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Purpose To describe the use of glycerine in improving media clarity in cases with edematous cornea. Methods Retrospective case-series including patients with posterior segment pathologies needing surgical invention and having corneal edema. Each case was studied for the role of topical application of glycerine instead of viscoelastic agents and the course of surgery. The cases were followed up for minimum 3-months duration. Results Six cases with corneal edema having posterior segment pathology underwent surgery with intraoperative topical application of glycerine. The corneal edema was seen to clear with progression of surgery and was maintained until the end of surgery. Procedures like vitreoretinal surgery, identification of break, internal limiting membrane peeling, intraocular lens explantation, scleral indentation, DSEK graft removal, and subretinal band removal could be performed in these cases. Conclusion Intraoperative glycerine use during vitreoretinal surgeries is helpful in improving the corneal clarity and maintaining it till the end of surgery.

Nuclear atypia scoring (NAS), forms a significant factor in determining individualized treatment plans and also for the prognosis of the disease. Automation of cancer grading using quantitative image-based analysis of histopathological images can circumvent the shortcomings of the prevailing manual grading and can assist the pathologists in cancer diagnosis. However, developing such a robust classifier model require sufficient amount of annotated data, while the labeled histopathological images are scarce and expensive to procure as annotation forms a time-consuming and laborious task. Hence, a semisupervised learning framework combined with the deep neural network based generative adversarial training, that can improve the performance of the classification model with limited annotated data, is proposed in this paper. The proposed NAS-SGAN model consists of discriminator and generator models that are trained in an adversarial manner using both labeled and unlabeled samples. The discriminator model is designed as an unsupervised model stacked over the supervised model sharing the model parameters and learns the data distribution by extracting the discriminative features. The generator model is trained over a stable feature matching objective function following a composite GAN architecture. The novelty of the proposed model is that, we have used a stacked supervised and unsupervised discriminator and a feature matching generator for the NAS-SGAN model and its for the first time the semi-supervised GAN model is explored for the grading of breast cancer. Experimental analysis shows that the proposed model could better discriminate different cancer grades thereby improving the robustness and accuracy of the system, even with limited amount of labeled samples.

Abstract: Alzheimer’s disease (AD) is a complex neurological disorder and multiple pathological factors are believed to be involved in the genesis and progression of the dis-ease. A number of hypothesis including Acetylcholinesterase, Monoamine oxidase, β-Amyloid, Tau protein etc. have been proposed for the initiation and progression of the disease. At present, acetylcholine esterase inhibitors and memantine (NMDAR antago-nist) are the only approved therapy for the symptomatic management of AD. Most of these single-target drugs have miserably failed in the treatment or halting the progression of the disease. Multi-factorial diseases like AD require complex treatment strategies that involve simultaneous modulation of a network of interacting targets. Since last few years, Multi-Target-Directed Ligands (MTDLs) strategy, drugs that can simultaneously hit mul-tiple targets, is being explored as an effective therapeutic approach for the treatment of AD. In the current review article, the authors have briefly described various pathogenic pathways associated with the AD. Importance of Multi-Target-Directed Ligands and their design strategies in recently reported articles have been discussed in detail. Potent leads identified through various structure-activity relationship studies and their drug like char-acteristics are described. Recently developed promising compounds have been summa-rized in the article. Some of these MTDLs with balanced activity profile against different targets have the potential to be developed as drug candidates for the treatment of AD.

Smart grid (SG) provides a suitable adjustment in the amount of power generation by providing the ability to supervise consumer behavior. SG uses in the smart system to encourage cultural heritage because it is accountable for providing power without any interruption. SG is one of the vital components to authorize smart systems with a lot of smart features to attract visitors to come and visit heritage. In SG, environment security and privacy are the major concern for communications. An authentication protocol provides secure communication between users and service provider for security and privacy purpose. Several authentication protocols are available in the literature. However, they are enabled to known security attacks easily or they are not computationally efficient for SG communication. In the present paper, we design an ECC-based mutual authentication protocol for smart grid communication using biometric approach. The present framework satisfy various security features such as replay attack, user anonymity, man in the middle attack, key freshness, message authentication, session key agreement, impersonation attack, non-traceability and non-transferability. Further, the proposed protocol takes much less communication and computation costs compared with other existing protocols in SG environment. Therefore, our scheme is convenient for practical application in SG communication.

The fabrication of piezoelectric ZnO-based MEMS acoustic sensor has been reported. The sensor structure consists of a piezoelectric ZnO film deposited between two Al electrodes on a thin silicon diaphragm. A microtunnel is fabricated in the sensor structure using novel approach. This microtunnel is used to protect the diaphragm and determine the lower cut-off frequency of device. The approach presented in this paper completely removed a serious problem of microtunnel blockages during fabrication of sensors. In the developed process, the acoustic sensor fabricated using SOI and the Pyrex glass wafers are diced separately with same chip dimensions. Finally, both Pyrex glass and acoustic sensor chips are fitted in a jig for alignment and then anodically bonded. In reference to microtunnel blockages, the yield of the present technique is obtained as almost 100%. The developed technique can also be used in manufacturing of similar devices where the microtunnels are required in device structure. The technological development is supported by extensive AFM, FESEM, Raman spectroscopy and XRD studies of ZnO film; glass-to-silicon bond strength measurement; resonance frequency measurement by LDV; response characterization of the fabricated sensor, and SEM microscopy of microtunnel mouth to demonstrate the feasibility and yield of the process.

The recognition of online handwriting is a vital application of pattern recognition, which involves the extraction of spatial and temporal information of handwritten patterns, and understanding the handwritten text while writing on the digital surface. Although, online handwriting recognition is a mature but exciting and fast developing field of pattern recognition, the same is not true for many of the Indic scripts. Gurmukhi is one of such popular scripts of India, and online handwriting recognition issues for larger units as words or sentences largely remained unexplored for this script till date. The existing study and first ever attempt for online handwritten Gurmukhi word recognition has relied upon the widely used hidden Markov model. This existing study evaluated against and performed very well in their chosen metrics. But, the available online handwritten Gurmukhi word recognition system could not obtain more than 90% recognition accuracy in data dependent environment too. The present study provided benchmark results for online handwritten Gurmukhi word recognition using deep learning architecture convolutional neural network, and obtained above 97% recognition accuracy in data dependent mode of handwriting. The previous Gurmukhi word recognition system followed the stroke based class labeling approach, whereas the present study has followed the word based class labeling approach. Present Online handwritten Gurmukhi word recognition results are quite satisfactory. Moreover, the proposed architecture can be used to improve the benchmark results of online handwriting recognition of several major Indian scripts. Experimental results demonstrated that the deep learning system achieved great results in Gurmukhi script and outperforms existing results in the literature.

