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Objectives: This study was aimed to evaluate antibiotic resistance pattern and biofilm formation in K. pneumoniae strains isolated from different clinical specimens and to study on association of drug resistance pattern with biofilm formation. Methods: A total of 944 clinical samples from patients attending Sahid Gangalal National Heart Center were processed from September 2019 to March 2020 to identify possible bacterial pathogens following standard microbiological procedures. K. pneumonaie isolates were further subjected to antibiotic susceptibility testing using modified Kirby Bauer disc diffusion technique. Biofilm formation was evaluated by tissue culture plate technique. Results: Of the total 944 samples, 15.47% (146) samples showed bacterial growth, among which 23.97% (35) were K. pneumoniae. Out of 35 K. pneumoniae isolates, 45.71% (16) were multidrug-resistant and 42.86% (15) were extensively drug-resistant. Sixty percent (21) of K. pneumoniae feebly produced biofilm. Significant association was observed between biofilm production and exhibition of multidrug resistance (p value

We investigate the properties of heavily C-doped GaN grown by hydride vapor phase epitaxy using both optical experiments and hybrid density functional theory calculations. Previous work has established that carbon acceptors $({\mathrm{C}}_{\mathrm{N}})$ give rise to a yellow luminescence band near 2.2 eV along with a blue luminescence band near 2.9 eV. Photoluminescence measurements show the yellow band shifting as a function of carbon concentration, suggesting a change in the behavior of carbon species as carbon content increases. With hybrid density functional theory we calculate the electrical and optical behavior of carbon centers containing multiple carbon impurities, which may arise in heavily doped material. We compare the behavior of these complexes to the isolated centers, and find that the dicarbon donor-acceptor $({\mathrm{C}}_{\mathrm{Ga}}\text{\ensuremath{-}}{\mathrm{C}}_{\mathrm{N}})$ complex is a candidate to explain the shift in the yellow luminescence peak. Tricarbon complexes have high formation energies and modest binding energies, and also give rise to optical transitions that are inconsistent with the observed spectra. We also identify the split dicarbon interstitial on the gallium site as a low-energy species with a large binding energy that may act to compensate carbon acceptors. Local vibrational modes are calculated for carbon impurity centers, and we compare these results to recent experiments. Dicarbon and tricarbon complexes involving ${\mathrm{C}}_{\mathrm{Ga}}$ and ${\mathrm{C}}_{\mathrm{N}}$ exhibit modes that are only slightly higher than the isolated species, while carbon interstitials and related complexes give rise to vibrational modes much higher than ${\mathrm{C}}_{\mathrm{Ga}}$ and ${\mathrm{C}}_{\mathrm{N}}$.

Carbon doping is a viable approach for compensating the unintentional donors in GaN and achieving semi-insulating substrates necessary for high-frequency, high-power devices. In this work, bulk material properties and point defects are studied in mm-thick free-standing carbon-doped GaN to understand the efficacy of the carbon dopant. Temperature-dependent Hall measurements reveal high resistivity and low carrier concentrations at temperatures as high as 560°C in a 6 × 1017 cm−3 C-doped sample, and electron paramagnetic resonance (EPR) indicates that carbon acts as the compensating defect. Photoluminescence, in agreement with photo-EPR, suggests that the compensating center is CN; however, additional defects, which possibly limit compensation, are formed at carbon concentrations greater than 5 × 1017 cm−3.

The postoperative analgesic efficacy of trans-muscular quadratus lumborum block in abdominal surgeries is well established; however, its intraoperative safety and efficacy as an anesthetic is still being explored. This retrospective case review was conducted to investigate the efficacy and safety of combined quadaratus lumburoum block and low-dose subarachnoid block for anesthesia in complex abdominal operations.Perioperative data of 29 patients, who underwent abdominal operations during the period of June/2019 to October/2019 under the combined technique, was analyzed. The primary outcome was intra and postoperative pain scores with the conox as qnox and numeric rating scale respectively at different time points. The secondary outcomes were intraoperative sedation scores with conox as qcon and perioperative dosage of fentanyl, changes in mean arterial pressure and the incidence of adverse events.The mean qnox scores at incision, viscera dissection, closure and before transport to the post anesthesia care unit were between 44.66 and 55.79. The mean numeric rating scale scores before bed on the operation day, at 8 am on the first postoperative day, before bed on the first postoperative day and at 8 am on the second postoperative day were between 3.41 and 3.86. The mean qcon scores during the operations were between 61.31 and 65.82 while it was 85.66 following the stoppage of all sedations. The mean total perioperative consumption of fentanyl was 38.7mcg. The proportion of patients having MAP changes of less than 20% from baseline was 85.72%. The incidence of peri-operative adverse events was low.For complex abdominal operations, a combination of ultrasound-guided QLB-TM and low dose spinal anesthesia achieves adequate analgesia and is a safe technique.

