Search

Diffuse alveolar hemorrhage (DAH) is a rare but potentially catastrophic complication of Systemic lupus Erythematosus (SLE), known to complicate about 2–5% of SLE cases. Here, we describe the case of a 9-year-old girl who presented DAH with at the initial diagnosis of SLE. A high index of suspicion is needed for prompt diagnosis in such cases and they require aggressive management at the initial diagnosis to avoid the associated high mortality.

Home automation offers a good solution to help conserve our natural resources in a time when we are all becoming more environmentally conscious. Home automation systems can reduce power consumption and when they are not in use automatically turn off lights and appliances. With home automation, many repetitive tasks can be performed automatically or with fewer steps. For example, each time the person gets out of his computer desk, for instance, the fan and the lights need to be turned off and switched on when he comes back to the computer desk. This is a repetitive task, and failure to do so leads to a waste of energy. This paper proposes a security/energy saving system based on face recognition to monitor the fan and lights depending on the presence or absence of the authenticated user. Initially, the authenticated faces/users LBPH (Local Binary Pattern Histogram) features were extracted and modelled using SVM to construct the face profile of all authenticated users. The webcam catches the user's picture before the PC and the Haar-cascade classifier, a profound learning object identification technique is used to identify face objects from the background. The facial recognition techniques were implemented with python and linked to the cloud environment of Ada-Fruit in order to enable or disable the light and fan on the desk. The relay status is transmitted from Ada Fruit Cloud to Arduino Esp8266 using the MQTT Protocol. If the unidentified user in the webcam is detected by this device, the information in the cloud will be set to ' off ' status, allowing light and fan to be switched off. Although Passive Infrared Sensor (PIR) is widely used in home automation systems, PIR sensors detect heat traces in a room, so they are not very sensitive when the room itself is hot. Therefore, in some countries such as INDIA, PIR sensors are unable to detect human beings in the summer. This system is an alternative to commonly used PIR sensors in the home automation process.

The research was conducted in Vijayapura district of Karnataka during the year 2019-20 with the sample size of 120 respondents. The findings revealed that, in case of beneficiary farmers about 40.00 per cent of red gram farmers were belonged to high level of knowledge. In case of nonbeneficiary farmers about 38.33 per cent of red gram farmers were belonged to medium level of knowledge. It is clear that, in case of beneficiary farmers about cent (100.00 %) per cent of the respondents had knowledge about improved red gram variety, recommended seed rate, recommended spacing, irrigation frequency, intercultivation, weeding, important pests, pest control, important diseases, harvesting and post-harvesting. In case of non-beneficiary farmers it is revealed that, cent (100.00 %) per cent of the respondents had knowledge about weeding and post-harvesting, 98.33 per cent of the red gram farmers had knowledge about inter cultivation, 90.00 per cent of the red gram farmers had knowledge about time of sowing, 86.67 per cent of the red gram farmers had knowledge about important diseases, 85.00 per cent of the red gram farmers had knowledge about disease control.

The research was conducted in Vijayapura district of Karnataka during the year 2019-20 with the sample size of 120 respondents. The findings revealed that, in case of beneficiary farmers about 41.67 per cent of the red gram farmers were found in high level of adoption category. While, In case of non-beneficiary farmers about 43.34 per cent of the red gram farmers were found in medium level of adoption level category. It is clear that, in case of beneficiary farmers about cent (100.00 %) per cent of the respondents have fully adopted red gram variety, recommended seed rate, intercultivation and weeding. Whereas, 83.33 per cent of the respondents have fully adopted recommended spacing, 76.67 per cent fully adopted pest management, 75.00 per cent fully adopted timely sowing and disease management, 73.33 per cent have fully adopted summer ploughing, 70.00 per cent fully adopted seed treatment, 66.67 per cent have fully adopted recommended dose of fertilizer, 51.67 per cent fully adopted nipping practice. It is clear that, in case of non-beneficiary farmers about cent (100.00 %) per cent of the respondents have fully adopted red gram variety and weeding. Followed by, 90.00 per cent have fully adopted recommended seed rate, 83.34 per cent have fully adopted intercultivation, 71.67 per cent have fully adopted seed treatment and recommended dose of fertilizer application, 70.00 per cent have fully adopted pest management, 68.33 per cent have fully adopted summer ploughing. Further about 56.67 per cent have fully adopted time of sowing, 55.00 per cent have adopted disease management.

The research was conducted in Vijayapura district of Karnataka during the year 2019-20 with the sample size of 120 respondents. The findings revealed that, in case of beneficiary farmers were majority (73.33 %) of the farmers expressed non-availability of labour, followed by lower price of produce at the time of harvesting (68.33 %), storage pest problem (63.33 %) and lack of storage facilities and non-availability of credit in time (61.67 %) as problems faced by them. It was also found that, 58.33 per cent of the farmers expressed non-availability of fertilizers at the peak time as the constraint, followed by lack of transportation facilities (48.33 %), high cost of fertilizers (43.33 %), lack of marketing facilities (41.67 %) and knowledge about use of weedicides (28.33 %). In order of priority in case of nonbeneficiary farmers were majority (71.67 %) of the farmers expressed lack of storage facilities, followed by lower price of produce at the time of harvesting (66.67 %), non-availability of labour and nonavailability of credit in time (61.67 %) and storage pest problem (60.00 %) as problems faced by them. It was also found that, 56.67 per cent of the farmers expressed high cost of fertilizers and lack of transportation facilities, followed by lack of marketing facilities (51.67 %) and knowledge about use of weedicides (40.00 %).

