Judicial Use Research Articles

The definition of conflict of interest: international legal aspect

The article focuses on the study of international legal instruments in the field of corruption prevention, specifically addressing the definition of «conflict of interest». The relevance of the topic stems from the increasing incorporation of the conflict of interest concept into various areas of public management and administration through national legislation. Many works of scientists are devoted to the study of the problem of conflict of interests: the authors analyzing the definitions of key terms as outlined in national legislation; the essence of the definition is revealed through the typology and the classification of different types of conflicts of interest. However, at the national level, a comprehensive understanding of the application of the conflict of interest concept has not yet been fully developed. There is also a lack of a conceptual framework that satisfies the requirements of legal certainty. The question of the definition of «conflict of interest» in a way that is suitable for judicial and administrative application remains a matter of debate. An important step toward resolving this issue is the examination of international legal approaches to defining the essence of the concept. The article analyzes international conventions, declarations, and other legal instruments related to the fight against corruption to interpret and clarify the meaning of «conflict of interest». It clarifies international legal approaches to defining the term for the purposes of legal regulation. The article notes that the definition of conflict of interest can encompass a broad range of issues, particularly those related to combating corruption, which may fall within both administrative and criminal law. It is concluded that the term «conflict of interest», as a specific legal term, is not explicitly defined in international legal acts. The definition of «conflict of interest», as a complete and independent legal term, suitable for judicial and administrative use, is shaped by the context of state interests, the constitutional and legal framework, and public service requirements.

Nitrate Contamination in the Groundwater and Associated Human Health Risk Assessment for Gaya District, Bihar, India

The study pertains to nitrate concentration in groundwater resources of the Gaya district, Bihar, India and its related health risk to the local population. Groundwater serves as the principal source of drinking water in the area. 40 representative groundwater samples were collected and analyzed for nitrate and other water quality parameters. The concentration of Nitrate (NO3 -) in the groundwater of Gaya district varied from 1.62 to 155.6 mg/L and exceeded the Bureau of Indian Standards (BIS) permissible limits for drinking water in 30% of the samples. The elevated nitrate levels were predominantly attributed to agricultural activities. To evaluate the human health risks associated with groundwater, Hazard Quotient for nitrate (HQnitrate) were calculated using the United States Environmental Protection Agency method. The mean HQnitrate values were estimated to be 1.03, 0.89 and 1.65 for the male, female and child populace, respectively depicting considerable risk to male and child populace. In 67.5% of the samples, HQnitrate for children exceeded the safety threshold of 1. The study advocates significant health risks, especially to children in many parts of Gaya district due to high concentrations of nitrate in the groundwater. Judicial use of nitrogen-based fertilizers is suggested to prevent further contamination of groundwater.

The Sensitivity Pattern of Uropathogens towards Oral Antibiotics among Children with Urinary Tract Infection

Background: Urinary tract infection (UTI) is common in paediatric age group. Because of extensive and injudicious use of oral antibiotics, uropathogens show increasing resistance to these drugs. The objective of the study was to identify the susceptibility pattern of uropathogens towards oral antibiotics among children suffering from UTI who were admitted to the paediatric ward at Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet. Materials and methods: This cross-sectional study was carried out among 100 children aged 2 months to 12 years, who had a confirmed diagnosis of UTI based on urine culture reports and was admitted to the paediatric department of Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet. The study period was 1st January 2018 to 31st December 2019. Results: The mean age of the patients was 46.48±38.58 months. Males were 34% and females were 66% and the male-female ratio was 1:1.9. The common presenting complaints of UTI cases were fever (67%), dysuria or crying during micturition (53%), abdominal pain (42%), an increased frequency of micturition (30%), and nausea and vomiting (26%). The most common isolated organism was E. coli (61%), followed by Klebsiella species (31%). Nitrofurantoin was the drug that the isolated organisms were most sensitive to, followed by levofloxacin and ciprofloxacin. The isolated organisms were highly resistant to cephalexin, amoxicillin, cephradine, cefaclor, cefixime, azithromycin, and co-trimoxazole. Conclusion: Uropathogens are mostly sensitive to nitrofurantoin, levofloxacin, and ciprofloxacin. These drugs may be used to empirically treat UTI in children, if necessary. Judicial antibiotic use should be practised to prevent the development of antibiotic resistance.