Introduction: Nepal is one of the countries which has been hit hard by the COVID-19 pandemic and has resulted in high morbidity and mortality across all age groups including neonates. There has been a paucity of studies regarding maternal to neonatal COVID-19 transmission and the published studies also have a poor sample size to reach any definite conclusion. Hence this study was carried out to see the clinical profiles of neonates born to COVID-19 mothers. Methods: It was a descriptive cross-sectional study. The study was conducted at a tertiary care centre over the period of one year from April 2020 to March 2021 after taking ethical clearance from the Institutional Review Committee with reference number drs2105211526. Convenient sampling was done. All neonates born to COVID-19 positive mothers who were diagnosed by a real-time polymerase chain reaction of the nasopharyngeal swab during the time of delivery were included in the study. Data analysis was done using Statistical Package for Social Sciences 20 using appropriate tools. Results: A total of 105 babies born to COVID-19 positive mothers who were tested for COVID-19 infection were included in the study. Ten (9.5%) (3.89-15.10 at 95% Confidence Interval) of neonates born to COVID-19 positive mothers were positive for the COVID-19 virus. All the neonates born to COVID-19 positive mothers were discharged home except one case who had other comorbidities. Fever was present in four (40%) of COVID-19 positive neonates. Conclusions: There is a possibility of vertical transmission of coronavirus in neonates although the outcome is favourable.

The accelerating rate of carbapenems resistance in Klebseilla pneumoniae isolates has put the treatment option worrisome. The effective strategy to ameliorate this alarming situation is possible through enhancing the combination therapy and appropriate laboratory diagnosis. Hence, the study was focused on identifying carbapenemase-producing K. pneumoniae and their antibiogram pattern.A total of 944 clinical samples from patients attending Sahid Gangalal National Heart Center were processed from September 2019 to March 2020 to identify the possible bacterial pathogens following the standard microbiological procedures. K. pneumonaie isolates were further subjected to antibiotic susceptibility testing by the modified Kirby Bauer disc diffusion technique. Phenotypic confirmation of carbapenemase production was done by the modified carbapenemase inactivation method. The minimum inhibitory concentration of colistin was determined by the broth microdilution method.Of the total 944 samples, 15.47% (146) samples showed bacterial growth, among which 23.97% (35) were K. pneumoniae. Out of 35 K. pneumoniae isolates, 45.71% (16) were multidrug-resistant followed by 42.86% (15) extensively drug-resistant. Fourteen isolates of K. pneumoniae were carbapenemase producers among which 20% (7) were serine carbapenemase while 20% (7) showed metallo-?-lactamase production. All the carbapenemase-producing K. pneumoniae were susceptible to colistin with0.125µg/ml. Carbapenemase activity showed statistically significant with multidrug resistance (p=0.05).An increasing resistance to the carbapenem drugs showed a great problem in the management of K. pneumoniae infections among immunocompromised patients especially cardiac patients however, colistin can be still an ultimate choice of drug for disease management.

Electron paramagnetic resonance (EPR) spectroscopy was used to study the point defects in 2 × 1017–1019 cm−3 C-doped GaN substrates grown by hydride vapor phase epitaxy. The intensity of an isotropic signal with g = 1.987 ± 0.001 increased monotonically with the carbon concentration, indicating that the EPR signal represents a carbon-related defect. In each sample, the signal intensity increased under illumination with photon energy greater than 2.75 eV, and the photo-induced signal decreased with subsequent illumination at 0.95 eV. A second signal, well-documented to be a shallow donor, appeared along with the g = 1.987 signal in the most lightly doped samples. The appearance of the donor confirms that the photo-induced increase is caused by excitation of an electron to the conduction band and implies that a defect level for the carbon-related center is about 1 eV above the valence band edge, consistent with temperature-dependent Hall measurements.

Electron paramagnetic resonance (EPR) spectroscopy was used to investigate a type of point defect present in 1019 cm−3 carbon-doped GaN substrates grown by hydride vapor phase epitaxy. A broad, isotropic resonance at g ∼ 1.987 was observed at 3.5 K, and the EPR intensity increased with illumination at energies greater than 2.75 eV and decreased with photon energies greater than 0.95 eV. The latter is consistent with a deep level of 0.95 eV above the valence band maximum and implies that the associated defect likely participates in donor compensation. The ionization energy for this defect is close to the predicted value for the (−/0) transition level of CN and transition levels associated with Ga vacancies such as VGa and VGa-ON-2H.