Bird flu in Nepal

Avian flu also known as bird flu is caused by deadly virus H5N1 which initially was found in birds and wild animals, however, later it was found in human beings causing severe respiratory related problems. This review article was performed to understand the epidemiology of outbreaks of H5N1 in different districts of Nepal. First outbreak of strain H5N1 was reported in 2009. Consequently, highest number of outbreaks i.e. 201 was noted in the year 2013. Till date only one human case was identified by NPHL which was later confirmed by genetic laboratory in Japan in collaborating with WHO

Correlation between value of Hba1c and degree of sensorineural hearing loss in type 2 diabetics

Background: Diabetes mellitus and hearing loss are common public health problems. Sensorineural hearing loss in Type 2 diabetes mellitus patients is an underestimated complication. The aim was to study the correlation between level of HbA1c and degree of sensorineural hearing loss. Methods: It was a cross sectional study carried on 130 known cases of T2DM, aged 25-50 years. Various confounding factors such as coexisting hypertension, ear disease, ototoxic drug intake, any neuropathic disorder was excluded in advance. All patients underwent clinical ear examination and pure tone audiometry test. Their level of HbA1c was measured. This value of HbA1c was correlated with the hearing threshold. Results: Out of 130, 58 subjects had normal hearing while 72 had hearing impairment. Among subjects (72 out of 130) having hearing impairment, significant correlation (p-value 0.035 for right ear and 0.029 for left ear) between hearing threshold and HbA1c was found. Also, level of HbA1c significantly (p-value 0.049) correlated with degree of hearing loss. Conclusions: Hearing loss is an underestimated complication of T2DM. This needs to be addressed with periodic hearing assessment of diabetes patients

Assessment of bacteriological quality of drinking water in Belagavi City, India

With the growing population and industrialization, the potability of drinking water has been decreased due to pollution and improper sanitization. In this context the present study was aimed to check the potability of drinking water by Multiple Tube method and Membrane Filter technique and to identify bacteria from Membrane Filter technique. 100 samples from 10 different wards of Belagavi City were collected. Bacteriological analysis was done for the presence of fecal coliforms, fecal Streptococci, Salmonella and Shigella by presumptive coliform test and multiple tube method (MPN) and membrane filter (MF) techniques were used for estimation of coliform bacteria. Twelve out of 100 samples were found to be unsatisfactory for drinking purpose. A total of five different strains were isolated from 100 samples. Genera isolated were Corynebacterium species, Micrococci, Gram positive Bacilli, Staphylococcus aureus, Citrobacter freundii. 88% of the sources were hygienic for drinking purposes and for the rest of the sources, proper measure should be taken to maintain sanitary of the drinking water by regular check on the equipment, maintaining structural faults and proper disinfection of equipments. DOI: http://dx.doi.org/10.5281/zenodo.279615

Increasing incidence of multidrug resistant Pseudomonas aeruginosa in inpatients of a tertiary care hospital

Background:Pseudomonas aeruginosa is an important pathogen isolated from various clinical infections. The occurrence of multidrug-resistant (MDR) Pseudomonas aeruginosa strains is increasing worldwide and limiting our therapeutic options resulting in high mortality. We aim to study the incidence of multidrug resistant Pseudomonas aeruginosa in inpatients from various departments along with rate of nosocomial infections.Methods:A cross sectional study from January 1, 2013 to December 31, 2013. A total of 167 Pseudomonas aeruginosa were isolated from 764 clinical specimens. The isolates were identified by standard microbiological techniques. The antibiotic susceptibility was done by Kirby Bauer method.Results:The highest number of isolates were from pulmonary samples n=90 (53.89%) followed by pus n=48 (28.74%). Overall, 39 (23.36%) isolates were nosocomial. The nosocomial isolates were mainly isolated from department of surgery, orthopaedics, obstetrics & gynaecology followed by others. Among 167 isolates screened, 53 (31.73%) were found to be MDR (resistant to ≥3 classes of antipseudomonal agents). The resistance was most against cephalosporins [Cefepime (65.26%), cefotaxime (60.47%)], fluoroquinolones [Ciprofloxacin (46.1%), levofloxacin (31.87%)] aminoglycosides [Amikacin (37.72%), gentamicin (31.13%)] followed by ureidopenicillins and carbepenems. About 56.75% isolates were suspected Metallo β lactamases producers.Conclusion:The study suggests that the incidence of nosocomial infection by multidrug resistant Pseudomonas aeruginosa is increasing globally especially the Metallo Beta lactamases producing strains. So there is a continuous need of conduction of surveillance programmes to formulate rational treatment strategies to combat this emerging challenge.

Detecting Attacks Using Big Data with Process Mining

Abstract- In current digital world, Security has become the major issue for the organization. Every day the amount of data is growing in the world. Processing and analyzing of the data is becoming the new challenge for the analyzers. For this purpose, big data is useful to process the high volume of data in less time. Current security tools like existing firewalls and Intrusion Detection Systems are still not able to detect and prevent the attacks and intrusions in full proof manner and giving many false alarms. Big Data analytics concept could be very useful for analyzing, detection and providing full security to the organization because of the ability of handling the large amount of data. In this paper, we have described the concept and the roll of big data. We have also proposed a model using process mining to generate the alerts in the case of attacks.   Index Terms— Big Data, Process Mining, Intrusion Detection System, Logs

