Search

Various attempts are being carried out for automating the applications of house. Automation itself has many limitations with respect to cost and accuracy. In this context, virtual assistant plays a key role. In this work, we are planning a smart virtual assistant to illustrate the implementation of various voice commands and perform various tasks or services to an individual. The functions of these tasks or services are based on user input and mainly depends on the ability to access information from an enormous online sources (such as weather report, time and playing music for us etc). Raspberry Pi is used as the key hardware for implementing this project and its essential primary input considered is user’s voice. Whenever the information is fetched through the voice commands, it will produce the appropriate output. In-addition to this, some extra modules have been used for implementing voice to text conversions and controlling home appliances. This type of application will be more helpful for the persons who are partially or completely blind, by giving them access to Wikipedia, Calculator, Email and Music. From the results, we could attain the features like knowing the time and date, switching on and off of the lights, making a call to a registered mobile number and start/stop of fan. Finally, it can act as a main source of information and entertainment for visually impaired persons.

Background : Heart failure with preserved ejection fraction (HFpEF) is the fastest growing form of HF and is associated with high morbidity and mortality. The primary chronic symptom in HFpEF is exercise intolerance, associated with reduced quality of life (QoL). Emerging evidence implicates left atrial (LA) dysfunction as an important pathophysiologic mechanism. Here we extend prior observations by relating LA dysfunction to peak oxygen uptake (peak VO2), physical function (distance walked in six minutes, 6MWD) and QoL (Kansas City Cardiomyopathy Questionnaire, KCCQ). Methods : We compared 75 older, obese, HFpEF patients to 53 healthy age-matched controls. LA strain was assessed by magnetic resonance cine imaging using feature tracking. LA function was defined according to its three distinct phases, with the LA serving as a reservoir during systole, as a conduit during early diastole, and as a booster pump at the end of diastole. LA stiffness index was calculated as the ratio of early mitral inflow velocity-to-early annular tissue velocity (E/e’, by Doppler ultrasound) and LA reservoir strain. Results : HFpEF had decreased reservoir strain (16.4±4.4% vs. 18.2±3.5%, p=0.018), lower conduit strain (7.7±3.3% vs. 9.1±3.4%, p=0.028), and increased stiffness index (0.86±0.39 vs. 0.53±0.18, p Conclusion : LA stiffness is independently associated with impaired exercise tolerance and QoL and may be an important therapeutic target in obese HFpEF. Registration : NCT00959660

Nd3+ doped TiO2 and undoped TiO2 were produced by the complication free hydro thermal synthesis process. The doping has reduced the bandgap of the tailored material compared to its purest form. The UV–vis spectroscopy and Photo Fluorescence spectroscopy are employed to study the characteristics of the synthesized material and the results drawn from the characterization vouch that the gap between the CB and VB has minimized. The absorption peak calculated using the spectro-flourometer asserts that Nd3+ doped TiO2 can be utilized well in the UV-A and UV-B regions along with the visible region of the solar light. This expansion in the area will enhance the efficiency of the solar cells.

With the increasing number of telecom providers and services, churn prediction gains tremendous interest in the current decade. The prediction models based on machine learning are the greatest fortune for customer retention campaigns as they pave the way to predict potential churners. Though the prediction is accurate by applying the machine learning classifiers, there are huge concerns imputing complexity in the prediction process. In most cases, the churn prediction becomes complex due to the telecom data’s inconsistency, sparsity, and hugeness. An effective churn prediction model is proposed to tackle such kinds of issues, . The proposed churn prediction is based on the optimized deep learning classifier built in the spark architecture to handle the hugeness of the telecom data. The optimized deep learning classifier is established through the optimal training of the deep convolutional neural network (DCNN) using the proposed Firefly-Spider Optimization (FSO), which is the integration of Spider Monkey Optimization (SMO) and firefly optimization algorithm (FA). The proposed prediction model’s effectiveness is analyzed using the Churn in Telecom’s dataset based on the performance measures. The proposed prediction model acquired the maximal dice coefficient, accuracy, and Jaccard coefficient of 94.61%, 94.76%, and 94.80%.

Introduction: The positive result of the treatment regimen mainly depends on the adherence of the patients towards the instruction given by the physician and termed as the noncompliance or incomplete adherence to treatment. Methods: The present study aimed to descriptively analyze and identify the reasons that increasing the incomplete adherence for psychotropic therapy based on information retrieved from the patient and their relatives in Institute of Mental Hospital (IMH), Chennai.90 participants were interrogated using a structured questioner by purposive-sampling procedure after receiving their informed consent. Results: The present study showed the involvement of different factors such as pre – mature stopping the drug regimen (28.8%), buying lesser quantity of the drugs than prescribed by physicians (24.4%), and irregular drug consuming (23.3%). The present study importance of creating the awareness regarding the optimal follow- ups and emphasized the advices regarding the changing the mental health service regimes. The patients and relatives should be given the psychological based awareness for reducing the noncompliance on the psychotropic regimes.

Brown-Sequard syndrome is an incomplete spinal cord lesion characterized by hemisection injury of the cord. We present a case of pregnancy, delivery and postpartum course following this rare neurological condition. A 42-year-old woman presented with past history of idiopathic hemicord myelitis leading to right sided hemiplegia with decreased contralateral sensation of pain and temperature, consistent with Brown-Sequard syndrome, which was treated with steroids and Therapeutic Plasma Exchange. Thereafter, she had near-complete motor recovery and complete sensory recovery over the next 3months. Three years later, she presented to us at 37+2 weeks of gestation with residual hemiparesis with motor power grade of 4/5 in right upper and lower limbs. She underwent Caesarean section for breech presentation, which was done under general anaesthesia in view of prior spinal cord lesion. She was discharged for follow-up in Neurology outpatient clinic and physical rehabilitation. At follow up after 12 months of delivery, she had complete motor and sensory recovery. Management of spinal cord lesions in pregnancy and delivery requires specialist multidisciplinary care due to risk of medical and obstetric complications. This case demonstrates a rare scenario of a primigravida at term gestation with residual deficits of a past spinal cord lesion. Keywords: Brown-Sequard syndrome, Case report, Hemicord myelitis, Hemiparesis, Pregnancy.

Software testing is a valuable and time-consuming activity that aims to improve the software quality. Due to its significance, combinatorial testing focuses on fault identification by the interaction of small amount of input factors. But, deep testing is not sufficient due to time or resources availability. To select the optimal test cases with least computation time, Hybrid Multi Criteria Particle Swarm and Ranked Firefly Metaheuristic Optimization(HMCPW-RFMO) technique are introduced. Initially, the population of the test cases is randomly initialized. Then the fitness is calculated by the pairwise coverage, execution cost, fault detection capability and average execution frequency. RFM approach starts with ‘n’ fireflies. The light intensity of each firefly gets initialized.If the light intensity of one firefly is minor than the other one, it moves near the brighter one. Next, the rank is given to the firefly based on their light intensity. Lastly, the high ranked firefly is chosen as a global best solution.The result reveals that HMCPW-RFMO technique improves the software quality.

