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Technology is widely promoted as a solution to greater independence and better health for the rapidly growing UK older population. If this is to be realised, we need to understand barriers and facilitators to uptake and investigate who wants this technology and who does not express an interest in use. This analysis is based on data from a population-based cohort study, the Cognitive Function and Ageing Study (CFAS)-II, which focused on brain health in older people and included questions about access to- and interest in- internet technologies. The factors affecting willingness to use technologies that support memory and ADL were identified using binary logistic regression analysis. 541 people aged 75 years and older from Cambridgeshire, Nottingham and Newcastle responded. Older adults were more willing to use technologies directed towards improving memory (65%) than towards ADL supportive technologies (38%). Regression analysis showed that an older age (OR = 0.64, 95% CI = 0.34–0.98), female gender (OR = 0.64, 95% CI = 0.42–0.99), no access to technology including laptops and tablets (OR = 0.48, 95% CI = 0.32–0.72), and self-reported physically less slowing down (but no objective health indicators) (OR = 0.57, 95% CI = 0.36–0.88) were strongly associated with UK older adults' lesser willingness to use memory assistive technologies while not having access to laptops and tablets (OR = 0.57, 95% CI = 0.39–0.84) was associated with willingness to use ADL supportive technologies. Older people, females and those with less access to technologies should be considered as target groups by healthcare providers, policymakers, and technology producers to promote technology and support healthy and independent ageing. [ABSTRACT FROM AUTHOR]

Objectives: Providing safe drinking water is essential for maintaining healthcare quality. The presence of biofilms in the water supply protects the organism from the antimicrobial effects of disinfectants leading to the formation of the MDR pathogen pool. Therefore, this study was taken up to determine the prevalence of biofilm formation in the bacteria isolated from the water system of a tertiary health care setup and study the effect of disinfectants on biofilms. Methods: Thirty-four drinking water samples were collected in sterile glass stopper bottles and transported to the lab. Standard bacteriological procedures identified isolates. Biofilm detection was carried out by the tissue culture plate (TCP) method. The effect of disinfectant (sodium hypochlorite) at various concentrations (0, 0.25, 0.5, 1, 2, and 4 %) on biofilm-producing organism were studied for 30 minutes and analyzed. Results: The culture positivity was 76.4% (26/34). Twenty samples showed monomicrobial growth, while only six samples showed polymicrobial growth of organisms. The most common organism isolated was Pseudomonas aeruginosa. Biofilm production was seen more in polymicrobial organisms, 91.66 % (11/12). A high level of resistance to chlorine compounds was seen in biofilm-producing microorganisms, especially those that produced robust biofilms. Conclusion: Resistance of biofilms against high levels of chlorine has implications for the delivery of safe drinking water. Drug resistance was seen in these organisms, which can be transmitted from drinking water sources to humans. Therefore, it is recommended that biofilm production should be evaluated in drinking water samples regularly. [ABSTRACT FROM AUTHOR]

Introduction: Lung cancer is the most common cause of cancer mortality worldwide, principally because of its late diagnosis. Chronic inflammation plays a significant role in tumour growth and progression via increasing the levels of inflammatory markers in blood. Inflammatory markers are expected to be valuable prognostic biomarkers in cancer. Markers like Absolute Neutrophil Count (ANC), Absolute Lymphocyte Count (ALC), platelet count, Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) may aid in assessing prognosis of lung cancer. Aim: To study the inflammatory markers (ANC, ALC, Platelet count, NLR and PLR) in lung cancer and correlate these markers with cancer stage and histopathological type. Materials and Methods: A hospital-based cross-sectional study was conducted in lung cancer patients at Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India. Sixty patients with lung cancer and sixty controls were included. The clinical characteristics, ANC, ALC, platelet count, NLR and PLR of cases and controls were assessed and compared. Also, the comparison of these inflammatory markers with Tumor, Nodes and Metastases (TNM) staging and histopathological type of lung cancer were documented and results were interpreted. The data analysis was done with the use of Statistical Package for Social Sciences (SPSS) software, IBM manufacturer, Chicago, USA, (Ver.) 26. Results: Mean age (years) of the case and control groups was 60.17 and 61.03, respectively. Distribution of gender in cases and controls was comparable. The major histology of lung cancer was Non-Small Cell Lung Cancer (NSCLC, 81.66%) out of which squamous cell carcinoma constituted 55.00% and adenocarcinoma 21.67%, followed by small cell carcinoma at 18.33%. Overall, 46.67% of the patients belonged to TNM staging IVA followed by IIIB (25.00%). The levels of ANC, platelet count, NLR and PLR were significantly elevated and ALC was decreased in cases as compared to control. There was no statistically significant association between the inflammatory markers ANC, ALC, platelet counts, NLR and PLR with the histopathological type of lung cancer. Mean ANC, platelet count, NLR and PLR were found to be significantly elevated in late stages of lung cancer, whereas, ALC had no such association with the stages of lung cancer. Conclusion: Inflammatory markers (ANC, platelet count, NLR, PLR, ALC) can serve as valuable prognostic biomarkers in lung cancer and can easily be used in resource-limited areas. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus complicates 1-14% pregnancies worldwide, it not only influences immediate maternal and neonatal outcomes but also increases the risk of future T2DM in the woman and her children. Aim of this study: To screen the primigravida, using 75gm OGCT one step, single value screening and diagnostic procedure and correlating their blood glucose values with neonatal birthweight. Material and Methods: Prospective observational study was done in the department of Obstetrics and Gynecology, Shadan Institute Of Medical Sciences, Teaching Hospital And Research Center for duration of 6 months that is from May 2022 to October 2022 on 100 primigravidae. Results: In this study, incidence of GDM was 11%, incidence of Glucose Intolerance was 12%, Mean Neonatal Birth Weight for normal glucose tolerance was 2.75kgs, impaired glucose tolerance was 3.03kgs and GDM was 3.22kgs, incidence of preterm labour with normal glucose tolerance was 6.4%, glucose intolerance was 8.3% and GDM was up to 18.2%, incidence of preeclampsia in normal blood glucose values was 10.3%, glucose intolerance was 16.6% and GDM was 18.2%,rate of caesarian section in normal glucose tolerance was 36.3%, impaired glucose tolerance was 75% and GDM was 63.6%, congenital anomalies among normal glucose tolerance was 0% and GDM was 9.1%, IUD among normal glucose tolerance was 1.1% and GDM was of 9.1%. Conclusion: In resource limited countries like India, DIPSI recommended one step, single value test irrespective of the last meal, is a very simple, cost effective and feasible procedure for universal screening and diagnosis of GDM. It is adopted by Ministry of Health (Government of India) for screening of GDM. The key finding here is that the risk of overweight and obese children rises in step with higher levels of blood sugar during pregnancy. By treating Gestational Diabetes, future risk of children becoming overweight, obese, PCOS, diabetes drops considerably. [ABSTRACT FROM AUTHOR]