Assessment of Biological Damage Induced during Multidetector Computed Tomography (MDCT) Examination.

Computed tomography (CT) is known for its non-invasiveness, fast procedure, and also for providing detailed diagnostic information to physicians. It also utilises low-dose-rate ionising radiation (X-rays) as a source for imaging. Multidetector computed tomography (MDCT) is an advanced system that uses iodinated contrast media for more accurate diagnostic results. Studies suggest using these contrasts will lead to greater radiation adsorption with significant DNA damage. No studies have been taken comparing the physical dose with the biological effect. The present study sheds light on the same by assessing the biological effect of CT with and without contrast intervention. The present study is timebound; thus, 21 participants attending for CT thorax and abdomen with no history of any cancer were included. The same participants underwent both pre-contrast and post-contrast studies. The blood sample was taken before the procedure and used as a control. Physical parameters like DLP and CTDI obtained from the instrument were compared with the MN frequency obtained (CBMN Assay). The study showed a significant increase (p-value < 0.05) in the Physical and MN frequency in the Post-Contrast group compared to the pre-contrast group. Although a positive correlation was observed between pre and post-contrast groups, the results were not found to be statistically significant (p-value < 0.05). The study confirms increased physical dose and MN frequency upon contrast intervention. This study recommends the judicial use of MDCT in disease diagnostics.

Prioritising quality: investigating the influence of image quality on forensic facial comparison

Morphological analysis in forensic facial comparison was recently validated for judicial use. However, no image quality assurance systems exist for this purpose, despite image triage being considered the best practice approach. Hence, this study aimed at testing a semi-quantitative scoring method to assess image quality and investigated facial image resolution and lighting quality quantitatively in a context of forensic facial comparison. For this purpose, 400 facial comparison photographic and CCTV image pools developed from the Wits Face Database were used. These facial images were analysed in prior studies that investigated the validity of morphological analysis. A semi-quantitative image quality scoring system was adapted and tested on the above sample and compared across correct and incorrect matches obtained as part of previous studies using a logistic regression model. In addition, facial images were cropped to the closest pixel comprising the face, head and neck areas; then, a face-to-image pixel proportion was calculated as an estimator of resolution quality; and pixel exposure qualities were obtained to be compared to facial comparison outcomes. Ideal and high image quality scores were related to correctness of matches, while low-quality scores were related to incorrect matches. High pixel proportions were related to true matches and low exposure was related to false positives, while high exposure was related to false negatives. These results suggest that an easy method for image triage could be employed by scoring image quality. Quantitative measures should be investigated further for thresholding quality suitability for confidence of facial comparisons.

Public Perceptions of Judicial Use of AI: A Legal &amp;amp; Psychological Perspective

Public Perceptions of Judicial Use of AI: A Legal &amp;amp; Psychological Perspective

Effect of magnesium sulphate on propofol requirement in abdominal surgeries under general anesthesia

