Clinical Presentation of Adult Pulmonary Tuberculosis (PTB): A Study of 103 Cases from a Tertiary Care Hospital

Tuberculosis, one of the oldest diseases known to affect humans, is a major cause of death worldwide. The disease, which is caused by the bacteria Mycobacterium tuberculosis complex, usually affects the lungs, although other organs are involved in up to one-third of causes. If properly treated, tuberculosis caused by drug-susceptible strains is curable in virtually all cases. If untreated, the disease may be fatal within five years in 50-65% of cases. Transmission usually takes place through the airborne spread of droplet nuclei produced by patients with infectious pulmonary tuberculosis. This cross sectional observational study was conducted to detect various clinical presentations of pulmonary tuberculosis patients in the Department of Medicine, Sir Salimullah Medical College and Hospital from January 2009 to December 2009. Sample was selected through inclusion methods from patients who was admitted in to hospital and confirmed as pulmonary tuberculosis after appropriate investigations and who gave informed written consent was finally enrolled in this study. A total 103 patients were selected for the study. Out of 103 cases 34.9% were above 50 years old, followed by 26.2% between 30-40 years old, 22.3% between 40-50 years old and remaining 16.5% bellow 30 years old. The male to female ratio was roughly 1.2:1. The most of the patients were housewife and farmer which were 31% and 28.1% respectively. The most of the patients came from low socio-economic group. About 55.3% cases were smoker and 43.7 were non smoker. Among the frequency of symptoms 73.7% were chronic cough for above one month followed by 70.8% were low grade fever, 41.8% were night sweats and the 2% were admitted in hospital for other complaints and after evaluation diagnosed as PTB. The most of the patients about 67% were suffering from less than six weeks duration. Among the physical findings the 67% cases were lost significant weight, 56.3% had fever and 56.3% had apical crepitation over chest. There was sputum positive for acid fast bacilli about 64.7%. The traditional TB diagnosis methods are time consuming and the most of the patients are poor in our country, they are unable to afford the modern costly investigations. Therefore we should more emphasis on clinical examinations, so that we can diagnosis pulmonary TB rapidly and can start treatment as early as possible.

Enhancing Quality of Learning Experience Through Intelligent Agent in E-Learning

In this paper an interactive recommending agent is proposed which helps an e-learner to enhance the quality of learning experience resulting in efficient achievement of learning objectives. The agent achieves this with the help of a fuzzy rule base working on a variety of learning materials and recommending the appropriate learning path through them. In a learner-centric environment the learning behaviour of a learner may vary to a great extent due to the characteristics of the learner and his environment. Students are often misled while choosing the appropriate path of web learning tools owing to non-availability of a human teacher/guide. By the response of a learner to different positive and negative motivation factors the proposed system employs a fuzzy machine that is fed with realization parameters e.g. Satisfied, Depressed etc. The fuzzy machine working on the paradigm of fuzzy inference system processes these realization parameters with the help of a fuzzy rule base to produce the crisp measures of the learner’s cognitive states in terms of Belief, Behaviour and Attitude. On the basis of these defuzzified crisp diagnostic parameters the proposed system will enhanced the quality of learning experience of an e-learner. To ensure this the system will provide more detailed discussion on the subject matter along with some additional learning tools. Learners often get confused to select the proper tools among various. Therefore the proposed system will also suggest most popular path among those learners with the same understanding. This recommendation comes from the analysis of data mining result. The system was tested with a wide variety of school-level students. The response obtained indicates that it is able to enhance the quality of learning experience through its recommendation.

Molecular-Characterization of Methicillin-Resistance Staphylococcus aureus (MRSA) from Different Tertiary Care Hospitals in Bangladesh