To summarise existing systematic reviews which assessed the effects of physical exercise on activities of daily living, walking, balance and visual processing in people with dementia or mild cognitive impairment In this overview of systematic reviews and meta-analyses, seven electronic databases were searched to identify eligible reviews published between January 2015 and April 2021. A total of 30 systematic reviews were identified and included in the overview. The most frequent type of exercise for the intervention group was multimodal exercises. Mind-body exercises, exergames, dance intervention and aerobic exercise were other exercise types. Most of the reviews reported that exercise is significantly effective for improving activities of daily living (SMD 95%CI, from 0.27 to 1.44), walking (SMD 95%CI, from 0.08 to 2.23), balance (SMD 95%CI, from 0.37 to 2.24) and visuospatial function (SMD 95%CI, from 0.16 to 0.51), which are among the most leading determinants of independent living in individuals with dementia or mild cognitive impairment. Evidence has shown that exercise (especially multicomponent exercise programmes including cognitive, physical and multitasking exercises) with sufficient intensity improves the activities of daily living skills. Exercise also improves walking, balance and visual processing, which can provide a more independent life for people with dementia and mild cognitive impairment. Cognitively impaired people should therefore be encouraged to exercise regularly in order to be more independent. Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2019192 [ABSTRACT FROM AUTHOR]

Introduction: Experiences at time of delivery not only influence women's self-esteem and mother-child bonding but may also have impact on future birthing preferences. Various factors may influence women's birthing experiences and thus overall maternal health and utilisation of institutional health services. Respectful maternity care is an individual-centric approach aimed at recognizing women's preferences and needs thereby promoting skilled assistance during childbirth. Objectives: To study various factors affecting women experiences at childbirth at different health care facilities of central India. To give recommendations for formulating policies towards respectful maternal care. Material and Methods: Descriptive Cross-sectional survey of 510 women delivering at different health facilities conducted over a period of 3months at Department of Obstetrics and Gynecology, PCMS, Bhopal. Factors related to pregnant women, family, staff, and hospital setup which may influence women experiences were assessed using a 20-item based questionnaire as tool. Results: Total 510women were interviewed(mean age 27.8yrs, overall literacy rate90%). Overall, 41% reported good birthing experience. Facility-wise deliveries were, medical college(33%), district hospital and PHC(41%), private set ups(20%), Dai(5%). Factors commonly associated with good birthing experience were delivery at private setup(55%), consideration for privacy(75%), good family support(40%), shorter labour duration(40%), consent prior to examinations(58%), vaginal delivery(43%), adequate pain relief(49%) and good neonatal outcome(44%). Women delivered by Dai(50%), those left unattended(50%) and those experiencing physical or verbal abuse(75%) reported overall bad experiences. Majority(70%) with good experience looked forward to future pregnancies. Conclusion: Regular feedbacks and audit of factors influencing women's birthing experiences take priority. Respectful maternity care by promoting institutional deliveries would thus reduce overall maternal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Appliance labels allow consumers to choose products based on their energy use. In most countries, the widely adopted comparative categorical labels give information on energy use in physical units such as kilowatt-hour. Studies on the impact of monetary cost information on labels have reported different results across appliances within studies, and for the same appliances across studies. Recent studies on refrigerators show that monetary information increases the probability of cost-effectiveness analysis and fosters choice of energy-efficient refrigerators but do not estimate the consumer willingness to pay for higher efficiency category. In a discrete choice experiment, we observe choices of a sample of households divided into groups based on whether they get operating cost information on hypothetical choices. We estimate a mixed logit model with correlated random parameters and estimate the magnitude and distribution of consumer willingness to pay for higher energy efficiency category. We find that energy cost information on labels facilitate comparison of refrigerators based on energy-efficiency and leads to a positive willingness to pay for higher levels of energy efficiency. It also increases the share of respondents having a positive willingness to pay for higher efficiency. We conclude that annual energy cost information on refrigerator labels can improve the effectiveness of labelling policy in India. [ABSTRACT FROM AUTHOR]

India's increased pace of urbanisation is evident, but the question remains as to whether India can harness its developmental potential by providing social infrastructure to meet its projected growth. This paper investigates the urbanisation trajectory with respect to the provision of social infrastructure in the Capital Region of India. First, it applies the differential urbanisation model and predicts counter‐urbanisation to be the next stage of development. Second, using socio‐economic indicators, the paper finds high literacy rates and non‐agricultural employment in small towns. Third, it explains deconcentration of large cities as an outcome of congested social infrastructure provision. Fourth, it determines that small towns continue to have poor provision of social infrastructure. This paper recommends the integration of spatial planning with social infrastructure planning, the empowerment of lower‐tier authorities for social infrastructure delivery, and measures for raising local government revenue in the region and in similar regions throughout the Global South. [ABSTRACT FROM AUTHOR]

Abstract Background Multi-drug resistant Acinetobacter baumannii has emerged as important nosocomial pathogen associated with various infections including lower respiratory tract. Limited therapeutic options contribute to increased morbidity and mortality. Acinetobacter baumannii has the ability to persist in the environment for prolonged periods. Breach in infection control practices increases the chances of cross transmission between patients and inter/intraspecies transmission of resistance elements. The present prospective work was conducted among patients with lower respiratory tract infections (LRTI) in the intensive care unit (ICU) to study the etiology with special reference to Acinetobacter baumannii and the role of immediate patient environment in the ICU as possible source of infection. Acinetobacter baumannii were characterized for antimicrobial susceptibility, mechanism of carbapenem resistance and virulence determinants. Molecular typing of the clinical and environmental isolates was undertaken to study the probable modes of transmission. Materials and methods Appropriate respiratory samples from 107 patients with LRTI admitted to ICU during September 2016 to March 2017 were studied for likely bacterial pathogens. Environmental samples (n = 71) were also screened. All the samples were processed using conventional microbiological methods. Consecutive Acinetobacter spp. isolated from clinical and environmental (health care workers and environment from ICU) samples were included in the study. Antimicrobial susceptibility was performed as per CLSI guidelines. Carbapenem resistance, mediated by carbapenemase genes (bla OXA-23-like, bla OXA-24-like, bla OXA-58-like and bla NDM-1) were studied by PCR. Biofilm forming ability was tested phenotypically using microtitre plate method. Pulse Field Gel Electrophoresis (PFGE) was used to study clonality of the clinical and environmental isolates. Results The prevalence of Acinetobacter baumannii was 26.2% (28/107) and 11.26% (8/71) among patients with LRTI and environmental samples respectively. The carbapenem resistance was high, 96.42% (27/28) and 87.5% (7/8) in clinical and environmental isolates respectively. The most common carbapenemase associated with resistance was bla OXA-23-like gene followed by bla NDM-1 among both the clinical and environmental isolates. All isolates were sensitive to colistin (MIC ≤ 1 μg/ml). Biofilm production was observed among all clinical (n = 28) and 87.5% (7/8) of the environmental isolates. Line listing of the cases suggests the occurrence of infections throughout the study period with no significant clustering. On PFGE, 12 clusters were observed and 16/36 isolates were present in one single cluster that included both clinical and environmental isolates which were either carbapenem resistant or sensitive. Discussion Carbapenem resistant Acinetobacter baumannii (CRAB) is an important cause of LRTI in the ICU. PFGE suggests spread of carbapenem resistant isolates via cross transmission among patients and the environment. The detection of bla NDM-1 gene among Acinetobacter baumannii and existence of carbapenem resistant and sensitive isolates within the same clones suggests horizontal transmission of resistant genes among various bacterial species. The ability of Acinetobacter baumannii to form biofilms may contribute to its persistence in the environment. This along with breach in infection control practices are the likely factors contributing to this transmission. This information can be used to strengthen and monitor infection control (IC) and the hospital cleaning and disinfection practices to prevent spread of resistant organisms within the ICU. Colistin remains drug of choice for management of CRAB. [ABSTRACT FROM AUTHOR]

