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Modern advancement in science and technology has altered the way we detect, treat and prevent different diseases in all aspects of human life. Rheumatoid Arthritis (RA) is chronic progressive autoimmune disease in which body’s immune system has role to protect the health by attacking foreign bacteria but the virus mistakenly attacking the joints as a result thickened synovium, pannus formation, & destruction of bone, cartilage occurs. Researchers are still researching but are unable to know the exact reason for the disease. Although, it is believed that genes and environmental factors play an important role in the development of RA. In this review the pathophysiology, predictors and factors involved in pathogenesis of RA have been investigated. The conventional drug therapeutic agents and emerging novel drug delivery system (NDDS) like nanoparticles, dendrimers, micelles, microspheres, liposomes and so on are discussed, as these are the tools which show promising effect in overcoming the limitations associated with conventional drug delivery systems. Although several NDDS have been used for various purposes, liposomes have been focused and found to have its potential applications in RA diagnosis and therapy. In addition, the therapeutic effectiveness, and challenges for RA by using these novel drug delivery systems have been reviewed along with its future perspectives.

Plants have filled in as a significant wellspring of elements for conventional drugs for centuries. Verifiable records and present day ethno botanical field examines feature their significance in the conventional treatment of irresistible malady. Be that as it may, plants form just a minor level of present collection of FDA-endorsed antimicrobial medications. The present article gives an outline of active components of plants as hint for other wellspring of antimicrobial agents to be used in the battle against microscopic organisms. It additionally surveys the ethno botanical way to deal with sedate disclosure and talks about various inventive focuses for future medication revelation endeavours in this field. Without an uncertainty, antimicrobials are miracle tranquilizers. They have represented a very long time against different irresistible infections and spared a huge number of lives. The ongoing disappointment of antimicrobials because of the sensational rise of multidrug-safe microbes and fast spread of new diseases, be that as it may, prompts wellbeing associations and the pharmaceutical business worldwide to change their methodology and to expand improvement of antimicrobials against quickly rising anti-infection safe microorganisms. In spite of the fact that there is thinking about elective wellsprings of characteristic antimicrobial molecules from plants having different methods of activity, some of which have been utilized in regular medication for a considerable length of time and have appeared to have serious impacts contrasted with other antimicrobials. This examination portrays plant intensity as an elective hotspot for antimicrobial agents.

Pyoderma gangrenosum (PG) is a rare neutrophilic disorder with an incidence rate of 3–10 cases per million per year, characterized by classically painful and aseptic ulcers, which may be associated with underlying systemic diseases. The pathergy reaction is seen in one-fourth of patients with PG. Accurate and timely diagnosis is crucial, as PG is known for its rapid progression. The management of PG is challenging and depends on its severity and rate of progression. An underlying systemic involvement should be sought even in spite of no symptoms. Herein, we report a case of giant pyoderma gangrenosum involving almost the entire left buttock with exceptionally raised c-ANCA levels, but no underlying systemic abnormality. The patient reported intense pain, rapid progression of the ulcers, an inability to perform daily activities, was significantly morbid and pathergy-positive. Aggressive and early management is required in cases such as this. A dramatic response was achieved with a combination of cyclosporine, dapsone, and methylprednisolone pulses.

The present investigation emphasizes on the evaluation of heavy metal pollution indices to assess the suitability of groundwater for human consumption. For this, thirty groundwater samples were collected from the villages near Ellenabad city of Sirsa during pre monsoon of 2018 from the tube-wells. The samples were collected from approximately 100 m of depth. The samples were analyzed using Inductively Coupled Plasma – Mass Spectrometry (ICP - MS) for heavy metals like As, Hg, Pb, Zn, Cu and Mn. The heavy metals As, Hg and Pb were not found in our samples. The indices like heavy metal pollution index (HPI), heavy metal evolution index (HEI) and Hazard index (HI) were calculated to assess the suitability for drinking. These indices numerically give the suitability of groundwater for human consumption. On the basis of HEI and HPI, all the samples were found to be suitable for human consumption. The value of HI > 1 shows the unsuitability of groundwater for consumption. On the basis of the analysis, it can be said that children are at more risk followed by adults and then infants. The value of HI > 1 has been found for only two samples and which was also for children in sample number 20 and 24. So, majority of the samples have been found to be suitable for human consumption. Principal component analysis was performed for factor analysis which shows the initial Eigen value of more than two and total variance of more than 41.

Background: Dermatology is primarily considered to be an outpatient-centered specialty. However, several inpatient admissions to other specialties require dermatologic consultation for optimum management. Aims: The aim of this study was to evaluate the pattern of referrals sent to the dermatology department by other Departments and impact of dermatology consultation on patient management. Materials and Methods: The study included all inpatients referred to dermatology department of a tertiary care centre of North India during a two year period. The demographic details, specialties requesting consultation, cause of referral, and dermatological advice have been recorded and analyzed. Results: Dermatology consultation changed the dermatologic diagnosis and treatment. General medicine requested the maximum number of referrals, skin rash being the most common cause for referral. Accurate diagnosis on referrals was provided by only 25.23 % of non dermatologists. Common dermatological disorders were often misdiagnosed by these physicians, and dermatology referrals had significant impact on the diagnosis and subsequent management of these patients. Conclusion: While dermatologic referral leads to improved patient care, there is a need for better training of non dermatologists enabling them to recognize and treat common dermatoses.