Radiograph plays the major role of diagnosis, treatment and surgery in the Dental field. There are many types of Intra and extra oral radiographs in which Dental Panoramic Radiograph helps in visualising the full view of the oral cavity. Pulpitis is the dental diseases caused due to the inflammation of the dental pulp from untreated caries, trauma or multiple restorations which leads to Apical Periodontitis. To predict the severity of pulp vitality pulp inflammation has to be evaluated. Radiographs helps the dentist in diagnosing the extent of tooth decay and inflammation. An automatic diagnostic model is proposed using robust algorithms to diagnose pulpits. Dental Panoramic Radiograph is used in the proposed research to diagnose the pulpitis and to classify the normal teeth from the pulpitis. The collected images are pre-processed using Histogram Equalization and filtered using Gaussian and Median filters. Modified K-Means algorithm is applied to segment the bony and teeth area from the oral cavity area. Integral Histogram of Gradients with Discrete Wavelet Transform feature extraction techniques and Multi-Layer Neural Network Classifier is proposed to achieve the accuracy of 91.09% which can be used as an assistive tool by the dentist to diagnose pulpitis.

Post COVID-19 sequelae are a constellation of symptoms often reported after recovering from COVID-19. There is a need to better understand the clinical spectrum and long-term course of this clinical entity. The aim of this study is to describe the clinical features and risk factors of post COVID-19 sequelae in the North Indian population. This prospective observational study was conducted at a tertiary healthcare centre in Northern India between October 2020 and February 2021. Patients aged >18 years with laboratory-confirmed COVID-19 were recruited after at least two weeks of diagnosis, and details were captured. A total of 1234 patients were recruited and followed up for a median duration of 91 days (IQR: 45-181 days). Among them, 495 (40.1%) had persistent symptoms post-discharge or recovery. In 223 (18.1%) patients, the symptoms resolved within four weeks; 150 (12.1%) patients had symptoms till 12 weeks, and 122 (9.9%) patients had symptoms beyond 12 weeks of diagnosis/symptom-onset of COVID-19. Most common symptoms included myalgia (10.9%), fatigue (5.5%), shortness of breath (6.1%), cough (2.1%), insomnia (1.4%), mood disturbances (0.48%) and anxiety (0.6%). Patients who were hospitalized were more likely to report fatigue as a feature of long COVID. Hypothyroidism (OR: 4.13, 95% CI: 2.2-7.6, p-value < 0.001) and hypoxia (SpO2 ≤ 93%) (OR: 1.7, 95% CI: 1.1-2.4, p-value 0.012) were identified as risk factors for long COVID sequelae. In conclusion, long COVID symptoms were common (22%), and 9.9% had the post COVID-19 syndrome. Myalgias, fatigue and dyspnoea were common symptoms. Patients with hypothyroidism and hypoxia during acute illness were at higher risk of long COVID.

Nowadays, major impact of researchers’ toevaluate the intensity of anxiety between Anxiety Disorder with the Patient, and theirefficacy of enlightened muscle relaxation and disorder of anxiety to the patients, intensity of anxiety amongst mental health center describe the anxiety disorder patients with correlated with the social cum geographical values. Hypothesis, nominated socio demographic variables around the difference between posttest level and pretestanxiety of disorder patients. Nearby is an important association among intensity of unease. In tangible background: Inaccurate Roy’s variation classical was cast-off for this study. Methodology: A Pre-experimental and progressive muscle and decreasetherapy by used as a posttest. 40 anxiety ailment patients were confident by successive sampling process.Hypothesis formulated between. Pre and posttest was shown progressive muscle relaxation on forty minutes trainingto the anxiety patients on 5 consecutive days. In our results suggested anxiety patients output of reduced levels of anxiety disorder on the 6th day of posttest. To evaluate the Reformist muscle slackening is non-invasive, cost effective, non – pharmacological complementary therapy to between disorder patients with anxiety and diminish anxiety. Also posttest levels varied with age, academic qualification, anxiety, social value and alcoholic addiction and its duration.

The postpartum period, also known as the puerperium and the "fourth trimester," refers to the time after delivery when maternal physiologic changes related to pregnancy return to the non-pregnant state. From the day of delivery to six-eight weeks after delivery is termed as the fourth trimester. A few days after birth, the mother’s breast will swell with milk and become tender swollen, firm, and painful breasts. If the breasts are severely engorged, they are very swollen, hard, shiny, warm, and slightly lumpy to the touch. This is called engorgement. Breast care is necessary postnatally since this will avoid complications such as mastitis – infection caused due to trapped milk. Post natal education on breast care is much needed for all mothers. Mastitis, for example, is an infection that causes inflammation of the breast tissue. It’s most commonly caused by milk trapped in the breast. Untreated mastitis can lead to complications such as a collection of pus in the clogged milk ducts. Often, even well educated women seem to know very less about breast care post childbirth. Hence the present study was framed to assess on how much knowledge the new mothers possess about breast care (sample size: 60). From the results obtained we conclude that all the new mothers post the awareness rendered about breast care acquired good or adequate knowledge regarding the same when compared to pre-test. This emphasizes the need for public health interventions and awareness programs to educate as well as minimize the related complications.

Accurate diagnosis with imaging and treatment planning are key in the execution of any surgical procedure.Panoramic radiography has been routinely used in dentistry to assist in clinical diagnosis, treatment procedure but it has limitations such as overlapping of anatomical areas which are of interest in the diagnosis. The invention of computed tomography (CT) had revolutionized the digital imaging though their limitations like 2-dimensional imaging features such as distortion, magnification, and superimposition were present. Cone beam computed tomography (CBCT) is rapidly gaining Interest in the medical fraternity. it was designed with the aim to offset some of the limitations of panoramic and CT imaging .CBCT ever since its inception, it had been routinely used in dentistry for its numerous advantages such as 3-dimensional and multi-planar views. Linear, Curved and angular measurements could be performed along with area and volume calculation and density. All with less radiation exposure compared to conventional computed tomography (CT) scans. In this case series three cases of jaw cysts have been presented with varied radiographic features and the role of CBCT in these cases flooding us with enormous radiographic informations which paved the way for precise surgical management.

