Characteristics of Fatal Cases of Pandemic Influenza A (H1N1) from September 2009 to January 2010 in Saurashtra Region, India

Background: India reported first case of 2009 pandemic influenza A (H1N1) virus infection in May, 2009 and Saurashtra region in August, 2009. We describe the characteristics of fatal cases of 2009 influenza A (H1N1) infection reported in Saurashtra region. Methods: From September, 2009 to January, 2010, we observed 71 fatal cases that were infected with 2009 influenza A (H1N1) virus and admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features were observed and documented. Results: Median age of the deceased (71) was 29 years, and 57.7% were females. Median time observed was 5 days from onset of illness to diagnosis of influenza A (H1N1), and 57.7% were referred from general practitioner (OR=0.42, CI=0.24-0.74). Median hospital stay reported was 3 days. All admitted patients received oseltamivir, but only 16.9% received it within 2 days of onset of illness. The most common symptoms were cough (97.2%), fever (93%), sore throat and shortness of breath. Co-morbid conditions were present in almost half of the patients who ultimately died, the most common of which was pregnancy (OR=0.15, CI=0.04-0.52). Radiological pneumonia was reported in 98% patients. Conclusion: Residing in urban area, delayed referral from general practitioner, presence of co-existing condition, especially pregnancy was responsible for mortality among influenza A (H1N1) infected positive

Charged analogue of Finch-Skea stars

We present solutions to the Einstein-Maxwell system of equations in spherically symmetric gravitational fields for static interior spacetimes with a specified form of the electric field intensity. The condition of pressure isotropy yields three category of solutions. The first category is expressible in terms of elementary functions and does not have an uncharged limit. The second category is given in terms of Bessel functions of half-integer order. These charged solutions satisfy a barotropic equation of state and contain Finch-Skea uncharged stars. The third category is obtained in terms of modified Bessel functions of half-integer order and does not have an uncharged limit. The physical features of the charged analogue of the Finch-Skea stars are studied in detail. In particular the condition of causality is satisfied and the speed of sound does not exceed the speed of light. The physical analysis indicates that this analogue is a realistic model for static charged relativistic perfect fluid spheres.Comment: 17 pages, To appear in Int. J. Mod. Phys.

A study of caesarean section rate by using Robson's ten group classification system at tertiary care hospital, Ahmedabad, India

Background: Caesarean delivery rate is rising continuously worldwide and is matter of concern. The Robson’s Ten-group classification system allows critical analysis of caesarean deliveries thereby helps to optimise caesarean section rates. Methods: This study was conducted at GMERS medical college and hospital, Sola, Ahmedabad, Gujarat, India. All patients who delivered between November 2021 and May 2022, were included in the study and were classified in 10 groups according to modified Robson’s classification system. The CS rate and contribution to the overall CS rate was calculated within each group.Results: Total number of deliveries was 836, out of them 242 was CS. The CS rate was 28.94%. The main contribution to overall caesarean rate was 39.67% by group 5, followed by 17.77% by group 1, 10.33% by group 2. CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 88% in nulliparous breech (group 6), 84.95% in previous CS (group 5), 40.62% in multiparous breech (group 7) and least 3.57% in multipara spontaneous labour (group 3).Conclusions: The Robson groups 1, 2, 5 and 6 were found to be the major contributors to the overall CS rate. These groups may be targeted for effective interventions to reduce the CS rate. Reduction of primary caesarean delivery, promoting vaginal birth after CS, and careful assessment of cases before induction of labour in nulliparous women, are likely to be a few effective strategies

Evaluation of bacteriological profile and antibiotic susceptibility pattern of patients with otorrhea in a tertiary care teaching hospital

Background: Otitis media is very common disease in developing country and if not treated properly can lead to hearing loss and serious neurological complications. Its bacteriology and antibiotic sensitivity varies in different population. Thus knowledge of the microbiological pattern with antibiotic susceptibility is important to deliver efficacious treatment of this disease. So, purpose of the present study was to determine the microbiological profile and antimicrobial susceptibility pattern of isolates from ear discharge in patients of otitis media.Methods: This study was conducted in Department of Microbiology of our institute for duration of one year. A total of 100 patients’ samples visiting ENT OPD were taken who complaining of ear discharge. Identification of organism was done by using standard biochemical reactions and antibiotic susceptibility testing done by using modified Kirby Bauer method as per CLSI guidelines.Results: Majority of the patients were between 21-30 years of age group (28%). The most common organism isolated was Pseudomonas aeruginosa (25.88%), highly sensitive to aminoglycosides and β-lactam + β-lactamase inhibitor (100%) followed by Staphylococcus aureus (21.17%), highly sensitive to aminoglycosides (100%) and fluoroquinolones (72.22%).Conclusions: Knowledge of the pathogenic agents responsible for otitis media and choice of effective antibiotics according to susceptibility pattern will guide the treatment. It also helps in reducing complications of the disease and decreasing emergence of resistance to antibiotics.

