Targeted hand hygiene audits and training: an effective tool for improvement in hand hygiene compliance

Background: Hand hygiene (HH) is the simplest, but most effective infection prevention and control measure. This study was aimed to determine HH compliance among health care workers (HCWs) in a cancer hospital and the impact of targeted and phased training over changes in HH compliance and determination of Hawthorne effect among HCWs. Methods: Prospective observational study conducted in two phases by HH trained auditor (Overt observer) and ICN (Covert observer) performing 30 minutes HH audit at ICU, haemato-lymphoid (HL) ward and paediatric ward to observe the pattern of HH compliance among HCW for HH moments and its impact over Hawthorne effect for HH compliance. Results: Highest compliance for HH was observed at HL ward (59.34%) in first phase and at ICU (70.08%) in second phase. Gradual and significant improvement in HH compliance was observed for ICU (52.24% to 70.08%), HL ward (59.34% to 68.48%) and paediatric ward (43.42% to 53.46%). Profession specific Hawthorne effect was observed for nurses with higher compliance in covert observation in first phase and for doctors with higher compliance in overt observation in second phase of the study. Conclusions: Regular targeted HH audit with motivational training is the better influential tool for improving HH compliance. Regular audits also improve efficiency of auditor for effective HH compliance supervision. Decentralization and availability of workstation specific HH auditor is the most of effective cost saving approach for achieving significant progressive improvement in HH adherence.

Significance of immune-inflammatory markers in predicting clinical outcome of COVID-19 patients

Background: The epidemic of coronavirus disease 2019 (COVID-19) has been rapidly spreading on a global scale affecting many countries and territories. There is rapid onset of generalized inflammation resulting in acute respiratory distress syndrome. We, thus, aimed to explore the potential of immune-inflammatory parameters in predicting the severity of COVID-19. Materials and Methods: Age, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), Lactate Dehydrogenase (LDH), C-reaction protein (CRP), and procalcitonin (PCT) of 611 patients with laboratory-confirmed COVID-19 were investigated and compared. Patients were divided on the basis of severity and survival into two groups. Data were expressed as mean or median values and percentages. The receiver operating characteristic curve was applied to determine the optimal cut-off values of these biomarkers. Results: The median age was 50 years and the male to female ratio was 3.7:1. The mean NLR, LMR, PLR, LDH, CRP, and Procalcitonin for the non-severe group were 4.16, 10.8, 133.7, 666.1, 49.9, and 0.15, respectively. In the severe group mean values of the above-mentioned immune-inflammatory markers were 17.8, 4.69, 268.2, 1277, 158.6, and 3.05, respectively. Elevated levels were significantly associated with disease severity. In ROC curve analysis, NLR had the largest area under the curve at 0.923 with the highest specificity (0.83) and sensitivity (0.88). Conclusion: This study shows that NLR, PLR, LDH, CRP, and Procalcitonin may be a rapid, widely available, useful predictive factor for determining the severity of COVID-19 patients.

Survival of plant growth promoting rhizobacteria [PGPR] in soil under pesticide stress

A study was conducted to determine the effects of pesticide application at different doses on the population density of two important plant growth promoting rhizobacteria [PGPR]: Methylobacterium spp. And Bacillus spp. These bacteria play an important role in plant growth promotion and as such are associated with the soil's nutritional value. The purpose of the study was to find whether or not pesticides do affect these PGPR and ultimately lead to environmental stress. Four organophosphates and four biopesticides were used for the purpose of the study. The results revealed that pesticide applications caused a drastic reduction in the microbial population present in the soil, especially Methylobacterium sp. which was completely extinct in soil treated with Chlorpyrifos, Phorate and Dimethoate, except for [count of 0.7 x 106, 30 days, R.D. in Phorate treated soil], [106, 40 days and 0.55 x 106, 30 days, 2 R.D. in Chlorpyrifos treated soil]. The same species proliferated well in biopesticide-treated soil except for a reduction in Neem treated plates [2.4 x 106 in R.D as compared to 3.3 x 106 in control]. Increased doses of Dimethoate and Chlorpyrifos had profound effects on the Bacillus sp. population. In the case of biopesticides, only Karanj had a negative impact on its count, especially at 10 R.D., maybe as a result of its antibacterial effect. So, our present research focuses on the extensive use of biopesticides from a sustainable agriculture point of view.

