Nosocomial Wound Infection amongst Post Operative Patients and their Antibiograms at Tertiary Care Hospital in India

Nosocomial infection constitutes a major public health problem worldwide. Increasing antibiotic resistance of pathogens associated with nosocomial infections also becomes a major therapeutic challenge for physicians. Thus, the aim of this study was to identify post operative bacterial infections in the patients developing surgical site infections at a tertiary University hospital in North India during July 2013 to Dec 2013.Methods: One hundred and ninety six swabs/pus specimens from various types of surgical sites suspected to be infected onclinical grounds were processed, by standard methods and antibiotic susceptibility testing of all the isolates was done by usingKirby Baur disc diffusion technique.Results: Of the one hundred and fifty-eight organisms isolated, the most common was Staphylococcus aureus (27.8 %), followedby Escherchia coli (24.05 %), Klebsiella pneumoniae (13.29 %), Pseudomonas aeruginosa (6.32%), Klebsiella oxytoca (5%),Enterococcus (5.6%) and other miscellaneous gram negative rods (9.4%) and Streptococcus pyogenes (1.30%). About 50% of theStaphylococcus aureus isolates were found to be methicillin resistant. In case of Escherichia coli, more than one-third of the isolates were found to be ESBL producers. The resistance to third generation cephalosporins and the quinolone ciprofloxacin was also quite high. Other isolates also showed a very high level of antibiotic resistance.Conclusion: In addition to the economic burden for antibiotic treatment, such infections for multi-resistant organisms are a serious threat to our surgical patients. To prevent these happenings, there is ar urgent need to adopt basic principles of asepsis and sterilization and to make judicious use of prophylactic and therapeutic antibiotics and determine current antimicrobial resistance to commonly prescribed drugs.Keywords: Wound infection; microorganisms; anti-microbial sensitivit

Bulk viscous cosmological model with interacting dark fluids

The objective of the present work is to study a cosmological model for a spatially flat Universe whose constituents are a dark energy field and a matter field which includes baryons and dark matter. The constituents are supposed to be in interaction and irreversible processes are taken into account through the inclusion of a non-equilibrium pressure. The non-equilibrium pressure is considered to be proportional to the Hubble parameter within the framework of a first order thermodynamic theory. The dark energy and matter fields are coupled by their barotropic indexes, which are considered as functions of the ratio between their energy densities. The free parameters of the model are adjusted from the best fits of the Hubble parameter data. A comparison of the viscous model with the non-viscous one is performed. It is shown that the equality of the dark energy and matter density parameters and the decelerated-accelerated transition occur at earlier times when the irreversible processes are present. Furthermore, the density and deceleration parameters and the distance modulus have the correct behavior which is expected for a viable scenario of the present status of the Universe.Comment: 10 pages, 7 figures, to be published in Brazilian Journal of Physic

Brane-World Gravity

The observable universe could be a 1+3-surface (the "brane") embedded in a 1+3+\textit{d}-dimensional spacetime (the "bulk"), with Standard Model particles and fields trapped on the brane while gravity is free to access the bulk. At least one of the \textit{d} extra spatial dimensions could be very large relative to the Planck scale, which lowers the fundamental gravity scale, possibly even down to the electroweak ($\sim$ TeV) level. This revolutionary picture arises in the framework of recent developments in M theory. The 1+10-dimensional M theory encompasses the known 1+9-dimensional superstring theories, and is widely considered to be a promising potential route to quantum gravity. At low energies, gravity is localized at the brane and general relativity is recovered, but at high energies gravity "leaks" into the bulk, behaving in a truly higher-dimensional way. This introduces significant changes to gravitational dynamics and perturbations, with interesting and potentially testable implications for high-energy astrophysics, black holes, and cosmology. Brane-world models offer a phenomenological way to test some of the novel predictions and corrections to general relativity that are implied by M theory. This review analyzes the geometry, dynamics and perturbations of simple brane-world models for cosmology and astrophysics, mainly focusing on warped 5-dimensional brane-worlds based on the Randall--Sundrum models. We also cover the simplest brane-world models in which 4-dimensional gravity on the brane is modified at \emph{low} energies -- the 5-dimensional Dvali--Gabadadze--Porrati models. Then we discuss co-dimension two branes in 6-dimensional models.Comment: A major update of Living Reviews in Relativity 7:7 (2004) "Brane-World Gravity", 119 pages, 28 figures, the update contains new material on RS perturbations, including full numerical solutions of gravitational waves and scalar perturbations, on DGP models, and also on 6D models. A published version in Living Reviews in Relativit

