Indian common krait envenomation presenting as fulminant myocarditis and coma: a case report

Fulminant myocarditis is an unusual manifestation of cardiotoxicity with severe elapid snake envenoming and is meagrely reported with snake bite due to Indian common krait. We report a 12-year-old boy who was admitted in complete locked-in state and hemodynamic instability after severe neurotoxic snake envenoming by Bungarus caeruleus (Indian common krait). His hospital course was complicated with recurrent episodes of sustained ventricular tachycardia requiring defibrillation; and cardiogenic shock requiring inotropes, vasopressors and intraaortic balloon counterpulsation. Severe heart failure features secondary to fulminant toxic myocarditis persisted even after full neurological recovery requiring prolonged standard medical heart failure therapy. Patient subsequently achieved full clinical recovery and regained normal left ventricular systolic function. We also reviewed the literature on cardiac manifestations, possible mechanisms and treatment of patients with cardiotoxicity due to elapid snake bites. The importance of anticipating severe cardiovascular complications is highlighted to help formulate appropriate therapeutic strategy

Evaluation of Integrated Childhood Development Services (ICDS) program implementation in an urban slum of Delhi, India

Background: The Integrated Childhood Development Services (ICDS) scheme is India’s foremost program imparting comprehensive and cost-effective services to meet the multi-dimensional needs of children. Following a populist approach, the program has now increased its umbrella coverage to reproductive age, pregnant and lactating women. The impact of such development and existing program performance remain debatable due to the paucity of evaluation research.Methods: A mix-methods descriptive case study was done using adapted ICDS monitoring tool in a pre-identified slum. The slum was purposely chosen for its intensive habitation of the poor and marginalized population. Primary data were collected through personalized interviews with program staff, health functionaries, and community representatives. Secondary data were collected from records available at Anganwadi centre (AWC). The data were triangulated and analyzed with results being expressed in narrative, simple proportions and percentages.Results: The mean coverage of ICDS services was 58.3%. Maximum coverage recorded for Supplementary Nutrition (SN) and minimal for Nutrition and Health Education (NHE). SN, immunization, Pre-school education (PSE) and growth monitoring (0-3 years) were regularly held. Maternal and child health services were unsatisfactory. Poor community perception reported for AWC and ICDS services with exception of SN.Conclusions: Present case study unveils poor infrastructure, coverage and community participation for ICDS services. Immunisation and referral networking is often dysfunctional reflecting the need for enhanced intersectoral cooperation. Adapted tools could serve as an effective strategy for evaluating and facilitating need-based improvements

The Anxiety of COVID-19 Outbreak and its Impact on Students’ Academic Activity: a Case Study of NIT Durgapur, India

Central Library National Institute of Technology (NIT) Durgapur, West Bengal, India conducted study after the announcement of nationwide lockdown in India to know the students’ awareness about COVID-19, anxiety caused, if any, due to the Pandemic and its impact over their academic activities. Central Library also tries to find out the user satisfaction and expectations during the lockdown. Authors opted Google form as a questionnaire which contains the questions of general perception and distributed via Institute email Ids. Responses were analysed using Microsoft Excel. Two hundred fifty research scholars and postgraduate students were selected randomly for the study and 135 (54%) responses received. 107 (77%) were male and 31 (23%) were female respondents. It was found that 133 (99%) of students were aware of the Coronavirus and its impact. 60 (44%) students have no impact over their normal routine at home whereas 22(16%) were afraid of the situation, 14 (10%) were worrying constantly. 47 (35%) were experiencing anxiety and stress. 89 (66%) students believed their lifestyle is changed, the majority of the students 46 (34%) were spending 2-4 hours in the study even more. 109 (81%) students were accessing e-resources through id/passwords and 96 (71%) students agreed that the library plays an inevitable role in their study.With the commencement of online teaching learning Central Library started extending its services beyond the campus and initiated to collect id/passwords so that e-resources can be made accessible off-campus. Simultaneously library started setting up remote access tool to integrate the subscribed e-resources at a single platform

The Anxiety of COVID-19 Outbreak and its Impact on Students’ Academic Activity: a Case Study of NIT Durgapur, India

