IDENTIFICATION AND MOLECULAR CHARACTERIZATION OF BACTERIA HAVING ANTIMICROBIAL AND ANTIBIOFILM ACTIVITY

Objective: The aim of the current study was to isolate and identify the bacteriocinogenic strain exhibiting broad range antimicrobial activity and antibiofilm activity from soil of animal farms.Methods: In the current study, bacterial strains were isolated from soil of twelve different regions of animal farm all over India and screened for antimicrobial activity against Staphylococcus epidermidis, Micrococcus luteus, Pseudomonas fluorescence and Escherichia coli. Antibiofilm ability of these selected strains was checked on preformed biofilm of S. epidermidis and in addition biofilm disruption potential was also determined. The potent bacterial strain was identified at molecular level by 16S ribosomal DNA (rDNA) sequencing.Results: 30 out of 231 strains isolated from soil were selected on the basis of antibacterial activity against S. epidermidis. One potential candidate (GAS 101) exhibited ≥99% inhibition against S. epidermidis, M. luteus, P. fluorescence and E. coli and also showed antibiofilm activity. GAS 101 16S rDNA sequencing data identified it as Bacillus subtilis. The sequence of B. subtilis was submitted to genbank under accession no. KJ564301.Conclusion: B. subtilis GAS 101 isolated from soil of animal farm showed the antibacterial activity against all indicator organisms and also displayed antibiofilm activity against preformed biofilm and inhibited biofilm formation of S. epidermidis

Analysis of Centralized Efficiency Improvement Practices in Australian Public Health Systems

Aim: Analysis of centralized efficiency improvement practices in Australian public health systems. Introduction: Public health systems seek to maximize outcomes generated for resources used through efficiency improvement (EI) in response to funding and demand pressures. Despite this focus, evidence for EI approaches at the whole-of-system level is lacking in the literature. There is an urgent need for evidence-based approaches to centralized EI to address these pressures. This study aims to address this gap by answering the research question “How is EI conceptualized and managed by central public health system management entities in Australia?”. Material and Methods: Document analysis was selected due to its suitability for systematically searching and appraising health system documentation, with this study following Altheide’s approach focusing on whole-of-system strategic plan and management framework documents originating from Australian public health organizations. Results: Conceptualization of efficiency varied substantially with no consistent definition identified, however common attributes included resource use, management, service and delivery. Forty-two of 43 documents contained approaches associated with improving efficiency at the whole of system level. Discussion: While no comprehensive framework for centralized EI was evident, we identified nine core approaches which together characterize centralized EI. Together these approaches represent a comprehensive evidence-based approach to EI at the whole of system level. Conclusion: The approaches to whole-of-system EI identified in this study are likely to be highly transferable across health systems internationally with approaches including strategic priority setting, incentivization, performance support, use of EI evidence, digital enablement and workforce capability development

Role of microbes in alleviating abiotic stress in plants

The leading threat to agricultural productivity is the recurrent variations in environmental conditions. A battery of abiotic stresses namely flooding, salinity, temperature, drought, heavy metal toxicities, nutrient deficiencies and oxidative stress causes irreversible damage resulting in loss of plant’s vigor and yield. The relationship between plants and microorganisms is a highly dynamic system. The plant microbiome consists of plant growth-promoting bacteria and fungi. In the last decade, many microbes that give hosts the ability to withstand abiotic stress have been characterized in detail. Their beneficial association with plants enables the plant to endure different stresses imposed on them thereby enhancing the plant's sustainability and productivity. For sustainable agriculture, it is very significant to comprehend microbiome-assisted mechanisms for mitigating abiotic stress. This review will shed light on the current knowledge about the roles of various microorganisms in mitigating against abiotic stresses. The understanding of these mechanisms will help to increase the yield of plants and meet the food demands of the expanding population

Clinical study comparing outcome of post in vitro fertilisation triplet pregnancy reduced to twins versus non reduced in vitro fertilisation triplet pregnancies

Background: There has been an upsurge in the number of multiple pregnancies with its attributability to increasing use of artificial reproductive techniques. To study clinical outcome of post IVF triplet pregnancy reduced to twin pregnancies   compared to those without triplet reduction.Methods: Hospital designed comparative study. 31 subjects were studied for comparative study design with triplets obtained after infertility treatment (assisted post-IVF). Out of 31, 15 subjects were expectantly managed who refused reduction while 16 subjects chose reduction to twins. Outcomes like prematurity, complications in neonate, birth weight discordance, neonatal mortality and maternal complications were studied.Results: The fetal (triplet) reduction group was associated with significant (p<0.002) higher neonatal birth weight as compared to non-reduced group. The fetal reduction group had significantly lower incidence of prematurity and neonatal complications like hyperbilirubinemia, respiratory distress syndrome and neonatal sepsis. The maternal complications were also higher in nonreduced in terms of PPROM, gestational hypertension, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy and gestational hypertension.Conclusions: It is indicated that the reduction of triplet to twins is effective considering more complications with non-reduced group and hence reduction improves favorable pregnancy outcomes

Ferricarboxy maltose to treat iron deficiency anemia in pregnancy: is it a feasible option?

