Neonatal septicemia: bacteriological profile in a tertiary level hospital in South India

Background: Early onset bacterial sepsis remains a major cause of neonatal morbidity and death. The choice of antibiotic for an infant with sepsis depends on the predominant bacterial pathogens and the antibiotic susceptibility profiles for the microorganisms causing disease in a particular geographic region. The purpose of this study was to analyze the bacteriological profile and antibiotic sensitivity pattern of neonatal septicemia in our neonatal unit.Methods: A descriptive cross sectional study carried was out at the NICU of a tertiary level hospital in South India for a period of one year.Results: Clinically suspected septicemia comprised 18.14% of total NICU admissions. Organism was isolated by blood culture in 14.9% of cases. The most common organisms causing septicemia were Coagulase negative Staphylococci, Klebsiella and Staphylococcus aureus. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. Resistance to Crystalline Penicillin, Ampicillin  and 3rd generation cephalosporins was high.Conclusions: The most common organism isolated in septicemia was Coagulase negative staphylococcus in our NICU. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. High resistance to commonly used antibiotics is worrisome. There should be a constant surveillance of the common microbes and their sensitivity pattern in each NICU and the antibiotic protocols should be periodically reviewed. Rational use of antibiotics and preventive measures like hand washing is the need of the hour

Optimization of multipoint incremental sheet metal forming of SS430 sheets using GRA

326-333Incremental sheet metal forming (ISF) is one of the best flexible manufacturing processes used to convert a sheet metal into required final shape using tool movement. In incremental sheet metal forming process, a single pointed forming tool is allowed to move over the sheet metal as per the pre-programmed numerical control of a computer. The advantage of making any complex part without die confirms its importance in the emerging automated industries. But this process has some limitations such as less formability and high surface roughness compared to the conventional forming process. Longer processing time is another drawback of the incremental sheet forming. This paper proposes a newly designed multi-point incremental forming (MPIF) tool to avoid the drawbacks faced by industry in increasing the formability and wall angle of the sheet metal with reduced time. The sheet metal stainless steel (SS) grade 430 has been used for forming process and the outputs obtained from MPIF and single point incremental forming (SPIF) have been compared with respect to wall angle, formability, surface roughness, spring back and forming time. Grey relational analysis (GRA) has been used to find the optimal value for the various responses obtained. The analysis of variance (ANOVA) calculation method has also been used to find the factors that influence the output responses. The responses obtained by the experiment have proved that the multipoint tool results better output

Paradoxical tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS) in HIV patients with culture confirmed pulmonary tuberculosis in India and the potential role of IL-6 in prediction

Background: The incidence, manifestations, outcome and clinical predictors of paradoxical TB-IRIS in patients with HIV and culture confirmed pulmonary tuberculosis (PTB) in India have not been studied prospectively. Methods: HIV+ patients with culture confirmed PTB started on anti-tuberculosis therapy (ATT) were followed prospectively after anti-retroviral therapy (ART) initiation. Established criteria for IRIS diagnosis were used including decline in plasma HIV RNA at IRIS event. Pre-ART plasma levels of interleukin (IL)-6 and C-reactive protein (CRP) were measured. Univariate and multivariate logistic regression models were used to evaluate associations between baseline variables and IRIS. Results: Of 57 patients enrolled, 48 had complete follow up data. Median ATT-ART interval was 28 days (interquartile range, IQR 14–47). IRIS events occurred in 26 patients (54.2%) at a median of 11 days (IQR: 7–16) after ART initiation. Corticosteroids were required for treatment of most IRIS events that resolved within a median of 13 days (IQR: 9–23). Two patients died due to CNS TB-IRIS. Lower CD4+ T-cell counts, higher plasma HIV RNA levels, lower CD4/CD8 ratio, lower hemoglobin, shorter ATT to ART interval, extra-pulmonary or miliary TB and higher plasma IL-6 and CRP levels at baseline were associated with paradoxical TB-IRIS in the univariate analysis. Shorter ATT to ART interval, lower hemoglobin and higher IL-6 and CRP levels remained significant in the multivariate analysis. Conclusion: Paradoxical TB–IRIS frequently complicates HIV-TB therapy in India. IL-6 and CRP may assist in predicting IRIS events and serve as potential targets for immune interventions

