A prospective study on antibiotic prescribing pattern among in-patients of medicine department of a tertiary care hospital

Background: Irrational prescription is a major contributor to the antimicrobial resistance. Tertiary care centres in a state are the centres of excellence where policies are framed. So, they have an important role in promoting rational antibiotic prescription.Methods: The study was conducted on in-patients of medicine ward in government medical college, Calicut, for a period of 2 months (January to February 2018), The data was collected from IP case records of patients. The parameters checked includes appropriateness of the antibiotic as, to whether it is according to our hospital antibiotic policy, whether de-escalation and change to oral drug was done, whether it is prescribed by generic name, is it given as fixed drug combination (FDC), is it from national list of essential medicine.Results: Among the 135-prescription analyzed, total 225 antibiotics were used. Cephalosporins (32%) were the most commonly used. Of this only 40% was given by generic prescription. 27% was FDCs. 55% was from national list of essential medicines and 69% of them were ‘WATCH’ drug according to WHO Antibiotic Policy. Regarding appropriateness of prescriptions around 56% included right drug, 93% had right dose and frequency, and 70% had right duration and 100% were given through right route.Conclusions: Strict adherence to hospital antibiotic policy and plan for effective teaching programs regarding antibiotic resistance and importance of rational prescription of antibiotics can improve the quality of antibiotic prescription and minimize antibiotic resistance

Enterotoxicity of Aeromonas hydrophila

Live cells and cell-free culture supernates of 50 strains of Aeromonas hydro-phila isolated from diarrhoeic and healthy human faeces, drinking water, sewage, the river Ganges and faeces from domestic animals caused accumulation of fluid in ligated ileal loops of adult rabbits. The amount of fluid produced was comparable to that of a toxigenic strain of Vibrio cholerae. Three of the strains gave positive reactions only after two passages in ileal loops of rabbits. Inocula of about 103 viable cells and 0-25 ml of culture supernate caused fluid accumulation in the loops. The enterotoxic factor was inactivated at 60°C for 20 min. and 65°C for 10 min., was precipitated with ammonium sulphate and was non-dialysable; these results indicate the protein nature of the enterotoxin. An inoculum of 40 μg of crude toxin caused as much fluid accumulation as larger inocula. The only histopathological change in the loops was depletion of mucus from the goblet cells

Performance Analysis of Adaptive Equalizers Over Multipath Faded Channels: Error Vector Magnitudes

Due to the increasing popularity of digital transmission systems, the need for channel equalizers has been acknowledged. These techniques are designed to counteract the effects of the inter-symbol interference (ISI) caused by the communication channels. An adaptive equalizer is used to operate on the output of a channel in order to provide an approximation of the transmission medium. An adaptive equalizer usually requires a training period to operate successfully. This method eliminates the effects of the wireless transmission channel and allows the subsequent symbol modulation. The paper presents an overview of the various adaptive equalizers, such as the least mean squares (LMS), decision feedback equalizers (DFE), and the Recursive least squares (RLS). It also explores their performance in terms of error vector magnitudes (EVM) over Rician and Rayleigh channels. The paper looks into the effects of adaptive equalizers on various digital modulation techniques for rectangular quadrature phase shift, amplitude modulation, such as the BPSK, QPSK, 4-QAM, 16-QAM, 64-QAM and 256-QAM. These modulations are analysed and measured in terms of symbol error rates and number of incorrect symbols

Experimental Testing and Validation of Adaptive Equalizer Using Machine Learning Algorithm

Due to the increasing demand for high-speed data transmission, wireless communication has become more advanced. Unfortunately, the various kinds of impairments that can occur when carrying data symbols through a wireless channel can affect the network performance. Some of the solutions that are proposed to address these issues include channel equalization, and that can be solved through machine learning techniques. In this paper, a hybrid approach is proposed that combines the features of tracking mode and training mode of adaptive equalizer. This method utilizes the concept of machine learning (ML) to classify different environments (highly, medium, low, open space cluttered) based on the measurements of their RF signal. The results of the study revealed that the proposed method can perform well in real-time deployments. The performance of ML algorithms namely Logistic Regression, KNN Classifier, SVM Classifier, Naive Bayes, Decision Tree classifier and Random Forest classifier is analyzed for different number of samples such as 10, 50 and 100. The performance of these algorithms is evaluated by comparing their accuracy, sensitivity, specificity, F1 score and Confusion Matrix. The objective of this study is to demonstrate that a single ML algorithm cannot perform well in all kinds of environments. In order to choose the best algorithm for a given environment, the decision device has to analyze the various factors that affect the performance of the system. For instance, the random forest classifier performed well in terms of accuracy (100 percent), specificity (100 percent), sensitivity (100 percent), and F1_score (100 percent). On the other hand, the logistic regression algorithm did not perform well in low cluttered environment

Crouzon’s syndrome with adenotonsillitis: conventional surgery in altered anatomy.