Background: The aging begun with the birth and observed as a continuous change in different phases of life due to weakening of the body function with respect to the time and quantity. Aging also causes a continuous stress on the adaptive response and indirectly enhance the disease conditions. The adaptive childhood degree is more important to the man for his well- being and happiness. But, due to stress increasing, a strong decreased adoptability led to the increase of the inner withdrawal,bitterness, weariness of life and depression are the results of failure to adapt. Methodology: The geriatrics eventually lead to depressed state and lack a prominentsupport. The current study aimed to analyze efficiency of the Reminiscence based therapy in aged and depressed people. The present work was based on quasi experimental nonequivalent control group designin selected senior citizen home, Chennai.Of 64 samples, experimental group (31)and control group (33) using Non-probability, purposive- sampling technique and measured based on Yesavage geriatric depression scale. Results: Continuously, twenty-one days, two session per day (morning and evening) the experimental group were demonstrated with Reminiscence therapy. Reminiscence therapy characteristically having non-pharmacological psychosocial intervention for depression remedy. The results showed the significant difference in degree of depression between the two groups. Conclusion: As conclusion, the study showed that reminiscence therapy had tremendously decreases the depression and elevated the well-being feeling in elder people.

Background: Fluoxetine (FLX) represents the antidepressant of choice for the management of pediatric mood-related illnesses. Accumulating preclinical evidence suggests that ontogenic FLX exposure leads to deregulated affect-related phenotypes in adulthood. Mood-related symptomatology constitutes a risk-factor for various neurological disorders, including Alzheimer’s disease (AD), making it possible for juvenile FLX history to exacerbate the development of neurodegenerative diseases. Objective: Because AD is characterized by the pathological accumulation of hyperphosphorylated tau, which can result from impaired function of protein degradation pathways, such as autophagy and the ubiquitin-proteasome system (UPS), we evaluated the long-term effects of adolescent FLX exposure on these pathways, using mice as a model system. Methods: We subjected C57BL/6 adolescent male mice to FLX (20 mg/kg/day) from postnatal day (PD) 35 to PD49. Twenty-one days after the last FLX injection (i.e., adulthood; PD70), mice were euthanized and, using immunoblotting analysis, we evaluated protein markers of autophagy (Beclin-1, LC3-II, p62) and the UPS (K48-pUb), as well as AD-associated forms of phosphorylated tau, within the hippocampus and prefrontal cortex. Results: Juvenile FLX pre-exposure mediated long-term changes in the expression of protein markers (increased LC3-II and decreased p62) that is consistent with autophagy activation, particularly in the prefrontal cortex. Furthermore, FLX history induced persistent accumulation of AD-associated variants of tau in both the hippocampus and prefrontal cortex Conclusion: Adolescent FLX treatment may have enduring effects in the neuronal protein degradation machinery, which could adversely influence clearance of abnormal proteins, potentially predisposing individuals to developing AD in later life.

Here, we report on the fabrication of Nb-doped SrTiO3 (SrTi0.90Nb0.10O3) thin films of various thicknesses (50 to 375 nm) using pulsed laser deposition. X-ray diffraction studies reveal that the SrTi0.90Nb0.10O3 films are polycrystalline in nature with texturing along the (110) direction. XPS studies show that Nb replaces Ti confirming B-site doping. We demonstrate that the band gap of the SrTi0.90Nb0.10O3 thin films exhibit a blue shift of ~ 340 meV with decrease in thickness from 375 to 50 nm. Impedance spectroscopic studies at various temperatures (30–150 °C) suggested that the dc conductivity of the films increases with increase in temperature suggesting a thermal activation of niobium donor in the films.

Background: The main aim of this study is to create an awareness regarding the side effects. The primary care givers and the patients should understand that if side effects are there also they do not stop the medicines. The psychotic medicines are very essential for the treatment and it should be effectively managed and given only after the consultation with the physician. So a basic knowledge regarding drugs, side effects and the immediate management of these side effects are essential. Methodology: Present study was conducted on quantitative approach for analyzing knowledge management of the psychotic drugs among the care takers based on the conceptual frame work, Imogene King's Goal attainment theory. The research design selected for the present study was one group pretest and posttest design (01 - X - 02). The sample of the study comprised of 40 primary care givers who are staying with the mentally ill clients in the selected mental health centers. Results and Discussion: Among the total 40 sample of primary care givers out of 14 (35%) in 29-38 years of age and 60% were females. 50% having secondary education. Hindu (65%). 52.5% of people worked in private job. Only 55% informed that their income was higher than 10000, 55% from urban area. While in the post -test, 1(2.5%) of the subject had average knowledge, 19(47.5%) subject had good knowledge and 20(50%) subject had excellent knowledge regarding the side effects of antipsychotics. The comparison between the mean difference in pre-test and post test score was 8.2. The calculated ' value was 13.71, whereas the tabulated’t’ value was 2.02, shows that the calculated ’t’ value was much higher than the tabulated ’t’ value. Conclusion: It shows that the planned teaching was effective in significant improving the knowledge of primary care givers of psychiatric patient regarding side effects of typical antipsychotics, so the null hypothesis H0 is rejected and the research hypothesis H1 is accepted.

Over the past two decades, traditional antimicrobial strategies have lost efficacy due to a rapid rise in antibiotic resistance and limited success in developing new antibiotics. Rather than relying on therapeutics solely targeting the bacterial pathogen, therapies are emerging that simultaneously focus on host responses. Here, we describe the most promising 'host-informed therapies' (HITs) in two categories: those that aid patients with fully functional immune systems, and those that aid patients with perturbed immune processes. Using Streptococcus pneumoniae, the leading cause of bacterial pneumonia, as a case study, we show HITs as an attractive option for supplementing infection management. However, to broaden their applicability and design new strategies, targeted research and clinical trials will be essential.

Background Chaos has implications for child health that may extend to childhood obesity. Yet, results from studies describing associations between chaos and childhood obesity are mixed. New approaches to studying the environments of young children may help to clarify chaos-obesity relationships. Methods We conducted a concurrent mixed methods analysis of quantitative and qualitative data describing home and neighborhood chaos among a diverse cohort of 283 caregiver-toddlers dyads from Ohio. We examined the underlying structure of environmental and household chaos using exploratory factor analysis then sought to validate the structure using qualitative field notes. We generated total scores for factors of chaos and described their distributions overall and according to cohort characteristics. Additionally, we conducted a thematic content analysis of brief ethnographies to provide preliminary construct validity for our indicators of chaos. Results Dyads varied according to household composition, income, education, and race/ethnicity. We found evidence for a multi-factor structure for chaos, which included disorganization and neighborhood noise. Household disorganization scores ranged from 0 to 7.3 and were on average 2.1 (SD = 1.8). Neighborhood noise scores ranged from 0 to 4 and were on average 1.1 (SD = 1.1). Both disorganization and neighborhood noise were associated with indicators of socioeconomic disadvantage, such as lower educational attainment and household income. Qualitative data from households with high and low scores on the two identified factors were aligned in ways that were supportive of construct validity and further contextualized the social and material environments in which chaos occurred. Conclusions Chaos represents a complex construct with implications spanning various disciplines, including childhood obesity research. Previous studies suggest challenges associated with measuring chaos may limit the conclusions that can be drawn about which aspect of chaos (if any) matter most of early childhood weight development. We advance the literature by demonstrating chaos may be comprised of conceptually distinct subdomains. Future childhood obesity prevention research may benefit from more contemporary measure of chaos, such as those relying on direct observations that account for a multifaceted underlying structure.

