Detection of vancomycin susceptibility among clinical isolates of MRSA by using minimum inhibitory concentration method

Background: Staphylococcus aureus is considered as a major pathogen causing a diversity of infections including bacteremia, pneumonia, skin and soft tissue including osteoarticular infections. Since 1961, Methicillin Resistant Staphylococci aureus (MRSA) emerged has one of the major and common cause of hospital acquired infection. However, due to wide spread usage of vancomycin for MRSA infections resulted in reduced susceptibility of S. aureus to vancomycin has been identified as a serious public health concern. The aim of the study is to identify the Methicillin Resistant Staphylococcus aureus (MRSA) from various clinical samples and to detect vancomycin susceptibility by Minimum Inhibitory Concentration (MIC) method.Methods: This study was conducted over period of one year December 2013 to November 2014. Clinical samples like pus, blood, sputum, urine and cerebrospinal fluid were collected from various clinical departments in Narayana General Hospital for selective isolation of Staphylococcus aureus. A total of 100 Staphylococcal aureus isolates were isolatedby using standard laboratory procedures. MRSA were detected using Oxacillin Disc on Muller Hinton Agar with 4% NaCl. Sensitivity pattern for vancomycin (30 µg) disc and for other recommended antibiotics was determined by Kirby-Bauer’s disk diffusion method. Minimum Inhibitory Concentration (MIC) was done for vancomycin sensitive isolates by standard agar dilution method.Results: Out of 100 S. aureus isolates, all were susceptible to vancomycin (30 µg) by disk diffusion method. But, 82 isolates of MRSA were susceptible to vancomycin at the concentration of 0.5-2 μg/ml of agar. 17 isolates showed intermediate sensitivity to vancomycin, in which 13 isolates with MIC 4μg/ml and 4 isolates with MIC 8 μg/ml and one isolate was resistant to vancomycin even with MIC of 16 μg/ml.Conclusions: The present study reveals the emergence of Vancomycin Intermediate Sensitive Staphylococcus aureus (VISA) and Vancomycin Resistant Staphylococcus aureus (VRSA). Disc diffusion method should not be employed for detection of vancomycin sensitivity for MRSA stains. The major cause may be attributed to unawareness and irrational usage of broad spectrum antibiotics.

Subclinical atherosclerosis and silent myocardial ischaemia in patients with type 2 diabetes: a protocol of a clinico-observational study

Introduction: Atherosclerotic cardiovascular disease is a significant modifiable complication in patients with diabetes and subclinical atherosclerosis is considered a surrogate marker of future vascular events. The clustering of cardiometabolic-risk factors in patients with diabetes and cardiovascular disease is increasingly being recognised. Recent evidence indicates that 20–50% of asymptomatic patients with diabetes may have silent coronary heart disease. However, the identification of subclinical atherosclerosis and silent myocardial ischaemia in patients with diabetes has been less well-explored, especially in low-resource population settings where cost-effective non-invasive clinical tools are available. The objective of this study is to identify patients with physician-diagnosed diabetes who are at risk of developing future cardiovascular events measured as subclinical atherosclerosis and silent myocardial ischaemia in an urban population of Eastern India.Methods and analysis This is a cross-sectional clinico-observational study. A convenience sampling of approximately 350 consecutive patients with type 2 diabetes based on predefined inclusion and exclusion criteria will be identified at an urban diabetes center. This estimated sample size is based on an expected prevalence of silent myocardial ischaemia of 25% (± 5%), we computed the required sample size using OpenEpi online software assuming an α level of 0.05 (95% CI) to be 289. On factoring 20% non-response the estimated sample size is 350. Previously validated questionnaire tools and well-defined clinical, anthropometric and biochemical measurements will be utilised for data collection. The two primary outcomes—subclinical atherosclerosis and silent myocardial ischaemia will be measured using carotid intima-media thickness and exercise tolerance testing, respectively. Descriptive and multivariate logistic regression statistical techniques will be employed to identify ‘at risk’ patients with diabetes, and adjusted for potential confounders. Ethics and dissemination: Ethical approval was granted by the institutional review board of Kalinga Institute of Medical Sciences, Bhubaneshwar, India. Data will be presented at academic fora and published in peer-reviewed journals

