Shambhavi Singh - Academia.edu (original) (raw)

Papers by Shambhavi Singh

Summary of differentially expressed genes based on a comparison of pool-and-split controls for ea... more Summary of differentially expressed genes based on a comparison of pool-and-split controls for each UVABC case compared to aggregated scRNA-seq data of breast epithelia from three reduction mammoplasties. Shared transcripts that were predicted to be differentially abundant in all five UVABC cases are assembled in the last worksheet. Each transcript reports the log2 fold change (log2FoldChange) and adjusted p value (padj).

2020 10th International Conference on Cloud Computing, Data Science & Engineering (Confluence)

With the on-going progress of global industrialization and the advancement of human society, the ... more With the on-going progress of global industrialization and the advancement of human society, the intake of fossil fuels is rising at an alarming rate, leading to extreme environmental issues, inclusive of the greenhouse effect. One of the major gases that produce the greenhouse effect is carbon dioxide (CO2). In the past 200 years the mean annual temperature of the Earth’s surface, averaged over the entire globe, has been increasing according to evidence. This paper analyzes and forecasts the emissions from carbon dioxide (CO2) using the dataset of the years 1995 to 2018 from India. The motivation behind this paper is also to educate people about how serious the current environmental issues are. The statistical technique of multiple linear regression is used for predicting and analysing the same. CO2 emission is considered to be the dependent variable while year, population and electricity consumption of India are considered to be the independent variables. The multiple linear regression model used generated a test score of 96.40%.

Exploring the Effect on 5 Senses in Children under Nitrous Oxide Sedation

Infectious Disorders - Drug Targets, 2022

Background: Superficial pyogenic infection (SPI) is the type of a pyogenic infection, which invol... more Background: Superficial pyogenic infection (SPI) is the type of a pyogenic infection, which involves the infections of the skin, subcutaneous tissue, and soft tissue. These infections can cause significant morbidity. Antimicrobial resistance (AMR) has emerged due to the rampant use of broadspectrum agents in superficial pyogenic infections. Objective: The aim of the study was to identify the microbial profile of superficial pyogenic infections and study their antimicrobial resistance. Methods: A cross-sectional observational study was carried out at the Department of Microbiology of a tertiary care hospital in the western region of Rajasthan. Samples included pus, aspirate from the abscess, necrotic tissue, and post-surgical drainage from infected skin at different sites of the patients attending OPD or admitted in IPD and ICU of the hospital. Identification of isolates was carried out by standard bacteriological techniques. The antibiotic susceptibility testing (AST) of bacterial i...

Indian Journal of Medical and Paediatric Oncology, 2021

Aim The predominant pattern of failure for oral carcinoma is locoregional failure. With improveme... more Aim The predominant pattern of failure for oral carcinoma is locoregional failure. With improvement in locoregional control, incidence of distant metastasis has increased. Reported incidence of distant metastasis is 8 to 10%. With an aim to define incidence and predictive factors for distant metastasis posttreatment of oral cavity cancer, the present analysis was done. Materials and Methods This is a retrospective chart review of 531 patients who underwent surgery for oral cavity carcinoma from August 2013 to December 2017. All patients had undergone surgery followed by adjuvant treatment as per histopathology report. Results The median age of the cohort was 49 years. The median follow-up of alive patients was 21 months (range: 1–56 months). Locoregional recurrence seen in 61, distant metastasis in 23, and 72 patients had locoregional recurrence with distant metastasis. Total incidence of distant metastasis was 18% (95 patients) with median detection 7 months’ posttreatment. The sit...