Contemporary urbanization, as experienced in India, is accompanied by increasing motorization and commuting lengths. A spatially unequal distribution of employment opportunities leads to important differences between urban and rural areas. Making use of newly released data at the district level on home-to-work commuting, this article examines the determinants of commuting patterns in the largest rural-urban megaregion of India. This paper finds that short trips and non-motorized travel are still predominant in the region. The residents of higher-income districts more often choose to commute by private motorized modes, including cars, whereas residents of poorer areas are tied to non-motorized modes and public transport, and they often must commute longer distances. One problem seems to be the low provision of rail service in the region compared to roads, which is more pronounced in rural areas. Overall, the socio-demographic, economic, infrastructure and area-based variables help explain the variation in the commuting patterns. This paper emphasizes that policy aiming at sustainable future transport in the National Capital Region requires (i) a shift in government policies from promoting road-based transportation to promoting transit, (ii) the regional integration of rural and urban areas by public transport, and (iii) investment in the provision of rural transport (roads and rail network) for regional development. [ABSTRACT FROM AUTHOR]

Appliance labels are a widely used policy instrument to increase the adoption of energy-efficient technologies. Most countries use categorical labels to facilitate comparison of appliances based on energy consumption. Studies have found that consumers respond positively to the labels, but the differentiated response to the categories on labels is not well understood in the literature. This study presents the results of a discrete choice experiment corroborated by an analysis of secondary market data to demonstrate that consumers differentiate between label categories; with a greater value being placed on appliances with higher levels of energy efficiency performance. We examine two appliances - air conditioners and refrigerators and observe that there are some differences in consumer response - likely due to the different usage patterns of the two appliances. Consumer responses were observed in hypothetical choice situations constructed ensuring statistical and design efficiency. In a mixed logit model specification with correlated random parameters, the magnitude and the distribution of consumer preference for the highest category of energy efficiency are estimated. The results are validated by estimating the incremental price of higher category of energy efficiency using market data for comparison. The sources of consumer heterogeneity for the highest category of energy efficiency are identified after controlling for other consumer variables. The findings presented in this paper are useful for improving the effectiveness of existing energy efficiency programs and designing new programs to accelerate adoption of energy efficient technologies. [ABSTRACT FROM AUTHOR]

In the countries of the Global South such as India, rapid urbanization and the increase in individual motorization may lead to a predominance of unsustainable commuting patterns. However, urbanization also has important positive effects, including the empowerment of women. This paper examines newly released, spatially disaggregated data on home-to-work commuting by non-agricultural workers in the National Capital Region of India. It aims to understand and compare commuting patterns in urban and rural areas, including choice of travel modes, commuting distances, and gender differentials. The results reveal a tendency observable in urban residents to use individual motorized transport more often both for short and for long trips, although the proportion of individual motorization is far from what it is in the industrial world. Rural areas are characterized by the predominance of non-motorized travel modes and a large share of long trips. The mobility gap between men and women does not appear to increase with literacy. In urban areas, women often choose to commute by car rather than using green modes of transportation (especially in higher-income districts). The paper stresses the importance of the area and gender differentials that need to be taken into account when formulating regional transport policies. [ABSTRACT FROM AUTHOR]

This paper proposes and applies a novel interdisciplinary framework to study peri-urban land use dynamics in India, which is theoretically embedded in the concepts of land use transition, land change science and neoliberlisation of nature. The framework is operationalised by a mixed methods approach cutting across scale and time to provide a comprehensive understanding of land use transitions. The paper proves the applicability of land use transition theory in India by establishing that the core state Delhi is in the "urbanised/industrialised" stage of land use transition, whereas the peripheral states are in a transition from "frontier" to "agricultural" stage of land use transition. The paper also provides evidence for different political economy-derived logics of nature's neoliberalisation. Field visits as well as expert and household interviews uncover a nexus between the state, civil society and economy in exploitation and degradation of natural resources for their vested interests. The use of local and global open access data in the framework makes it transferable to similar regions of the Global South facing data constrains. • Interdisciplinary framework is applied to India's land use transition analysis. • Theoretical approach is embedded in land change science and political economy. • Mixed methods approach cutting across scale and time is applied. • Stages of land use transition trajectory are detected for peri-urban areas in India. • Urban expansion is faster than population growth and depleted arable land and water. [ABSTRACT FROM AUTHOR]

This article examines the growth of census towns in India's Capital Region because the unregulated growth of census towns has been the key feature of recent urbanization in India. The article first examines the population and municipal status dynamics, location and economic characteristics of census towns as well as their migratory and commuting patterns. The status and costs of providing basic amenities and social infrastructure are then analyzed. The paper emphasizes the contribution of contemporary theories that explain the growth of census towns and the role of secondary and primary data in capturing their characteristics. Taking advantage of the economic potential of India's urbanization as census towns will require the following: (i) the enforcement of reforms to empower Gram Panchayat for spatial planning and growth regulation; (ii) the discontinuation of subsidized infrastructure provision and charging development tax; and (iii) investment in decentralized infrastructure for more accountable and more efficient delivery of basic amenities. [ABSTRACT FROM AUTHOR]

Based on the importance of distance as specified by Central Place Theory and New Economic Geography, this paper investigates the distance effect on urban transformation in the Capital Region of India by using spatial data and recently released census data on employment and urban amenities. This study applies a multiple-ring model and identifies a shadow effect for lower-tier settlements at a distance of 50 km and beyond 100 km from the megacity of Delhi. The higher-tier settlements produce 50 km wide shadow on lower-tier settlements, after which latter starts to trigger growth. The population seems to concentrate in the megacity and other million-plus cities in the region to maximize the utility of urban amenities, which are available only in higher-tier centres. The growth of million-plus cities in close proximity to Delhi state is a complementary effect. As the distance from higher-tier settlements increases, employment opportunities and the availability of urban services decrease, thus hindering the growth of the lower-tier settlements in the hierarchy. The paper concludes that traditional spatial decentralization polices have met with limited success and recommends embracing space-based policies to increase the growth potential of lower-tier settlements in the hinterland and to reduce spatial disparities in the region. [ABSTRACT FROM PUBLISHER]

Introduction: With advancing health care sciences, the prevalence of Accidental Exposure to Patient's Blood (AEBP) amongst Health Care Personnel (HCP) is bound to increase. The only means of preventing such accidental exposure is safe working practices. It is the responsibility of the teachers to inculcate these practices amongst their students. Aim: To evaluate the knowledge, practice and attitude regarding Post Exposure Prophylaxis (PEP) and Hepatitis-B Virus (HBV) immunization amongst faculty and undergraduate students and to assess the frequency of these occupational exposure with the objective of inculcating safe working practices in the teaching curriculum. Materials and Methods: The present study is a descriptive analytical cross-sectional study done from May 2012 to August 2012 in a newly established ESIC dental college at Rohini, Delhi. A 36-item survey questionnaire was distributed to 50 faculty and 115 dental undergraduate students. The survey included questions on demographic details of the respondents, the prevalence of AEBP, the knowledge regarding PEP and HBV immunization and the status of the respondents. The data was analysed using SPSS 12.0 software using various statistical tests such as frequency analysis, Chi-square test and others. Results: The mean age of the study group was 23.3±6.3 years. The prevalence of such accidental exposure was high being 49.7% in our study group. More than half of these respondents did not report the injury. The knowledge regarding the transmissibility of blood borne pathogens and the post exposure prophylaxis was suboptimal amongst the students and even teachers. Almost 20% of the study group was not immunized for HBV. Conclusion: Managing AEBP in HCP is a challenging issue. They are highly prevalent, largely underreported and poorly managed because of the unawareness regarding the hospital's protocols for reporting and PEP as is seen in the present study. Besides the administrative measures, orientation and reinforcement training of all the staff including faculty is desirable to maintain high level of knowledge and effectively handle such occupational exposure. [ABSTRACT FROM AUTHOR]

