Antibiotic Sensitivity Pattern of Bacterial Isolates from the Intensive Care Unit of a Tertiary Care Hospital in India

Purpose: To undertake an audit of the antimicrobial (AM) sensitivity pattern of bacterial isolates in the intensive care units (ICU) of a tertiary hospital of Bhavnagar, India.Methods: Retrospective analysis of the indoor case papers of ICUs from January 2010 to 31st March 2011 was carried out at Department of Pharmacology, Govt. Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, India. Information collected include demographic data of the patient, admission unit, duration of hospital stay, diagnosis, type of infection, empirical treatment, indication of the use of the antimicrobials (AMs). Others include collected specimen, causative agent, sensitivitypattern, and treatment changes based on the sensitivity pattern in a case record form. AM sensitivity testing was performed by the modified Kirby Baur method as recommended by clinical and laboratory standard institute (CLSI). Internal and external quality control were maintained for culture and sensitivity method.Results: The most commonly isolated organisms were Klebsiella pneumoniae (28.6 %) and Pseudomonas aeruginosa (16.3 %). Lower respiratory tract infection (LRTI) was the most common infection. Imipenem, meropenem and levofloxacin were the most effective antimicrobials for Gramnegative isolates (GNIs) while vancomycin ciprofloxacin, and gentamicin were the most efficacious antimicrobials for Gram-positive isolates (GPIs). Widespread resistance to third generationcephalosporins and cloxacillin was noted for GNIs and GPIs, respectively. Meropenem (100 %) > levofloxacin (100 %) > sparfloxacin (94.4 %) > gentamicin (83.3 %) was the rank order of antimicrobial activity against LRTI.Conclusion: GNIs were the predominant cause of infection in ICUs. Third generation cephalosporinsresistant GNIs were the predominant resistant organisms. The study showed that fluoroquinolones and aminoglycosides could be used as first line AMs for the effective management of LRTI in a hospital setting.Keywords: Antibiotic sensitivity, Bacterial resistance, Intensive care unit, Tertiary hospita

Breath-hold FSE for accurate imaging of myocardial and hepatic R2

Session 21: Hepatic Storage Disease - Oral presentationMRI provides a means to non-invasively assess tissue iron concentration by exploiting the paramagnetic effects of iron on T2 or T2*. The most widely used method is T2* imaging is sensitive to non-iron related magnetic field (B0) inhomogeneities, which can confound T2* measurements within the whole heart and liver. An alternative method is T2 imaging, but they are generally performed during free breathing with respiratory gating due to their low data acquisition efficiency. The purpose of this study was to develop a breath-hold fast spin echo (FSE) sequence for fast and accurate imaging of myocardial and hepatic T2.published_or_final_versionThe 17th Scientific Meeting & Exhibition of the International Society of Magnetic Resonance in Medicine (ISMRM), Honolulu, HI., 18-24 April 2009. In Proceedings of ISMRM 17th Scientific Meeting & Exhibition, 2009, p. 20

R2 imaging of ferritin iron in thalassaemia patients off and on iron-chelation therapy

Myocardial Tissue Characterization: Fat, Hemorrhage & Edema - Poster presentationAccurate assessment of iron burden is crucial for the management of iron-chelation therapy. MRI provides a means to non-invasively assess tissue iron concentration by exploiting the paramagnetic effects of iron on the relaxation rates of solvent protons. The most widely used method is R2* imaging, which has been shown to be sensitive to myocardial iron overload. Recently, a breath-hold fast spin echo sequence has been proposed for fast and accurate imaging of myocardial and hepatic R2. The purpose of this study was to determine which relaxation rates are sensitive to iron-chelation therapy.published_or_final_versionThe 17th Scientific Meeting & Exhibition of the International Society of Magnetic Resonance in Medicine (ISMRM), Honolulu, HI., 18-24 April 2009. In Proceedings of ISMRM 17th Scientific Meeting & Exhibition, 2009, p. 375

Emplacement of inflated Pāhoehoe flows in the Naude’s Nek Pass, Lesotho remnant, Karoo continental flood basalt province: use of flow-lobe tumuli in understanding flood basalt emplacement

Physical volcanological features are presented for a 710-m-thick section, of the Naude’s Nek Pass, within the lower part of the Lesotho remnant of the Karoo Large Igneous Province. The section consists of inflated pāhoehoe lava with thin, impersistent sedimentary interbeds towards the base. There are seven discreet packages of compound and hummocky pāhoehoe lobes containing flow-lobe tumuli, making up approximately 50% of the section. Approximately 45% of the sequence consists of 14 sheet lobes, between 10 and 52-m-thick. The majority of the sheet lobes are in two packages indicating prolonged periods of lava supply capable of producing thick sheet lobes. The other sheet lobes are as individual lobes or pairs, within compound flows, suggesting brief increases in lava supply rate. We suggest, contrary to current belief, that there is no evidence that compound flows are proximal to source and sheet lobes (simple flows) are distal to source and we propose that the presence of flow-lobe tumuli in compound flows could be an indicator that a flow is distal to source. We use detailed, previously published, studies of the Thakurvadi Formation (Deccan Traps) as an example. We show that the length of a lobe and therefore the sections that are ‘medial or distal to source’ are specific to each individual lobe and are dependent on the lava supply of each eruptive event, and as such flow lobe tumuli can be used as an indicator of relative distance from source

