Characterization of the Sediment Bacterial Community Structure and Composition in Najafgarh Lake and Adjoining Dhansa Barrage.

This study was undertaken to assess the changes in the community structure, diversity, and composition of sediment bacteria in a shallow lake, Najafgarh Lake (NL), that receives untreated sewage effluent through drains connected to it. These changes were analyzed by comparing the sediment bacterial community structure of NL to the sediment bacterial community structure of Dhansa Barrage (DB), which receives no such effluents. 16S rRNA amplicon was used for bacterial community analysis. Water and sediment samples were also analyzed and compared revealing high conductivity, ammonia, nitrite content, and low dissolved oxygen in NL. The organic matter content is also higher in the sediments of NL. Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria are the predominant phyla in both sites and account for 91% of total bacterial abundance in DB and only 77% in the case of NL. Proteobacteria have the highest relative abundance, accounting for around 42% of the total bacterial population in the case of DB and Firmicutes has the highest relative abundance in Najafgarh at 30%. The diversity analysis found significant differences in the community structure at the two sites. The variation in the bacterial communities in the two wetlands is significantly associated with two water parameters (conductivity and temperature) and two sediment parameters (Sediment Nitrogen and Sediment Organic Matter). Correlation Analysis showed that high ammonia, nitrite, and conductance in NL resulted in bacterial communities shifting towards phyla abundant in degraded ecosystems like Acidobacteria, Choloroflexi, Caldiserica, Aminicenantes, Thaumarchaeota, and Planctomycetes.

Empiric antibiotic and in-vitro susceptibility of urosepsis pathogens: do they match? The outcome of a study from south India.

INTRODUCTION: Urosepsis is life threatening, unless treated immediately. Empirical treatment with appropriate antibiotics lowers the risk of a poor outcome. However, with increasing resistance among common uropathogens, there is a need for continuous review of the existing protocol to determine whether there is a correlation between empirical antibiotic therapy and in-vitro susceptibility pattern of the pathogens causing urosepsis. METHODOLOGY: A prospective study was carried out on 66 confirmed cases of urosepsis from January 2017 to December 2018 after obtaining ethical clearance. Demographic details, risk factors, length of hospital stay, bacteriological profile, empirical antibiotic given, and change in antibiotic following susceptibility report and outcome was recorded. RESULTS: Among the 66 urosepsis cases 63 of them were started on empiric antibiotic. The correlation between the empirical antibiotic given and the in-vitro antimicrobial susceptibility was found to be significant with a p value < 0.0001. Among the 63 for whom empiric antibiotics was started further escalation of antibiotic was done in 46 patients. The remaining 20% of cases were changed over to a different antibiotic, in line with susceptibility report. The mortality rate was (15.1%) with a confidence interval of (CI = 15 ± 3.5). The association between the risk factors for urosepsis and their effect on mortality rate was analyzed. Diabetes mellitus and chronic kidney disease were identified as important independent risk factors and had direct influence on the mortality rate with significant p value of 0.0281 and 0.0015 respectively. CONCLUSIONS: A significant correlation was identified between the empirical antibiotic given and in-vitro antibiotic susceptibility pattern.

Effectiveness of Milieu Therapy in reducing conflicts and containment rates among schizophrenia patients.

OBJECTIVES: To evaluate effectiveness of Milieu Therapy in reduction of conflict and containment rates among schizophrenia patients. METHODS: This study utilized quasi experimental non-equivalent control group pre-post design. One hundred schizophrenia patients admitted in acute psychiatric wards were non-randomly assigned to either of the experimental (n=50) or control group (n=50). The experimental group received both milieu therapy and routine hospital treatment. The Milieu Therapy intervention Included environmental modification and structuring ward activities, establishing effective interaction with patient, and teaching caregivers on managing conflict behavior of patient. The control group received only routine treatment in the hospital. Outcome measures on conflict and containment rates were evaluated for both the groups at baseline and at 2nd, 3rd and 15th day. The Patient-Staff Conflict Checklist Shift Report (PCC-SR) was used to collect information about rates of conflict and containment. RESULTS: Compared with control group, the experimental group participants showed decrease in aggressive behavior, self-harm behavior and general rule breaking behavior at baseline and 2nd, 3rd and 15th day (F=4.61, p < 0.004, η2=0.04; F=11.92, p < 0.001, η2=0.11; F=6.94, p < 0.001, η2=0.06) over seven days interval. CONCLUSIONS: The present study findings provided evidence for the effectiveness of integrating Milieu Therapy in psychiatric acute wards in reducing conflict behaviors among schizophrenia patients. Milieu therapy should be considered as an integral part of psychiatric care settings in these patients.