A 38-year-old woman who had previously been diagnosed and treated for unilateral Vogt-Koyanagi-Harada syndrome (VKH) and had undergone multiple intravitreal bevacizumab injections to manage inflammatory choroidal neovascularisation in her right eye, presented 2 years later with visual complains in left eye. Clinical examination, fluorescein angiography, indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) assisted evaluation confirmed active inflammation of left eye along with absence of any inflammation in the right eye. Unilateral active inflammation can be seen in the setting of VKH. To our best knowledge, ours is the first case of VKH in which unilateral active inflammation has been proven based on ICGA and EDI OCT analysis.

BACKGROUND Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel, enveloped, positive, single-stranded ribose nucleic acid (RNA) beta corona virus that causes coronavirus disease-2019 (COVID-19). During the COVID-19 outbreak, various ocular symptoms including conjunctivitis were reported as a manifestation of the disease and viral RNA was found in the patients’ tears. Eye specialists may be the first person to examine a patient suffering from COVID-19 in cases presenting with conjunctivitis. Conjunctivitis is a very common ocular presentation with varied causes. The purpose of this study is to evaluate the frequency of ocular signs and symptoms in cases of COVID-19. METHODS In this prospective observational study, we collected and analysed data from 522 laboratory-confirmed positive cases of Covid-19 from pure dedicated COVID-19 hospital from June 2020 to December 2020. All symptomatic patients were examined in detail and symptomatic treatment was provided taking appropriate self-protection. RESULTS Between June 2020 and December 2020, a total of 522 reverse transcription polymerase chain reaction (RT PCR) confirmed patients of Covid-19 presented to hospital were included in the study. Out of 522 patients, 421 were male and 101 were female. The mean age of the patients was 38.35 years. Out of these 522 patients, 4 patients (0.76 %) had ocular manifestations consistent with follicular conjunctivitis, 2 patients (0.38 %) had chemosis and epiphora, 6 patients (1.14 %) had lacrimation. No patients had loss of vision or other vision threatening events. No ocular symptoms were presented as first symptoms of COVID-19 in any of the 522 cases. CONCLUSIONS In our study, we found out that the overall prevalence of ocular events is low. Total 12 cases (2.29 %) amongst 522 COVID-19 cases had ocular manifestations. Ocular events other than conjunctivitis and lacrimation, like chemosis and epiphora were more common in severely ill patients. All symptomatic patients had presented in early course of disease, majority before the hospitalization. Presentation of ocular symptoms as initial COVID-19 symptoms was not seen in our study; no cases were presented as initial COVID-19 symptoms. KEYWORDS Covid-19; Ocular Symptoms, Corona Virus, Corona Virus Disease 2019 (Covid-19), Conjunctivitis

Objective To evaluate whether there would be a difference in outcome when the smaller ultra mini 12 Fr sheath was used instead of the mini 16 Fr sheath for percutaneous nephrolithotomy (PCNL) in paediatric patients for stones less than 25 mm. Methods This was a prospective cohort study of patients who underwent PCNL in our hospital in a 2 year period from 2016 to 2018 by a single surgeon. PCNL was performed in a prone position and tract was dilated to the respective size using single step dilatation. Laser was used to fragment the stone. Stone-free outcome was defined as absence of stone fragment at 3 months on kidney, ureter, and bladder (KUB) X-ray. Results There were 40 patients in each group. Mean stone size was comparable between the two groups, (14.5 mm vs. 15.0 mm). The procedure was completed faster in the 16 Fr group compared to 12 Fr group, (24.5 min vs. 34.6 min). Stone clearance was highly successful in both groups (97.5% vs. 95%). There was no difference in complications between the two groups. The decrease in hemoglobin was minimal in both groups (0.2 g/dL vs. 0.3 g/dL). Conclusions We found that the success rates were similar in both mini PCNL and the smaller ultra-mini PCNL groups. No significant difference in bleeding was noted in our pilot study, however, operative time was longer in the ultra-mini group as compared to the mini sheath group.

Friction stir welding (FSW) is a new solid-state welding technique used to join similar and dissimilar materials, especially aluminium alloys. Friction stir (FS) welding proposes numerous benefits compared to conventional fusion welding techniques and can be successfully applied in shipbuilding, aerospace, automobile, and railway industries. This paper gives a comprehensive review of the FSW process and its technical aspects. The effects of tool pin profiles, feed rate, tool tilt angle and welding speed, etc., and mechanical and metallurgical behavior of FS welded joints have been reviewed in this article. In addition, this paper covers the literature review of friction stir welding of similar and dissimilar aluminum alloys (AA), optimization techniques, welding defects, and fatigue behavior of FS welded joints. Furthermore, a summarized report of work done by many researchers in friction stir welding is also presented. Finally, it also identifies the future scope, applications, and research gap.

Background A prospective study to evaluate the rotational stability of toric intraocular lenses (IOLs). Methods A prospective study of 30 eyes in 29 patients. All patients with regular astigmatism of range 0.75–4 D were included in the study. Exclusion criteria included irregular corneal astigmatism, post-refractive surgery and corneal dystrophies. All patients underwent uncomplicated phacoemulsification cataract surgery by the same surgeon. Three eyes with corneal astigmatism of 0.75–1.5 D were implanted with the AcrySof SA60T3 IOL, eight eyes with astigmatism between 1.5 and 2.0 D received the SA60T4 IOL and eight eyes with astigmatism between 2.0 and 2.50 D received the SA60T5 and rest with astigmatism of 2.5 D and higher received SA60T6 and above models. Main outcome measure was the post-operative position of the lens, assessed at day 1, 1 week, 1 month and 6 months, using toric marker and the slit lamp. Results There was no significant rotation of IOL observed during a follow-up period of 6 months. Overall, the post-operative rotation was within 5° in 95% of cases. There was no trend for either clockwise or anti-clockwise rotation. However, IOL rotation happens mostly within the first month of surgery, and if it is significant, it requires early repositioning. Conclusion Toric IOLs are very effective and consistent in correcting astigmatism during the cataract surgery. Once placed to its position, toric IOLs demonstrate rotational stability in the capsular bag.