Can we predict difficult laparoscopic cholecystectomy preoperatively? A comprehensive study

Background: In the study, we have tried to assess some preoperative factors (history, clinical and ultrasonographic factors) that might make the laparoscopic cholecystectomy difficult. Objective was to study the predictive scoring pattern in difficult laparoscopic cholecystectomy cases. Methods: It was a prospective observational study. Ninety cases of suspected cholecystitis were identified for study presented to Jehangir hospital, Pune with upper abdominal pain or vomiting or dyspepsia or jaundice. Such patients were studied in detail clinically, admitted and investigated. Ultrasound abdomen was done in all patients. Results: Out of 90 cases studied, 64 patients (71.1%) had pre op score between 0-5 i.e. easy level, 21 patients (23.3%) had pre-op score between 6-10 i.e. difficult level and 5 patients (5.6%) had pre-op score between 11-15 i.e. very difficult level against intra-op scoring of 57 patients (63.33%) being easy, 28 patients (31.1) difficult and 05 patient (5.6%) had very difficult surgery. Conversion rate in present study to open surgery was 5.6%. For predicting easy laparoscopic cholecystectomy, accuracy of preop score was 85.6% and for predicting very difficult lap cholecystectomy, accuracy of preoperative score was 95.6%. Conclusions: Strongly significant factors predicting difficult laparoscopic cholecystectomy were number of hospitalisations, impacted stone and obesity. This study demonstrated that a scoring system predicting the difficulty in laparoscopic cholecystectomy is feasible and easy way. Identification of these factors preoperatively might help to psychologically prepare the patients for open surgery and for prolonged convalescence

Life Test Based on Progressively Group-Censored Samples From Exponential Distribution With Periodic Change in Failure Rate

A life test experiment based on progressively group censored sample with periodic change in the failure rate of an exponential distribution is considered. Estimates of the two failure rates under different conditions of usage of an item together with their asymptotic standard error are obtained by the method of maximum likelihood. A numerical example is given using the data available in the form of grouped observations under two conditions of usage during alternate time intervals of fixed lengths T/Sub1 and T/Sub2

Comparative eco-physiological potential of a submerged and a free floating aquatic plant to treat domestic wastewater

Domestic wastewater treatment has become a remarkable aquatic environmental problem for all over the world. Due to non-availability of cheaper methods and higher cost of treatment plants, municipalities are diverting untreated domestic wastewater in to aquatic bodies like ponds and lakes, where it is causing eutrophication due to higher concentration of nutrients and leads water unhygienic to use. Present research experimented by culturing Hydrilla verticillata, and Pistia stratiotes seprately in domestic wastewater for subsequent seven days over the year. The quality of domestic wastewater before and after the treatment/culture was evaluated by analyzing physico-chemical parameters of domestic wastewater followed by APHA-AWWA-WPCF (1980).The results of physico-chemical analysis of domestic wastewater and estimation of net primary productivity of experimental aquatic plants after the culture have indicated an improvement in water quality and increase in biomass. Both the aquatic plants proved to be efficient in treatment of domestic wastewater and their increased weight in culture has potential value in biomass generation.It is concluded that both the aquatic plants perform significant potential to remove nutrients from domestic wastewater and also showed seasonal variation for the purpose

The H1 Forward Track Detector at HERA II

In order to maintain efficient tracking in the forward region of H1 after the luminosity upgrade of the HERA machine, the H1 Forward Track Detector was also upgraded. While much of the original software and techniques used for the HERA I phase could be reused, the software for pattern recognition was completely rewritten. This, along with several other improvements in hit finding and high-level track reconstruction, are described in detail together with a summary of the performance of the detector.Comment: Minor revision requested by journal (JINST) edito