Purpose: The Mahabharata by Vyasa and the Iliad by Homer both have a surfeit of Heroes. The two great heroes are Karna from the Mahabharata and Achilles from the Iliad. They have a few things in common as their lives are heavily influenced by fate. As fate is inescapable, they confronted their death head-on. The figures of Karna and Achilles stand out dramatically in both Indian and Greek mythology respectively casting everyone else in the gloom, thus making both the masterpieces incomplete without these heroes. Though these spartan heroes were invincible due to their origin, they lay their lives in Kurukshetra and Trojan wars respectively. They decided to be glorious despite knowing the fact that they would die in the battle. Few characters in the ancient literature have been drawn with such perfect skill and insight into human nature as Maharathi Karna, a character who has never been truly understood, has been continually misinterpreted despite the completeness, candor, and clarity of the amazing Epic in providing us with specifics of his existence. The most important aspect of his life narrative which is often overlooked or glossed over by modern writers which has far-reaching implications is that Karna was born out of wedlock and so cast away at birth. His adroitness and the values he lived and loved for standing him in good stead for a hero. Design / Methodology/Approach: The paper is prepared by accumulating secondary data from educational websites and written articles. The study shall be carried out with the use of Research Journals, Scholarly Books, Doctoral Theses, and websites. This qualitative research is carried out by studying and interpreting the existing knowledge on the subject using the keywords “Karna”, “Epic”, “Tragic flaw”, “Battle”, “Loyalty” which are accessible in online articles, peer-reviewed journals, publications and a variety of related portals. Findings/Result: Karna's entire life was spent trying to figure out who he was and to find an answer to the same. Karna's life also shows us how life is full of unrelenting choices; the options being limited. Friendship with someone who has aided at times of need and to whom one has sworn lifelong loyalty and friendship is admirable, but there must be a fine line drawn between this duty and other, more important responsibilities. Karna is, without a doubt, a figure who, in Aristotelian terminology, possesses the classical features of a tragic hero, as well as a figure with a great deal of literary potential. Originality/Value: This paper attempts to make a sincere study of Karna as a tragic hero under classical examples of Aristotle's ‘Hamartia’ where a hero wants to ‘Triumph’ but while doing so he commits an intentional error and ends up achieving exactly the opposite with disastrous results. The story of the life of Karna is pre-eminently great nevertheless fate and destiny played an unwarranted and calamitous game facilitating the reader of the Epic to identify himself or herself with the Tragic Hero. Paper Type: Exploratory research paper.

Now a days, International Agency for Research on Cancer (IARC) in December 2020 states that Breast cancer is the number one common cancer around the world and it has surpassed lung cancer occurrence. WHO and IARC in 2020 have decided to join hands in eradicating or minimising deaths caused due to breast cancer by creating an awareness of breast health, early diagnosis and providing quality care to everyone in need. The occurrence of cancer has not gone down but doubled in the last 20 years. It was estimated to be 10 million in 2000 but has raised to an alarming 19.3 million in 2020. Currently it is projected that 20% of the world population will develop cancer. It is an utmost significant fact that Breast among other cancers can be cured if detected well in advance. The present study aimed to analyse the awareness about self- examination to find out the breast cancer among the female. The participants were patients and their relatives in a government hospital (n=100). Only, 24% of them had showed adequate knowledge on self-examination and 51% having known about it but, not on practicing. The remaining, 25% of even did not know about such a method. This study showed that the important of creating awareness among women, especially, on the illiterates.

Introduction: The study is conducted to determine the functional and structural differences between NTG and POAG, to assess the rate of conversion of NTG into POAG and its early intervention. Materials and Methods: It is a hospital based prospective, cross-sectional study of 56 NTG and 56 POAG patients. History was taken and comprehensive ophthalmic examination with glaucoma work up was done. Results: Majority of the patients belonged to the age group between 51 and 60 years i.e. 48.2% in NTG and 62.5% in POAG. Majority of the NTG patients i.e. 33 (58.9%) were females while 41(73.2%) were males in POAG. 40% of NTG patients had systemic association like bronchial asthma, diabetes, hypertension, ischemic heart disease and migraine. There was no significant difference in CDR between two groups. Inferior & temporal neuroretinal rim thinning was more common in NTG. While bipolar thinning & superior rim thinning was more common in POAG. There is significantly more thinning of RNFL in POAG than NTG. The mean deviation (MD) & pattern standard deviation (PSD) in visual fields between NTG & POAG showed no significant difference. Whereas the field loss was near centre of fixation in NTG group compared to POAG which was diffuse. Conclusion: These differences between NTG and POAG suggest that the pathogenesis of NTG includes IOP and IOP independent risk factors, while IOP is the main risk factor in POAG. The parameters assessed determine the risk and progression of NTG to POAG. Keywords: NTG, OPTIC DISC CDR, NRR, POAG, RNFL.

Background Diabetic hand infections are associated with significant morbidity and disability. Amputations cause permanent disability, and multiple surgical procedures lead to morbidity. Diabetic foot infections have been well-studied but literature on hand infections is limited. We undertook a retrospective study of patients with diabetic hand infections operated at our center to study the factors at presentation with significant association with amputation and number of surgical procedures. Patients and Methods Demographic data of 51 patients was collected. The six parameters, namely, duration of diabetes, “onset of symptoms to presentation” interval, presence of comorbidities, HbA1c level, random blood sugar (RBS) levels at admission, and culture characteristics were selected for statistical analysis to find a relationship with the two outcome variables: number of procedures done and need for amputation. Results On bivariate analysis, Gram-negative infection was found to have a significant relationship with the need for multiple of procedures (p = 0.014). The mean difference between the “onset of symptoms to presentation” interval between the amputation/non-amputation groups (2.9 days, p = 0.04) and the multiple procedures/non-multiple procedure groups (4.4 days, p = 0.02) was found to be statistically significant. Presence of comorbidities, long duration of diabetes, HbA1c, and RBS levels at admission did not show any statistically significant association with the two outcome variables studied. Conclusion In the present study, we found that infection with Gram-negative organisms is significantly related to the need for multiple surgical procedures. A delay in presentation can influence the risk of amputation as well as multiple procedures. Institution of early appropriate care is important to get a good outcome.

