Application of Linear Programming Approach for Determining Optimum Production Cost

Cost optimization problem deals with that problem which aims to find out the most appropriate ways to fulfill the demand of a particular product of any manufacturing company with minimum cost. Linear programming is one of the most appropriate techniques for scheduling the optimum cost of manufacturing. In this study, the production schedule of a bicycle manufacturing company is taken into account. The mathematical formulation of the problem under consideration is performed by using a linear programming approach. An operations research software, TORA (Temporary-Ordered Routing Algorithm), has been used in solving the problem and analyzing the results. Results reveal that a specific schedule has a great impact on optimizing the production cost

Prevalence and characteristics of polycystic ovarian syndrome in women attending in outpatient department of obstetrics and gynecology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Background: Polycystic ovary syndrome (PCOS) is a heterogenous, multifactorial, complex genetic disorder. Most commonly, it affects the females of reproductive age. This is one of the most widespread diseases across the world and if left untreated, may result in infertility and even uterine cancer. Methods: A cross sectional observation study of 100 PCOS patients was carried out from August 2018 to July 2019 in gynecology out-patient department of Bangabandhu Sheikh Mujib medical university, Dhaka. In this study clinical, biochemical and hormonal profile of these patients were analyzed and correlation was done between clinical features and biochemical and hormonal profile. Results: The prevalence of PCOS was 6.11% in the gynecology out-patient visits and 35.39% among infertile women. The mean age group of the patients was 24.3±5.16 SD. The mean BMI was 24.66±5.34 SD. The mean duration of infertility was 5.17 years. The prevalence of metabolic syndrome in our study was 15.0%. In this study menstrual irregularity was the most common complaint. Spearman’s correlation between various clinical and laboratory parameters showed positive correlation exists between BMI and testosterone (r=0.4824; p<0.0001).Conclusions: The study showed that most of our polycystic ovary syndrome subjects were present with oligomenorrhea. Hirsutism and central obesity were also common presentation. Obese women with PCOS had more severe ovulatory dysfunction and need more attention for their appropriate management.

Risk factors associated with post cesarean surgical site wound infection in Bangabandhu Sheikh Mujib medical university, Bangladesh

Background: Caesarean section is one of the most commonly performed surgical procedures in hospitals. Surgical site infections are a common complication after a caesarean section (C-section) and mainly responsible for increased maternal mortality and morbidity, the dissatisfaction of patients, longer hospital stays as well as higher treatment costs. Methods: This prospective cohort was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh included 400 women (247 emergency CS, 153 elective CS) from September 2019 to August 2020. Data were collected through consent, medical record reviews, and questionnaires. SSI risk factors were assessed, and wound examinations were conducted before discharge. STATA 14.0 was used for analysis. Participants were educated about SSI symptoms and monitored for 30 days post-operation. Results: Nulliparous individuals were more common in the emergency CS group (61.5% vs. 32% in Elective CS). Ruptured membranes were higher in emergency CS (71.7% vs. 2.6% in elective CS). Prophylactic antibiotic usage differed significantly (88.7% in emergency CS vs. 3.9% in elective CS). Post-discharge wound infections were more prevalent in emergency CS (10.53% vs. 2.61% in elective CS). No significant differences were found in other parameters. High-risk factors included BMI >30 and operation time ≥45 min. Conclusion: SSI rates may be underestimated with limited hospital observation. Prolonged operation times (>38 min) and high BMI (>30) significantly increased SSI risk. Identifying high-risk subgroups and administering antibiotics accordingly can help prevent SSI and reduce unnecessary antibiotic use

Determination of Extended-Spectrum β-Lactamases and AmpC Production in Uropathogenic Isolates of Escherichia coli and Susceptibility to Fosfomycin