Sugar fatty acid esters are practical importance and have a variety of applications that include surfactants and as an emulsifying agent. In this study, we report glucose stearate synthesis using lipase-FeO nanoparticles catalyst. The influence of various reaction factors, such as silica gel concentration, molar ratio of sugar/acid, reaction temperature and speed of agitation on esterification by immobilized enzyme was analyzed. The glucose stearate esterification degree of 87.2 % was obtained under the optimized condition: 1:2 molar ratio of glucose/stearic acid, 2 % (w/v) of silica gel at 120 rpm and 40 °C. Glucose esters were characterized according to their surfactant activity like emulsification index, oil displacement activity and antimicrobial activity. The results indicated glucose stearate acts as biosurfactant, with emulsification index of 66 % in mustard oil and oil displacement activity of 19.64 cm. [ABSTRACT FROM AUTHOR]

This paper empirically examines the applicability of the planetary urbanization concept to understand the complexities associated with the rural-to-urban transformation process unfolding in India. It contributes to the rural-urban debate by investigating the role of non-urban spaces – here census towns – in accelerating India's process of urbanization. The Capital Region of India is taken as a study area and a mixed methods approach is used to establish concentrated and extended urbanization as interlinked processes in relation to the growth of census towns. The applied mixed methods approach helps to overcome the critiques of deploying Global North theories, here planetary urbanization, on the Global South context by not only establishing a general pattern and dynamics of growth but also by contextualizing the local characteristics of rural to urban transformation as census towns. The analysis established a dense network of transport and a high level of commuting for work between statutory towns and census towns in the urban periphery and hinterland overcoming the traditional urban and rural divide. This paper makes a methodological and analytical contribution to the concept of planetary urbanization, whereby growth of census towns can be explained as an interlinked process of concentrated, extended and differential urbanization. The political economy analyses established that the differences between statutory and census towns can be traced back to state rescaling and investment policies. In this process, rural areas are rapidly acquiring urban characteristics as census towns and to some extent perform better on socioeconomic and infrastructural aspects compared to statutory towns (official urban areas). • Concept of planetary urbanization applied to India's rural to urban transformation. • Concentrated and extended urbanization established as interlinked processes. • Rural areas are rapidly acquiring urban characteristics as census towns. • Mixed methods help overcome the critique of planetary urbanization concept. [ABSTRACT FROM AUTHOR]

The policy of economic liberalization pursued by the Indian government since the 1990s in response to an economic slowdown has led to the creative destruction of institutional space and the built environment. India launched the Smart Cities Mission and the Delhi-Mumbai Industrial Corridor to enhance infrastructure delivery and employment opportunities. Focusing on these cases and using direct observation and in-depth personal interviews, this paper explores the role of emergent neoliberal projects in the country's institutional and spatial restructuring at different scales. The aim is to make a twofold contribution to urban research: first, to contribute to the discourse on neoliberalism by identifying institutional and spatial restructuring in India based on the concept of creative destruction; and second, by validating the significance of strong state and political willingness in distributing neoliberal benefits such as affordable housing and services to the poor. The paper argues for a stronger role of the state in creating equity in the urban development process and infrastructure delivery. • Institutional and spatial restructuring under neoliberal projects in India is examined. • The concept of "creative destruction" is operationalized. • Moments of restructuring are supported by in-depth personal interviews. • A stronger role of the state in urban development process is argued for. [ABSTRACT FROM AUTHOR]

In this work, we report the covalent immobilization of lipase enzyme on the surface of chitosan coated magnetic nanoparticles (MNPs) using N -(3-dimethylaminoproyl)- N -ethylcarbodiimide (EDC) and N -hydroxysuccinimide (NHS) as coupling agents. Surface functional groups of chitosan coated MNPs, lipase enzyme, and immobilized lipase enzyme were characterized by Fourier transform infrared spectroscopic (FT-IR) analysis. The structural characteristics of the chitosan coated magnetic nanoparticles were analyzed by X-ray Diffraction (XRD) studies. The statistical methodology with central composite design (CCD) was applied to evaluate the effects of immobilization, including the magnetic nanoparticles, lipase enzyme, pH and immobilization time on the enzyme activity. Based on the statistical analysis, the optimum immobilization conditions of magnetic nanoparticles (40 mg), lipase enzyme (40 mg), pH (9), and immobilization time (6 h), the maximum enzyme activity obtained was 16.94 U/mL. The optimum pH and temperature for maximum enzyme activity of immobilized lipase are found to be pH 9 and 40 °C respectively. The immobilized lipase exhibited excellent catalytic activity over eight successive cycles and retain 64% original stability. The Michaelis–Menten enzyme kinetic studies of immobilized lipase on chitosan coated MNPs showed maximum activity ( V max ) and Michaelis–Menten constant ( K m ) of 33.7 (μmol/mL min) and 0.89 mM respectively. The thermal stability of lipase was significantly improved after immobilization. The thermal deactivation rate of immobilized lipase was studied to follow the Arrhenius law with deactivation energy of 73 kJ/mol. Glucose ester yield of 80.8% was achieved in this study revealed that immobilized lipase on MNPs have promising application in industrial scale for sugar ester production. [ABSTRACT FROM AUTHOR]

The preparation of chitosan-coated magnetic nanoparticles (MNPs) and covalent immobilization of α-amylase for starch hydrolysis was investigated. Surface morphology, chemical composition, and structural characteristics of the MNPs were analyzed by scanning electron microscopy, energy dispersion spectrometry, and X-ray diffractometry, respectively. Surface functional groups of MNPs, chitosan-coated MNPs, and α-amylase-immobilized MNPs were characterized by Fourier transform infrared spectroscopy. Response surface methodology based on three levels was implemented to optimize three immobilization conditions and a regression model was developed. α-Amylase-immobilized MNPs provided better stability towards pH and temperature. The prepared thermostable nanobiocatalyst is well-suited for industrial processes involving starch hydrolysis. [ABSTRACT FROM AUTHOR]

In the 20th and 21st centuries, the world has experienced rapid urbanization and slum proliferation. Slum residents form a significant portion of urban populations and contribute to the development of cities. However, due to their highly concentrated consumption and waste production patterns, slums endure and exacerbate, among other things, environmental degradation. To date, our understanding of slums in Indian cities has been primarily based on census data and evidence from remote sensing images. These data do not yet provide spatial slum dynamics over time and are limited to static and statistical representation. In addition to the obsolescence of spatial data, the non-availability of consistent socio-economic data leads to data integration problems. Therefore, new approaches that consider the scarcity of data and the choice of analytical techniques are needed; planners without advanced technical training should also be able to easily apply these approaches. This study provides a comprehensive approach to examine the urban transformation of the National Capital Territory of Delhi (NCT-Delhi), India, from 1971 to 2011. Combining data from multi-temporal remote sensing images, census population statistics, slum enumeration and the provision of essential services, these investigations reveal a previously undocumented rapid increase in built-up areas outside municipal boundaries. The findings confirm the spatial shift of slums from the city center towards the periphery. The analysis provides a revealing insight: the emergence and growth of slums are outcomes of the prevailing urban planning environment, the limited success of adopted policies and the government's inability to foster growth. [ABSTRACT FROM AUTHOR]

