects of centchroman among healthcare workers. Tablets were not readily available to postpartum women at home, which was also a contributing factor. There were the following changes implemented: sensitization of the healthcare workers, daily focused FP counselling of women in outpatient clinics and postnatal wards, and measures to ensure a continuous supply of tablets. At discharge, eligible postpartum women were given a three-month supply of tablets for ready access. ASHA (accredited social health activist) workers who are engaged in other governmental health initiatives were included in the loop to maintain contact and supply tablets to women initiated on centchroman.Results: Contraceptive utilization increased from 0.5-0.7% at beginning of the study to 29% by incorporating the solutions. Failure of contraception occurred in one user. Pearl index for centchroman in our study was 0.22%.Conclusions: Simple, practical solutions identified through quality improvement initiatives resulted in improved coverage and utilization of contraceptive. This study can be an important example for problem solving of challenges in low resource settings

Dietary Salt Intake and Hypertension in An Urban South Indian Population – [CURES - 53]

Objective : The aim of the study was to determine the mean dietary salt intake in urban south India and to look at its association with hypertension. Methods : The Chennai Urban Rural Epidemiology Study (CURES) is an ongoing population based study on a representative population of Chennai city in southern India. Phase 1 of CURES recruited 26,001 individuals aged ≥ 20 years, of whom every tenth subject (n=2600) was invited to participate in Phase 3 for detailed dietary studies and 2220 subjects participated in the present study (response rate : 84.5%). Participants with self-reported history of hypertension, diabetes or heart disease were excluded from the study (n=318) and thus the final study numbers were 1902 subjects. Dietary salt, energy, macronutrients and micronutrients intake were measured using a validated semi-quantitative food frequency questionnaire. Diagnosis of hypertension was based on the National Cholesterol Education Programme (NCEP) Adult Treatment Panel III criteria. Logistic regression analysis was used to look at the association of dietary salt with hypertension. Results : Mean dietary salt intake (8.5 g/d) in the population was higher than the recommended by the World Health Organization (<5g/d). Higher salt intake was associated with older age and higher income (p for trend<0.0001). Subjects in the highest quintile of salt intake had significantly higher prevalence of hypertension than did those in the lowest quintile (48.4 vs 16.6%, p<0.0001). Both systolic and diastolic blood pressure significantly increased with increase in quintiles of total dietary salt both among hypertensive and normotensive subjects (p for trend p1 teaspoon/day at the dining table was associated with a higher prevalence for hypertension compared to zero added salt (38.5% vs 23.3%, Chi-square = 18.95; p<0.0001). Multiple logistic regression analysis revealed that even after adjusting for age, gender, body mass index, total energy intake and dietary fat, total dietary salt intake was positively associated with hypertension. [Odds ratio (OR): 1.161, 95% Confidence Interval (CI): 1.115-1.209, p<0.0001]. Conclusion: Intake of dietary salt in urban south India is higher than currently recommended. Increasing salt intake is associated with increased risk for hypertension even after adjusting for potential confounders. This calls for urgent steps to decrease salt consumption of the population at high ris

Partial Purification and Biochemical Characterization of Extracellular Pectinase from Aspergillus Niger Isolated from Groundnut Seeds

To produce and partially purify pectinases from Aspergillus niger isolateJGIm2, characterize the enzymes for potential industrial applications in clarifying fruit juices. Methodology and results: Isolates of Aspergillus niger were screened for ability to produce pectinases by the enzymatic index method. All the 34 isolates screened were producers with isolates JGIm2, JGIm3 and JGIm5 being the best. Optimum enzyme production was found with medium containing 1.5% pectin after 48 h of fermentation. Partial purification of the enzyme was carried out by ethanol precipitation to give two fold purification and 56% yield. The enzyme had pH & temperature optima of 4.0 and 45°C, Km and Vmax values of 0.178 g/dl & 11.62 IU/mg protein, respectively. Clarification of banana and pineapple juice using the partially purified enzyme resulted in 38 and 41% reduction in viscosity as determined spectroscopically

Classical Many-particle Clusters in Two Dimensions

We report on a study of a classical, finite system of confined particles in two dimensions with a two-body repulsive interaction. We first develop a simple analytical method to obtain equilibrium configurations and energies for few particles. When the confinement is harmonic, we prove that the first transition from a single shell occurs when the number of particles changes from five to six. The shell structure in the case of an arbitrary number of particles is shown to be independent of the strength of the interaction but dependent only on its functional form. It is also independent of the magnetic field strength when included. We further study the effect of the functional form of the confinement potential on the shell structure. Finally we report some interesting results when a three-body interaction is included, albeit in a particular model.Comment: Minor corrections, a few references added. To appear in J. Phys: Condensed Matte

NEW APPROACH FOR NEIGHBOR DISCOVERY IN MOBILE AD HOC NETWORKS

Multipath directing permits building and utilization of numerous ways meant for routing among a resource and destination pair. The resource repetition misuses and difference in the primary network to give profit, for example, fault tolerance, load balancing, data transfer aggregation, as well as change in QoS measurements, for example, interruption. The three components to a path discovery, multipath routing, path maintenance and traffic distribution. Path discovery includes discovering accessible ways utilizing predefined criteria. A well known metric is way disjointness, a measure of resource contrasting qualities between paths. Traffic dispersion system describes how simultaneously accessible ways are utilized, and how data to the same goal is part and flowed over diverse ways. Path support specifies when and how new paths are procured if the states of at present accessible paths change. We display a choice of these protocols and give a discussion on how multipath strategies might be stretched out to wireless mesh networks. In conclusion we quickly portray the path selection structure in the current proposal for IEEE 802.11s mesh standard. Despite the fact that the proposal does not characterize utilization of multipath routing, its extensible system for path selection gives procurement to such protocols to be implemented

Towards defining heterotic gene pools using SSR markers in pearl millet [Pennisetum glaucum (L.) R. Br.]