Background: Urinary tract infection due to Escherichia coli is one of the common problem in clinical practice. Various drug resistance mechanisms are making the bacteria resistant to higher group of drugs making the treatment options very limited. This study was undertaken to detect ESBLs and AmpC production in uropathogenic Escherichia coli isolates and to determine their antimicrobial susceptibility pattern with special reference to fosfomycin. Materials and Methods: A total number of 150 E. coli isolates were studied. ESBL detection was done by double disc synergy and CLSI method. AmpC screening was done using cefoxitin disc and confirmation was done using cefoxitin/cefoxitin-boronic acid discs. In AmpC positive isolates, ESBLs was detected by modifying CLSI method using boronic acid. Antimicrobial susceptibility pattern was determined following CLSI guidelines. Fosfomycin susceptibility was determined by disc diffusion and E-test methods. Results: ESBLs production was seen in 52.6% of isolates and AmpC production was seen in 8% of isolates. All AmpC producers were also found to be ESBLs positive. ESBLs positive isolates were found to be more drug resistant than ESBLs negative isolates. All the strains were found to be fosfomycin sensitive. Conclusions: ESBLs and AmpC producing isolates are becoming prevalent in E. coli isolates from community setting also. Amongst the oral drugs, no in-vitro resistance has been seen for fosfomycin making it a newer choice of drug (although not new) in future. An integrated approach to contain antimicrobial resistance should be actually the goal of present times

Health-care-associated infections: Risk factors and epidemiology from an intensive care unit in Northern India

Background and Aims: Health-care-associated infection is a key factor determining the clinical outcome among patients admitted in critical care areas. The objective of the study was to ascertain the epidemiology and risk factors of health-care-associated infections in Intensive Care Units (ICUs) in a tertiary care hospital. Methods: This prospective, observational clinical study included patients admitted in ICU over a period of one and a half years. Routine surveillance of various health-care-associated infections such as catheter-associated urinary tract infections (CAUTI), central-line-associated blood stream infections (CLABSI), and ventilator-associated pneumonias (VAP) was done by the Department of Microbiology through specific Infection Surveillance Proforma. Results: Out of 679 patients, 166 suffered 198 episodes of device-associated infections. The infections included CAUTI, CLABSI, and VAP. The number of urinary tract infection (UTI) episodes was found to be 73 (10.75%) among the ICU patients who had indwelling urinary catheter. In addition, for 1 year CAUTI was calculated as 9.08/1000 catheter days. The number of episodes of blood stream infection was 86 (13.50%) among ICU patients having central line catheters. Also, CLABSI was found to be 13.86/1000 central line days. A total of 39 episodes (6.15%) of VAP was found in ICU patients over 18 months and VAP present for 6.04/1000 ventilator days. Conclusions: The organisms most commonly associated with health-care-associated infections were Pseudomonas aeruginosa and Acinetobacter species. The risk factors identified as being significantly associated with device associated infections in our ICU were diabetes, COPD and ICU stay for ≥8 days (P < 0.05)

Multiple subcutaneous cysts due to Exophiala spinifera in an immunocompetent patient.

Item does not contain fulltextHere we report a case of a 55-year-old Indian male presenting with multiple subcutaneous cysts, which developed from painful nodules at the dorsal right wrist joint. Subsequently a painful nodule appeared on the left knee joint. Cytological examination of the knee swelling revealed a suppurative inflammatory lesion consisting of neutrophils, lymphocytes, multinucleated giant cells and few fungal elements, without involvement of the overlying skin. Exophiala spinifera was cultured (CBS 125607) and its identity was confirmed by sequencing of the internal transcribed spacer (ITS rDNA). The cysts were excised surgically, without need of additional antifungal therapy. There was no relapse during one-year follow-up and the patient was cured successfully. In vitro antifungal susceptibility testing showed that posaconazole (0.063 mug/ml) and itraconazole (0.125 mug/ml) had the highest and caspofungin (4 mug/ml) and anidulafungin (2 mug/ml) the lowest activity against this isolate. However, their clinical effectiveness in the treatment of E. spinifera infections remains to be evaluated. In this case report, we have also compiled cases of human E. spinifera mycoses which have been reported so far.1 februari 201

Fatal Cerebral Phaeohyphomycosis in an Immunocompetent Individual Due to Thielavia subthermophila▿

We report the first case of fatal brain infection in an Indian farmer caused by Thielavia subthermophila, a dematiaceous thermophilic fungus in the order Sordariales, and present a review of previous infections from this order. The patient failed amphotericin B therapy combined with surgical excision despite the drug's low MICs in vitro