Hydrocarbons, which are found in plastic, are an excellent energy source due to their high energy density. The disposal of plastic waste presents significant energy saving and recovery opportunities. The purpose of this study is to determine how much energy can be recovered from waste plastics as a possible alternative fuel source for cars. This research aims to assess the performance of waste plastic pyrolysis oil (WPO) generated by polyethylene pyrolysis. Ethanol is an appealing alternative fuel since it is made from renewable bio-resources and works as an oxygenated fuel in diesel engines, allowing for emission reductions. Three different percentages of WPO were combined with ethanol to create a tertiary fuel blend. This research examines the performance and emission requirements of a single-cylinder direct injection diesel engine. With diesel, D70W20E10′s specific fuel consumption reduces by about 7.5 %. Carbon monoxide emissions from D70W20E10 were about 6.5 % lower than diesel and 13.5 % lower than hydrocarbon at various loadings. The most optimum running condition was further examined using the Full Factorial Design method.

This study presents the synergy of high ash coal with different biomass when blended in different ratios for co-gasification using a fluidized bed gasifier. The moisture, CO2, oxygen, hydrogen and numerous other compounds have synergetic effects on the co-gasification because of affinity to heat and prone to reaction. The mineral constituents, discrete mineral species and ion-exchangeable elements present in coal, biomass and bottom ash residue have been identified by XRD, XRF, FTIR and SEM-EDX. The catalytic effects of mineral, major oxides, halides and chlorites content on co-gasification have been assessed. The mineral (e.g. calcite, dolomite, hematite, etc.) present in the high ash coal and biomass plays a catalytic role. Other minerals (e.g. quartz, sulfide, kaolinite and phosphates) negatively influence co-gasification and product gas composition. The positive relationship of CaO, MgO and Fe2O3 with CCE, CGE and increasing heat values also supports major oxides catalytic role. The blend of press mud and high ash coal has given better results due to more Ca, K, Mg and Na elements. SEM microphotographs reveal catalytic effects at the micro-level, indicated by the extensive cracking of hydrocarbon compounds. The empirical models proposed for estimation of catalytic effects of minerals on co-gasification.

The economic and industrial development of any nation depends on energy. To fulfil the future energy requirements, it is very necessary to switch over the renewable energy sources for energy generation. Among all the renewable energy sources solar energy can effectively convertible to the other forms of energy but the major drawback is that it is only available during the day time and if it needs to be utilised during the night-time, the only option is to store it during the day time when it is abundantly available. Several techniques have been introduced for the storage of solar thermal energy and there are three basic ways to store the solar thermal energy i.e. in the form of sensible heat, latent heat and thermochemical heat. The main objective of the present work is to compare different energy storage techniques which resulted that a metal hydride based thermochemical energy storage (MH-TCES) system is more suitable. In addition, it enlightens on the selection of working materials for MH-TCES.

It is observed that in industries the evolution of new materials play a vital role in the manufacturing of machine components of lightweight and high strength and composite is one of the new materials which serves that expectations of the industrial application though the organic polymer composites that are used in many of the machine tools and automobile industries is increasing the environmental issue and recycling is been degradation of obsolete component hence here we are going to prepare a natural composite like the kenaf fiber-reinforced composite with the cellulose and organic epoxy resin and subsequently the testing like the tensile, flexural and impact test are to be carried for checking its strength. The material should carry high stiffness. In the automobile industry, the kenaf material is more useful to make the material that is lightweight and easily decomposable after its use. This is compactable and weight less.

Introduction: Renal dysfunction at presentation is uncommon in primary membranous nephropathy (PMN). The data on the outcome of PMN patients with renal dysfunction at outset are scarce. The objective of the current study was to report the clinical outcomes of PMN patients with renal dysfunction. Material and Methods: This prospective longitudinal observational study included PMN patients (both incident and treatment resistant) with an estimated glomerular filtration rate of 2. Immunosuppressive treatment was as per the unit’s protocol. Patients were evaluated for proteinuria, creatinine, and serum albumin at monthly intervals for 6 months, then quarterly for a year, and then biannually. Both serum and tissue anti-PLA2R were performed at baseline. Outcome: Percentage of patients achieving clinical remission. Results: Sixty-four adults met study criteria and were analysed. The median (IQR) age of the patients was 48 (40, 56) years. PMN was PLA2R related in 52 (81.3%) patients. Twenty-eight (43.8%) and 30 (46.9%) patients were in remission at 12 months and at the end of the study [median (IQR) follow up: 24 months (12, 35)], respectively. Eight (12.5%) had progressed to end-stage renal disease at the last follow-up. Median (IQR) baseline anti-PLA2R titre was 150.1 RU/mL (38.5, 308). Nineteen (61.3%) and 18 (58.1%) patients with >90% reduction in anti-PLA2R titres at 12 months were in clinical remission at 12 months and at the end of the follow-up, respectively. Both cyclical cyclophosphamide/steroids (cCYC/GC) and rituximab were equally effective in inducing remission, but rituximab had a favourable adverse event profile compared to cCYC/GC. Conclusion: To conclude, both cCYC/GC and rituximab are equally effective in inducing remission of nephrotic state with compromised renal function due to PMN. Immunosuppression induces remission in up to 50% PMN patients with CKD-stage 3–4.

