Appraising LaQshya's potential in measuring quality of care for mothers and newborns: a comprehensive review of India's Labor Room Quality Improvement Initiative.

BACKGROUND: Poor intrapartum care in India contributes to high maternal and newborn mortality. India's Labor Room Quality Improvement Initiative (LaQshya) launched in 2017, aims to improve intrapartum care by minimizing complications, enforcing protocols, and promoting respectful maternity care (RMC). However, limited studies pose a challenge to fully examine its potential to assess quality of maternal and newborn care. This study aims to bridge this knowledge gap and reviews LaQshya's ability to assess maternal and newborn care quality. Findings will guide modifications for enhancing LaQshya's effectiveness. METHODS: We reviewed LaQshya's ability to assess the quality of care through a two-step approach: a comprehensive descriptive analysis using document reviews to highlight program attributes, enablers, and challenges affecting LaQshya's quality assessment capability, and a comparison of its measurement parameters with the 352 quality measures outlined in the WHO Standards for Maternal and Newborn Care. Comparing LaQshya with WHO standards offers insights into how its measurement criteria align with global standards for assessing maternity and newborn care quality. RESULTS: LaQshya utilizes several proven catalysts to enhance and measure quality- institutional structures, empirical measures, external validation, certification, and performance incentives for high-quality care. The program also embodies contemporary methods like quality circles, rapid improvement cycles, ongoing facility training, and plan-do-check, and act (PDCA) strategies for sustained quality enhancement. Key drivers of LaQshya's assessment are- leadership, staff mentoring, digital infrastructure and stakeholder engagement from certified facilities. However, governance issues, understaffing, unclear directives, competency gaps, staff reluctance towards new quality improvement approaches inhibit the program, and its capacity to enhance quality of care. LaQshya addresses 76% of WHO's 352 quality measures for maternal and newborn care but lacks comprehensive assessment of crucial elements: harmful labor practices, mistreatment of mothers or newborns, childbirth support, and effective clinical leadership and supervision. CONCLUSION: LaQshya is a powerful model for evaluating quality of care, surpassing other global assessment tools. To achieve its maximum potential, we suggest strengthening district governance structures and offering tailored training programs for RMC and other new quality processes. Furthermore, expanding its quality measurement metrics to effectively assess provider accountability, patient outcomes, rights, staff supervision, and health facility leadership will increase its ability to assess quality improvements.

Assessment of bioaerosol pollution over Indo-Gangetic plain.

Aerosol plays a very important role in climate change and public health. It affects cloud condensation nuclei and causes a number of epidemic diseases. The correlations of aerosol with epidemic diseases are due to the biotic components of aerosol. The present study deals with the measurements and characterization of bioaerosol over Indo-Gangetic plain. The levels of PM10 and PM2.5 are much higher than the recommended value set by NAAQS in India. Bacterial and fungal concentrations are in the reported range. Bacterial concentration is higher than fungal concentration. Gram-positive bacteria contribute 75% while gram-negative bacteria contribute 25% only. A total seven types of fungi are identified in aerosols. Aspergillus niger is dominant. Meteorological parameters play important roles in growth and presence of microorganism in the air. Bacterial concentrations are governed mainly by temperature while fungal concentration is influenced by relative humidity.

Presence of Virus like Particles in Human Pathogenic Fungi: Chrysosporium sps and Candida albicans.

Out of eight isolates of different human pathogenic fungi, four were found to be infected with virus like particles (VLP): Chrysosporium pseudomerdarium, C. xerophillum, C. keratinophillum and Candida albicans through electron microscopy. Frozen mycelium without abrasive was seemingly better disruption method for VLP extraction in Chrysosporium extracts but in Candida albicans disruption with abrasive revealed the presence of considerable amount of VLP. The growth of five isolates of Chrysosporium species associated with VLP was significantly affected by different media tested. Absorption spectra revealed the nucleo protein nature of VLP in C. albicans. Virus like particles in Chrysosporium species reported for the first time and in C. albicans, it is reported for the first time in India.

Production of peptide antifungal antibiotic and biocontrol activity of Bacillus subtilis.

