Evaluation of prescription pattern of antimicrobials in the treatment of respiratory tract infections in pediatric patients attending a tertiary care hospital

Background: Irrational use of antimicrobials is a complex and multifactorial problem in developing countries. Prescriptions not adhering to the treatment guidelines, self-medication, inappropriate use of drugs by patients can inadvertently lead to development of antimicrobial resistance. An observational study was designed to evaluate antimicrobial use in pediatric population with respiratory tract infections and its adherence to national treatment guidelines. Methods: This was a cross sectional observational study initiated after taking institutional ethics committee permission. The prescriptions of children diagnosed with upper respiratory tract infections and lower respiratory tract infections (LRTI) were screened. Their demographic profile and details of drugs prescribed were recorded. Results: Out of 230 pediatric prescriptions,155 (67%) were from outpatient department and 75 (33%) from those admitted in ward. Total 145 children were diagnosed with URTI whereas 85 had LRTI. In this study, 60 children with URTI received combination of amoxicillin and clavulanic acid (Co-amoxiclav) whereas 66 children with LRTI received Co-amoxiclav,18 ceftriaxone (N=18), 6 vancomycin (N=6) and 18 were prescribed oseltamivir (N=18), either alone or in combination. Other drugs prescribed included, paracetamol for fever and cough syrups. Out of 195 drugs prescribed by brand names, 138 (70.8%) were antimicrobials. Fixed dose combination amoxicillin and clavulanic acid, paracetamol and cough syrups were available from hospital pharmacy. None of the prescriptions had polypharmacy. Conclusions: URTI was treated using single antimicrobial whereas LRTI was treated with more than one antimicrobials or combination of antimicrobial and antiviral agent. The prescriptions were in accordance with the national treatment guidelines

N-trans-Feruloyltyramine from Tinospora cordifolia

837-83

A Field-Based Approach for Determining ATOFMS Instrument Sensitivities to Ammonium and Nitrate

Aerosol time-of-flight mass spectrometry (ATOFMS) instruments measure the size and chemical composition of individual particles in real-time. ATOFMS chemical composition measurements are difficult to quantify, largely because the instrument sensitivities to different chemical species in mixed ambient aerosols are unknown. In this paper, we develop a field-based approach for determining ATOFMS instrument sensitivities to ammonium and nitrate in size-segregated atmospheric aerosols, using tandem ATOFMS-impactor sampling. ATOFMS measurements are compared with collocated impactor measurements taken at Riverside, CA, in September 1996, August 1997, and October 1997. This is the first comparison of ion signal intensities from a single-particle instrument with quantitative measurements of atmospheric aerosol chemical composition. The comparison reveals that ATOFMS instrument sensitivities to both NH_4^+ and NO_3^- decline with increasing particle aerodynamic diameter over a 0.32−1.8 μm calibration range. The stability of this particle size dependence is tested over the broad range of fine particle concentrations (PM_(1.8) = 17.6 ± 2.0−127.8 ± 1.8 μg m^(-3)), ambient temperatures (23−35 °C), and relative humidity conditions (21−69%), encountered during the field experiments. This paper describes a potentially generalizable methodology for increasing the temporal and size resolution of atmospheric aerosol chemical composition measurements, using tandem ATOFMS-impactor sampling

Evaluating Emissions in a Modern Compression Ignition Engine Using Multi-Dimensional PDF-Based Stochastic Simulations and Statistical Surrogate Generation