Central Library National Institute of Technology (NIT) Durgapur, West Bengal, India conducted study after the announcement of nationwide lockdown in India to know the students’ awareness about COVID-19, anxiety caused, if any, due to the Pandemic and its impact over their academic activities. Central Library also tries to find out the user satisfaction and expectations during the lockdown. Authors opted Google form as a questionnaire which contains the questions of general perception and distributed via Institute email Ids. Responses were analysed using Microsoft Excel. Two hundred fifty research scholars and postgraduate students were selected randomly for the study and 135 (54%) responses received. 107 (77%) were male and 31 (23%) were female respondents. It was found that 133 (99%) of students were aware of the Coronavirus and its impact. 60 (44%) students have no impact over their normal routine at home whereas 22(16%) were afraid of the situation, 14 (10%) were worrying constantly. 47 (35%) were experiencing anxiety and stress. 89 (66%) students believed their lifestyle is changed, the majority of the students 46 (34%) were spending 2-4 hours in the study even more. 109 (81%) students were accessing e-resources through id/passwords and 96 (71%) students agreed that the library plays an inevitable role in their study.With the commencement of online teaching learning Central Library started extending its services beyond the campus and initiated to collect id/passwords so that e-resources can be made accessible off-campus. Simultaneously library started setting up remote access tool to integrate the subscribed e-resources at a single platform

Corona Pandemic and Environment in India: A Perspective

As far as the natural environment is seen, it is a major basis for the positive life of the living beings in every way. In this, life continues to develop gradually. Every small activities of the living beings keep on flourishing in this. Human population has increased tremendously in the last century. To meet the needs of this huge population, natural resources had to be exploited on a large scale. As a result, pollution was born in the environment. A decline in natural resources was recorded, due to which various kinds of natural hazards arose at many places. Recently, the corona virus knocked, due to this the lockdown process was adopted not only in India but in the whole world, due to which there was a huge reduction in environmental pollution. In this research paper, the positive changes in the environment due to the corona virus epidemic have been underlined

Fuzzy rule based optimization in machining of glass fiber reinforced polymer (GFRP) composites

With the increasing use of Fiber Reinforced Polymer (FRP) composites outside the defense, space and aerospace industries; machining of these materials is gradually assuming a significant role. The current knowledge of machining FRP composites is in transition phase for its optimum economic utilization in various fields of applications. Therefore, material properties and theoretical mechanics have become the predominant research areas in this field. With increasing applications, economical techniques of production are indeed very important to achieve fully automated large-scale manufacturing cycles. Although FRP composites are usually molded, for obtaining close fits and tolerances and also achieving near-net shape, certain amount of machining has to be carried out. Due to their anisotropy, and non-homogeneity, FRP composites face considerable problems in machining like fibre pull-out, delamination, burning, etc. There is a remarkable difference between the machining of conventional metals and their alloys and that of composite materials. Further, each composite differs in its machining behavior since its physical and mechanical properties depend largely on the type of fibre, the fibre content, the fibre orientation and variabilities in the matrix material. Considerable amount of literature is readily available on the machinability of conventional metals/alloys and also polymers to some extent; with very limited work on FRP composites. Therefore, machining process optimization for all types FRP composites is still an emerging area of research. In this context, the present research highlights a multi-objective extended optimization methodology to be applied in machining FRP-polyester/epoxy composites with contradicting requirements of quality as well as productivity. Attempt has been made to develop a robust methodology for multi-response optimization in FRP composite machining 6 for continuous quality improvement and off-line quality control. Design of Experiment(DOE) has been be selected based on Taguchi’s orthogonal array design with varying process control parameters like: spindle speed, feed rate and depth of cut. Multiple surface roughness parameters of the machined FRP product along with Material Removal Rate (MRR) of the machining process have been optimized simultaneously. A Fuzzy Inference System (FIS) integrated with Taguchi’s philosophy has been proposed for providing feasible means for meaningful aggregation of multiple objective functions into an equivalent single performance index (MPCI). This Multi Performance Characteristic Index (MPCI) has been optimized finally. Detailed methodology of the proposed fuzzy based optimization approach has been illustrated in this reporting and validated by experiments

Sphingobacterium multivorum causing fatal meningoencephalitis: a rare case report

