BACKGROUND: Rapid turnaround time of blood culture reports should be the main motive for a clinical microbiologist for optimal patient care. Categorical agreement (CA) between direct disk diffusion (dDD) and reference disk diffusion (rDD) may vary between laboratories. AIMS AND OBJECTIVES: This study was designed to determine the CA and understand various types of errors associated with antibiotic organism combination, so that caution can be derived while interpreting and reporting dDD results in the earliest meaningful time frame. MATERIALS AND METHODS: In the present study, dDD results were compared to the rDD results from the positive blood culture bottles. CA and various types of errors were evaluated. RESULTS: A total of 965 pathogens and 7106 organism antibiotic combinations were evaluated in this study. Overall, there was a CA of 96% which was extremely satisfactory. The categorical disagreement was found only in 4% of organism antibiotic combinations; majority of which were major error (ME, 2.1%) followed by very ME (1%) and minor error (0.9%). The errors were marginally high for Enterobacteriaceae testing against β lactam- β lactamase inhibitor combinations, for Pseudomonas species; against aminoglycosides and ciprofloxacin and Staphylococcus species against cefoxitin, one should be vigilant while reporting dDD result of these antibiotic organism combinations. CONCLUSION: dDD is of paramount importance for early institution of targeted therapy and is considered as one of the key stewardship intervention. Our study gives an insight that every laboratory must perform dDD for positively flagged blood culture specimens; the result of which should be confirmed later by performing rDD. One should be vigilant while reporting dDD result of BL BLI for Enterobacteriaceae; aminoglycosides and CF for Pseudomonas species; cefoxitin for Staphylococcus species and HLG for Enterococcus species. Supplementary tests such as MRSA latex should be included when necessary.

Bedsides TCBV with cTEE guidance is effective palliation for neonates and small infants with critical AS and allows for continuous hemodynamic assessment without the use of ionizing radiation. Our early and late results appear comparable to surgical valvotomy.

Introduction: Duchenne muscular dystrophy (DMD) is characterized by absence of the subsarcolemmal protein dystrophin, present in skeletal muscles and cardiomyocytes. We hypothesized that progressive respiratory and left ventricular (LV) insufficiencies in DMD could be parallel and interrelated phenomena. Methods: We conducted a retrospective chart review of 27 patients with DMD. Our primary objective was to compare the rates of decline between pulmonary function test (PFT) measures (forced expiratory volume in the first second, forced vital capacity, peak expiratory flow rate, maximal inspiratory/expiratory pressure) and echocardiographic estimates of LV end‐diastolic volume and LV ejection fraction. Results: The rates of decline/year of PFTs and LV estimates were not significantly different. Pulmonary function test measures of ventilatory efficiency and strength had strong intercorrelations. Pulmonary function tests and LV estimates had weak but statistically significant correlations. Discussion: A comparable rate of decline in PFTs and LV indices in DMD provides evidence for concurrently progressive deterioration in respiratory and LV functions. Muscle Nerve, 2019

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Objective Metabolite changes in biofluids, tissues and tumours can be studied to identify metabolomic changes to correlate them to a disease (PD produces disturbances in the metabolome). The biomarkers for the same are recognized by monitoring these changes. Complicated biological samples such as cerebrospinal fluid (CSF), blood and urine can be analysed using NMR spectroscopy that aids in increasing the translation of information. The different types of NMR include proton NMR (H-NMR), Carbon NMR (C-NMR), Heteronuclear Single Quantum Coherence (HSQC), Heteronuclear Multiple Bond Correlation (HMBC) and so on. Background NMR is based on the measurement of proton wide-line spectra in its early stages. Later on, the deuteron NMR (2H NMR) technique gained popularity since it offered information about polymer molecular processes. The solid-state NMR (SSNMR) approach, as well as the 13C cross-polarization magic angle spinning NMR (13C CP/MAS NMR), gained popularity after that. The proton high-resolution magic angle spinning NMR (HR-MAS NMR) was created after that for use in biomedical applications. Additional information, such as molecular reorientations of some nuclei, such as 13C, 15N, or 31P, has been obtained using two-dimensional (2D) NMR. Methods The application of NMR consists of a typical one-dimensional (1D) 1H NMR spectrum that can be acquired in a few minutes using an automated high throughput protocol. An important potential of metabolomics is the identification of biomarkers to diagnose PD, to monitor disease progression, and to evaluate a patient’s response to treatment. Thus, one of the primary goals of metabolomics is to identify the specific metabolites significantly perturbed in response to a disease state. Critical information on cellular processes, molecular interactions and metabolic pathways associated with PD is thus obtained. Results/Advantages NMR based techniques eliminate the need of ionizing radiation, helping in avoiding exposure to harmful X-Rays. A wide range of biological processes can be studied. Combination of NMR spectroscopy and imaging helps obtain a large amount of anatomical, physiological, and metabolic data with just a single experiment. NMR techniques have a non-destructive nature, minimal sample handling, high throughput and high reproductivity. Conclusion This poster illuminates a brief analysis/detection of NMR metabolomics of Parkinson's disease. Metabolomics plays a huge role in the identification of possible biomarkers, metabolic mechanisms and inception of the disease progression. NMR metabolomics has a great potential in assisting the analysis/detection of the PD biomarkers, identifying novel biomarkers to diagnose PD, aid in drug discovery and the development of personalized medicine.