Infections caused by Staphylococcus aureus were treated by methicillin, but about 95% of S. aureus has been resistance to methicillin, both in the community and hospitals and are increasing day by day. MRSA produces altered penicillin binding protein, PBP2a, due to the expression of mecA gene. Some strains of both the MRSA and MSSA carry PVL gene. This cross sectional observational study was conducted to detect the molecular-characterization of methicillin resistant Staphylococcus aureus (MRSA) and carried out in the Department of Microbiology, Mymensingh Medical College from July 2014 to December 2015. Clinical samples for this study were wound swab, pus, exudates from diabetic ulcer and burn ulcer, aural swab, blood and urine which were collected from three tertiary care hospitals such as from MMCH, BIRDEM hospital and SSMCH. Standard microbiological procedure & biochemical tests were carried out to detect S. aureus. Oxacillin disk diffusion method (ODDM) was done by Kirby-Bauer disk diffusion method. Out of a total 109 culture positive samples 69 isolates of S. aureus were selected for the study. Among the 69 isolates 33, 27 and 09 were from MMCH, BIRDEM hospital and SSMCH respectively. Among the 69 isolates, 17(24.6%) and 52(75.3%) were distinguished as MRSA and MSSA respectively by ODDM. In contrast, detection of presence and absence of mecA gene by PCR identified 20(28.9%) and 49(71.01%) isolates as MRSA and MSSA respectively. Multiplex PCR was performed by standard protocol with specific primers for detection of 16S rRNA gene for Staphylococcus, nuc gene for Staphylococcus aureus, mecA gene for MRSA, PVL gene as a virulence factor and ACME-arc gene for worldwide spreading USA 300 MRSA clone. The PVL gene were detected in 3 out of 20 MRSA (15%) and 19 out of 49 MSSA (38.7%) and the ACME- arc gene was not found in any isolates. All of the S. aureus (MRSA and MSSA) isolates were sensitive to Vancomycin and Gentamicin. All MRSA isolates (100%) showed resistance to Penicillin and Oxacillin. Of the MRSA isolates about 88.2% were resistance to Ceftazidime, 64.7% were resistance to Erythromycin and Ciprofloxacin, 11.7% were resistance to Tetracycline. Among the MSSA isolates 94.2% were resistance to Penicillin and 9.6% resistance to Ciprofloxacin. The MSSA were less resistance for non-beta lactam drugs than MRSA.

Surfing the High Energy Output Branch of Nonlinear Energy Harvesters

Hysteresis and multistability are fundamental phenomena of driven nonlinear oscillators, which, however, restrict many applications such as mechanical energy harvesting. We introduce an electrical control mechanism to switch from the low to the high energy output branch of a nonlinear energy harvester by exploiting the strong interplay between its electrical and mechanical degrees of freedom. This method improves the energy conversion efficiency over a wide bandwidth in a frequency-amplitude-varying environment using only a small energy budget. The underlying effect is independent of the device scale and the transduction method and is explained using a modified Duffing oscillator model.

Impact of post-operative radiation on coronary arteries in patients of early breast cancer: A pilot dosimetric study from a tertiary cancer care center from India

BACKGROUND

The significant impact of postoperative radiotherapy (PORT) on cardiac morbidity in patients of early breast cancer (EBC) undergoing breast-conserving surgery has been shown in different studies. The present study was conducted to assess the impact of surgery and the side of involvement on radiation dose to left anterior descending artery (LAD) and Left circumflex coronary artery (LCx).

MATERIALS AND METHODS

Totally, 58 patients of EBC were randomly chosen for this dosimetric study and planned with tangential field technique without intensity modulation (IM). Heart, LAD, and LCx (n = 55) were contoured. Dose volume histograms were analyzed to determine the Dmax (maximum dose) and Dmean (mean dose) of LAD and LCx. Student's t-test was used for comparative analysis of the means.

RESULTS

The mean Dmax of LAD for left (L) EBC was 3.17 Gray (Gy) while for right (R) EBC it was 0.86 Gy (P = 0.007; 95% C.I, 1.14-3.48). The mean Dmean of LAD for L-EBC and R-EBC were 1.97 Gy and 0.79 Gy, respectively (P = 0.029; 95% C.I, 0.77-1.60). The mean-Dmax of LCx for patients with L-EBC (2.9 Gy; range: 1.2-4.35 Gy) was statistically higher than that for R-EBC (1.3 Gy; range: 0.7-3.2 Gy) (P = 0.045). The mean-Dmean of LCx for L-EBC (2.1 Gy; range: 0.6-3.6 Gy) was also significantly higher than that of L-EBC (0.9 Gy; range: 0.7-2.1 Gy) (P = 0.03). There was no significant impact of the pattern of surgery on LAD dose, but significance was noted for LCx dose parameters (P = 0.04 and 0.08 for m-Dmax and m-Dmean of LCx).

CONCLUSION

This pilot dosimetric study confirms the assumption that patients with left-sided EBC are at higher risk of developing long-term cardiac morbidity when treated with PORT due to increased dose to LAD.

