Automatic prostate segmentation of magnetic resonance imaging using Res-Net.

OBJECTIVES: Segmenting the prostate from magnetic resonance images plays an important role in prostate cancer diagnosis and in evaluating the treatment response. However, the lack of a clear prostate boundary, heterogeneity of prostate tissue, large variety of prostate shape and scarcity of annotated training data makes automatic segmentation a very challenging task. In this work, we proposed a novel two stage segmentation method to automatically segment prostate to support accurate and reproducible results with multisite and multivendor dataset. In the proposed method, we use the combination U-Net with residual blocks. METHODS: The proposed method comprises two stage neural network, first is 2D U-Net, used find the approximate location of prostate, the second is the combination of U-Net and Res-Net used for accurate segmentation of prostate. The network was trained on 116 patient datasets from three publicly available data sources. 80% of data is used for training, 10% for validation, and 10% for testing. The commonly used segmentation evaluation metrics Dice similarity coefficient (DSC), Sensitivity, and Specificity are used for quantitative evaluation of the network. RESULTS: With the proposed method average DSC value of 93.8%, Sensitivity value of 94.6% and Specificity of 99.3% was achieved on test datasets. CONCLUSIONS: Our experimental results show that the segmentation accuracy can be improved significantly using two stage neural networks.

An amide to thioamide substitution improves the permeability and bioavailability of macrocyclic peptides.

Solvent shielding of the amide hydrogen bond donor (NH groups) through chemical modification or conformational control has been successfully utilized to impart membrane permeability to macrocyclic peptides. We demonstrate that passive membrane permeability can also be conferred by masking the amide hydrogen bond acceptor (>C = O) through a thioamide substitution (>C = S). The membrane permeability is a consequence of the lower desolvation penalty of the macrocycle resulting from a concerted effect of conformational restriction, local desolvation of the thioamide bond, and solvent shielding of the amide NH groups. The enhanced permeability and metabolic stability on thioamidation improve the bioavailability of a macrocyclic peptide composed of hydrophobic amino acids when administered through the oral route in rats. Thioamidation of a bioactive macrocyclic peptide composed of polar amino acids results in analogs with longer duration of action in rats when delivered subcutaneously. These results highlight the potential of O to S substitution as a stable backbone modification in improving the pharmacological properties of peptide macrocycles.

Comparison of a novel immunocapture assay with standard serological methods in the diagnosis of brucellosis.

BACKGROUND: Microbiological culture methods and immunological assays currently available are technically challenging, difficult to interpret even in non-endemic areas. They are also time consuming leading to misdiagnosis, treatment delay, and severe morbidity and mortality. Therefore, the development of a simple and accurate diagnostic assay which could be performed even in small laboratories is a pressing need. This has prompted us to evaluate an assay based on the immunocapture technique in a region where brucellosis is prevalent. METHODS: The immunocapture test was evaluated for diagnostic efficacy on 211 patients with suspected brucellosis. Standard tube agglutination test (SAT), 2-mercaptoethanol (2-ME) agglutination, Coombs, immunocapture tests, and blood cultures were performed on these 211 blood samples. 190 sera belonging to healthy blood donors of endemic and non-endemic areas and 43 sera obtained from non-brucellosis patients were also subjected to SAT, 2-ME, Coombs, and immunocapture tests. A total of 15 blood cultures belonging to blood donors of endemic area and non-brucellosis cases were done. RESULTS: SAT picked up only 21 (9.9%), Coombs established the diagnosis in 69 (32.7%), while the immunocapture test confirmed the diagnosis in 76 (36%; p < 0.001)) patients with brucellosis, including 48 culture-confirmed cases. Sensitivity and specificity of the immunocapture technique were 97.29% and 97.08% respectively. SAT could not exclude the diagnosis in 55 cases as they were confirmed in most cases by the Coombs test and in all by immunocapture. CONCLUSIONS: Our results clearly show that immunocapture is superior to SAT in all stages of illness but is not significantly superior to Coombs. It also seems to be a useful tool in diagnosing a relapse. Immunocapture and Coombs tests were found to be more sensitive eliminating the ambiguity in the interpretation of the results for diagnosing brucellosis. The Coombs test is laborious, subjective in interpretation and demanding on skills. The immunocapture technique does not have the subjective reading errors, is simple to perform, and the results of the immunocapture technique seem to be reproducible. Thus we recommend the immunocapture technique especially for brucellosis-endemic countries. The Coombs, immunocapture, and 2-ME tests may also be considered useful tools in assessing treatment outcome.

Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis.

AIM AND BACKGROUND: This systematic review aimed to investigate the efficacy of laser photobiomodulation (PBM) on the acceleration of orthodontic tooth movement (OTM). REVIEW METHODS: The study protocol was registered at PROSPERO (CRD42019121465). An extensive electronic search for randomized control trials and clinical control trials via Medline (via PubMed), The Cochrane Controlled Clinical Trials Register, and Scopus up to date 24/02/2019 was done. Hand searching was performed for relevant journals. Reference articles were retrieved and exported to Mendeley Desktop 1.13.3 software. The risk of bias was assessed using the Cochrane risk of the bias assessment tool. Articles were further analyzed using Revman5.3 software. RESULTS: A total of 14 articles were considered for systematic review and 9 articles were considered for meta-analysis. The results of the meta-analysis showed a significant difference between the laser group and conventional orthodontic treatment with Forest plots showing more tooth movement in the laser group compared to the control group in 2-3 months (mean difference = 1.73; CI: 0.9-2.57; p = 0.00001; I 2 = 89 %). CONCLUSION: Although the analysis of the results shows that laser PBM favors OTM, the results are inconclusive as the heterogeneity across studies was high. CLINICAL SIGNIFICANCE: Laser PBM may be considered as novel, safe, and noninvasive adjuvant therapy for the acceleration of OTM in children. HOW TO CITE THIS ARTICLE: Yavagal CM, Matondkar SP, Yavagal PC. Efficacy of Laser Photobiomodulation in Accelerating Orthodontic Tooth Movement in Children: A Systematic Review with Meta-analysis. Int J Clin Pediatr Dent 2021;14(S-1):S94-S100.

Safety Assessment of Ubiquinol Acetate: Subchronic Toxicity and Genotoxicity Studies.

Coenzyme Q10 (CoQ10) is a lipid soluble, endogenous antioxidant present at highest levels in the heart followed by the kidney and liver. The reduced CoQ10 ubiquinol is well known for its chemical instability and low bioavailability. The present study was designed to synthesize ubiquinol acetate, which is more stable and biologically active, and further evaluate its safety and genotoxic potential. Synthesized ubiquinol acetate showed better stability than that of ubiquinol at the end of 3 months. In vitro genotoxicity studies (AMES test, in vitro micronucleus and chromosomal aberration) showed ubiquinol acetate as nongenotoxic with no clastogenic or aneugenic effects at high dose of 5000 and 62.5 µg/mL, respectively. In subchronic toxicity study, ubiquinol acetate was administered orally to Sprague Dawley rats at 150, 300, and 600 mg/kg/day for 90 days. No treatment related adverse effects were observed in males at 600 mg/kg/day; however, females showed treatment related increase in AST and ALT with small focal irregular white-yellow spots in liver on gross necropsy examination. Histopathological evaluation revealed hepatocellular necrosis in high dose females which was considered as adverse. Based on the results, the No-Observed-Adverse-Effect Level (NOAEL) of ubiquinol acetate in males and females was determined as 600 and 300 mg/kg/day, respectively.

Sub-pixel Area Calculation Methods for Estimating Irrigated Areas.