We report a case of fatal meningitis caused by bacteria, Sphingobacterium multivorum, probably first time being reported from India. S. mulivorum has been isolated from various clinical specimens but it is only rarely been associated with serious infections. Sphingobacterium species are generally resistant to aminoglycosides and polymyxin B. Susceptibility to β-lactam antibiotics is variable, requiring testing for individual drug. This 36 year male had two weeks history of high-grade fever with altered sensorium and occasional seizures. Patient admitted with septicemia and subsequently developed meningitis and succumbed to his illness after being discharged against medical advice. His CSF culture yielded S. multivorum subsequently confirmed by mini API, bioMérieux Inc. Marcy-l’Etoile France. Due to its rare association with common clinical conditions, it requires a high degree of suspicion and expertise to prove its presence in clinical specimens. Since this bacterium is inherently resistant to many classes of antibiotics, a vigilant and efficient microbiological work up is needed to establish its diagnosis and prompt treatment

Scenario of mycobacterial and fungal infection in HIV seropositive patients and their co-relation with CD4 count in Western Uttar Pradesh

Background: HIV infection is defined by sero-conversion and the detection of HIV-specific antibodies. Emergence and pandemic spread of acquired immunodeficiency syndrome is due to the exposure to human immunodeficiency virus (HIV). A decrease in CD4 count is at least partially responsible for the profound immunodeficiency that leads to various OIs in HIV- infected persons. When the CD4 count falls below 200cells/µL, there is irreversible breakdown of immune defence mechanism and patient become prey to a variety of human opportunistic pathogens.HIV positive patients must receive infections screening and access medical care before onset of advanced immunosuppression.Methods: In this study, total 230 HIV positive patients were selected during 18 months of study period. CD4 counts were estimated of all HIV positive cases. Positive HIV patients were investigated further to detect mycobacterial and fungal opportunistic infections. They were subjected to routine microscopy such as KOH mount, India ink, Gram’s staining for suspected fungal infection and ZN staining method for suspected mycobacterial infection. For fungal infection, samples were inoculated in two Sabouraud Dextrose Agar followed by different biochemical test and LPCB mount; for mycobacterial infection, samples were cultured on LJ medium followed by biochemical test.Results: In our study, maximum patients presented with complain of fever (90.43%), weight loss (73.91%) followed by loss of appetite (35.65%), breathlessness (33.91%), coughing (28.69%) and chest pain (22.17%). Overall prevalence of OIs (Mycobacterium and fungal) was 93 (40.43%) among 230 HIV positive patients. Among OIs 63(27.39%) patients were detected as having Mycobacterial infection and 41(17.82%) as had opportunistic fungal infections. Maximum OIs were related to patients with CD4 count 0-200 cells/µL followed by 201-400 Cells/µL. Most common OIs, among mycobacterial and opportunistic fungal infection were M. tuberculosis (50 isolates) and Candida spp. (26 isolates) respectively.Conclusions: This study provides important information about the risks of OIs at lower CD4 counts among HIV positive patients. These results highlight the need for early screening of HIV infected patients for opportunistic infections. There is also need to increase awareness in healthcare providers in order to improve decisions regarding prophylaxis for prevention of OIs and appropriate therapeutic intervention

A study of association of vitamin D deficiency and coronary artery disease

Background: Recently vitamin D has received great interests for its multiple effects on inflammatory system and potential role in atherothrombosis. Coronary artery disease (CAD) is one of the common causes of death and disability in developed countries. Experimental evidence points to the involvement of multiple factors in coronary plaque formation, including vitamin D. The study aimed to examine the association of coronary artery disease with vitamin D level.Methods: 140 patients of CAD (coronary artery disease) and 101 age and sex matched control were enrolled in the study and 25-hyroxyvitamin D (25(OH)D) concentration was measured. All participants were evaluated for presence of conventional risk factors for coronary artery disease. Association of vitamin D level was established after adjusting other risk factors using logistic regression analysis.Results: In our study vitamin D level is significantly lower in patient group (CAD patients) compared with control group (18.2±10.9 vs 28.8±21ng/mL). Vitamin D deficiency was present in 81.4% patient in CAD patients whereas 57.7% in control group. Vitamin D deficiency was found to be an independent predictor of CAD after adjusting effect of other risk factors like hypertension, diabetes, smoking, obesity, high blood cholesterol and level of physical activity with adjusted odds ratio (95% confidence interval) 2.695 (1.148-6.330).Conclusions: In present study patients of coronary artery disease had significantly low level of vitamin D as compared to individual without coronary artery disease. Vitamin D deficiency was found to be an independent predictor of CAD after adjusting other risk factors emphasizing that vitamin D can be a potential risk factor for development of coronary artery disease.