The “Good-Girl” Value Construct: Asian Indian Immigrant Women in the U.S. and Contested Spaces

The multiple constructions of identity that define an Indian woman - as a wife, a mother, a Goddess - and the thread that holds these identities together, the “good-girl” are explored in this paper. Fox’s (1977) argument of the use of “nice-girl” or “good-girl” as value constructs for the social control of women is used to examine the narratives of three Asian Indian immigrant women. The discourses presented in the case studies, reflect strongly on the socialized nature of the “good-girl” construct and indicate how its influences, sources, and definitions lead women to communicatively produce and reproduce the meanings of this construct whilst undergoing the dual tensions of embodying and resisting becoming the “good-girl”

The “Good-Girl” Value Construct: Asian Indian Immigrant Women in the U.S. and Contested Spaces

The multiple constructions of identity that define an Indian woman - as a wife, a mother, a Goddess - and the thread that holds these identities together, the “good-girl” are explored in this paper. Fox’s (1977) argument of the use of “nice-girl” or “good-girl” as value constructs for the social control of women is used to examine the narratives of three Asian Indian immigrant women. The discourses presented in the case studies, reflect strongly on the socialized nature of the “good-girl” construct and indicate how its influences, sources, and definitions lead women to communicatively produce and reproduce the meanings of this construct whilst undergoing the dual tensions of embodying and resisting becoming the “good-girl”

A RISING THREAT – RISK FACTORS AND OUTCOMES RELATED TO INFECTIONS WITH ACINETOBACTER SPECIES

ABSTRACTObjective: Acinetobacter species is an important cause of community as well as nosocomial infections with a high mortality rate. The study was doneto analyze the risk factors associated with Acinetobacter infections and their outcomes.Methods: The clinical details of 100 patients having infections with Acinetobacter species over a period of 1-year were analyzed for underlying riskfactors and outcomes. The antibiotic sensitivity results were interpreted according to the Clinical Laboratory Standards Institute guidelines.Results: Majority of the infections caused by the Acinetobacter species were lower respiratory tract infections, most common being ventilatorassociatedpneumonia. 47% of the isolates were multi drug resistant and 26% were extensively drug resistant. There is a significant chance of drugresistance and a poor outcome with intensive care unit (ICU) stay, prolonged hospital stay of more than 7 days, the presence of 5 or more risk factors.Endotracheal intubation and mechanical ventilation were the risk factors for increased drug resistance in the ICU. Drug resistance was also seen morefrequently in patients with chronic obstructive pulmonary disease, chronic kidney disease, and patients on post-operative care.Conclusion: The steady increase in drug resistant Acinetobacter species and limited antibiotics available advocates an uncompromising approachtoward infection control and a judicious use of antibiotics especially in the ICU. An understanding about the risk factors helps in the appropriateapproach and management of the patient.Keywords: Acinetobacter, Risk factors, Invasive procedures, Nosocomial

Molecular and Clinical Features of Heterogeneous Vancomycin Intermediate Staphylococcus aureus in Tertiary Care Hospitals of South India

Objectives: This study aimed to detect heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) among methicillin resistant S. aureus (MRSA) isolated from healthcare-associated infections and identify staphylococcal cassette chromosome mec (SCCmec) types. Methods: Isolation and identification of MRSA were done using standard bacteriological methods. Antimicrobial susceptibility testing was done using Kirby-Bauer disc diffusion and macrolide-lincosamide-streptogramin B (MLSB) phenotypes identified using D test. The minimum inhibitory concentration (MIC) of vancomycin was determined using agar dilution. hVISA were confirmed by modified population analysis profile-area under the curve (PAP-AUC) test. SCCmec types and Panton-Valentine leukocidin (pvl) were detected using multiplex PCR. Results: Out of 220 MRSA stains, 14 (6.4%) were hVISA. None of the MRSA isolate was vancomycin intermediate or resistant. All hVISA were susceptible to linezolid and teicoplanin. Macrolide-streptogramin B (MSB) phenotype was present in 42.9% hVISA. 92.9% hVISA strains had vancomycin MIC in the range 1-2 µg/mL. Majority of hVISA and vancomycin susceptible MRSA were isolated from skin and soft tissue infections. SCCmec III and IV were present in 50% and 35.7% hVISA respectively. 14.3% hVISA harboured SCCmec V. Conclusion: The rate of hVISA among MRSA was 6.4%. MRSA strains should be tested for hVISA before starting vancomycin treatment. None of the isolates was vancomycin intermediate or resistant. All the hVISA strains were susceptible to linezolid and teicoplanin. The majority of hVISA were isolated from skin and soft tissue infections. The majority hVISA harboured SCCmec III and IV. Keywords: MRSA; Hospital infection; Molecular typing; Vancomyci

Evaluation of role of Tigecycline among clinically significant multidrug resistant pathogens from a tertiary care hospital [version 1; peer review: 2 approved]

Background Tigecycline, a glycylcycline antibiotic is a promising option for the treatment of single or multidrug resistant pathogens. The aim of the study was to evaluate the in-vitro Tigecycline susceptibility of various pathogens from clinical samples received at the tertiary care hospitals in South India. Methods The analysis of specimens from patients admitted were carried out in this prospective cross sectional study. The identification and antimicrobial susceptibility testing was performed by semi-automated Vitek 2 systems and Kirby Bauer method. Pattern of data analysis was done by descriptive statistics. Results Among 2574 isolates, 812 isolates were gram positive pathogens and 1762 isolates were gram negative pathogens. Resistance to Tigecycline was more common among gram negative pathogens (18.62%) in comparison to the gram positive pathogens (0.49%). Among 740 Extended Spectrum Beta Lactamases (ESBL) producers such as Klebsiella species & E coli, 629 isolates were susceptible, and 93 isolates were resistant to the tigecycline. All the methicillin resistant Staphylococcus aureus (MRSA) isolates were susceptible to tigecycline. Conclusion Multidrug resistant (MDR) pathogens like Acinetobacter species, and Klebsiella species were found to be highly effective in vitro to tigecycline for elimination of infections caused by both gram positive and gram negative pathogens. The use of combination therapy becomes crucial to prevent the development of Pan Drug resistance

