MetS is a condition characterized by chronic low-grade inflammation, which arises because of increased abdominal adiposity and IR. Large multicenter studies are needed to gain insight into its pathogenesis and derive treatment strategies.

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Background and Objectives: This study was designed to determine the in vitro efficacy of mecillinam against extended spectrum beta lactamse producing Enterobacterales. Materials and Methods: After proper permission from Ethical Review Committee of the Institute, all samples yielding growth of ESBL producingEnterobacterales were part of the study and were processed according to routine microbiological procedures. Routine antibiotic sensitivity testing was done onMuller Hinton Agar by Modified Kirby Bauer Method. All Gram negative isolates were subjected to concomitant detection of ESBL production by doubledisc synergy method. All ESBL producers were then subjected to the mecillinam Minimum Inhibitory Concentration (MIC) determination by E test. The results were interpreted as per CLSI Guidelines. Results: A total of 120 ESBL producing Enterobacterales isolates were included in the study. The mean age of patients with ESBL infection was 45 ± 18.7years. There were 44% male and 55% female patients. Majority of the ESBL producing Enterobacterales were isolated from urine samples (56%), followed bypus. Among the isolated organisms, Escherichia coli (45%) was the most frequently isolated organism followed by Klebsiella spp. (22%). Overall 83% of theisolates turned out to be sensitive to mecillinam. MIC50 of mecillinam against ESBL producing Gram negative rods (GNR) turned out to be 1 ug/ml and MIC90 turned out to be 2 ug/ml. Conclusion: Mecillinam shows good in vitro efficacy against ESBL producing Enterobacterales in our study. Further studies with more sample size and from diverse areas across the country should be done to evaluate its efficacy.

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Conflicts at work are usually seen as obstacles to organizational performance. thus, in their seminal work on the theory of organizations. March define conflict as a blockage of the normal mechanisms of decision making. at the same time, according to a study of the cabinet opp, carried out in 2008 with 5000 European and American employees, 85% of French employees say they are regularly confronted with a conflict at work. the scale and consequences of conflicts should therefore lead organizations to be equipped to process them. however, according to this same study, 73% of employees have never received training and 45% expect their manager to intervention. conflict management is therefore a real challenge.