Sustainable Entrepreneurship, Renewable Energy-Based Projects, and Digitalization, 2020

SIAM Journal on Optimization, 2021

Fixed Point Theory and Algorithms for Sciences and Engineering, 2021

In 1990, Romero presented a beautiful formula for the projection onto the set of rectangular matr... more In 1990, Romero presented a beautiful formula for the projection onto the set of rectangular matrices with prescribed row and column sums. Variants of Romero’s formula were rediscovered by Khoury and by Glunt, Hayden, and Reams for bistochastic (square) matrices in 1998. These results have found various generalizations and applications.In this paper, we provide a formula for the more general problem of finding the projection onto the set of rectangular matrices with prescribed scaled row and column sums. Our approach is based on computing the Moore–Penrose inverse of a certain linear operator associated with the problem. In fact, our analysis holds even for Hilbert–Schmidt operators, and we do not have to assume consistency. We also perform numerical experiments featuring the new projection operator.

Indian economy is in transit of sectorial changes due to which the employment scenario has change... more Indian economy is in transit of sectorial changes due to which the employment scenario has changed from sector to sector and from region to region. The decline in the share of agriculture sector has given a rise in the unemployment problems in the rural areas of India, due to which a large chunk of people are migrating from rural areas to urban areas in search of livelihood.Nonetheless, the Uttar Pradesh one of the most populated state of India, which comprises a population of approximately 2 crore as per 2011 Census. The economy of Uttar Pradesh is primarily an agrarian economy, where a majority of people are largely dependent on agriculture and its allied activities. Therefore, with an increasing population the per-capita land size is continuously declining in Uttar Pradesh and a massive flow of labor are migrating from rural areas of Uttar Pradesh to its adjacent cities particularly to capital city Lucknow for employment andlivelihood.

BMJ Global Health, 2020

BackgroundEvidence-based practices that reduce childbirth-related morbidity and mortality are cor... more BackgroundEvidence-based practices that reduce childbirth-related morbidity and mortality are core processes to quality of care. In the BetterBirth trial, a matched-pair, cluster-randomised controlled trial of a coaching-based implementation of the WHO Safe Childbirth Checklist (SCC) in Uttar Pradesh, India, we observed a significant increase in adherence to practices, but no reduction in perinatal mortality.MethodsWithin the BetterBirth trial, we observed birth attendants in a subset of study sites providing care to labouring women to assess the adherence to individual and groups of practices. We observed care from admission to the facility until 1 hour post partum. We followed observed women/newborns for 7-day perinatal health outcomes. Using this observational data, we conducted a post-hoc, exploratory analysis to understand the relationship of birth attendants’ practice adherence to perinatal mortality.FindingsAcross 30 primary health facilities, we observed 3274 deliveries and ...

Computational Optimization and Applications, 2021

The problem of finding a best approximation pair of two sets, which in turn generalizes the well ... more The problem of finding a best approximation pair of two sets, which in turn generalizes the well known convex feasibility problem, has a long history that dates back to work by Cheney and Goldstein in 1959. In 2018, Aharoni, Censor, and Jiang revisited this problem and proposed an algorithm that can be used when the two sets are finite intersections of halfspaces. Motivated by their work, we present alternative algorithms that utilize projection and proximity operators. Our modeling framework is able to accommodate even convex sets. Numerical experiments indicate that these methods are competitive and sometimes superior to the one proposed by Aharoni et al.

New Business Models in the Course of Global Crises in South Asia, 2021

BJOG: An International Journal of Obstetrics & Gynaecology, 2021

ObjectiveTo understand the prevalence of intrapartum oxytocin use, assess associated perinatal an... more ObjectiveTo understand the prevalence of intrapartum oxytocin use, assess associated perinatal and maternal outcomes, and evaluate the impact of a WHO Safe Childbirth Checklist intervention on oxytocin use at primary‐level facilities in Uttar Pradesh, India.DesignSecondary analysis of a cluster‐randomised controlled trial.SettingThirty Primary and Community public health facilities in Uttar Pradesh, India from 2014 to 2017.PopulationWomen admitted to a study facility for childbirth at baseline, 2, 6 or 12 months after intervention initiation.MethodsThe BetterBirth intervention aimed to increase adherence to the WHO Safe Childbirth Checklist. We used Rao‐Scott Chi‐square tests to compare (1) timing of oxytocin use between study arms and (2) perinatal mortality and resuscitation of infants whose mothers received intrapartum oxytocin versus who did not.Main outcome measuresIntrapartum and postpartum oxytocin administration, perinatal mortality, use of neonatal bag and mask.ResultsWe ob...

