A PROSPECTIVE STUDY OF THE IMPACT OF MICROBIOLOGICAL CULTURES ON ANTIBIOTIC PRESCRIBING PATTERN IN A TERTIARY CARE HOSPITAL

Objective: Antibiotics are frequently prescribed because of clinical suspicion of infection, while the results of the microbiological analysis are still awaited. This study was undertaken to assess the impact of microbiological culture results on the antibiotic prescribing pattern. Methods: This prospective observational study was conducted on 400 patients of either sex and any age with positive microbiological culture results. Empirical antibiotic therapy details were recorded and change in empirical antibiotic therapy after positive culture results was also recorded. Assessment of sensitivity resistance pattern of microorganisms was also performed. Results: In the study, male: female ratio was 1.01:1. The majority of patients i.e. 94 (24.50%) were in the 46 y to 60 y of age group. Definitive antibiotic therapy was initiated in 103 patients (25.75%) out of 400 patients. The highest number of changes in antibiotic therapy was done in urinary tract infections (63.95%) and septicemia (32.61%) cases. Klebsiella (34.25%), E. coli (32%) and Staphylococcus aureus (14.75%) were commonly isolated microorganisms. Cephalosporins (77.75%) and aminoglycosides (47%) were commonly used in empirical antibiotic therapy, while nitrofurantoin (47.57%) and penicillins (22.33%) were commonly used in definitive antibiotic therapy. Definitive antibiotic therapy was associated with a reduced duration of hospital stay as compared to empirical antibiotic therapy (p<0.0001). Conclusion: Antibiotic prescribing is infrequently influenced by microbiological culture results. Adjustment of the antimicrobial therapy according to microbiological culture results can decrease the duration of hospital stay as well as can decrease the spread of antimicrobial resistance

A Study of the Non-Visual Factors of Cars Affecting the Consumer’s Cognitive Appeal

The success of a car in the market depends on visual as well as non-visual factors. Both these sets of factors influence the cognitive appeal of cars for potential buyers. Purchasing a car is not only about economic choices but also related to emotional, aesthetic, sensory responses to driving, kinship patterns, habitation, sociability, and functionality. This study aimed to identify the major non-visual factors of cars that affect the cognitive perception of buyers and estimate their importance relative to each other. A set of non-visual factors and their sub-factors were identified through a literature search and an open-ended survey among car owners. Many of the sub-factors had the same meaning and therefore these factors were grouped under twenty separate sub-factors. Then, these twenty sub-factors were analyzed by using the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach to evaluate the most influential sub-factors among the identified sub-factors. Six designers were involved in the analysis of the sub-factors through the DEMATEL approach. The results showed that the car’s brand value, cost, engine performance, reliability, and safety are the top five sub-factors. Outcomes of this study can be utilized by designers and top management people to understand the most influential factors affecting the cognitive behavior of consumers when purchasing a car. This understanding will help companies to design cars as per the requirements of consumers, which will ultimately lead to better profitability of these companies

A Study of the Non-Visual Factors of Cars Affecting the Consumer’s Cognitive Appeal

The success of a car in the market depends on visual as well as non-visual factors. Both these sets of factors influence the cognitive appeal of cars for potential buyers. Purchasing a car is not only about economic choices but also related to emotional, aesthetic, sensory responses to driving, kinship patterns, habitation, sociability, and functionality. This study aimed to identify the major non-visual factors of cars that affect the cognitive perception of buyers and estimate their importance relative to each other. A set of non-visual factors and their sub-factors were identified through a literature search and an open-ended survey among car owners. Many of the sub-factors had the same meaning and therefore these factors were grouped under twenty separate sub-factors. Then, these twenty sub-factors were analyzed by using the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach to evaluate the most influential sub-factors among the identified sub-factors. Six designers were involved in the analysis of the sub-factors through the DEMATEL approach. The results showed that the car’s brand value, cost, engine performance, reliability, and safety are the top five sub-factors. Outcomes of this study can be utilized by designers and top management people to understand the most influential factors affecting the cognitive behavior of consumers when purchasing a car. This understanding will help companies to design cars as per the requirements of consumers, which will ultimately lead to better profitability of these companies