A 41-year-old man with a history of bullet injury 1 month ago was evaluated for decreased vision in the right eye. The patient’s left eye was normal. Best-corrected visual acuity was 20/200 in the right eye. The dilated fundus showed the temporal area of bare sclera, surrounding pigmentation

BACKGROUND Treatment of amblyopia by patching is the gold standard. However, it is associated with poor compliance, difficult to use, has risk of allergy, has social stigma and may cause cosmetic problems. We wanted to compare the efficacy of standard patching therapy and Digital Smart Glasses (Liquid Crystal Glasses) in the treatment of Amblyopia. METHODS In this comparative, prospective, interventional, safety/efficacy study with the primary purpose of treatment, 60 eyes of the children 3 - 8 years of age with previously untreated, moderate (visual acuity of 20/40 to 20/100 in the amblyopic eye), unilateral, anisometropic amblyopia were included. All subjects were using optimal refractive correction before start of occlusion therapy. Digital smart glasses group used a 6-hour intermittent occlusion therapy with liquid crystal glasses, set at 40-second opaque / 20 second transparent intervals (occluded 66% of wear time) which gives an effective 4 hours of occlusion and it is compared with 4 hours of continuous patching therapy. Occlusion was applied only to the good eye. All 60 children were followed up regularly for 36 weeks. Best corrected visual acuity for distance was measured. Visual acuity for distance was measured with the help of Snellen’s chart. RESULTS There is a statically significant gain in visual acuity in both groups from baseline in each visit. Difference in mean gain in visual acuity was statically significant between both groups at 4 weeks , 8 weeks, 12 weeks, 24 weeks of therapy (p

The universal verification methodology (UVM) testbench utilizes the bus interface to access the design under verification (DUV) and registers using constraint random access. The UVM testbench is not able to perform cross-platform reusable verification. Alone UVM libraries are non-efficient for cross-platform migration, and individual C package modules are prone to miss corner cases with lower functional coverage. Thus, conventional UVM testbench needs a C test module for target-specific implementation. This work targets the implementation of hybrid UVM-C testbench architecture to potentially implement the auto-survivor path generation on higher integration. This paper proposes the UVM-C testbench model is capable of creating reusable test cases for design and registers with cross-platform communication. The new automation helps in the extraction of input parameters to implement script-based auto-covergroups and basic assertions to improvise functional coverage. The proposed UVM-C model implementation reduces the processing time, module capture value, and simulation time compared to state-of-the-art SystemVerilog and UVM verification methodologies. The method refines the processing time and simulation time by 16.41% and 15.23% as compared to SystemVerilog, while the improvement is 7.89% and 7.44% from UVM. The work also provides an average simulation instance value improvement of 11 per module per testbench run as compared to sole conventional UVM testbench.

Objective: Till date, a very few prospective studies have examined the association between serum homocysteine levels and the risk of stroke and stroke subtypes in Indian populations. Methods: A prospective, case - control study of Indian subjects 10–90 years of age was conducted using frozen serum samples from 103 participants in cardiovascular risk surveys collected from December 2017 to November 2018. By the end of 103, we identified 55 incidents of severe strokes, one control subject per case was selected by matching for sex, age, community, year of serum storage, and fasting status. Serum total homocysteine levels were measured by Cobas c-311. Results: Compared with control subjects, total (n_206), hemorrhagic (n_106), and ischemic (n_87) strokes had higher geometric mean values of total homocysteine and higher proportions of homocysteine −25.0 μ mol/L. Homocysteine was estimated after adjustment for body mass index, smoking, alcohol intake, hypertension, and other cardiovascular risk factors. The excess risk of total and ischemic strokes did not vary significantly according to sex, age, smoking status, or hypertensive status. Conclusion: High total homocysteine concentrations were associated with the increased risk of total stroke, more specifically ischemic stroke) Capsuloganglionic and frontoparietal infarct (8 each)., among Indian men and women.

Lung malignant growth is one of the most threatening ailments affecting most of the nations in the world, and detection in earlier stages has been a challenge. Early detection can help in saving many lives. This paper shows a methodology that uses a convolutional neural network (CNN) in machine learning for the detection of tumours in the lung. The specificity of the model is desirable and dependable and increasingly productive in contrast to the accuracy shown by conventional neural system frameworks.

Introduction Kidney Disease: Improving Global Outcomes (KDIGO) 2012 recommends cyclical cyclophosphamide plus glucocorticoids (GC) (modified Ponticelli regimen) or calcineurin inhibitors (CNIs) such as tacrolimus (TAC) or cyclosporine as the first-line agents for the management of primary membranous nephropathy (PMN) that is resistant to antiproteinuric therapy with renin-angiotensin system blockers. However, the long-term outcome of patients treated with CNIs is not known. Methods We report the outcomes of 70 patients randomized 1:1 to receive modified Ponticelli regimen or TAC/GC for renin-angiotensin system–resistant PMN who were prospectively followed for 6 years. Patients were followed monthly for 12 months, then quarterly for 12 months, and then every 6 months through the end of 6 years. Results At the end of 6 years, 21 (61.76%) and 9 (28.12%) patients maintained relapse-free remission in modified Ponticelli regimen and TAC/GC groups, respectively (relative risk [RR]: 2.19, 95% confidence interval [CI]: 1.23 to 4.15), and 30 (88.23%) and 17 (53.12%) patients were in remission (including relapses) in modified Ponticelli regimen and TAC/GC groups (RR: 1.66; 95% CI: 1.21 to 2.45), respectively. There was no significant difference in the proportion of patients who had a 40% decline in the estimated glomerular filtration rate (eGFR), death, or end-stage kidney disease between the groups. None of the patients treated with modified Ponticelli regimen reported a solid organ or hematological malignancy. Conclusions To conclude, in the long-term, modified Ponticelli regimen is superior to TAC/GC as first-line therapy for the management of antiproteinuric-resistant PMN., Graphical abstract