Background &amp; Objective: Magnesium sulphate (MgSO4) has the potential to be used as a part of balanced anesthesia due to its inherent pharmacological actions. Its judicial use can enhance patient safety. We evaluated the effect of MgSO4 on the total dose of propofol used under bispectral index (BIS) targeted general anesthesia for abdominal surgeries.&#x0D; Methodology: This prospective randomized controlled trial was conducted on 60 adult patients of either sex, scheduled for elective surgery under general anesthesia. Patients were allocated to two study groups of 30 patients each. In Group I, MgSO4 was administered as 30 mg/kg intravenously (IV) in 100 ml normal saline (NS) over 15 min followed by 10 mg/kg/h infusion intraoperatively. In Group II 100 ml NS was administered over 15 min followed by NS infusion intraoperatively. Anesthesia was induced with propofol, fentanyl, and atracurium in both groups. Intraoperative propofol infusion was started to keep BIS values within 45-55. Data was compared for total dose of propofol used, Ramsay sedation score, recovery characteristics and hemodynamic parameters. Data so collected was statistically analyzed.&#x0D; Results: The mean quantity of propofol required for induction was less in Group I as compared to Group II, being 1.70 ± 0.19 mg/kg and 2.39 ± 0.58 mg/kg respectively (P &lt; 0.001). Group I achieved BIS 60 (59.20 ± 7.63 seconds) faster than Group II (78.36 ± 13.03 sec) (P &lt; 0.001). The requirement of propofol for maintenance was less in Group I (4.48 ± 0.95 mg/kg/h) as compared to Group II (6.63 ± 1.65 mg/kg/h) (P &lt; 0.001). During recovery, the MgSO4 group needed more time to reach BIS 70 as compared to control group with their mean values being 8.86 ± 1.48 min and 6.88 ± 1.54 min respectively. Response to verbal commands and orientation was also significantly delayed in MgSO4 group as compared to control group (P &lt; 0.001).&#x0D; Conclusion: Magnesium sulphate co-administration with propofol decreases the dosage of propofol to maintain a constant BIS value at 45–55. Sedation and delayed recovery are the notable drawbacks of using magnesium sulphate.&#x0D; Abbreviations: NMDA - N-methyl-D-aspartate; BIS - Bi‑spectral index; HR - Heart rate; MAP - mean arterial pressure&#x0D; Preregistration: Clinical Trial Registry-India (CTRI/2020/11/029315)&#x0D; Key words: Magnesium Sulphate; Propofol; BIS Target; Balanced Anesthesia&#x0D; Citation: Kaur H, Singh A, Prasad V, Singh A, Gupta KK, Sharma P. Effect of magnesium sulphate on propofol requirement in abdominal surgeries under general anesthesia. Anaesth. pain intensive care 2023;27(5):471−477. DOI: 10.35975/apic.v27i5.2118&#x0D; Received: January 14, 2023; Reviewed: July 17, 2023; Accepted: July 20, 2023

Review on Scrub Typhus: An Important Etiology of Acute Undifferentiated Fever Illness.

One of India's predominant public health issues is acute undifferentiated fever illness (AUFI), a typical response to an infectious agent. Diagnosisbecomes challenging when the disease has been reported with fever as the primary symptom. Among thecases presenting at a tertiary care hospitalin central India, 88% had an acute undifferentiated fever, the most common being dengue infection. In India, rural communities are at more risk from AUFI than cities. Most of those in danger are those who reside in remote areas, and one of the most significant risksis for those who reside close toforests. AUFI is a complex condition for physicians to deal with and is one of the most frequent clinical conditions for which empirical treatment is required. Nowadays, AUFI can be managed by a syndromic approach with the judicial use of antibiotics. Symptoms of AUFI, along with myalgia, headache, and anorexia, can be caused by various illnesses. Patients are recommended to undertake a battery of investigations, which may delay the therapy and increase expenses because many diseases may present with the same symptoms. In the developed world, viral illness is the primary cause of AUFI. However, in developing countries like India, it can also be brought on by potentially curable but life-threatening conditions such as malaria, leptospirosis, hantavirus infection, and Japanese encephalitis. Lack of knowledge of the locally prevalent illnesses, which might be the causeof AUFI, and lack of preliminary screening and diagnostics at the point of care to identify the etiologies make it difficult to control these generally curable causes of the burden of AUFI, especially in tropical and subtropical countries. A deeper understanding of AUFI is required to develop better diagnostics and cures for various etiologies, especially scrub typhus.

Impact of Mobile Phone Usage on Behavioral Change of Rural Youth in India - A Cross-Sectional Analysis

The study was taken up among the rural youths in the age group of 15-35 to find out the impact of mobile phone use on their behavioral changes in Salem District of Tamil Nadu. The study was based on primary data. Five demographic variables such as age, gender, marital status, family size and education were used as background variables to understand their inter-relationship between them. One common finding emerged from the background variables that the majority of mobile phone users were unmarried and school and college going students. To determine the impacting factors on behavioral changes due to more use of mobile phones, factor analysis was used. The factor analysis was clearly indicated psychological factors (stress, anxiety and depression) attributed to more use of mobile phone followed by increasing possibility of health hazards like non-communicable diseases and sedentary behavior on behavioral changes of respondents. Therefore, it is understood that the mobile phone usage can cause behavioral changes of the age group between (15-35), as this group prone to accept anything without understanding the long-term effects. Although mobile phone has become an integral part of daily life, it cannot be avoided but its judicial use could overcome some of its negative effects.