Objective BCG can improve the response to vaccines directed against viral infections, and also, BCG vaccination reduces all-cause mortality, most likely by protecting against unrelated infections. However, the effect of BCG vaccination on dendritic cell (DC) subsets is not well characterized. Methods We investigated the impact of BCG vaccination on the frequencies of DC subsets and type I and III interferons (IFNs) using whole blood and plasma samples in a group of elderly individuals (age 60-80 years) at one-month post-vaccination as part of our clinical study to examine the effect of BCG on COVID-19. Results Our results demonstrate that BCG vaccination induced enhanced frequencies of plasmacytoid DC (pDC) and myeloid DC (mDC). BCG vaccination also induced diminished plasma levels of type I IFNs, IFNα and IFNβ but increased levels of type III IFNs, IL-28A and IL-29. Conclusions Thus, BCG vaccination was associated with enhanced DC subsets and IL-28A/IL-29 in elderly individuals, suggesting its ability to induce non-specific innate immune responses.

Ayurvedic medicines are being used increasingly to fight or prevent common diseases. Udhara vayuhara churna is a polyherbal formulation containing Piper longum (Piperceae) Zingiber officinalis (Zingiberaceae), Elettaria cardamom (Zingiberaceae), Plumbago zeylanica (Plumbaginaceae), Carum carvi (Umbelliferae), Acorus calamus (Araceae) and Embilica officinalis (Euphorbiaceae). Methanolic and aqueous extracts of Udhara vayuhara churna were screened for their antimicrobial activity against Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Aspergillus niger and Candida albicans. The results of antimicrobial activity of aqueous and methanolic extracts of the Udhara vayuhara churna indicated that methanolic extract inhibited the growth of one or more test pathogens than aqueous extract. Udhara vayuhara churna formulation extracts showed a broad spectrum of antimicrobial activity. Phytochemical investigation revealed the presence of tannins, saponins, alkaloids, glycosides, flavonoids and essential oils. This may be due to the multifunctional effect of all the seven plant ingredients of Udhara Vayuhara churn.

The present study is aimed to identify the effect of gratitude as an adaptive regulating mechanism from suicidal ideation (SI) for veterans with mental illness (study 1) and student veterans with posttraumatic stress disorder (PTSD) symptoms (study 2) in the United States. Descriptive statistics and regression analyses were used to examine sociodemographic characteristics and relationships between gratitude and SI. Our study 1 consisted of 156 veterans with mental illness. The mean age for study 1 was 37.85. Our study 2 consisted of 232 student veterans with PTSD symptoms. The mean age for study 2 was 28.43. Higher gratitude scores in study 1 and study 2 were significantly associated with lower SI scores after adjusting for demographics and depression. This study partially supports the association between gratitude and SI in veterans with mental illness. Based on the results from this study, gratitude interventions may be effective in reducing SI when working with veterans with mental illness.

Ovarian teratomas are the most common germ cell tumors and are classified as mature, immature and malignant.Mature cystic teratomas, also called dermoid cysts, are the most common germ cell tumour, accounting for upto 70% of benign ovarian masses in the reproductive years and 20% in postmenopausal women.Immature ovarian teratoma affects primarily younger patients and mature cystic teratomas seen in reproductive age groups. This case report provides a brief summary of the clinicopathological features of the ovarian teratomas such as, the immature teratoma which being a rare tumour was diagnosed in a 15 year old adolescent girl, managed surgically by laparotomy followed by chemotherapy, and the other case of a benign mature cystic teratoma in an elderly 52 year old postmenopausal woman, managed surgically although benign cystic teratomas are rare in the postmenopausal age group.

Although antimicrobials are the cornerstone of neonatal sepsis management, adjunctive therapies are required to improve outcomes. The aim of our study was to evaluate the effect of exchange transfusion (ET) on mortality (primary outcome) in neonatal sepsis, as well as on immunoglobulin, complement and neutrophil levels and assess its complications (secondary outcomes). Databases searched include PubMed, NCBI, Google Scholar, CINHAL, Ovid and Scopus. Randomized controlled trials (RCTs), controlled observational studies (COSs) and uncontrolled observational studies (UOSs) reporting mortality data from using ET in neonatal sepsis were included. Studies with additional interventions, non-septic ET indications and populations aged > 28 days were excluded. Data extracted include demographics, features of study, sepsis and ET, as well as mortality rates, immunological and laboratory changes and complications. Data was meta-analysed and displayed using forest plots. The meta-analysis of 14 studies (3 RCTs, 11 COSs) revealed a mortality benefit in septic neonates who underwent ET-RR 0.72 (CI 0.61–0.86, p = 0.01) and a significant increase in pooled immunological parameters (immunoglobulin, complement levels) (SMD 1.13, [0.25, 2.02], p = 0.02) and neutrophil levels (SMD 1.07 [0.04, 2.11], p = 0.03) compared to controls. The descriptive analysis of 9 UOSs revealed thrombocytopenia as the most frequently reported complication (n = 48). Moderate–high risk of bias was largely due to inadequate sample sizes and follow-up durations. Conclusion: Currently, the use of ET in neonatal sepsis is not directly recommended due to low certainty of evidence, inadequate power and moderate–high risk of bias and heterogeneity. Trial registration: PROSPERO (CRD42020176629) ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=176629 )

OBJECTIVES Nursing professionals form the first line of contact and are in a unique place to provide appropriate oral advice to patients. The study assessed the effectiveness of oral health training program for nurses. DESIGN The effectiveness of the program was evaluated by a pre and post questionnaire assessment on 50 nurses. RESULTS Nursing professionals had a significant increase (p

