Clinico-microbiological analysis of bactibilia isolates in patients of cholecystectomy

Background: The current study determined microbial flora in bile aspirates from patients undergoing cholecystectomy along with antibiotic susceptibility pattern and resistance mechanism viz. extended spectrum β-lactamase (ESBL).Methods: The study included 110 such patients which were divided in three groups as: Group A that included acute cholecystitis with or without cholelithiasis, Group B included chronic cholecystitis with or without cholelithiasis and Group C included other hepatobiliary ailments requiring cholecystectomy viz. gallbladder carcinoma, acute emphysematous gall bladder and mucocele gall bladder. The bile was subjected to complete microbiological and histopathological examination. Antimicrobial susceptibility of the isolates was performed as per CLSI guidelines.Results: Bacteria were recovered from 07 samples (20%) in Group A, 17 (48.57%) in Group B and 11 (31.43%) in Group C. The polymicrobial infection was seen in 04 (11.43%) patients. The most common organisms isolated were Escherichia coli 15 (38.46%), Klebsiella pneumoniae and Pseudomonas aeruginosa 8 (20.51% each). The majority of Enterobacteriaceae isolates were susceptible to piperacillin-tazobactam and carbapenems. The ESBL production was observed in 17 (43.58%) isolates.Conclusions: Therefore, antimicrobial susceptibility of potential causative organisms, presence of resistant strains in bile, the severity of the cholecystitis, and the local susceptibility pattern must be taken into consideration while prescribing antibiotics. A protocol regarding the management of such cases should be formulated based on observations of similar studies.

Seroprevalence of antistreptolysin O antibodies in a tertiary health care centre in Haryana, India: a three year retrospective study

Background: Presence of antistreptolysin O antibodies in a patient’s sera may be an isolated evidence of recent infection by group A or less commonly, group C or G Streptococcus, especially in patients suspected of having a non suppurative sequel to this infection.Methods: A retrospective study was done on the sera samples received in the Department of Microbiology, PGIMS Rohtak, India for the detection of ASO, over a period of three years. The test was carried out by latex agglutination rapid test kit by Aspen.Results: A total of 4632 samples were received in the laboratory during the study period. Of these, 1058 (22.8%) were found to be positive for the presence of ASO having titre of >200 IU/mL.Conclusions: The prevalence of ASO was found to be highest in the age group 0-20. The presence of elevated streptococcal antibody titres in such a population reflects a high background prevalence of streptococcal infections. Thus, determination of ASO antibodies should be taken into consideration when evaluating the role of group A streptococcus in non-purulent complications of infections

Role of endometrial thickness in natural and stimulated cycles in infertility

Background: The endometrium plays an important role in infertility. The growth of endometrium depends on serum oestradiol level and blood flow to the uterus. A thin endometrium is defined as a lining of less than 7 mm which is associated with infertility. The endometrium is best seen on Transvaginal scan (TVS). The purpose of this study was to evaluate the role of endometrial thickness and its outcome in natural and stimulated cycles in infertile women.Methods: This prospective cohort study was conducted from June 2018 to May 2019 in LLRM Medical College Meerut, Uttar Pradesh, India. Total 150 infertile women of age less than 35 years presented with either primary or secondary infertility were enrolled. Each patient was undergoing transvaginal scan (TVS) to measure endometrial thickness follicular monitoring.Results: The endometrial thickness and pregnancy rate was higher in letrozole induced group as compared to clomiphene with estradiol valerate and clomiphene with sildenafil citrate induced group.Conclusions: Letrozole had better effect on endometrial thickness and pregnancy rate as compared to clomiphene citrate with estradiol valerate and clomiphene citrate with sildenafil citrate

