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The Development and Assessment of a Herbal Floating Tablet for Peptic Ulcer Disease. The goal of creating a herbal floating tablet is to extend the drugs duration in the gastrointestinal tract. This will increase the drugs bioavailability and result in greater absorption than with a convectional dose form. Due to its gastro-retentive feature, the medicine remains at the site of inflammation for a longer amount of time, resulting in a more targeted action and fewer adverse effects than with conventional dose forms. Both industrialised and developing nations have seen a sharp rise in the usage of herbal products in recent years. One of the most significant medicinal plants, Bacopa Monnieri (Brahmi), has several beneficial properties including anti-ulcer, anti-inflammatory, anti-microbial, hepatoprotective, analgesic, antipyretic, anti-bacterial, and anti-fungal properties. Due to a number of factors, peptic ulcer disease is very common in the community. KEYWORDS: Brahmi, Formulation, Quality control parameters, Evaluation

Background Left ventricular ejection fraction (LVEF) is used as quantitative parameter to evaluate myocardial function. However, interobserver variation, limited reproducibility, and dependence on pre-load and after-load reduces its accuracy. The fall in LVEF occurs very late, when myocardial dysfunction is already advanced. Myocardial strain measurements (especially global longitudinal strain) is a new parameter to detect myocardial dysfunction before derangements in LVEF. The aim of this article is to share our experience of this novel diagnostic tool. Methods Feature tracking method of strain assessment is performed using routine long and short axis cine images of cardiac MRI (CMR). Dedicated post-processing CMR software can perform off-line analysis and provide results in form of color-coded maps, percentage values as well as strain over time curve for each myocardial segments. Results Global longitudinal strain (GLS) is more sensitive than LVEF and can identify sub-clinical left ventricular (LV) dysfunction in various cardiomyopathies. It is also an important prognostic marker in serial assessment of heart failure patients. Regional differences in strain parameters can provide clues in hypertrophic cardiomyopathy as well as amyloidosis. GLS is recommended as routine measurement in patients undergoing chemotherapy to detect LV dysfunction prior to fall in LVEF. Strain imaging can be applied to guide placement of the LV pacing lead in patients receiving cardiac resynchronization therapy. More clinical data is needed to evaluate its role in ischemic heart disease. Conclusion Strain imaging can identify LV dysfunction earlier than conventional methods and this opens a new perspective in risk stratification and therapeutic decision-making of various cardiac pathologies.

Global agriculture is challenged with achieving sustainable food security while the climate changes and the threat of drought increases. Much of the research attention has focused on above-ground plant responses with an aim to improve drought resistance. The hidden half, that is, the root system belowground, is receiving increasing attention as the interface of the plant with the soil. Because roots are a sensing organ for nutrients and moisture, we speculate that crop root system traits can be managed using smart nutrient application in order to increase drought resistance. Roots are known to be influenced both by their underlying genetics and also by responses to the environment, termed root plasticity. Though very little is known about the combined effect of water and nutrients on root plasticity, we explore the possibilities of root system manipulation by nutrient application. We compare the effects of different water or nutrient levels on root plasticity and its genetic regulation, with a focus on how this may affect drought resistance. We propose four primary mechanisms through which smart nutrient management can optimize root traits for drought resistance: (1) overall plant vigor, (2) increased root allocation, (3) influence specific root traits, and (4) use smart placement and timing to encourage deep rooting. In the longer term, we envision that beneficial root traits, including plasticity, could be bred into efficient varieties and combined with advanced precision management of water and nutrients to achieve agricultural sustainability.