Life Stress, Social Support and Sex-role among Women.

Background: Emotions or stress can have a major impact on the physical as well as the psychological well-being of an individual. Methodology: The study was conducted on 30 females. The aim was to study life stress along with social support and sex role in their life. The urban and rural women has equal numbers,all were educated and were in age groups 15-54 years. Results: The result shows that life stress as dependent variable on social support and sex role play a significant role in maladaptive behavior among females.

How can the postgraduate training program in pathology departments in India be improved.

There exists a wide variation in the competence of the postgraduate residents trained in pathology in different institutions across India. This results in strong disparities in the clinical diagnostic skills, teaching skills, research capabilities and the managerial skills of the graduates. The end users of this training, namely the community, clinicians and health care institutions would benefit from a more uniform and better trained pathologist. The article reviews the reasons for the variation in the quality of the training programs. The main deficiencies include, lack of well-defined criteria for recruitment of residents, training facilities, faculty resources, curriculum with well-defined learning objectives and competencies, hands-on experiences in diagnostic and research activities, diagnostic specimens and medical autopsies, exposure to molecular pathology, pathology informatics, electron microscopy, research experiences, communication skills, professional behavior and bioethics, business practices in pathology and quality assurance. There is also a lack of defined career tracks in various disciplines in laboratory medicine, standard protocols for evaluation and regional and national oversight of the programs. The steps for rectification should include defining the competencies and learning objectives, development of the curriculum including teaching methods, facilities and evaluation strategies, communication skills, professional behavior skills, teaching skills, legal aspects of practicing pathology and the various career pathways to subspecialties in pathology. The training should include defined exposure to molecular pathology, electron microscopy, quality control and assurance, laboratory accreditation, business aspects of pathology practice, review of literature, evidence-based medicine, medical autopsy and medical informatics. Efforts should be made to share human and laboratory resources between regional cooperation. The oversight and accreditation policies should be evolved and well-documented. Web-based platforms need to be developed for easy interaction among residents, faculty and administrators on a national level.

Synergistic antimicrobial activity of tea & antibiotics.

Tea leaves are known for its antibacterial activity against many microorganisms. In this study we attempted to describe the synergistic antimicrobial activity of tea and antibiotics against enteropathogens. Antimicrobial activity of boiled water tea extract and organic solvent extract were studied against Salmonella typhimurium 1402/84, S. typhi, S. typhi Ty2a, Shigella dysenteriae, Yersinia enterocolitica C770, and Escherichia coli (EPEC P2 1265) determining minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and death rate kinetics at MBC of tea extract in presence of subinhibitory concentration of antibiotic. Both green tea or black tea extracts effectively inhibited the growth of S. typhimurium 1402/84, S. typhi, S. typhi Ty2a, S. dysenteriae, Y. enterocolitica C770, and E.coli (EPEC P2 1265). However, the growth inhibitory concentration of tea extract was lower for green tea as compared to black tea extract. Antimicrobial activity of green tea tea methanol: water extract tea was better as compared to boiled water tea extract of green tea. Based on death rate kinetics results, S.typhi Ty2a appeared to be highly sensitive and Y. enterocolitica C770 the most resistant. Chloramphenicol and tea extract in combination inhibited the growth of S.dysenteriae at 2.5 microg/ml chloramphenicol (MIC 5 microg/ml) and 5.094 mg/ml black tea extract (MIC 9.089 mg/ml). Tea extract showed synergistic activity with chloramphenicol and other antibiotics like gentamycin, methicillin and nalidixic acid against test strains.

Hypospadias-hypertelorism syndrome.

A young male child presented with hypospadias. Examination revealed additional anomalies including hypertelorism and upslanting of palpebral fissures, suggesting a diagnosis of hypospadias-hypertelorism syndrome. The case is reported because of its rarity and some unusual features.

Effect of cycocel and furfuryl amino purine on protein metabolism of pearl millet (Pennisetum americanum L.) under simulated drought conditions.

Water stress drastically decreased relative water content and total soluble protein whereas it increased free amino acids, proline and protease enzyme in P. americanum. Treatments with 6-furfuryl amino purine (0.50 mM) and cycocel (60 mM) maintained the levels of soluble protein contents but the applications of furfuryl amino purine decreased free amino acids and free proline under stress conditions.