Assessing the Safety of Stem Cell Therapeutics

Unprecedented developments in stem cell research herald a new era of hope and expectation for novel therapies. However, they also present a major challenge for regulators since safety assessment criteria, designed for conventional agents, are largely inappropriate for cell-based therapies. This article aims to set out the safety issues pertaining to novel stem cell-derived treatments, to identify knowledge gaps that require further research, and to suggest a roadmap for developing safety assessment criteria. It is essential that regulators, pharmaceutical providers, and safety scientists work together to frame new safety guidelines, based on “acceptable risk,” so that patients are adequately protected but the safety “bar” is not set so high that exciting new treatments are lost

Multifocal tuberculosis-associated immune reconstitution inflammatory syndrome – a case report of a complicated scenario

Background Tuberculosis (TB)-associated Immune reconstitution inflammatory syndrome (TB-IRIS) is an aberrant inflammatory response in TB patients with advanced human immunodeficiency virus coinfection, after antiretroviral therapy commencement. Case presentation We present a rare case of a 51-year-old woman living with HIV who developed a series of TB-IRIS events occurring at multiple sites sequentially, highlighting the clinical complexity in diagnosis and management. Conclusion This case illustrates how complicated a clinical scenario of successive TB-IRIS episodes can be, in terms of clinical management

Regulatory evaluation of Glybera in Europe-two committees, one mission

publishersversionPeer reviewe

Template-Assisted Synthesis and Characterization of Passivated Nickel Nanoparticles

Potential applications of nickel nanoparticles demand the synthesis of self-protected nickel nanoparticles by different synthesis techniques. A novel and simple technique for the synthesis of self-protected nickel nanoparticles is realized by the inter-matrix synthesis of nickel nanoparticles by cation exchange reduction in two types of resins. Two different polymer templates namely strongly acidic cation exchange resins and weakly acidic cation exchange resins provided with cation exchange sites which can anchor metal cations by the ion exchange process are used. The nickel ions which are held at the cation exchange sites by ion fixation can be subsequently reduced to metal nanoparticles by using sodium borohydride as the reducing agent. The composites are cycled repeating the loading reduction cycle involved in the synthesis procedure. X-Ray Diffraction, Scanning Electron Microscopy, Transmission Electron microscopy, Energy Dispersive Spectrum, and Inductively Coupled Plasma Analysis are effectively utilized to investigate the different structural characteristics of the nanocomposites. The hysteresis loop parameters namely saturation magnetization and coercivity are measured using Vibrating Sample Magnetometer. The thermomagnetization study is also conducted to evaluate the Curie temperature values of the composites. The effect of cycling on the structural and magnetic characteristics of the two composites are dealt in detail. A comparison between the different characteristics of the two nanocomposites is also provided

A community based field research project investigating anaemia amongst young children living in rural Karnataka, India: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Anaemia is an important problem amongst young children living in rural India. However, there has not previously been a detailed study of the biological aetiology of this anaemia, exploring the relative contributions of iron, vitamin B12, folate and Vitamin A deficiency, inflammation, genetic haemoglobinopathy, hookworm and malaria. Nor have studies related these aetiologic biological factors to household food security, standard of living and child feeding practices. Barriers to conducting such work have included perceived reluctance of village communities to permit their children to undergo venipuncture, and logistical issues. We have successfully completed a community based, cross sectional field study exploring in detail the causes of anaemia amongst young children in a rural setting.</p> <p>Methods and design</p> <p>A cross sectional, community based study. We engaged in extensive community consultation and tailored our study design to the outcomes of these discussions. We utilised local women as field workers, harnessing the capacity of local health workers to assist with the study. We adopted a programmatic approach with a census rather than random sampling strategy in the village, incorporating appropriate case management for children identified to have anaemia. We developed a questionnaire based on existing standard measurement tools for standard of living, food security and nutrition. Specimen processing was conducted at the Primary Health Centre laboratory prior to transport to an urban research laboratory.</p> <p>Discussion</p> <p>Adopting this study design, we have recruited 415 of 470 potentially eligible children who were living in the selected villages. We achieved support from the community and cooperation of local health workers. Our results will improve the understanding into anaemia amongst young children in rural India. However, many further studies are required to understand the health problems of the population of rural India, and our study design and technique provide a useful demonstration of a successful strategy.</p