Tarunyapiadaka is one of the Kshudraroga and most common skin disorders. Ayurvedic medicine plays important role in the patients who are in deep depression due to disfiguration of face and Tarunyapidaka in the field of Cosmetiology. In the present study an effort has been made to formulate an effective, economic and simple remedy to help in the total cure and preventing of Tarunyapidaka. In the present study 40 Subjects diagnosed with Tarunyapidaka w.s.r to Acne Vulgaris fulfilling the Inclusion criteria were selected for study and randomly categorized into two groups as Group A and Group B each consisting of 20 subjects from OPD and IPD of department of PG studies in Kayachikitsa department of Ayurveda Mahavidhyalaya, Hubbali have been treated with Amapachana with Guduchi Churna. In group A Sadhyosnehapana with Panchatikta Ghrita. Sarvanga Abhyanga with Elaadi Taila followed by Sarvanga Swedana. And Sneha Virechana was administered with Trivruth Lehya. After Samsarjana Krama, Navaka Kashaya given as a Shamanoushadi along with Manjista with Madhu Lepa. In Group B Sadhyosnehapana with Panchatikta Ghrita. Sarvanga Abhyanga with Elaadi Taila followed by Sarvanga Swedana and Sneha Virechana was administered with Trivruth Lehya. After Samsarjana Krama, Gopanganadi Kashaya given as a Shamanoushadi along with Manjista with Madhu Lepa for 45 days to assess the clinical efficacy of Navaka Kashaya and Gopanganadi Kashaya. Significant changes in Subjective and Objective criteria were observed.

Metabolism is the natural process of the body, which is necessary to maintenance of the homeostasis of an individual person. Everybody constitutions are always in the process of metabolism, which is a combination of Anabolism (Construction) and Catabolism (Deterioration). As Agni is prime factor for all the Chayapachayakriya. Medoroga, is one of the Metabolic disease, in which contributing factors are Agni, Ama along with Kaphapradhana Tridosha, Medodhathu. Due to various types of etiological factors, the Agni in the body gets vitiated and Jatharagnimandya occurs. By this Jatharagnimandya, Dhathuparinama will not occur properly. This will lead to Medoroga and further many other Upadravas. To correct these conditions, Ayurveda has many modes of therapies like Samshodhana, Samshamana. By these we can correct the metabolism from the root cause. Here 40 Subjects diagnosed with Medoroga w.s.r. to Hyperlipidemia fulfilling the Inclusion criteria were selected for study and randomly categorized into two groups as Group A and Group B each consisting of 20 subjects. For both groups Amapachana with Chitrakadi Vati, Sadhyosnehapana with Murchita Sarshapa Taila, Sarvanga Abhyanga with Murchita Tila Taila followed by Swedana. And Virechana was administered with Virechana Gulika. Than each group received two different Shamanoushadhi. So, the objective of the study is to establish the efficacy of Virechana along with Dashanga Guggulu and Virechana along with Shadushana Guggulu in the management of Medoroga.

This Paper proposes method to recommend a set of songs based on the facial emotion state of the user. Emotion state of the user is detected with the help of google mobile vision SDK. The detected emotion state is fed to Expression-X algorithm that would sort the music (based on emotion value is keyed in) and generates a playlist which suites the emotion state of user. Since emotions are calculated based on the facial expression of a user, achieving 100% accuracy is undoubtedly hard as everyone has their own way of expressing emotions facially, with repetitive testing we have achieved 70–75% success rate in detecting the rite emotion state of the user, and generating the suitable set of song recommendation.

Normally, the long queues and crowd can be seen at the canteens/hotels whenever there is a lunch break in an organization or within a campus. This paper proposes a solution for eliminating the queue system and introduces the facility to remotely place food orders. Further, this paper proposes a real-time food recommendation system to suggest the dishes to users based on their past orders. The solution has been implemented through a mobile application built using Flutter. The mobile application has been empowered with a machine learning model for recommending the items that the user might like. The proposed method has been tested with 2 vendors catering to 60 customers successfully. The accuracy of the recommendation has been satisfactory.

Ever since the outbreak in Wuhan, China, a variant of Coronavirus named “COVID 19” has taken human lives in millions all around the world. The detection of the infection is quite tedious since it takes 3–14 days for the symptoms to surface in patients. Early detection of the infection and prohibiting it would limit the spread to only to Local Transmission. Deep learning techniques can be used to gain insights on the early detection of infection on the medical image data such as Computed Tomography (CT images), Magnetic resonance Imaging (MRI images), and X-Ray images collected from the infected patients provided by the Medical institution or from the publicly available databases. The same techniques can be applied to do the analysis of infection rates and do predictions for the coming days. A wide range of open-source pre-trained models that are trained for general classification or segmentation is available for the proposed study. Using these models with the concept of transfer learning, obtained resultant models when applied to the medical image datasets would draw much more insights into the COVID-19 detection and prediction process. Innumerable works have been done by researchers all over the world on the publicly available COVID-19 datasets and were successful in deriving good results. Visualizing the results and presenting the summarized data of prediction in a cleaner, unambiguous way to the doctors would also facilitate the early detection and prevention of COVID-19 Infection.

One of the major problems faced by visually impaired people is navigating from one place to another. Commercially available walking canes only serve as obstacledetectors for these people. The need for an economical guidance and navigation system for the blind is long overdue. Existing solutions are highly cost-ineffective, rendering them available only to people on the higher end of the economic strata. A cheap and affordable piece of technology can help the blind commute to their workplace instead of relying on help from random strangers to even commute walkable distances. In this paper, we propose a design for a walking stick to help the visually impaired commute to their livelihood. The proposed solution works on the Internet of Things realm wherein the blind can “communicate” with the environment. This prototype is equipped with an ESP8266, a power source for the development board and coin motors along with a smartphone application, thereby making it accessible for even the working class visually impaired.