Primary dysmenorrhoea is the most common gynaecological disease in menstruating women. It is a symptom complex with cramping lower abdominal pain radiating to the back and legs often accompanied by gastro intestinal and neurological symptoms as well as general malaise. In conventional system of medicine there is no permanent cure for primary dysmenorrhoea. In order to find out a permanent remedy for preventing the recurrence of primary dysmenorrhoea and to evaluate the effect of virechana in reducing the symptoms of primary dysmenorrhoea, this particular study has been under taken. In Ayurveda gynaecological pathologies are explained under the heading of yonirogas. Clinical features of primary dysmenorrhoea are having similiarities with that of udavartha yoni roga. Apanavatavaigunya is the main causative factor for udavartha yoni roga. In the treatment principle of apanavatavaigunyasnigdhavirechana is indicated. An Interventional type of Quasi Experimental study that is before and after study without control was conducted in Govt Ayurveda College Panchakarma Hospital, Poojapura and Govt Ayurveda College Hospital Thiruvanathapuram. One group of thirty patients fulfilling the inclusion criteria and diagnostic criteria were recruited for the study. Intervention administered were rookshana with takra, snehapana with sukumaraghritha, sarvangaabhyanga and avagahasweda with vataharapatra and virechana was done using sukumaraerandamThaila followed by samsarjanakrama based on suddhi obtained after virechana. Subjective parameters were assessed before and after treatment for three consecutive cycles. Pain the major parameter was recorded as per visual analogue scale and associated symptoms using verbal descriptive scale. Pain and associated symptoms were reduced immediately after the treatment which showed treatment was effective in pacifying the disease. Moreover, in the consecutive follow ups symptoms got reduced remarkably which showed treatment had sustained and progressive effectiveness in reducing the symptoms of disease and on statistical evaluation p value was found to be highly significant.

Steganography using image interpolation has created a new research area in multimedia communication. A reversible data concealing in HSI and CMY color models using image interpolation is proposed in this paper. The HSI and CMY image models are interpolated using High Capacity Reversible Steganography (CRS) technique. The median plane of both HSI and CMY color models are selected for secret message bit concealing. The secret message bits are concealed in the cover plane by Exclusive OR (XOR) operation. Since the cover image is recovered after secret message bit retrieval, this finds application in military and medical imaging applications. The experimental results of proposed scheme showed very high embedding capacity of about 16 bits in each pixel location of calculated pixel value, good image quality with a surface similarity index measure (SSIM) value 1 and high PSNR. Also, high robustness is achieved on comparing with the existing works.

The tourism business is the most effective means to strengthen the economic and financial stability of a country. In a developing country like India this business acts as the backbone to improve the level of happiness of its residents. Sustainable tourism provides equal opportunity to every stakeholder to contribute their part in the development of the society as well as the site. The main purpose of the study was to explore the four dimensions of sustainable tourism, which involve “economic sustainability, environmental sustainability, sociocultural sustainability, and institutional sustainability,” and to study their impact on tourist’s satisfaction. This study involves a survey conducted on tourists visiting selected travel destinations from various states in India. The travel destinations selected for the study involved 26 destinations from 8 states of India. The results suggested a positive relationship of three (environmental, sociocultural, and institutional) sustainability dimensions on tourist’s satisfaction. Findings indicate that the dimensions of environment, sociocultural, and institutional sustainability are important for tourist’s satisfaction and should be included for a holistic approach to planning and monitoring sustainable tourism development.

An atypical morphotype of pea (Pisum sativum L.) was identified during the germplasm characterization programme at the Indian Council of Agricultural Research-National Bureau of Plant Genetic Resources, New Delhi. This accession was recognised with prominent and intact funiculus on the seed. To explore the possible role of the extended funiculus, imbibition and physiological behaviour study was carried out on the seeds of selected accession of similar morphology. Compared to checks, the higher water uptake was reported in the seeds with extended funiculus in the exotic collection (EC0414478). Moreover, EC0414478 also showed the highest biomass along with the chlorophyll and Relative Water Content in response to drought at the early vegetative stage. This can be utilized as donor for drought tolerance for developing variety/genetic stocks for early sown peas, especially in rice fallow areas. A more detailed investigation is required to assess the drought tolerance potential of identified germplasm under field conditions.

An attempt was made to investigate the naturally occurring radionuclide 40K body content of the Kakrapar Gujarat Site (India) population by using whole-body counting method. The population comprises occupational workers (regular and contract personnel working at Kakrapar Atomic Power station) and students from various educational institutions. A total of 1056 subjects of different age groups and gender were monitored for 40K body content by using a Standfast-II Whole Body Counting System. The reactor released radionuclides such as 137Cs, 60Co and 131I are not detected in occupational workers of Kakrapar Atomic Power station which indicates that occupational workers are free from radioactive contamination. Based on the activity measurement, an effective dose due to 40K was estimated for different groups of the site population based on the dietary habits, sex and age. Statistical significant correlation was not observed in any of the groups. The annual effective dose due to 40K was found to be in the range of 52–243 μSv y−1 with an average of 133 ± 35 μSv y−1 for the vegetarian group (588 subjects), 60–223 μSv y−1 with an average of 136 ± 35 μSv y−1 for the non-vegetarian group (468 subjects), 52–243 μSv y−1 with an average of 134 ± 35 μSv y−1 for the male group (1007 subjects) and 67–203 μSv y−1 with an average of 128 ± 35 μSv y−1 for the female group (49 subjects), respectively. Among the four age groups of the population studied, an effective dose due to 40K is slightly higher in the age group of 20–29 (161 subjects). The annual effective dose due to 40K reported by UNSCEAR, 1982(3) is 180 μSv y−1.

Internet of Energy (IoE) provides two-way communication for reform of energy utilization between service providers and consumers. To provide secure, efficient, and reliable operations in IoE should be protected from cyber-attacks. Many frameworks have been proposed so far to address security and privacy concerns of these systems. In the vehicle-grid system, we propose a useful mutual authenticated key agreement framework using elliptic curve cryptography and hash function. The aim of the proposed protocol is to maintain secure communication between vehicles and the grid system with reliable computation and communication costs. In the proposed protocol, a vehicular user securely access services that are provided by the grid server. We prove the security of the proposed framework in formal and informal ways. We also show the correctness of the mutual authentication and key agreement of this framework by using Burrows–Abadi–Needham logic. We provide formal security verification of the proposed protocol by using AVISPA tool. Further, we show that this work is better in terms of computation and communication costs compare to other related protocols in the same environment. As a result, the proposed framework is a real life-application in this system.

