Response surface optimization of cellulase production by Aspergillus stellatus NFCCI 5299 in shake flask submerged fermentation using wheat bran.

The expense of cellulase enzymes is the main barrier to the enzymatic saccharification of biomass. Numerous tactics, such as the utilizing inexpensive lignocellulosic substrates as well as economically feasible fermentation techniques for the production of the enzyme may reduce the cost of cellulases. The present investigation was aimed to improve cellulase production employing potential cellulolytic soil fungi, Aspergillus stellatus NFCCI 5299 using wheat bran as substrate. Employing response surface methodology (RSM) with central composite design (CCD), the most efficient process parameters were determined. The ideal conditions for the synthesis of carboxy methyl cellulase (CMCase) and filter paper cellulase activity (FPase) were 6 days of incubation, inoculum size of 4 mycelial disc, 125 rpm of agitation, and 3.5% of wheat bran. The significant mycelial development and enzymatic digestion of wheat bran were discovered by scanning electron microscopy (SEM) and fourier transform infrared (FTIR) analysis. The findings suggested that it can be practicable to use wheat bran as substrate under submerged fermentation utilizing Aspergillusstellatus NFCCI 5299 for efficient cellulase production.

Role of telemedicine in obstetrics and gynecology: an experience at tertiary care center.

BACKGROUND: The telemedicine/telehealth is well established and rapidly evolving innovation in modern practice of medicine. It is used in nearly every aspect of obstetrics and gynecology. Telehealth intervention may reduce the need for in-person visits amongst high-risk obstetric patients. It is an effective innovation for chronic gynecological conditions. RESEARCH DESIGN AND METHODS: This was a prospective, observational study where the online platform 'e-Sanjeevani' was used. It was a health care worker to doctor (specialist) consultation regarding the patient. After an interaction, provisional diagnosis and management plan was made, and an electronic prescription for the same was generated and printed at the patient's end. RESULTS: A total of 3219 patients were attended in 10 months. The majority of the cases had a gynecological problem (71.5%), with menstrual irregularity being the commonest. Among pregnant patients, consultations for early pregnancy complications were made in 29% of the cases. 5.8% were referred because of some surgical intervention. CONCLUSION: Non-emergency patients who can be managed medically can be prevented from unnecessary visits to the hospital and managed through teleconsultation, which decreases the burden of patient load at the tertiary center.

Acute kidney injury and it's outcome following maternal near miss event: A prospective observational study from a tertiary care hospital.

Purpose: Haemorrhage, preeclampsia and sepsis are the leading causes of renal dysfunction in women with a maternal nearmiss(MNM) complication. The study aimed to assess the prevalence, pattern and follow up of these women. Methods: This was a hospital based prospective observational study, conducted over one year. All women with a MNM leading to acute kidney injury (AKI) were analysed for fetomaternal outcomes and renal function at 1 year of followup. Results: The incidence of MNM was 43.04 per 1000 livebirths. 18.2% women developed AKI. 51.1% women developed AKI in the puerperal period. Most common cause of AKI was haemorrhage seen in 38.3% women. The majority of women had s.creatinine between 2.1 to 5 mg/dl and 44.68% required dialysis. 80.8% women recovered fully when the treatment was initiated within 24 h. One patient underwent renal transplant. Conclusion: Early diagnosis and treatment of AKI results in full recovery.

Impact of covid 19 pandemic on severe maternal outcomes -An observational study from a referral institute of India.

Introduction: Covid 19 pandemic has taken the world by storm. As far as maternal health is concerned, it has been affected both directly and indirectly. Not only are the women getting affected by COVID disease but also the health services are suffering in terms of availability, approachability and access. The study aimed to analyze the change in the trends of maternal near and maternal mortality comprising severe maternal outcome (SMO) between 2019 and 2020 in the department of obstetrics and gynaecology of our hospital due to COVID pandemic. Methods: This retrospective study was conducted in the Obstetrics and Gynaecology department of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. The maternal death review data and maternal near miss statistics were analysed. This included assessing the change in the number of maternal deaths and obstetric near miss, their respective causes, and case fatality rate specific to COVID during pregnancy. Results: The total births decreased from 6056 in 2019-4140 in 2020 whereas women with severe maternal outcomes increased from 4.6% in 2019 to 6.5% in 2020(p value < 0.001). The incidence of nearmiss increased significantly from 3.5% in 2019 to 5.1% in 2020(p value < 0.0001) and maternal mortality ratio increased from 1122 per 1 lakh births to 1425 per 1 lakh births. Haemorrhage was the most common cause of maternal near miss with 45.8% in 2019 and an increase to 50.2% in 2020. The percentage of illiterate patients with near miss statistically reduced in 2020(p value - 0.004). Average hospital stay also reduced from 16.5+/-2.1 days to 12.6+/-6.3 days (p value < 0.0001). The average time taken to reach the hospital, however, increased from 27+/-3 h to 36+/-4 h (p value < 0.0001). The rate of direct maternal deaths increased from 45.6% to 52.5% between 2019 and 2020(p-value-0.434). Conclusion: Covid 19 pandemic has affected both maternal mortality and morbidity. Keeping the current situation in mind, it becomes increasingly important to develop patient education via electronic media and teleconsultations. One-stop portals and helplines which involve multidisciplinary teams should be available to all such pregnancies.

Pyoderma gangrenosum at an episiotomy site in successive pregnancies: A case report.

Pyoderma gangrenosum (PG) is an ulcerative, neutrophil-predominant inflammatory disease of the skin that commonly presents as painful ulcers. PG during pregnancy is extremely rare. We report the case of a 28-year-old woman with a painful, rapidly progressive ulcerative lesion at an episiotomy site presenting 16 days following a vaginal delivery. No systemic association was found after an exhaustive work-up and the patient was successfully managed with the help of oral prednisolone. It should be noted that when a postoperative ulcerative wound defect is not healing despite standard wound care, antibiotic treatment, and negative cultures, the possibility of PG should be considered. We conclude that early diagnosis of PG is essential because this condition is usually misdiagnosed and surgical intervention may lead to deterioration of lesions. The case highlights the uncommon presentation of PG at a rare site, thereby calling for a high index of suspicion in order to arrive at the diagnosis.

Role of stereospecific nature of germinants in Bacillus megaterium spores germination.

The present study was undertaken with the objective to assess the effect of distinct stereoisomeric forms of nutrient germinants (selected sugars and amino acids) on the process of germination onset in dormant spores of Bacillus megaterium MTCC 2949. In this respect, epimers of glucose and enantiomers of alanine were employed in current work. When supplemented with these stereoisomers, spores were found germinated only with d-glucose and d-mannose among epimers of glucose and only with l-alanine among enantiomers of alanine. Interestingly, germination in spores was observed to negligible extent with d-galactose and d-alanine. These findings were obtained on the basis of four type of germination assays, namely reduction in absorbance measured at 600 nm (≤5 to ≥30%), refractility examination (phase bright and dark), esterase assay [fluorescence units 0.455-94.62 (×103)] and fluorescent staining (fluorescent/non-fluorescent signals). Understanding of spores germination process and efficacy of different forms of germinants to trigger germination is of immense importance. It aids in development of sensing and sterilization indicating tools employing chiefly spores as biorecognition elements and in uncovering the mechanism of diseases, food contamination and spoilages resulting from the germination of spores. The findings of current work support the possibility to explore such germination mechanism by significantly giving the clue for potential existence of stereospecific receptor sites on the surface of B. megaterium spores. Perhaps, these sites can specifically differentiate and recognize stereoisomerically diverse forms of germinants for induction of germination.