Clinical profile of hospital acquired pneumonia in a tertiary care hospital, South India

Background: Hospital acquired infections continue to be an important cause of morbidity and mortality among hospitalized patients. Hospital acquired pneumonia (HAP) results in a significant increase in the cost of care of hospitalized patients. Its development prolongs a patient’s stay in the Intensive Care Unit (ICU). Accurate information concerning the clinical profile of HAP is lacking in South India. This study was conducted prospectively to evaluate the clinical profile of HAP in ICU patients.Methods: This prospective study was conducted over a period of one year among 2454 patients admitted in IMCU of Coimbatore Medical College & Hospital, Tamil Nadu. The specimens’ sputum, bronchoscopic alveolar lavage (BAL) and endotracheal aspirate (ETA) were collected for microbiological confirmation and processed using standard laboratory techniques.Results: Out of 2454 cases, 253 (10.3%) patients developed HAP.  The incidence of HAP was higher (55.73%) in the age group more than 60 years. Out of 1352 patients on mechanical ventilation, 62.0% of patients (n=157) developed HAP.Conclusions: This study provides an insight into the incidence of HAP with the occurrence being most in the age group more than 60 years. Our study also highlights that mechanical ventilation was an important risk factor for the development of HAP.

Epidemiological and Bacteriological profile of Hospital Acquired Pneumonia with special reference to Klebsiella Pneumoniae and its characterization by Antibiogram and Klebocin typing.

INTRODUCTION : Hospital acquired infections continue to be an important cause of morbidity and mortality among hospitalized patients. The critically ill patient is at particular risk of developing ICU acquired infection, with the lungs being especially vulnerable. Hospital acquired pneumonia (HAP) is currently the second most common hospital infection accounting for 13 to 18 percent of all nosocomial infections, with estimates of associated mortality ranging from 20 to 50 percent. The majority of cases of HAP occur outside of ICUs. However the highest risk is in patients on mechanical ventilation. Estimates of incidence range from 4 to 7 episodes per 1000 hospitalizations. Intubated patients may have rates of pneumonia 7 to 21- fold higher than patients without a respiratory therapy device. Infection rates are twice as high in large teaching hospitals as compared with smaller institutions. Though HAP is widely analyzed by many researchers, not much is known about the incidence and bacteriological profile i.e., only few studies are being published by them. This study is conducted prospectively to evaluate the clinical and bacteriological profile of HAP in ICU patients. It may increase the awareness of clinicians about the need to reduce the morbidity and mortality by coming to know about the various pathogens causing HAP and its sensitivity and/or resistance to various antibiotics. The clinicians need to establish a suitable antibiotic policy by working out local ICU antibiogram charts. This study is also done to find out the prevalence of ESBL producers in HAP. Klebocin typing in association with antibiogram may help to find out the source of Hospital Acquired Infections. AIMS AND OBJECTIVES : To analyze the incidence, epidemiology, antimicrobial susceptibility pattern of isolates from HAP patients in IMCU and klebocin typing of Klebsiella pneumoniae isolated in HAP. OBJECTIVES: 1. To study the incidence of Hospital Acquired Pneumonia (HAP) among patients admitted in IMCU. 2. To evaluate the Clinical and Bacteriological profile of HAP. 3. To determine the antibiotic susceptibility pattern of the all bacteria isolated. 4. To find out the prevalence of ESBL producers in HAP. 5. To evaluate the role of Klebocin typing in epidemiological typing of K.pneumoniae strains. 6. To detect the source of infection in IMCU using antibiogram and klebocin typing. MATERIALS AND METHODS : This prospective study was conducted over a period of one year among patients admitted in Intensive Medical Care Unit (IMCU) of Coimbatore Medical College & Hospital, Tamil Nadu. The study population comprised all patients admitted to the IMCU from May 1, 2007 to April 30, 2008. Approval was obtained from the Ethical Committee prior to conducting the study and informed consent from all patients under study was also obtained. HAP was diagnosed based on standard diagnostic criteria adapted by the Centers for Disease Control and Prevention for the diagnosis of pneumonia if signs of pneumonia occurred after 48 hours following IMCU admission. HAP was considered when new or progressive chest radiographical infiltrates occurred ≥48 hours after hospital admission in conjunction with the following clinical criteria: At least one of the following: 1. Fever (> 38° C/ 100.4° F) with no other recognized cause 2. Leukocytosis (≥ 12,000 WBC/mm3) or leucopenia (< 4,000 WBC/mm3) 3. For adults ≥ 70 years old, altered mental status with no other recognized cause. RESULTS : During the one-year study period, among 2658 patients admitted to the IMCU, only 2454 cases were followed and included in this study. The remaining 204 cases were excluded. (118 died within 48hrs of admission, 86 were discharged or went home against advice). Among 2454 patients, 64% of patients (n=1570) were males and 36% (n=884) were females. The mean age was 59.96 with the range of 15 to 89 yrs old. 35% of the patients were more than 60yrs of age. Out of 2454 cases, 253(10.3%) patients developed HAP. The highest incidence of HAP (55.73%) was observed in the age group more than 60 years. CONCLUSION : The incidence of HAP was 10.3% with the occurrence being most in the age group more than 60 years. Mechanical ventilation was a important risk factor for the development of HAP. Klebsiella pneumoniae, Pseudomonas aeruginosa, E.coli, Acinetobacter, Proteus spp, and MRSA were the most common bacterial isolates. The most effective antibiotics against the GNB isolated from HAP patients were Imipenem followed by Cefepime and Gatifloxacin. The antibiotic susceptibility pattern of the isolates will help the clinicians to choose the appropriate antimicrobial agents for prophylactic as well as treatment purposes. When klebocin typing was used in association with antibiogram, in 86.84% cases of nosocomial Klebsiella infection probable source of infection could be detected. Thus a combination of these two typing methods poses a contribution in epidemiological studies

