A study on clinical and laboratory profiles of hemorrhagic and ischemic strokes in an Eastern Indian teaching Hospital

Background: Stroke is a frequent cause of death and disability. This study was carried out to establish the pattern of various types of cerebrovascular accident (CVA) and comparison between hemorrhagic and ischemic stroke in Eastern India.Methods: This is a retrospective study of sample size 367 CVA patients; among them, 218 were ischemic and 149 were hemorrhagic admitted to Department of General medicine and Neurology of the hospital.Results: Of the total 367 patients, there were 149 as hemorrhagic stroke patients and 218 patients as ischemic stroke patients. Ratio of hemorrhagic to ischemic stroke was 40.6: 59.4. Among patients in hemorrhagic patients male to female ratio was 1.6:1 and in ischemic stroke patients male to female ratio was 1.27:1. It was recorded that prevalence of ischemic stroke was higher than hemorrhagic type.Conclusions: The CVA was associated with blood pressure, cholesterol and use of tobacco as the common risk factor for ischemic stroke. It was recorded that ischemic stroke patients had reported frequently than hemorrhagic patients

Isolation of ESBL-producing gram-negative bacteria and in silico inhibition of ESBLs by flavonoids

AbstractObjectiveTo evaluate nosocomial accounts of 426 extended spectrum β-lactamase (ESBL)-producing strains from 705 isolates of 9 pathogenic gram-negative bacteria in vitro. We analysed the genetic divergence of ESBLs by constructing a phylogenetic tree and modelled flavonoid inhibition of ESBLs with in silico molecular docking to determine effective control options.MethodsNine ESBL-producing bacteria were isolated from urine samples and their antibiograms were determined by the disc-diffusion method. Comparative models of the 9 ESBL enzymes were generated computationally using reference sequences, and validated by Ramachandran plots. Molecular docking with 11 flavonoids was conducted against the ESBL models.ResultsIsolated strains were floridly multidrug-resistant. From the docking study, the predicted minimum energy value of amikacin was −8.108 kcal/mol against the wild type TEM-1 ESBL of Acinetobacter baumannii, while the docking value against the mutant type Escherichia coli was −7.388 kcal/mol. The docking scores obtained corroborated the in vitro results showing that the antibiotic was incapable of controlling the ESBL of the mutant strain. Among 11 flavonoids tested against the mutant ESBL of E. coli, epigallocatechin 3-gallate and eriodictyol, with docking scores of −9.448 and −8.161 kcal/mol, respectively, were the most effective, with drug-likeness scores of 0.39 and 1.37, respectively, compared to 1.03 for amikacin.ConclusionDocking scores and drug-likeness scores indicated that flavonoids are compelling alternative antimicrobial agents that could serve as complementary therapy for newly arising ESBL-producing bacteria. Phylogenetic tree analysis elucidated the genetic relationship of the 9 ESBL serotypes

In vitro antibacterial efficacy of plants used by an Indian aboriginal tribe against pathogenic bacteria isolated from clinical samples

AbstractObjectivesTo evaluate antibacterial efficacies of 21 medicinal plants used by an Indian aboriginal tribe against infectious diseases caused by bacteria isolated from clinical samples.MethodsStandard biochemical procedures were followed for identifying bacteria that were isolated from several clinical samples. All of the bacterial strains were subjected to antibiotic sensitivity tests by Kirby–Bauer's disc diffusion method. From antibiograms of isolated Gram-positive and Gram-negative bacteria, it was discernible that samples were multidrug resistant (MDR). The methanol leaf-extract of Solanum xanthocarpum was subjected to thin layer chromatography (TLC) for phytochemical analysis. Molecular docking of β-lactamase enzyme of Escherichia coli with phytochemicals of S. xanthocarpum was performed to locate effective compounds.ResultsThe most effective 5 plants, which caused the size of the zone of inhibition to range from 21 to 27 mm, were Buchanania latifolia, Careya arborea, Ocimum tenuiflorum, Senna alata and S. xanthocarpum, for MDR bacteria. S. xanthocarpum had the lowest MIC value of 0.67 mg/ml and the lowest MBC value of 1.51 mg/ml against E. coli. In the TLC study, 9 spots of methanol leaf-extract of S. xanthocarpum were recorded with two solvent systems. The phytochemicals of S. xanthocarpum, solasodine and stigmasterol glucoside had the highest docking score values, −10.868 kcal/mol and −10.439 kcal/mol, respectively, against β-lactamase.ConclusionThis study could prove in vitro antimicrobial efficacy of 5 uncommon plants against MDR pathogenic bacteria. Solasodine and stigmasterol glucoside were computationally recorded as the best controlling chemicals from the plant S. xanthocarpum

Robust Coordinated Design of PSS and TCSC using PSO Technique for Power System Stability Enhancement