Risk Assessment for Cloud Computing

The broad implementation of cloud computing has brought a dramatic change to multiple industries, which derives from the development of the Internet-related technologies. Cloud service providers have untangled a lot of issues to maintain a robust quality of service. Despite the utilization of proficient techniques in resource management that has made optimal planning possible, as one resource is allocated to multiple users the risk of resources unavailability in cloud computing is still present. The level of risk is evaluated based on the probability of an incident occurring, which is mapped against the estimated negative impact. The probability of an incident occurring can be determined by the threat exploiting the vulnerability. All though a zero-risk scenario is impractical, effective risk assessment strategies equipped with efficient mitigation mechanisms can decrease the negative impact. As of now there are three types of cloud computing systems public, private and hybrid each with different levels of security. Most In this paper, we examine the various risk assessment models with regards to a Cloud Computing and touching upon Information Assets and Risk, Privacy and Confidentiality Concerns, Data Governance

POSTPARTUM CONTRACEPTIVE USE IN RURAL BAREILLY

Background: Contraception is an important intervention to reduce burden of unwanted pregnancy and promote healthy living among women. Objectives: To find out the postpartum contraceptive usage and identify the different variables which affect the postpartum contraception among the rural females of Bareilly district. Methods: The cross sectional study was carried out in randomly selected villages of Bhojipura Block of Bareilly district, Uttar Pradesh. All women who had delivered within last one year were interviewed by house to house survey to collect data regarding socio-demographic characteristics and contraceptive use by structured questionnaire. A total of 123 women participated in the study. Chi- square test was used to analyze data. Results: Only 13.8% mothers adopted postpartum contraception. Lack of knowledge (32.5%) and young infant being breastfed (28.5%) were the common reasons of not using any contraceptive method. Contraceptive use was higher amongst females aged less than 30 years and those belonging to middle socioeconomic class and nuclear families. The significant influence of the women’ educational status on utilization of family planning methods was observed (p<0.05). Conclusions: Low percent of postpartum contraceptive use indicates the need for improving awareness among the study population

Prevalence and fungal profile of pulmonary aspergillosis in immunocompromised and immunocompetent patients of a tertiary care hospital

Background: Aspergillus is a fungus which may present an array of pulmonary manifestations, depending on the patient’s immunological and physiological state. Although the incidence of pulmonary aspergillosis occurs primarily in immunocompromised patients but the incidence is also rising in immunocompetent individuals, especially in developing countries. Aim: The objective of the study was to determine the prevalence and predisposing factors of pulmonary aspergillosis along with species identification. Materials and Methods: One hundred and three patients admitted to the Department of Chest and Tuberculosis and in the Department of Medicine from Jan 2012 to Jan 2013 were included in this study. The patients were epitomized on the basis of clinical signs and symptoms, physical examination, chest radiography, CT scans, histopathological examination, bronchoscopy and fungal examination including potassium hydroxide mount, fungal culture of sputum and bronchoalveolar lavage. Species identification was done by colony characteristics, slide culture and Lactophenol Cotton blue mount. Results: Out of the 103 patients, (63 males and 40 females) Aspergillus species has been isolated from 17 (16.5%) males and 07 (6.79%) females. Various predisposing factors of pulmonary aspergillosis have been identified in which pulmonary tuberculosis, chronic smoking and environmental exposure to asbestos, cement its tops the list. Many of the patients had multiple predisposing factors. Aspergillus species were isolated in 24 (23.3%) cases. Aspergillus fumigatus was the predominant species isolated in 13 (54.16%) cases followed by Aspergillus flavus in 07 (29.16%) cases, Aspergillus niger in 03 (12.5 %) and Aspergillus terrus in 1 (4.16%) cases. Conclusion: It is concluded that the prevalence of pulmonary Aspergillosis is quite high in immunocompromised individuals and low in immunocompetent individuals. An adequate and efficient evaluation of the etiological agents has a crucial role in the management of such patients

Effective Feedback Practices in Formative Assessment : Recognizing the Relevance

Feedback is proposed to be a critical element of formative assessment (FA) but  evidence reflects its sparse  and incongruous implementation . Current study on feedback sessions post formative assessment was undertaken to establish the extent to which it can make significant contribution in improving learning outcomes and the learners’ perception about the same when compared to written feedback comments in answer sheets, which is a routine practice. An Experimental, Randomized, Controlled study with sample population being students in first phase of medical curriculum , were randomized into cases (n= 37) and matched controls ( n= 38) . The cases underwent feedback sessions after formative assessment. Difference in scores between cases and controls in Summative assessment was statistically significant (P = 0.002). Scores in formative and Summative assessment was statistically non-significant (p = 0.30) within controls (n=38) and statistically significant (P = 0.006) within cases ( n= 37). Qualitative analysis was done for comparing the utility and efficacy of feedback sessions compared to written comments on answer sheets. Study concludes that feedback sessions post - formative assessment, irrespective of success, may determine greater involvement of students in learning process and improve learning outcome. The tutors should be made aware of proper feedback techniques and tailor feedback sessions according to specific needs. Students should be made conscious of various assessment process so that they become cognizant of seeking feedback. Keywords : Formative assessment  , Written comments ,  Feedback session

Perspective Chapter: Glioblastoma of the Corpus Callosum

Glioma is the most common malignant tumour of the brain, in which glioblastoma (GBM) is the most aggressive form which infiltrates through the white fibre tracts. Corpus callosum (CC) is most invaded by GBM, it carries poor prognosis as mostly these tumours are not touched upon due to the belief of post operative cognitive decline, or there is incomplete resection leading to tumour recurrence. However current advancement in technology, operative techniques and better understanding of nature of CC-GBM, maximal safe resection is being carried out with better outcomes in comparison with the GBM without infiltration of CC