Informant consensus factor and antimicrobial activity of ethno medicines used by the tribes of wayanad district kerala

The ethno botanical investigation of medicinal plants used by the Kurichia, Kuruma, Kattunaika, Adiya and Paniya tribes of Wayanad district, Kerala were recorded. One thousand(1000)ethno medicines derived from 500 plants used by the tribal medical practitioners weredocumented. Of this, 10 species were frequently used for treating various infectious diseases. An informant consensus factor was calculated for 10 species which are being frequently used. The leaf extracts of these plants were screened for antimicrobial activity against Escherichia coli, Staphylococcus aureusand Aspergillus niger.Among the plants screenedGarcinia gummi gutta(Clusiaceae) was found to possess highly significantantibacterial activity and significant antifungal activity was observed inNothapodytes nimmoniana (Icacinaceae) which possess highest antifungal activity. These two species have shown the highest informant consensus factor values

Ondansetron versus palonosetron: a comparative study on efficacy and safety in prevention of postoperative nausea and vomiting

Background: Postoperative nausea and vomiting (PONV) is a major complication in patients who undergo surgery under general anaesthesia. Various drug regimens and antiemetic interventions have been tried from time-to-time for prevention of PONV but with a variable success rate. This study compares the safety and efficacy of ondansetron and palonosetron in preventing PONV in such patients.Methods: A prospective study was conducted in 60 ASA grades - I and II patients of either sex, aged between 20 to 50 years, scheduled for elective surgery under general anaesthesia, 30 of who received 4 mg ondansetron and the remaining 30 received 0.05 mg palonosetron intravenously 5 minutes before induction of anaesthesia. Postoperatively they were observed for 24 hours for complete response, any episodes of nausea and vomiting, their severity, need for rescue antiemetic and side effects. After the study, results were compiled and the data was analysed using Student’s T test. P value 0.5). Complete antiemetic response was 60% in ondansetron group and 83% in palonosetron group. There was no significant statistical difference between both the groups in causing headache (p >0.5) and dizziness (p >0.05).Conclusions: Our study concludes that the antiemetic efficacy is comparable for both ondansetron and palonosetron in the given doses in preventing PONV and none is superior. Both the study drugs had almost the same adverse effect profile

Optimización de un pretratamiento enzimático para semillas de mostaza utilizando metodología de superficie de respuesta

In order to investigate the effect of an enzymatic pre-treatment process for the extraction of oil from black mustard seeds (Brassica nigra) using viscozyme, the reaction parameters such as temperature, buffer-to-seed ratio and enzyme concentration were considered as determinant factors in the central composite design. Optimization was carried out according to the four-variable five-level central composite design of experiments. The effects of enzyme concentration (5–12%), temperature (40–55 °C), pH (5.0–6.0), and reaction time (1–7 h) on the free oil liberated were studied. Residual oil was collected by subjecting the treated meal to soxhlet extraction for 4 h. An enzyme dose of 7.5% (w/w), pH 5.0, 50 °C, and 5 h with constant shaking at 450 rpm were found to be opti­mal conditions. Centrifuging the mixture at 7000 rpm for 30 min separated the oil with a recovery of 71–73.1%.Con el fin de investigar el efecto de un pretratamiento enzimático para la extracción de aceite de semillas de mostaza negra (Brassica nigra) utilizando viscozima, los parámetros de la reacción, como la temperatura, la relación de tampón/semilla y las concentraciones de enzima, se consideraron factores deter­minantes en el diseño. La optimización se llevó a cabo mediante cuatro diseños de experimentos compuestos de cinco niveles. Se estudió el efecto de la concentración de enzima (5-12%), temperatura (40-55 °C), pH (5.0-6.0), y tiempo de reacción (1-7 h) sobre el aceite liberado. El aceite residual se recolectó sometiendo la pasta tratada a una extracción de soxhlet durante 4 h. Las dosis de enzima del 7,5% (p/p), pH 5,0, 50 °C y 5 h con agitación constante a 450 rpm fueron las condiciones óptimas. La centrifugación de la mezcla a 7000 rpm durante 30 minutos separó el aceite con una recuperación de 71-73.1%

Management of tibial diaphyseal fractures with linear external skeletal fixators using carbon connecting rods in dogs