Low birth weight Stunting Wasting Severe wasting Underweight Anemia Underweight Anemia (non-pregn... more Low birth weight Stunting Wasting Severe wasting Underweight Anemia Underweight Anemia (non-pregnant) Anemia (pregnant) % Undernutrition among children (<5y) Undernutrition among women (15-49y)

Indian Journal of Surgical Oncology, 2020

T4 b carcinoma of oral cavity has poor outcomes. The aim for analysis is to evaluate the clinical... more T4 b carcinoma of oral cavity has poor outcomes. The aim for analysis is to evaluate the clinical outcomes with infratemporal fossa clearance for stage T4b carcinoma of oral cavity. Fifty four patients out of maintained data of 528 patients of oral cavity carcinoma were evaluated for current retrospective analysis. All had T4b disease on imaging and underwent bite composite resection with ITF clearance. The median age of the cohort was 52 years. At last follow-up, 28 patients were alive. Twenty two patients had loco-regional recurrence (ITF recurrence 7), and 16 patients had distant metastasis. At median follow-up of 29 months, 2-year loco-regional control, DFS and OS were 52%, 54% and 54%, respectively. Perineural invasion, pathological tumour stage, node positive and ITF tissue involvement were associated with poor oncological outcomes. ITF clearance is feasible in clinical practice and provides curative option for this group.

Journal of Family Medicine and Primary Care, 2020

An iatrogenic injection abscess is usually easy to treat if caused by aerobic bacteria but some r... more An iatrogenic injection abscess is usually easy to treat if caused by aerobic bacteria but some rapidly growing mycobacteria (RGM), namely, Mycobacterium fortuitum, M. chelonae, and M. abscessus are associated with postinjection abscess and may cause delayed wound healing. RGM can cause mild localized cellulitis or abscess to osteomyelitis following penetration injuries or unsafe injection practices. A 7-year-old girl was presented to pediatric surgery OPD with abscess formation over the right buttock. Incision and drainage from abscess were performed in OPD and pus sample was sent for aerobic bacterial culture and sensitivity. On gram stain plenty of pus cells with no microorganism were seen and growth on blood agar after 48 h of aerobic incubation at 37°C showed small off-white pinpoint, smooth butyrous waxy colonies. Smear prepared from blood agar showed uniformly stained short, slender, faintly stained gram-positive bacilli, for which acid-fast staining (1% and 20% H2SO4) was performed that showed acid-fast bacilli. The isolate was further identified by the molecular method and was confirmed to be Mycobacterium fortuitum by genotype Mycobacterium CM VER 1.0 (HAIN LIFESCIENCE, BioMerieux India Pvt. Ltd.).