Effectiveness of Milieu Therapy in reducing conflicts and containment rates among schizophrenia patients

Objective. To evaluate effectiveness of Milieu Therapy in reduction of conflict and containment rates among schizophrenia patients. Methods. This study utilized quasi experimental non-equivalent control group pre-post design. One hundred schizophrenia patients admitted in acute psychiatric wards were non-randomly assigned to either of the experimental (n=50) or control group (n=50). The experimental group received both milieu therapy and routine hospital treatment. The Milieu Therapy intervention Included environmental modification and structuring ward activities, establishing effective interaction with patient, and teaching caregivers on managing conflict behavior of patient. The control group received only routine treatment in the hospital. Outcome measures on conflict and containment rates were evaluated for both the groups at baseline and at 2nd, 3rd and 15th day. The Patient­Staff Conflict Checklist Shift Report (PCC-SR) was used to collect information about rates of conflict and containment. Results. Compared with control group, the experimental group participants showed decrease in aggressive behavior, self-harm behavior and general rule breaking behavior at baseline and 2nd, 3rd and 15th day (F=4.61, p<0.004, η2=0.04; F=11.92, p<0.001, η2=0.11; F=6.94, p<0.001, η2=0.06) over seven days interval. Conclusion. The present study findings provided evidence for the effectiveness of integrating Milieu Therapy in psychiatric acute wards in reducing conflict behaviors among schizophrenia patients. Milieu therapy should be considered as an integral part of psychiatric care settings in these patients.

Objetivo. Evaluar la efectividad de la terapia Milieu en la reducción de las tasas de conflicto y contención entre los pacientes con esquizofrenia. Métodos. Este estudio utilizó un diseño cuasi experimental con grupo control no equivalente y evaluación pre y posintervención. Cien pacientes con esquizofrenia hospitalizados en salas psiquiátricas en un hospital público en Karnataka (India) se asignaron de forma no aleatoria a los grupos experimental (n=50) y control (n=50). El grupo experimental recibió la terapia de Milieu, además del tratamiento hospitalario de rutina. La terapia de Milieu incluyó la modificación ambiental y la estructuración de las actividades de la sala, el establecimiento de una interacción efectiva con el paciente y la enseñanza a los cuidadores sobre el manejo del comportamiento conflictivo del paciente. El grupo control recibió solamente el tratamiento de rutina en el hospital. Las medidas de resultado (tasas de conflictos y de contención) se evaluaron en ambos grupos en los días de inicio, 2º, 3º y 15º posadmisión. El Patient­Staff Conflict Checklist Shift Report (PCC-SR) se utilizó para la recolección de la información acerca de las tasas de conflicto y contención. Resultados. En comparación con el grupo de control, los participantes del grupo experimental mostraron una disminución en el comportamiento agresivo, el comportamiento de autolesión y el comportamiento de incumplimiento de las reglas generales al inicio y al segundo, tercer y décimo quinto día (F=4.61, p<0.004, η2=0.04; F=11.92, p<0.001, η2=0.11; F=6.94, p<0.001, η2=0.06). Conclusión. Los hallazgos del presente estudio proporcionaron evidencia de la efectividad de la Terapia Melieu en la reducción de comportamientos conflictivos en el paciente esquizofrénico hospitalizado en fase aguda. La Terapia Milieu debe considerarse como una parte integral en los entornos de atención de estos pacientes.

Objetivo. Avaliar a eficácia da terapia Milieu na redução das taxas de conflito e contenção entre pacientes com esquizofrenia. Métodos. Este estudo utilizou um desenho quase-experimental com um grupo controle não equivalente e avaliação pré e pós-intervenção. Cem pacientes com esquizofrenia hospitalizados em salas psiquiátricas em um hospital público de Karnataka (Índia) foram designados não aleatoriamente para os grupos experimental (n = 50) e controle (n = 50). O grupo experimental recebeu terapia Milieu, além de tratamento hospitalar de rotina. A terapia de Milieu incluiu modificação ambiental e estruturação das atividades da enfermaria, estabelecendo uma interação efetiva com o paciente e ensinando os cuidadores sobre o gerenciamento do comportamento conflitante do paciente. O grupo controle recebeu apenas tratamento hospitalar de rotina. As medidas de resultado (taxas de conflito e contenção) foram avaliadas em ambos os grupos nos dias de início, 2, 3 e 15 após a admissão. O Relatório de Mudança de Lista de Verificação de Conflitos entre Pacientes e Funcionários (PCC-SR) foi usado para coletar informações sobre taxas de conflitos e contenção. Resultados. Comparados ao grupo controle, os participantes do grupo experimental mostraram uma diminuição no comportamento agressivo, no comportamento autolesivo e no não cumprimento das regras gerais no início e no segundo, terceiro e décimo quinto dia (F = 4,61, p <0,004, η2 = 0,04; F = 11,92, p <0,001, η2 = 0,11; F = 6,94, p <0,001, η2 = 0,06). Conclusão Os achados do presente estudo forneceram evidências da eficácia da Terapia Melieu na redução de comportamentos conflitantes no paciente esquizofrênico hospitalizado na fase aguda. A terapia Milieu deve ser considerada como parte integrante do ambiente de atendimento desses pacientes.