A quality indicator is a tool that enables the user to quantify the quality of a selected aspect of care by comparing it with a set benchmark. The objective of this study was to review quality indicators for COVID-19 molecular testing at S.S. Institute of Medical Sciences and Research Centre and to compare with the predefined quality indicators in order to improve the performance of the molecular laboratory and to initiate the corrective and preventive measures. Over the period of one year we assessed different quality indicators collected from the molecular laboratory of a tertiary care hospital in Central Karnataka which has processed 36000 throat swabs for the diagnosis of COVID-19. Twelve quality indicators under pre-analytical, analytical and post analytical stage were assessed for the quality by referring it with the select criteria. Missing test request form / specimen (1.36/1000) was the most common inconsistency observed during the assessment of pre-analytical indicators followed by specimen inadequacy (0.194/1000), duplicate specimen referral forms (SRF) generated in ICMR portal (0.277/1000) and color change in the viral transport medium. In analytical phase, non-conformity with QC was seen in 2.83/1000 samples. In post analytical phase, excessive turnaround time was seen in 0.75/1000 samples followed by revised reports due to transcription error (0.38/1000) and duplicate reports (0.13/1000). The results of assessment of quality indicators in the molecular laboratory explicitly supports that laboratory could keep the incidence of errors to the minimum level by following proper corrective and preventive measures. Thus, catering quality laboratory services during devastated COVID pandemic year.

In this study, performance comparison for steel and biaxial geogrid reinforced concrete samples is explored. The basic properties of geosynthetics and concrete ingredients were studied. Formulae and derivations of limiting moment, maximum load, and area of geogrid reinforcements for flexural slab were obtained by limit state design methodology. Three types of textile and one biaxial geogrid were individually employed in concrete specimens (cubes, prisms, and slabs). From the results, the geogrid exhibited good performance with the concrete. The flexural behaviour of the steel-reinforced sample is compared with the geogrid reinforced ones. The flexural test of geogrid reinforced flexural members showed satisfactory results. The load-carrying capacity, deflection, and energy absorption of the geogrid reinforced slab, as compared to the steel-reinforced slab, increased by 25, 6.5, and 23%, respectively. The study demonstrated a sustainable reinforcement of concrete that can be a practical solution to corrosion issues experienced in the construction field.

Purpose Cancer patients and their caregivers are overwhelmed with features of uncertainty, fear, shock, worry, anxiety, sadness, and grief. To add on to their misery, the COVID-19 pandemic has severely afflicted the cancer care delivery. The study was conducted to observe the challenges faced by cancer patients and their caregivers and to formulate strategies for oncological setups to overcome those challenges. Methods After obtaining institutional ethical clearance, a descriptive cross-sectional study was conducted to observe the challenges faced by patients and their caregivers at the level of various domains (physical, logistic, psychological, socioeconomic, and spiritual) who visited the outpatient and inpatient department of cancer pain and palliative care unit. The results were expressed in absolute numbers. Results Major challenges encountered were suffering from physical symptoms like pain, nausea, vomiting, dyspnea (90%), postponement of cancer treatment (80%), fear of contracting COVID infection due to hospital visit (93.5%), lack of accommodation (70%), and lack of spiritual clarity and hope (50%). Conclusions Major challenges faced by patients were in physical and psychological domains, and those by caregivers were in socioeconomic domains and handling physical symptoms of their patients. It is imperative to recognize and be cognizant of the challenges faced by cancer patients and their caregivers. Health care setups should formulate strategies to alleviate these challenges and provide holistic care to cancer patients. These strategies will hold in good stead for future pandemics also.

Gastrointestinal (GI) lipomatosis has been reported in the GI medicine literature, but esophageal lipomatosis has never been reported at all. We report the case of an 86-year-old man with multiple medical comorbidities who was admitted to our hospital for community-acquired pneumonia. Computed tomography angiography of his pulmonary arteries ruled out the possibility of pulmonary embolism but showed a 9-mm circumferential wall thickening in the proximal esophagus measuring −172 HU, which is similar in opacity to the adipose tissue. The patient was asymptomatic and without any current or prior symptoms of dysphagia or odynophagia. The barium esophagogram was unremarkable; there were no strictures, masses, or mucosal abnormalities. There was no evidence of esophageal dilatation on either imaging modality. Esophageal lipomatosis is only described in a few case reports in the radiological literature and, to our knowledge, has not been reported in the GI literature at all. It is important to highlight in the GI literature this as a benign entity that does not cause symptoms and typically does not warrant invasive diagnostic or therapeutic interventions.

An experiment was conducted with 55 rice varieties to assess the genetic diversity by using Mahalanobis D2 Statistical and characterization of genotypes using principal component analysis. All genotypes exhibited a wide and significant variation for 19 traits, by cluster analysis grouped into ten clusters. The maximum genotypes were included in Cluster 6 (16) followed by cluster 4 (10), cluster 3 (8), cluster 2 (7), cluster 5 (5), cluster 8 (4), cluster 1 (2), with 29.09, 18.18, 14.54, 12.72, 9.09, 7.27 and 3.63 proportion respectively, the rest of three clusters had one genotype each. Maximum cluster distance obtained between cluster×constituted by single entry (Pusa Basmati) showed highest inter cluster distance from cluster V (20727.37), VII (18414.79), I (17228.89) and cluster III (17010.24) are having very high inter cluster distance and also by cluster IX from cluster VIII (8852.36), VI (7559.67), I (7444.68) and cluster VII (6666.83) followed by cluster VI from cluster V (6225.95). The lowest inter cluster distance was observed between cluster II and cluster IV III and VI followed by between cluster I and cluster VIII, XI, II, VI and cluster IV. The intra cluster D2 values ranged from Zero (Cluster VII, IX, X) to 2233.91 (Cluster VIII). Contribution of amylose content was highest towards genetic divergence (23.43%) by taking 348 times ranked first followed by days to 50% flowering (23.37%) by 347 times, single plant yield (23.3%) by 346 times. The PCA analysis showed that first eight principal components accounted for about 85.4%.

