Drug resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolated from contact lenses in Karachi-Pakistan

BACKGROUND: The contaminated contact lens provides Pseudomonas aeruginosa an ideal site for attachment and biofilm production. Continuous contact of the eye to the biofilm-infested lens can lead to serious ocular diseases, such as keratitis (corneal ulcers). The biofilms also prevent effective penetration of the antibiotics, which increase the chances of antibiotic resistance. METHODS: For this study, 22 Pseudomonas aeruginosa isolates were obtained from 36 contact lenses and 14 contact lens protective fluid samples. These isolates were tested against eight commonly used antibiotics using Kirby-Bauer disk diffusion method. The biofilm forming potential of these isolates was also evaluated using various qualitative and quantitative techniques. Finally, a relationship between biofilm formation and antibiotic resistance was also examined. RESULTS: The isolates of Pseudomonas aeruginosa tested were found resistant to most of the antibiotics tested. Qualitative and quantitative biofilm analysis revealed that most of the isolates exhibited strong biofilm production. The biofilm production was significantly higher in isolates that were multi-drug resistant (p < 0.0001). CONCLUSION: Our study indicates that multi-drug resistant, biofilm forming Pseudomonas aeruginosa isolates are mainly involved in contact lens associated infections. This appears to be the first report from Pakistan, which analyzes both antibiotic resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolates from contact lens of the patients with contact lens associated infections

Predictors of mortality in brain abscess

Objective: Brain abscess carries significant morbidity and mortality. Our objective was to elucidate the clinical presentation of brain abscess and to assess predictors of mortality in these patients.Methods: All patients with a brain abscess presenting to the Aga Khan University Hospital, a tertiary care referral center in Karachi, Pakistan, were studied retrospectively. Statistical analysis involved univariate analysis and a logistic regression model.Results: Among the 66 patients analyzed, a distant metastatic focus of infection was the most commonly identified predisposing factor (29%). Otogenic infection was the commonest contiguous source and sinusitis was noticeably absent. Multiple abscesses were frequent (35%). Streptococci were the most common isolates (39%). Lumbar puncture was performed in 44% and steroids administered in 33%. Treatment was surgical in 58%. Most comatose patients were treated conservatively. Overall mortality was 29%. Univariate analysis identified comatose presentation and identification of a distant focus of infection as predictors of mortality. The logistic regression model, however, identified a distant focus of infection as the only independent predictor.Conclusion: Age greater than 30 years, corticosteroid use, multiple abscesses, performance of lumbar puncture and conservative management had no affect on outcome

Occupancy based household energy disaggregation using ultra wideband radar and electrical signature profiles

Human behaviour and occupancy accounts for a substantial proportion of variation in the energy efficiency pro le of domestic buildings. Yet while people often claim that they would like to reduce their energy bills, rhetoric frequently fails to match action due to the effort involved in understand- ing and changing deeply engrained energy consumption habits. Here, we present and, through dedicated experiments, test in-house developed soft-ware to remotely identify appliance energy usage within buildings, using energy equipment which could be placed at the electricity meter location. Furthermore, we monitor and compare the occupancy of the location under study through Ultra-Wideband (UWB) radar technology and compare the resulting data with those received from the power monitoring software, via time synchronization. These signals when mapped together can potentially provide both occupancy and speci c appliances power consumption, which could enable energy usage segregation on a yet impossible scale as well as usage attributable to occupancy behaviour. Such knowledge forms the basis for the implementation of automated energy saving actions based on a households unique energy profi le

On the Internal Absorption of Galaxy Clusters

A study of the cores of galaxy clusters with the Einstein SSS indicated the presence of absorbing material corresponding to 1E+12 Msun of cold cluster gas, possibly resulting from cooling flows. Since this amount of cold gas is not confirmed by observations at other wavelengths, we examined whether this excess absorption is present in the ROSAT PSPC observations of 20 bright galaxy clusters. For 3/4 of the clusters, successful spectral fits were obtained with absorption due only to the Galaxy, and therefore no extra absorption is needed within the clusters, in disagreement with the results from the Einstein SSS data for some of the same clusters. For 1/4 of the clusters, none of our spectral fits was acceptable, suggesting a more complicated cluster medium than the two-temperature and cooling flow models considered here. However, even for these clusters, substantial excess absorption is not indicated.Comment: accepted by the Astrophysical Journa