Frequency and Outcome of Emergency Oculoplastic Cases with Adaptations in Management during Covid-19 Pandemic

Purpose: To determine whether treating emergency oculoplastic conditions with protective modification have any effect on treatment outcome visiting tertiary oculoplastic service. Study Design: Interventional case series. Place and Duration of Study: Department of Ophthalmology, Lady Reading Hospital, from March to September 2020. Methods: We included all patients operated during pandemic at oculoplastic service. Protective modifications included; use of loupe instead of surgical microscope, avoidance of General Anesthesia, judicial use of cautery, use of absorbable suture and follow up through phone call and minimum visits. Results: A total of 117 patients were eligible with a mean age of 25.399 ± 34.89 years. Majority of the patients were male, 74 (63.2%). The mean follow-up time was 04 months. Satisfactory surgical and functional outcome was seen in 107 (91.5%) patients. There was no statistically significant difference in outcome with reference to gender (p-value of 0.824) and treatment (p-value of 0.168). Similarly, treatment outcome was statistically insignificant (p value 0.342) in different oculoplastic conditions. Unsatisfactory outcome due to various complications was seen in 10 (8.5%) patients at follow up of 01 to 05 months which were then given special treatment at followup. Conclusion: With adopted protocols and modifications in techniques, outcome was acceptable in common emergency oculoplastic conditions. Proper follow up through telemedicine was helpful in picking up the complicated cases for timely intervention to get satisfactory outcome during Covid 19 pandemic.

Advances in the Management of Pain in Chronic Pancreatitis.

The data on recent advances in managing chronic pancreatitis (CP) pain is limited. This review highlights the role of endotherapy and the advances in the overall management of pain in CP. Of late, pancreatic biodegradable stents have been used in endotherapy with appreciable success. These include slow, medium, and fast degrading stents, which optimize the overall management of CP and could prevent the need for multiple procedures. Endoscopic ultrasound-guided celiac plexus block is reserved in selected patients to treat debilitating pain. Total pancreatectomy with islet autotransplantation in small duct disease has shown promising results. The indications for treating pain in CP with endoscopy and surgery need to be better defined. The complexity of pain control due to the incomplete understanding of pathomorphology makes the management of CP challenging. The current treatment methods are still evolving. Therapy aims to reduce pain, optimize recovery, maintain quality of life, and meet postoperative needs. Initial management includes lifestyle modification, nutrition optimization, risk factor reduction with abstinence from alcohol, cessation of tobacco and smoking. Supportive medical management involves the judicial use of analgesics, neuromodulators, antioxidants, pancreatic enzyme replacement for insufficiency, and diabetes management. Patients with intractable pain are ideal for therapeutic intervention. Being less invasive with an acceptable complication rate makes endotherapy the preferred first-line treatment. If found to be cost-effective, biodegradable stents can reduce the overall cost. Unfortunately, if patients remain symptomatic, surgery is preferred in case of failure or recurrence. For optimal results, appropriate patient selection is vital to maximizing outcomes.

Superficial desmoplastic fibroblastoma (collagenous fibroma): Clinicopathologic study of 11 cases.

Desmoplastic fibroblastoma (collagenous fibroma) is a rare soft tissue tumor that usually arises in the subcutis or skeletal muscle. Cases superficial to fascia are unusual and can cause diagnostic difficulty. We present 11 cases of superficial desmoplastic fibroblastoma involving a wide anatomic distribution. Archives were searched using the term "desmoplastic fibroblastoma" over a 10-year period (2012-2022). Cases superficial to fascia were retrieved, and available clinicopathologic features were recorded. Only cases involving the dermis were included. Eleven cases were identified, all of which were received in consultation. Tumors involved the head and neck (2), lower extremity (2), back (2), foot (1), shoulder (1), axilla (1), hand (1), and breast (1). Each consisted of a hypocellular proliferation of bland stellate to spindled fibroblasts set in a collagenous to focally myxoid stroma. The immunohistochemical stains available for review demonstrated SMA positivity (4/7) and negative immunoreactivity for CD34 (0/6), EMA (0/3), desmin (0/3), and S100 (0/7). Desmoplastic fibroblastoma may present superficially in the dermis to subcutis, posing a potential source of diagnostic difficulty. Recognition of the characteristic histopathologic features of desmoplastic fibroblastoma with judicial use of immunohistochemical stains should allow for accurate diagnosis.

