An Adaptive Quadrilateral Mesh in Curved Domains

An nonlinear elliptic system for generating adaptive quadrilateral meshes in curved domains is presented. The presented technique has been implemented in the C++ language with the help of the standard template library. The software package writes the converged meshes in the GMV and the Matlab formats. Grid generation is the first very important step for numerically solving partial differential equations. Thus, the presented C++ grid generator is extremely important to the computational science community

Nonlinear elliptic problems with the method of finite volumes

We present a finite volume discretization of the nonlinear elliptic problems. The discretization results in a nonlinear algebraic system of equations. A Newton-Krylov algorithm is also presented for solving the system of nonlinear algebraic equations. Numerically solving nonlinear partial differential equations consists of discretizing the nonlinear partial differential equation and then solving the formed nonlinear system of equations. We demonstrate the convergence of the discretization scheme and also the convergence of the Newton solver through a variety of practical numerical examples

ANTIMICROBIAL AGENT’S UTILIZATION AND COST PATTERN IN MEDICAL INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL

Objective: The objective of this study was to evaluate the utilization and cost pattern of AMAs (Antimicrobial Agents) in the Medical ICU of a tertiary care teaching hospital, and to determine the predictor of antimicrobial number per day. Methods: A prospective cross-sectional study was carried out and a total of 101 patients were studied. The drugs were classified into different groups according to the World Health Organization’s ATC (Anatomical Therapeutic Chemical) Classification System.  Results: The mean [95% confidence interval (CI)] duration of ICU stay was 7.11 (5.70-8.52) days and the mortality rate in the ICU was 42.6%. The AMAs DDD (Defined Daily Dose) per 100 patient days and number of AMAs per prescription were 296.64 and 2.65, respectively. Piperacillin-tazobactam was the most commonly utilized AMAs followed by metronidazole, meropenem, fluconazole, and colistin. The mean number [95% CI] of AMAs, DDD, and cost (INR) per patient were 18.82 (14.05-23.59), 21.09 (15.36-26.81) and 25,827 (18,716-32,939) respectively. The AMAs constituted 88.53% of the total treatment cost. Meropenem was the most costly AMA (32.10% of the total AMAs cost) followed by imipenem-cilastatin (20.50%), colistin (14.65%), piperacillin-tazobactam (8.40%), and clindamycin (4.47%). The independent predictor for the antimicrobial number per day was acute physiology and chronic health evaluation II (APACHE-II) score at admission and nosocomial infections. Conclusion: The AMAs, DDD per 100 patient days, and number per prescription were higher. This leads to a higher cost of AMAs per patient and the AMAs cost out of the total cost as compared to previous studies. We suggest, there is a need to formulate and implement an antimicrobial restriction policy