Heavy metals (HMs) have a very significant clinical role in the pathogenesis, progression and management of cardiovascular diseases (CVDs). The prevalence of CVDs was reported to be higher in critically environmentally HM-polluted (EHMP) steel industrial town Mandi-Gobindgarh (India) for the last more than a decade. To ascertain the role of HMs in the onset of CVDs, the present study was chosen to investigate HMs content in myocardial infarction (MI) patients from EHMP steel industrial town Mandi-Gobindgarh. Total of 110 MI patients along with number- and age-matched healthy volunteers were recruited in the present investigation. The CVDs risk factors estimated in MI patients were overweight (higher body mass index), hypertension (higher systolic and diastolic blood pressures), dyslipidaemia (higher serum cholesterol, triglycerides and lower HDL cholesterol), inflammation (higher-serum C reactive protein and aldosterone) and elevated oxidative stress (higher urinary 8-hydroxydeoxyguanosine). An imbalance of serum electrolyte concentrations including Na (hypernatremia), Ca (hypercalcaemia) and K (hypokalaemia) was also observed in MI patients in which CVDs risk factors were found to correlate positively with serum Na and Ca and negatively with serum K, respectively. Hair HM analysis was used as a bio-indicator for monitoring body HM status from past environmental HM exposure in which CVDs risk factors were observed to correlate positively with higher hair concentrations of Zn, Fe, Mo, Pb, As, Ca and Na and negatively with lower hair concentrations of Cu, Mg, Mn and K in MI patients, respectively. Thus, higher hair concentrations of Zn and Pb indicate their higher environmental exposure and possible cause of higher CVDs risk factors in MI patients from Mandi-Gobindgarh.

Here, we report the fabrication of the p-n hetero-junction devices of p-Zn1-xSbxO/n-Si− grown by utilizing the radio-frequency sputtering technique. The fabricated devices were analyzed for morphological and structural modifications under atomic force microscopy (AFM) and X-Ray diffraction (XRD) techniques. The AFM studies reveal the growth of agglomerated nanoparticles like structures distributed throughout the surfaces of the deposited films, whereas, XRD studies reveal the significant change in crystallite size, lattice parameters, stress and strain with the incorporation of antimony (Sb) in ZnO matrix. The conduction behavior of charge carriers has been systematically analyzed in the fabricated hetero-junction devices. Current–Voltage (I–V) characteristics reveal a trap free space charge limiting current conduction in the fabricated devices. The room temperature mobility of charge carriers for the pristine ZnO, Zn0.97Sb0.03O and Zn0.95Sb0.05O thin film devices are found to be 8.06 × 10–2, 19.0 × 10–2 and 40.69 × 10–2 cm2/Vs, respectively.

This article focuses on understanding watershed development practices in adherence to target 6.6 to protect water-related ecosystems and target 6.b for community participation in water management u...

We have investigated the spin-Hall effect (SHE)-assisted spin transfer torque (STT) switching mechanism in a three-terminal MTJ device developed using p-MTJ (perpendicular magnetic tunnel junction) and heavy metal materials of high atomic number, which possesses large spin–orbit interaction. Using p-MTJ schematic and complementary-metal-oxide-semiconductor (CMOS) logic, we have designed three basic hybrid logic-in-memory structure-based logic gates NOR/OR, NAND/AND, and XNOR /XOR. Then the performances of these hybrid gates are evaluated and the results are compared with the conventional CMOS-based gates in terms of power, delay, power delay product, and device count. From the analysis, it is concluded that SHE-assisted STT MTJ/CMOS logic gates are nonvolatile, consume less power, and occupy a smaller die area as compared to conventional CMOS only logic gates.

BACKGROUND Exposure of various tropical infections and infestations like tuberculosis, filariasis, malaria, anemia, kala-azar and poor sanitation are major health concerns in Bihar and it’s neighboring state. Spleen size increases in several other diseases e.g., metabolism or storage disorder, malignancies and hematological disorders. Determining the normal parameters of spleen is essential for assessment of splenomegaly in routine ultrasonography (USG) or in the computed tomography (CT) scan. In this study, we wanted to estimate the CT based measurement of splenic dimensions in various planes, splenic index (linear dimension) and splenic volume and also to estimate the relationship of splenic index and splenic volume with age, gender and other splenic dimensions. METHODS It was a retrospective study and data was collected from January 2019 to December 2019. A total of 154 cases (including both genders) of age range 18 - 60 years were collected from the vitrea system (Vitrea software used for the 3-D assessment of splenic volume) and clinical data was collected from the medical record section. CT scan data of only those patients were included who had the clinical history of pain in abdomen, abdominal trauma or other diseases not affecting the spleen. Various measurements including splenic length and thickness at hilum and maximum thickness in axial view and height (maximum interpolar and true vertical height) in coronal views were recorded. RESULTS 154 cases including both gender and age range of 18 - 60 years were included in our study. There were 60 males and 94 females. The average age of the male and female patients was 45.93 +/- 15.19 years and 45.87 +/- 15.12 years respectively. The mean splenic dimensions were 9.03 +/- 1.49 cm in length (axial view), 3.69 +/- 0.05 cm thickness at hilum (axial view) and 9.05 +/- 2.23 cm maximum craniocaudal length and 7.9 +/- 2.96 cm true vertical length (coronal view). Mean splenic index and mean splenic volume were 340.30 +/- 107.39 cm3 and 227.02 +/- 62.22 cm3 respectively. There was statistically significant correlation between splenic volume and maximum craniocaudal length (r2 = 0.4848, P = 0.001), maximum axial length (r2 = 0.4765, P < 0.001) and true vertical length (r2 = 0.3142, P = 0.001) with 95 % confidence interval. For all splenic measurements, there was stronger correlation with maximum craniocaudal length followed by maximum axial length. However, there was no statistically significant correlation either of splenic volume with age in either gender (r2 = 0.019, P = 0.043) or splenic index with age in either gender present (r2 = 0.016, P = 0.059). CONCLUSIONS Maximum splenic length both in coronal (craniocaudal) and axial sections are positively and strongly correlated with splenic volume and splenic index but age of the individuals doesn’t show any correlation either with the splenic volume or with splenic index. Hence, a regional reference of splenic parameters was established with a slightly different range of values reported previously. KEY WORDS Splenic Volume, Splenic Index, Computed Tomography