The potential growth of communication medium and its associated devices are rapidly increasing day by day. A most powerful communication support with 5G network features is required nowadays to resolve all communication overheads. The traditional method of embryonic data transfer between base station and the user device follows channel allocation strategy, which is internally used for the maintenance of random entry of data packets resulted in poor scalable nature, poor traffic handling, latency, and so on. The efficiency of network technologies with 5G support suffers from major issues such as the network performance, collision, and delay that are needed to be concerned with. To combat this, the technique of decoding of two or more packets is followed; hence, the concept of NORA was proposed. In analysis of the existing NORA method, Zadoff–Chu sequence was used to obtain the performance of NORA in 5G which gave better performance yet, resulting in collisions. Keeping these issues in consideration, an efficient communication model called fair scheduling non-orthogonal random access (FSNORA) is proposed. In the proposed method, we have scrutinized NORA to improve the fairness of scheduling by using round-robin algorithm so as to make a contentionless system and improve the channel enhancement of 5G networks. Simulation results convey that there is an improvement in the access delay, success probability, throughput, collision probability, and the preamble transmissions in context with contention compared to the existing NORA method.

Background Discrepancies in the management of pharyngitis in children have been reported in Europe and the United States, and recommendations concerning the use of clinical scores, rapid antigen diagnostic tests (RADTs) or throat cultures, and the indications for antibiotic treatment largely differ. Objective This article summarizes the Italian guidelines on the management of pharyngitis in children issued by the National Institute of Health. Methods A multidisciplinary panel of experts (the Guidelines Development Group) developed and used a set of key questions to conduct a systematic review of the literature. Relevant publications in English were identified through a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through April 30, 2011. Final recommendations were scaled according to the Italian National Guidelines Program grading. Results Eighteen clinical questions were defined, and 44 recommendations were issued. None of the available scoring systems is sufficiently accurate to identify group A β-hemolytic streptococci (GABHS) pharyngitis in settings with low prevalence for rheumatic disease. RADT should be performed by trained personnel in every child with a history and signs/symptoms suggestive of GABHS pharyngitis. RADT is not recommended in children with a McIsaac score of 0 or 1 with ≥2 signs/symptoms suggestive of viral infection. Backup culture in children with negative RADT result is not recommended. Culture test with antibiotic susceptibility assay should be performed exclusively for epidemiologic purposes. Streptococcal antibody titers are of no value in diagnosing acute pharyngitis. Antibiotic therapy is recommended in microbiologically documented GABHS pharyngitis. Because penicillin V is not available in Italy, amoxicillin (50 mg/kg/d in 2–3 doses orally) for 10 days is the first choice of treatment. In noncompliant cases, benzathine penicillin may be administered. Although not routinely recommended due to the high cost and wide spectrum of activity, a 5-day course with a second-generation cephalosporin may be used in noncompliant cases. Macrolides should be limited to children with demonstrated type I hypersensitivity to penicillin. Ibuprofen or paracetamol is recommended for relief of pain or fever associated with discomfort. Because the carrier state is not associated with increased risk of suppurative complications and risk of GABHS transmission to contacts is minimal, the carrier state should never be investigated and treated. Recommendations for the management of suppurative complications are given. Conclusions This guideline provides a comprehensive, evidence based, tool for the diagnosis and therapy of acute pharyngitis in children.