© 2018 SAE International. All Rights Reserved. Digital engineering workflows, involving physico-chemical simulation and advanced statistical algorithms, offer a robust and cost-effective methodology for model-based internal combustion engine development. In this paper, a modern Tier 4 capable Cat® C4.4 engine is modelled using a digital workflow that combines the probability density function (PDF)-based Stochastic Reactor Model (SRM) Engine Suite with the statistical Model Development Suite (MoDS). In particular, an advanced multi-zonal approach is developed and applied to simulate fuels, in-cylinder combustion and gas phase as well as particulate emissions characteristics, validated against measurements and benchmarked with respect to the predictive power and computational costs of the baseline model. The multi-zonal SRM characterises the combustion chamber on the basis of different multi-dimensional PDFs dependent upon the bulk or the thermal boundary layer in contact with the cylinder liner. In the boundary layer, turbulent mixing is significantly weaker and heat transfer to the liner alters the combustion process. The integrated digital workflow is applied to perform parameter estimation based on the in-cylinder pressure profiles and engine-out emissions (i.e. NOx, CO, soot and unburnt hydrocarbons; uHCs) measurements. Four DoE (design-of-experiments) datasets are considered, each comprising measurements at a single load-speed point with various other operating conditions, which are then used to assess the capability of the calibrated models in mimicking the impact of the input variable space on the combustion characteristics and emissions. Both model approaches predict in-cylinder pressure profiles, NOx, and soot emissions satisfactorily well across all four datasets. Capturing the physics of emission formation near the cylinder liner enables the multi-zonal SRM approach to provide improved predictions for intermediates, such as CO and uHCs, particularly at low load operating points. Finally, fast-response surrogates are generated using the High Dimensional Model Representation (HDMR) approach, and the associated global sensitivities of combustion metrics and emissions are also investigated

Coexistence and Phase Separation in Sheared Complex Fluids

We demonstrate how to construct dynamic phase diagrams for complex fluids that undergo transitions under flow, in which the conserved composition variable and the broken-symmetry order parameter (nematic, smectic, crystalline, etc.) are coupled to shear rate. Our construction relies on a selection criterion, the existence of a steady interface connecting two stable homogeneous states. We use the (generalized) Doi model of lyotropic nematic liquid crystals as a model system, but the method can be easily applied to other systems, provided non-local effects are included.Comment: 4 pages REVTEX, 5 figures using epsf macros. To appear in Physical Review E (Rapid Communications

Identification of Metals Found in the Leaves of Tabernaemontana alternifolia

Abstract: Tabernaemontana alternifolia, an Ayurvedic medicinal plant is found in the western ghats of Maharashtra. The leaves, roots, bark-stem are used in Ayurvedic system of medicines. Leaves are used in the form of churna/extract or in combination with the other plant materials in their formulations. It is administered orally. Metal analysis of the leaves of Tabernaemontana alternifolia shows a high percentage of metals like magnesium, calcium, iron, copper and manganese. The present results will prove to be useful in understanding the role of metal ions in the biogenesis of the secondary metabolites of the medicinally important plant

Evaluation of an Air Quality Model for the Size and Composition of Source-Oriented Particle Classes

Air quality model predictions of the size and composition of atmospheric particle classes are evaluated by comparison with aerosol time-of-flight mass spectrometry (ATOFMS) measurements of single-particle size and composition at Long Beach and Riverside, CA, during September 1996. The air quality model tracks the physical diameter, chemical composition, and atmospheric concentration of thousands of representative particles from different emissions classes as they are transported from sources to receptors while undergoing atmospheric chemical reactions. In the model, each representative particle interacts with a common gas phase but otherwise evolves separately from all other particles. The model calculations yield an aerosol population, in which particles of a given size may exhibit different chemical compositions. ATOFMS data are adjusted according to the known particle detection efficiencies of the ATOFMS instruments, and model predictions are modified to simulate the chemical sensitivities and compositional detection limits of the ATOFMS instruments. This permits a direct, semiquantitative comparison between the air quality model predictions and the single-particle ATOFMS measurements to be made. The air quality model accurately predicts the fraction of atmospheric particles containing sodium, ammonium, nitrate, carbon, and mineral dust, across all particle sizes measured by ATOFMS at the Long Beach site, and in the coarse particle size range (D_a ≥ 1.8 μm) at the Riverside site. Given that this model evaluation is very likely the most stringent test of any aerosol air quality model to date, the model predictions show impressive agreement with the single-particle ATOFMS measurements

A Field-Based Approach for Determining ATOFMS Instrument Sensitivities to Ammonium and Nitrate