Functional outcome of patients undergoing lumbar discectomy

Background: Sciatica resulting from a lumbar intervertebral disc herniation is the most common cause of radicular leg pain in adult working population. It can be treated with both conservative and operative methods. In our study, surgical treatment of lumbar disc prolapse has been done by open discectomy. We wish to assess the outcome of surgery in patients with lumbar disc prolapse undergoing lumbar discectomy.Methods: 40 patients were included in this study and were followed up for up to 1 year postoperatively. We assessed the outcome of each patient with ODI and VAS post-operatively and on follow-up at 3 weeks, 6 months and 1 year. Subjective evaluation of the patient’s satisfaction at the final follow-up was also done.Results: We found that males had higher incidence of PIVD with an average duration of symptoms before surgery about 8.62 months. Left side was most involved and level l4-l5 was most involved level. The mean ODI and VAS score pre-operatively were 26.85±4.20 and 7.73±0.88 respectively, which changed to 4.48±5.15 and 1.70±1.57, respectively at 1 year post-operative follow-up. These were statistically highly significant. Most of the patients (34) gave a subjective evaluation as excellent at 1 year follow-up.Conclusions: Our study established that open discectomy has a satisfactory functional outcome and leads to a significant improvement in the patients’ quality of life

Correlation of functional results of caudal epidural steroid injections with duration of symptoms in PIVD

Background: Low backache and sciatica is a common complaint signifying some underlying pathology; it may be a soft tissue strain or disc protrusion, or conditions such as neoplasm or ankylosing spondylitis besides others. We aim to assess the functional outcome of epidural steroid injection in patients with low backache and sciatica as well as the effect of pre operative duration of symptoms in Indian population presenting to our centre, on the post procedure outcome, if any.Methods: 50 patients were evaluated with complaints of low backache and radiculopathy. They were subjected to following questionnaires including the ODI and VAS, and the scores were evaluated before and after the intervention, and at every follow up.Results: Patients commonly affected were from 4th and 5th decade. The commonest intervertebral disc involved was L4-5 (44%) followed by L5-S1 (30%). Significant Functional status improvement according to ODI scoring was observed in all follow up visits. Similarly significant reduction in pain intensity according to VAS scoring was observed in all follow up visits. On comparing the improvement in functional status (ODI) and pain (VAS) between the 3 groups, it is seen that patients in group A had the highest rate of improvement, while patients in group C had the least improvement.Conclusions: Caudal epidural injections are safe, effective and less expensive modality of treatment without any significant complications. The lesser the duration of symptoms i.e. earlier the patient presents, better are the results with caudal epidural injection.

DQSSA: A Quantum-Inspired Solution for Maximizing Influence in Online Social Networks (Student Abstract)

Influence Maximization is the task of selecting optimal nodes maximising the influence spread in social networks. This study proposes a Discretized Quantum-based Salp Swarm Algorithm (DQSSA) for optimizing influence diffusion in social networks. By discretizing meta-heuristic algorithms and infusing them with quantum-inspired enhancements, we address issues like premature convergence and low efficacy. The proposed method, guided by quantum principles, offers a promising solution for Influence Maximisation. Experiments on four real-world datasets reveal DQSSA's superior performance as compared to established cutting-edge algorithms.Comment: AAAI Conference on Artificial Intelligence 202