It is evident that a huge amount of data is currently being generated. Across the world, 2.5 quintillion bytes of data is being recorded currently. It is almost equivalent to 0.5 Million TB or it is enough to occupy 10 Million Blue-ray disks. The amount of data is expected to surpass 44 trillion gigabytes at the end of 2020 (as compared to 4.4 trillion gigabytes during the end of 2013). The lion’s share of the data being recorded in the information systems is basically related to healthcare activities. Extracting useful information/insights from a large quantity of data is very important. Visualizing data could yield wonderful results, and summaries hidden in data, especially, visualization could do a wonderful job in health care. Data visualization saves time and conveys information more meaningfully. It is a powerful way to summarize which assists all stakeholders. This chapter presents an attempt to summarize healthcare data through exploratory data analysis and process mining control-flow discovery techniques. Exploratory data analysis of healthcare data presents a way to explore healthcare data meaningfully, and process mining based control flow visualization presents the way to extract the causal relationships between the activities of the process. Process mining way of visualizing healthcare helps in identifying the discrepancies between planned and actual healthcare processes. Final sections of this chapter present Process Mining based control flow visualizations on real-time event log detailed in healthcare information systems.

Character recognition is an active research area for recognizing handwritten or optical characters using computers. The number of languages in the world is about 7000, which demands different technologies to deal with the characters. Different tools help to get the scanned documents in the form of images and then technologies are used to recognize the characters. In this paper, a convolution neural network (CNN) model is proposed for recognizing 52 Telugu characters. The performance of the proposed model has been evaluated by optimizers such as Adam, Adagrad, Adadelta, and Stochastic Gradient Descent. The preprocessing step is also supported in improving the accuracy. The CNN model is compared with VGG-16 and the accuracy obtained is less. A highest accuracy of 90.8% is achieved by Adam for the proposed CNN model.

IntroductionPatient rights are “those rights that are attributed to a person seeking healthcare”. Patient rights have implications for quality of healthcare and acts as a key accountability tool. It can galvanise structural improvements in the health system and reinforces ethical healthcare. States are duty bound to respect, protect and promote patient rights. The rhetoric on patient rights is burgeoning across the globe. With changing modes of governance arrangements, a number of state and non-state actors and institutions at various levels play a role in the design and implementation of (patient rights) policies. However, there is limited understanding on the multilevel institutional mechanisms for patient rights implementation in health facilities. We attempt to fill this gap by analysing the available scholarship on patient rights through a critical interpretive synthesis approach in a systematic scoping review.MethodsThe review question is ‘how do the multilevel actors, institutional structures, processes interact and influence the patient rights implementation in healthcare facilities? How do they work at what level and in which contexts?” Three databases PubMed, LexisNexis and Web of Science will be systematically searched until 30th April 2020, for empirical and non-empirical literature in English from both lower middle-income countries and high-income countries. Targeted search will be performed in grey literature and through citation and reference tracking of key records. Using the critical interpretive synthesis approach, a multilevel governance framework on the implementation of patient rights in health facilities which is grounded in the data will be developed.Ethics and disseminationThe review uses published literature hence ethics approval is not required. The findings of the review will be published in a peer-reviewed journal.Registration numberPROSPERO 2020 CRD42020176939

Microarray is an influential and dominant method so as to explore the expression of DNA in organisms for bulk amount of pattern of genes. To draw a better and perfect biological conclusion there is a great demand for a novel approach to grid a microarray image. The best part of the techniques discussed in the literature demands manual involvement, which inevitably reduces the efficiency and reproducibility of the whole automation process. This work deals with the spatial topology method to grid an image. Gridding of microarray image done in two stages initially identification of grid line position is done then followed by grid refinement. The outcome of the proposed approach proves accuracy of gridding

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and the presence of circulating autoantibodies directed against self-antigens. Prevalence of SLE in children and adolescents is 1-6 per 100,000 population. Liver dysfunction occurs in approximately in 50-60% of the patients with SLE.And the incidence of lupus hepatitis in diagnosed SLE patients is 9.3%. We are reporting a case of 11-year-old female child who presented with fever, skin rashes, oral ulcers, irritability and positive antinuclear antibody (ANA) with deranged liver function test (LFT) in the form of elevated transaminases, bilirubin level and altered coagulation profile. Hepatitis serology was negative, with low C3 levels, diagnosed as SLE with lupus hepatitis with lupus nephritis stage IV with psychosis. Clinical improvement along with improvement in terms of laboratory findings was seen on corticosteroids therapy. It is important to differentiate lupus hepatitis from autoimmune hepatitis (AIH) as AIH presents similar to lupus hepatitis, has poor prognosis. While lupus hepatitis being rare cause for mortality in patients with SLE has good response with early intervention with corticosteroids therapy.

Home automation is the mechanism of controlling household appliances automatically using various control system techniques. Nowadays, humans have become much dependent on electronic appliances and technology related to it. This paper gives a proposal to control home appliances using voice commands. We plan to implement an IOT-based system to automate light and fan operations using speech. A model that comes up with smart automation using Google Assistant serves this purpose. The user issues the voice command to the Google Assistant which gets interpreted and based on that the proposed system instructs the relay to switch on/off the home appliance. Adafruit and IFTT application recognize voice commands and instruct the power relay for the appliances accordingly through ESP8266 Wi-Fi. The communication between the appliances and microcontroller is established via Wi-Fi and Adafruit library; whereas, IFTT is used to control and monitor the status of devices.