Evaluation of organophosphorus and synthetic pyrethroid insecticides against six vector mosquitoe species

Três compostos organo-fosforados - malation, folition e temefos -e dois piretroides sintéticos - alfametrina e deltametrina - foram usados para controlar o estado da susceptibilidade das larvas e adultos de seis mosquitos vetores na Índia. Foram utilizadas cepas de laboratório e área de Culex quinquefasciatus (filariasis) e Aedes albopictus (Dengue) e cepas de laboratório de Aedes aegypti (Dengue), Anopheles stephensi e Anopheles culicifacies (Malária) e Culex tritaenorhynchus (encefalite japonesa). Os valores de C1(50) obtidos para esses inseticidas mostram que todas as espécies incluindo as cepas de área foram muito susceptíveis. Nos mosquitos adultos das referidas espécies salvo na cepa da área de Culex quinquefasciatus com o malathion, observou-se 100% da mortalidade às doses discriminatórias recomendadas pela Organização Mundial de Saúde. O efeito residual da alfametrina, deltametrina, malation e folition a 25 mg (ai)/m² em diversas superfícies contra seis espécies de mosquitos vetores evidenciou que a alfametrina foi a mais efetiva em todas as superfícies tratadas (argila, "plywood", cimento e palha).Three organophosphorus compounds- malathion, folithion and temephos- and two synthetic pyrethroids- alphamethrin and deltamethrin- were used for monitoring the susceptibility status of larvae and adults of six vector mosquitoe species: Culex quinquefasciatus (Filariasis) and Aedes albopictus (Dengue) (both laboratory and field strains); laboratory strains of Aedes aegypti (Dengue), Anopheles slephensi and Anopheles culicifacies (Malaria), and Culex tritaeniorhynchus (Japanese encephalitis) in India. From the LC50 values obtained for these insecticides, it was found that all mosquito species including the field strains of Cx. quinquefasciatus and Ae. albopictus were highly susceptible Except for Cx. quinquefasciatus (field strain) against malathion, 100% mortality was observed at the discriminating dosages recommended by World Health Organization. The residual effect of alphamethrin, deltamethrin, malathion and folithion at 25 mg (ai)/m² on different surfaces against six species of vector mosquitoes showed that alphamethrin was the most effective on all four treated surfaces (mud, plywood, cement and thatch). Nevertheless, residual efficacy lasted longer on thatch than on the other surfaces. Therefore, synthetic pyrethroids such as alphamethrin can be effectively employed in integrated vector control operations

