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Background: Sepsis in neonates by resistant strains remains a significant cause of mortality and morbidity in developing countries. This study attempted to find out the organisms responsible for early onset sepsis (EOS) and late onset sepsis (LOS) and determine their antimicrobial sensitivity pattern. Materials & Methods: This prospective observational single centre study was conducted on 1000 neonates during January to September 2018, that were investigated for rule out sepsis, at the Neonatal Intensive Care Unit of Ad-din Medical College Hospital, Dhaka. Results: Fifty-four neonates were found with culture proven sepsis.Coagulase-negative Staphylococci (CONS) (68.42%)was the commonest and followed by Acinetobacter (18.42%) were found on culture isolates in EOS. In LOS, CONS (75%) is the most predominant organism. Among the gram negative Acinetobacter (50%) was the most prevalent bacteria followed by E.coli (28.57%). None of the gram positive isolates were sensitive to Amikacin. Majority of the gram positive showed susceptibilities to Vancomycin (83%) and Linezolid (78%). Among gram negative isolates 93% were sensitive to Colistin, 63% to Gentamicin & 54% to Levofloxacin. Conclusion: Present study indicated that gram positive species especially CONS continue to be the predominant causative organism in both EOS and LOS and followed by Acinetobacter and E. coli in gram negative species. Bangladesh J Child Health 2020; VOL 44 (3) :133-138

A story in a comic book employs different visual elements such as images, text, speech balloons, caption boxes, symbols, and sound effects. These elements work in harmony to convey the narrative to...

Background: Perinatal asphyxia (PNA) remains a significant cause of death and disability despite the important advances in perinatal care in the past decades. Early neonatal mortality within the first 24 hours contributes substantially to overall neonatal mortality rates. Estimates of the incidence of perinatal asphyxia vary, in resource-rich countries is about 1/1000 live births and in resource-poor countries is probably much more common, an incidence of 5–10/1000 live births and represents the second most common cause of neonatal death (24%) after preterm birth related complications (35%). About one quarter of all neonatal deaths globally are caused by PNA & an equal number of serious neurological consequences ranging from cerebral palsy & mental retardation to epilepsy. Objective: To determine how well neonatal arterial blood pH and base deficit predict immediate outcome (survival to discharge) following perinatal asphyxia. Methods: This was a prospective study conducted in the delivery room and adjacent neonatal area (NICU) of Ad-din Medical College Hospital (AMCH), over 6 months from 1st June and 30th November, 2017. Research assistants were trained to observe and record events related to labor and neonatal resuscitation. Patient information was obtained which included patient characteristics (gender, birth weight & gestational age) and APGAR scores at and beyond 5 minutes. Within one hour of delivery all admitted neonates were subjected to an arterial blood gas (ABG) analysis by GEM Premier 3000 blood gas analyzer and pH and base deficit were noted. All the neonates were classified according to GA, BW and Gender. After proper cleaning the collected data were analyzed thoroughly. Descriptive analyses were performed; differences in outcome by GA, BW, Gender, APGAR scores and ABG (pH and base deficit) status were determined using analysis of variance. Analyses were performed using the Statistical Package for Social Sciences (SPSS) version (Chi-Square test). Results: A total 50 neonates were studied in this period of which 72% survived & 28 % expired. Death was mostly observed in neonate who had very high level of base deficit (> 20mmol/L) & very low pH (pH 35 - 37 weeks (58%) of GA (p = 0.0050). The neonates with birth weight (BW ) >2000 - 2500gm (p = 0.494). In this study most of the neonates were male (70%) & recovery rate was relatively better among baby boys (74.3%) than baby girls (66.67%) (p = 0.582). High APGAR score neonates had better rate of recovery than poor APGAR score neonates. The neonates with APGAR score 4-6 beyond 5 minutes were observed 88.33% survival & the neonates with APGAR score 0-3 beyond 5minutes were 55% survival (p= 0.028). High pH value neonates in 1st hour ABG were found higher rate of survival in comparison to low pH value neonates. It was 83.33% in pH 7.10- 20mmol/L neonates, 33.33% in base deficit > 15 - 20mmol/L neonates & 87.18% in base deficit > 12 -15mmol/L neonates respectively (p=0.00003). Conclusion: From this study it is concluded that initial pH and base deficit of 1st hour ABG of neonates along with APGAR score at or beyond 5 minutes is a good predictor of risk & immediate outcome following perinatal asphyxia. A good percentage of neonates recover due to early diagnosis, meticulous nursing care and timely intervention. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.238-243

Readymade garments (RMG) manufacturing defects carry a significant role in reducing the quality of the products. Real-time production data tracking can play an important role to track those defects. A web-based software like InTrack can be a pioneer to produce that trackable data. InTrack is a Quality Control (QC) web-application to track RMG manufacturing defects using production line data. It requires complex architectural decisions for the backend and intricate management of frontend states and components. We have studied in-depth into the engineering of such a data intensive web-application and applicable for the RMG industies.