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Patsatzakis S, Oloktsidou E, Lolakos K, Papapostolou E, Grosomanidis V, Suda S, Ikeda T, Ono S, Ueno T, Izutani Y, Gaudry S, Desailly V, Pasquier P, Brun PB, Tesnieres AT, Ricard JD, Dreyfuss D, Mignon A, White JC, Molokhia A, Dean A, Stilwell A, Friedlaender G, Peters M, Stipulante S, Delfosse A, Donneau AF, Ghuysen A, Feldmann C, Freitag D, Dersch W, Irqsusi M, Eschbach D, Steinfeldt T, Wulf H, Wiesmann T, Kongpolprom N, Cholkraisuwat J, Beitland S, Nakstad E, Stær-Jensen H, Drægni T, Andersen G, Jacobsen D, Brunborg C, Waldum-Grevbo B, Sunde K, Hoyland K, Pandit D, Hayakawa K, Oloktsidou E, Kotzampassi K, Fyntanidou B, Patsatzakis S, Loukipoudi L, Doumaki E, Grosomanidis V, Yasuda H, Admiraal MM, Van Assen M, Van Putten MJ, Tjepkema-Cloostermans M, Van Rootselaar AF, Horn J, Ragusa F, Marudi A, Baroni S, Gaspari A, Bertellini E, Taha A, Abdullah T, Abdel Monem S, Alcorn S, McNeill S, Russell S, Eertmans W, Genbrugge C, Meex I, Dens J, Jans F, De Deyne C, Cholkraisuwat J, Kongpolprom N, Avard B, Burns R, Patarchi A, Spina T, Tanaka H, Otani N, Ode S, Ishimatsu S, Cho J, Moon JB, Park CW, Ohk TG, Shin MC, Won MH, Dakova S, Ramsheva Z, Ramshev K, Cho J, Moon JB, Park CW, Ohk TG, Shin MC, Cho J, Moon JB, Park CW, Ohk TG, Shin MC, Marudi A, Baroni S, Gaspari A, Bertellini E, Orhun G, Senturk E, Ozcan PE, Sencer S, Ulusoy C, Tuzun E, Esen F, Tincu R, Cobilinschi C, Tomescu D, Ghiorghiu Z, Macovei R, Van Assen M, Admiraal MM, Van Putten MJ, Tjepkema-Cloostermans M, Van Rootselaar AF, Horn J, Fallenius M, Skrifvars MB, Reinikainen M, Bendel S, Raj R, Abu-Habsa M, Hymers C, Borowska A, Sivadhas H, Sahiba S, Perkins S, Rubio J, Rubio JA, Sierra R, English S, Chasse M, Turgeon A, Lauzier F, Griesdale D, Garland A, Fergusson D, Zarychanski R, Tinmouth A, Van Walraven C, Montroy K, Ziegler J, Dupont Chouinard R, Carignan R, Dhaliwal A, Lum C, Sinclair J, Pagliarello G, McIntyre L, English S, Chasse M, Turgeon A, Lauzier F, Griesdale D, Garland A, Fergusson D, Zarychanski R, Tinmouth A, Van Walraven C, Montroy K, Ziegler J, Dupont Chouinard R, Carignan R, Dhaliwal A, Lum C, Sinclair J, Pagliarello G, McIntyre L, Groza T, Moreau N, Castanares-Zapatero D, Hantson P, Carbonara M, Ortolano F, Zoerle T, Magnoni S, Pifferi S, Conte V, Stocchetti N, Carteron L, Suys T, Patet C, Quintard H, Oddo M, Rubio JA, Rubio J, Sierra R, Spatenkova V, Pokorna E, Suchomel P, Ebert N, Jancik J, Rhodes H, Bylinski T, Hawthorne C, Shaw M, Piper I, Kinsella J, Kink AK, Rätsep IR, Boutin A, Moore L, Chasse M, Zarychanski R, Lauzier F, English S, McIntyre L, Lacroix J, Griesdale D, Lessard-Bonaventure P, Turgeon AF, Boutin A, Moore L, Green R, Lessard-Bonaventure P, Erdogan M, Butler M, Lauzier F, Chasse M, English S, McIntyre L, Zarychanski R, Lacroix J, Griesdale D, Desjardins P, Fergusson DA, Turgeon AF, Goncalves B, Vidal B, Valdez C, Rodrigues AC, Miguez L, Moralez G, Hong T, Kutz A, Hausfater P, Amin D, Struja