Evaluation of role of Tigecycline among clinically significant multidrug resistant pathogens from a tertiary care hospital [version 2; peer review: 2 approved]

Background Tigecycline, a glycylcycline antibiotic is a promising option for the treatment of single or multidrug resistant pathogens. The aim of the study was to evaluate the in-vitro Tigecycline susceptibility of various pathogens from clinical samples received at the tertiary care hospitals in South India. Methods The analysis of specimens from patients admitted were carried out in this prospective cross sectional study. The identification and antimicrobial susceptibility testing was performed by semi-automated Vitek 2 systems and Kirby Bauer method. Pattern of data analysis was done by descriptive statistics. Results Among 2574 isolates, 812 isolates were Gram positive pathogens and 1762 isolates were Gram negative pathogens. Resistance to Tigecycline was more common among Gram negative pathogens (18.62%) in comparison to the Gram positive pathogens (0.49%). Among 740 Extended Spectrum Beta Lactamases (ESBL) producers such as Klebsiella species & E coli, 629 isolates were susceptible, and 93 isolates were resistant to the tigecycline. All the methicillin resistant Staphylococcus aureus (MRSA) isolates were susceptible to tigecycline. Conclusion Multidrug resistant (MDR) pathogens like Acinetobacter species, and Klebsiella species were found to be highly effective in vitro to tigecycline for elimination of infections caused by both Gram positive and Gram negative pathogens. The use of combination therapy becomes crucial to prevent the development of Pan Drug resistance

Antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin on Enterococcus faecalis: A confocal laser scanning microscopic study [version 1; peer review: 1 approved, 2 approved with reservations]

Background: Sealers with antimicrobial properties play an important role in endodontic therapy success especially against Enterococcus faecalis infection found in failed root canal therapy. Addition of antibiotic agents to endodontic sealers may show significant increase in their antibacterial properties both against anaerobic and aerobic microbes. The purpose of the present study was to evaluate antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin against E. faecalis and post-root canal treatment viability of Enterococcus faecalis on the first and seventh day. Methods: A total of 60 extracted human mandibular premolar teeth were decoronated after initial decontamination with 1% NaOCl. Root length standardized to 12 mm. Canal instrumentation was done using ProTaper Universal file system till size F2 using 5.25% NaOCl. It was then infected with a pure strain of E. faecalis for a period of four days. Obturation was done using plain sealer, (n=30) and sealer-antibiotic combination, (n=30). Half of the teeth were sectioned at 24 hours (S, SA) and other half were sectioned seven days after obturation (S7, SA7). All samples were stained with SYTO9 and propidium iodide for imaging under Confocal Laser Scanning microscope. Statistical analysis was performed with the statistical software SPSS v. 17.0 (SPSS for Windows; SPSS Inc, Chicago, IL). Data was analysed using One Way ANOVA and post hoc Tukey test to determine statistical significance with p value < 0.01 considered significant. Results: Statistically significant differences were observed in green to red ratio between group S (9.561976) and S7 (0.435418) (p < 0.01). There was no difference found between SA (mean of green to red ratio, (0.70431) and SA7 (mean of green to red ratio, 0.85184). Conclusions: Antibiotics added to the sealer effectively eradicated of E. faecalis 24 hours post-obturation. However, after seven days, plain sealer was as effective as sealer-antibiotic combination

Antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin on Enterococcus faecalis: A confocal laser scanning microscopic study [version 2; peer review: 1 approved, 2 approved with reservations]

Background: Sealers with antimicrobial properties play an important role in endodontic therapy success especially against Enterococcus faecalis infection found in failed root canal therapy. Addition of antibiotic agents to endodontic sealers may show significant increase in their antibacterial properties both against anaerobic and aerobic microbes. The purpose of the present study was to evaluate antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin against E. faecalis and post-root canal treatment viability of Enterococcus faecalis on the first and seventh day. Methods: A total of 60 extracted human mandibular premolar teeth were decoronated after initial decontamination with 1% NaOCl. Root length standardized to 12 mm. Canal instrumentation was done using ProTaper Universal file system till size F2 using 5.25% NaOCl. It was then infected with a pure strain of E. faecalis for a period of four days. Obturation was done using plain sealer, (n=30) and sealer-antibiotic combination, (n=30). Half of the teeth were sectioned at 24 hours (S, SA) and other half were sectioned seven days after obturation (S7, SA7). All samples were stained with SYTO9 and propidium iodide for imaging under Confocal Laser Scanning microscope. Statistical analysis was performed with the statistical software SPSS v. 17.0 (SPSS for Windows; SPSS Inc, Chicago, IL). Data was analysed using One Way ANOVA and post hoc Tukey test to determine statistical significance with p value < 0.01 considered significant. Results: Statistically significant differences were observed in green to red ratio between group S (9.561976) and S7 (0.435418) (p < 0.01). There was no difference found between SA (mean of green to red ratio, (0.70431) and SA7 (mean of green to red ratio, 0.85184). Conclusions: Antibiotics added to the sealer effectively eradicated of E. faecalis 24 hours post-obturation. However, after seven days, plain sealer was as effective as sealer-antibiotic combination