Power system stability improvement by coordinated design of a Power System Stabilizer (PSS) and a Thyristor Controlled Series Compensator (TCSC) controller is addressed in this paper. Particle Swarm Optimization (PSO) technique is employed for optimization of the parameterconstrained nonlinear optimization problem implemented in a simulation environment. The proposed controllers are tested on a weakly connected power system. The non-linear simulation results are presented for wide range of loading conditions with various fault disturbances and fault clearing sequences as well as for various small disturbances. The eigenvalue analysis and simulation results show the effectiveness and robustness of proposed controllers to improve the stability performance of power system by efficient damping of low frequency oscillations under various disturbances

Oscillatory and asymptotic behaviour of a neutral differential equation with oscillating coefficients

In this paper, we obtain sufficient conditions so that every solution of $$\big(y(t)- \sum_{i=1}^n p_i(t) y(\delta_i(t))\big)'+\sum_{i=1}^m q_i(t) y(\sigma_i(t)) = f(t)$$ oscillates or tends to zero as $t \to \infty$. Here the coefficients $p_i(t), q_i(t)$ and the forcing term $f(t)$ are allowed to oscillate; such oscillation condition in all coefficients is very rare in the literature. Furthermore, this paper provides an answer to the open problem 2.8.3 in [7, p. 57]. Suitable examples are included to illustrate our results

Prevalence of multidrug resistant uropathogenic bacteria in pediatric patients of a tertiary care hospital in eastern India

SummaryToday, because systemic infections such as urinary tract infection (UTI) affect even pediatric patients, antibiotic resistant bacteria have become a constant clinical challenge. In the present study, a total of 1054 urine samples were collected from pediatric patients over 18 months. From these samples, 510 isolates of pathogenic bacteria were collected using HiCrome UTI agar. Antibiotic sensitivity tests of isolates were performed using the Kirby–Bauer method. Two Gram-positive bacteria (Enterococcus faecalis and Staphylococcus aureus) and 7 Gram-negative bacteria (Citrobacter freundii, Enterobacter aerogenes, Escherichia coli, Klebsiella oxytoca, K. pneumoniae, Proteus vulgaris and Pseudomonas aeruginosa) were isolated. Antibiograms of isolated bacteria were ascertained using antibiotics of 4 classes: aminoglycosides, β-lactams, fluoroquinolones and 2 stand-alones (co-trimoxazole and nitrofurantoin). Based on percent values of antibiotic resistance, isolated bacteria were (in decreasing order of number of isolated isolates): E. coli (109)>S. aureus (65)>E. faecalis (82)>E. aerogenes (64)>C. freundii (41)>P. aeruginosa (32)>K. pneumoniae (45)>K. oxytoca (50)>P. vulgaris (22). Surveillance results show that MDR isolates of 9 pathogenic bacteria were prevalent in the environment around the hospital. Thus, revisions to the antimicrobial stewardship program in this area of the country are required to increase clinician confidence in empiric therapy, which is often used for UTI cases

Surveillance of bacteria Pseudomonas aeruginosa and MRSA associated with acute suppurative otitis media (ASOM)

Background: Otitis media particularly with suppuration is a critical disease-causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft. This surveillance includes isolation and antibiotic profiles of causative bacteria from ear discharges of patients in 3years attending outpatients of a hospital.Methods: Bacterial strains were grown in suitable media and were subjected to antibiotic profiling by the Kirby-Bauer’s method with most antibiotics of the day.Results: In total there were 1164 colonies with 1043 bacterial and 121 fungal isolates from 1230 ear discharge samples. Among 371 Pseudomonas aeruginosa isolates, tobramycin 30 µg/disk had the highest susceptibility rate as 93.2%, followed by ceftazidime 30µg/disk 91.5% and amikacin 10µg/disk 64.4%. From 359 Staphylococcus isolates, there were 236 coagulase negative Staphylococcus (CONS) + methicillin sensitive S. aureus (MSSA) and 123 methicillin resistant S. aureus (MRSA). Staphylococcus including MRSA isolates were most susceptibility to cloxacillin 15µg/disk 95.2%, followed by erythromycin 15µg/disk 83.3% and gentamicin 30µg/disk 78.5%. Of 1164, 49 patients presented post aural abscess, 12 patients had intracranial complications, 9 patients had facial palsy and 3 patients had labyrinthitis.Conclusions: Isolated bacteria, P. aeruginosa and MRSA were multidrug resistant. P. aeruginosa was most common followed by S. aureus. More than 90% P. aeruginosa and 90% S. aureus isolates were sensitive to tobramycin 30 µg/disk and cloxacillin 30 µg/disk, respectively. Therefore, these two antibiotics may be included in the formulary regimen to overcome bacterial infections involved in ASOM