Assessment of Body Composition and Heart Rate Variability in Bronchial Asthma

Background: Previous  studies were focused mainly either on autonomic modulation using heart rate variability (HRV) or body composition in the bronchial asthma patients, but our study has correlated  both  HRV and body composition  indices in  asthmatic patients. Aim & Objective:To evaluate the possible association of HRV and body composition parameters  with  main  spirometric  indices  in newly diagnosed asthmatic  patients & to compare these findings with healthy subjects. Methods: Thirty   asthmatic  patients (study group ) and 30 apparently healthy subjects (controls) in age group of 20-55 years of both genders  were included.  BMI, waist- hip ratio (WHR)   and  body fat % were measured. Time  and  frequency  domain  parameters of HRV   were recorded to determine sympathetic and parasympathetic autonomic modulations. Forced vital Capacity (FVC),  Forced  expiratory  volume  at  1st second (FEV1) & FEV1/FVC ratio parameters were recorded.Results: HF ms2 & HF n.u were significantly (P<0.001) higher and LF n.u & LF-HF  ratio  were significantly (P<0.001)  lower in asthmatics as compared to control. WHR was found to be significantly higher in study group as compared to control (P<0.001). We found a negative correlation of LF n.u & LF- HF ratio & positive  correlation  of  HF n.u with FEV1(L), FEV1/FVC %  &  WHR which  was  not found statistically significant. Conclusion: In our study we observed altered autonomic activity with parasympathetic dominance as HF component was higher in asthmatic patients. We also found a significant association between WHR and asthma. Key words :  Bronchial asthma,  body composition,  heart rate variability

To study the role of epidural analgesia in anaemic parturients

Background: To study the safety of epidural analgesia, effect on cardiotocographic parameters, fetal outcome and obstetric outcome of epidural analgesia in anaemic parturients and maternal satisfaction as well as pain relief among antenatal cases admitted in Upper India Sugar Exchange, GSVM Medical College, Kanpur, UP, India.Methods: This prospective study was conducted in anaemic parturients with cephalic presentation, singleton pregnancy having 36-42 weeks of gestation. Subjects of present study were divided into 2 groups. Control group included anaemic parturients not undergoing epidural analgesia. Study group included anaemic parturients who will be undergoing epidural analgesia. All these patients were followed up to delivery. When cervix was 3cm dilated, NST was taken 15minutes before analgesia and every 30 minutes after analgesia. Top up dose (0.0625% bupivacaine) was injected through catheter on parturients demand. For effect on CTG parameters, NST was taken 15minutes before analgesia and every 30 minutes after analgesia. Following every top up dose 10 minute monitoring for uterine contractions and effect for adequate analgesia was noted. Side effects and complaints noted at 5, 15, 30, 45, 60, 90, 120, 150 and 180 min interval. Fetal condition was also monitored and evidence of fetal distress, on clinical and/or cardiotocographic monitoring, was recorded. Patients walking duration was recorded in relation to study time from epidural insertion to delivery time. Labour was managed and mode of delivery and time of delivery was noted. Assessment of neonatal outcome was done with the help of Apgar scoring at 1 and 5minute after delivery and NICU admissions.Results: Maximum numbers of patients are lying between age groups of 18-23 and 24-29 years and are of gestational age group 37-40 weeks in both study and control group. The duration of 1st stage of labour in maximum number of primigravida patients is 5-8 hours and in multigravida it was 2-4 hours in both epidural and control group. The visual analogue scale is according to pain perceived during the course of labour and delivery by the epidural and control group. The degree of pain relief is statistically highly significant between epidural and control groups. Occurrences of maternal tachycardia are 5 times more in cases in whom epidural analgesia was not given.Conclusions: There is no statistically significant difference in the duration of 2nd stage of labour in both the groups of primigravida as well as there is no effect on the duration of second stage of labour in multigravida parturients in both the groups. Pain relief was more in the epidural group and was more satisfied after their delivery. There was no difference in effect on fetal outcome in epidural and control groups. There was no significant effect on cardiotocographic parameters except for the fact that for about 30 minutes post epidural top-up, there was fetal bradycardia which easily subsided with conservative management with left lateral position and oxygen. Maternal tachycardia was less in epidural group. This was highly significant because anaemic parturients are more prone to develop signs of cardiac failure during labour due to increase in stroke volume due to increase in heart rate due to pain

Ohmic-Viscous Dissipation in MHD Slip Flow of Cu-blood Nanofluid over a Stretching Surface along Nanoparticle Shapes