Background Andrographis paniculata (Burm.f.) Nees has been well-researched for its immunomodulatory effects. Objective(s) To investigate the immunomodulatory effects of standardized A. paniculata extract (SAPE) in healthy adults. Materials and methods The study was an open-label, single-centre study conducted for 30 days. Thirty participants with absolute lymphocyte counts of 1000–4000 cells/mm3 were enrolled and were instructed to ingest 200 mg of SAPE daily for 30 days. The participants visited the clinic at baseline, and days 3, 7, and 30. Immune cells such as NK cell (CD3-CD16+CD56+), T cells (CD3+), T helper cells (CD3+CD4+), T cytotoxic cells (CD3+CD8+) were measured using flow cytometry. Serum cytokines that include interferon gamma (IFN-γ), interleukin-4 (IL-4), interleukin-2 (IL-2), interleukin-12 (IL-12), and tumor necrosis factor alpha (TNF-α) were measured using ELISA. The SAPE used in this study was a standardized proprietary extract (AP-Bio®/KalmCold®) developed from the leaf extracts of A. paniculata. Results SAPE increased T cells, T helper cells and significantly increased IFN-γ, IL-4, and decreased IL-2 at day 30. A subgroup analysis of participants with absolute lymphocyte counts of 1000–3000 cells/mm3 indicated that there is a significant increase in the T cells, T helper cells at day 7 and 30 and significant increase in IFN-γ, IL-4 and decrease in IL-2 at day 30. There was no treatment related adverse effects following SAPE intake for 30 days. Conclusion Supplementation of SAPE resulted in immunomodulatory effects evidenced by its effects on immune cells and cytokines and it was found to be safe and tolerable.

Aims Since 1968, heart transplantation has become the definitive treatment for patients with end-stage heart failure. We aimed to summarize our experience in heart transplantation at Stanford University since the first transplantation performed over 50 years ago. Methods and results From 6 January 1968 to 30 November 2020, 2671 patients presented to Stanford University for heart transplantation, of which 1958 were adult heart transplantations. Descriptive analyses were performed for patients in 1968–95 (n = 639). Stabilized inverse probability weighting was applied to compare patients in 1996–2006 (n = 356) vs. 2007–19 (n = 515). Follow-up data were updated through 2020. The primary endpoint was all-cause mortality. Prior to weighting, recipients in 2007–19 vs. those in 1996–2006 were older and had heavier burden of chronic diseases. After the application of stabilized inverse probability weighting, the distance organ travelled increased from 84.2 ± 111.1 miles to 159.3 ± 169.9 miles from 1996–2006 to 2007–19. Total allograft ischaemia time also increased over time (199.6 ± 52.7 vs. 225.3 ± 50.0 min). Patients in 2007–19 showed superior survival than those in 1996–2006 with a median survival of 12.1 vs. 11.1 years. Conclusion In this half-century retrospective descriptive study from one of the largest heart transplant programmes in the USA, long-term survival after heart transplantation has improved over time despite increased recipient and donor age, worsening comorbidities, increased technical complexity, and prolonged total allograft ischaemia time. Further investigation is warranted to delineate factors associated with the excellent outcomes observed in this study.

A female patient of 25 years of age came to OPD of Arogyam Health Care on 15\5\2076 B.S. with complaints of want issue since 3 years. She had not achieved her menses since 3 months and her menstruation was irregular since menarche. Methodology: Detailed history with all necessary clinical, physical examination and laboratory investigations were carried out. No gross physical and chemical abnormality was found. All the laboratory investigations (including USG and hormonal analysis) were found to be normal. So the treatment was planned according to the symptoms. Diagnosis made on the basis on the basis of presenting complaints was Vandhaytwa. Patient was treated with Arogyavardhi vati, Dashmoolarista, Kanchanar guggulu, Matra vasti and nasya with Mahanarayan taila, Bandhyaharan churna and Aswagandha churna. Patient was kept on follow. Result: Patient had got her menstruation regularly with normal duration while taking medicine. Also the amount of flow was also improved and the patient got conceived. Keywords: Vandhyatwa, Vasti, Nasya, Arogyavardhini vati, Dashmoolarishta

A Christain women aged 29 yrs visited OPD of NIA demmed to be university on (24/04/2021) with the complaint of Amenorhoea 9 months (G2P1A0L1) associated with itching on upper and lower extremities since 3 month. She also complaints of swelling in her leg, which resembles us towards the pedal edema. She also complaints of severe hyperacidity, chest pain on and off, occasional headache since 10 days in the first visit. Her L.M.P.-15/08/2020, E.D.D: 22/05/21 and P.O.G.-35 weeks 6 days. Diagnostic assessment was done by USG and Laboratory investigations and Clinical examination. The findings of USG revealed Single live intrauterine pregnancy of 34 weeks 6 days with mild IUGR, mild oligohydramnios. Loop of cord around neck, Normal fetoplacental blood flow pattern. Placenta was Grade III With calcified. In Ayurvedic classics lakshanas of Garbhakshaya, Garbhasosha, Vatabhipanna Garbha are near to signs and symptoms of IUGR. Ksheera vasti was planned along with it oral medications Avipatikar Churna, Pittantak Churna , Kapardika Bhasma, Shankha Bhasma and Gokshura Churna in combination, Phalasarpi, Swarna Vasanta malati rasa and Punarnavastak Kwatha. Patient got relief from Severe oedema. The other complaints like severe hyperacidity, Headache were relieved. Then after her B.P. was 110/70 throughout. Fetal movements were good after Vasti procedure due to which patient felt well relaxed. Patient got her labor pain and delivered on 8th May with the weight 2.2kg male child at Government Hospital. The delivery was uneventful. After ksheeravasti there was increase in weight of the baby around 118gms. Just in six days Vasti provided such a enormous change. Keywords: IUGR, Pregnancy Induced hypertension, Ksheera Vasti, Punarnavastak kwatha, Gokshura Churna

Coated and laminated fabrics intended for out-door application suffer from property degradation due to hazardous environmental factors, which results in poor durability and limited shelf-life. In t...

In this study, an attempt has been made to develop an automated muscle fatigue detection system using cyclostationary based geometric features of surface electromyography (sEMG) signals. For this purpose, signals are acquired from fifty-eight healthy volunteers under dynamic muscle fatiguing contractions. The sEMG signals are preprocessed and the epochs of signals under nonfatigue and fatigue conditions are considered for the analysis. A computationally effective Fast Fourier transform based accumulation algorithm is adapted to compute the spectral correlation density coefficients. The boundary of spectral density coefficients in the complex plane is obtained using alpha shape method. The geometric features, namely, perimeter, area, circularity, bending energy, eccentricity and inertia are extracted from the shape and the machine learning models based on multilayer perceptron (MLP) and extreme learning machine (ELM) are developed using these biomarkers. The results show that the cyclostationarity increases in fatigue condition. All the extracted features are found to have significant difference in the two conditions. It is found that the ELM model based on prominent features classifies the sEMG signals with a maximum accuracy of 94.09% and F-score of 93.75%. Therefore, the proposed approach appears to be useful for analysing the fatiguing contractions in neuromuscular conditions.