AIM OF THE STUDY: In paediatric patients, recurrent febrile pharyngo-tonsillitis is usually due to chronic inflammation of the tonsils and/or adenoids: these episodes are often associated with other clinical manifestations (respiratory obstruction of naso-pharyngeal origin; auricular inflammation, especially effusive otitis media and acute otitis media; streptococcal beta-haemolytic Group A (SBEGA) infection, causing a distant disorder of varying severity and which may, therefore, give rise to serious pathological conditions). A retrospective multicentric investigation has, therefore, been carried out in order not only to further elaborate findings emerging from earlier studies, performed in other countries, in which random methods were used, but also to focus on: 1. the possible association of these clinical manifestations with recurrent febrile pharyngo-tonsillar inflammation in relation to frequency of the condition; 2. results obtained with adenoidectomy or with adeno-tonsillectomy, referring to the overall clinical outcome of the pathological condition, bearing in mind data emerging from the control groups, submitted to strict follow-up, associated with any medical treatment deemed necessary. MATERIAL AND METHODS: The study population comprised 692 patients (394 male, 298 female), age range 2-11 years and with a minimum follow-up of 2 years. Considering the clinical manifestations emerging from the case history, the following two investigations were carried out: 1. the first, on 501 patients, all previously submitted to adeno-tonsillectomy in whom the recurrent febrile pharyngo-tonsillar inflammation had occurred, respectively > 4 or < or = 4 episodes during the last 12 months; 2. the second, on 455 patients in whom recurrent febrile pharyngo-tonsillar inflammation, in the 12 months prior to the beginning of the study, had been < or = 4 episodes: in 264 cases, adeno-tonsillectomy was carried out; in 144, adenoidectomy; 47 children were studied as controls and, therefore, submitted to watchful waiting. The results obtained were statistically analysed by chi2 and Fisher test: a "p" value of < 0.05 was considered statistically significant. RESULTS: The first investigation showed that all symptomatological manifestations considered were resolved following adeno-tonsillectomy, in a significantly high percentage of cases (recurrent febrile pharyngo-tonsillar in flammation: 91.8%; naso-pharyngeal respiratory obstruction: 92.2%; pathological ASO titre: 69.8%; distant disorders probably due to SBEGA: 76%; effusive otitis media: 76%; acute recurrent otitis media: 87.5%). The most interesting clinical findings obtained can be summarized as follows: naso-pharyngeal respiratory obstruction is a frequent finding; the incidence is statistically higher in cases in which recurrent febrile pharyngo-tonsillar inflammation is less frequent (p < 0.05): in these patients, this is an important pathological manifestation indicating the need for surgery; the higher incidence is associated with at significant finding of pathological auricular processes; the percentages of recovery for naso-pharyngeal respiratory obstruction are statistically greater in the group of patients in whom the recurrent febrile pharyngo-tonsillar inflammation is more frequent: an identical result is found in patients with the effusive form of otitis media and in those with recurrent acute otitis media; a pathological ASO titre is more frequently found, the difference being statistically significant (p < 0.05), in the group of patients with more frequent recurrent febrile pharyngo-tonsillar inflammation, albeit this factor does not affect the percentage of recovery; also the favourable evolution and recovery of clinical distant manifestations, related to streptococcal beta-haemolytic Group A infection, are correlated with the return to normal of the ASO titre. The second investigation demonstrated the efficacy of surgical treatment, adeno-tonsillectomy and adenoidectomy, in all the clinical manifestations studied, the possibility of achieving resolution of recurrent febrile pharyngo-tonsillar inflammation even in the control subjects submitted to medical treatment, but also the lack of success, in the latter, as far as concerns naso-pharygeal respiratory obstruction, the pathological ASO titre and the inflammatory auricular processes. CONCLUSIONS: The present investigations confirm previous observations emerging from randomized clinical studies, regarding the possibility to achieve valid prevention of recurrent febrile pharyngo-tonsillar inflammation, also in a large percentage of control patients submitted to watchful waiting; these investigations, however, also demonstrated that, in the control group, the percentage of subjects in whom recovery of other symptoms was achieved was very low compared to that in the groups submitted to surgery. In other words, clearly emerges as far as concerns the overall symptomatological picture of the patients, the efficacy of the surgical treatment, but also the lack of success of the medical treatments in all clinical manifestations associated with recurrent febrile inflammations. Therefore, it is necessary to select and advise the most suitable treatment strategy, not in relation to the Guidelines elaborated on the basis of results emerging from statistical research, that, due to the intrinsic methodology limits cannot be applied to all cases in an acritical fashion, but in relationship to the specific clinical picture of each individual patient.

