We conducted a retrospective review of the clinical data on patients with polymicrobial candidemia during a nine-year period (1992-2000) at our tertiary care University Hospital. Also, the clinical features of patients with polymicrobial vs monomicrobial candidemia were compared. There were 16 (5.2%) patients with multiple candidal species in blood among 303 patients with candidemia. Patients' age varied from 21-85 years (median 52 years); they had serious underlying co-morbidities with prolonged hospitalization (median duration 13 days); all had intravenous vascular catheters, had been exposed to multiple antibiotics and were heavily colonized with Candida. Concomitant serious bacterial infections were common (56%). Candida albicans was isolated from blood in 11 of 16 patients; other species were C. glabrata (7 patients), C. tropicalis (6 patients) and C. parapsilosis (4 patients). Sixty seven percent (8 of 12) patients had causative Candida species isolated from vascular catheter tip culture. Polymicrobial candidemia occurred in sicker, non-oncologic patients with frequent concomitant bacterial infections, as compared to those with monomicrobial candidemia. Crude mortality was 43%, a rate similar to that seen with monomicrobial candidemia. Polymicrobial candidemia is uncommon, seen in hospitalized patients with multiple co-morbidities and heavy candidal colonization; removal of vascular catheter and institution of antifungal therapy are important therapeutic maneuvers.

A detailed energetic estimate of the barotropic and baroclinic semidiurnal internal tides over the Andaman Sea is performed by using the three-dimensional Massachusetts Institute of Technology general circulation model. Model-simulated currents and density fields are validated using in situ observations with high temporal resolution from a buoy located at 10.5°N, 94°E. The generation and dissipation regions of internal tides and their propagation in the domain are identified by quantifying the distribution of total tidal energy among generation, radiation, and dissipation. The model simulation suggests that the internal tides are mainly generated in the north of Sumatra coast, in the Sombrero channel, south of the Car Nicobar Island, and north of the Andaman Island. From these generation sites, a portion of the energy propagates into the Andaman Sea and the remainder propagates toward the southern Bay of Bengal. The depth-integrated baroclinic energy fluxes are found to be a maximum of~30 kW/m at the major generation sites in the domain. The model-estimated energy dissipation rates suggest that the maximum amount of energy dissipates near the generation sites themselves. In the region north of the Sumatra coast, almost 87% of the barotropic energy is converted into baroclinic energy and 23% (0.91 GW) of the converted baroclinic energy is ultimately radiated out from the generation sites. The barotropic-to-baroclinic conversion rate over the whole domain is estimated to be~23 GW, out of which, a major part~18 GW (80%) dissipates near the generation sites. This reveals that the local dissipation of baroclinic energy dominates in the Andaman Sea.Plain Language Summary Internal waves (IWs) in the oceans are ubiquitous phenomena, and they play an important role for a wide range of oceanic processes such as transfer of energy and momentum in the interior of global oceans, sound wave propagation, vertical transport of nutrients, and regional ecosystems. Andaman Sea is known to be an active region in the world's ocean where IWs of exceptionally high amplitudes are observed, but it still remains as one of the least explored regions. In this present study, spatial distribution of generation, propagation, and dissipation of IWs of tidal frequency, that is, internal tides are examined using a numerical model. The detailed energy budget analysis is carried out for this region. The simulated results show that, from the total barotropic-to-baroclinic conversion rate, 80% (~18 GW) of internal tide energy dissipates near the generation sites in the Andaman Sea.

The 26 December Indian Ocean tsunami was an extraordinary event in the history of natural hazards. It severely affected many countries surrounding the Indian Ocean: Indonesia, Thailand, Malaysia, Myanmar, Bangladesh, India, Sri Lanka, the Maldives, and African countries. Unlike the previous tsunami events in the last 40 years, the seriously affected areas are so vast that a traditional ground-level tsunami survey covering all the necessary areas by a single survey team was impractical. This destructive event will undoubtedly provide many opportunities to explore both basic and applied research in tsunami science and engineering fields and will lead to better preparedness for future disasters. A tsunami runup survey was conducted that spans Vedaranniyam (10° 23.5′ N) to Vodarevu (15° 47.6′ N)—more than 600 km of the southeast Indian coast—which suffered from the distant tsunami, whose source was more than 1,500 km away.

No abstract