T, Haubitz S, Huber A, Mueller B, Schuetz P, Brown T, Collinson J, Pritchett C, Slade T, Le Guen M, Hellings S, Ramsaran R, Alsheikhly A, Abe T, Kanapeckaite L, Abu-Habsa M, Bahl R, Russell MQ, Real KJ, Abu-Habsa M, Lyon RM, Oveland NP, Penketh J, Mcdonald M, Kelly F, Alfafi M, Alsolamy S, Almutairi W, Alotaibi B, Van den Berg AE, Schriel Y, Dawson L, Meynaar IA, Talaie H, Silva D, Fernandes S, Gouveia J, Santos Silva J, Foley J, Kaskovagheorgescu A, Evoy D, Cronin J, Ryan J, Huck M, Hoffmann C, Renner J, Laitselart P, Donat N, Cirodde A, Schaal JV, Masson Y, Nau A, Leclerc T, Howarth O, Davenport K, Jeanrenaud P, Raftery S, MacTavish P, Devine H, McPeake J, Daniel M, Kinsella J, Quasim T, Alrabiee S, Alrashid A, Alsolamy S, Gundogan O, Bor C, Akýn Korhan E, Demirag K, Uyar M, Frame F, Ashton C, Bergstrom Niska L, Dilokpattanamongkol P, Suansanae T, Suthisisang C, Morakul S, Karnjanarachata C, Tangsujaritvijit V, Mahmood S, Al Thani H, Almenyar A, Vakalos A, Avramidis V, Sharvill R, Penketh J, Morton SE, Chiew YS, Pretty C, Chase JG, Shaw GM, Knafelj R, Kordis P, Patel S, Grover V, Kuchyn I, Bielka K, Aidoni Z, Grosomanidis V, Kotzampassi K, Stavrou G, Fyntanidou B, Patsatzakis S, Skourtis C, Lee SD, Williams K, Weltes ID, Berhane S, Arrowsmith C, Peters C, Robert S, Caldas J, Panerai RB, Robinson TG, Camara L, Ferreira G, Borg-Seng-Shu E, De Lima Oliveira M, Mian NC, Santos L, Nogueira R, Zeferino SP, Jacobsen Teixeira M, Galas F, Hajjar LA, Killeen P, McPhail M, Bernal W, Maggs J, Wendon J, Hughes T, Taniguchi LU, Siqueira EM, Vieira Jr JM, Azevedo LC, Ahmad AN, Abu-Habsa M, Bahl R, Helme E, Hadfield S, Loveridge R, Shak J, Senver C, Howard-Griffin R, Wacharasint P, Fuengfoo P, Sukcharoen N, Rangsin R, Sbiti-Rohr D, Schuetz P, Na H, Song S, Lee S, Jeong E, Lee K, Cooper M, Milinis K, Williams G, McCarron E, Simants S, Patanwala I, Welters ID, Zoumpelouli E, Volakli EA, Chrysohoidou V, Georgiou S, Charisopoulou K, Kotzapanagiotou E, Panagiotidou V, Manavidou K, Stathi Z, Sdougka M, Salahuddin N, AlGhamdi B, Marashly Q, Zaza K, Sharshir M, Khurshid M, Ali Z, Malgapo M, Jamil M, Shafquat A, Shoukri M, Hijazi M, Abe T, Uchino S, Takinami M, Rangel Neto NR, Oliveira S, Reis FQ, Rocha FA, Moralez G, Ebecken K, Rabello LS, Lima MF, Hatum R, De Marco FV, Alves A, Pinto JE, Godoy M, Brasil PE, Bozza FA, Salluh JI, Soares M, Krinsley J, Kang G, Perry J, Hines H, Wilkinson KM, Tordoff C, Sloan B, Bellamy MC, Moreira E, Verga F, Barbato M, Burghi G, Soares M, Silva UV, Azevedo LC, Torelly AP, Kahn JM, Angus DC, Knibel MF, Brasil PE, Bozza FA, Salluh JI, Velasco MB, Dalcomune DM, Marshall R, Gilpin T, Tridente A, Raithatha A, Mota D, Loureiro B, Dias J, Afonso O, Coelho F, Martins A, Faria F, Al-Dorzi H, Al Orainni H, AlEid F, Tlaygeh H, Itani A, Hejazi A, Arabi Y, Gaudry S, Messika J, Ricard JD, Guillo S, Pasquet B, Dubief E, Dreyfuss D, Tubach F, Battle C, James K, Temblett P, Davies L, Battle C, Lynch C, Pereira S, Cavaco S, Fernandes J, Moreira