Journal of Family Medicine and Primary Care, 2020

Respiratory tract infections are the most common diseases that are associated with social burden ... more Respiratory tract infections are the most common diseases that are associated with social burden for the patient. Western Rajasthan has cases of Cystic fibrosis due to migrant population. The dry and dusty environment has led to prevalence of silicosis and COPD. As per IDSA (2018) guidelines, patients attending Out-Patient Department do not need microbiological investigations for lower respiratory tract infections (LRTI) except for influenza and tuberculosis. Aims: This study was conducted to identify the bacterial aetiology of LRTI among patients who attended AIIMS, Jodhpur, and to ascertain the current scenario of bacterial susceptibility in respiratory tract infections in order to optimize empiric therapy in Hospitals ad community. Methods and Material: In total, 1,775 lower respiratory tract samples were received in Bacteriology Section of Microbiology Department (January 2017 to December 2018). Bartlett's criteria were stringently used to assess quality of specimen. Semiquantitative cultures were done for tracheal aspirate and bronchoalveolar lavage samples. Following culture, the isolated organisms were identified and antimicrobial sensitivity was performed according to CLSI. Results: Total 769 bacterial pathogens were isolated from 1,775 samples collected from cases of VAP, HAP, CAP, COPD, and cystic fibrosis. Pseudomonas species was the commonest isolate (31%), followed by Klebsiella pneumonia (21.3%), Acinetobacter species (17.5%), Escherichia coli (15.4%), and Staphylococcus aureus (5%). Others include Group A β-hemolytic Streptococcus, Burkholderia cepacia complex, Stenotrophomonas maltophilia, and Nocardia. Gram-negative organisms showed increased resistance to routinely used antibiotics. Gram-positive organisms showed 100% susceptibility to vancomycin, linezolid, and clindamycin. Conclusions: Cotrimoxazole, βL-βLIs, aminoglycosides, and all second-line antibiotics tested were effective for treatment of RTIs.

Cancer evolves from premalignant clones that accumulate mutations and adopt unusual cell states t... more Cancer evolves from premalignant clones that accumulate mutations and adopt unusual cell states to achieve transformation. Previously, we pinpointed the oligodendrocyte precursor cell (OPC) as a cell-of-origin for glioma, but the early changes of mutant OPCs during premalignancy remained unknown. Using mice engineered for inducible Nf1–Trp53 loss in OPCs, we acutely isolated labeled mutant OPCs by laser-capture microdissection and determined gene-expression changes by bulk RNA sequencing and a fluctuation analysis, called stochastic profiling, which uses RNA-sequencing measurements from random pools of 10 mutant cells. At 12 days after Nf1–Trp53 deletion, while bulk differences were mostly limited to mitotic hallmarks and genes for ribosome biosynthesis, stochastic profiling revealed a spectrum of stem-progenitor (Axl, Aldh1a1), proneural, and mesenchymal states as potential starting points for gliomagenesis. At 90 days, bulk sequencing detected very few differentially expressed tra...

Small-cell lung cancers derive from pulmonary neuroendocrine cells, which have stemlike propertie... more Small-cell lung cancers derive from pulmonary neuroendocrine cells, which have stemlike properties to reprogram into other cell types upon lung injury. It is difficult to uncouple transcriptional plasticity of these transformed cells from genetic changes that evolve in primary tumors or secondary metastases. Profiling of single cells also problematic if the required sample dissociation activates injury-like signaling and reprogramming. Here, we defined cell-state heterogeneities in situ through laser capture microdissection-based 10-cell transcriptomics coupled with stochastic-profiling fluctuation analysis. Using labeled cells from a small-cell lung cancer mouse model initiated by neuroendocrine deletion of Rb1–Trp53, we profiled variations in transcript abundance to identify cell-to-cell differences in regulatory state in vitro and in vivo. Fluctuating transcripts in spheroid culture were partly shared among Rb1–Trp53-null models, and heterogeneities increased considerably when ce...

Health Policy and Planning, 2019

In India, most women now delivery in hospitals or other facilities, however, maternal and neonata... more In India, most women now delivery in hospitals or other facilities, however, maternal and neonatal mortality remains stubbornly high. Studies have shown that mistreatment causes delays in care-seeking, early discharge and poor adherence to post-delivery guidance. This study seeks to understand the variation of women’s experiences in different levels of government facilities. This information can help to guide improvement planning. We surveyed 2018 women who gave birth in a representative set of 40 government facilities from across Uttar Pradesh (UP) state in northern India. Women were asked about their experiences of care, using an established scale for person-centred care. We asked questions specific to treatment and clinical care, including whether tests such as blood pressure, contraction timing, newborn heartbeat or vaginal exams were conducted, and whether medical assessments for mothers or newborns were done prior to discharge. Women delivering in hospitals reported less atten...

