Bacteriological Profile of Wound Infection and Antibiotic Susceptibility Pattern of Various Isolates in a Tertiary Care Center

Introduction: Wound infection due to various pathogenic microorganisms and the development of resistance to antibiotics is one of the major problems in medical sector. This study aimed to identify the etiological agents of wound infection along with their antibiotic susceptibility. Methods: A total of 400 wound swab specimens were collected from the patients visiting a tertiary center in western Nepal over a period of six months. Thus, collected specimens were processed in Microbiology laboratory for isolation of causative agents. Antibiotic susceptibility test was performed for entire isolates by Kirby Baur disc diffusion method. Methicillin-Resistant Staphylococcus aureus was detected by cefoxitin disc diffusion test and Extended- Spectrum Beta-Lactamases producing Enterobacteriaeae by Phenotypic confirmatory disc diffusion test as recommended by Clinical and Laboratory Standards Institute. Results: Two hundred and fifty-nine (64.7%) of specimens were infected, giving rise to 269 different isolates. Among these, 166 (61.7%) were gram positive and 101 (37.6%) were gram negative bacteria. Staphylococcus aureus (n = 130, 48.3%) was the most predominant bacteria followed by Escherichia coli (n=44, 16.3%), and Klebsiella pneumoniae (n=23, 8.5%). Gentamicin followed by co-trimoxazole was the most effective among the tested antibiotics for Staphylococcus aureus. Gentamicin and ciprofloxacin were shown effective for isolated gram-negative bacteria. Conclusion: Fifty-eight (44.6%) of total Staphylococcus aureus were Methicillin-Resistant Staphylococcus aureus positive and 16 (20.7%) of total Enterobacteriaceae were Extended-Spectrum Beta-Lactamases producers. The increased prevalence of Methicillin-Resistant Staphylococcus aureus and Extended-Spectrum Beta-Lactamase suggest rational use of antibiotics on the basis of antibiotic sensitivity results

Staged cost optimization of urban storm drainage systems based on hydraulic performance in a changing environment

International audienceUrban flooding causes large economic losses, property damage and loss of lives. The impact of environmental changes mainly, the urbanization and the climatic change leads to increased runoff and increased peak flows which the drainage system must be able to cope with to overcome possible damage and inconveniences caused by the induced flooding. Allowing for detention storage to compliment the capacity of the drainage system network is one of the approaches to reduce urban floods. The traditional practice was to design systems against stationary environmental forcings ? including design rainfall, landuse, etc. Due to the rapid change in climate-environment, this approach is no longer economically viable and safe, and explicit consideration of changes that gradually take place during the life-time of the drainage system is warranted. In this paper, a staged cost optimization tool based on the hydraulic performance of the drainage system is presented. A one dimensional hydraulic model is used for hydraulic evaluation of the network together with a genetic algorithm based optimization tool to determine optimal intervention timings and amounts throughout the lifespan of the drainage network. The model was applied in a case study area in the city of Porto Alegre, Brazil. It was concluded that considerable financial savings and/or additional level of flood-safety can be achieved by approaching the design problem as a staged plan rather than one-off scheme

Mental health issues in pregnant women in Nepal

Mental health of pregnant women and new mothers is a growing area of concern in both low- and high-income countries. This editorial highlights some of the key mental issues faced by women in rural Nepal and outlines an intervention based on training community health care workers by experienced UK volunteers

Translation and cross-cultural adaptation of Nepali versions of the patient-reported outcomes measurement information system (PROMIS®) pain intensity, pain interference, pain behavior, depression, and sleep disturbance short forms in chronic musculoskeletal pain

Purpose: The Patient-Reported Outcomes Meaurement Information System (PROMIS®) measures have been translated into many languages and have been shown to have strong measurement properties across a wide range of clinical conditions. However, Nepali translations of the PROMIS short forms are not yet available. The aim of this study was to translate and cross-culturally adapt the PROMIS Pain Intensity, Pain Interference, Pain Behavior, Depression, and Sleep Disturbance short forms into Nepali. Methods: We used the Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology, which incorporated two forward translations, synthesis of the translations, a back-translation, and three independent reviews, harmonization, cognitive debriefing, revisions, and proof reading. The translation and review teams were fluent in Nepali and English and represented five different countries and four continents. We evaluated the short forms for comprehensibility and relevance (two key aspects of the content validity of an instrument), conducting cognitive debriefing with six adults with chronic musculoskeletal pain, in compliance with recommendations by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The final version was proofread by two native Nepali speakers before and three new proofreaders after cognitive debriefing. Results: All five short forms were successfully translated and cross-culturally adapted into Nepali while maintaining equivalence to the source. Conclusions: The translation and review team, along with a sample from the target population with chronic musculoskeletal pain and the proofreaders considered all five PROMIS short forms relevant and comprehensible. An important next step is to evaluate the measurement properties of these instruments

Building on smallholder traditional farming practices to enhance cost-effective land resources conservation in Malawi : A case study of Sangadzi area 【Article】

In Malawi land resources degradation is a serious problem threatening productivity of land resourcesand affecting the livelihood of the majority of smallholder farmers. Programs to curb further degradationof the land resources and ensure increased food security among the resource poor households are under-way. Most of these programs however, tend to focus more on the research-tested conventional methodsthan on traditional farming methods and practices. However, understanding traditional farming practicesand building on what farmers do based on the resources under their exposure, offers an opportunity toredirect conventional research efforts towards provision of sustainable solutions to the common ruralproblems of hunger and land resources degradation. Based on a field survey, the objective of this paperis to analyse smallholder traditional land resources conservation practices and soil fertility managementtechniques and try to find their compatibility with the research efforts

National Workshop on Mental Health Education & Research

Bournemouth University, Liverpool John Moores University and Tribhuvan University in Nepal organised a two-day National Workshop on Mental Health Education & Research in Kathmandu in August 2016. The workshop handbook is a combination of update on the project as well as training materials for nurses and public health lecturers

Use of traditional serological methods and oral fluids to assess immunogenicity in children aged 2-16 years after successive annual vaccinations with LAIV.