The National Health Policy in India mentions equity as a key policy principle and emphasises the role of affirmative action in achieving health equity for a range of excluded groups. We conducted a scoping review of literature and three multi-stakeholder workshops to better understand the available evidence on the impact of affirmative action policies in enhancing the inclusion of ethnic and religious minorities in health, education and governance in India. We consider these public services an important mechanism to enhance the social inclusion of many excluded groups. On the whole, the available empirical evidence regarding the uptake and impact of affirmative action policies is limited. Reservation policies in higher education and electoral constituencies have had a limited positive impact in enhancing the access and representation of minorities. However, reservations in government jobs remain poorly implemented. In general, class, gender and location intersect, creating inter- and intra-group differentials in the impact of these policies. Several government initiatives aimed at enhancing the access of religious minorities to public services/institutions remain poorly evaluated. Future research and practice need to focus on neglected but relevant research themes such as the role of private sector providers in supporting the inclusion of minorities, the political aspects of policy development and implementation, and the role of social mobilisation and movements. Evidence gaps also need to be filled in relation to information systems for monitoring and assessment of social disadvantage, implementation and evaluative research on inclusive policies and understanding how the pathways to inequities can be effectively addressed.

Satisfaction is a pleasant or positive emotion. It can also be a feeling. If a Satisfaction during intercourse and fertility agents are intact then the whole intension will be lost. Ayurvedic medicine plays important role in the patients who are in deep depression due to dissatisfaction and infertility in the field of Andrology. Gati is the core characteristic concerned with any disorder of Vata. If Shukra Dhatu gets vitiated by Vata Dosha causes Shukragata Vata. Here 40 subjects diagnosed with Shukragata Vata w.s.r to Premature Ejaculation fulfilling the Inclusion criteria were selected for study and randomly categorized into two groups as Group A and Group B each consisting of 20 subjects. Group A received Amapachana with Hareetakyadi Churna, Tritiya Baladi Yapana Basti was administered in Yoga Basti schedule, later Vanari Yoga granules given as a Shamanoushadi. Group B received Amapachana with Hareetakyadi Churna, Sadhyosnehapana with Shalmali Ghrita. Sarvanga Abhyanga with Murchitatila Taila followed by Sarvanga Swedana and Sneha Virechana was administered with Eranda Taila. After Samsarjana Krama, Vanari Yoga granules was given as a Shamanoushadi. So the objective of the study is to establish such a treatment modality which can be helpful in treating the Shukragata Vata.

Vata Vyadhi is considered one among the Ashta Maha Gada as told by Acharya’s. Out of all Nanatmaja Vata Vyadhis, the disease Pakshaghata is considered superior among the other Vataja disorders. In modern era, the Lakshana’s of Pakshaghata is closely resembles the disease Hemiplegia. In Hemiplegia, symptoms appears due to the Ischemia of Brain tissue which is an end result of improper blood supply to the brain either due to thrombus, embolism or may be due to rupture of any cerebral blood vessels. Acharya Bhela, has considered Pakshaghata as one among the Asthi Majjagata Roga’s. Acharya Sushruta also states that, the Mastulunga Majja is nothing but it is Majjadhara Kala. So, here an attempt has been made to evaluate the efficacy of Brimhana Nasya along with Shamanoushadi’s for the management of Pakashaghata.

Background Contamination of orthodontic appliances is due to the unhygienic practices followed during manufacturing and packaging processes, which may lead to cross-contamination. Although literature has indicated the need for sterilization or disinfection of orthodontic appliances before using in the oral cavity, this is still not employed in routine clinical practice. In this view, the current study evaluates the bacterial load on orthodontic brackets along with the disinfecting efficacy of chlorhexidine. Methods A total of 140 brackets were obtained from four different manufacturers and divided into six groups: group 1 (American Orthodontics; n = 30), group 2 (3M Unitek; n = 30), group 3 (Ortho Organizers; n = 30), group 4 (China Dental Orthodontic; n = 30), group 5 (negative control; n = 10), and group 6 (positive control; n = 10). Various microbiological and biochemical tests were conducted on the brackets to detect the type and growth of bacteria. Brackets that showed microbial contamination were then subjected to disinfection using 0.01% and 2% chlorhexidine solutions. Results Microbial contamination was detected on brackets of all the four groups. Bacteria, including Staphylococcus aureus, S. epidermidis, Lactobacilli, Klebsiella pneumoniae, Bacillus licheniformis, and B. cereus, were identified in these groups. Upon disinfection with 0.01% chlorhexidine solution, brackets in group 2 displayed complete decontamination, while all brackets in the other groups containing gram-negative bacteria exhibited complete decontamination with 2% chlorhexidine. Conclusion Orthodontic brackets received from four manufacturers showed high bacterial contamination. Disinfecting ability of 2% chlorhexidine proved highly effective in destroying both gram-positive and gram-negative bacteria. Therefore, use of 2% chlorhexidine in clinical practice for the disinfection of orthodontic brackets is suggested, before placement in the oral cavity.

Microarray is an important tool and powerful technique that is used to analyze the expression of DNA in organisms for large scale gene sequences and gene expressions. Microarray technology allows massively parallel, high throughput profiling of gene expression in a single hybridization experiment. Processing of microarray images provides the input for further analysis of the extracted microarray data. This work deals on the basic principles on the methods used to grid an image. Gridding has become a prominent objective in microarray image analysis. To grid an image various methods such as grid alignment, sub grid detection, Bayesian Model, hill climbing approach, genetic algorithm and optimal multilevel thresholding has been taken for this study. This paper focuses on the various methods that are widely used to grid the image.

