Is empirical antibiotic treatment required in COVID-19 patients? What lessons have we learnt over the past 1 year?

Background: Secondary bacterial infections manifest during or after a viral infection(s) and can lead to negative outcomes and sometimes fatal clinical complications. The choice for an empiric antibiotic therapy requires a broad spectrum of activity against pathogens including beta-lactamase producing pathogens. Ceftriaxone+sulbactam+disodium EDTA is one of the antibiotic combinations used to prevent secondary infections. The objective was to evaluate rate of secondary bacterial infections in patients receiving empirical antibiotic therapy through retrospective analysis of data from a tertiary care center.Methods: A single center, retrospective analysis of data from hospital of COVID-19 patients treated in the ICU or wards was conducted. Patients who received empirical antibiotic therapy including ceftriaxone+sulbactam+disodium EDTA were included in the study.Results: 99 patients (mena age 75±9.89 years) were included in the retrospective analysis. Diabetes and hypertension were the most common comorbidities in the patients. The total WBC count was raised (12.36±9.01). All the biological markers were raised. 45% patients had abnormalities in chest X-ray. The mean CT severity index was 13.81±5.64. Bacterial superinfection was observed only in 1 patient.Conclusions: Bacterial co infections and secondary bacterial infections are a major risk factor for adverse COVID-19 outcomes. The use of appropriate prophylactic antibiotics such as ceftriaxone+sulbactam+disodium EDTA has significantly reduced the prevalence of secondary bacterial infections in patients with severe COVID.

Implementing lean in healthcare warehouse operations - evaluation of 5S best practice

Lean strategies in healthcare aim at improving patient throughput, reducing medication errors, redesigning work flow, improving patient safety, and reducing cycle time. Documented studies to improve healthcare’s warehouse operation are not common in the literature. Managing types of medical supplies has always been a priority due to demand uncertainties and the risk of shortages that would profoundly affect patient safety. This study showcases two implementation approaches for the Lean tool 5S (Hybrid and Traditional) conducted in three different hospitals’ central warehouses at Ochsner Health System. These warehouses store similar medical products with over 1000 types of supplies (e.g. syringes, gloves, primary IV) that supply different departments within hospitals and clinics. The participating warehouses faced similar problems due to over/under stocked inventories, space constraints, and poor layouts. The objective of this study was to compare the impact of implementing a Hybrid 5S (integrated with inventory management techniques and process improvement tools) along with two Traditional 5S’s to improve healthcare warehouse operations. Although the two approaches improved the baseline warehouse process, the warehouse that used the Hybrid 5S showed the greatest improvement with an increase of 59.5% in inventory turnover, 15.7% space saved, and least number of non-conformities in the 5S audit tool

Characterization And Alkaline Fusion Recovery Process Of Rare Earths And Thorium From Malaysian Monazite

The use of edges to determine an optimal region of interest (ROI) location is increasingly becoming popular for image deblurring. Recent studies have shown that regions with strong edges tend to produce better deblurring results. In this study, a direct method for ROI localization based on edge refinement filter and entropy-based measurement is proposed. Using this method, the randomness of grey level distribution is quantitatively measured, from which the ROI is determined. This method has low computation cost since it contains no matrix operations. The proposed method has been tested using three sets of test images - Dataset I, II and III. Empirical results suggest that the improved edge refinement filter is competitive when compared to the established edge detection schemes and achieves better performance in the Pratt's figure-of-merit (PFoM) and the twofold consensus ground truth (TCGT); averaging at 15.7 % and 28.7 %, respectively. The novelty of the proposed approach lies in the use of this improved filtering strategy for accurate estimation of point spread function (PSF), and hence, a more precise image restoration. As a result, the proposed solutions compare favourably against existing techniques with the peak signal-to-noise ratio (PSNR), kernel similarity (KS) index, and error ratio (ER) averaging at 24.8 dB, 0.6 and 1.4, respectively. Additional experiments involving real blurred images demonstrated the competitiveness of the proposed approach in performing restoration in the absent of PSF

Knowledge-directed intelligent information retrieval for research funding.