A novel case of MSTO1 gene related congenital muscular dystrophy with progressive neurological involvement

Recessive mutations in the MSTO1 gene, encoding for a mitochondrial distribution and morphology regulator, have been recently described in a very limited number of patients with multisystem involvement, mostly characterized by myopathy or dystrophy, cerebellar ataxia, pigmentary retinopathy and raised creatine kinase levels. Here we report an additional patient with recessive MSTO1-related muscular dystrophy (MSTO1-RD), and clinical and radiological evidence of progressive cerebellar involvement. Whole-exome sequencing identified two novel MSTO1 missense variants, c.766C > T (p. (Arg256Trp) and c.1435C > T (p. (Pro479Ser), predicted as damaging by in silico tools. We also report a distinct pattern of selective involvement on muscle MRI in MSTO1-RD. This case confirms a consistent MSTO1-related neuromuscular phenotype and in addition suggests a progressive neurological component at least in some patients, in keeping with the mitochondrial role of the defective protein

Contributing Factors of Time Overrun in Public Sector Construction Projects

Time overrun is a major issue in construction projects. Its causes vary, depending upon the nature and size of the project. Developing countries are more susceptible to this problem due to limited resources and lack of managerial skills. This paper focuses on the identification and classification of time overrun factors in public sector projects in Pakistan. Data was collected by the use of a questionnaire given to different professionals in the construction field. Average index (AI) was used to determine each factor’s relative importance. Results indicate that financial difficulties faced by constructor, inadequate planning and scheduling, financial difficulties faced by client, delays in payment by the client, delays in decision making by the client, design mistakes, frequent design changes, material shortage, incompetent sub-constructor assigned by the constructor, poor site management and supervision and inadequate constructor’s experience are the most significant factors of time overrun in public sector construction projects in Pakistan. This study aims to be useful in addressing the issue of time overrun in the construction industry

Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry.

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291

Rentabilitätsvergleiche im Umlage- und Kapitaldeckungsverfahren : Konzepte, empirische Ergebnisse, sozialpolitische Konsequenzen

Die demographischen Veränderungen sind Auslöser einer grundsätzlicheren Debatte über Alterssicherungsverfahren, nämlich der Wahl eines effizienten Finanzierungsverfahrens der Altersvorsorge. Im Zentrum der Debatte steht immer wieder der Renditevergleich zwischen dem Umlage- und dem Kapitaldeckungsverfahren. Ihm gilt dieses Papier. Er ist keineswegs so einfach, wie es oft suggeriert wird, da Versicherungs- und Risikoaspekte, vor allem aber das Übergangsproblem berücksichtigt werden müssen. Der vorliegende Beitrag stellt den wirtschaftstheoretischen Hintergrund mit den wichtigsten relevanten Konzepten dar und präsentiert empirische Schätzungen zur heutigen und Simulationsergebnisse zur zukünftigen Entwicklung der relevanten Renditen. Wir schließen mit den sozialpolitischen Konsequenzen für eine reformierte Altersvorsorge

The soft X-ray emission in a large sample of galaxy clusters with ROSAT PSPC

The study of soft X-ray emission of 38 X-ray selected galaxy clusters observed by ROSAT PSPC indicates that the soft excess phenomenon may be a common occurrence in galaxy clusters. Excess soft X-ray radiation, above the contribution from the hot intra-cluster medium, is evident in a large fraction of sources, and is clearly detected with large statistical significance in the deepest observations. The investigation relies on new, high resolution 21 cm HI observations. The sample selection also features analysis of infra-red images, to further ensure reliability of results with respect to the characteristics of Galactic absorption. The possibility of background or calibration effects as cause of the excess emission is likewise investigated; a detailed analysis of the distribution of the excess emission with respect to detector position and Galactic HI column density shows that the excess emission is a genuine celestial phenomenon. We find evidence for a preferential distribution of the soft excess emission at distances larger than ~150-200 kpc from the centers of clusters; this behavior may be naturally explained in the context of a non-thermal Inverse-Compton scenario. Alternatively, we propose that the phenomenon may be caused by thermal emission of very large-scale `warm' filaments seen in recent hydrodynamic simulations. This new interpretation relieves the very demanding requirements of either the traditional intra-cluster `warm' gas and the non-thermal scenarios. We also investigate the possibility of the soft excess originating from unresolved, X-ray faint cluster galaxies.Comment: ApJ in pres