Background & Objective: A prospective comparative study was done to see the prevalence of Dengue, Malaria and mix infections in the patients attending in tertiary care hospital during a period of March 2013- February 2014. Study also included the pattern of changing Hematological parameters during infections. Methodology: Patients suffering from fever of more than 4-5 days were investigated for Dengue, Malaria and concurrent infections. Peripheral blood smear examination was done for Malaria while Rapid card and IgM & IgG ELISA were done for Dengue. Hematological investigations- CBC, Platelet count was done by sysmex auto analyzer. Results: Total 3650 samples of suspected cases tested for Dengue and Malaria. Out of 3650 samples 934 were positive of Dengue, Malaria and mix infections. Out of 934, 105 were Malaria, 816 Dengue and 13 cases of mix infections were found. In Malaria positive cases Hematological parameters showed anaemia, thrombocytopenia and Eosinophilia while in Dengue cases thrombocytopenia was observed. Conclusion: Prevalence of Dengue is more than Malaria in Moradabad during the study period. Hematological parameters of the cases Dengue, Malaria now are changing their patterns that are a serious matter of concerned. Even mix infections are also building up in the society that's why Hematological parameters must be monitored regularly. [ABSTRACT FROM AUTHOR]

Background and Aims: Catheter-associated urinary tract infection (CAUTI) is one of the most common health care acquired infection encountered in clinical practice. The present study was planned to assess the knowledge and attitude of health care providers regarding the indications for catheterization and methods of preventing CAUTI. Methods: A prospective questionnaire-based survey was done from March 2011 to August 2011. A structured questionnaire comprising of 41 items related to demographic details of the respondents, their knowledge regarding indications for catheterization and methods of preventing CAUTI was given to 54 doctors and 105 nurses. The response was evaluated for statistical correlation using a computer software. Results: The mean years of experience of the respondents in the health care setup was 6.8 years. Only 57% of the respondents could identify all the measures for prevention of CAUTI. The knowledge regarding the indication for catheterization though suboptimal was significantly better amongst the doctors as compared to nurses. Conclusion: The knowledge regarding indication and preventive measures was suboptimal in our study group. There is a tremendous scope of improvement in catheterization practices in our hospital and education induced intervention would be the most appropriate effort toward reducing the incidence of CAUTI. [ABSTRACT FROM AUTHOR]

Objective: The diagnosis of enteric fever currently depends upon the isolation of Salmonella from a patient, most commonly by blood culture. This facility is not available in many areas where the disease is endemic. The Widal agglutination test which demonstrates the presence of somatic (O) and flagellar (H) agglutinins to Salmonella in the patient's serum using O and H antigen suspension is one of the most utilized diagnostic tests for typhoid fever in developing countries. In the recent past, a rapid slide test was developed which is now the most commonly used technique in local laboratories because of its convenience. The semiquantitative slide test provides an approximation to the tube test titre. The present study was an attempt to compare the results of semi-quantitative slide agglutination with the quantitative tube method to ascertain any significant difference between two methods. Material and Methods: 300 precollected blood samples of OPD patients were collected over a period of 4 months and subjected to semi-quantitative rapid slide and quantitative tube Widal tests using commercially available Salmonella antigen test kits. Results: From the 300 samples studied, 17(5.7%) serum samples were positive by slide test method while 25(8.7%) seropositive by Tube test method. Present study shows, slight difference in the results obtained by the two methods of Widal test. Conclusion: The Tube Widal test is more sensitive and specific than slide Widal test, especially for rule out prozone phenomena, but slide Widal agglutination test is found to good alternative screening test because less time consuming, easy to perform, cost effective and can be applied in resource poor nations. There is an urgent need for the rational design and evaluation of effective and appropriate diagnostics for typhoid fever. [ABSTRACT FROM AUTHOR]

Introduction: Rickettsia diseases are now established as re-emerging zoonotic bacterial infections in the Indian subcontinent. Objectives: The retrospective study was conducted to see the trends of scrub typhus with cofactors like disease & sex ratio significance and impact of seasons on the disease outcome in the Jaipur, Rajasthan. Methods: A total of 2233 samples were processed between January 2013 to November 2016 suspecting rickettsia infection with complaints of fever, rash, oedema, hepatosplenomegaly, lymphadenopathy and an eschar, with or without a history of tick exposure at Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan. IgM antibodies to Orientia tsutsugamushi antigen were tested by ELISA method. Results: A total of 2233 samples were processed from january 2013 to november 2016. Out of 2233 samples 475 samples were IgM antibody reactive by ELISA method. In 2013 positivity is 36.38% while in 2014 positivity is 24.34%. In 2015, 21.49% positivity rate while jannov16, 12.43% positvity. Females are more prone to infection then male patients specially with rural background. Maximum numbers of cases were reported from the month of August to October. Conclusions: Scrub typhus is prevalent but an underdiagnosed disease in India. The prevalence is gradually decreasing with increasing sample size every year with female patients predominence. Trends are more in late rainy season between August and October months. Rickettsia - specific IgM ab ELISA tests can help in early diagnosis & early empiric therapy which can be given to reduce serious complications and mortality. [ABSTRACT FROM AUTHOR]

Abstract: Managing growth in rapidly growing complex mega urban regions in India is a growing concern for planners and scholars. Although the government attempts to regulate the development by spatial decentralization, there are no easy solutions, resulting in undesirable growth and associated problems. However, a good mix of (fiscal and regulatory) interventions, although difficult to implement, has the potential to achieve effective urban growth, as exemplified by Tokyo in Asia and London in Europe. Examining the National Capital Region (NCR) Delhi as a case study, this study evaluated the performance of some aspects of spatial decentralization policy. The investigation identified the need to link jobs and housing, redefine the concept of greenbelt, and integrate transport and land-use planning. We recommend introducing a mix of interventions to effectuate spatial decentralization. [Copyright &y& Elsevier]

While neoliberalisation has long drawn scholarly attention, there have been few attempts to quantify the course of restructuring under neoliberal urbanisation. This paper aims to describe and quantify the restructuring process in India for the period 1991–2011. Theoretically embedded in the notion of "creative destruction", the paper adopts a multi-method approach to better discern the interjurisdictional differences of the restructuring process. This research contributes to the urban debate by statistically measuring and distinguishing restructuring process between urban and rural areas using creative destruction moments as well as by underscoring the need for an integrated analysis of rural and urban areas for addressing spatial disparities. • Concept of creative destruction is applied to India. • Multi-method approach is operationalized across space and time. • Neoliberal restructuring is measured by a set of destructive and creative moments. • Features of the restructuring process in urban and rural areas are discerned. • Integrated analysis of rural and urban areas is recommended to curtail disparities. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) is an important and common cause of mortality and morbidity in immunocompromised patients such as those with HIV/AIDS, transplant recipients on immunosuppressive therapy, and malignant hematological disease. After primary infection with CMV the virus becomes latent in multiple organs and can later be reactivated during severe dysregulation of the immune system. A large population carry dormant virus and are thus at risk for reactivation. However, reactivation of CMV has been reported in "non-immunosuppressed patients" such as severe trauma, sepsis, shock, burns, cirrhosis and other critically ill patients lying in the intensive care units. Therefore, the intensivists are increasingly facing a dilemma of identifying such patients to treat and there is a debate if there is a scientific justification for prophylaxis in such immunocompetent patients. [ABSTRACT FROM AUTHOR]