The goal of this paper was to develop and demonstrate practical methods forcomputing sub-pixel areas (SPAs) from coarse-resolution satellite sensor data. Themethods were tested and verified using: (a) global irrigated area map (GIAM) at 10-kmresolution based, primarily, on AVHRR data, and (b) irrigated area map for India at 500-mbased, primarily, on MODIS data. The sub-pixel irrigated areas (SPIAs) from coarse-resolution satellite sensor data were estimated by multiplying the full pixel irrigated areas(FPIAs) with irrigated area fractions (IAFs). Three methods were presented for IAFcomputation: (a) Google Earth Estimate (IAF-GEE); (b) High resolution imagery (IAF-HRI); and (c) Sub-pixel de-composition technique (IAF-SPDT). The IAF-GEE involvedthe use of "zoom-in-views" of sub-meter to 4-meter very high resolution imagery (VHRI)from Google Earth and helped determine total area available for irrigation (TAAI) or netirrigated areas that does not consider intensity or seasonality of irrigation. The IAF-HRI isa well known method that uses finer-resolution data to determine SPAs of the coarser-resolution imagery. The IAF-SPDT is a unique and innovative method wherein SPAs aredetermined based on the precise location of every pixel of a class in 2-dimensionalbrightness-greenness-wetness (BGW) feature-space plot of red band versus near-infraredband spectral reflectivity. The SPIAs computed using IAF-SPDT for the GIAM was within2 % of the SPIA computed using well known IAF-HRI. Further the fractions from the 2 methods were significantly correlated. The IAF-HRI and IAF-SPDT help to determine annualized or gross irrigated areas (AIA) that does consider intensity or seasonality (e.g., sum of areas from season 1, season 2, and continuous year-round crops). The national census based irrigated areas for the top 40 irrigated nations (which covers about 90% of global irrigation) was significantly better related (and had lesser uncertainties and errors) when compared to SPIAs than FPIAs derived using 10-km and 500-m data. The SPIAs were closer to actual areas whereas FPIAs grossly over-estimate areas. The research clearly demonstrated the value and the importance of sub-pixel areas as opposed to full pixel areas and presented 3 innovative methods for computing the same.

Comparative Evaluation of Different Modes of Laser Assisted Endodontics in Primary Teeth: An In vitro Study.

INTRODUCTION: The presence of bacteria in root canals has been considered to be responsible for endodontic treatment failure, even in case of primary teeth. The use of lasers can be a valuable addition in removing bacterial load in areas where traditional methods may fail to succeed. Methods like direct laser irradiation of canals, Laser Activated Irrigation (LAI) with sodium hypochlorite (NaOCl) and Photodynamic Therapy (PDT) seem to be a promising alternative for disinfection. AIM: This study was designed to compare the efficacy of latest advancements in disinfection techniques using diode laser namely direct laser irradiation, photodynamic therapy and laser activated irrigation using sodium hypochlorite. MATERIALS AND METHODS: Sixty freshly extracted primary teeth either single or multi-rooted teeth with two third of their root length intact were collected. Instrumentation was completed to size 30 H-file. Teeth were randomly divided into Group 1- Direct Laser- irradiation, Group 2 - Photodynamic therapy; Group 3- Laser activated irrigation with 2.5% NaOCl. The tooth specimens were inoculated with Enterococcus faecalis. The bacterial colonies were counted preoperatively. Laser irradiation was performed for all groups in accordance to the groups each tooth belonged to. Postoperatively the bacterial colonies were counted. One-way Analysis was applied to compare bacterial count at baseline and post-test between three groups. Tukey's post-hoc test was applied for pairwise comparison between groups. Paired t-test was applied to compare the mean baseline bacterial count with post-test mean bacterial count. RESULTS: The results obtained with all the three groups postoperatively were highly significant (p-value<0.001). Statistically significant difference between results of Group 1 and Group 2 and also between Group 1 and Group 3 was found (p-value≤ 0.001). However, no statistical difference between Group 2 and Group 3 was found (p-value- 0.96). CONCLUSION: Disinfection strategies using diode laser by techniques gives promising results. Techniques like laser activated irrigation and photoactivated disinfection are better than direct laser irradiation in eliminating Enterococcus feacalis.

