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This article discusses the quasi-optimality of adaptive nonconforming finite element methods for distributed optimal control problems governed by 푚-harmonic operators for m = 1 , 2 . A variational discretization approach is employed and the state and adjoint variables are discretized using nonconforming finite elements. Error equivalence results at the continuous and discrete levels lead to a priori and a posteriori error estimates for the optimal control problem. The general axiomatic framework that includes stability, reduction, discrete reliability, and quasi-orthogonality establishes the quasi-optimality. Numerical results demonstrate the theoretically predicted orders of convergence and the efficiency of the adaptive estimator. [ABSTRACT FROM AUTHOR]

In recent years, a wide range of clinical infections are being caused by carbapenem-resistant Enterobacterales, Acinetobacter baumannii and Pseudomonas aeruginosa. This is a matter of great concern, as carbapenem-resistant infections have fewer treatment options. The Enterobacterales comprises a large group of bacterial species commonly causing infections in healthcare settings. The most common bacteria are Escherichia coli and Klebsiella pneumoniae, which can cause both nosocomial and community-acquired infections. This study aimed to determine the prevalence of carbapenem- resistant Enterobacterales, P. aeruginosa, and A. baumannii, in a tertiary care center in India. The study was conducted over a period of seven months, from May 2022 to November 2022. The specimens were processed at the Microbiology Laboratory of Kalinga Institute of Medical Sciences- Pradyumna Bal Memorial Hospital, Bhubaneswar. Standard procedures were used to process the clinical specimens brought to the laboratory. Carbapenem-resistant isolates were screened according to the CLSI 2022 guidelines. This study included 3,006 isolates of Enterobacterales, A. baumannii, and P. aeruginosa. Of these, 29.40% (n = 844) were found to be carbapenem resistant. The breakup is as follows: 689 (77.94%) were Enterobacterales, 108 (12.21%) were A. baumannii, and 87 (9.84%) were P. aeruginosa. Thus, our investigation revealed an overall prevalence of carbapenem-resistant Enterobacterales, A. baumannii, and P. aeruginosa of 29.40%, which corresponds to previous studies in India. Early patient screening, isolation, and contact prevention measures will help reduce infection transmission. Further, larger multi-centric studies are required to obtain a wider perspective regarding this issue. [ABSTRACT FROM AUTHOR]

Background: Needle stick injury (NSI) is one of the significant and serious health hazards encountered by healthcare workers (HCWs), as it is a risk factor for transmission of blood-borne infections like HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). This study aims to describe the frequency and distribution of the NSIs reported in the institution over a period of four years, the factors associated with it and the immediate post-exposure prophylaxis administered., Methods: A record-based retrospective analysis of the NSIs suffered by HCWs working in the Pradyumna Bal Memorial Hospital (PBMH), Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar over a period of four years (2019 - 2022) was conducted. Data was extracted from the Exposure Prevention Information Network (EPINet) using a researcher-made proforma and analysed using Epi Info software 7.3.2., Results: There were a total of 115 reported cases of NSIs, the incidence being 2.52%, 1.55%, 0.85% and 1.64% in the years 2019,2020,2021 and 2022 respectively. The most commonly affected age group was 18-30 years with females constituting the majority. Nurses were more commonly affected in the first two years of the study (2019 and 2020) whereas in 2021 and 2022 housekeeping staff suffered more injuries. The highest incidence of NSIs (40%-59%) was noted to have occurred in the morning shift. Inpatient department (IPD) contributed the maximum number of cases of NSIs. Out of the 93 cases with known source patient, HIV serological status was negative for all, while HBV and HCV status was positive in nine and two cases respectively. The serology status for the three viral markers (HIV, HBV and HCV) was unknown in 22 cases. After evaluation for the necessity of post-exposure prophylaxis (PEP), initial PEP was given to 14 persons for prevention of HBV and to 20 persons for HIV prevention., Conclusion: Of the total NSIs reported over the four years, the incidence of NSIs per thousand HCWs showed a declining trend; with the younger age group and female gender reporting a higher incidence. Job category wise, housekeeping staff and nursing staff suffered more NSIs. Highest number of NSIs were reported from IPD. A greater proportion of NSIs were due to hollow bore needles. Most of the injuries occurred during daytime. Source patient could be identified in majority of the cases. HCWs who were identified to be at risk received immediate PEP as per the institutional policy. Stringent documentation of NSIs can assist in root cause analysis and to implement measures to prevent their occurrence., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, Kalinga Institute of Medical Sciences issued approval KIIT/KIMS/IEC/1054/2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singh et al.)

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major causes of hospital and community-acquired infections. Fewer drugs, such as vancomycin, teicoplanin, and daptomycin, are effective against it, but they come with high toxicity. Fifth-generation cephalosporins like ceftaroline and second-generation cefuroxime are effective against MRSA. Limited studies are available on ceftaroline resistance in the literature. This study was undertaken to determine ceftaroline resistance in MRSA in a tertiary care hospital in Eastern India. A cross-sectional, hospital-based study was carried out with MRSA isolates obtained from various clinical samples of patients. Identification of the isolates to the species level was performed by an automated Vitek system, and selected samples were genotypically confirmed by detecting the mecA gene via real-time PCR. Out of a total of 334 Staphylococcus aureus isolates examined in this study, the prevalence of MRSA was seen in 59.3% (198/334), and methicillin-sensitive Staphylococcus aureus was in 40.7% (136/334). Of the total 198 MRSA isolates, ceftaroline intermediate MRSA was seen in 8.6% (17/198), and ceftaroline sensitive MRSA was in 91.4% (181/198), respectively. Among the 17 ceftaroline intermediate MRSA isolates, 88.2% (15/17) showed a minimum inhibitory concentration (MIC) of 2 µg/ml, and 11.8% (2/17) showed an MIC of 3 µg/ml. All the remaining 91.4% (181/198) isolates were sensitive to ceftaroline and showed an MIC ≤1 µg/ml. Real-time PCR confirmed the presence of the mecA gene in MRSA isolates. In this present study, not a single isolate was resistant to ceftaroline, suggesting that it, being a safer drug, can be used in place of glycopeptides such as vancomycin or teicoplanin and linezolid, where resistance has already been detected. The rational use of ceftaroline could be useful in clinical settings, and further studies will confirm the findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Roy et al.)

Background The novel coronavirus disease (COVID-19) has become pandemic. For effective disease control, quarantine of the infected and exposed cases for an optimal period is critical. Currently, infected individuals are quarantined for 14 days. We tried to check if the quarantine period practiced is optimal in the Indian context. Methods This cross-sectional study was conducted in Odisha, India. We compiled and analyzed the information of 152 laboratory-confirmed SARS-CoV-2 positive cases. Descriptive analysis was conducted. Results Out of the 152 cases, 80% were males, 9.8% were symptomatic, 66.4% had travel history, and 53.9% had contact with COVID-19 cases. The incubation period ranged from 1-50 days with a median of 19.5 days (IQR: 17-27 days). The median periods were similar according to gender, history of contact, and presence of symptoms. Interestingly, 84.7% of the cases had an incubation period of more than 14 days. To cover 95% and 90% of the individuals, the quarantine period may have to be extended to 38 days and 35 days, respectively. Conclusion A longer observed incubation period (minimum 28 days) suggests the extension of the quarantine period for adults beyond the presently practiced 14 days. Considering the fast-spreading outbreak, an extended quarantine period for 28 days or active periodic follow-up could be more effective., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Das et al.)