Background/Objectives: Crouzon’s syndrome is characterized by premature closure of the cranial sutures, midface hypoplasia, orbital deformities & other associated abnormalities.Children with Crouzon syndrome frequently have obstructive sleep apnea due to the underdevelopment of the midface.Case report: A 12 year old boy of Crouzon’s syndrome with chronic adeno-tonsillitis was managed by adeno-tonsillectomy under general anaesthesia by scalpel cautery method. The boyresponded well to surgery & the mild sleep disorder disappeared within a week uveventfully.Conclusion: Sleep disorders in this condition can be treated by improving the airway by selective procedures like midface advancement, mandibular expansion , adeno-tonsillectomy,uvulo-palatopharyngoplasty, anterior tongue reduction & endoscopic tracheal granuloma excision.

Human otoacariasis: a common outbreak in rubber growing belt of Karnataka.

Background/Objective: Soft tick in the ear is a very common acute painful and distressing condition in the flowering months of October to March. It’s a common condition in the rubber growing belt of Sullia.The mouthparts of the tick grips firmly the skin of the external auditory canal or the tympanic membrane and sucks blood and swells up. Otoscopy and removal of the tick from the ear can be done in outpatients in adults and difficult in a frightened irritable child.Materials and methods: 312 cases of intra-aural ticks presenting to the opd and casualty which included 131 males and 181 females were included in the study.Results: Out of the 312 cases of intra-aural ticks, 170 cases were treated in the outpatient and 140 cases under short general anesthesia with oto-microscopy.Conclusion: Intra-aural tick infestation is an acute painful condition which needs prompt management by an experienced otolaryngologist. Proper visualization and instrumentation is necessary to avoid complications.

Seroprevalence Study of Human Brucellosis by Conventional Tests and Indigenous Indirect Enzyme-Linked Immunosorbent Assay

Brucellosis is one of the most important reemerging zoonoses in many countries. Brucellosis is caused by Gram-negative coccobacillus belonging to genus Brucella. Human brucellosis often makes the diagnosis difficult. The symptoms and clinical signs most commonly reported are fever, fatigue, malaise, chills, sweats headaches, myalgia, arthralgia, and weight loss. Some cases have been presented with only joint pain, lower backache, and involuntary limb movement, burning feet, or ischemic heart attacks. The focus of this work was to develop a highly sensitive and specific indirect ELISA by using smooth lipopolysaccharide antigen of Brucella abortus 99 to detect anti-Brucella antibodies at Project Directorate on Animal Disease Monitoring and Surveillance. Serum samples collected from 652 individuals in whom fever was not the major symptom but the complaint was of joint pain, headache, lower backache, and so forth, were screened by Rose Bengal plate agglutination test (RBPT) and standard tube agglutination test (STAT). Subsequent testing of sera by indigenous indirect ELISA detected 20 samples positive (3.6% seroprevalence), and indirect ELISA was found to be more sensitive than RBPT and STAT. The seroprevalence in South Karnataka was 2.14%, and in North Karnataka it was 0.92%

Cloud Storage That Makes Use Of A Feature-Based Encoding Hierarchy To Maximize Efficiency

Sharing data securely in the cloud is a major difficulty, but cipher text-policy attribute-based encryption has emerged as a top tool for meeting this need. The shared data files used in many different professions, including medicine and the military, have a multi-tiered, intricate structure. The file-sharing structure, however, has not been studied in cipher text-policy attribute-based encryption. Here, we provide a novel cloud-based encryption approach that takes advantage of hierarchies of file attributes. Before encrypting a folder tree, it is common practice to merge the various access controls into a single control scheme. Some components of the encryption text that pertain to attributes might be reused between files. The time and money needed to store encrypted documents and conduct encryption are therefore minimized. Finally, it is demonstrated that the proposed method is safe under the null hypothesis. In experimental simulations of encryption and decryption, the proposed method has been proven to be exceedingly efficient. Our method's advantages become more evident as more data is included

Multistep microsatellite mutation in the maternally transmitted locus D13S317: a case of maternal allele mismatch in the child

Examination of a case of a paternity dispute with 17 autosomal short tandem repeats (STR) loci revealed a mismatch of the maternally transmitted allele at the locus D13S317 in the questioned child. The composition of the alleles of this locus in the mother, questioned child and suspected father was 8/8, 11/11 and 8/11, respectively. The sequence analysis of the regions flanking the locus D13S317 and peak height measurements of the paternal, maternal and child alleles at this locus excluded the possibility of null allele as a cause of the allelic mismatch inherited by the child. The results suggested expansion of the microsatellite repeat motif, TATC by three repeat units as a probable cause for the allelic mismatch in the child. This is a rare case of maternally transmitted multistep microsatellite mutation reported for the first time for this locus in the forensic DNA analysis. The mutation rate at D13S317 locus in maternal and paternal meiosis was 0.04 and 0.14%, respectively, and overall mutation rate was 0.15%. The probability of maternity and paternity were 0.999999 and 0.999999, respectively, for all the 17 autosomal STR loci analyzed. Furthermore, the sequence of two hypervariable regions of mitochondrial DNA, HV1 and HV2 and the maternal alleles of six X chromosome STR loci in the questioned child matched completely with the mother. These results conclusively proved that the mother and suspected father are the biological parents of the questioned child

Rare case report of metastatic cervical carcinoma

Although carcinoma of cervix is among the most common malignancies in women, cutaneous metastasis is very unusual. Here we report a case of a parous woman diagnosed with adenocarcinoma of cervix who did not undergo chemotherapy in spite of being advised after initial surgery, presenting with cutaneous metastasis at the operative scar site 2 years later