Summary of differentially expressed genes based on a comparison of pool-and-split controls for ea... more Summary of differentially expressed genes based on a comparison of pool-and-split controls for each UVABC case compared to aggregated scRNA-seq data of breast epithelia from three reduction mammoplasties. Shared transcripts that were predicted to be differentially abundant in all five UVABC cases are assembled in the last worksheet. Each transcript reports the log2 fold change (log2FoldChange) and adjusted p value (padj).

2020 10th International Conference on Cloud Computing, Data Science & Engineering (Confluence)

With the on-going progress of global industrialization and the advancement of human society, the ... more With the on-going progress of global industrialization and the advancement of human society, the intake of fossil fuels is rising at an alarming rate, leading to extreme environmental issues, inclusive of the greenhouse effect. One of the major gases that produce the greenhouse effect is carbon dioxide (CO2). In the past 200 years the mean annual temperature of the Earth’s surface, averaged over the entire globe, has been increasing according to evidence. This paper analyzes and forecasts the emissions from carbon dioxide (CO2) using the dataset of the years 1995 to 2018 from India. The motivation behind this paper is also to educate people about how serious the current environmental issues are. The statistical technique of multiple linear regression is used for predicting and analysing the same. CO2 emission is considered to be the dependent variable while year, population and electricity consumption of India are considered to be the independent variables. The multiple linear regression model used generated a test score of 96.40%.

Exploring the Effect on 5 Senses in Children under Nitrous Oxide Sedation

Infectious Disorders - Drug Targets, 2022

Background: Superficial pyogenic infection (SPI) is the type of a pyogenic infection, which invol... more Background: Superficial pyogenic infection (SPI) is the type of a pyogenic infection, which involves the infections of the skin, subcutaneous tissue, and soft tissue. These infections can cause significant morbidity. Antimicrobial resistance (AMR) has emerged due to the rampant use of broadspectrum agents in superficial pyogenic infections. Objective: The aim of the study was to identify the microbial profile of superficial pyogenic infections and study their antimicrobial resistance. Methods: A cross-sectional observational study was carried out at the Department of Microbiology of a tertiary care hospital in the western region of Rajasthan. Samples included pus, aspirate from the abscess, necrotic tissue, and post-surgical drainage from infected skin at different sites of the patients attending OPD or admitted in IPD and ICU of the hospital. Identification of isolates was carried out by standard bacteriological techniques. The antibiotic susceptibility testing (AST) of bacterial i...

Indian Journal of Medical and Paediatric Oncology, 2021

Aim The predominant pattern of failure for oral carcinoma is locoregional failure. With improveme... more Aim The predominant pattern of failure for oral carcinoma is locoregional failure. With improvement in locoregional control, incidence of distant metastasis has increased. Reported incidence of distant metastasis is 8 to 10%. With an aim to define incidence and predictive factors for distant metastasis posttreatment of oral cavity cancer, the present analysis was done. Materials and Methods This is a retrospective chart review of 531 patients who underwent surgery for oral cavity carcinoma from August 2013 to December 2017. All patients had undergone surgery followed by adjuvant treatment as per histopathology report. Results The median age of the cohort was 49 years. The median follow-up of alive patients was 21 months (range: 1–56 months). Locoregional recurrence seen in 61, distant metastasis in 23, and 72 patients had locoregional recurrence with distant metastasis. Total incidence of distant metastasis was 18% (95 patients) with median detection 7 months’ posttreatment. The sit...