Effect of chlorpyrifos on soil microbial diversity and its biotransformation by Streptomyces sp. HP-11.

The application of pesticides in agricultural fields not only reaches the target pests but also with soil where it interacts with soil microorganisms resulting in change of microbial diversity. Chlorpyrifos (CP) is one such organophosphorous insecticide most widely used against various insects, termites, and beetles throughout the globe. In the present work, the effect of CP on soil microbial population was assessed by the cultivable method. The fertile soil which does not have a history of any pesticide application was treated with 100 and 200 µg/g of CP along with control which received only sterile water and incubated for 1, 7, and 14 days. The soil amended with the insecticide showed decrease in the number of colony forming units (CFU) of bacteria and fungi. However, Streptomyces sp. HP-11 which tolerated high concentration and also inhibited fungal population was further selected for biodegradation studies. After 14 days of incubation in Mineral salt media (MSM), the strain HP-11 biotransformed CP into 3, 5, 6-trichloro-2-pyridinol (TCP) and Diethyl Phosphorothioate (DETP), and its formation was confirmed by the m/z peak of LC-MS analysis, which was later metabolized to unknown polar metabolites. The results obtained highlights that the application of chlorpyrifos favored the Actinomycete growth in the soil, thereby inhibiting other microorganisms and the strain HP-11 harbors metabolic pathway for detoxification of CP and its hydrolysis product TCP into polar metabolites, thus suggesting the strain HP-11 will be a potential bioaugmenting agent for the bioremediation of chlorpyrifos contaminated soil and water.

Effect of storage media on fracture resistance of reattached tooth fragments using G-aenial Universal Flo.

BACKGROUND: Over a period of the past few years' episodes of dental trauma more commonly coronal fractures of anterior teeth are being increasingly reported in children. Fragment reattachment can be considered as a valid treatment option in such situations. However, ideal medium for storage of fragments before reattachment needs to be explored. AIM: To compare the fracture resistance of incisor tooth fragments stored in four storage media: Dry air, milk, coconut water, or egg white before reattaching them with G-aenial Universal Flo. MATERIALS AND METHODS: Forty-eight freshly extracted maxillary incisors were divided into four groups. Teeth were then sectioned, and fragments were stored in dry air (Group I), milk (Group II), coconut water (Group III), and egg white (Group IV). The fragments were reattached using simple reattachment technique and tested on the Universal Testing Machine. Statistical analysis was performed using one-way analysis of variance and post hoc Tukey's test. RESULTS: There was statistically significant difference (P < 0.05) in fracture resistance values between the groups. The highest fracture resistance value was demonstrated by Group II, whereas least fracture resistance values were observed in Group IV. CONCLUSION: Along with milk, coconut water being tested for the first time can be considered a viable alternative.

Case report on anorexia nervosa.

Anorexia nervosa is an eating disorder characterized by excessive restriction on food intake and irrational fear of gaining weight, often accompanied by a distorted body self-perception. It is clinically diagnosed more frequently in females, with type and severity varying with each case. The current report is a case of a 25-year-old female, married for 5 years, educated up to 10(th) standard, a homemaker, hailing from an upper social class Hindu (Marvadi) family, living with husband's family in Urban Bangalore; presented to our tertiary care centre with complaints of gradual loss of weight, recurrent episodes of vomiting, from a period of two years, menstrual irregularities from 1 year and amenorrhea since 6 months, with a probable precipitating factor being husband's critical comment on her weight. Diagnosis of atypical anorexia nervosa was made, with the body mass index (BMI) being 15.6. A multidisciplinary therapeutic approach was employed to facilitate remission. Through this case report the authors call for the attention of general practitioners and other medical practitioners to be aware of the symptomatology of eating disorders as most patients would overtly express somatic conditions similar to the reported case so as to facilitate early psychiatric intervention.