Whole Slide Imaging Technology and Its Applications: Current and Emerging Perspectives.

Background. Whole slide imaging (WSI) represents a paradigm shift in pathology, serving as a necessary first step for a wide array of digital tools to enter the field. It utilizes virtual microscopy wherein glass slides are converted into digital slides and are viewed by pathologists by automated image analysis. Its impact on pathology workflow, reproducibility, dissemination of educational material, expansion of service to underprivileged areas, and institutional collaboration exemplifies a significant innovative movement. The recent US Food and Drug Administration approval to WSI for its use in primary surgical pathology diagnosis has opened opportunities for wider application of this technology in routine practice. Main Text. The ongoing technological advances in digital scanners, image visualization methods, and the integration of artificial intelligence-derived algorithms with these systems provide avenues to exploit its applications. Its benefits are innumerable such as ease of access through the internet, avoidance of physical storage space, and no risk of deterioration of staining quality or breakage of slides to name a few. Although the benefits of WSI to pathology practices are many, the complexities of implementation remain an obstacle to widespread adoption. Some barriers including the high cost, technical glitches, and most importantly professional hesitation to adopt a new technology have hindered its use in routine pathology. Conclusions. In this review, we summarize the technical aspects of WSI, its applications in diagnostic pathology, training, and research along with future perspectives. It also highlights improved understanding of the current challenges to implementation, as well as the benefits and successes of the technology. WSI provides a golden opportunity for pathologists to guide its evolution, standardization, and implementation to better acquaint them with the key aspects of this technology and its judicial use. Also, implementation of routine digital pathology is an extra step requiring resources which (currently) does not usually result increased efficiency or payment.

Testing or Trusting? Urine Cotinine Levels in Plastic Surgery.

Preoperative laboratory examinations are a common practice throughout all surgical disciplines. Smoking prior to and shortly after elective aesthetic surgery is generally discouraged, but abstinence is rarely examined. Nicotine's major metabolite is cotinine, which is distributed in various body fluids, including blood, saliva, and urine. Urine cotinine levels are a useful short-term marker of nicotine exposure, whether active or passive, and correlate with daily tobacco use. Urinary levels are precise, rapid, easy to examine, and accessible. The aim of this literature review was to describe the current body of knowledge relevant to cotinine levels in the fields of general and plastic surgery. It was hypothesized that the current available data are enough to support the judicial use of such tests in high-risk surgical candidates, especially in aesthetic surgeries. A literature review via PubMed was conducted to identify publications that used the terms "cotinine" and "surgery," according to the PRISMA standard flowchart. After subtracting duplications, the search results yielded 312 papers. After a reduction process as per exclusion criteria, 61 articles were identified and fully reviewed by both authors. Fifteen full-text articles were eligible for qualitative synthesis. Enough data have accumulated to strongly support the judicial use of cotinine tests prior to elective surgery and specifically in aesthetic surgery.

Detection and mitigation of antibiotic residues in poultry products and byproducts