Pearl millet is a climate resilient crop and the most widely grown millet worldwide. In a maiden attempt to identify potential heterotic groups for grain yield in pearl millet, a total of 88 polymorphic SSR markers were used to genotype 343 hybrid parental lines of pearl millet. The SSR markers generated a total of 532 alleles with a mean value of 6.05 alleles per locus, mean gene diversity of 0.55, and an average PIC of 0.50. Out of 532 alleles, 443 (83.27%) alleles were contributed by B- lines with a mean of 5.03 alleles per locus. R- lines contributed 476 alleles (89.47%) with a mean of 5.41, while 441 (82.89%) alleles were shared commonly between B- and R- lines. The gene diversity and PIC were high among R- lines (0.55 and 0.50) than B- lines (0.49 and 0.44) revealed that R- lines were more diverse than B- lines. The unweighted neighbor-joining tree based on simple matching dissimilarity matrix obtained from SSR data clearly differentiated B- lines into 10 sub-clusters (B1, B2, B3, B4, B5, B6, B7, B8, B9 and B10), and Rlines into 11 sub-clusters (R1, R2, R3, R4, R5, R6, R7, R8, R9, R10 and R11). The parents, three checks and 99 hybrids generated by crossing between representative lines of each of the B- cluster with that of each of the R- cluster were evaluated in line ? tester design over three environments. Based on pooled mean performance, the cross combinations generated between clusters B1 and R3, B2 and R4, B3 and R5, B4 and undetermined cluster, B5 and 11R, B6 and R3, B8 and R4, B9 and R7 and B10 and R5 had shown higher grain yield per plant compared to their counterparts. Based on per se performance, high sca effects and standard heterosis over superior check, F1s generated from crosses between representatives of groups B3 and B10 with representative of group R5 resulted in best heterotic combinations for grain yield. These represent putative heterotic gene pools in pearl millet.publishersversionPeer reviewe

Influence of hospital policy on partograph use in tertiary care facilities in India: a cross sectional survey

Background: Partograph is an effective, but underutilized tool for monitoring labour. This study examined the influence of hospital policy on the knowledge, attitude, practice and skills of doctors towards partograph plotting.Methods: A cross-sectional survey among doctors posted in labour rooms of tertiary care public teaching hospitals of India was carried out, using self-administered questionnaire to assess knowledge, attitude and practice; and labour case scenarios were provided to assess partograph plotting skills. Chi-square test or Fisher’s exact test were employed to test the significance of association between knowledge, attitude, practice and skills of 150 doctors working in hospitals with (n=3) and without (n=2) policy of routine partograph plotting.Results: The majority of doctors in both groups had correct knowledge about different partograph components. However, doctors working in hospitals with a policy of partograph use, demonstrated significantly better skills using case scenarios for plotting partographs (p<0.01), and a positive attitude towards plotting partograph and its use as a decision support tool (p=0.000) as compared to doctors working in hospitals without a routine partograph plotting policy.Conclusions: Hospital policy of routine partograph plotting may positively influence utilization of partograph in tertiary care public hospitals in India

Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity

Aims To establish the prevalence of admission plasma glucose in 'diabetes' and 'at risk' ranges in emergency hospital admissions with no prior diagnosis of diabetes; characteristics of people with hyperglycaemia; and factors influencing glucose measurement. Methods Electronic patient records for 113 097 hospital admissions over 1 year from 2014 to 2015 included 43 201 emergencies with glucose available for 31 927 (74%) admissions, comprising 22 045 people. Data are presented for 18 965 people with no prior diagnosis of diabetes and glucose available on first attendance. Results Three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years,  24 hours. Conclusions Hyperglycaemia was evident in 21% of adults admitted as an emergency; various aspects related to follow-up and initial testing, age and ethnicity need to be considered by professional bodies addressing undiagnosed diabetes in hospital admissions

Enzymatic hydrolysis of market vegetable waste and subsequent ethanol fermentation-Kinetic evaluation

In this work, kinetic properties evaluation was made for bioethanol production from sugar hydrolysate of vegetable waste. The saccharified sugars were fermented by using Saccharomyces cerevisiae. The effect of various saccharification factors on sugars release were studied and observed that the optimized conditions contributed to 14.4 gL-1of fermentable sugars production. The produced sugars were subjected to batch fermentation by Saccharomyces cerevisiae at pH 4.5 and the kinetic parameters of fermentation were estimated by fitting the experimental data in modified logistic equations. The data revealed product (ethanol) yield (YP/S) of 0.39g/g of reducing sugars. Maximum specific growth rate (μmax), the yield of ethanol on biomass (YP/X) and the yield of biomass on sugars utilization (YX/S) were determined to be 0.18 h-1, 1.097 g/g and 0.313 g/g, respectively. The process yielded 4.13 gL-1 of ethanol by consumption of 10.6 gL-1 sugars with a volumetric production rate of 0.0861±0.002 gL-1 h-1