Background: Neonatal infections are the commonest cause of neonatal mortality along with perinatal asphyxia and consequence of Prematurity and Low Birth Weight (LBW) in Bangladesh. Early Onset Neonatal Sepsis (EONS) is neonatal sepsis occurring within the first 72 hours of birth and it is much more fulminant and has a higher mortality than Late Onset Sepsis (LOS). Sepsis in neonate remains a significant cause of mortality and morbidity in developing countries. Changing bacterial flora and emergence of resistant strains adds to the problem. Thus, neonatal sepsis requires accurate and timely clinical and laboratory diagnosis and proper management for better outcome. The organisms responsible for Early Onset Sepsis (EOS) are different than Late Onset Sepsis (LOS). In this study an attempt has been made to know the positivity rate of EOS and profile of bacteria responsible for EOS and determine the antimicrobial sensitivity pattern that were investigated for rule out sepsis. Methods: This was a prospective observation single centre study over a period of nine months (January to September, 2017) conducted on neonates born at Ad-din Medical College Hospital (AMCH), Dhaka and subsequently admitted in Neonatal Intensive Care Unit (NICU) within 72 hours of birth that were investigated for rule out sepsis. Dual blood sample for cultures from separate area along with essential investigations were sent by collecting samples under aseptic precautions. Empirical antimicrobial therapy was started according to antimicrobial guidelines in the NICU. The blood cultures test were carried out by BD BACTEC automated blood culture system and susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Results: A total of 700 neonates were investigated to rule out sepsis and 5.43% neonates were found with culture proven sepsis in the study. The gram positive bacteria accounted for 71% and gram negative 29% of the total isolates. Out of total 38 isolates, Coagulase-Negative Staphylococci (CONS) (68.4%) was the commonest followed by Acinetobacter (18.4%) and E. coli (7.9%) was common culture isolates. Among the gram positive, CONS (96.3%) was commonest isolate and in gram negative Acinetobacter (63.6%) was the most prevalent bacteria followed by E.coli (27.3%). Gram positive isolate, especially CONS (68.4%) was the major culprit for the early onset sepsis. Among the commonly used antibiotics, the susceptibilities were remarkably low to Amikacin (16%) in comparison to Ampicillin (42%) Cefotaxime (45%) and moderately high to Gentamicin (58%) for both gram positive & gram negative isolates. All (100%) gram positive isolates were resistant to Amikacin. Majority of the gram positive showed low susceptibilities to Meropenem (22%) Ciprofloxacin (41%) Ampicillin (48%) & Oxacillin (48%) in comparison to Cefotaxime (52%) Levofloxacin (55%) Gentamicin (70%), Linezolid (70%) and Vancomycin (74%). 50% of Coagulase Negative Staphylococcus (CONS) were resistant to Methicillin/Oxacillin. The sensitivity pattern of majority of gram negative isolates showed high level of resistance to Piperacillin+Tazobacterm (9%) and Ampicillin (27%) Gentamicin (27%) Cefotaxime (27%) less sensitive to Ciprofloxacin (45%); moderately high to Levofloxacin (54%) & Amikacin (54%) and highly sensitive to Imipenem/Meropenem (73%) & Colistin (91%). Gentamicin (58%) and Levofloxacin (55%) were showed marginal superiority compared to Ampicillin (42%) and Cefotaxime (45%) for effective coverage of both. Conclusion: Present study indicated that gram positive species especially CONS continue to be the predominant causative organism followed by Acinetobacter and E. coli in gram negative species. The antibiotic susceptibility profile suggested that for a given cohort empiric (initial) choice of Ampicillin and Gentamicin in EOS. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 3-8

Background: Since its inception, the neonatal mechanical ventilator has been considered an essential tool for managing preterm neonates with Respiratory Distress Syndrome (RDS) and is still regarded as an integral component in the neonatal respiratory care continuum. Mechanical ventilation of newborn has been practiced for several years with several advances made in the way. As compared to the western world and neighboring countries, neonatal ventilation in our country is still in its infancy. To analyze the common indications and outcome of preterm neonates required mechanical ventilation.Methods: This was a retrospective observational study conducted on preterm neonates required mechanical ventilation over a period of 12 months (July 2013 to June 2014).Results: A total of 50 neonates were mechanically ventilated during the study period of which 68% (n=34) survived. The survival rate was higher (77%) in 34

