Prevalence of biofilm producing aerobic bacterial isolates in burn wound infections at a tertiary care hospital in northern India

Burn wounds frequently get infected due to a break in skin integrity and prolonged hospitalization. Microbial flora originating from the patient's own flora colonize and infect the burn wounds. Bacterial biofilms in particular are postulated as the culprit for the development of non-healing burn wounds by inducing chronic inflammation in these patients. In the present study, 190 wound isolates obtained from patients admitted to the burn ward at the Pt. B.D. Sharma PGIMS, Rohtak, were evaluated for biofilm formation along with Antimicrobial Susceptibility Testing (AST). Biofilm detection was done by modified Tissue Culture Plate method and AST was done by Kirby-Bauer disc diffusion method. A total of 190 isolates were studied, which included Staphylococcus aureus, Coagulase negative Staphylococcus, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella spp., Proteus spp., Citrobacter spp., Escherichia coli and Enterobacter spp. Of these, 68.9% isolates showed biofilm formation. Biofilm formation was more common in Pseudomonas aeruginosa followed by Klebsiella spp. and Staphylococcus aureus. Biofilm producing isolates showed greater multidrug resistance than non-biofilm producers. In our study, a high rate of biofilm formation and antimicrobial drug resistance was seen.

Brain-computer interfaces in the completely locked-in state and chronic stroke

Brain-computer interfaces (BCIs) use brain activity to control external devices, facilitating paralyzed patients to interact with the environment. In this chapter, we discuss the historical perspective of development of BCIs and the current advances of noninvasive BCIs for communication in patients with amyotrophic lateral sclerosis and for restoration of motor impairment after severe stroke. Distinct techniques have been explored to control a BCI in patient population especially electroencephalography (EEG) and more recently near-infrared spectroscopy (NIRS) because of their noninvasive nature and low cost. Previous studies demonstrated successful communication of patients with locked-in state (LIS) using EEG- and invasive electrocorticography-BCI and intracortical recordings when patients still showed residual eye control, but not with patients with complete LIS (ie, complete paralysis). Recently, a NIRS-BCI and classical conditioning procedure was introduced, allowing communication in patients in the complete locked-in state (CLIS). In severe chronic stroke without residual hand function first results indicate a possible superior motor rehabilitation to available treatment using BCI training. Here we present an overview of the available studies and recent results, which open new doors for communication, in the completely paralyzed and rehabilitation in severely affected stroke patients. We also reflect on and describe possible neuronal and learning mechanisms responsible for BCI control and perspective for future BMI research for communication in CLIS and stroke motor recovery.

Brain-machine interface (BMI) in paralysis

INTRODUCTION

Brain-machine interfaces (BMIs) use brain activity to control external devices, facilitating paralyzed patients to interact with the environment. In this review, we focus on the current advances of non-invasive BMIs for communication in patients with amyotrophic lateral sclerosis (ALS) and for restoration of motor impairment after severe stroke.

BMI FOR ALS PATIENTS

BMI represents a promising strategy to establish communication with paralyzed ALS patients as it does not need muscle engagement for its use. Distinct techniques have been explored to assess brain neurophysiology to control BMI for patients' communication, especially electroencephalography (EEG) and more recently near-infrared spectroscopy (NIRS). Previous studies demonstrated successful communication with ALS patients using EEG-BMI when patients still showed residual eye control, but patients with complete paralysis were unable to communicate with this system. We recently introduced functional NIRS (fNIRS)-BMI for communication in ALS patients in the complete locked-in syndrome (i.e., when ALS patients are unable to engage any muscle), opening new doors for communication in ALS patients after complete paralysis.