Objectives: Novel coronavirus (COVID-19) pandemic has brought to the fore various challenges faced by pain and palliative care physicians working in oncology setup all over the country. Cancer care has been afflicted a lot during the pandemic, with challenges faced by patients and their caregivers as well as the healthcare workers. The questionnaire based online survey was conducted to explore the personal challenges faced, strategies adopted and to compare the challenges between different oncology setups. Materials and Methods: After obtaining institutional ethical clearance the online questionnaire prepared through Google forms was rolled out to pain and palliative care physicians working all over the country with the help of social media platforms. The results were expressed in absolute number, percentage and comparisons were made with the help of Fisher’s exact test. Results: Maximum challenges faced were the fear of carrying infection back home (91%), the possibility of attending to a COVID positive case in day to day clinical practice because of inadequate space and screening (62%) and limited services provided by NGO’s during pandemic (71%). Strategies commonly adopted were the provision of necessary personal protective equipment (83%), the conduct of educational sessions for the task force members (67%), maximum utilization of available space in the hospital (85%) and stockpiling of necessary medications and equipment (75%). Conclusion: It is the need of the hour to formulate strong and effective strategies to overcome the challenges encountered by pain and palliative care physicians so that we are equipped in the future to deal with any kind of pandemics.

Objectives: The availability of routine care for patients with cancer during the coronavirus disease 2019 (COVID-19) pandemic has become challenging, and the use of telemedicine can be promising in this area. The objective of the study is to evaluate the feasibility of telemedicine-based palliative interventions in cancer patients. Materials and Methods: This retrospective study was conducted in a tertiary care centre with 547 follow-up patients who used palliative medicine teleconsultation services. The following data were retrieved from the records: Patient’s reason for the call, the main barriers to a hospital visit, the assistance given to them by the physician on the call and the patients’ satisfaction with the service on a 4-point scale. The data were analysed using percentages for categorical variables and mean/standard deviation for quantitative variables. Results: Out of the 547 patients, 462 (84.46%) utilised voice calling service, and the major reason for not visiting the hospital were cited to be fear of contracting COVID-19 (37.3%), inability to attend due to health constraints (7.13%) and issues with transportation (48.8%). The majority of the calls (63.62%) calls were regarding uncontrolled symptoms of the primary diseases. A total of 402 (73.49%) patients were very satisfied, and a total of 399 (72.94%) decided to continue to use this medium in the future as well. Conclusion: Telemedicine is a good modality for the assessment of chronic pain and providing symptomatic supportive care in patients with cancer in the COIVD-19 pandemic.

The recent emergence of the COVID-19 pandemic has contributed to the drastic production and use of healthcare and personal protective equipment, leading to the release of a huge quantity of hazardous medical and solid wastes in the environment. Meanwhile, these solid wastes may contribute to the spread of the SARS-CoV-2 viral particles when disposed of without proper treatment and care. Since SARS-CoV-2 could persist on different material surfaces including plastic, steel, paper, cardboard, cloth, and wood, proper management of these hazardous solid wastes has become a challenging task during the COVID-19 pandemic. In this paper, an overview of the consumption of COVID-19-related healthcare and personal protective equipment along with the production of hazardous solid waste is presented. The efficient management of these wastes is necessary to prevent the entering of SARS-CoV-2 in various environmental compartments. Therefore, some preventive measures including the use of biodegradable materials for manufacturing personal protective equipment, minimizing the use of non-biodegradable materials, efficient pre- and-post planning, careful segregation, and disposal are, therefore, proposed for their sustainable management. The findings reported in this paper contribute to tackling the problems associated with hazardous solid waste management, particularly for low- and middle-income countries.

Background Food irradiation is a non-thermal, energy-efficient, non-chemical and physical method of food preservation in which the food is exposed to various ionizing and non-ionizing radiations. It is used to extend the shelf-life of a product by not adversely affecting its nutritive parameters. Scope and approach The present review deals with the current understanding of the effect of ionizing and non-ionizing radiations on different properties of fruits and vegetables. Conclusions Studies have revealed the positive effects of irradiation on physical and nutritional properties of different fruits and vegetables followed by significant reduction in microbial load during storage. Food irradiation can be seen as a promising, safe and well-established technology but still underutilized at large scale. The buying behaviour of consumers poses a significant challenge with innovating food processing technologies like food irradiation. Thus, on the basis of the current review, scientific proofs of irradiated food safety is still needed and work needs to be accomplished to increase technological appeal for food safety. Data collected from existing studies revealed that UV-C has the potential to be proved better than other preservation techniques at an acceptable dose that can be helpful in maintaining the desirable quality, enhancing the nutritive value of product during storage and has the efficacy of eliminating COVID-19.

Background: A study titled ‘Integration of AYUSH (Ayurveda) with National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)’ implemented in India in three districts of three states, namely Bhilwara (Rajasthan), Gaya (Bihar), and Surendranagar (Gujarat) since 2015 for the management of various non-communicable diseases (NCDs) through integrated approach. Objective(s): To evaluate the effect of Ayurveda medication, lifestyle modification, and Yoga in integration with standard care for the management of essential hypertension. Material and methods: A retrospective analysis of the demographic and clinical records available from NPCDCS-AYUSH Integration Project was done. The data of participants with Essential Hypertension (EHTN), aged between 30 and 60 years, who had completed six months integrated management as per the treatment protocol of the NPCDCS-AYUSH Integration project between July 2018 and March 2019 were taken and distributed in two groups based on their intervention. Those advised for lifestyle modification and Yoga in addition to standard care with any of the five medicines/combinations i.e. Amlodipine or Atenolol or Amlodipine + Atenolol or Losartan or Telmisartan were assigned Group I and those who were given Ayurveda medication, lifestyle modification and Yoga in addition to standard care were assigned to Group II. The change in blood pressure was analysed and dose reduction/discontinuation of conventional medications was also observed. Results: Data of 1938 participants who had completed treatment under the NPCDCS program was analysed. At the 6th month, systolic and diastolic blood pressure was significantly reduced (P