I, Almeida E, Seabra Pereira F, Malheiro M, Cardoso F, Aragão I, Cardoso T, Fister M, Knafelj R, Muraray Govind P, Brahmananda Reddy N, Pratheema R, Arul ED, Devachandran J, Velasco MB, Dalcomune DM, Knafelj R, Fister M, Chin-Yee N, D’Egidio G, Thavorn K, Heyland D, Kyeremanteng K, Murchison AG, Swalwell K, Mandeville J, Stott D, Guerreiro I, Devine H, MacTavish P, McPeake J, Quasim T, Kinsella J, Daniel M, Goossens C, Marques MB, Derde S, Vander Perre S, Dufour T, Thiessen SE, Güiza F, Janssens T, Hermans G, Vanhorebeek I, De Bock K, Van den Berghe G, Langouche L, Devine H, MacTavish P, Quasim T, Kinsella J, Daniel M, McPeake J, Miles B, Madden S, Devine H, Weiler M, Marques P, Rodrigues C, Boeira M, Brenner K, Leães C, Machado A, Townsend R, Andrade J, MacTavish P, McPeake J, Devine H, Kinsella J, Daniel M, Kishore R, Fenlon C, Quasim T, Fiks T, Ruijter A, Te Raa M, Spronk P, Chiew YS, Docherty P, Dickson J, Moltchanova E, Scarrot C, Pretty C, Shaw GM, Chase JG, Hall T, Ngu WC, Jack JM, Morgan P, Avard B, Pavli A, Gee X, Bor C, Akin Korhan E, Demirag K, Uyar M, Shirazy M, Fayed A, Gupta S, Kaushal A, Dewan S, Varma A, Ghosh E, Yang L, Eshelman L, Lord B, Carlson E, Helme E, Broderick R, Hadfield S, Loveridge R, Ramos J, Forte D, Yang F, Hou P, Dudziak J, Feeney J, Wilkinson K, Bauchmuller K, Shuker K, Faulds M, Raithatha A, Bryden D, England L, Bolton N, Tridente A, Bauchmuller K, Shuker K, Tridente A, Faulds M, Matheson A, Gaynor J, Bryden D, ᅟ SSYHRC, Ramos J, Peroni B, Daglius-Dias R, Miranda L, Cohen C, Carvalho C, Velasco I, Forte D, Kelly JM, Neill A, Rubenfeld G, Masson N, Min A, Boezeman E, Hofhuis J, Hovingh A, De Vries R, Spronk P, Cabral-Campello G, Aragão I, Cardoso T, Van Mol M, Nijkamp M, Kompanje E, Ostrowski P, Omar A, Kiss K, Köves B, Csernus V, Molnár Z, Hoydonckx Y, Vanwing S, Stessel B, Van Assche A, Jamaer L, Dubois J, Medo V, Galvez R, Miranda JP, Stone C, Wigmore T, Arunan Y, Wheeler A, Bauchmuller K, Bryden D, Wong Y, Poi C, Gu C, Molmy P, Van Grunderbeeck N, Nigeon O, Lemyze M, Thevenin D, Mallat J, Ramos J, Correa M, Carvalho RT, Forte D, Fernandez A, McBride C, Koonthalloor E, Walsh C, Webber A, Ashe M, Smith K, Jeanrenaud P, Marudi A, Baroni S, Ragusa F, Bertellini E, Volakli EA, Chochliourou E, Dimitriadou M, Violaki A, Mantzafleri P, Samkinidou E, Vrani O, Arbouti A, Varsami T, Sdougka M, Bollen JA, Van Smaalen TC, De Jongh WC, Ten Hoopen MM, Ysebaert D, Van Heurn LW, Van Mook WN, Sim K, Fuller A, Roze des Ordons A, Couillard P, Doig C, Van Keer RV, Deschepper RD, Francke AF, Huyghens LH, Bilsen JB, Nyamaizi B, Dalrymple C, Molokhia A, Dobru A, Marrinan E, Ankuli A, Molokhia A, McPeake J, Struthers R, Crawford R, Devine H, Mactavish P, Quasim T, Morelli P, Degiovanangelo M, Lemos F, MArtinez V, Verga F, Cabrera J, Burghi G, Rutten A, Van Ieperen S, De Geer S, Van Vugt M, Der Kinderen E, Giannini A, Miccinesi G, Marchesi T, Prandi E. Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Background