Thesis (M.Sc.)- University of Natal, Pietermaritzburg, 2001.Researchers have always found difficulty in attaining funding from the National Research Foundation (NRF) for new research interests. The field of Artificial Intelligence (AI) holds the promise of improving the matching of research proposals to funding sources in the area of Intelligent Information Retrieval (IIR). IIR is a fairly new AI technique that has evolved from the traditional IR systems to solve real-world problems. Typically, an IIR system contains three main components, namely, a knowledge base, an inference engine and a user-interface. Due to its inferential capabilities. IIR has been found to be applicable to domains for which traditional techniques, such as the use of databases, have not been well suited. This applicability has led it to become a viable AI technique from both, a research and an application perspective. This dissertation concentrates on researching and implementing an IIR system in LPA Prolog, that we call FUND, to assist in the matching of research proposals of prospective researchers to funding sources within the National Research Foundation (NRF). FUND'S reasoning strategy for its inference engine is backward chaining that carries out a depth-first search over its knowledge representation structure, namely, a semantic network. The distance constraint of the Constrained Spreading Activation (CSA) technique is incorporated within the search strategy to help prune non-relevant returns by FUND. The evolution of IIR from IR was covered in detail. Various reasoning strategies and knowledge representation schemes were reviewed to find the combination that best suited the problem domain and programming language chosen. FUND accommodated a depth 4, depth 5 and an exhaustive search algorithm. FUND'S effectiveness was tested, in relation to the different searches with respect to their precision and recall ability and in comparison to other similar systems. FUND'S performance in providing researchers with better funding advice in the South African situation proved to be favourably comparable to other similar systems elsewhere

Critical investigation of the impact of brand communities and new media in marketing Sony’s PlayStation

The gaming industry has flourished in the recent years. It is interesting to see many gaming companies competing against each other to attain the top spot in the gaming industry. The companies have resorted to invest a lot in understanding consumer behavior to gain maximum benefit for both the firm in terms of sales and consumer in terms of gaming experience. Companies have identified that brand community and new media as the best medium to interact with its loyal customers. This research critically examines these interactions between consumer and the company and tries to gain insights on the impact of marketing strategies used by Sony to market its Sony PlayStation. It also identifies if the strategies implemented by Sony are effective. And in order to achieve this, both the company and consumer point of view was observed from new media techniques and brand communities. Even though a lot of marketing strategies used by Sony was effective, it was found that the consumer’s perception about the reliable source of information was not available from the official forums

The dynamics of informal trading in Westcliff, Chatsworth : a case- study of the Bangladesh market.

Thesis (M.Sc.U.R.P.)-University of KwaZulu-Natal, Durban, 2004.No abstract available

Guiding entrepreneurs to success through franchising : a case study of Midas in Durban.

MBA University of KwaZulu-Natal, Durban 2012.The decline of employment globally with various countries and economies either in recession, post recession or on the brink of recession is a serious concern to governments, the private sector, civic organizations and the general population. Associated with this decline are dynamics of poverty, food insecurity, maladministration and corruption, civil war, and a new world order. Governments are now looking to implement and support successful solutions that have been tried and tested. It has been identified that franchising is successful solution that is on the increase globally. Franchising is a multibillion dollar revenue creator globally and accounts significantly for employment. The automotive sector is growing at an unprecedented rate with the greater number of motor cycles, cars, taxis, busses and trucks on the road. The Midas franchise is the second fastest growing franchise in South Africa. There are more than two hundred and twenty franchises in South Africa and surrounding countries. The aim of this research study is to investigate if franchising provides entrepreneurs, especially new business owners a more secure business start up, and to assess the success of the Midas franchise. The research methodology adopted in this study adopts a qualitative research method. The instruments used to obtain data are questionnaires, face to face interviews, observation and photography. The study area encompasses franchisees from the eThekwini Municipal area. Six Midas franchisees and the KZN regional Midas franchisor have been interviewed. The findings have proven to be remarkable, supporting the hypothesis which states that franchising is a successful tool to assist entrepreneurs. Most entrepreneurs have citied their contentment with being with a franchisee and their optimism to venture into more franchises. The franchisor boasted their rapid expansion in South Africa. There were also recommendations arising out of the study so as to enhance entrepreneurship and franchising in South Africa