The Cosmological Constant

This is a review of the physics and cosmology of the cosmological constant. Focusing on recent developments, I present a pedagogical overview of cosmology in the presence of a cosmological constant, observational constraints on its magnitude, and the physics of a small (and potentially nonzero) vacuum energy.Comment: 50 pages. Submitted to Living Reviews in Relativity (http://www.livingreviews.org/), December 199

Hepatobiliary and pancreatic tuberculosis: A two decade experience

<p>Abstract</p> <p>Background</p> <p>Isolated hepatobiliary or pancreatic tuberculosis (TB) is rare and preoperative diagnosis is difficult. We reviewed our experience over a period two decades with this rare site of abdominal tuberculosis.</p> <p>Methods</p> <p>The records of 18 patients with proven histological diagnosis of hepatobiliary and pancreatic tuberculosis were reviewed retrospectively. The demographic features, sign and symptoms, imaging, cytology/histopathology, procedures performed, outcome and follow up data were obtained from the departmental records. The diagnosis of tuberculosis was based on granuloma with caseation necrosis on histopathology or presence of acid fast bacilli.</p> <p>Results</p> <p>Of 18 patients (11 men), 11 had hepatobiliary TB while 7 had pancreatic TB. Two-thirds of the patients were < 40 years (mean: 42 yrs; range 19–70 yrs). The duration of the symptoms varied between 2 weeks to 104 weeks (mean: 20 weeks). The most common symptom was pain in the abdomen (n = 13), followed by jaundice (n = 10), fever, anorexia and weight loss (n = 9). Five patients (28%) had associated extra-abdominal TB which helped in preoperative diagnosis in 3 patients. Imaging demonstrated extrahepatic bile duct obstruction in the patients with jaundice and in addition picked up liver, gallbladder and pancreatic masses with or without lymphadenopathy (peripancreatic/periportal). Preoperative diagnosis was made in 4 patients and the other 14 were diagnosed after surgery. Two patients developed significant postoperative complications (pancreaticojejunostomy leak <abbrgrp><abbr bid="B1">1</abbr></abbrgrp> intraabdominal abscess <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>) and 3 developed ATT induced hepatotoxicity. No patient died. The median follow up period was 12 months (9 – 96 months).</p> <p>Conclusion</p> <p>Tuberculosis should be considered as a differential diagnosis, particularly in young patients, with atypical signs and symptoms coming from areas where tuberculosis is endemic and preoperative tissue and/or cytological diagnosis should be attempted before labeling them as hepatobiliary and pancreatic malignancy.</p

Stochastic backgrounds of relic gravitons: a theoretical appraisal

Stochastic backgrounds or relic gravitons, if ever detected, will constitute a prima facie evidence of physical processes taking place during the earliest stages of the evolution of the plasma. The essentials of the stochastic backgrounds of relic gravitons are hereby introduced and reviewed. The pivotal observables customarily employed to infer the properties of the relic gravitons are discussed both in the framework of the $\Lambda$CDM paradigm as well as in neighboring contexts. The complementarity between experiments measuring the polarization of the Cosmic Microwave Background (such as, for instance, WMAP, Capmap, Quad, Cbi, just to mention a few) and wide band interferometers (e.g. Virgo, Ligo, Geo, Tama) is emphasized. While the analysis of the microwave sky strongly constrains the low-frequency tail of the relic graviton spectrum, wide-band detectors are sensitive to much higher frequencies where the spectral energy density depends chiefly upon the (poorly known) rate of post-inflationary expansion.Comment: 94 pages, 32 figure