The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.

Methods

Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).

Results

Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.

Conclusion

Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

Observation and Structure Determination of an Oxide Quasicrystal Approximant

We report on the first observation of an approximant structure to the recently discovered two-dimensional oxide quasicrystal. Using scanning tunneling microscopy, low-energy electron diffraction, and surface x-ray diffraction in combination with ab initio calculations, the atomic structure and the bonding scheme are determined. The oxide approximant follows a 3^{2}.4.3.4 Archimedean tiling. Ti atoms reside at the corners of each tiling element and are threefold coordinated to oxygen atoms. Ba atoms separate the TiO_{3} clusters, leading to a fundamental edge length of the tiling 6.7 Å.

Antimicrobial Susceptibility Pattern of Methicillin-Resistance Staphylococcus aureus from Different Tertiary Care Hospitals Including Mymensingh Medical College Hospital

The aim of this study was to detect antimicrobial susceptibilities and the presence of drug resistance genes of MRSA from tertiary care hospitals. This study was carried out in the Department of Microbiology, Mymensingh Medical College during the period from Jan, 2015 to Dec, 2015. Clinical samples, including wound swab, pus, exudates from diabetic ulcer and burn ulcer, aural swab, blood and urine were collected. Standard microbiological procedure & biochemical tests were carried out to detect S. aureus. Oxacillin disk diffusion test was done by Kirby-Bauer disk diffusion method. Total 69 isolates of S. aureus were selected for the study. The isolates were collected from three different tertiary care hospitals, of which 33, 27 and 9 were from Mymensingh Medical College Hospital (MMCH), BIRDEM hospital and Sir Salimullah Medical College Hospital (SSMCH) respectively. Among the 69 isolates, 17(24.6%) and 52(75.3%) were distinguished as MRSA and MSSA respectively by ODDM (Oxacillin disk diffusion method). In contrast, detection of presence and absence of mecA gene by PCR identified 20 (28.9%) and 49 (71.01%) isolates as MRSA and MSSA respectively. All of the S. aureus (MRSA and MSSA) isolates were sensitive to vancomycin and gentamicin. All MRSA isolates (100%) showed resistance to Penicillin and Oxacillin. Among the MRSA isolates about 88.2% were resistance to Ceftazidime, 64.7% were resistance to Erythromycin and Ciprofloxacin, 11.7% were resistance to Tetracycline. Among the MSSA isolates about 94.2% were resistance to Penicillin and 9.6% resistance to Ciprofloxacin. The MSSA were less resistance for non-beta lactam drugs than MRSA. Regarding drug resistance genes, the blaZ genes were present in 47 out of 49(95.8%) MSSA and in 18 out of 18 (100%) MRSA. The erythromycin resistance gene ermB was found in 8.69% isolates, of which highest 20% in MRSA and 4.08% in MSSA. The ermA was not found in any isolates. Among tetracycline resistance genes, tetK were detected in 10.1% and tetL were found in 2.8% of MRSA. The highest tetK genes were found in 20% of MRSA and in 6.1% of MSSA. Regarding, the gentamicin drug resistance, the aac(6')-Iaph(2'')-Ia gene was not found in any isolates. The relatively high proportion of MRSA and the associated antibiotic resistance seen in this study emphasizes the need for country based surveillance to characterize and monitor MRSA and to develop strategies that will improve MRSA treatment and control.

Migraine in Children: A Review

Recurrent headache is common in children. Among them migraine is the most common disabling cause of primary headache. It causes serious disability in child's life and family. It causes negative impact on their quality of life. Clinical characteristic of migraine in children differ from adult. It may be shorter in duration and bifrontal or bitemporal in location in contrast to adult which is longer in duration and usually unilateral. It is less common before 3 years of age. Males are more affected before puberty. But after puberty females are predominantly affected. Intensity of pain is moderate to severe. There are some triggering factors. Positive family history usually present. Disability can be assessed by PedMIDAS scale in children and adolescents which is modified version of MIDAS scale for adult. Diagnosis of migraine usually clinical but evaluation should be done to exclude severe underlying secondary cause. Management consists of pharmacological and non pharmacological approach. Parental education, life style modification is the mainstay of management. Acute treatment consists of Acetaminophen, NSAIDs and Triptans. Among Triptans, Sumatriptan nasal spray is only found effective for children. Preventive therapy aims to decrease frequency and severity of headache. Flunarizine, Propranolol, Amitryptylline, Levetiracetam, Valproate, Topiramate are found effective in pediatric age group. Pediatrician should evaluate the child to exclude secondary cause of headache when indicated. They should have also proper knowledge and skills to manage a child having migraine to improve their quality of life and academic achievement.

Senna alexandrina Mill. induced ultrastructural changes on Hymenolepis diminuta

Senna alexandrina Mill. has been used for antimicrobial activity. In the present study, the crude ethanolic extract of the plant and a synthetic compound Sennoside were tested in vitro on Hymenolepis diminuta to evaluate its potential anthelmintic efficacy through ultrastructural changes. Worms were maintained between rat model and beetle and the test parasites were exposed to different concentrations of crude ethanolic leaf extracts of S. alexandrina. Praziquantel was used as a reference drug. Dose dependent efficacy was observed in terms of motility and time of mortality in all treated parasites. Ultrastructural micrography revealed irrevocable destruction all over the body tegument accompanied with sloughing of microtriches and swellings of the basal lamina. Vacuolization of the syncytium along with sparsely cytoplasmic cytons and depletion of parenchymatous layer were observed accompanied by deformities in the cell organelles. Extensive deformities in the tegument indicates that the plant extract alter membrane permeability of the parasite leading to paralysis and subsequent death. Thus, S. alexandrina can be regarded as a potential anthelmintic agent.