BMI FOR STROKE MOTOR RECOVERY

In addition to assisted communication, BMI is also being extensively studied for motor recovery after stroke. BMI for stroke motor recovery includes intensive BMI training linking brain activity related to patient's intention to move the paretic limb with the contingent sensory feedback of the paretic limb movement guided by assistive devices. BMI studies in this area are mainly focused on EEG- or magnetoencephalography (MEG)-BMI systems due to their high temporal resolution, which facilitates online contingency between intention to move and sensory feedback of the intended movement. EEG-BMI training was recently demonstrated in a controlled study to significantly improve motor performance in stroke patients with severe paresis. Neural basis for BMI-induced restoration of motor function and perspectives for future BMI research for stroke motor recovery are discussed.

Risk factors associated with low birth weight

BACKGROUND

Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as Low Birth Weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million low birth-weight (LBW) babies are born every year throughout the world. Though, the health situation of Nepal has improved substantially over the years, the low birth-weight (LBW) rate still high. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns.

METHODS

A cross sectional hospital based study was conducted in Obstetrics and Gynaecology ward of Janakpur Zonal Hospital, Janakpur, Nepal from December 2009 to January 2010. Altogether 306 respondents were taken and respondents were mothers who have delivered newborns in hospital.

RESULTS

A total of 1426 birth occurred during the study period (December 2009 to January 2010), of which 306 met the study criteria. Among which 66 (21.56%) were low birth weight (LBW) and 240 were normal birth weight (NBW). Overall mean birth weight was found to be 2.75 ± 0.639 kg. Out of total 21.56% newborns were weighing less than 2.50 kg and mean birth weight was 1.96 ± 0.409 kg. The study also shows that majority 73 (86%) of the research centers didn't start the research yet.

CONCLUSIONS

This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age, educational level and economic status) and antenatal care are more important.

QUALITY OF LIFE IN MEN WITH LOCALIZED PROSTATE CANCER TREATED BY RADICAL PROSTATECTOMY OR RADIOTHERAPY

Radical prostatectomy and radiotherapy are the most commonly utilized modalities for managing patients with localized prostate cancer. Each has effects on quality of life that are important in decision making. Long term side effects of these treatment modalities include urinary, bowel and sexual dysfunction, and have been documented. Comparison of the side effects of these different modalities continues to be explored, emphasizing their effects on quality of life (QOL) from the patient's viewpoint. Questionnaires were mailed to 224 eligible patients and a response was elicited in 161 men (72%). The final number of patients who completed all the questionnaires was 151. Of these, 73 (48%) had radical prostatectomy and 78 (52%) had radiotherapy. General well being measures demonstrated a definite advantage favoring men treated with radical prostatectomy. Prostate cancer specific QOL measures were similar among men treated with surgery or radiotherapy. Radiotherapy treated men were slightly more likely to report bowel-related problems than surgically treated men. Urinary QOL measures were no different between treated groups. Surgically treated men reported lower level of sexual function than radiotherapy treated men.

Extended spectrum -lactamases (ESBL) - an emerging threat to clinical therapeutics

Extended spectrum -lactamases (ESBLs) are plasmid mediated, TEM and SHV derived enzymes, first isolated in Western Europe in mid 1980s, most commonly in Klebsiella spp., followed by Escherichia coli. These enzymes are capable of hydrolyzing broad spectrum cephalosporins and monobactams but inactive against cephamycins and imipenem. In addition, ESBL producing organisms exhibit coresistance to many other classes of antibiotics resulting in limitation of therapeutic option. Several risk factors have been suggested. A variety of classification schemes have been developed. Recently, Bush-Jacoby-Medeiros scheme integrated functional and molecular characteristics. ESBLs have serine at their active site and attack the amide bond in the lactam ring of antibiotics causing their hydrolysis. Because of inocolum effect and substrate specificity their detection is a major challenge. Two indicators of ESBLs are eight fold reduction in MIC and potentiation of the inhibitor zone of third generation cephalosporin in the presence of clavulanic acid. Incidence of these organisms is being continuously increasing through out the world with limited treatment alternatives. It becomes necessary to know the prevalence of these organisms and to formulate treatment policy. Moreover, restricted use of the third generation cephalosporins lead to withdrawal of selective pressure and use of lactam and -lactamase inhibitor combinations may exert reverse mutation on these enzymes.