Recurrent hypoglycemia in childhood may be caused by various endocrine or metabolic disorders, of which growth hormone deficiency is a rare cause. A 5-year-old girl presented to us with short stature and recurrent episodes of hypoglycemic seizures. On evaluating for the same, critical sample showed normal cortisol and low c-peptide levels. Neuroimaging ruled out pituitary anomalies. Growth hormone deficiency was diagnosed after GH stimulation test (with clonidine and insulin) revealed low basal and post-stimulation values. Following GH supplementation, no further hypoglycemia was noted. This rare case is being reported to highlight the importance of treating the underlying etiology of hypoglycemia to prevent adverse neurological outcome.

Summary This article presents a review of the battery energy storage method or BESS for its acronym in English (Battery Energy Storage System), considering that the era of high capacity storage batteries is approaching and why historically the storage of energy did not appear in the planning or operation of electrical systems. However, this solution is currently setting a global trend for having high levels of efficiency and why it is also being driven by the need to modernize the network in order to increase the use of renewable energies.

A chronic venous leg ulcer is not so common in Ayurvedic practices. But deep vein thrombosis is more common in clinics. Venous and arterial diseases are most usual cause of leg ulcers accounting to 60 to 80% of them. On an average 33 to 60% of these ulcers are present for more than 6 weeks and therefore referred to as venous leg ulcers. The case reported here was as a result of repeated trauma with a history since 20 years. The treatment was given at IPD level diagnosing it as Upadrava Roopi Vatarakta with valid Chikitsa Siddhanta. This case report provides us a guide lines that even a chronic ulcer can be healed with proper assessment of Dosha, Dhatu, Strotas involvement.

Subclinical Hypothyroidism is a clinical syndrome which result from the deficiency of Thyroid hormones. Usually, it runs a chronic course with slow and insidious onset. Sometimes it is only accidentally diagnosed. Thyroid gland abnormality where, on one hand influences body metabolism up to a great extent, on the other hand, it is found more in females with ratio of male to female being 1:6, if left untreated it can lead to severe complication. In Ayurveda there is no direct comparison regarding symptoms of Subclinical Hypothyroidism but on the basis of clinical presentation it can be correlated with different entities as syndrome, so it is difficult to give a single Ayurvedic term for it, as there are many systems which are involved in the pathogenesis of Subclinical Hypothyroidism. Hence the symptoms of Pre-clinical and post clinical findings are compared with Rasapradoshaja Vikaras.

Kasa is one of the most common Vikara which makes the patient to consult a physician. Kasa is one of the pranavaha srothodusti janita vyadhi which hinders the normal life style. Kaphaja Kasa is a type of Kasa dominated by Kapha and Vatadusti. Ayurveda texts explains the Nidana, Samprapti and treatment of Kaphaja Kasa in detail in many contexts. Chronic bronchitis is a pathological condition characterized by the chronic cough and excessive mucous secretion in the tracheo bronchial tree. Cigarette smoking, environmental pollution, unaccustomed occupational surroundings are major causes of chronic bronchitis. Even though it is not life threatening, but on triggering causes may lead to acute exacerbation of symptoms and may need immediate intervention. Kaphaja Kasa can be best compared with chronic bronchitis. The mucolids, expectorants and cough suppressants are failing to relive the chronic bronchitis, so there is a major role of Ayurveda in treatment of Kaphaja Kasa. Here an attempt is made to review causes, pathogenesis and treatment of Kaphaja Kasa w.s.r. to chronic bronchitis.

In Ayurveda, Jwara is not merely the concept of raised body temperature, but as is said in Charaka Samhita, 'Deha- Indriya- Manah- Santap' is the cardinal symptoms of Jwara. This can be defined as the state where the body, mind as well as sense oragans suffer due to the high temperature. Vishamajwara is a type of fever, which is described in all Ayurvedic texts. Charaka mentioned Vishamajwara and Chakrapani have commented on Vishamajwara as Bhutanubanda, Susruta affirmed that Aagantuchhanubhandohi praysho Vishamajware. Madhavakara has also recognised Vishamajwara as Bhutabhishangajanya (infected by microorganism). Vishamajwara is irregular (inconsistent) in it's Arambha (nature of onset commitment), Kriya (action production of symptoms) and Kala (time of appearance) and possesses Anushanga (persistence for long periods). The treatment of this disease depends upon Vegavastha and Avegavastha of Jwara. Various Shodhana and Shamana procedures are mentioned in classics to treat Visham Jwara.

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.

