[Purpose] The job of secondary school teachers involves a lot of head down posture as frequent reading, assignment correction, computer use and writing on a board put them at risk of developing occupational related neck pain. Available studies of neck pain experienced by teachers are limited. The purpose of this study was to determine whether training of deep cervical flexor muscles with pressure biofeedback has any significant advantage over conventional training for pain and disability experienced by school teachers with neck pain. [Subjects] Thirty teachers aged 25–45 years with neck pain and poor craniocervical flexion test participated in this study. [Methods] A pretest posttest experimental group design was used in which experimental group has received training with pressure biofeedback and conventional exercises while control group received conventional exercises only. Measurements of dependent variables were taken at baseline, and after 2 and 4 weeks of training. Pain intensity was assessed using a numeric pain rating scale and functional disability was assessed using the neck disability index. [Results] The data analysis revealed that there was significant improvement in pain and disability in both the groups and the results were better in the experimental group. [Conclusion] Addition of pressure biofeedback for deep cervical flexor muscles training gave a better result than conventional exercises alone. Feedback helps motor learning which is the set of processes associated with practice or experience leading to permanent changes in ability to respond.

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Context:Critical care units provide a favourable environment for the antimicrobial resistant organisms to disseminate. There is recent increase in number of extended spectrum beta lactamase (ESBL) producers because of the emergence of CTX M Beta lactamases produced by Enterobacteriaceae. They colonize the intestinal flora and spread with greater intensity in the community and hospital. Usage of Carbapenems becomes mandatory as the ESBL inhibitor combination antibiotics (Amoxicillin/Clavulanate) are not effective especially against CTX M ESBLs.Aim:The aim of this study is to detect ESBL producing bla CTX M gene in Enterobacteriaceae from infections in Critical care patients and to stress on the intensity of the problem and to make interventions to curb the emergence and dissemination of CTX M ESBLs.Materials and Methods:A total of 118 Enterobacteriaceae isolates from Critical care unit patients were recovered from a variety of clinical specimens. Antimicrobial susceptibility test was done and isolates with resistance or with reduced susceptibility to any of the third generation Cephalosporins were selected for the study. Phenotypic confirmation of ESBL production was done by Double Disc Synergy Test and confirmed by minimum inhibitory concentration. Multiplex polymerase chain reaction was performed to screen the four groups of CTX-M ESBLs.Results:Among the 118 isolates of Enterobacteriaceae 54 isolates were positive for CTX-M group I ESBL which constitutes 45.7 %.Conclusions:Early detection of CTX M producing Enterobacteriaceae by continuous surveillance and thereby reducing their spread and restricted use of third generation Cephalosporins (3GC) antibiotics could be the possible routes to prevent the emergence and spread of CTX M ESBL producing organisms.

Introduction: Ventilator Associated Pneumonia(VAP) remains a major cause of mortality and morbidity among critical ill patients. An imbalance between normal host defenses and the ability of microorganisms to colonize and invade the lower respiratory tract results in hospital acquired pneumonia. Aims and objectives were to isolate and identify bacterial pathogens from VAP and to determine their antibiogram. Material and Methods:A total of 66 Endotracheal aspirates were included in this study. 0.01 ml of sample was inoculated onto Blood agar,Chocolate agar and MacConkey agar and plates were incubated overnight at 37°C for 24 and 48 hours. Bacterial isolates were identified by standard biochemical tests. Antimicrobial sensitivity testing was performed on Muller Hinton Agar by Kirby Bauer disk diffusion and interpreted as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The occurrence of VAP was more common in the age group of 18-30 years (46.51%). Of the total cases 59.09% showed monomicrobial growth and 6.06% showed polymicrobial growth. The predominant gram negative isolate obtained was Klebsiella sp (68.89%) followed by Acinetobacter sp(15.56%) and Pseudomonas aeruginosa (13.33%). Among the Gram negative bacilli, 24.44% were resistant to Piperacillin Tazobactam and 35.56% to Cefoperazone sulbactam and 31.11% isolates were resistant to meropenem.All gram negative isolates were sensitive to Imipenem. Conclusion: Knowledge on incidence of VAP, its etiology and susceptibility patterns is essential to initiate the empirical antibacterial therapy for patients on mechanical ventilation