Among different bacterial cultures, a potent Bacillus subtilis MTCC-8114 was isolated from garden soil samples which showed 16 and 14 mm inhibition zones by spot inoculation method and 24 and 22 mm inhibition zones by well agar diffusion method against test fungi i.e. Microsporum fulvum and Trichophyton species. Among four media tested, the maximum growth and antibiotic production was found in trypticase soya broth (TSB) medium at 37 degrees C, pH-7 and 48 h of incubation. The Rf value (0.64) by Thin Layer Chromatography (TLC) technique and UV and FTIR spectral data of the active antifungal compound, indicated that the isolated compound belongs to peptide antifungal antibiotic group. MIC value of antifungal antibiotic was 135 and 145 microg/ml.

Incidence of keratinophilic fungi in waterlogged condition of paddy soil.

Prevalence of keratinophilic fungi was observed in paddy field soil during different stages of cultivation viz., transplanting, tillering, milking and maturation. Out of total 76 soil samples, 65 soil samples were found to be positive for the keratinophilic fungi. Fourteen species belonging to a single genus Chrysosporium were isolated through out the cropping season. C. keratinophilum (17.1%) followed by C. tropicum (13.15%) were found to be the most dominating geophilic species. The highest percent distribution of keratinophilic fungi appeared during the milking stage (100%) of paddy cultivation, followed by the maturation stage (89.47%).

Aspergillus niger as a new allergic agent associated with bindis and its efficacy against homeopathic drugs.

Aspergillus was found as a dominant fungi to associate with brands of bindis. Among three potencies of four homeopathic drugs, Lycopodium 1M, Sulphur 1M, and Sepia 30 showed maximum inhibition zone of Aspergillus niger in inhibition zone technique. In poison food technique, Sepia 30M, Tellurium 30M, Sulphur 1M and Lycopodium 200 showed maximum percentage inhibition against A. niger

Biological control of dermatophytic fungus Trichophyton species by Bacillus subtilis.

A potent Bacillus subtilis-2 isolated from soil samples, showed 14 mm inhibition zone by spot inoculation method and 22 mm inhibition zone by well agar diffusion method against pathogenic test fungii. i.e. Trichophyton species. Among four media tested, the maximum growth and antibiotic production was found in trypticase soya broth (TSB) medium at 37 degrees C, pH 7 and 48 hrs of incubation. The MIC of antifungal substance was 35 microl/ml. The isolated Bacillus subtilis -2 has strong antifungal activity against dermatophytic fungi Trichophyton sp. and requires chemical characterization for its bioactive principle.

Diversity of keratinophilic mycoflora in the soil of Agra (India).

Diversity of keratinophilic mycoflora in the soil of Agra was under observation for 1 year (July 2001-June 2002) and isolation of keratinophilic fungi was followed by the hair-baiting method. The frequency of occurrence of keratinophilic fungi in 284 soil samples collected from various hospitals, cattle yards, poultry farms, crop fields and playgrounds was determined, 204 samples (72%) having been found to be positive. A total of 33 species classified into 11 genera (Acremonium, Aspergillus, Chrysosporium, Emmonsia, Geomyces, Keratinophyton, Microsporum, Myceliophthora, Penicillium, Sporotrichum, Trichophyton) were encountered from the soil samples. Sporotrichum spp. were found to be the most dominant species followed by Trichophyton simii. The parameter of keratinophilic fungi found in the samples studied ranged from 62 to 80% where playgrounds yielded the maximum number of species (80%) while the least dominating soil was hospital soil (62%). Among all the baits used maximum fungi occurred on human hairs (82%) followed by chicken feather (74%), wool (61%) and the least on horns (45%). The spectrum of keratinophilic fungi isolated from different sites differed considerably according to the frequency of use by humans.

Biodegradation of wool by Trichophyton simii and Aspergillus niger.

The amount of protein released into liquid culture medium and weight loss were taken as measures of wool degradation by Trichophyton simii and Aspergillus niger. Protein released into the culture medium was observed to be greater after T. simii treatment than after A. niger treatment. Sulphitolysis was shown by T. simii, whereas it was absent in the case of A. niger, pH was found to be alkaline with an increase in soluble protein in the culture medium in the case of both uniculture and dual culture. However, both the weight loss of wool and the amount of protein released were significantly reduced when both fungi were allowed to attack the substrate. The behaviour of these fungi in dual culture reflects their antagonistic activities.