A comparative study of different modalities of treatment in nicotine dependence syndrome.

UNLABELLED: There are different modalities for management of Nicotine dependence, but it is still inconclusive which is the best modality for the treatment of Nicotine dependence syndrome (NDS). In this background the present study was carried out to assess the efficacy and to compare different modalities for the treatment of NDS. METHODS: Patients diagnosed as NDS as per ICD-10 were taken up for study. These patients were administered proforma to elicit sociodemographic details, Fagerstrom test for Nicotine Dependence, Questionnaire of Smoking Urges-Brief and breath analysis was done using carbon monoxide meter. Assessment was done at base line and at weekly follow-ups for 12 weeks. Patients were divided into six groups randomly. Group A received BUP at a dose of 150mg/day for 3 days; subsequently increased to 300mg/day, Group B: for initial 6 weeks Nicotine gum of 4mg every 1-2 hourly was used and next 6 weeks every 2-4 hourly was used, Group C: BI, Group D: BI+BUP, Group E: BI+NRT, Group F received BUP+NRT+BI. RESULTS: The quit rates at end of the study were BUP-30%, NRT-26.66%, BI-23.33%, BI+BUP-43.33%, BI+NRT-33.33%, and BI+BUP+NRT-50%. BI+BUP+NRT had 2-3 times more quit rates than the individual modality treatment group. CONCLUSION: There was no statistically significant difference between the study groups, but there was clinical difference in quit rates. Among the groups BI+BUP+NRT had higher quit rates compared to other groups. Combination modalities yield better quit rates than individual modalities.

Finite element stress analysis of stainless steel crowns.

BACKGROUND: Though stainless steel crowns (SSCs) have often been stated as the best restorative modality, there are limited studies demonstrating its efficacy in restoring the functional integrity of the primary dentition. Hence has arisen, the necessity to establish the supremacy of SSCs. AIM: Evaluation of the efficacy of SSC to with stand compressive (0°), shearing (90°), and torsional (45°) stress when used as a restorative material. SETTINGS AND DESIGN: The study design employed four finite element models, each with differing amounts of tooth structure, which were exported to ANSYS software and subjected to an average simulated bite force of 245N. MATERIALS AND METHODS: Four maxillary deciduous primary molars restored with SSCs (3M ESPE) were subjected to spiral computed tomography (CT) in order to obtain three-dimensional (3D) images, which were then converted into finite element models. They were each subjected to forces along the long axis of the tooth and at 45°and 90°. RESULTS: The maximal equivalent von Mises stress was demonstrated in the SSCs of all the models with only a minimal amount observed in the underlying dentine. In all situations, the maximal equivalent von Mises stress was well below the ultimate tensile strength values of stainless steel and dentine. CONCLUSION: Even at maximal physiologic masticatory force levels, a grossly destructed tooth restored with SSC is able to resist deformation.

An outbreak of multidrug resistant typhoid fever in Bangalore.

Six hundred and eighty five blood cultures from children clinically diagnosed as enteric fever yielded 176 salmonella strains showing isolation success rate of 25.7%, S. typhi were 164 (93.2%), S. paratyphi A 5 (2.8%), S. choleraesuis 4 (2.3%) and S. typhimurium 3 (1.7%). Antibiogram of 164 isolates of S. typhi showed triple drug resistance (TDR) in 156 strains (95.1%) to chloramphenicol, ampicillin and cotrimoxazole, and sensitivity of 90.2% and 95.1% to norfloxacin and ciprofloxacin respectively. Minimum inhibitory concentrations (MIC) of chloramphenicol were between 360 mcg and 640 mcg per ml. Phage types of 38 strains of TDR S. typhi were predominantly E1 and 0 with prevalences of 47.4% and 36.8% respectively in this region. All children with S. typhi isolates sensitive to quinolones in Vitro responded well to these drugs with almost no relapse and hence, the newer generation of quinolones could be considered as the first choice in the primary treatment of enteric fever.