Background: Iron deficiency is a common cause of anaemia in pregnancy which influences the health of mother and developing fetus. Intravenous (IV) iron preparations are considered, when oral iron therapy is ineffective or intolerant. Ferric carboxymaltose is an IV preparation that can be given with ease of administration and better tolerated. The aim of this study was to assess the efficacy and safety of IV ferric carboxymaltose in pregnant mother with all grades of anemia in the second and third trimester.Methods: This is a prospective observational study where 44 pregnant women with iron deficiency anemia [IDA] received ferric carboxymaltose up to 15mg/kg in second and third trimester. The parameters that were taken into account, to assess the effectiveness of the treatment was repeat haemoglobin [Hb] measurements and the subjective sense of wellbeing in the patient. The safety of the drug was analysed by continuous fetal heart rate [FHR] monitoring during the infusion and observation of any adverse reactions.Results: Ferric carboxymaltose intravenous infusion significantly increased Hb levels above baseline values in all women. The Increase in Hb levels were observed at 3- and 6-weeks post infusion therapy. FHR monitoring did not show any drug related unfavourable effect on the fetus. Of the 44 women interviewed, 33 (75%) women reported sense of well-being, 7 (15.9%) women could not feel any difference after the infusion and 4 (9.1%) patients could not comment. No serious adverse effects were noticed but minor side effects occurred in 3 (6.8%) patients.Conclusions: This prospective study showed safety and efficacy of ferric carboxymaltose in pregnancy with IDA which is consistent with available observational data

Association of serum cytokines IL-6, TNF-α, PTX-3 and progesterone modulation in cases of recurrent pregnancy loss

Background: Cytokines are major immune regulators, which play a critical role in the pathophysiology of unexplained recurrent pregnancy loss. Th1 class of cytokines has been shown to exert deleterious effects on pregnancy causing early loss.Methods: The changeover in the levels of Th1 cytokines was studied in two major groups; Gp I (N=30) comprised of RPL subjects with two or more consecutive spontaneous miscarriages history and Gp II (N=30) comprised of normal pregnancy controls .The efficacy of oral micronized progesterone was assessed in regulation of cytokine levels ,with Gp Ia (N=15) treated with 200 mg oral micronized progesterone and Gp Ib (N=15) comprised of untreated RPL subjects and its role in improving pregnancy outcome was also determined. The present study determined the levels of cytokine TNF-α, IL-6 and PTX-3 in serum samples for all the subjects at three time points at the time of enrolment, with (GpIa) or without (Gp Ib) progesterone administration at 20 weeks or abortion if earlier and at the time of delivery. Results: The results indicated that the levels of Th1 cytokines (TNF-α [37.80 versus 78.09], IL-6 [16.93 versus 81.12] and PTX-3 [17.42 versus 73.53]) was found to be reduced at every time point in the treated cases with an RPL history as compared to untreated ones. Further, the cases treated with with oral micronized progesterone were found to have better pregnancy outcomes (p<0.005 significant number of live births).Conclusions: The levels of interlukins, TNF-α, IL-6, PTX-3 in cases of RPL may not have a major contributory role in predicting outcome, however exogenous progesterone decreases the Th1 pro inflammatory response and efficiently improves the pregnancy outcomes by modulation of cytokine levels

NPM Falters in Fiji

New Public Management (NPM) has virtually replaced traditional public administration as the model for the delivery of public value since 1979 and 1980 when the UK and US adopted a radically different approach to management in the public sector. NPM assumes that the market is preferable to government as a coordinator of social relations and public service delivery. This reliance on the market as an automatic “adjuster” raises a number of issues in the use of NPM in traditional settings. NPM also has a number of inherent contradictions and weaknesses. This paper analyses critically some of the common features of the NPM “model” and questions its suitability especially in traditional contexts like Fiji. It concludes that the gaps in prescribing the means to achieving its well-articulated and accepted ends, coupled with its contextual assumptions, renders NPM a model of questionable appropriateness for public enterprise restructuring

Comparison of Intubating Conditions on the basis of Neuromuscular Monitoring versus Clinical Assessment Guided Tracheal Intubation: A Randomized Interventional Study

Background: Laryngoscopy and endotracheal intubation have been associated with marked hemodynamic responses and hazards. This study was undertaken with the purpose to compare the intubating conditions when the suitable time for intubation was judged by either clinical assessment or train-of-four monitoring. Methods: 60 patients without any difficult airway predictors, posted for surgery under general anaesthesia, were randomised into two groups. In Group A patients, the trachea was intubated after train of four counts became zero in adductor pollicis muscle, whereas in Group B patients, intubation was done after clinically judging jaw muscle relaxation. The primary objective was to compare Intubating conditions and mean duration of time between the administration of a neuromuscular blocker and endotracheal intubation. The secondary objectives included number of attempts, changes in hemodynamic parameters. Results were analysed by the Analysis of variance and chi-square tests. Results: In all Group A patients excellent and good intubating conditions were observed, whereas 25 out of 30 patients (83%) in Group B showed excellent and good intubation conditions. The mean time required for intubation was significantly longer in Group A compared to Group B (369 ± 79 s vs. 191 ± 5 s). HR and mean arterial pressure were significantly higher in Group B as compared to Group A after laryngoscopy and tracheal intubation (P < 0.05). Conclusion: Better intubating conditions and more haemodynamic stability are seen after attaining complete relaxation of laryngeal muscles, as detected by neuromuscular monitoring of adductor pollicis muscle.