Extended-spectrum β-lactamase and AmpC β-lactamase Production among Gram-negative Bacilli Isolates Obtained from Urinary Tract Infections and Wound Infections

Extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases continue to be a major problem in healthcare settings. Due to the scarcity of information regarding the antibiotic susceptibility patterns particularly from urinary tract infection (UTI) and wound infections, the current study was carried out to assist the clinicians to prescribe appropriate antibiotics against Gram-negative clinical isolates. In the current study, urine (n = 620) and pus (n = 228) samples were collected from different sites (at various clinical departments) and subjected to direct microscopic examination, culture and antibiotic susceptibility testing (AST). In the AST testings, the isolates that exhibited reduced zone of inhibition to one or more of the antibiotics such as cefotaxime (≤27 mm), ceftriaxone (≤25 mm), ceftazidime (≤22 mm), cefpodoxime (≤17 mm) and aztreonam (≤27 mm) were considered as potential ESBL producers and the ESBL production was confirmed using phenotypic screening test (double-disk synergy test) and phenotypic confirmatory test (combined-disk test). However, isolates showing resistance or decreased sensitivity to cefoxitin, cefotaxime, ceftriaxone, ceftazidime, cefpodoxime or aztreonam and sensitive to cefepime were considered as a screen positive AmpC producer and subjected to AmpC disk tests. The current study concluded that 72.41% and 21.76% of ESBL and AmpC producers were detected, respectively in our hospital. It was also observed that the double-disk synergy and combined-disk tests were equally effective for ESBL detection. Further, AmpC disk test is simple, easy to perform and interpret, requiring less expertise for the rapid detection of AmpC isolates

Magnetic resonance imaging in the diagnosis of lumbar canal stenosis in Indian patients

Introduction: Magnetic resonance imaging (MRI) has become the choice of imaging modality for lumbar canal stenosis (LCS) due to limitations and radiation risks of computed tomography (CT) and spinal radiography. The radiological criteria for diagnosis of LCS are still ambiguous. Aim of this study is to find out the radiological dimensions on MRI of lumbar spinal canal in Indian patients and the critical dimensions at which the symptoms occur. Materials and Methods: A cross-sectional study was conducted in ESI Hospital, New Delhi from July 2011 to 2013. Two study groups were studied, the symptomatic LCS group, consisted of 30 individuals of either sex in age group of 45-65 years. The control group consisted of 30 asymptomatic age matched individuals. MRI scans were performed on 1.5 Tesla scanner. Dimensions of lumbar canal at all the levels (L1-L5) of lumbar vertebra of 60 patients were measured. Results: In our study, in symptomatic group, narrowest mid-sagittal diameter antero-posterior (mean 10.61) was at L5-S1 level. The interligamentous diameter (ILD) showed no significant difference between the two groups. Lateral recess depths showed a significant difference between the two groups at all levels except L1 on right side and L1 and L2 on left side. Critical canal dimension was found to be 11.13 mm. Conclusion: MRI can effectively evaluate the lumbar canal stenosis. The critical canal dimensions at which symptoms of stenosis appear were 11.13

Switchable Graphene-Based Bioelectronics Interfaces

Integration of materials acts as a bridge between the electronic and biological worlds, which has revolutionized the development of bioelectronic devices. This review highlights the rapidly emerging field of switchable interface and its bioelectronics applications. This review article highlights the role and importance of two-dimensional (2D) materials, especially graphene, in the field of bioelectronics. Because of the excellent electrical, optical, and mechanical properties graphene have promising application in the field of bioelectronics. The easy integration, biocompatibility, mechanical flexibility, and conformity add impact in its use for the fabrication of bioelectronic devices. In addition, the switchable behavior of this material adds an impact on the study of natural biochemical processes. In general, the behavior of the interfacial materials can be tuned with modest changes in the bioelectronics interface systems. It is also believed that switchable behavior of materials responds to a major change at the nanoscale level by regulating the behavior of the stimuli-responsive interface architecture

A GREEN TRANSACTION TAGGING AND A METHOD OF ASSIGNING GREEN SCORE FOR CARDS

The present disclosure relates to a method and a system for developing a green merchant scorecard and calculating a green score for cards based on expenditure data. The present disclosure uses server data, uniquely combined with external emissions data, to quantify how green businesses are eventually consumed by the consumers. Thereafter the emission data may be used for underwriting and cross-selling of green bonds/green loans by targeting the right consumers. The present disclosure provides a solution for identifying green brands and is used directly to compute carbon reduction in a purchase

Clinical signs that predict severe illness in children underage 2 months: a multicentre study

Background: Neonatal illness, particularly in the first week of life, is a leading cause of death worldwide. Improving identification of young infants who require referral for severe illness is of major public-health importance. Methods: infants under 2 months of age brought with illness to health facilities in Bangladesh, Bolivia, Ghana, India, and South Africa were recruited in two age-groups: 0-6 days and 7-59 days. A trained health worker recorded Pakistan 31 symptoms and clinical signs. An expert paediatrician assessed each case independently for severe illness that required hospital admission. We examined the sensitivity, specificity, and odds ratio (OR) for each symptom and sign individually and combined into algorithms to assess their value for predicting severe illness, excluding jaundice. Findings: 3177 children aged 0-6 days and 5712 infants aged 7-59 days were enrolled. 12 symptoms or signs predicted severe illness in the first week of life: history of difficulty feeding (OR 10 . 0, 95% CI, 6. 9-14 . 5), history of convulsions (15.4, 6.4-37 . 2), lethargy (3.5, 1.7-7. 1), movement only when stimulated (6.9, 3.0-15.5), respiratory rate of 60 breaths per minute or more (2-7, 1.9-3.8), grunting (2.9, 1.1-7.5), severe chest indrawing (8.9, 4. 0-20. 1), temperature of 37.5 degrees C or more (3.4, 2.4-4.9) or below 35.5 degrees C (9.2, 4. 6-18.6), prolonged capillary refill (10 . 5, 5.1-21.7), cyanosis (13.7, 1.6-116.5), and stiff limbs (15.1, 2.2-105.9). A decision rule requiring the presence of any one sign had high sensitivity (87%) and specificity (74%). After we reduced the algorithm to seven signs (history of difficulty feeding, history of convulsions, movement only when stimulated, respiratory rate of 60 breaths per minute or more, severe chest indrawing, temperature of 37.5 degrees C or more or below 35.5 degrees C), mainly on the basis of prevalence of each sign or symptom, sensitivity (85%) and specificity (75%) were much the same. These seven signs also did well in 7-59-day-old infants (sensitivity 74%, specificity 79%). Interpretation: A single simple algorithm could be recommended for identifying severe illness in infants aged 0-2 months who are brought to health facilities. Further research is needed on screening newborn children for illness in the community during routine home visits