STUDY DESIGN A translation, cross-cultural adaptation, and validation study. OBJECTIVE The aim of this study was to translate, adapt cross-culturally, and validate the Kannada version of the Oswestry Disability Index (ODI). SUMMARY OF BACKGROUND DATA Low back pain is recognized as an important public health problem. Self-administered condition-specific questionnaires are important tools for assessing a patient. For low backache, the ODI is used widely. Preferred language of a region can have an effect on interpretation of questions and thus scoring. A search of literature showed no previously validated Kannada version of the ODI. METHODS Cross-cultural adaptation and translation was carried out according to previously set guidelines. Patients were recruited from the orthopedic outpatient department. They filled out a booklet containing the Kannada version of the ODI, Kannada version of the Roland Morris Disability Questionnaire (RMDQ), and a 10-point visual analog scale for pain (VASpain). RESULTS The Kannada ODI was answered by 91 patients and retested in 35 patients. After removing questionnaires with stray or ambiguous markings causing difficulty in computation of scores, 76 test questionnaires and 32 retest questionnaires were available for statistical analysis. The Kannada version showed an excellent internal consistency (Cronbach's alpha = 0.92). The Kannada version of the ODI showed good correlation with the RMDQ (r = 0.72) and moderate correlation with VASpain (r = 0.58). It also showed an excellent test-retest reliability (ICC = 0.96). Standard error of measurement (SEM) was also low (4.08) and a difference of 11 points is the "Minimum Detectable Change (MDC)." CONCLUSION The Kannada version of the ODI that was developed showed consistency and reliability. It can be used for assessment of low back pain and treatment outcomes in Kannada-speaking populations. However, in view of a smaller sample size, it will benefit from verification at multiple centers and with more patients. LEVEL OF EVIDENCE 3.

Background: Evaluating the pharmacotherapy is essential at neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) to identify and understand pattern and variability in drug use in polypharmacy, also to promote interventions that will improve patient outcomes.Methods: In our study, we audited pharmacotherapy of 300 neonates and 100 pediatric patients admitted to NICU and PICU from November 2018 to February 2019. WHO-CORE prescribing indicators, WHO-ATC system and WHO-ICD 10th version was used to evaluate pharmacotherapy and to understand the pattern and extent of medication use and to systematically classify drugs and diseases respectively.Results: A total of 1207 medications containing 34 unique active ingredients were prescribed for 300 neonates with an average of 4.02 (±2.0) drugs per neonate admitted to NICU and the most prescribed drugs were anti-infectives for systemic use 799. A total of 976 medications containing 69 unique active ingredients were prescribed with an average of 9.76 (±3.81) per pediatric patients admitted to PICU with anti-infectives for systemic use 331 tops the list. More than 75% of drugs was prescribed in generic name with 98% constant availability of key drugs at intensive care unit.Conclusions: This study substantiates the need for reinforcement of institutional antibiotic policies as antibiotics are widely prescribed and there is an increase trend of antibiotic resistance at critical care unit, assessment of WHO core prescribing indicators are reflective of quality care revealing the awareness about strict monitoring of pharmacotherapy.

Ayurveda believes in different pathology which sets in different Srotas to produce different diseases. Whenever a favorable condition and situation arise, diseases will manifest. Nanatmaja Vikara, Anubandha, Gatavata and Avarana are different pathologies explained in Ayurveda. Avarana is one of the most difficult concept to understand teach and incorporate in clinical practice. It is either least observed, diagnosed or goes unidentified due to lack of skill. To understand and analyze the Avarana, Meticulous knowledge of basic concept of Ayurveda is essential. It is assumed that symptoms complex in Avarana leads to misunderstanding, wrong diagnosis and sometimes end with complications. The symptoms produced in Avarana are based on the principles of Rupahani (Karmakshaya), Rupavriddi (Karmavriddhi) and Rupantara (Anya Karma). The present article is an attempt made to have a critical clinical study of role of Avarana in the manifestation of Rupavriddhi, Rupahani, Rupantara.

Avarana is a very broad concept dealt in Ayurveda explaining the concepts of many diseases generally termed as Avarana Janya Vyadhis like Vata Rakta. Vatarakta is generally correlated with Gouty Arthritis where Serum Uric Acid increase and deposition in the joints are considered to be the major pathological causes. The correlation between these two disease mainly focuses on the similarity between the symptoms, site of attack and re-occurrence pattern. Here an attempt is made in this article to discuss the various concepts in the relation between Avarana, Serum Uric Acid and the micro pathogenesis in Vatarakta / Gouty Arthritis.

All the functions of the body are controlled by three fundamental factors called Tridosha. As per Ayurveda, these are considered as ‘the pillars of the body’. Dosha’s in the state of equilibrium perform the normal functions of the body but when they get vitiated, they cause diseases. Urustambha is a lifestyle disorder and it is commonly seen in the higher socio-economic status. Sushrutha Acharya named this disease as Adhyavata. Urustambha is a grave condition, in which the patient’s thighs become painful, numb and immobile. In this disease, deranged Vata due to intake of Apathya Ahara Vihara sub-charged with the Meda and Kapha settle down into the lower limbs which gives rise to painful and immobile condition of the lower limbs.

Ardita is one among Nanatmaja Vata Vyadhi which manifest suddenly due to Ashukaritva of Vayu. As Ardita has some similarity with Pakshaghata and after Pakshaghata it takes prime position among Vata Vyadhi. Ardita is characterized by symptoms like Ardha Mukha Vakrata. As it affect the Mukha of body mainly, due to its Adhisthana in Mukha patient suffer physically as well as mentally, if not treated properly. So for the treatment of Ardita understanding of its Nidana and its Samprapti become very necessary.

The disease Pravahika is a Swatantra Vyadhi as well as an Upadrava of Atisara. Acharya Charaka mentions it as a symptom in Kaphaja Atisara and as a Vastivyapat. Susruta and Madhavakara have first identified Pravahika as a distinctive disease. Vagbhata has also explained about Bimbishi, which is a synonym of Pravahika. In developing countries, the unhealthy environment or environmental hazards, unhealthy food habits and occupation plays an important role in creating serious problems. Among this, Amoebiasis is a common communicable infection of gastro-intestinal tract, which has a worldwide distribution. Amoebiasis results due to the infection by Entamoeba histolytica. It is estimated that >480 million people carry the infection in their intestinal tract and approximately 1/10th of infected people suffer from invasive Amoebiasis. It was estimated that in 2010 Amoebiasis accounted for about 55,000 death worldwide.[1] The objectives of the present study is to assess the efficacy of Sangrahi Vasti and Kutaja Parpati in the management of Pravahika (Intestinal Amoebiasis).