Multidrug resistant Salmonella typhi in Bangalore, south India.

A total of 204 strains of salmonella were isolated in blood cultures during the year 1991 outbreak of enteric fever in and around Bangalore. Out of this, 190 were S. typhi, 6 S. paratyphi A, 5 S. typhimurium and 3 S. choloraesuis. Antibiogram of 190 strains of S. typhi showed resistance of 94.7%, 95.8% and 96.9% to chloramphenicol, ampicillin and cotrimoxazole and sensitivity of 65.3%, 88.4% and 94.2% to gentamycin, norfloxacin and ciprofloxacin respectively. Minimum inhibitory concentrations (MIC) of chloramphenicol were between 360 mcg and 640 mcg per ml. There was high degree (94.7%) of triple drug resistance to chloramphenicol, ampicillin and cotrimoxazole.

Evaluation of immuno efficiency of hemorrhagic septicemia vaccine strain (vaccine seed).

OBJECTIVE: To compared seed culture of hemorrhagic septicemia (HS) bacteria which was used to produce vaccine for its antibody induction efficiency before and after passaging in natural host (calf) using laboratory animals. METHODS: Serial dilution of virulent bacteria was injected in to mice which were immunized with HS vaccine which was obtained from seed bacteria before and after back passaged in calf. Ratio of survived and dead was calculated by Reed-Meunch hypothesis and the LD50 value for each vaccine trial groups were calculated. RESULTS: The immunological study revealed that vaccine prepared from back passaged seed culture showed greater improvement in its immunopotency than seed vaccine (before back passage). Around 200 mice were used to study the immuno efficiency of vaccine. Each mouse was from the same source, which were free from the Pastuerella infection previous to expose to trial infection. The same broth culture of HS was used to induce infection in mice in both trials (vaccine before back passage and vaccine after back passage). The 0.2 mL of broth dilution from 10(-1) to 10(-10) was used, as dilution increases, death rate decreases. It indicates the minimum load of bacterium is required to induced infection. CONCLUSIONS: Obtained results revealed that back passaged vaccine seed HS bacteria in its natural host had provided better immune efficiency to the culture than laboratory stock culture, and this findings recommended that regular annual back passage was mandatory for the vaccine seed culture of Pastuerella multocida bacteria for better establishment of immune potent vaccines.

A comparison of early and delayed arthroscopically-assisted reconstruction of the anterior cruciate ligament using hamstring autograft.

Delayed rather than early reconstruction of the anterior cruciate ligament is the current recommended treatment for injury to this ligament since it is thought to give a better functional outcome. We randomised 105 consecutive patients with injury associated with chondral lesions no more severe than grades 1 and 2 and/or meniscal tears which only required trimming, to early (< two weeks) or delayed (> four to six weeks) reconstruction of the anterior cruciate ligament using a quadrupled hamstring graft. All operations were performed by a single surgeon and a standard rehabilitation regime was followed in both groups. The outcomes were assessed using the Lysholm score, the Tegner score and measurement of the range of movement. Stability was assessed by clinical tests and measurements taken with the KT-1000 arthrometer, with all testing performed by a blinded uninvolved experienced observer. A total of six patients were lost to follow-up, with 48 patients assigned to the delayed group and 51 to the early group. None was a competitive athlete. The mean interval between injury and the surgery was seven days (2 to 14) in the early group and 32 days (29 to 42) in the delayed group. The mean follow-up was 32 months (26 to 36). The results did not show a statistically significant difference for the Lysholm score (p = 0.86), Tegner activity score (p = 0.913) or the range of movement (p = 1). Similarly, no distinction could be made for stability testing by clinical examination (p = 0.56) and measurements with the KT-1000 arthrometer (p = 0.93). Reconstruction of the anterior cruciate ligament gave a similar clinical and functional outcome whether performed early (< two weeks) or late at four to six weeks after injury.

Skin dose measurements using MOSFET and TLD for head and neck patients treated with tomotherapy.