Dogs (12) with unstable tibial diaphyseal fractures, selected for this study, were stabilized with bilateral uniplanar Type II external skeletal fixators using stainless steel positive profile centrally threaded transfixation full pins, 2- way AO clamps and indigenously designed carbon fiber rods. Clinical lameness evaluation and radiographic evaluation for fixator stability, fragment alignment and callus formation were studied. Post-operatively, no breakage or bending of the carbon fiber rods was seen throughout the fixation period. Fixator staged disassembly and complete removal was done on an average 4–9 weeks in all cases which showed grade I lameness after removal. Complications like pin tract infection, wound at suture site due to wound dehiscence and wound at pin-skin interface were seen, which subsided later without any affect on bone healing. Lameness grading, pain score and radiographic evaluation of healing were estimated in all the cases throughout the fixation period. ESF using carbon fiber connecting rod appears as a practicable method for repair of tibial diaphyseal fractures with minimum risk of fixator destabilization. Fixator staged disassembly at 4 weeks accelerated bone healing and promoted earlier limb function

Preliminary phytochemical screening and antimicrobial activity of Samanea saman

Samanea saman is a tropically distributed medicinal plant. Antimicrobial activity of aqueous extract of this plant was investigated by Well-diffusion method against three organisms: Escherichia coli, Staphylococcus aureus and Candida albicans. The plant extract showed inhibitory activity against all the tested organisms. Five mg/ml inhibited the growth of E. coli but slightly higher concentration of 10 mg/mL was necessary to show inhibition against S. aureus and C. albicans. Phytochemical screening of the plant revealed the presence of tannins, flavonoides, saponins, steroids, cardiac glycosides and terpenoids. The study scientifically validates the use of plant in traditional medicine

Physics Potential of the ICAL detector at the India-based Neutrino Observatory (INO)

The upcoming 50 kt magnetized iron calorimeter (ICAL) detector at the India-based Neutrino Observatory (INO) is designed to study the atmospheric neutrinos and antineutrinos separately over a wide range of energies and path lengths. The primary focus of this experiment is to explore the Earth matter effects by observing the energy and zenith angle dependence of the atmospheric neutrinos in the multi-GeV range. This study will be crucial to address some of the outstanding issues in neutrino oscillation physics, including the fundamental issue of neutrino mass hierarchy. In this document, we present the physics potential of the detector as obtained from realistic detector simulations. We describe the simulation framework, the neutrino interactions in the detector, and the expected response of the detector to particles traversing it. The ICAL detector can determine the energy and direction of the muons to a high precision, and in addition, its sensitivity to multi-GeV hadrons increases its physics reach substantially. Its charge identification capability, and hence its ability to distinguish neutrinos from antineutrinos, makes it an efficient detector for determining the neutrino mass hierarchy. In this report, we outline the analyses carried out for the determination of neutrino mass hierarchy and precision measurements of atmospheric neutrino mixing parameters at ICAL, and give the expected physics reach of the detector with 10 years of runtime. We also explore the potential of ICAL for probing new physics scenarios like CPT violation and the presence of magnetic monopoles.Comment: 139 pages, Physics White Paper of the ICAL (INO) Collaboration, Contents identical with the version published in Pramana - J. Physic

Action heritage: research, communities, social justice

Societies are unequal and unjust to varying degrees and heritage practitioners unavoidably work with, perpetuate and have the potential to change these inequalities. This article proposes a new framework for undertaking heritage research that can be applied widely and purposefully to achieve social justice, and which we refer to as action heritage. Our primary sources are semi-structured conversations we held with some of the participants in three heritage projects in South Yorkshire, UK: members of a hostel for homeless young people, a primary school, and a local history group. We examine ‘disruptions’ in the projects to understand the repositioning of the participants as researchers. The disruptions include introducing a scrapbook for personal stories in the homeless youth project and giving the school children opportunities to excavate alongside professional archaeologists. These disruptions reveal material and social inequalities through perceptible changes in how the projects were oriented and how the participants thought about the research. We draw on this empirical research and theorisations of social justice to develop a new framework for undertaking co-produced research. Action heritage is ‘undisciplinary’ research that privileges process over outcomes, and which achieves parity of participation between academic and community-based researchers through sustained recognition and redistribution