Investigation of Effluent Quality from an Effluent Treatment Plant of a Textile Industry, Fakir Knitwear Ltd. Narayangonj, Bangladesh

Textile industries are the major contributor to environmental pollution and health hazards by generating huge amount of effluents that contain several pollutants and coloring agents. The concentration of these pollutants can be reduced to the permissible limit with the help of an Effluent Treatment Plant (ETP). The study was conducted to observe the textile effluent management techniques of an Effluent Treatment Plant (ETP) of Fakir Knitwear Limited (FKL), Narayanganj, Bangladesh. FKL set up a biological treatment plant to treat the effluent generated by the industry. Different effluent quality parameters were investigated at different stages in ETP. The effluent of the outlet was dark colored probably because of soluble coloring materials of the effluent but it is comparatively better than that of raw wastewater. There were found higher EC values than the standards which indicated that the greater amount of salts in the water due to dumping of solid wastes and discharging of industrial effluents. The highest TDS value 2054 ppm was observed at the screening pit unit than the other parts of the ETP. The highest DO was found 4.58 ppm in clarification tank which was within the standard value of aquaculture. The study also showed that the lowest BOD (24 ppm) and COD (145 ppm) was found at the outlet which was comparatively better than others. Although the effluent from the outlet contained pollutants, these effluent quality was comparatively good than the untreated waste water discharged from the industry. After treatment, the effluent of outlet moderately ensures the standard quality for aquaculture and irrigation. The results suggested that it is obvious to run the ETP regularly to improve the quality of effluents to save our native environment from the harmful effects of wastewater.J. Environ. Sci. & Natural Resources, 8(2): 25-31 2015

Growth, yield, water use efficiency and competitive functions of intercropping system of maize (Zea mays L.) and mungbean (Vigna radiata L.) as influenced by irrigation

Field experiment was conducted at Instructional Farm, Jaguli (Mohanpur), Bidhan Chandra Krishi Viswavidyalaya, West Bengal, India during two consecutive summer seasons of 2010-11, and 2011-12. The experiment was laid out in split-plot design having 4 levels of irrigation– rainfed without mulch, rainfed with mulch, irrigation at IW (depth of irrigation water) / CPE (Cumulative pan evaporation) ratios of 0.5 and 0.75 in main-plot and 4 inter cropping systems, sole maize, sole mungbean, maize + mungbean (1:1 row ratio) and maize + mungbean (3:2 row ratio) considered as sub-plot treatments replicated thrice. Results revealed that application of irrigation and intercropping systems markedly influenced the growth, yield and yield components (number of cobs/plant, number of grains/cob in case of maize and number of pods/plant and number of seeds/pod in case of mungbean) where the maximum value of these components were recorded with the application of irrigation at IW/CPE ratio 0.75 in sole crop. Maize-mungbean in 3:2 row ratio yielded higher than that of 1:1 intercropping system which might be due to less light interception and more competition for water and nutrition between both the crops. CU of water increased with the increasing levels of irrigation and the maximum value (17.75 kg ha-1 mm- 1) of WUE (water use efficiency) was observed with irrigation at IW: CPE ratio 0.75 under intercropping system of maize : mungbean in 3:2 row ratio followed by IW: CPE ratio 0.50. Among the sole crop, maximum WUE was with IW/CPE ratio 0.75 might be due to more consumption of water corresponding to production potential of maize, while, it was more under rainfed with mulch in mungbean. The relative crowding coefficient (RCC) also revealed both the intercropping systems were advantageous and the land equivalent ratio (LER) increased with the level of irrigation.Thus, maize grown in association with mungbean (3:2 row ratio) were found to be more profitable (B:C ratio of 2.58) with higher monetary advantage as compared to sole crop of maize (B:C ratio of 1.98) with the application of irrigation at IW: CPE ratio of 0.75 in new alluvial zone of West Bengal.SAARC J. Agri., 13(2): 94-107 (2015)

Intuitive wireless control of a robotic arm for people living with an upper body disability

Assistive Technologies (ATs) also called extrinsic enablers are useful tools for people living with various disabilities. The key points when designing such useful devices not only concern their intended goal, but also the most suitable human-machine interface (HMI) that should be provided to users. This paper describes the design of a highly intuitive wireless controller for people living with upper body disabilities with a residual or complete control of their neck and their shoulders. Tested with JACO, a six-degree-of-freedom (6-DOF) assistive robotic arm with 3 flexible fingers on its end-effector, the system described in this article is made of low-cost commercial off-the-shelf components and allows a full emulation of JACO's standard controller, a 3 axis joystick with 7 user buttons. To do so, three nine-degree-of-freedom (9-DOF) inertial measurement units (IMUs) are connected to a microcontroller and help measuring the user's head and shoulders position, using a complementary filter approach. The results are then transmitted to a base-station via a 2.4-GHz low-power wireless transceiver and interpreted by the control algorithm running on a PC host. A dedicated software interface allows the user to quickly calibrate the controller, and translates the information into suitable commands for JACO. The proposed controller is thoroughly described, from the electronic design to implemented algorithms and user interfaces. Its performance and future improvements are discussed as well.