Sustainable Entrepreneurship, Renewable Energy-Based Projects, and Digitalization, 2020

SIAM Journal on Optimization, 2021

Fixed Point Theory and Algorithms for Sciences and Engineering, 2021

In 1990, Romero presented a beautiful formula for the projection onto the set of rectangular matr... more In 1990, Romero presented a beautiful formula for the projection onto the set of rectangular matrices with prescribed row and column sums. Variants of Romero’s formula were rediscovered by Khoury and by Glunt, Hayden, and Reams for bistochastic (square) matrices in 1998. These results have found various generalizations and applications.In this paper, we provide a formula for the more general problem of finding the projection onto the set of rectangular matrices with prescribed scaled row and column sums. Our approach is based on computing the Moore–Penrose inverse of a certain linear operator associated with the problem. In fact, our analysis holds even for Hilbert–Schmidt operators, and we do not have to assume consistency. We also perform numerical experiments featuring the new projection operator.

Indian economy is in transit of sectorial changes due to which the employment scenario has change... more Indian economy is in transit of sectorial changes due to which the employment scenario has changed from sector to sector and from region to region. The decline in the share of agriculture sector has given a rise in the unemployment problems in the rural areas of India, due to which a large chunk of people are migrating from rural areas to urban areas in search of livelihood.Nonetheless, the Uttar Pradesh one of the most populated state of India, which comprises a population of approximately 2 crore as per 2011 Census. The economy of Uttar Pradesh is primarily an agrarian economy, where a majority of people are largely dependent on agriculture and its allied activities. Therefore, with an increasing population the per-capita land size is continuously declining in Uttar Pradesh and a massive flow of labor are migrating from rural areas of Uttar Pradesh to its adjacent cities particularly to capital city Lucknow for employment andlivelihood.

BMJ Global Health, 2020

BackgroundEvidence-based practices that reduce childbirth-related morbidity and mortality are cor... more BackgroundEvidence-based practices that reduce childbirth-related morbidity and mortality are core processes to quality of care. In the BetterBirth trial, a matched-pair, cluster-randomised controlled trial of a coaching-based implementation of the WHO Safe Childbirth Checklist (SCC) in Uttar Pradesh, India, we observed a significant increase in adherence to practices, but no reduction in perinatal mortality.MethodsWithin the BetterBirth trial, we observed birth attendants in a subset of study sites providing care to labouring women to assess the adherence to individual and groups of practices. We observed care from admission to the facility until 1 hour post partum. We followed observed women/newborns for 7-day perinatal health outcomes. Using this observational data, we conducted a post-hoc, exploratory analysis to understand the relationship of birth attendants’ practice adherence to perinatal mortality.FindingsAcross 30 primary health facilities, we observed 3274 deliveries and ...

Computational Optimization and Applications, 2021

The problem of finding a best approximation pair of two sets, which in turn generalizes the well ... more The problem of finding a best approximation pair of two sets, which in turn generalizes the well known convex feasibility problem, has a long history that dates back to work by Cheney and Goldstein in 1959. In 2018, Aharoni, Censor, and Jiang revisited this problem and proposed an algorithm that can be used when the two sets are finite intersections of halfspaces. Motivated by their work, we present alternative algorithms that utilize projection and proximity operators. Our modeling framework is able to accommodate even convex sets. Numerical experiments indicate that these methods are competitive and sometimes superior to the one proposed by Aharoni et al.

New Business Models in the Course of Global Crises in South Asia, 2021

BJOG: An International Journal of Obstetrics & Gynaecology, 2021

ObjectiveTo understand the prevalence of intrapartum oxytocin use, assess associated perinatal an... more ObjectiveTo understand the prevalence of intrapartum oxytocin use, assess associated perinatal and maternal outcomes, and evaluate the impact of a WHO Safe Childbirth Checklist intervention on oxytocin use at primary‐level facilities in Uttar Pradesh, India.DesignSecondary analysis of a cluster‐randomised controlled trial.SettingThirty Primary and Community public health facilities in Uttar Pradesh, India from 2014 to 2017.PopulationWomen admitted to a study facility for childbirth at baseline, 2, 6 or 12 months after intervention initiation.MethodsThe BetterBirth intervention aimed to increase adherence to the WHO Safe Childbirth Checklist. We used Rao‐Scott Chi‐square tests to compare (1) timing of oxytocin use between study arms and (2) perinatal mortality and resuscitation of infants whose mothers received intrapartum oxytocin versus who did not.Main outcome measuresIntrapartum and postpartum oxytocin administration, perinatal mortality, use of neonatal bag and mask.ResultsWe ob...

