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

Midgut antibodies reduce the reproductive capacity of <i>Anopheles stephensi </i>(Diptera: Culicidae)

330-334Rabbits immunized with polypeptides of midgut of glucose fed A.stephensi resulted in high titer of antibodies (104-106) as detected by ELISA. Effect of antisera on fecundity, hatchability and engorgement was investigated. Fecundity was reduced drastically (62.4%). Eight polypeptides were recognized by the antisera raised against midgut tissues viz., 92, 85, 55, 52, 45, 38, 29 and 13 kDa.Cross reactivity of these antibodies with different tissues of A.stephensi as well as different species of Anopheles was also analyzed. The results indicated that anti-mosquito midgut antibodies had the potential to disrupt the reproductive physiology of mosquitoes in view of the present study, there is a need for further investigation with target antigens

Predictors and outcome of obstetric admissions to intensive care unit: A comparative study

This descriptive observational study was carried out in Guru Teg Bahadur Hospital to identify predictors and outcome of obstetric admission to Intensive Care Unit (ICU). Ninety consecutive pregnant patients or those up to 42 days of termination of pregnancy admitted to ICU from October 2010 to December 2011 were enrolled as study subjects with selection of a suitable comparison group. Qualitative statistics of both groups were compared using Pearson′s Chi-square test and Fisher′s exact test. Odds ratio was calculated for significant factors. Low socioeconomic status, duration of complaints more than 12 h, delay at intermediary facility, and peripartum hysterectomy increased probability of admission to ICU. High incidence of obstetric admissions to ICU as compared to other countries stresses on need for separate obstetric ICU. Availability of high dependency unit can decrease preload to ICU by 5%. Patients with hemorrhagic disorders and those undergoing peripartum hysterectomy need more intensive care

Data_Sheet_1_Whole genome analysis for plant growth promotion profiling of Pantoea agglomerans CPHN2, a non-rhizobial nodule endophyte.DOCX

Reduced agricultural production as well as issues like nutrient-depleted soils, eutrophication, and groundwater contamination have drawn attention to the use of endophyte-based bioformulations to restore soil fertility. Pantoea agglomerans CPHN2, a non-rhizobial nodule endophyte isolated from Cicer arietinum, exhibited a variety of plant growth-promoting traits. In this study, we used NextSeq500 technology to analyze whole-genome sequence information of this plant growth-promoting endophytic bacteria. The genome of P. agglomerans CPHN2 has a length of 4,839,532 bp and a G + C content of 55.2%. The whole genome comprises three different genomic fractions, comprising one circular chromosome and two circular plasmids. A comparative analysis between P. agglomerans CPHN2 and 10 genetically similar strains was performed using a bacterial pan-genome pipeline. All the predicted and annotated gene sequences for plant growth promotions (PGPs), such as phosphate solubilization, siderophore synthesis, nitrogen metabolism, and indole-3-acetic acid (IAA) of P. agglomerans CPHN2, were identified. The whole-genome analysis of P. agglomerans CPHN2 provides an insight into the mechanisms underlying PGP by endophytes and its potential applications as a biofertilizer.</p

A novel mechanism for ERK-dependent regulation of IL4 transcription during human Th2-cell differentiation

We demonstrate that the mitogen-activated protein kinases extracellular signal-regulated kinase (ERK)-1 and ERK-2 have a central role in mediating T-cell receptor-dependent induction of IL4 expression in human CD4<SUP>+</SUP> T cells. Significantly, this involved a novel mechanism wherein receptor cross-linking induced activated ERK to physically associate with a promoter element on the IL4 gene. The proximally localized ERK then facilitated recruitment of the key transcription factors necessary for initiating IL4 gene transcription. Although both ERK-1 and ERK-2 bound to the promoter, recruitment of either one alone was found to be sufficient. We thus identify a novel mode of function for ERK wherein its physical association with the promoter serves as a prerequisite for enhanceosome assembly. This unusual pathway is also indispensable for human Th2-cell differentiation