BACKGROUND: The UK introduced quadrivalent live attenuated influenza vaccine (qLAIV) for children in 2013/2014. The impact of annual vaccination on effectiveness and immunogenicity is being assessed. METHOD: A phase III/IV open-label study of the immunogenicity of annual vaccination with qLAIV (Fluenz™) was conducted over three consecutive years (2014/15-2016/17) in 254, 249 and 162 children respectively. Serum responses to vaccine components were measured by Haemagglutination Inhibition (HAI) and anti-A(H1N1)pdm09 Neuraminidase (NAI) assays, stratified according to previous receipt of AS03B-adjuvanted A(H1N1)pdm09 pandemic vaccine in 2009/10. Antibody levels to the A(H1N1)pdm09 and H3N2 vaccine components in oral fluids (OF) were explored using an ELISA. FINDINGS: More paired pre- and post-vaccination oral fluids (96%) than paired sera (87%) were obtained. Geometric mean titre rises using HAI assays were limited, with maximum rises seen in year one for both influenza B strains when 39% and 43% of subjects seroconverted (95% confidence interval 33-46% and 36-50%, respectively) and year two for influenza H3N2, when 40% (33-46%) individuals seroconverted. Prior pandemic vaccine receipt resulted in higher pre- and post-vaccination A(H1N1)pdm09 HAI titres and lower pre-and post-vaccination NAI (N1 neuraminidase) titres in all three years. OF results were congruent with HAI results; assay specificity compared to HAI was 88.1 and 71.6 percent, and sensitivity was 86.4 and 74.8 percent respectively for A(H1N1)pdm09 and H3N2. CONCLUSION: In all three study years, vaccination with qLAIV resulted in poor antibody responses. However, OFs are an alternative specimen type that allows self sampling, can easily be obtained from children, and their analysis leads to similar conclusions as classic serology by HAI. Their suitability for seroprevalence studies should be investigated. We demonstrated a sustained effect from prior receipt of the AS03B-adjuvanted A(H1N1)pdm09 vaccine, even after repeat vaccination with qLAIV indicating that early exposure to influenza antigens has a significant long lasting effect

Capture into Rydberg states and momentum distributions of ionized electrons

The yield of neutral excited atoms and low-energy photoelectrons generated by the electron dynamics in the combined Coulomb and laser field after tunneling is investigated. We present results of Monte-Carlo simulations built on the two-step semiclassical model, as well as analytic estimates and scaling relations for the population trapping into the Rydberg states. It is shown that mainly those electrons are captured into bound states of the neutral atom that due to their initial conditions (i) have moderate drift momentum imparted by the laser field and (ii) avoid strong interaction ("hard" collision) with the ion. In addition, it is demonstrated that the channel of capture, when accounted for in semiclassical calculations, has a pronounced effect on the momentum distribution of electrons with small positive energy. For the parameters that we investigated its presence leads to a dip at zero momentum in the longitudinal momentum distribution of the ionized electrons.Comment: 9 pages, 8 figures in one zip-archiv

Enhancement of Ethanol Production in Electrochemical Cell by Saccharomyces cerevisiae (CDBT2) and Wickerhamomyces anomalus (CDBT7)

Bioethanol (a renewable resource), blended with gasoline, is used as liquid transportation fuel worldwide and produced from either starch or lignocellulose. Local production and use of bioethanol supports local economies, decreases country's carbon footprint and promotes self-sufficiency. The latter is especially important for bio-resource-rich land-locked countries like Nepal that are seeking alternative transportation fuels and technologies to produce them. In that regard, in the present study, we have used two highly efficient ethanol producing yeast strains, viz., Saccharomyces cerevisiae (CDBT2) and Wickerhamomyces anomalous (CDBT7), in an electrochemical cell to enhance ethanol production. Ethanol production by CDBT2 (anodic chamber) and CDBT7 (cathodic chamber) control cultures, using 5% glucose as substrate, were 12.6 ± 0.42 and 10.1 ± 0.17 mg·mL−1 respectively. These cultures in the electrochemical cell, when externally supplied with 4V, the ethanol production was enhanced by 19.8 ± 0.50% and 23.7 ± 0.51%, respectively, as compared to the control cultures. On the other hand, co-culturing of those two yeast strains in both electrode compartments resulted only 3.96 ± 0.83% enhancement in ethanol production. Immobilization of CDBT7 in the graphite cathode resulted in lower enhancement of ethanol production (5.30 ± 0.82%), less than free cell culture of CDBT7. CDBT2 and CDBT7 when cultured in platinum nano particle coated platinum anode and neutral red-coated graphite cathode, respectively, ethanol production was substantially enhanced (52.8 ± 0.44%). The above experiments when repeated using lignocellulosic biomass hydrolysate (reducing sugar content was 3.3%) as substrate, resulted in even better enhancement in ethanol production (61.5 ± 0.12%) as compared to glucose. The results concluded that CDBT2 and CDBT7 yeast strains produced ethanol efficiently from both glucose and lignocellulosic biomass hydrolysate. Ethanol production was enhanced in the presence of low levels of externally applied voltage. Ethanol production was further enhanced with the better electron transport provision i.e., when neutral red was deposited on cathode and fine platinum nanoparticles were coated on the platinum anode