Low birth weight Stunting Wasting Severe wasting Underweight Anemia Underweight Anemia (non-pregn... more Low birth weight Stunting Wasting Severe wasting Underweight Anemia Underweight Anemia (non-pregnant) Anemia (pregnant) % Undernutrition among children (<5y) Undernutrition among women (15-49y)

Indian Journal of Surgical Oncology, 2020

T4 b carcinoma of oral cavity has poor outcomes. The aim for analysis is to evaluate the clinical... more T4 b carcinoma of oral cavity has poor outcomes. The aim for analysis is to evaluate the clinical outcomes with infratemporal fossa clearance for stage T4b carcinoma of oral cavity. Fifty four patients out of maintained data of 528 patients of oral cavity carcinoma were evaluated for current retrospective analysis. All had T4b disease on imaging and underwent bite composite resection with ITF clearance. The median age of the cohort was 52 years. At last follow-up, 28 patients were alive. Twenty two patients had loco-regional recurrence (ITF recurrence 7), and 16 patients had distant metastasis. At median follow-up of 29 months, 2-year loco-regional control, DFS and OS were 52%, 54% and 54%, respectively. Perineural invasion, pathological tumour stage, node positive and ITF tissue involvement were associated with poor oncological outcomes. ITF clearance is feasible in clinical practice and provides curative option for this group.

Journal of Family Medicine and Primary Care, 2020

An iatrogenic injection abscess is usually easy to treat if caused by aerobic bacteria but some r... more An iatrogenic injection abscess is usually easy to treat if caused by aerobic bacteria but some rapidly growing mycobacteria (RGM), namely, Mycobacterium fortuitum, M. chelonae, and M. abscessus are associated with postinjection abscess and may cause delayed wound healing. RGM can cause mild localized cellulitis or abscess to osteomyelitis following penetration injuries or unsafe injection practices. A 7-year-old girl was presented to pediatric surgery OPD with abscess formation over the right buttock. Incision and drainage from abscess were performed in OPD and pus sample was sent for aerobic bacterial culture and sensitivity. On gram stain plenty of pus cells with no microorganism were seen and growth on blood agar after 48 h of aerobic incubation at 37°C showed small off-white pinpoint, smooth butyrous waxy colonies. Smear prepared from blood agar showed uniformly stained short, slender, faintly stained gram-positive bacilli, for which acid-fast staining (1% and 20% H2SO4) was performed that showed acid-fast bacilli. The isolate was further identified by the molecular method and was confirmed to be Mycobacterium fortuitum by genotype Mycobacterium CM VER 1.0 (HAIN LIFESCIENCE, BioMerieux India Pvt. Ltd.).