Majority of the people in Bangladesh are still not aware about the health hazards of antibiotic residues. In this research, farmer’s awareness has been investigated by a questionnaire in different poultry farms, retail sellers and poultry markets and spread out the knowledge of public health hazards of antibiotics residues. Poultry farmers were found well educated about health hazards of antibiotic residues and aware about the judicial use of antibiotics before selling the poultry for human consumptions. During this survey, sufficient samples (thigh muscle, breast muscle, liver etc., n=100) were collected from different poultry farms, retail sellers and poultry markets. Randomly 50 livers, 50 thigh muscle and 50 breast muscle samples respectively were evaluated by TLC analysis. Out of 50 samples for each 2 liver, 2 breast muscle and 2 thigh muscle samples were found positive for Amoxicillin antibiotic; 5 liver, 3 breast muscle and 3 thigh muscle samples were found positive for Ciprofloxacin; 3 liver, 3 breast muscle and 3 thigh muscle samples were found positive for Cefalexin; 2 liver, 2 breast muscle and 2 thigh muscle samples were found positive for Enrofloxacin; 4 liver, 2 breast muscle and 2 thigh muscle samples were found positive for Oxytetracycline. Gentamicin and Neomycin were found negative for any samples. Further investigation was done in indoor discriminate and indiscriminate use of antibiotics (Cefalexin) in broilers. Indoor experiment was investigated in poultry chicks. Day old chicks were collected and reared up to 30 days. On day 14th, the chicks were randomly divided into three groups namely control group (n=10), discriminate antibiotic group (n=10) and indiscriminate antibiotic group (n=10). Discriminate antibiotic group was treated with antibiotics (Cefalexin) for one week followed by withdrawal period for one week, whereas; indiscriminate antibiotic group was treated with antibiotic (Cefalexin) for two weeks until the day of sacrifice. Liver, thigh muscle and breast muscle samples were collected and evaluated by TLC method. Control and discriminate antibiotics birds were found negative for any antibiotics residues. On the other hand, ten liver samples, eight thigh muscles and eight breast muscles were found positive for Cefalexin in indiscriminate group. Indiscriminate uses of antibiotic indicated that antibiotic residue mitigation for human safe meat production depends on withdrawal period and farmers awareness. Therefore, poultry treated with antibiotics are required for specific withdrawal period until all residues are depleted to safe levels before human consumption. Asian Australas. J. Food Saf. Secur. 2023, 7 (1), 33-39

Knowledge, attitudes and behaviour of Egyptians towards antibiotic use in the community: can we do better?

BackgroundInfectious diseases are among the leading causes of death worldwide. This is concerning because of the increasing capacity of the pathogens to develop antibiotic resistance. Antibiotic overuse and misuse remain the main drivers of resistance development. In the USA and Europe, annual campaigns raise awareness of antibiotic misuse hazards and promote their judicial use. Similar efforts are lacking in Egypt. This study assessed the knowledge of the public in Alexandria, Egypt of antibiotic misuse risks and their habits towards antibiotic use, in addition to conducting a campaign to increase awareness of the safe use of antibiotics.MethodsA questionnaire assessing knowledge, attitudes and behaviour towards antibiotics was used to collect responses from study participants at various sports clubs in Alexandria in 2019. An awareness campaign to correct misconceptions and a post awareness survey followed.ResultsMost of the participants were well-educated (85%), in their middle age (51%) and took antibiotics last year (80%). 22% would take an antibiotic for common cold. This dropped to 7% following the awareness. There was a 1.6 time increase in participants who would start an antibiotic on a healthcare professional’s advice following the campaign. A 1.3 time increase in participants who would finish an antibiotic regimen was also observed. The campaign made all participants recognize that unwise antibiotic use is harmful to them or others; and 1.5 more participants would spread the word about antibiotic resistance. Despite learning of the risks of antibiotic use, there was no change in how often participants thought they should take antibiotics.ConclusionsAlthough awareness of antibiotic resistance is rising, some wrong perceptions hold fast. This highlights the need for patient and healthcare-tailored awareness sessions as part of a structured and national public health program directed to the Egyptian population.

Outbreak of scrub typhus in western part of India: containment and lessons learnt

Background: Scrub typhus is one of the most covert diseases of present era. Diagnosis is often missed, and tools for confirming diagnosis are often not available in resource-poor setups. The aim of the study was to investigate an outbreak investigation and suggests methods of containment. Methods: An epidemiological investigation of Scrub typhus outbreak though active and passive surveillance. Time, Place and person distribution, mean, median stand deviation were used during analysis. Results: Cases presented with high grade fever (100%), bodyache (91%) and headache (81%). Nearly, 22% cases presented with Eschar, 16% of blood samples were positive for OX-19 antigens, 9% blood samples were sent for enzyme linked immunosorbent assay (ELISA) and were positive for IgM antibodies. Conclusions: An outbreak of Scrub Typhus infection was successfully contained without any mortality by effectively using Chemoprophylaxis, judicial use of chemicals and personal protective measures.