A unified framework for managing provenance information in translational research

<p>Abstract</p> <p>Background</p> <p>A critical aspect of the NIH <it>Translational Research </it>roadmap, which seeks to accelerate the delivery of "bench-side" discoveries to patient's "bedside," is the management of the <it>provenance </it>metadata that keeps track of the origin and history of data resources as they traverse the path from the bench to the bedside and back. A comprehensive provenance framework is essential for researchers to verify the quality of data, reproduce scientific results published in peer-reviewed literature, validate scientific process, and associate trust value with data and results. Traditional approaches to provenance management have focused on only partial sections of the translational research life cycle and they do not incorporate "domain semantics", which is essential to support domain-specific querying and analysis by scientists.</p> <p>Results</p> <p>We identify a common set of challenges in managing provenance information across the <it>pre-publication </it>and <it>post-publication </it>phases of data in the translational research lifecycle. We define the semantic provenance framework (SPF), underpinned by the Provenir upper-level provenance ontology, to address these challenges in the four stages of provenance metadata:</p> <p>(a) Provenance <b>collection </b>- during data generation</p> <p>(b) Provenance <b>representation </b>- to support interoperability, reasoning, and incorporate domain semantics</p> <p>(c) Provenance <b>storage </b>and <b>propagation </b>- to allow efficient storage and seamless propagation of provenance as the data is transferred across applications</p> <p>(d) Provenance <b>query </b>- to support queries with increasing complexity over large data size and also support knowledge discovery applications</p> <p>We apply the SPF to two exemplar translational research projects, namely the Semantic Problem Solving Environment for <it>Trypanosoma cruzi </it>(<it>T.cruzi </it>SPSE) and the Biomedical Knowledge Repository (BKR) project, to demonstrate its effectiveness.</p> <p>Conclusions</p> <p>The SPF provides a unified framework to effectively manage provenance of translational research data during pre and post-publication phases. This framework is underpinned by an upper-level provenance ontology called Provenir that is extended to create domain-specific provenance ontologies to facilitate provenance interoperability, seamless propagation of provenance, automated querying, and analysis.</p

Imaging-guided chest biopsies: techniques and clinical results

Background This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. Methods Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive. Results Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy. Conclusion Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications

Geochemical characterization of oceanic basalts using Artificial Neural Network

The geochemical discriminate diagrams help to distinguish the volcanics recovered from different tectonic settings but these diagrams tend to group the ocean floor basalts (OFB) under one class i.e., as mid-oceanic ridge basalts (MORB). Hence, a method is specifically needed to identify the OFB as normal (N-MORB), enriched (E-MORB) and ocean island basalts (OIB)

A Semantic Problem Solving Environment for Integrative Parasite Research: Identification of Intervention Targets for Trypanosoma cruzi

Effective research in parasite biology requires analyzing experimental lab data in the context of constantly expanding public data resources. Integrating lab data with public resources is particularly difficult for biologists who may not possess significant computational skills to acquire and process heterogeneous data stored at different locations. Therefore, we develop a semantic problem solving environment (SPSE) that allows parasitologists to query their lab data integrated with public resources using ontologies. An ontology specifies a common vocabulary and formal relationships among the terms that describe an organism, and experimental data and processes in this case. SPSE supports capturing and querying provenance information, which is metadata on the experimental processes and data recorded for reproducibility, and includes a visual query-processing tool to formulate complex queries without learning the query language syntax. We demonstrate the significance of SPSE in identifying gene knockout targets for T. cruzi. The overall goal of SPSE is to help researchers discover new or existing knowledge that is implicitly present in the data but not always easily detected. Results demonstrate improved usefulness of SPSE over existing lab systems and approaches, and support for complex query design that is otherwise difficult to achieve without the knowledge of query language syntax

Tackling health literacy: adaptation of public hypertension educational materials for an Indo-Asian population in Canada

<p>Abstract</p> <p>Background</p> <p>Indo-Asians in Canada are at increased risk for cardiovascular diseases. There is a need for cultural and language specific educational materials relating to this risk. During this project we developed and field tested the acceptability of a hypertension public education pamphlet tailored to fit the needs of an at risk local Indo-Asian population, in Calgary, Alberta, Canada.</p> <p>Methods</p> <p>A community health board representing Calgary's Indo-Asian communities identified the culturally specific educational needs and language preferences of the local population. An adaptation of an existing English language Canadian Public Hypertension Recommendations pamphlet was created considering the literacy and translation challenges. The adapted pamphlet was translated into four Indo-Asian languages. The adapted pamphlets were disseminated as part of the initial educational component of a community-based culturally and language-sensitive cardiovascular risk factor screening and management program. Field testing of the materials was undertaken when participants returned for program follow-up seven to 12 months later.</p> <p>Results</p> <p>Fifty-nine English-speaking participants evaluated and confirmed the concept validity of the English adapted version. 28 non-English speaking participants evaluated the Gujarati (N = 13) and Punjabi (N = 15) translated versions of the adapted pamphlets. All participants found the pamphlets acceptable and felt they had improved their understanding of hypertension.</p> <p>Conclusions</p> <p>Involving the target community to identify health issues as well as help to create culturally, language and literacy sensitive health education materials ensures resources are highly acceptable to that community. Minor changes to the materials will be needed prior to formal testing of hypertension knowledge and health decision-making on a larger scale within this at risk community.</p