The study of temperature regulation of human body will help to better understand the physiology and functioning of every biological system. Skin is the largest organ of the integumentory system playing an important role to maintain the body core temperature (Tb) at 37°C. Any disturbance in the temperature regulation may cause lots of abnormality in the body. The purpose of this paper is to present an overview of temperature variations of tissues of human peripheral region during wound healing process after plastic surgery. An attempt has been made to study temperature variations of normal region (region before surgery) as well as abnormal region (region after surgery) of human peripheral region after the plastic surgery at different atmospheric temperatures and rates of evaporation for an undressed wound by extending finite domain to infinite using infinite element method (IEM). The two-dimensional peripheral region (skin and subcutaneous tissues) consists of finite triangular elements of very small size and the infinitely long rectangular elements. The appropriate shape functions are used for the elements. Physiological parameters like thermal conductivity, rate of metabolism, blood mass flow rate, latent heat, rate of evaporation etc. are used along with the proper initial and boundary conditions. The temperature variations are noted for tissue of donor site (normal region) as well as tissues after surgery (abnormal region). The information obtained from this model can be of great use for biomedical scientists for application in treatment of various diseases as well as helpful to develop protocols for medical purpose. [ABSTRACT FROM AUTHOR]

Hemoglobin (Hb)-F inducers are known to improve Hb level and transfusion dependence in thalassemia. This pilot study was conducted to assess the efficacy and safety of Hb-F inducer thalidomide compared to hydroxyurea (HU) in Hb E-β thalassemia patients. This was a prospective interventional single-centre study with 45 Hb E-beta thalassemia patients equally divided into group-I (thalidomide+folic acid), group-II (HU + folic acid) and group-III (folic acid). Response was assessed at various time intervals with 12-months follow up period. Primary end points were increment in Hb, Hb-F level and improvement in transfusion requirement; secondary end point were tolerability and safety. There was 100% responder (R: Hb-increment ≥1 g/dl) in group-I with 66.67% major responder (MaR: Hb-increment ≥2 g/dl), while there were 40% and 0% responder in group-II and III respectively. Hb-increment was significantly (p-value <0.0001) better in thalidomide arm compared to HU. The Hb-increment was attributable to both increase in Hb-F levels and reduction in ineffective erythropoiesis in thalidomide arm. Transfusion reduction was significantly better in group-I compared to group-II (100% vs 34%). No severe adverse effects was reported by patients of any group. Thalidomide showed a persistent significant Hb-increment and transfusion independence in Hb E-β thalassemia patients compared to HU. [ABSTRACT FROM AUTHOR]

This paper revisits the potential of urban cycle models to investigate the current challenges of urbanisation in India. It contributes not only by empirically examining the past, current and future trend of urban development, but also by predicting the demand for social infrastructure for sustainably accommodating the predicted growth. Using a non-spatial model, rapid growth is predicted in small cities in developed regions and in intermediate cities in developing regions. The adopted spatial model suggests a decline of megacity cores, but the growth of million-plus city cores and respective peripheries should be anticipated. Socio-economic factors are helpful for understanding the growth of million-plus city cores and megacity suburbs. In those cities predicted to grow, the provision of health and education infrastructure will be below the government norms. Given the data constraints, rapid growth and institutional constraints, this research develops and implements an analytical approach, thereby enhancing understanding of spatial development and elucidating the policy reforms needed to reduce the spatial disparities in India. This approach is transferable to the regions of the Global South facing similar constraints. • Urban cycle models are revisited to establish urbanisation stages in India. • Growth of small and intermediate-size cities is predicted. • Megacities core will decline and million-plus cities core will grow. • Provision of health and educational infrastructure is inadequate in cities. • Policy reforms for reducing spatial disparities in the Global South are recommended. [ABSTRACT FROM AUTHOR]

Background: The presence of anti-HBc IgG in the absence of HBsAg is usually indicative of a past self-limiting HBV infection. But it is frequently associated with co-infection with HCV which can worsen the existing status of chronic liver disease (CLD). Objectives: The present study was planned to evaluate the significance of isolated HBc IgG positivity in patients of CLD and look for the presence of HCV co-infection in such patients. Methods: Clinical profiles and biochemical tests were done for all the 77 CLD cases included in the study. Blood samples were taken from these patients and tested by the commercially available EIA for the presence of HBsAg, anti-HBc IgG, anti-HBs and anti-HCV. HBV DNA was detected by amplifying the surface region in all the cases. Results: Isolated anti-HBc IgG positivity defined as the presence of anti-HBc IgG in absence of any other serological markers of HBV infection was detected in 28 patients. Out of 64 patients positive for anti-HBc IgG 36 had the markers of HBV, either HBsAg, HBV DNA or anti-HBs alone or in combination. There was a significant association between isolated anti-HBc IgG positivity and HCV co-infection. Conclusion: Anti-HBc IgG should be tested in all patients with CLD as it is frequently the only marker of HBV infection in such patients and they should be monitored closely as such patients can develop CLD. Presence of co-infection with HCV should be actively searched for in such patients. [ABSTRACT FROM AUTHOR]

Although strategies to create transport corridor are prevalent in the global South, there is a lack of empirical research to evaluate these initiatives, in particular whether they have realised their general goal of reducing regional disparities. The current paper describes a multi-method approach involving spatial and non-spatial analysis to investigate spatial disparity along a proposed corridor and examine its integration within the existing settlement structure. The analytical framework is tested on India's Delhi-Mumbai Industrial Corridor. A rationale is developed to enable a critical view of corridor policies as strategies for development in the global South. One important finding regarding policies on transport corridors is the risk that future growth will remain concentrated in districts directly linked to a proposed corridor, leaving peripheral areas marginalised. An integrative analysis of current spatial and social disparities in India shows growth to be high in areas with good accessibility between urban and rural areas. Specifically, growth in rural areas is fostered by the availability of good road network, and polytechnic and vocational institutions, whereas in urban areas, growth is positively associated with the provision of secondary schools. In order to prevent or even reduce disparities, this research recommends that spatial strategies be developed with mechanisms to enable their implementation by lower tiers of governments, that spatial plans and infrastructure outlays be reformed to improve accessibility between proposed corridors and peripheral areas, and that accessibility indicators be included in the design and implementation of transport development policies. • An ex-ante evaluation of disparities along transport corridor in India is conducted. • A multi-method approach involving spatial and non-spatial analysis is used. • Socioeconomic disparities are established. • Lack of integration between corridor and existing settlements is ascertained. • Evidence-based policy reforms are recommended for reducing disparities in India. [ABSTRACT FROM AUTHOR]

The urbanisation process in the Global South is characterised by the blurring of the boundaries between urban and rural areas and the lack of institutional capacity, which have made the process highly unsustainable. In India, an example of such development is the rapid growth of "census towns". These settlements are not acknowledged as urban by the state, but they play an important role in accommodating population growth. This paper aims to elucidate and understand the process and characteristics of Indian urbanisation better in light of relevant theoretical discourses by using a mix of statistical analysis and field survey. It argues for moving from traditional master planning, which originated from the Global North to a more participatory and strategic approach in order to achieve infrastructure integrated development. • Contemporary theories are validated on census towns growth in India. • Mixed-methods approach helps uncover important characteristics of urbanisation. • Census towns are unplanned developments, but are crucial for Indian urbanisation. • A move from master planning to participatory strategic planning is recommended. [ABSTRACT FROM AUTHOR]

