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Big Data As A Service Is Used In Today’s Scenario To Handle And Process The Big Amount Of Data Which Are Generated From Different Source Every Day. Since Data Is Stored On The Cloud Platform, The System Could Suffer A Failure And Give Attackers The Opportunity To Launch Various Categories Of Attacks.Manyresearcheshave Been Done In This Domain To Provide Security And Protection To The Data On Cloud. The Blockchain Technology Is A Secure, Distributed And Privacy-Preserving Decentralized Ledger Where The Transactions Are Flexible, Secure,Verifiable And Permanent Way.Here, The Transaction Data Is Encrypted Andkept In A Wrapped Block (I.E., Record) Which Are Spreadthrough The N/W In A Provable And Unabashedmode Across The Entire Network To Enhance Information Security And Data Privacy. In This Paperwe Have Proposed A Framework For An Access Control With Privacy Protection In Bdaas Based On Blockchain Technology. Here Blockchain Technology Is Used Only For Storing The Transaction Log Information Whenever Any Kind Of Event Log Occurred In System.

Objectives: Fine-needle aspiration cytology is a useful diagnostic tool for soft-tissue lesions, which helps in further management of patient. Although, various soft-tissue lesions have preference for particular site of human body, yet usefulness/role of site in cytological diagnosis in the published literature is not very well highlighted. In this study, our aim was to analyze the location of soft-tissue lesions as encountered in cytology practice. Material and Methods: Details of soft-tissue lesions who underwent fine-needle aspiration in a period of 12 months were analyzed. Age, gender, and site of soft-tissue lesion were noted. All the soft-tissue cases were divided into two categories. Group 1 – soft-tissue lesions situated at elbow, forearm, wrist, and hand for upper extremities; and knee, lower leg, ankle, and foot for lower extremities. Group 2 – soft-tissue lesions occurring at other sites. Pearson’s Chi-square test and significance of difference between proportions were analyzed to assess the significance. Results: A total of 928 cases were reported over a period of 12 months. Soft-tissue lesions in Group 1 and Group 2 were 172 and 756 cases, respectively. All the soft-tissue lesions except ganglion cyst (GC) and giant cell tumor (GCT) of tendon sheath are more prevalent in Group 2. There was a statistically significant association (P < 0.001) between cytological diagnosis of soft-tissue lesion and site of lesion. The difference in occurrence of epidermal inclusion cyst, GC, and GCT of tendon sheath between Groups 1 and 2 was found to be statistically significant (P < 0.001). Conclusion: We found significant difference in occurrence of some of the soft-tissue lesion at distal extremity as compared to other location. This may be helpful in arriving at a proper cytological diagnosis.

The entire world is running behind the smart technology to accomplish the daily needs in a smart way such as smart farming, smart irrigation system, smart transportation system, smart medical management, handling of smart home appliances, smart security, etc. Smart technology is the soul property of internet services and accessing data from virtual servers, which raises the alarm of security vulnerability and threats. In recommended system we have focused on application layer security which are concerned with application interface and queue manager for service exchange. As application layer is the closest to end user and produces the big threat to the application platform it motivates us to recommend strong multilevel security system to identify the different activity of handlers and identify their roles to enroute of accessing confidential data services. Subsequently, our work is to assure that every user should have an authentication key with specific privileges to get the desired information. In focus, we see the security management by integrating the Kerberos authentication protocol with honey encryption technique to provide strong multilevel security system.

Background In India, it was reported previously about varying prevalence of asthma and chronic bronchitis among leather tannery workers with moderate to high exposures at the workplace to be significantly associated with asthma. This study intended to estimate the prevalence of asthma, tuberculosis, and chronic bronchitis among leather tannery workers and to identify the risk factors associated with it. Data and Methods The data used in this study were collected through a cross-sectional household survey of 284 male tannery workers in the Jajmau area of Kanpur city in the state of Uttar Pradesh, during January–June 2015. A binary logistic regression analysis was performed to identify the factors associated with respiratory symptoms. Results The prevalence Asthma and Chronic Bronchitis among Tannery workers was 12.3% and 11.6% which is higher as compared to non-tannery workers. The findings revealed that the prevalence of symptoms suggestive of asthma, tuberculosis, and chronic bronchitis among the tannery workers was higher compared to non-tannery workers. The study revealed that long time tannery working harms health, as tannery workers are more likely to be suffering from asthma and chronic bronchitis who worked above 11 years in the tannery (p Conclusion The study concludes that age, education, media exposure, working hours in the tannery, type of work engagement within tannery occupation, and exposure to chemicals are the major risk factors for asthma, tuberculosis, and chronic bronchitis among the male tannery workers. Specific health insurance facilities should be provided, such as the Employee's State Insurance Scheme (ESIS), from the day a person begins work in a tannery.