Rammed earth construction provides an efficient alternative construction material to limit energy consumption and CO2 emission. It possesses various characteristics of a sustainable material, but its mechanical capacity is sensitive to humidity variations. It is, therefore, important to better understand water transport within rammed earth when subjected to varying ambient conditions. In this context, the present work aims to analyze the hydraulic behavior of a reduced piece of rammed earth wall consisting of a column of size 14cm x 14cm x 30cm subjected to drying from the initial compaction water content in an indoor environment. The columns had transient non-uniform relative humidity, which was measured in-situ. Thermo-hydraulic coupled numerical modeling was developed using realistic atmospheric boundary conditions. The material and hydric parameters were chosen from an experimental study previously performed at the material scale. A parametric study was performed in order to evaluate the sensitivity of the modeling to both material parameters and boundary conditions. The results of the numerical simulations were highly sensitive to parameter values used for the water retention curve and the surface mass transfer coefficient, with a satisfactory matching of experimental results only achieved after adjusting initial estimates of relevant parameter values.

In the last one decade, the concept of SSCM, green and circular economy has been developed we have seen the synchronization of green and sustainable supply chain management practices by the firms to reduce the impact over the environment in developed countries as well as in developing countries. The intent of the author is to identify benefits of the new practices. The methodology used for the study is to analyze the available literature and identify the main attributes and prioritize using relative importance index. The study shall perceive direct and indirect benefits from the community and the surroundings. The study provides insight to the topic and to validate the results of the research same type of study to complete in the other regions of the country to have a clear and better understanding of the topic is suggested.

Résumé Deux enquêtes ménages, complétées par des entretiens qualitatifs, ont été menées en 2013 et 2014 au Maroc et en Tunisie, deux pays ayant ratifiés la convention des Nations-Unies relative aux droits des personnes handicapées et résolument engagés dans des politiques innovantes destinées à promouvoir les droits de ces dernières. Ces enquêtes portent sur les inégalités dont font l’objet les personnes en situation de handicap en matière de capabilités, c’est-à-dire les opportunités réelles que possède une personne de vivre la vie qu’elle choisit de vivre. S’appuyant sur le cadre conceptuel des capabilités d’Amartya Sen, les analyses présentées dans cette étude démontrent un important déficit en matière d’éducation, d’emploi et de qualité de la vie liée à la santé – une vision plus restrictive du bien-être que celle proposée par Sen, mais néanmoins intéressante pour comparer deux populations – pour les personnes en situation de handicap par rapport au reste de la population dans ces deux pays. Si la situation s’est améliorée pour la jeune génération comparée à celle de leurs parents, l’accès à l’éducation – qui est un droit pour les enfants en situation de handicap au Maroc comme en Tunisie – reste loin d’être acquis dans les deux pays. De même, l’accès a l’emploi des personnes en situation de handicap reste incertain, dans des emplois plus précaires et a des salaires inférieurs que le reste de la population en âge de travailler. L’exclusion sociale dont sont largement victimes les personnes en situation de handicap – comme le montrent les exemples de l’éducation et de l’emploi – ont un coût considérable en termes de qualité de vie liée à la santé évalué comme étant l’équivalent d’une réduction de 20 et 18 ans, respectivement au Maroc et en Tunisie, de l’espérance de vie moyenne des personnes en bonne santé et sans handicap. Les politiques récentes de lutte contre les discriminations et la promotion des droits des personnes en situation de handicap vont dans la bonne direction mais une volonté politique forte est nécessaire pour qu’elles s’inscrivent dans la durée. La société civile a un important rôle à jouer pour maintenir la dynamique actuelle. Two household surveys completed with qualitative interviews were carried out in 2013 and 2014 in Morocco and Tunisia, two countries which ratified the United Nations convention of the rights of persons with disabilities and actively engaged in innovative policies to promote those rights. The two surveys look at inequalities among persons with disabilities in terms of capabilities, i.e. real opportunities a person has to live the life she values. Based on the capability approach of Amartya Sen, analysis presented in this study show an important gap in terms of education, employment and health related quality of life – a somehow more narrow perspective on wellbeing than the one proposed by Sen, but nevertheless interesting to compare two populations – for persons with disabilities compared to the rest of the population in both countries. If the situation seems improved for the new generation compared to their parents’ generation, access to education – which is a right for children with disabilities in Morocco and Tunisia – is far from being secured in both countries. Similarly, access to employment of persons with disabilities remains uncertain, in more precarious jobs and for lower wages than the rest of the working age population. Social exclusion that persons with disabilities face – as shown in the case of education and employment – have a considerable cost in terms of health related quality of life estimated to be the equivalent of a reduction of 20 and 18 years, respectively in Morocco and Tunisia, of the average life expectancy of persons in good health and without a disability. The recent policy against discrimination and for the promotion of the rights of the persons with disabilities are going in the right direction but a strong political will is required for them to become long term. Civil society has an important role to play to keep the current momentum. [ABSTRACT FROM AUTHOR]