Context: Furan and its derivatives constitute a vital class of heterocyclic chemistry used widely in organic synthesis via Diels–Alder reactions. As fluorine incorporation has been of great interest due to the limited possible pathways, the present study on [4 + 2] cycloaddition Diels–Alder reaction, between hexafluoro-2-butyne and 2-substituted (NH2, OCH3, OTMS, NHBoc) furans, uses the reaction as a likely route. The computational study revealed that that the reaction is feasible in all conditions and is most favorable for NH2 substituent in furan. The study of the effect of temperature has depicted that low temperature favors the formation of adducts, while the rise in temperature prefers ring opening to form 4-substituted-2,3-di(trifluoromethyl)phenol derivatives. The feasibility of a reaction has been determined by Gibbs energy change. The transition state study has been performed to find the activation energy, C–C single bond formation and global electron density transfer (GEDT) involved in the adduct formation. MEP plots have been used to understand the region of electrophilicity and nucleophilicity character. Furthermore, the mechanism for the formation of phenol products has been discussed. The decomposition of the NHBoc group at higher temperatures has been proved via a proposed mechanism and compared with experimental results. Methods: The reaction was theoretically investigated using B3LYP hybrid functional with 6–311 + G(d,p) basis sets, in gas phase and under different solvent conditions like water, acetonitrile, and THF. The transition state structures of the adduct were optimized at the lower basis set B3LYP/6–31 + G(d,p) as well as at the higher basis set B3LYP/6–311 + G(d,p) level. The changes in Gibbs energy (∆G) for the formation of products at different temperatures and in various solvents have been calculated at B3LYP/6–311 + G(d,p) level. [ABSTRACT FROM AUTHOR]

Introduction: The kidney is one of the most highly differentiated organs in the body, affected by various disease processes, some resulting in permanent damage leading to surgical removal of the organ i.e., nephrectomy. Patterns of the indications for nephrectomy vary in different age groups, geographical locations and time periods. Nephrectomy is a common procedure in urological practice done for various conditions like calculi, chronic pylelonephritis, malignancy, obstruction, injury etc., with wide range of morbidity and mortality. Aim: The aim of this study was to study the pattern of histopathological lesions in nephrectomy cases in Southern Rajasthan. Materials and Methods: This study was conducted in the Department of Pathology, Geetanjali Medical College and Hospital (GMCH), Udaipur, Rajasthan. It was a cross-sectional study performed on 121 patients, from January 2015 to March 2020 in which patient's detail such as age, sex, gross and microscopic findings were retrieved and reviewed. Data was tabulated and analysed. Results: A total of 121 specimens of nephrectomy were included in the study. Among 121 nephrectomy cases, higher incidence was observed in 6th and 3rd decade of life with approximately equal preponderance of male and female; 0.98:1. Out of 121 cases 88 (72.7%) were non-neoplastic and 33 (22.27%) were neoplastic. Conclusion: Benign conditions of kidney are the leading cause of End Stage Renal Disease (ESRD) in the developing world. In our country, there are an increased number of ESRD which require dialysis and transplantation. This study has been performed to know the different causes of nephrectomy in a tertiary care center of India. [ABSTRACT FROM AUTHOR]

Introduction: It is unclear if serum procalcitonin (PCT) estimated at sepsis suspicion can help detect culture-positive sepsis in neonates. We evaluated the diagnostic performance of PCT in culture-positive sepsis in neonates. Methods: This was a prospective study (February 2016 to September 2020) conducted in four level-3 units in India. We enrolled neonates suspected of sepsis in the first 28 days of life. Neonates with birth weight <750 g, asphyxia, shock, and major malformations were excluded. Blood for PCT assay was drawn along with the blood culture at the time of suspicion of sepsis and before antibiotic initiation. The investigators labeled the neonates as having culture-positive sepsis or "no sepsis" based on the culture reports and clinical course. PCT assay was performed by electrochemiluminescence immunoassay, and the clinicians were masked to the PCT levels while assigning the label of sepsis. Primary outcomes were the sensitivity, specificity, and likelihood ratios to identify culture-positive sepsis. Results: The mean birth weight (SD) and median gestation (IQR) were 2,113 (727) g and 36 (32–38) weeks, respectively. Of the 1,204 neonates with eligible cultures, 155 (12.9%) had culture-positive sepsis. Most (79.4%) were culture-positive within 72 h of birth. The sensitivity, specificity, and positive and negative likelihood ratios at 2 ng/mL PCT threshold were 52.3% (95% confidence interval: 44.1–60.3), 64.5% (60.7–68.1), 1.47 (1.23–1.76), and 0.74 (0.62–0.88), respectively. Adding PCT to assessing neonates with 12.9% pretest probability of sepsis generated posttest probabilities of 18% and 10% for positive and negative test results, respectively. Conclusion: Serum PCT did not reliably identify culture-positive sepsis in neonates. [ABSTRACT FROM AUTHOR]

Erasmus syndrome is the association of silica exposure and subsequent development of systemic sclerosis. Here we discuss five cases that presented with progressive shortness of breath, arthralgia, skin tightening, and Raynaud's phenomenon. History of exposure to silica dust was present in all cases, and further serological (Anti-Scl-70 antibody positive), radiological, and histopathological (skin biopsy) investigations confirmed the diagnosis of systemic sclerosis. Hence the diagnosis of Erasmus syndrome was made. Therefore, careful screening should be done in patients of silicosis with systemic symptoms to rule out any associated connective tissue disorder. Timely diagnosis and early intervention can prevent the patients from developing life-threatening complications and improved quality of life. [ABSTRACT FROM AUTHOR]

Introducation: Multi-drug resistant nosocomial infections are one of the leading causes of mortality and morbidity amongst hospitalized patients throughout the world, accounting a major burden on the patients and public health system of any country Method :To determine the prevalence of aerobic bacterial in different clinical specimens received from various Intensive Care Units (MICU, SICU, CCU, PICU, and NICU) and their antibiotic susceptibility pattern in the isolated organisms in a tertiary care hospital in Jaipur, Rajasthan. Result : Out of 500 samples, 213 (43%) samples showed growth while 287 (57%) did not show any growth. In the 213 positive samples 183 (85.92%) were Gram Negative bacilli while 25(1.74%) were Gram Positive Cocci and 5 (2.34%) were candida spp.Out of Gram Negative Isolates Acinetobacter Spp. was found to be maximum 35.2% followed by E.coli 19.7%, Klebsiella spp.19.2%, Pseudomonas 12.2%, Citrobacter 0.93% and Proteus Spp. 0.93%. Among Gram Positive Isolates Staphylococcus aureus was maximum 6.5% followed by Enterococcus 3.75%, CONS 0.93% and streptococcus spp.0. 46%. Candida spp. contributes 2.34% of all positive culture. Conclusion: Isolates are sensitive to combination drugs while more resistant to single drug. Among gram negative bacteria most common isolate was Acinetobacter spp. 75 (35.2%) which were resistant to most of the antibiotics like amoxycillin- clavulanic acid (83%), cefotaxime (76%), imipenem (71%), piperacillin- tazobactam (53%),cefepime (57%) while sensitive to aztreonam (64%) and cotrimoxazole (64%). [ABSTRACT FROM AUTHOR]

Objective. Past decade has seen increase in cases of tuberculous meningitis (TBM) and multidrug resistance in such cases. The mortality rate for a mismanaged IBM is very high which increases manifold in presence of associated complicating factors. The present study was thus planned to evaluate the prevalence of MDR-TBM and look for associated complicating factors and carry Out drug sensitivity pattern in all culture positive isolates. Methods: One hundred cerebro-spinal fluid (CSF) samples from children clinically suspected of having TBM were collected and processed for detection of Mycobacterium tuberculosis by conventional methods like Ziehl-Neelsen (ZN) staining, Lowenstein- Jensen (U) culture and newer method like BACTEC 460 TB culture. Antimicrobial susceptibility was performed on all culture positive isolates by BACTEC 460 TB system. Findings: Twenty two cases could be diagnosed as definitive TBM based on BACTEC culture. Of these 22 cases, six cases (27.3%) were positive by ZN staining and/or U culture. Of all isolates tested for drug sensitivity 18 were Sensitive to all four drugs whereas 4 isolates were resistant to more than one drug. conclusion: Since the prevalence of MDR-TBM is very high we conclude that all CSF samples should be subjected to sensitivity testing to diagnose it at an early time and determine its sensitivity pattern in view of its very high mortality. [ABSTRACT FROM AUTHOR]