Electroless Deposition of Nanolayered Metallic Coatings

Electroless metallic coating is referred as the deposition of a substrate material by the process of chemical or autocatalytic reduction of aqueous metal ions deposited to a substrate material without any external supply of power. Electroless nickel alloys are generally considered synonymous to the word “electroless coating” as ~90% of productions in industries are of this alloy coating. Rest of the electroless metallic coatings includes gold, copper, palladium, cobalt, silver, etc. These electroless metallic coatings (other than electroless nickel coatings) are also one of the vibrant areas in the field of materials properties and surface engineering research. From the year 2000 to till date, nearly 1000 SCI indexed research papers were published on this topic. However, no comprehensive studies about the recent progress on this topic were reported elsewhere so far. In this context, the present chapter aims to give a complete overview on various aspects of the rest of the electroless metallic nanocoatings/layer as a whole. More importance will be on the recent developments of the nanocharacteristics and future scopes

Efficacy and safety of intravenous and/or oral levonadifloxacin in the management of secondary bacterial pulmonary infections in COVID-19 patients: findings of a retrospective, real-world, multi-center study

Background: Owing to dysregulated immune response, secondary bacterial pulmonary infections involving both gram-positive and gram-negative pathogens are common in COVID-19 patients and are often associated with higher mortality. This is a first ever report on the safety and efficacy of levonadifloxacin in the treatment of secondary bacterial pulmonary infections in patients with COVID-19 pneumonia.Methods: This multi-center, retrospective, post-marketing and real-world study assessed the safety and efficacy of IV and/or oral levonadifloxacin in the treatment of bacterial infections encountered in COVID-19 patients. Data for 154 male/female patients above 18 years of age who received levonadifloxacin (injectable and/or oral) was collected from 44 participating sites. Study outcomes were the clinical and microbial success at the end of therapy. Safety was assessed based on clinical and laboratory adverse events.Results: Among the 154 patients assessed, 121 (78.6%) were males and 142 (92.2%) were hospitalized. Majority of the patients (119) received all-IV therapy while 11 patients were prescribed with IV followed by oral regimen. All-oral therapy was received by 24 patients. The most common co-morbid conditions were diabetes (19.6%) and hypertension (19.2%). Post-treatment with levonadifloxacin, clinical and microbial success rates were 96.8% and 97.0% respectively.Conclusions: Levonadifloxacin showed promising safety and efficacy when used as IV and/or oral therapy for the treatment of secondary bacterial pulmonary infections in COVID-19 patients. Clinically relevant features of levonadifloxacin such as availability of both IV and oral options, broad spectrum coverage and reassuring safety in patients with significant co-morbidities could help simplify the management.Trial registration no. CTRI/2020/09/028152 [Registered on: 30/09/2020]

Base extrusion is found at helical junctions between right- and left-handed forms of DNA and RNA

Base extrusion is a major structural feature at the junction between B- and Z-DNA (the B–Z junction) where a base pair is broken, and the two bases are extruded from the double helix. Despite the demonstration of base extrusion at the B–Z junction, it is not clear whether a similar base extrusion occurs at other types of junctions involving the left-handed Z conformation. Here, we investigate structural changes of bases at three Z-form junctions: DNA B–Z and Z–Z and RNA A–Z junctions. By monitoring fluorescently labeled duplex nucleic acids using 2-aminopurines at various positions relative to the junction point, we show that base extrusion occurs not only at the DNA B–Z junction, but also at the RNA A–Z and DNA Z–Z junctions. Our data suggest that base extrusion is a general feature of Z-form nucleic-acid junctions.Korean Science and Engineering Foundation (grant NRL-2006-02287)Korea (South). Ministry of Science and Technology (21C Frontier Functional Proteomics Program FPR08B2-270)Korean Science and Engineering Foundation (Ubiquitome Research Program M105 33010001-05N3301-00100)Korea Research Foundation (MOEHRD, Basic Research Promotion Fund; KRF-2005-070-C00078