CVD is the one of the main reason of death compared to other diseases globally. Nearly 17.9 million people die every year because of this disease. WORLD HEALTH ORGANIZATION predicts that the deaths will increases by 24.5 million in 2030. Heart diseases involve diseases of the guts and blood vessels/artery. Four out of five deaths are occurs due to heart attacks. Nearly One-third of those deaths occur under the age of 70. The most of the people died in developing countries only. India is also comes under this category. For heart disease identification by examining the symptoms we need vascular specialists, which are very finite number in developing nations. Also, the medical tests/procedures for heart diseases are that’s a bit steep; At times out of the range for patient’s family. Early recognition is important in these type of diseases with low cost forecasting. In these days ML algorithms are used for forecasting of many other applications. These algorithms can be used for forecasting of CVD. The timely prediction of the heart diseases helped in taking decisions about the patients which resulted reduction of their risks. This project proposes a prediction model to predict whether patient have a heart disease or not by using entered symptoms in webform and to give an awareness on heart disease and some useful tips on heart disease.

Eisenmenger's syndrome(ES) refers to the development of pulmonary hypertension and reversal of shunt in patients with long standing congenital heart defects with left-to-right shunt. The cardiovascular changes in pregnancy, labour and puerperium add to the morbidity and mortality associated with this high-risk cardiac condition. Fetal outcome is also poor with increased incidence of stillbirth and prematurity. We report 3 such patients of ES with severe pulmonary hypertension. The rst patient presented in advanced pregnancy with unbooked status. She had a spontaneous preterm precipitate labour before cardiac optimization and delivered vaginally with successful outcome. The second patient presented to us in early third trimester with right heart failure, which was stabilized after caesarean section. The third patient also had a good outcome, despite additional complications of pulmonary edema. Neonatal outcome in our case series was marred by complications like fetal growth restriction, prematurity, perinatal asphyxia and one neonatal death. A multidisciplinary team approach involving obstetric medicine specialists, cardiologists, anaesthesiologists and neonatologists, is required for peripartum care of these patients to improve the maternal and perinatal outcomes.

Background Older patients who are hospitalized for acute decompensated heart failure have high rates of physical frailty, poor quality of life, delayed recovery, and frequent rehospitaliza...

Background: The importance of treating dyslipidemias based on cardiovascular risk factors is highlighted by the National Cholesterol Education Program guidelines. Dyslipidemia is dened as a disorder of lipoprotein metabolism. In India ,the prevalence of dyslipidemia was found to be higher in males 38.7% than in females which is 23.3%. The hypercholesterolemia and hyper triglyceridemia are more prominent in the age group 31-40 years in both the age groups. objective: The main objective of the study is to assess clinical pharmacist education on evaluation of prevalence, monitoring and lipid control in dyslipidemic patients in a tertiary care hospital.method: The present study is a prospective observational study. Participants were randomly assigned to the experimental group and non-experimental group. Data were collected by using proforma and questionnaire after admission to the hospital and at the time of follow up in out-patient department. result: A total of 150 patients were recruited and 147 patients completed the study. Three patients in the non-experimental group dropped out of the study because they moved to another hospital. In the present study, we have analyzed 147 dyslipidemic patients. Among them in the experimental group, there were 75 participants. The patients aged above 18 years were included in the study. Prevalence of dyslipidemia was found to be highest in the patients aged above 61 years (56%) and least in the patients aged between 20-30 years (1%). All the Pvalues (p

Tuberculosis (TB) is a global public health problem and is a leading cause of death, especially in underdeveloped and developing countries. In the majority of instances, renal tuberculosis is caused by the secondary hematogenous transmission of mycobacterium from pulmonary lesions to the renal cortex either during the initial TB infection or reactivation/endogenous reinfection of an old tuberculous focus. Upper tract urothelial carcinoma is a relatively rare kind of genitourinary malignancy and the majority of them take their origin from the urothelial lining epithelium. The co-occurrence of both renal tuberculosis and upper tract urothelial carcinoma is a rare presentation, and several theories have been proposed to demonstrate the etiological relationship between these two conditions. Here we reported a case of co-existing renal tuberculosis and urothelial carcinoma in a 54-year-old female with a remote history of treated pulmonary tuberculosis and also discussed the possible etiological root causes for their co-occurrence.

Hypertriglyceridemia is an independent risk factor of coronary heart disease (as established through various previously conducted studies) and it's rising incidence is creating a need for the immediate attention of it's management. Instead of focusing on the controversies involving the toxicity caused due to the long-term use of statin therapy in conventional mode of treatment, opting for a safer alternative system of treatment seems important. Five cases of diagnosed HTG, with triglyceride levels above 200 were treated with homoeopathic medicine - Fucus vesiculosus, in mother tincture form. The primary outcome measure was to evaluate the reduction in the blood triglyceride levels. All the five cases showed a reduction in triglyceride levels to normal range within 4 months of starting the treatment with the Fucus vesiculosus mother tincture. Also, it was observed that the borderline cholesterol levels and high LDL levels in 2 cases were found to reduce to normal. Treatment involving Fucus vesiculosus in cases diagnosed with HTG showed significant reduction in triglyceride levels along with other parameters of lipid profile. Further authentication of results with significant sample sizes may be taken up., Highlights • Traditional use of Fucus vesiculosus in vogue in many countries and basing on previous in-vitro and in-vivo studies, it has been used in the treatment of patients diagnosed with Hypertriglyceridemia. • A case series of 5 treated cases of Hypertriglyceridemia with the homoeopathic remedy “Fucus vesiculosus” with positive outcome has been reported. • Further large sample studies and RCTs are warranted.

Background: Vesiculobullous lesions are the major contribution of various skin disorders. They are primary morphological representation of various pathological stimuli. Histopathology plays major role in the initial phase of diagnosis helps in further evaluation to identify the underlying etiology. Aim and Objective: To study the prevalence of various morphological types of vesiculobullous skin lesions in different age groups in a rural area. Methodology: A Retrospective study conducted from May 2018 to May 2021, at Katuri Medical College & Hospital, Guntur. A study of vesiculobullous lesions of the skin biopsies of 90 cases was received to the department of pathology, at Katuri Medical College & Hospital, for 3 years. Complete clinical and relevant history was recorded. The specimens were routinely processed and H&E-stained slides were studied. Results: Out of 454 skin biopsies, of which 90 cases (19.8%) were diagnosed as vesiculobullous lesions by histopathologically. Pemphigous vulgaris comprised 38 cases (42.23%) followed by Bullous pemphigoid 24 cases (26.67%), in clinically suspected Autoimmune Bullous Disorders. Conclusion: Clinical examination has greater significance in diagnosis still histopathological examination plays vital role, helps to arrive at a definitive diagnosis in the majority of vesiculobullous disorders. Skin biopsy is inexpensive, carried out as OPD procedure with minimal discomfort to the patient.