The purpose of this work was to estimate skin dose for the patients treated with tomotherapy using metal oxide semiconductor field-effect transistors (MOSFETs) and thermoluminescent dosimeters (TLDs). In vivo measurements were performed for two head and neck patients treated with tomotherapy and compared to TLD measurements. The measurements were subsequently carried out for five days to estimate the inter-fraction deviations in MOSFET measurements. The variation between skin dose measured with MOSFET and TLD for first patient was 2.2%. Similarly, the variation of 2.3% was observed between skin dose measured with MOSFET and TLD for second patient. The tomotherapy treatment planning system overestimated the skin dose as much as by 10-12% when compared to both MOSFET and TLD. However, the MOSFET measured patient skin doses also had good reproducibility, with inter-fraction deviations ranging from 1% to 1.4%. MOSFETs may be used as a viable dosimeter for measuring skin dose in areas where the treatment planning system may not be accurate.

Study of burn sepsis with special reference to Pseudomonas aeruginosa.

Fifty cases of burn of different degrees were subjected to clinical and microbiological studies. A total of 60 isolates were obtained. Of these, 40 (80.0% incidences) were Ps aeruginosa, 8 (16.0 incidences) Staph pyogenes, 6 (12.0% incidences) Kl pneumoniae, 4 (80.0% incidences) Esch coli and 2 (4.0% incidences) C albicans. Monobacterial cultures showed isolations in 41 cases (82.0%) and 34 (68.0%) of them were Ps aeruginosa. At the time to admission 42 cases (84.0%) were infected and during one week of hospitalisation another 8 cases (16.0%) were infected yielding an overall infection rate of 100%. The commonest organism on admission and after hospitalisation was Ps aeruginosa with isolation rates of 60.0% (30) and 20.0% (10) respectively. Gram-negative bacilli, predominantly Ps aeruginosa were found in the lower part of the body with an incidence of 74.0% (37). Staph pyogenes was found in the upper half showing an incidence of 12.0% (6) next to 20.0% (10) incidence of Ps aeruginosa. The incidence of burn infection was high in patients with deep and major burn wounds, the bacterial isolates being 76.0% (38) and 80.0% (40) respectively. Silver sulphadiazine exhibited antimicrobial action in the range of 14 to 390 microM/ml, while cerium sulphadiazine had no inhibitory effect even up to 667 microM/ml on pseudomonas isolates. Zinc sulphadiazine was effective in inhibiting the growth of 10 isolates tested in 40 to 297 microM/ml range.

Reservoirs of nosocomial pathogens in neonatal intensive care unit.

A total of 256 swabs taken from different areas of neonatal intensive care units (ICU) in KCG Hospital and AMC Hospital, Bangalore were bacteriologically investigated for prevalence, source and spread of nosocomial bacteria. Culture studies revealed growth in 217 (84.8%) swab samples indicating considerable contamination of different areas of the units and sources of infection. Klebsiella pneumoniae (27.3%) was the predominant organism followed by Esch coli (16.8%), Staph aureus (11.7%), Staph epidermidis and Pseudomonas aeruginosa (10.2%), enterococcus and proteus (4.7%), Citrobacter freundi (3.5%) and Clostridium tetani (2.4%) isolated from the equipment, cradles, other inanimate objects and environmental surfaces. Out of 312 isolates, monobacterial prevalence was 43.6% in contrast to polybacterial prevalence of 56.4%. Klebsiella pneumoniae (74.3%) was the predominant monobacterial isolate. The indoor air of the units was found to carry common nosocomial bacteria of 4 or more different bacterial species at dangerous levels as observed by colony counts of 15 to 30 on exposed blood agar plates. Almost all sources in ICU revealed the presence of Klebsiella Pneumoniae, Esch coli, pseudomonas and staphylococcus thus forming the potential reservoirs of nosocomial infections to babies and this could be attributed to overcrowding, poor ventilation system and failure to follow basic principles of strict protective barrier nursing.