Purification, cloning, and DNA sequence analysis of a chitinase from an overproducing mutant of Streptomyces peucetius defective in daunorubicin biosynthesis

Extracellular chitinases of Streptomyces peucetius and a chitinase overproducing mutant, SPVI, were purified to homogeneity by ion exchange and gel filtration chromatography. The purified enzyme has a molecular mass of 42 kDa on SDS-PAGE, and the N-terminal amino acid sequence of the protein from the wild type showed homology to catalytic domains (Domain IV) of several other Streptomyces chitinases such as S. lividans 66, S. coelicolor A3(2), S. plicatus, and S. thermoviolaceus OPC-520. Purified SPVI chitinase cross-reacted to anti-chitinase antibodies of wild-type S. peucetius chitinase. A genomic library of SPVI constructed in E. coli using lambda DASH II was probed with chiC of S. lividans 66 to screen for the chitinase gene. A 2.7 kb fragment containing the chitinase gene was subcloned from a lambda DASH II clone, and sequenced. The deduced protein had a molecular mass of 68 kDa, and showed domain organization similar to that of S. lividans 66 chiC. The N-terminal amino acid sequence of the purified S. peucetius chitinase matched with the N-terminus of the catalytic domain, indicating the proteolytic processing of 68 kDa chitinase precursor protein to 42 kDa mature chitinase containing the catalytic domain only. A putative chiR sequence of a two-component regulatory system was found upstream of the chiC sequence.

Anthocyanin, bisabolol and phenylammonialyase activity in cell cultures of Populus deltoides

Phenolics, anthocyanin and alpha-bisabolol production from poplar (Populus delotides) in tissue culture was determined. A number of phenolic acids were identified by HPLC. PAL activity in response to phytohormones, cells growth and anthocyanin production showed a positive correlation. A component, alpha-bisabolol, was identified using gas chromatography and UV spectroscopy. In vitro production of said metabolites was influenced by phytohormones.

Comparative evaluation of antimicrobial activity of polyvinylpyrrolidone (PVP)-iodine versus topical antibiotics in cataract surgery

Comparative evaluation of polyvinylpyrrolidone (PVP)-iodine versus topical broad-spectrum antibiotics for disinfecting the eye and surrounding area to prevent postoperative complications was carried out on 100 patients. PVP-iodine proved superior antiseptic for pre-operative preparation of eyes before cataract surgery. It was cheaper, caused minimal side-effects, reduced bacterial counts to a great extent and eliminated fungi completely.

Vaginitis in non pregnant women in Haryana

Study was carried out in 100 patients of non-specific vaginitis (NSV) to find out the incidence of vaginitis due to G. vaginalis. Out of a total of 100 subjects 20 were positive for G. vaginalis as compared to only 6 in equal number of normal matched controls. One positive specimen showed concomitant presence of C. albicans and E. coli was found in another positive specimen. Presence of amines and clue cells in the discharge did not correlate with the isolation rate of G. vaginalis, thus emphasizing the necessity of culture to diagnose NSV due to G. vaginalis.

Multidrug-resistant Salmonella typhi in Haryana in 1989-90

Of a total of 730 strains of S. typhi isolated in 1989-90, in the Medical College Hospital, Rohtak (India), 218 isolates showed resistance to chloramphenicol, ampicillin and cotrimoxazole. Minimum inhibitory concentration (MIC) for ampicillin and cotrimoxazole was up to 3200 micrograms/ml, intermediate for chloramphenicol (200-800 micrograms/ml) and low for tetracycline (50-400 micrograms/ml). A significant observation was prevalence of E1 as the predominant phage type amongst resistant strains accounting for 88.8 per cent of the resistant isolates, 95.8 per cent of these showed block resistance to ACCoT.