not availableBangladesh J Child Health 2017; VOL 41 (1) :67-69

There is a paucity of information about which impairments, cognitive or neurological, determine the functional outcome after aneurysmal subarachnoid hemorrhage (SAH). The present study aims to determine the relative contributions of each of the above impairments for determining the functional outcome after SAH.This is a prospective observational study including patients with aneurysmal SAH. Patients underwent assessment at 6 months after discharge for neurological deficits, cognitive impairment, and functional outcome using the National Institute of Health and Social Sciences (NIHSS) score, National Institute of Mental Health and Neurosciences (NIMHANS) Neuropsychology Test Battery, and Glasgow Outcome Scale - Extended (GOSE), respectively. The correlation of GOSE with NIHSS scores and neuropsychological test scores was done using Spearman's rho correlation coefficient.Fifty-six patients underwent assessment using all the three tools, i.e., NIHSS, neuropsychological tests, and GOSE. Fifty-one healthy volunteers participated in the study for neurological examination and neuropsychological assessment. At 6 months, patients with SAH had significant cognitive impairment as compared to controls. The mean NIHSS score was 10.01 ± 9.04, indicating moderately severe impairment. The median GOSE at 6 months was 6 (range: 3-8) indicating the upper level of moderate disability. There was a significant correlation of NIHSS scores with GOSE, Spearman's rho -0.653 (0.001). There was a significant correlation of neuropsychological test scores with GOSE and NIHSS. The Spearman's rho for NIHSS vs GOSE was within range for neuropsychological scores vs GOSE.Both the neurological deficits and cognitive impairment determine functional outcome after SAH at 6 months.

Neurocutaneous melanosis (NCM) is a rare congenital disorder. Most of the cases described in literature for this entity have involvement of the leptomeninges and other structures of brain such as brain stem, temporal lobes, and spinal meninges and no involvement of leptomeninges and presence of lesions in bilateral temporal lobes. NCM without the involvement of leptomeninges should be considered a distinct entity as the prognosis is favorable as compared to cases with leptomeningeal involvement who develop early hydrocephalus and multiple cranial nerve palsies.

Need for design of a part or as a whole of a utility item/issue and ergonomics considerations interact in an intertwined way while re-looking the issue either for betterment of existing product or to develop a new one. Around 4000 students of 13 hostels use bicycles in IIT Guwahati campus and identity of bicycles is an issue. The present study looks into the possibilities of using identity labels on bicycles being used in IIT Guwahati campus by the students of different hostel resident. Attempt has been made to develop an ergonomically visible and aesthetically appealing numbering system with specific attention to information flow presentation for easy readability and legibility in both static and moving conditions. Study was conducted through placing relevant information using horizontal and vertical orientation on the mudguard. This study was done with the observational and experimental analysis of the design. Results show that instead of horizontal orientation, the vertical placement on mudguard area is preferred. It was clearly found that the new design was better in terms of readability, legibility, and design aesthetics.

Objective: To study the acute phase serum biomarkers in patients with mild traumatic brain injury (mTBI) and to correlate them with short term cognitive deficits. Materials and Methods: This is a prospective observational study conducted at a tertiary care center for neurotrauma. The participants included patients with mTBI (n = 20) and age, gender, and education-status matched healthy controls (n = 20). In both the groups, the serum concentrations of biomarkers ubiquitin C terminal hydrolase (UCH-L1) and S100 calcium-binding protein B (S100B) were measured. Both the groups underwent neuropsychological tests. The serum tests were done in the acute stage after injury and the neuropsychological tests were done 3 months after injury. Results: There was no significant increase in the serum S100B and UCH-L1 levels in patients with mTBI. Patients with mTBI had significant cognitive deficits at 3 months after injury, which was suggestive of involvement of diffuse areas of the brain, in particular, the premotor, prefrontal, and medial inferior frontal lobes and the basitemporal region. The correlation of biomarkers with cognitive deficits in patients with mTBI was found in the following domains: working memory, verbal learning, verbal fluency, and visual memory. Conclusion: The serum biomarkers of mTBI have a correlation with selective domains of neuropsychological outcome.

Sound is an invisible and intangible effect found in nature which is conveyed in different techniques in different media (films, novels etc.). Sound Symbolic Words or SSW are known as comprising of word categories that resemble or convey sound (audible as well as inaudible). As printed comic books have to rely on visual perception to create the sound inside the reader’s mind, thus along with perception ability of the reader, her cultural exposure is also necessary in order to decode the meaning of the SSW. This poses a challenge to the designer to create words that signify the nature of the sound being represented. To create a visual representation of the sound it is essential to understand the syntactical structure of the words. Already the syntax of the SSW has been defined in earlier study [1], this paper aims to establish its relation with the meaning of the word. The SSW were categorized based on the semantic variables studied from a corpus of 40 titles and 1401 SSW. The results can be utilized by any designer to create SSW based on a given context.

Comics are cultural artifacts that narrate stories through sequential images. With the turn of the century, these artifacts are being understood as a form of visual language. To understand the visual language of comics, it is imperative to study its core components: image and text. In this paper, the status of sound symbolic words used in Indian comic books is reviewed, which may lead to the analysis and creation of further sound symbolic words. It is found that the onomatopoeic words, created based on the typographic attributes like, alignment, weight, color, texture and size are more effective in conveying the meaning of a sound. Identification of these factors provides insights about the relationship of a sound to its textual representation. This study will prove helpful to the comic book designers by being an additional tool for communicating their story more efficiently.