Keeping in view the complications and the case fatality associated with dengue virus, several serologic tests have been developed. However, the major drawback of these serologic tests is the need for a venous blood sample obtained by invasive venipuncture. As a noninvasive alternative, saliva provides a body fluid that contains antibodies of diagnostic importance. Hence, the detection of DEN-specific IgM and IgG antibodies in serum and saliva from 80 patients was compared. Salivary IgM antibodies were detected in 100% of the serum IgM-positive samples and in 30% of the serum samples that were negative for IgM antibodies. Salivary IgG antibodies were detected in 93.3% of the serum samples that were positive for anti-dengue IgG antibodies and in none of the serum IgG-negative cases. None of the specimens from the healthy controls showed the presence of IgM or IgG antibodies. The detection of both IgG and IgM antibodies in saliva correlated well with the serum IgG and IgM detection by the ELISA test ( r = 0.6322 and r = 0.4227). Detection of salivary IgM antibodies by ELISA showed 100% sensitivity, 70% specificity, 90.9% positive predictive value, and 100% negative predictive value. The detection of IgG in saliva proved to be a promising tool as the sensitivity, specificity, positive predictive value, and negative predictive value were found out to be 93.3%, 100%, 100%, and 83.3%, respectively. Thus, from this study we conclude that the detection of DEN-specific salivary IgG and IgM antibodies are useful markers for dengue infection. [ABSTRACT FROM AUTHOR]

Introduction: In development of cancer chronic inflammation plays a major role. Most established determinants of Prostate Carcinoma (PCa) are modern life style genetics, and age. In the first prostate biopsy, approximately 1 out 5 men i.e., 20% with PCa may be misdiagnosed. Therefore, there is clear requirement of novel markers, which can detect both clinically significant PCa, and prevent unnecessary biopsy. Some solid tumours found to have association of Neutrophil to Lymphocyte Ratio (NLR), Platelate to Lymphocyte Ratio (PLR) and Red-cell Distribution Width (RDW). Aim: Aim of this study was to scrutinise the significance of association of Prostate Specific Antigen (PSA), PLR, NLR and RDW with PCa. Materials and Methods: This study was conducted using the cross-sectional method in the Department of Pathology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan between Jan 2018 to Nov 2020. In this cross-sectional study 84 patients who underwent Tran Rectal Ultrasound (TRUS) guided were included. Complete Blood Count (CBC) was used to determine PLR, NLR and RDW and biochemical test for PSA. Patients were divided into two groups; having benign and malignant pathology. Unpaired t-test, Mann-whitney U test, logistic regression analysis and correlation were performed for statistical analysis. Results: With the use of univariate logistic regression, association between PSA, NLR, PLR, RDW values and PCa detection was determined. We found that serum PSA was significantly more in the PCa group (as BPH and prostatitis are both benign conditions so are kept in nonPCa group) compared to other two groups (p<0.001). There was no statistically significant difference in NLR, PLR and RDW values (p=0.150, p=0.070. p=0.441, respectively was found in nonPCa and PCa group). Conclusion: PSA has statistically significant association with PCa group but PLR, NLR and RDW was not considered to be the significant predictor in benign as well as malignant group. [ABSTRACT FROM AUTHOR]

Objective: The major objective of this study was to carry out concurrent testing of cervical swab samples with both conventional and fluorescent staining method using Giemsa stain & direct fluorescent antibody stain (DFA) respectively. The study would enable us to establish an appropriate, effective and sensitive method of diagnosis of genital chlamydial infections within the present set-up. Material & methods: The study "A Comparative Study of laboratory Diagnosis of Genital Chlamydial Infections in Women by Immunofluorescence and Conventional Staining Method" was conducted on 50 patients attending the OPD of a tertiary care hospital of Ahmedabad. Results: Out of the total 50 cases tested, four samples were found positive containing dark-purple inclusion bodies of Chlamydia trachomatis surrounding the nuclei of the host cells in Giemsa and the same were positive for elementary bodies of C. trachomatis by the DFA staining. Based on these samples, the prevalence of is 8% only. Conclusion: The present comparative study of Giemsa and DFA staining for Chlamydia trachomatis infections in females showed that both methods are equally sensitive for the detection of the microorganism. [ABSTRACT FROM AUTHOR]

The mortality associated with lower respiratory tract infection is high. Indiscriminate use of antimicrobials leads to alteration of respiratory tract flora and development of multi-drug resistance. Rapid diagnostic tests to confirm infection can guide the clinicians about antimicrobial treatment. So the present study was planned to evaluate the role of direct gram stain examination as a rapid and simple test to help clinicians for appropriate patient management. The present study was conducted on 1000 respiratory specimens which were processed using conventional microbiological techniques. Gram stain smear and culture results were compared statistically to assess the sensitivity, specificity, positive and negative predictive value. The agreement between gram stain smear examination and culture was calculated using kappa statistics. Potential pathogens were obtained from 28 of 209 deeply coughed out sputum samples (13.3%) and from 19 of 315 saliva mixed sputum samples (6%). Out of 473 tracheal aspirates, 115 (24.3%) had potential pathogens. The sensitivity for predicting infection was higher for good quality sputum samples (54%) as compared to poor quality sputum samples (37%). The gram stain and culture of tracheal samples had a good agreement for predicting infection whereas there was only moderate agreement for sputum sample. Gram stain smear examination from respiratory samples can be used to guide empiric antibiotic therapy pending final culture sensitivity results if the attending physicians ensure appropriate sample collection and transport. In absence of these supportive measures smear examination should not be relied upon for empiric treatment. • Gram stain and culture of tracheal aspirates has good agreement for predicting infection. • Only moderate agreement for sputum sample. • Sputum Gram stain can be used to guide empiric antimicrobial therapy provided proper collection and transport are ensured. [ABSTRACT FROM AUTHOR]

Background. Tuberculosis (TB) is a disease that affects hundreds of millions of people across the world. However, the incidence in developed countries has decreased over the past decades causing physicians to become unfamiliar with its unspecific symptoms. Pregnant individuals are especially difficult because many symptoms of active TB can mimic normal physiological changes of pregnancy. We present a case report of a 26-year-old multiparous woman, G4P3003, at 38-week gestation with a history of positive PPD who emigrated from Ghana 6 years ago. She came to the hospital with an initial complaint of suprapubic pain, pressure, and possible leakage of amniotic fluid for the past week. Patient also complained of a productive cough for the past 3 to 4 months with a decrease in vision occurring with the start of pregnancy. Visual acuity was worse than 20/200 in both eyes. Definitive diagnosis of active TB was delayed due to patient refusal of chest X-ray. Fortunately, delay in diagnosis was minimized since patient delivered within 24 hours of admission. Active TB was confirmed with intraocular dissemination. Patient had optic atrophy OS (left eye) and papillitis, choroiditis, and uveitis OD (right eye) due to TB infiltration. Fetus was asymptomatic and anti-TB therapy was started for both patients. [ABSTRACT FROM AUTHOR]