Drug price control order: the impact on pharmacoeconomics

Background: The objective of the present study was to analyze the prices of metformin, losartan, atorvastatin, paracetamol and aspirin for the doses which are included in the list of Drug Price Control Order (DPCO) 2013.Methods: Current index medical specialties India, 37th year, April-July 2015 issue was used for analysis. The retail prices of the drugs in INR were tabulated in Microsoft Office Excel 2013. The prices of the above listed drugs were compared with prices of DPCO 2013 for the same doses of drugs. The analysis of drugs costing more than the prices listed in the DPCO with the margin of the difference in percentage was carried out.Results: Out of 25 brands of metformin 500 mg tablet, 11 (44%) brands had price higher than listed in DPCO 2013. Similarly, prices for losartan 25 mg and 50 mg tablets, 8 (25%) out of 32 and 11 (31.42%) out of 35 were higher respectively. For atorvastatin 5 mg and 10 mg tablets, 2 (9.52%) out of 21 and 8 (13.55%) out of 59 brands had higher prices. For paracetamol 500 mg tablet, 12 (63.15%) out of 19 brands were priced higher than DPCO list. For aspirin 100 mg tablet and 325 mg tablet, 3 (100%) out of 3 brands and 1 (100%) out of 1 brand had higher prices.Conclusions: Many of the brand formulations have higher prices than the DPCO 2013 issued by government of India. The clinicians prescribing these drugs should be aware of these brand formulations to reduce the cost of the drug therapy

Optimizing Electric Vehicle Efficiency with Real-Time Telemetry using Machine Learning

In the contemporary world with degrading natural resources, the urgency of energy efficiency has become imperative due to the conservation and environmental safeguarding. Therefore, it's crucial to look for advanced technology to minimize energy consumption. This research focuses on the optimization of battery-electric city style vehicles through the use of a real-time in-car telemetry system that communicates between components through the robust Controller Area Network (CAN) protocol. By harnessing real-time data from various sensors embedded within vehicles, our driving assistance system provides the driver with visual and haptic actionable feedback that guides the driver on using the optimum driving style to minimize power consumed by the vehicle. To develop the pace feedback mechanism for the driver, real-time data is collected through a Shell Eco Marathon Urban Concept vehicle platform and after pre-processing, it is analyzed using the novel machine learning algorithm TEMSL, that outperforms the existing baseline approaches across various performance metrics. This innovative method after numerous experimentation has proven effective in enhancing energy efficiency, guiding the driver along the track, and reducing human errors. The driving-assistance system offers a range of utilities, from cost savings and extended vehicle lifespan to significant contributions to environmental conservation and sustainable driving practices

Assessment of outcome of distal radius inta-articular fractures using wrist-spanning mini-fixator in distraction

Background: The distal radius fractures are complex injuries. There are many treatment options for these fractures. The benefits of external fixation with mini fixator have been seen in many studies. In our study, the distal radius fracture belonging to type B and C of AO classification were treated with wrist spaning mini extrernal fixator with/without additional k wires. We wish to analyse the functional outcome and to determine any complications of this procedure.Methods: 20 patients were included in this study and were followed up for up to 6 months postoperatively. We assessed pain using VAS score at 6 weeks follow-up and the outcome of each patient was assessed using Mayo wrist score post-operatively on follow-up at 3 months and 6 months.Results: Predominance towards males and left upper limb was observed in our study. At the end of six months, the range of motion as assessed according to the criteria given by Mayo wrist score, excellent results (MWS>=90) were seen in 4 patients (20%), good results (MWS 80-89) were seen in 12 patients (60%),and fair (MWS 70-79) in 4 patient (20%). At the end of result, significant reduction in terms of pain, wellbeing, personal life, social life, lifting, travelling and sleeping was seen.Conclusions: Predominance towards males and left upper limb was observed in our study. At the end of six months, the range of motion as assessed according to the criteria given by Mayo Wrist Score, excellent results (MWS>=90) were seen in 4 patients (20%), good results (MWS 80-89) were seen in 12 patients (60%),and fair (MWS 70-79) in 4 patient (20%). At the end of result, significant reduction in terms of pain, wellbeing, personal life, social life, lifting, travelling and sleeping was seen.