Bio synthesis, Characterization of ZnO Nanoparticles from Scoparia dulcis L. plant extract and its in-vitro Antioxidant, Acetylcholinesterase Activity

The current investigation is focused on the use of green synthesis methods for zinc oxide nanoparticles (ZnO NPs) from Scoparia dulcis L. extract (SDE). SDE-mediated ZnO NPs (SDE-ZnO-NPs) were made using a simple and eco-friendly method that required little reaction time and calcinations temperature. UV-Vis, FTIR, X-ray powder diffraction, SEM, TEM &amp; EDAX were used into characterizes the skeletal and synthetic properties concerning biosynthesized ZnO nonmaterial. The UV–Visible spectroscopy absorption peak for SDE-ZnO-NPs was found to be at 380 nm, confirming the production of ZnO NPs. The FTIR spectrum also revealed bioactive functional groups as well as metal-oxygen groups. Synthesized ZnO NPs had a rod shape in 200 nm, according to TEM examination. The Zn and O in the produced ZnO NPs were approved by the EDAX analysis. The XRD results revealed that it had a crystal structure that was similar to SDE-ZnO-NPs. The dose-related Acetylcholinesterase inhibitory action of SDE-ZnO NPs was determined utilizing the Ellman’s test. AChE activity of the synthesized nanoparticles showed potential inhibitory activity with IC50 values of 75.34 µg/mL. The antioxidant activity was investigated the biosynthesized ZnO-NPs using DPPH, ABTS assay

RT-PCR assay for the detection of infective (L3) larvae of lymphatic filarial parasite, Wuchereria bancrofti, in vector mosquito Culex quinquefasciatus

Background & objectives: Periodic monitoring of vector population for infection and infectivity rates is central to the evaluation of the filariasis elimination strategies in endemic areas to monitor the success of MDA and also to establish endpoints for intervention. The main objective of this study was to develop a RT-PCR assay, based on L3 stage-specific primers to detect the presence of infective stage larvae of filarial parasite, Wuchereria bancrofti in the vector Culex quinquefasciatus. Material & Methods: Subtracted probe development technique was employed for the identification of infective stage (L3) specific genes. The subtracted cDNA was labeled by non-radioisotopic method and used for screening cDNA library of L3 stage larvae of W. bancrofti constructed in UniZap XR. Recombinants were probed and identified from the library. The inserts of the recombinant clones were purified and sequenced. Primers were designed based on the sequence information of three recombinant clones for detecting L3 larvae of W. bancrofti in the vector by RT-PCR assay. Preliminary laboratory evaluation was carried out to assess the sensitivity and specificity of WbL31 RT-PCR assay.Results: cDNA library of L3 stage of W. bancrofti constructed in UniZap XR vector, constituted 5×105 phages with 80–90% recombinant phages and the size of inserts varied from 0.1 to 1.0 kb. When subtracted cDNA was random prime labeled and used for screening cDNA library of L3 stage of W. bancrofti constructed in UniZap XR, 18 clones were identified from the library. Three genes were found up-regulated in the L3 stage, out of which WbL31 (cuticular collagen) was found to be useful in detecting L3 larvae of W. bancrofti in the vector by RT-PCR assay with high specificity and sensitivity (98–100% ). Conclusion: Present paper marks first report on the development of an infective stage-specific RT-PCR assay (WbL31 RT-PCR assay) to detect L3 stage W. bancrofti in the vector. This assay will have potential application in assessing the transmission of infection and hence in decision-making related to elimination programme

Influence of deficit irrigation and nano NK application on root dynamics, physiology and WUE of transplanted rice (Oryza sativa)