Variation in Pharmacognostic Characters and Polyphenolic Contents among Four Species of Medicinal Plants from the Genus Spermacoce (Rubiaceae)

Spermacoce hispida L. is one of the important medicinal plants used in traditional systems of medicine. It is observed that, several times it is difficult to differentiate the plant from the other allied species from the same genus, Spermacoce, especially, when they are in drug form. Therefore, the present study aims to document the differences in the pharmacognostic characters, preliminary phytochemical analysis and polyphenolic contents from the leaves of four species belonging to the genus Spermacoce, viz. S. hispida L., S. mauritiana O. Gideon, S. stricta L. and S. ocymoides Burm. Transverse section passing through the midrib with lamina on either sides, epidermal characters, leaf constants, organoleptic characters, physicochemical analysis, extractive values and preliminary phytochemical analysis were carried out for all these species. Total phenolic content by Folin-Ciocalteu method and total flavonoids by AlCl₃ method were also estimated from the leaves of all these species. The results indicated that S. hispida can be clearly differentiated from the other selected species on the basis of size and number of epidermal cells, size of trichomes, leaf constants, physicochemical analysis and extractive values. However, it is also found that S. hispida possess total phenolic content at 6.88±0.34 mg CAE/g and 9.17±0.46 mg TAE/g. Total flavonoids was at 5.98±0.30 mg QE/g. The study will provide information with respect to identification and differentiation amongst selected species of genus Spermacoce.

Live imaging the phagocytic activity of inner ear supporting cells in response to hair cell death

Hearing loss and balance disorders affect millions of people worldwide. Sensory transduction in the inner ear requires both mechanosensory hair cells (HCs) and surrounding glia-like supporting cells (SCs). HCs are susceptible to death from aging, noise overexposure, and treatment with therapeutic drugs that have ototoxic side effects; these ototoxic drugs include the aminoglycoside antibiotics and the antineoplastic drug cisplatin. Although both classes of drugs are known to kill HCs, their effects on SCs are less well understood. Recent data indicate that SCs sense and respond to HC stress, and that their responses can influence HC death, survival, and phagocytosis. These responses to HC stress and death are critical to the health of the inner ear. Here we have used live confocal imaging of the adult mouse utricle, to examine the SC responses to HC death caused by aminoglycosides or cisplatin. Our data indicate that when HCs are killed by aminoglycosides, SCs efficiently remove HC corpses from the sensory epithelium in a process that includes constricting the apical portion of the HC after loss of membrane integrity. SCs then form a phagosome, which can completely engulf the remaining HC body, a phenomenon not previously reported in mammals. In contrast, cisplatin treatment results in accumulation of dead HCs in the sensory epithelium, accompanied by an increase in SC death. The surviving SCs constrict fewer HCs and display impaired phagocytosis. These data are supported by in vivo experiments, in which cochlear SCs show reduced capacity for scar formation in cisplatin-treated mice compared with those treated with aminoglycosides. Together, these data point to a broader defect in the ability of the cisplatin-treated SCs, to preserve tissue health in the mature mammalian inner ear.

High speed low power optical detection of sub-wavelength scatterer

Optical detection of scatterers on a flat substrate, generally done using dark field microscopy technique, is challenging since it requires high power illumination to obtain sufficient SNR (Signal to Noise Ratio) to be able to detect sub-wavelength particles. We developed a bright field technique, based on Fourier scatterometry, with special illumination and detection control to achieve this goal with a power level that can be sustained by most substrates including polymers. The performance of the system in a roll-to-roll line in production environment and strict throughput requirement is shown.

Selective interlayer ferromagnetic coupling between the Cu spins in YBa2Cu3O7-x grown on top of La0.7Ca0.3MnO3

Studies to date on ferromagnet/d-wave superconductor heterostructures focus mainly on the effects at or near the interfaces while the response of bulk properties to heterostructuring is overlooked. Here we use resonant soft x-ray scattering spectroscopy to reveal a novel c-axis ferromagnetic coupling between the in-plane Cu spins in YBa2Cu3O7-x (YBCO) superconductor when it is grown on top of ferromagnetic La0.7Ca0.3MnO3 (LCMO) manganite layer. This coupling, present in both normal and superconducting states of YBCO, is sensitive to the interfacial termination such that it is only observed in bilayers with MnO2 but not with La0.7Ca0.3O interfacial termination. Such contrasting behaviors, we propose, are due to distinct energetic of CuO chain and CuO2 plane at the La0.7Ca0.3O and MnO2 terminated interfaces respectively, therefore influencing the transfer of spin-polarized electrons from manganite to cuprate differently. Our findings suggest that the superconducting/ferromagnetic bilayers with proper interfacial engineering can be good candidates for searching the theorized Fulde-Ferrel-Larkin-Ovchinnikov (FFLO) state in cuprates and studying the competing quantum orders in highly correlated electron systems.