Keratinase production by Bacillus megaterium RS1 using the statistical tool central composite design

Keratinase producing bacterium Bacillus megaterium RS1 was obtained from feather dumping site of Rajapalayam. The optimal level of the key variables (starch, feather meal, calcium chloride) was used to determine the effect of their interactions on keratinase production using the statistical tool [(Central composite design (CCD) of response surface methodology (RSM)]. The second-order quadratic model with the optimum conditions [(starch (1%); feather meal (3%) and calcium chloride (0.02%)] was used. The nearness of the coefficient of determination (R2 = 1.0000) to 1 ensures the satisfactory adjustment of the quadratic model to the experimental data. The maximum keratinase production was 142.9 U/ml.Keywords: Keratinase, Central composite design (CCD), response surface methodology (RSM), Bacillus megaterium RS1 starch, feather meal, calcium chloride

Strongyloides hyperinfection syndrome, Cytomegalovirus enteritis with viremia and recurrent gram-negative sepsis in a patient with recurrent thymoma: a case report

Strongyloides stercoralis is an intestinal nematode which is endemic in tropical and subtropical countries.  It may cause asymptomatic infections, mild eosinophilia or hyperinfection syndrome in the most severe form. We are reporting a case of Strongyloides hyperinfection syndrome in an immunosuppressed patient with recurrent thymoma and myasthenic crisis. This patient is a 51-year-old man with myasthenia gravis on long term pyridostigmine and prednisolone and mycophenolate. He presented with copious diarrhoea and was in septic shock. His blood and urine cultures grew Klebsiella pneumoniae and Pseudomonas aeruginosa. Oesophago-gastro-duodenoscopy (OGD scopy) and biopsy showed severe active duodenitis with strongyloidiasis and moderate active antral gastritis with strongyloidiasis. He was diagnosed to have Strongyloides hyperinfection and was treated with oral Ivermectin. He recovered well. He was subsequently diagnosed to have CMV enteritis with viraemia and was treated with intravenous Ganciclovir. Our case emphasizes the association of Strongyloides hyperinfection with superimposed CMV infection and gram-negative sepsis due to prolonged immunosuppression and autoimmunity in Thymoma patients. Recurrent thymoma and high-grade infiltrative thymoma often poses difficulty in the management of myasthenia patients. A high index of suspicion and aggressive treatment is paramount in approaching a patient with multiple risk factors of hyperinfection syndrome and autoimmunity. This case is reported in view of its rarity and significance regarding the multidisciplinary approach in decreasing morbidity and mortality in hyperinfection syndrome with an autoimmune background

Immunization status of children upto 3 years in rural block, Muzaffarnagar

Background: The year 2012-2013 was declared as ‘Year of intensification of Routine Immunization (IRI) in India. As per CES, DLHS and AHS, Full Immunization for the children of age group of 12-23 months of Uttar Pradesh is 30.2 (DLHS 2007), 40.9 (CES 2009) and 45.3 (AHS 2010-2011). Studies have been done to assess the primary immunization status i.e. BCG, OPV3, DTP3 and Measles. Data on the Booster doses and the additional vaccine is insufficient. Objectives: To assess the status of full Immunization, Complete Immunization and the status of Immunization with regard to different vaccine and reasons for partial and No Immunization. Design & Methodology: A community based cross sectional study was done (Aug to December 31th 2014) in the field practice area of rural health and training centre (RHTC) of Muzaffarnagar Medical College, Muzaffarnagar. 50% of the villages i.e. 3 villages (Bilaspur, Shernagar and Dhandhera) selected by simple random sampling technique and the age group selected were up to three years of age. The data was analyzed using MS excel sheet and the software used was software Epi-info version 7.1.3. Results and Conclusion: The Full Immunization in the age group of children between 12-23 months was 65% with antigen coverage maximum for BCG (93%) and lowest for Measles (68%). Reason for partial and unimmunized children were majority due to non-availability of vaccine at the centre followed by fear of AEFI. Complete Immunization in the age group between 24-36 months was 46% with MCV 2 coverage being the lowest (34%). Full Immunization in the age group of 24-36 months is significantly more than 12-23 months age group. Tendency is to have less and less immunization as the age of the child grows (P<0.05)

Strategies to provide care to Non-COVID Patients in the COVID Era: An Experience from a Tertiary Care Institute in Northern India

With the COVID-19 pandemic the health system is facing dual burden of cases, one being the COVID-19 or Severe Acute Respiratory Illness (SARI) cases and the second being the other Non-COVID cases. The Non-COVID cases due to the burden of the SARI cases became almost neglected by the Health System increasing the sufferings of the Non-COVID cases. In the current COVID times All India Institute of Medical Sciences, Gorakhpur continued to provide the health care to the Non-COVID cases. The current manuscript provides the detailed strategy and results of the various strategies used to provide care to such Non-COVID patients with minimum risk to the healthcare staff

Prevalence of depression and health related quality of life among patients with diabetes mellitus and hypertension attending a secondary care hospital in district Faridabad, Haryana

Background:  Diabetes mellitus (DM) and hypertension (HT) have significant effect on the mental health of the patient. and. We aimed to estimate the prevalence of depression, and the quality of life among patients with diabetes mellitus and hypertension who attended a secondary care hospital. Methods: A cross-sectional study was carried out among 618 patients who had DM and/or HT.  PHQ-9 and WHO-BREF QOL questionnaire were administered to assess depression and health related quality of life respectively. Results: More than 2/3rd of patients had depression. Among those who had depression, nearly half (46%) had moderate depression and 2.1% had severe depression. The proportion of severely depressed patients was higher in diabetes mellitus group compared to the hypertension group.   Patients that were depressed had poorer quality of life compared to non-depressed, and the difference was statistically significant. Conclusion: Patients with diabetes mellitus and hypertension may be screened for depression and managed accordingly

An epidemiological comparative study of weight and height parameters for nutritional assessment of adolescents in a rural area of North India

Research Question: What is the simplest way to assess the nutritional status of adolescents? Objectives: (1) To compare and identify the most appropriate method for rapid assessment of nutritional status of rural adolescents using height and weight parameters. (2) To assess whether EHPA chart is superior over the conventional method of using BMI for the nutritional assessment of adolescents or not. Study Design: Cross-sectional study. Study Setting: Eight registered schools in the field practice area of Rural Health Training Center, Bilaspur, Department of Community Medicine, Muzaffarnagar Medical College, Muzaffarnagar, U.P., INDIA. Sample size: 467 i.e., all the school going rural adolescents of both sexes (11-19 yrs of age). Study variables: Height and weight. Methodology: The weight and height of all the study subjects was recorded by portable dial weighing machine and stadiometer respectively with due permission of the school principal. Age of subjects were recorded from the school register as on their last birthday. The data were subjected to comparision for nutritional assessment by using two study tools i.e., conventional BMI and EHPA chart. Statistical analysis: Proportion and Chi square test by using epi info statistical package. Result:   A total of 467 adolescents were examined. By using conventional BMI, 93.79% of adolescents were classified as underweight and 4.06% as normal; however with the help of EHPA chart it was found that 38.97% adolescents were underweight and 58.67% were normal. Conclusion: Existing norms of using conventional BMI for assessing nutritional status of adolescents is inappropriate as far too many normal adolescents fall in undernourished category, whereas EHPA chart prevents such fallacies