A field experiment was conducted during the rainy (kharif) (June–September, 2022) and winter (rabi) (December 2022–March, 2023) seasons at Agricultural College and Research Institute (Tamil Nadu Agricultural University, Coimbatore, Tamil Nadu), Madurai, Tamil Nadu to study the effect of irrigation methods and nutrient management strategies on the growth of roots, physiological aspects, yield and water use efficiency of transplanted rice (Oryza sativa L.). Experiment was conducted in a split-plot design comprised of 3 irrigation methods, viz. Irrigation at 15 cm depletion of water level in field water tube (M1); Alternate wetting and drying (M2); Conventional flooding (M3) in main plot and 7 nutrient management strategies, viz. Application of 50% N + nano urea as foliar spray (S1); 75% N + nano urea as foliar spray (S2); 50% K + nano potash as foliar spray (S3); 75% K + nano potash as foliar spray (S4); 50 and 75% N and K + nano urea and potash as foliar spray (S5); 100% RDF (S6); and absolute control (S7) in sub plot, replicated thrice. Results indicated that under M1S2, root characteristics like length, volume and dry weight were notably higher. Physiological attributes such as stomatal conductance, transpiration and photosynthetic rate recorded high with M2S5. However, the maximum yield and water use efficiency were observed with M2S5. In conclusion, the treatment combination M2S5 is considered as practical recommendation for farmers in the Periyar Vaigai command area, ensuring optimal yield while economically utilizing water and fertilizers

Cauchyness and convergence in fuzzy metric spaces

[EN] In this paper we survey some concepts of convergence and Cauchyness appeared separately in the context of fuzzy metric spaces in the sense of George and Veeramani. For each convergence (Cauchyness) concept we find a compatible Cauchyness (convergence) concept. We also study the relationship among them and the relationship with compactness and completeness (defined in a natural sense for each one of the Cauchy concepts). In particular, we prove that compactness implies p-completeness.Almanzor Sapena acknowledges the support of Ministry of Economy and Competitiveness of Spain under grant TEC2013-45492-R. Valentín Gregori acknowledges the support of Ministry of Economy and Competitiveness of Spain under grant MTM 2012-37894-C02-01.Gregori Gregori, V.; Miñana, J.; Morillas, S.; Sapena Piera, A. (2017). Cauchyness and convergence in fuzzy metric spaces. Revista de la Real Academia de Ciencias Exactas Físicas y Naturales Serie A Matemáticas. 111(1):25-37. https://doi.org/10.1007/s13398-015-0272-0S25371111Alaca, C., Turkoglu, D., Yildiz, C.: Fixed points in intuitionistic fuzzy metric spaces. Chaos Solitons Fractals 29, 1073–1078 (2006)Edalat, A., Heckmann, R.: A computational model for metric spaces. Theor. Comput. Sci. 193, 53–73 (1998)Engelking, R.: General topology. PWN-Polish Sci. Publ, Warsawa (1977)Fang, J.X.: On fixed point theorems in fuzzy metric spaces. Fuzzy Sets Syst. 46(1), 107–113 (1992)George, A., Veeramani, P.: On some results in fuzzy metric spaces. Fuzzy Sets Syst. 64, 395–399 (1994)George, A., Veeramani, P.: Some theorems in fuzzy metric spaces. J. Fuzzy Math. 3, 933–940 (1995)George, A., Veeramani, P.: On some results of analysis for fuzzy metric spaces. Fuzzy Sets Syst. 90, 365–368 (1997)Grabiec, M.: Fixed points in fuzzy metric spaces. Fuzzy Sets Syst. 27, 385–389 (1989)Gregori, V., Romaguera, S.: Some properties of fuzzy metric spaces. Fuzzy Sets Syst. 115, 485–489 (2000)Gregori, V., Romaguera, S.: On completion of fuzzy metric spaces. Fuzzy Sets Syst. 130, 399–404 (2002)Gregori, V., Romaguera, S.: Characterizing completable fuzzy metric spaces. Fuzzy Sets Syst. 144, 411–420 (2004)Gregori, V., López-Crevillén, A., Morillas, S., Sapena, A.: On convergence in fuzzy metric spaces. Topol. Appl. 156, 3002–3006 (2009)Gregori, V., Miñana, J.J.: Some concepts realted to continuity in fuzzy metric spaces. In: Proceedings of the conference in applied topology WiAT’13, pp. 85–91 (2013)Gregori, V., Miñana, J.