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Objective: To evaluate the applicability of modified early warning (MEWS) Score for prediction of hospital outcomes of medical emergency patients. Design: Prospective hospital based observational study. Setting: A tertiary care level medicine emergency unit in a medical college of North India. Study Population: 300 Patients admitted in medicine emergency. Method: Patients of both sexes of age more than 18 years who were admitted in medical emergency unit at MMIMSR, Ambala were evaluated. Patients who were in cardiac arrest at arrival and those who died within the first 24 hours were excluded and 300 patients were included. Modified Early Warning Score based on physiological parameters was recorded at admission for each patient and monitored over the next 24 hours in the emergency unit. Hospital outcome of the patient in terms of mortality, need for critical care, prolonged stay and uneventful discharge were recorded and correlated with MEWS scores over the first 24 hours in the emergency unit. Receiver Operating Characteristic (ROC) curves was generated to evaluate the utility of MEWS as a tool to predict patient outcome in medical emergency setting. Result: Of the 300 patients studied, the mean age of patients was 49 years, and the majority of the patients were male (61%). A MEWS Score of >5 at 24 hours of admission was associated significantly with in-hospital mortality of patients ( p < 0.0001). The ROC (Receiver Operator Characteristic) curve revealed that in those patients who had a 24 hours MEWS >/= 5, the area under curve was (AUC) = 0.9. (95% CI: 0.95-0.98). Thus, MEWS was an effective predictor of in hospital mortality with sensitivity (78%) and specificity (94%). Conclusion: MEWS, a scoring system based on easily recordable physiological parameters can be used as an effective tool to triage and monitor patients in medical emergency units, to identify patients who are at greater risk of clinical deterioration and need close monitoring or early transfer for critical care or other timely interventions. Thus, application of MEWS in medical emergency units can be a useful tool to improve patient care, ensure optimal utilization of resources and prevent inappropriate discharge or neglect of sick patients.

Here the review converses the `molecular cross-talk` of biofuel production mechanisms for Staphylococcus aureus. Staphylococcus aureus is a leading cause of bacterial infections globally in both healthcare and community settings. The succes of this bacterium is the of an expansive repertoire of virulence factors in combination with acquired antibiotic resistance and propensity for biofilm formation. S. aureus leverages these factors to adapt to and subvert the host immune response. With the burgeoning fiels of immunometabolism, is has become clear that the metabolic program of leukocytes dictates their inflammatory status and overall effectiveness is clearing an infection. The treatment of S. aureus infections become complicated due to the capacity of S. aureus �multidrug-resistant� occurs because of biofilm formationon the surfaces depending on biotic and abiotic factors, genetic factors, and numerous environmental, which vary from species to species. A broad range of molecular phenomenon contributes a high range of recalcitrance that is insisting on the biofilm formation. The previous published literature illustrated that all strains of Staphylococcal sp. contain the �ica locus� and several can form biofilms in vitro condition. Absences of �ica locus� results diminish of capability to produce biofuels, along with `PIA gene`, or mediate `N-acetyl glucosaminyl transferase activity� in vitro condition.

प्राचीन काल से ही वर्ण व्यवस्था ने सामाजिक ताने बाने पर कुत्सित प्रहार किया है। आज के आधुनिक युग में जाति गत भेद भाव युवा मन में विद्रोह की भावना उत्पन्न की है। जिसका सजीव चित्रण हिन्दी दलित कहानीकार, डॉ. सुशीला टाकभौर, ओमप्रकाश वाल्मीकि जी की कहानियों में परिलक्षित होता है। प्रस्तुत शोध-पत्र में दशवें दशक की कहानियों में जातिगत भेद-भाव का तुलनात्मक अध्ययन प्रस्तुत करने का प्रयास किया गया है, तथा दलित युवा शिक्षित सवर्ण युवाओं सम्मिलित आक्रोश की विवेचना कर इस निष्कर्ष को प्राप्त किया है कि जातिगत समरसता के लिये सामाजिक परिवर्तन हो रहा है परन्तु इसकी गति अभी सुस्त है, इसकी गति को तेज करने के लिये हिन्दी साहित्य के कलमकारो को और अधिक प्रयास करने की आवश्यकता है संकेतः विद्रोह, जातिप्रथा, दलित, सवर्ण,

The presented research paper presents a comparative study of Dalit discourse in the stories of Sushila Takbhaure. From the analysis of Sushila Takbhaure ji's stories, it is known that Sushila Takbhaure ji's story is influenced by Ambedkarite ideology and presents a lively and poignant example of Dalit struggle. In this research paper, a review of Dalit movement, Dalit anger, and status of women has been presented.

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