Cardiac resynchronization therapy (CRT) is the currently used non-pharmacologic therapy for heart failure (HF) patients with a conduction disturbance. The purpose of CRT is to resynchronize contraction between and within ventricles. This dyssynchrony arises from an abnormality in the heart's electrical conducting system that causes the two ventricles to beat asynchronously. Studies from clinical trials have shown that about 30% of the patients do not gain any benefits from CRT. Computational models may have the potential to predict the response of patients to CRT and could be used to optimize the effects of this therapy. Hence, we have developed methods for generating anatomically detailed patient-specific three-dimensional finite element models of the failing human heart from clinical measurements. Two three-dimensional finite element models were generated from cardiac computed tomography and magnetic resonance images obtained at end- diastole using a newly developed semi-automatic technique of landmark points. Landmark points are anatomical locations identified on the cardiac images that allow us to estimate the extent of the heart in order to build a 3D model of the failing heart. Seventeen landmark points were used to precisely determine the circumferential and longitudinal extent of the failing human heart. A 3D finite element model with 50 nodes and 24 elements was generated for two patients with dyssynchronous heart failure. These 3D models were then used to estimate myocardial wall thickness and ventricular cavity volume. The method of landmark points provides an efficient way to generate finite-element meshes

Head injury is considered one of the single most important causes of subdural hematoma. Other cause include bleeding diasthesis. We report here a case of 70-year-old female patient with chronic myeloid leukemia (CML) presenting with bilateral chronic subdural hematoma after an incremental high-dose of imatinib mesylate (IM) due to loss of complete molecular response. IM is useful to treat a wide range of diseases, including Philadelphia chromosome-positive CML, as it has high tolerability and low incidence of minor side effects. Hemorrhage is a rare complication of IM. IM is associated with reduced α2-plasmin inhibitor and platelet dysfunction. This case report emphasizes on the need to consider chronic subdural hematoma as atypical cause of headache in a patient of CML taking high-dose IM.

Idiopathic intracranial hypertension (IIH) is characterized by symptoms of raised intracranial tension (ICT) as headache and visual disturbances due to raised cerebrospinal fluid pressure, however without any ventricular enlargement or space occupying lesion. The characteristic findings include papilledema which is usually bilateral, however which may be unilateral or asymmetrical. We report a case of 35-year-old female patient who came with complaints of headache and diplopia. She underwent magnetic resonance imaging of the brain which showed changes in bilateral globes, optic nerves and sella, which were suggestive of increased ICT. The ventricles and basal cisterns were normal. No other abnormality was seen. The magnetic resonance venogram was also normal. Thus, we concluded the diagnosis of IIH. The patient underwent therapeutic lumbar puncture after which she showed significant improvement in symptoms.

Impinging jets are adopted in drying of textiles, paper, cooling of gas turbine components, freezing of tissue in cryosurgery and manufacturing, electronic cooling. In this paper an experimental investigation is carried out on impinging jets in porous media with the wall heated from below with a uniform heat flux. The fluid is air. The experimental apparatus is made up of a fun systems, a test section, a tube, to reduce the section in a circular section. The tube is long 1.0 m and diameter of 0.012 m. The test section has a diameter of 0.10 m and it has the thickness of 10, 20 and 40 mm. In the test section the lower plate is in aluminum and is heated by an electrical resistance whereas the upper plate is in Plexiglas. The experiments are carried out employing a aluminum foam 40 PPI at three thickness as the test section. Results are obtained in a Reynolds number range from 5100 to 15300 and wall heat flux range from 510 W/m2 to 1400 W/m2. Results are given in terms of wall temperature profiles, local and average Nusselt numbers, pressure drops, friction factor and Richardson number.

A 20-month-old girl successfully underwent repair of pulmonary artery sling through a median sternotomy by division of the left pulmonary artery and its reimplantation into the main pulmonary artery without cardiopulmonary bypass or tracheal reconstruction. The patient is doing well on 18 months follow-up with unobstructed pulmonary blood flow and dramatic reduction of tracheal stenosis. Simple repair of pulmonary artery sling is feasible with good results in selected cases without tracheomalacia.