-J., Sapena, A.: On Banach contraction principles in fuzzy metric spaces (2015, submitted)Gregori, V., Miñana, J.-J.: std-Convergence in fuzzy metric spaces. Fuzzy Sets Syst. 267, 140–143 (2015)Gregori, V., Miñana, J.-J.: Strong convergence in fuzzy metric spaces Filomat (2015, accepted)Gregori, V., Miñana, J.-J., Morillas, S.: Some questions in fuzzy metric spaces. Fuzzy Sets Syst. 204, 71–85 (2012)Gregori, V., Miñana, J.-J., Morillas, S.: A note on convergence in fuzzy metric spaces. Iran. J. Fuzzy Syst. 11(4), 75–85 (2014)Gregori, V., Morillas, S., Sapena, A.: On a class of completable fuzzy metric spaces. Fuzzy Sets Syst. 161, 2193–2205 (2010)Gregori, V., Morillas, S., Sapena, A.: Examples of fuzzy metric spaces and applications. Fuzzy Sets Syst. 170, 95–111 (2011)Kramosil, I., Michalek, J.: Fuzzy metric and statistical metric spaces. Kybernetika 11, 326–334 (1975)Mihet, D.: On fuzzy contractive mappings in fuzzy metric spaces. Fuzzy Sets Syst. 158, 915–921 (2007)Mihet, D.: Fuzzy $$\varphi$$ φ -contractive mappings in non-Archimedean fuzzy metric spaces. Fuzzy Sets Syst. 159, 739–744 (2008)Mihet, D.: A Banach contraction theorem in fuzzy metric spaces. Fuzzy Sets Syst. 144, 431–439 (2004)Mishra, S.N., Sharma, N., Singh, S.L.: Common fixed points of maps on fuzzy metric spaces Internat. J. Math. Math. Sci. 17(2), 253–258 (1994)Morillas, S., Sapena, A.: On Cauchy sequences in fuzzy metric spaces. In: Proceedings of the conference in applied topology (WiAT’13), pp. 101–108 (2013)Ricarte, L.A., Romaguera, S.: A domain-theoretic approach to fuzzy metric spaces. Topol. Appl. 163, 149–159 (2014)Sherwood, H.: On the completion of probabilistic metric spaces. Z.Wahrschein-lichkeitstheorie verw. Geb. 6, 62–64 (1966)Sherwood, H.: Complete Probabilistic Metric Spaces. Z. Wahrschein-lichkeitstheorie verw. Geb. 20, 117–128 (1971)Tirado, P.: On compactness and G-completeness in fuzzy metric spaces. Iran. J. Fuzzy Syst. 9(4), 151–158 (2012)Tirado, P.: Contraction mappings in fuzzy quasi-metric spaces and [0,1]-fuzzy posets. Fixed Point Theory 13(1), 273–283 (2012)Vasuki, R., Veeramani, P.: Fixed point theorems and Cauchy sequences in fuzzy metric spaces. Fuzzy Sets Syst. 135(3), 415–417 (2003)Veeramani, P.: Best approximation in fuzzy metric spaces. J. Fuzzy Math. 9, 75–80 (2001

Incremental dimension reduction of tensors with random index

We present an incremental, scalable and efficient dimension reduction technique for tensors that is based on sparse random linear coding. Data is stored in a compactified representation with fixed size, which makes memory requirements low and predictable. Component encoding and decoding are performed on-line without computationally expensive re-analysis of the data set. The range of tensor indices can be extended dynamically without modifying the component representation. This idea originates from a mathematical model of semantic memory and a method known as random indexing in natural language processing. We generalize the random-indexing algorithm to tensors and present signal-to-noise-ratio simulations for representations of vectors and matrices. We present also a mathematical analysis of the approximate orthogonality of high-dimensional ternary vectors, which is a property that underpins this and other similar random-coding approaches to dimension reduction. To further demonstrate the properties of random indexing we present results of a synonym identification task. The method presented here has some similarities with random projection and Tucker decomposition, but it performs well at high dimensionality only (n>10^3). Random indexing is useful for a range of complex practical problems, e.g., in natural language processing, data mining, pattern recognition, event detection, graph searching and search engines. Prototype software is provided. It supports encoding and decoding of tensors of order >= 1 in a unified framework, i.e., vectors, matrices and higher order tensors.Comment: 36 pages, 9 figure