Agricultural sustainability in Karnataka: Application of Sustainable Livelihood Security Index

The present study was carried out in Karnataka state to assess the relative agricultural sustainability status ofKarnataka during the year 2021–22 using Sustainable Livelihood Security Index (SLSI). Three indicators, viz.Ecological Security, Economic Efficiency and Social Equity Index were used. The results of the study show that inKarnataka better conditions for sustainable agriculture exist in majority of the Southern districts. However, few Northern districts, viz. Belagavi, Raichur, Bagalkote and Ballari have better level of ecological security and some Southern districts Bengaluru (U), Bengaluru (R), Chikkaballapur, Kolar and Ramanagara have low level of ecological security. In economic efficiency and social equity indicator also, majority of the Northern districts lagged behind compared to southern districts while Belagavi and Kalburgi districts have shown better performance compared to rest of the districts in the state. Adoption of sustainable agricultural practices such as judicial use of fertilizers and plant protection chemicals, efficient water use techniques (drip and sprinkler irrigation), use of organic manures and diversification of farm activities would help in sustainable agricultural development. To achieve ecological sustainability, steps need to be taken to enhance forest cover through afforestation especially in the districts which have poor ecological security. Further, there is a need to enhance the crop yield, encourage dairy farming and improve work force participation through training and skill development in the districts with poor economic efficiency.

Pattern of bacterial infections in cancer patients: Experience from a Tertiary Cancer Center

Introduction: Though with the invent of better diagnostic and therapeutic modalities the mortality rates due to cancer have fallen over the past years, but infection remains a primary or associated cause of death, with bacteria most commonly agent. Objectives: This study was undertaken to monitor the types of pathogens commonly found in cancer patients undergoing anticancer treatment and their antibiotic resistance patterns. Materials and methods: Total 100 patients, who were admitted for chemotherapy in department from 1 may 2021 to 31st July 2021 were enrolled and different samples were taken were sent to microbiology department for culture and sensitivity and then analysis was done. Results: Maximum number of samples were of pus (26%) and sputum (26%), followed by urine sample, while blood and vaginal swab samples were least. Overall, 91% organism were gram negative bacteria. In pus samples, maximum no.of microbes found were klebsiella pneumoniae (37.03%) followed by E.coli (33.33%). In stool sample, commonest organism was klebsiella pneumoniae (50%) and in sputum, klebsiella pneumoniae was the most common found organism (57.69%), In urine, commonest organism was E.coli (66.66%) ,followed by klebsiella pneumoniae (33.33%). ESBL producing microbes were 69.09%, while ESBL non-producing were 30.9%.Highest resistance was seen with flouroquinolones(55%) while least with carbopenum(4%). Conclusion: Judicial use of antibiotics, based on culture and sensitivity reports wherever possible, is of utmost importance so that further development of antibiotic resistance and infection related mortality can be reduced.

Point Prevalence Survey and Patterns of Antibiotic Use at Kirinyaga County Hospitals, Kenya

Background: Antibiotics are useful in treating and managing infections in outpatient and inpatient care settings. However, irrational antibiotic use can lead to improper patient care, antimicrobial resistance, wastage of resources and sometimes even death. The pattern of antibiotic use varies from one medical practitioner to another, infection, patient, wards, country and region. The study was a conducted as a baseline to describe the prevalence and patterns of antibiotic use in Kirinyaga County hospitals. Methodology: The study was a point prevalence survey of antibiotics use among patients admitted to four hospitals in Kirinyaga county and the study utilised the World Health Organization methodology for point prevalence survey of antibiotics in hospitals. Data were abstracted from patients’ files of patients who consented using a pretested tool. The data was exported to MS Excel for cleaning and analysed descriptively Results: The prevalence of antibiotic use in the four hospitals in Kirinyaga county was 44.0% (95%CI 38.6-49.5%). Penicillins were the most prescribed antibiotic class at 29.1%, followed by cephalosporins at 23.0%. Ceftriaxone and metronidazole were the highest prescribed at 22.0% and 19.8%, respectively. Antibiotics were mainly prescribed for community-acquired infections at 58.2%, followed by surgical prophylaxis at 26.0%. Most patients (52.5%) received two antibiotics, predominantly benzylpenicillin and gentamicin, at 40.3%. The majority, 63.0%, of all antibiotics were administered parenterally. There was poor documentation of the administration of medicines on the treatment sheet. Conclusion: There was a relatively high prevalence of antibiotic use, all prescribed empirically. Community acquired infections were the most common indication for antibiotics. There was extensive use World Health Organization “watch” category of antibiotics without microbiological tests. There is a need for antibiotic stewardship program to ensure judicial use of antibiotics.