The purpose of this study was to evaluate the effect of the piezoelectric device on intraoperative hemorrhage control during surgery and the quality of life of patients after endodontic microsurgery.A total of 40 patients were randomly divided into the piezo group (n = 20) and the control group (n = 20). In the piezo group, after flap reflection, bone cutting, granulation tissue removal, and root-end resection were performed using the piezoelectric surgical device and surgical carbide burs, and curettes were used in the control group. The quality of life of patients was evaluated daily for 1 week postsurgery for limitations of oral and general functions, pain, and other symptoms. Limitation of functions and other symptoms were recorded by a modified version of the patient's perception questionnaire using a 5-point Likert scale for mouth opening, chewing, speaking, sleeping, daily routine, missed work, swelling, nausea, and bad taste/breath, and the visual analog scale was adopted for pain. Hemorrhage control during surgery was independently assessed by the surgeon and 2 blinded observers and recorded as 0 (no hemorrhage control), 1 (intermittent control), and 2 (complete control). The chi-square test was used to assess hemorrhage control. For variables related to function and symptoms other than pain and analgesics taken, the Fisher exact test was used. For the assessment of pain between the 2 groups, the Mann-Whitney U test was used.For parameters of quality of life, the piezo group showed significantly less swelling on the first, second, and third days and pain on the first and second days compared with the control group (P.05). Analgesics taken were also significantly less in the piezo group (P.05). In the piezo group, complete hemorrhage control was achieved in 10 patients, and in the control group, it was achieved only in 1 patient (P.05).Piezoelectric surgery resulted in improved quality of life of patients in the first week postsurgery with lower levels of pain and swelling as well as the number of analgesics taken and better hemorrhage control during surgery.

The study investigated the impact of mandatory work from home due COVID-19 on personal and professional lives of people with different demographics. Statistical analysis of an online survey data (N=237) reveals that the impact on personal life dimensions—healthy lifestyle, family bonding, and physical stress—does not differ across people within different demographics. However, impact on emotional well-being is sensitive to gender and industry groups. Family size is also an important demographic factor impacted upon personal life dimensions. Professional dimensions related to work productivity and adopting new ways of working does not differ across demographics except for occupational role. Dimensions related to new skill development and change in professional attitude does differ across occupational roles. The study concludes by stating future research directions for mandatory work from home situation, and prescription to post-COVID-19 strategies for organizations. Copyright © 2021, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited.

The paper is regarding the automating of driver’s license testing system and updating the results to the person through website and conjointly through registered email. Usually, while driving test the person who requested for license have to be compelled to show his driving skills ahead of the authorities. The person need to operate the vehicle according to several rules. If he fails, he/she are knocked out and have to appear for the driving test next time. The Officials observe mistakes of the applicant physically. The proposed solution for the automation of existing manual test method permits the elimination of intervention of humans and improves the accuracy of driving test thereby going paperless, with Driving Skill Evaluation System. In the proposed system, we have a tendency of taking data from sensor as inputs from hardware simulator and stores into the database. In this system, the person participating in the test are obsereved by sensors. Therefore weather the person is qualified or not is informed to the applicant as well as the authorities. Gradual increase in number of road hazards are due to less practice in driving and illegal driving license given to the unskilled drivers by taking bribe. To beat this drawback, automated driving license test will be advantageous. This solution is introduced for ensuring the quality in approving in license to enhance safety.

Aim: The study aims to detect the effective channel in cognitive radio network at low SNR using an innovative algorithm based on matched filter detection and compared it with energy detection. Materials and methods: The spectrum sensing based on novel matched filter detection with 10 samples is compared with the energy detection by varying the SNR conditions, using MATLAB. Results: The probability of detection of the matched filter is high at low SNR(-30db) then compared to the probability of detection of energy detection at low SNR(-10db) and the significance level is 0.002, i.e., (P

Aim: The aim of the study is to solve the problem of mutual interference among SUs based on Stackelberg game theory. Materials and Methods: This paper proposes an innovative algorithm based on Stackelberg game theory to reduce interference among secondary users. MATLAB software is used to implement the algorithm. The algorithm is tested to find Signal to Interference noise ratio (SINR) of about 10 secondary users in CRN using novel Stackelberg game theory and compared with the SINR of Secondary users using Cournot game theory. Results: The Statistical analysis is done by performing Independent Variable test and T-test using SPSS software. The mean SINR is maximum for Stackelberg game theory (100.9±1 mdb), and the least SINR (13.11±1mdb) is seen for Cournot game theory. Conclusion: The algorithm based on Stackelberg game theory shows maximum SINR than the Cournot game theory. Since SINR is maximum Signal quality will be high and Interference will be less among the users due to which the network performance is improved.

Hypertension is the most prevalent modifiable factor for the development of heart failure. However, the optimal blood pressure (BP) target for preventing heart failure remains uncertain. The SPRINT (Systolic BP Intervention Trial) was a large, randomized open-label trial (n=9361 participants) that showed the superiority of a systolic BP target of P =0.81). A separate analysis demonstrated that the reduction in ADHF events in the intensive treatment group in SPRINT was not due to the differential use of diuretics between the 2 treatment groups. Although intensive BP treatment resulted in a lower cardiovascular disease event rate, this was not significantly associated with changes in left ventricular mass, function, or fibrosis, as assessed in SPRINT HEART, an ancillary study to SPRINT. Intensive BP treatment, however, significantly attenuated increases in carotid-femoral pulse wave velocity. Overall, these data highlight the importance of preventing ADHF in high cardiovascular risk hypertensive patients by optimal BP reduction as tested in SPRINT.

Cerebral vascular malformations constitute one of the key abnormalities in children with PHACE syndrome, which is characterized by Plaque like cutaneous hemangiomas, Posterior fossa abnormalities, arterial Cerebrovascular and Eye abnormalities, with or without Sternal clefts (PHACES when sternal clefts are present), and associated midline anomalies. Both moyamoya arteriopathy and intracranial aneurysms have been reported in children with this syndrome. Herein, we report the successful treatment of a growing left posterior-communicating artery aneurysm arising from an aberrant left internal carotid artery (LICA) with balloon assisted coiling (BAC) in a child with PHACE syndrome. We circumvented the limitations posed by the narrow caliber of the proximal LICA, by successfully navigating a coiling microcatheter from the basilar artery into the LICA via a persistent trigeminal artery. BAC was then achieved using a Scepter Mini balloon microcatheter for aneurysm neck remodelling.