Journal of Family Medicine and Primary Care, 2020

Respiratory tract infections are the most common diseases that are associated with social burden ... more Respiratory tract infections are the most common diseases that are associated with social burden for the patient. Western Rajasthan has cases of Cystic fibrosis due to migrant population. The dry and dusty environment has led to prevalence of silicosis and COPD. As per IDSA (2018) guidelines, patients attending Out-Patient Department do not need microbiological investigations for lower respiratory tract infections (LRTI) except for influenza and tuberculosis. Aims: This study was conducted to identify the bacterial aetiology of LRTI among patients who attended AIIMS, Jodhpur, and to ascertain the current scenario of bacterial susceptibility in respiratory tract infections in order to optimize empiric therapy in Hospitals ad community. Methods and Material: In total, 1,775 lower respiratory tract samples were received in Bacteriology Section of Microbiology Department (January 2017 to December 2018). Bartlett's criteria were stringently used to assess quality of specimen. Semiquantitative cultures were done for tracheal aspirate and bronchoalveolar lavage samples. Following culture, the isolated organisms were identified and antimicrobial sensitivity was performed according to CLSI. Results: Total 769 bacterial pathogens were isolated from 1,775 samples collected from cases of VAP, HAP, CAP, COPD, and cystic fibrosis. Pseudomonas species was the commonest isolate (31%), followed by Klebsiella pneumonia (21.3%), Acinetobacter species (17.5%), Escherichia coli (15.4%), and Staphylococcus aureus (5%). Others include Group A β-hemolytic Streptococcus, Burkholderia cepacia complex, Stenotrophomonas maltophilia, and Nocardia. Gram-negative organisms showed increased resistance to routinely used antibiotics. Gram-positive organisms showed 100% susceptibility to vancomycin, linezolid, and clindamycin. Conclusions: Cotrimoxazole, βL-βLIs, aminoglycosides, and all second-line antibiotics tested were effective for treatment of RTIs.

Cancer evolves from premalignant clones that accumulate mutations and adopt unusual cell states t... more Cancer evolves from premalignant clones that accumulate mutations and adopt unusual cell states to achieve transformation. Previously, we pinpointed the oligodendrocyte precursor cell (OPC) as a cell-of-origin for glioma, but the early changes of mutant OPCs during premalignancy remained unknown. Using mice engineered for inducible Nf1–Trp53 loss in OPCs, we acutely isolated labeled mutant OPCs by laser-capture microdissection and determined gene-expression changes by bulk RNA sequencing and a fluctuation analysis, called stochastic profiling, which uses RNA-sequencing measurements from random pools of 10 mutant cells. At 12 days after Nf1–Trp53 deletion, while bulk differences were mostly limited to mitotic hallmarks and genes for ribosome biosynthesis, stochastic profiling revealed a spectrum of stem-progenitor (Axl, Aldh1a1), proneural, and mesenchymal states as potential starting points for gliomagenesis. At 90 days, bulk sequencing detected very few differentially expressed tra...

Small-cell lung cancers derive from pulmonary neuroendocrine cells, which have stemlike propertie... more Small-cell lung cancers derive from pulmonary neuroendocrine cells, which have stemlike properties to reprogram into other cell types upon lung injury. It is difficult to uncouple transcriptional plasticity of these transformed cells from genetic changes that evolve in primary tumors or secondary metastases. Profiling of single cells also problematic if the required sample dissociation activates injury-like signaling and reprogramming. Here, we defined cell-state heterogeneities in situ through laser capture microdissection-based 10-cell transcriptomics coupled with stochastic-profiling fluctuation analysis. Using labeled cells from a small-cell lung cancer mouse model initiated by neuroendocrine deletion of Rb1–Trp53, we profiled variations in transcript abundance to identify cell-to-cell differences in regulatory state in vitro and in vivo. Fluctuating transcripts in spheroid culture were partly shared among Rb1–Trp53-null models, and heterogeneities increased considerably when ce...

Health Policy and Planning, 2019

In India, most women now delivery in hospitals or other facilities, however, maternal and neonata... more In India, most women now delivery in hospitals or other facilities, however, maternal and neonatal mortality remains stubbornly high. Studies have shown that mistreatment causes delays in care-seeking, early discharge and poor adherence to post-delivery guidance. This study seeks to understand the variation of women’s experiences in different levels of government facilities. This information can help to guide improvement planning. We surveyed 2018 women who gave birth in a representative set of 40 government facilities from across Uttar Pradesh (UP) state in northern India. Women were asked about their experiences of care, using an established scale for person-centred care. We asked questions specific to treatment and clinical care, including whether tests such as blood pressure, contraction timing, newborn heartbeat or vaginal exams were conducted, and whether medical assessments for mothers or newborns were done prior to discharge. Women delivering in hospitals reported less atten...