All India Institute of Medical Sciences, Rishikesh

The current investigation focuses on isolating and identifying soil fungi from pulp and paper mill wastes and their potential to produce cellulases. Out of 82 identified fungal colonies, 12 isolated species belong to the genera Aspergillus, Cladosporium, Fusarium, Penicillium, Humicola, Rhizopus, of which one was sterile mycelia. Moreover, 12 fungal isolates were further subjected to qualitative screening, confirming cellulase production from 10 isolates. The cellulolytic index (CI) ranged from 1.33 to 2.47. The highest CI was exhibited by Fusarium sp. (KU11), and the lowest CI was shown by Humicola sp. (KU9) and Cladosporium sp. (KU8), respectively. The present study's findings revealed that Fusarium sp. (KU11) was found to be a potent cellulase producer that can be effectively utilized in pulp and paper industries for waste recycling and other relevant applications.

Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, with acute exacerbations (AECOPD) often resulting in hypercapnic respiratory failure requiring ventilatory support. Non-invasive ventilation (NIV) has become the preferred first-line therapy in such cases; however, early prediction of NIV failure remains crucial for optimizing outcomes and preventing delayed intubation. Objective To identify clinical, biochemical, and physiological predictors associated with NIV success or failure in patients with AECOPD presenting with hypercapnic respiratory failure. Methods This prospective observational study was conducted over 18 months in the Respiratory Care Unit of a tertiary-care center. A total of 130 eligible AECOPD patients (pH < 7.35, PaCO₂ > 45 mmHg) treated with NIV were enrolled. Patients requiring immediate intubation or having contraindications to NIV were excluded. Serial clinical assessment, arterial blood gases (ABG), and organ dysfunction scores were monitored at baseline and during NIV. NIV failure was defined as intubation or in-hospital death. Data were analyzed using SPSS v23, and predictors were determined by multivariate logistic regression. Results NIV was successful in 92 (70.8%) and failed in 38 (29.2%) patients; 16 patients (12.3%) died during hospitalization. Baseline demographic, clinical, and biochemical parameters were not significantly associated with NIV outcome. Independent predictors of NIV failure were a SOFA score ≥6 (OR 2.9; 95% CI 1.5–5.4; p=0.004) and pH improvement <0.03 within 6 h of NIV initiation (OR 3.4; 95% CI 1.8–6.3; p=0.002). Complications such as shock, pneumonia, arrhythmia, and acute kidney injury were significantly higher in the failure group. NIV failure was associated with prolonged ICU and hospital stay (p<0.01). Conclusion In AECOPD with hypercapnic respiratory failure, early physiological response—particularly pH improvement within six hours—and baseline organ dysfunction (SOFA ≥6) are strong independent predictors of NIV failure. Structured monitoring of ABG and organ scores during the first 24 h can guide timely escalation and improve clinical outcomes.

Abstract Background Stature estimation from skeletal remains is critical in forensic anthropology, particularly when long bones are fragmented, decomposed, or absent due to trauma, environmental factors, or mass disasters. Among hand bones, middle phalanges stand out as small yet structurally resilient elements that frequently preserve even in compromised remains, making them valuable for stature estimation and identification. While direct skeletal measurements provide the gold standard, establishing reference equations from living individuals—using indirect crease-to-crease lengths as proxies for osseous dimensions—offers practical baseline data applicable to both dry bones and body parts recovered with intact soft tissues. This approach bypasses the need for immediate dissection or maceration, enabling non-invasive stature estimation and reconstruction in medicolegal scenarios. Methodology A total of 140 cases were included in this study, fulfilling the inclusion and exclusion criteria. Stature was measured using a wall-mounted stadiometer, while middle phalangeal lengths (index, middle, ring, and little fingers of both hands) were determined via digital vernier calipers and impression technique, using proximal and distal interphalangeal joint creases as landmarks. Two independent, blinded observers followed standardized anthropometric protocols, with inter-observer reliability assessed statistically. Regression analysis evaluated phalangeal length-stature relationships. Statistical analysis utilized SPSS with Shapiro–Wilk normality testing, t-tests/Mann–Whitney U for group comparisons, Pearson correlations, simple/multiple/stepwise regression (R2, SEE, LOOCV validation), multicollinearity assessment (VIF), and inter-observer reliability (ICC, Bland–Altman; α = 0.05). Results All middle phalangeal lengths demonstrated significant positive correlations with mean stature (166.24 ± 8.94 cm; r = 0.20–0.48, p < 0.05), peaking at the right middle finger (r = 0.479). Simple linear regressions accounted for 4–23% of stature variance (R2 = 0.040–0.230), while multiple regression models achieved 29–33% explanation (maximum R2 = 0.327, p < 0.0001). Inter-observer reliability proved excellent across techniques (ICC = 0.89–0.98). Conclusions Middle phalangeal measurements are reliable, sexually dimorphic predictors of stature. The impression technique matches vernier caliper accuracy while offering greater practicality for field and postmortem use, supporting its inclusion in forensic protocols for identification from fragmented hand remains.

During World Antimicrobial Resistance Awareness Week (WAAW) 2024, All India Institute of Medical Sciences (AIIMS) Rishikesh implemented a structured, multi-sectoral Institutional Action Plan (IAP) to transition from conventional awareness activities to an integrated antimicrobial stewardship approach. The initiative emphasized coordinated institutional action through education, advocacy, and practice-based interventions involving healthcare workers, hospital administration, and the community. The seven-day program included institutional capacity building, assessment and incentivization, and public and community outreach activities. Evaluation was conducted using predefined indicators assessing healthcare worker knowledge enhancement through pre- and post-intervention assessments, compliance with bedside antimicrobial stewardship practices via interactive audits, adoption of standardized prescribing tools, and community outreach through educational roleplays and talks. Targeted training was delivered to over 300 healthcare workers, including focused stewardship training for pharmacists. The program achieved institution-wide engagement involving more than 3,000 participants. Key antimicrobial stewardship policy documents were released during the inauguration, reflecting administrative commitment. Bedside stewardship activities audited and trained over 1,000 healthcare workers across more than 40 clinical areas, leading to the identification of a high-performing clinical unit as the institutional stewardship champion. Core stewardship practices were reinforced through an institutional pledge taken by over 2,000 healthcare workers, and individual stewardship champions were identified across professional categories. Structured workshops strengthened stewardship competencies among selected participants, while public outreach activities reached over 1,500 community members. Media engagement further amplified program visibility and messaging. The IAP implemented during WAAW 2024 demonstrated a feasible, scalable, and integrated institutional model for antimicrobial stewardship. By combining policy reinforcement, structured training, performance recognition, and community engagement, the initiative fostered measurable behavior change across institutional and public domains. This technical framework may be adapted by other tertiary-care institutions to strengthen antimicrobial stewardship implementation and sustain long-term efforts to contain Antimicrobial Resistance (AMR).