MHD nanofluid has been of great importance due to its influential thermal aspects. Present study involves two dimensional MHD boundary layer slip flow of Cu-blood nanofluid towards a linearly stretching sheet under impact of Ohmic heating, viscous dissipation and suction/injection process. Influence of various shapes of Cu nanoparticles on temperature has also been taken into consideration. Governing partial differential equations have been converted into nondimensional form through suitable similarity transformations and solved numerically via special spectral relaxation method (SRM). Effect of emerging parameters, suction/injection parameter, velocity slip parameter, solid volume fraction, magnetic parameter, Brinkman number and shape factor have been explored and described graphically. Numerical values of shear stress and heat flux have been reported via table and influence of controlling parameters have also been analysed on skin friction coefficient and Nusselt number. Subsequently, the validation of the results has been established through comparison with previously published data. The results of this investigation can be applicable in biomedical fields

Ohmic-Viscous Dissipation in MHD Slip Flow of Cu-blood Nanofluid over a Stretching Surface along Nanoparticle Shapes

559-568MHD nanofluid has been of great importance due to its influential thermal aspects. Present study involves two dimensional MHD boundary layer slip flow of Cu-blood nanofluid towards a linearly stretching sheet under impact of Ohmic heating, viscous dissipation and suction/injection process. Influence of various shapes of Cu nanoparticles on temperature has also been taken into consideration. Governing partial differential equations have been converted into nondimensional form through suitable similarity transformations and solved numerically via special spectral relaxation method (SRM). Effect of emerging parameters, suction/injection parameter, velocity slip parameter, solid volume fraction, magnetic parameter, Brinkman number and shape factor have been explored and described graphically. Numerical values of shear stress and heat flux have been reported via table and influence of controlling parameters have also been analysed on skin friction coefficient and Nusselt number. Subsequently, the validation of the results has been established through comparison with previously published data. The results of this investigation can be applicable in biomedical fields

Obstetric hysterectomy, still a life saving tool in modern day obstetrics: a five year study

Background: Objective of current study was to study the indications and maternal outcome of emergency obstetric hysterectomy and its role in reduction of maternal morbidity and mortality in complicated obstetric cases.Methods: A prospective study of the cases of emergency obstetric hysterectomy performed over a period of five years from 2009 to 2013 was done.Results: During the study period, 105 emergency obstetric hysterectomies were performed giving an incidence of 0.54% .The incidence of hysterectomy following vaginal delivery was 0.54% and that of caesarean hysterectomy was 2.08%. It was most common in the age group 26-35 years (66.66%) and in women of parity 3-4 (71.42%).Rupture uterus was the most common indication accounting for 59.04% cases followed by Atonic PPH (18.09%). Febrile illness and wound infection were the two most common co-morbidities. Maternal mortality was 5.71%.Conclusions: Emergency obstetric hysterectomy is potentially a life saving procedure which every obstetrician must be familiar with in cases of catastrophic rupture uterus and intractable haemorrhage. With the help of prostaglandins, modern policies of active management of labor, timely performance of caesarean section, internal iliac artery ligation, compression sutures etc. obstetric hysterectomy should be made a more rare procedure

Tillage and Mulching Effects on Crop Productivity and Moisture Dynamics in Fodder Sorghum Based Cropping Systems under Rainfed Condition

Indian farmers generally take more than one crop in a year to maximize their total production and profits. In this process fodder sorghum followed by crops like chickpea, wheat, oat, barley and mustard are common in Bundelkhand region of central India. The soils of Budelkhand region of India are medium to low in fertility with low organic matter content and poor water holding capacity that limits the fodder and food productivity. Therefore, adoption of resource conserving technologies in fodder sorghum based cropping systems under rainfed conditions is one of the potential areas, where increase in green fodder and food production with enhanced resource use efficiency can be achieved (Dixit et al., 2014). Adoption of resource conserving technologies includes minimal soil disturbance, maintaining soil cover and crop diversification through conservation of moisture for which the role of green manure mulches has been well recognised. Under rainfed situation, moisture stress has been identified as one of most important factor limiting yield of post rainy season crop. Introducing conservation tillage (zero tillage/reduced tillage) along with foliage mulching may improve soil moisture conservation, weed control, soil physic-chemical and biological properties, system productivity and may also reduce fuel, animal or human energy required for land preparation