Aerosol time-of-flight mass spectrometry (ATOFMS) instruments measure the size and chemical composition of individual particles in real-time. ATOFMS chemical composition measurements are difficult to quantify, largely because the instrument sensitivities to different chemical species in mixed ambient aerosols are unknown. In this paper, we develop a field-based approach for determining ATOFMS instrument sensitivities to ammonium and nitrate in size-segregated atmospheric aerosols, using tandem ATOFMS-impactor sampling. ATOFMS measurements are compared with collocated impactor measurements taken at Riverside, CA, in September 1996, August 1997, and October 1997. This is the first comparison of ion signal intensities from a single-particle instrument with quantitative measurements of atmospheric aerosol chemical composition. The comparison reveals that ATOFMS instrument sensitivities to both NH_4^+ and NO_3^- decline with increasing particle aerodynamic diameter over a 0.32−1.8 μm calibration range. The stability of this particle size dependence is tested over the broad range of fine particle concentrations (PM_(1.8) = 17.6 ± 2.0−127.8 ± 1.8 μg m^(-3)), ambient temperatures (23−35 °C), and relative humidity conditions (21−69%), encountered during the field experiments. This paper describes a potentially generalizable methodology for increasing the temporal and size resolution of atmospheric aerosol chemical composition measurements, using tandem ATOFMS-impactor sampling

Nepal Ambient Monitoring and Source Testing Experiment (NAMaSTE): Emissions of particulate matter from wood-and dung-fueled cooking fires, garbage and crop residue burning, brick kilns, and other sources

The Nepal Ambient Monitoring and Source Testing Experiment (NAMaSTE) characterized widespread and under-sampled combustion sources common to South Asia, including brick kilns, garbage burning, diesel and gasoline generators, diesel groundwater pumps, idling motorcycles, traditional and modern cooking stoves and fires, crop residue burning, and heating fire. Fuel-based emission factors (EFs; with units of pollutant mass emitted per kilogram of fuel combusted) were determined for fine particulate matter (PM2.5), organic carbon (OC), elemental carbon (EC), inorganic ions, trace metals, and organic species. For the forced-draft zigzag brick kiln, EFPM2.5 ranged from 12 to 19gkg-1 with major contributions from OC (7%), sulfate expected to be in the form of sulfuric acid (31.9%), and other chemicals not measured (e.g., particle-bound water). For the clamp kiln, EFPM2.5 ranged from 8 to 13gkg-1, with major contributions from OC (63.2%), sulfate (23.4%), and ammonium (16%). Our brick kiln EFPM2.5 values may exceed those previously reported, partly because we sampled emissions at ambient temperature after emission from the stack or kiln allowing some particle-phase OC and sulfate to form from gaseous precursors. The combustion of mixed household garbage under dry conditions had an EFPM2.5 of 7.4±1.2gkg-1, whereas damp conditions generated the highest EFPM2.5 of all combustion sources in this study, reaching up to 125±23gkg-1. Garbage burning emissions contained triphenylbenzene and relatively high concentrations of heavy metals (Cu, Pb, Sb), making these useful markers of this source. A variety of cooking stoves and fires fueled with dung, hardwood, twigs, and/or other biofuels were studied. The use of dung for cooking and heating produced higher EFPM2.5 than other biofuel sources and consistently emitted more PM2.5 and OC than burning hardwood and/or twigs; this trend was consistent across traditional mud stoves, chimney stoves, and three-stone cooking fires. The comparisons of different cooking stoves and cooking fires revealed the highest PM emissions from three-stone cooking fires (7.6-73gkg-1), followed by traditional mud stoves (5.3-19.7gkg-1), mud stoves with a chimney for exhaust (3.0-6.8gkg-1), rocket stoves (1.5-7.2gkg-1), induced-draft stoves (1.2-5.7gkg-1), and the bhuse chulo stove (3.2gkg-1), while biogas had no detectable PM emissions. Idling motorcycle emissions were evaluated before and after routine servicing at a local shop, which decreased EFPM2.5 from 8.8±1.3 to 0.71±0.45gkg-1 when averaged across five motorcycles. Organic species analysis indicated that this reduction in PM2.5 was largely due to a decrease in emission of motor oil, probably from the crankcase. The EF and chemical emissions profiles developed in this study may be used for source apportionment and to update regional emission inventories