The Shareera depends on Anna and other four factors namely Vata, Pitta, Kapha and Rakta, Rakta is considered as Mula of the Shareera, the external injury or internal injury or due to coagulation disorders there may be bleeding which may lead to morbidity or mortality. In Ayurveda these bleeding disorder is considered as Raktapitta, one of the Mahavega, Mahagada by the Charakacharya. Thus treatment of these bleeding disorder can be done through Sudha Vargeeya Dravya which are rich in Calcium components, in the form of calcium carbonate, calcium sulphate, calcium fluoride etc. Calcium as fourth clotting factor and as cofactor helps in coagulation of the blood. Thus Sudha Vargeeya Dravya by their Parthiva and Shairyata properties does the coagulation of blood and pacifies the Pitta and Rakta Dusthi. Many plant origin, animal origin and mineral origin have been mentioned in various texts of Ayurveda which can act as Calcium supplements and helps in Raktapitta Chikitsa.

The effect of Gandharva Haritaki, Sudarshana Vati, Arogyavardhini Vati along with Punarnavadi Kashaya were studied clinically on a case of Hepatits - C by modern diagnostic tools with USG Abdomen and Hematological investigations. The review of the patient was done on daily basis in IPD and weekly basis after discharge, the clinical features like loss of appetite, heaviness of abdomen and general weakness were completely subsided during the 2nd month of treatment.

Acharya Charaka explained six unique treatment modalities which are called as Shadvidhopakramas. Rukshana is one among those Upakramas. The Word ‘Upakrama’ has several meaning like planning, beginning, remedy and preparation etc. here Upakrama refers to planning a suitable treatment modality and working to execute it. Shadvidhopakrama includes Langhana, Brimhana, Sthambhana, Rukshana, Snehana and Swedana. These can be broadly classified under two headings as Santarpana and Apatarpana. Santarpaniya Upakramas are Brimhana, Snehana and Sthambana, where as Apatarpaniya Upakramas are Langhana, Rukshana and Swedana. Out of these six types, Rukshana is of the same importance as others. The details of Rukshana will be dealt in this article.

Gouty Arthritis has now become a common disease condition which we deal in Ayurveda, but a proper treatment protocol is not followed in many cases. The case reported here was as a result of improper diet and lack of exercise which resulted in an increase serum uric acid level and joint inflammation. The treatment was given at IPD level diagnosing it as Gambhira Vatarakta with valid Chikitsa Siddhanta. This case report provides us a guidelines that even a chronic gouty arthritis with a very high serum uric acid can be treated as per Vataraktha Chikitsa Siddhanta in Ayurveda.

A recognizable license plate in a picture taken by a traffic monitoring system is crucial for identifying the vehicles involved in traffic violations. In the image of a vehicle taken by a surveillance camera, the license plate is often blurred due to fast motion and cannot be recognized by the human eye. In this type of blurring, the blur kernel can be seen to be a linear uniform convolution parametrically described by its angle and length. In this paper, we introduce a new estimation technique to determine this kernel accurately in order to improve our de-blurred result. We use the Hough transform in estimating the direction in which the image is blurred. To determine the extent of the blur in that direction, we employ a new method involving the cepstrum of the blurred image. We compare the performance of our method to that of other recent blind de-blurring techniques. These comparisons show that our proposed scheme can handle significant blur in the captured image to give a good output image.

Recognizing a license plate clearly while seeing a surveillance camera snapshot is often important in cases where the troublemaker vehicle(s) have to be identified. In many real world situations, these images are blurred due to fast motion of the vehicle and cannot be recognized by the human eye. For this kind of blurring, the kernel involved can be said to be a linear uniform convolution described by its angle and length. We propose a new de-blurring technique in this paper to parametrically estimate the kernel as accurately as possible with emphasis on the length estimation process. We use a technique which employs Hough transform in estimating the kernel angle. To accurately estimate the kernel length, a novel approach using the cepstral transform is introduced. We compare the de-blurred results obtained using our scheme with those of other recently introduced blind de-blurring techniques. The comparisons corroborate that our scheme can remove a large blur from the image captured by the camera to recover vital semantic information about the license plate.

Mental health services are an integral component of primary health care. Yet, provision of mental health services in rural areas of several countries in the Global South is scarce. In spite of a long history of establishment of centres of excellence in mental health and national mental health programmes, India lags behind in terms of making mental healthcare available and accessible in rural areas. Several experiences have shown the important role of non-professional health workers in primary health care in identifying and providing care and support to individuals and families with mental health problems. Based on our experience, we conclude that it is possible to build the capacity of primary health workers to identify mental health problems and participate as the first point of contact within a system involving primary health centres with trained doctors and visiting psychiatrists. Through a well-coordinated local health system and referral of complicated cases, it is possible to provide basic mental health care services within primary health care in a cost-effective manner. In this chapter, we describe the response of the Indian health system in the form of the district mental health programme and discuss the gaps in its implementation. Subsequently, we describe our experience with provision of mental health services within an Indian primary health centre (PHC) setting and discuss its history, implementation strategy and impact in terms of diagnosis, treatment, follow-up and rehabilitation. We also discuss the implications (lessons learned and challenges/limitations) for country policymakers and for Global Mental Health.

Background India has the distinction of financing its healthcare mainly through out-of-pocket expenses by individual families contributing to catastrophic health expenditure and impoverishment. Nearly 70 % of the expenditure is on medicines purchased at private pharmacies. Patients with chronic ailments are especially affected, as they often need lifelong medicines. Over the past years in India, there have been several efforts to improve drug availability at government primary health centres. In this study, we aim to understand health system factors that affect utilisation and access to generic medicines for people with non-communicable diseases. Methods This study aims to understand if (and how) a package of interventions targeting primary health centres and community participation platforms affect utilisation and access to generic medicines for people with non-communicable diseases in the current district context in India. This study will employ a quasi-experimental design and a qualitative theory-driven approach. PHCs will be randomly assigned to one of three arms of the intervention. In one arm, PHCs will receive inputs to optimise service delivery for non-communicable diseases, while the second arm will receive an additional package of interventions to strengthen community participation platforms for improving non-communicable disease care. The third arm will be the control. We will conduct household and facility surveys, before and after the intervention and will estimate the effect of the intervention by difference-in-difference analysis. Sample size for measuring effects was calculated based on obtaining at least 30 households for each primary health centre spread across three distance-based clusters. Primary outcomes include availability and utilisation of medicines at primary health centres and out-of-pocket expenditure for medicines by non-communicable disease households. Focus group discussions with patients and in-depth interviews with health workers will also be conducted. Qualitative and process documentation data will be used to explain how the intervention could have worked. Discussion By taking into consideration several health system building blocks and trying to understand how they interact, our study aims to generate evidence for health planners on how to optimise health services to improve access to medicines. Trial registration Protocol registered on Clinical Trials Registry of India with registration identifier number CTRI/2015/03/005640 on 17th March 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1680-3) contains supplementary material, which is available to authorized users.

Introduction There is evidence for use of cemented hemiarthroplasty resulting in greater anchoring and lesser peri prosthetic fracture. However, this procedure results in more haemodynamic instability and cardiopulmonary complications termed as 'cement reaction' or bone cement implantation syndrome. There has been a heightened interest among surgeons to compare cemented and uncemented hemiarthroplasty for fracture neck of femur. Aim To compare cemented and uncemented hemiarthroplasty in terms of blood loss during the procedure, post-operative complications, mortality, functional recovery and long term clinical outcome. Materials and methods In a prospective study spanning 8 years from January 2006 to January 2014 in a tertiary care hospital, 52 cases of fracture of neck were selected. Twenty four patients underwent cemented and 28 patients underwent uncemented hemiarthroplasty. Mean follow up duration was 59.3 months. Harris Hip Score evaluation was done at each follow up. Radiological evaluation was done at each follow up for calcar length and periprosthetic fractures. Results Mean age of patients was 70 years. Harris Hip scores at 3, 6 and 12 months did not show statistically significant differences. Periprosthetic osteolysis or loosening was not seen in the present study. No complications noted in uncemented hemiarthroplasty. Four patients who had cemented hemiarthroplasty had infections. No mortality occurred during admission and within 12 months after surgery. Conclusion No significant difference was noted between the cemented and uncemented hemiarthroplasty procedures on long term follow up in terms of functionality. No re-operations and no mortality reported. Cemented hemiarthroplasty had more blood loss and minimal post-operative complications.

Bioabsorbable stents have altogether opened a new perceptive in coronary interventions and a debate on benefits over bare metallic stents and drug eluting stents. There had been difference of opinion from experts in this state of art over the technology, indications of usage, clinical benefits and economics. The review enumerates material and technical related issues of so for developed bioabsorbable stents and the players involved. Unbiased, categorical information on the clinical trials of the stents – till date are also discussed.

Ectodermal dysplasia is a rare hereditary disorder with a characteristic physiognomy. It is a genetic disorder affecting the development or function of the teeth, hair, nails and sweat glands. Depending on the particular syndrome ectodermal dysplasia can also affect the skin, the lens or retina of the eye, parts of the inner ear, the development of fingers and toes, the nerves and other parts of the body. Each syndrome usually involves a different combination of symptoms, which can range from mild to severe. The history and lessons learned from hypohidrotic ectodermal dysplasia (HED) may serve as an example for unraveling of the cause and pathogenesis of other ectodermal dysplasia syndromes by demonstrating that phenotypically identical syndromes can be caused by mutations in different genes (EDA, EDAR, EDARADD), that mutations in the same gene can lead to different phenotypes and that mutations in the genes further downstream in the same signaling pathway (NEMO) may modify the phenotype quite profoundly. The aim of this paper is to describe and discuss the etiology, genetic review, clinical manifestations and treatment options of this hereditary disorder. How to cite this article: Deshmukh S, Prashanth S. Ectodermal Dysplasia: A Genetic Review. Int J Clin Pediatr Dent 2012; 5(3):197-202.

The New Medical Device Regulations of European Union replace the E.U’s current Medical Device Directive (93/42/EEC) and the E.U’s Directive on Active Implantable Medical Devices (90/385/EEC) According to the draft document, NB’s would be placed under a strict regimen of super vision, although it remains unclear whether the intended sanctions could be implemented against the will of a Member State, should the need occur. The qualification requirements for auditing and reviewing NB staff are steeply increased. Greater emphasis will be placed on clinical data and the Clinical Evaluation. For implantable medical devices and Class III devices clinical investigations will be expected since equivalence will generally no longer be an acceptable approach, although some exceptions can be made. The proposed MDR attempts to make more transparent the periods for review by various parties for different activities. Implementation of Unique device identification helpful for the unambiguous identification of a specific device on the market.