Lean management is a work philosophy of continuous improvement to achieve a smooth work flow by minimizing all kinds of waste including time, cost and manpower. The concept of lean management started as early as 1980’s and was soon adopted by production industry. However, incorporation of this concept in healthcare has been very gradual and hesitant, though lean heath care has immense potential to improve operational performance. A clinical laboratory, which is essential in practice of evidence-based medicine, can be efficiently managed using lean management concept. Only a few publications in English literature have studied the effect of implementation of lean management in a clinical laboratory. There are certain challenges that a health care manager is likely to face in the implementation of lean management in clinical laboratory especially in developing nations. The present review discusses the implementation of lean management in a clinical laboratory with identification of various steps which require lean thinking.

Background Nutrition has been a low-priority area in Pakistan, with low visibility from the political leadership. Despite various efforts, Pakistan has been reported to have one of the highest prevalences of child and women malnutrition compared to other developing counties. Therefore, this study intends to examine the prevalence and determinants of nutritional status of women and children in Pakistan. Methods The present study uses the Demographic Health Survey (DHS) data from Pakistan 2012–13 (PDHS-3). The nutritional status of women was examined through Body-Mass Index (Underweight, normal, overweight, & obese), and that of children was examined through stunting (severe and moderate), wasting (severe, moderate, overweight), and underweight (severe, moderate, overweight). Descriptive statistics and bivariate analysis have been used along with multinomial logistic regression. Results A higher proportion of children in rural areas were severely stunted (19.6% vs. 12.5%), severe wasted (2.4% vs. 2.2%), and severe underweight (9.4% vs. 6%) than their urban counterparts. A higher proportion of rural women (9.5% vs. 5.5%) were underweight than urban women, whereas a higher proportion of urban women were obese (24.3% vs. 19.0%) than rural women. The odds of severe stunting (OR = 0.24; C.I. = 0.15–0.37), severe underweight (OR = 0.11; C.I. = 0.05–0.22) were lower among children from the richest wealth quintile than their poorest counterparts. The Relative Risk Ratio (RRR) of being overweight (RRR = 3.7; C.I. = 2.47–5.54) and Obese (RRR = 4.35; C.I. = 2.67–7.07) than normal BMI were higher among women from richest wealth quintile than women belonged to poorest wealth quintile. Conclusion This study has highlighted determinants associated with maternal and child nutritional status, whereby the child’s nutritional status was measured by stunting, wasting, and underweight, and BMI measured the mother’s nutritional status. The main risk factors for a child’s poor nutritional status include low household wealth, urban residence, and mother’s educational status. Similarly, the main risk factors for women’s poor nutritional status include increasing the women’s age, educational status, rural residence, and household wealth. Poor households should be provided special attention to improve the nutritional status among women and children in poor households.

This paper presents the comparative analysis of various types of DC-DC converters using DC output voltage and the THD at the output side. The analysis is made in a standalone PV power system having the source and the load as two constants. The analysis basically involves the Buck-Boost Converter, Buck Converter, Boost converter, Zeta converter, and the Cuk converter. The harmonics present in the VSC output and the output of the DC converter at the same input basically decides the power quality produced by using the particular converter.

Background Unacceptably high rate of childhood stunting for decades remained a puzzle in the eastern Indian state of Bihar. Despite various programmatic interventions, nearly half of the under-five children (numerically about 10 million) are still stunted in this resource-constrained state. Data and methods Using four successive rounds of National Family Health Survey (NFHS) data spread over more than two decades and by employing unconditional quantile regressions and counterfactual decomposition (QR-CD), the present study aims to assess effects of various endowments as well as returns to those endowments in disparities in childhood stunting over the period. Results The results show that although the child’s height-for-age Z-scores (HAZ) disparity largely accounted for differing levels of endowments during the earlier decades, in the later periods, inadequate access to the benefits from various development programmes was also found responsible for HAZ disparities. Moreover, effects of endowments and their returns varied across quantiles. We argue that apart from equalizing endowments, ensuring adequate access to different nutrition-centric programmes is essential to lessen the burden of childhood stunting. Conclusion The state must focus on intersectoral convergence of different schemes in the form of state nutrition mission, and, strengthen nutrition-centric policy processes and their political underpinnings to harness better dividend.

Distributed generators (DGs) are connected near load centers and integrated to grid for optimum power system operations. The challenging task for integration of DGs is the proper size and location, due to random character of generation and energy consumption. The objective of the research is to provide the proper size and location of DGs to optimize the voltage profile and reduction in active and reactive power losses. Optimization of distributed generators is performed through fuzzy logic controllers at Ramchandrapura 33/11 kV, 69 bus radial distribution substation, Kota, India. Fuzzy logic controller provides possible solution on selection of distributed generators on the basis of voltage profile of the bus and the impedance of the branch connected DGs at consumer’s end. Forward or backward sweep methodology is used to optimize the load flow analysis for calculation of real and reactive power losses and voltage profile with and without implementation of distributed generators. Proposed approach provides a possible solution for efficient integration of DGs.

This paper aims to track the efficacy of the Test and Treat model of human immunodeficiency virus (HIV) prevention adopted by the government of India, 2015–16, using the last two rounds of National Family Health Survey, providing community-based insights in the testing of HIV prevalence in 2005–06 and 2015–16. The survey collected information from a nationally representative sample of 69,751 men and 124,385 women in 2005–06 and 103,411 men and 121,118 women age 15–49 in 2015–16 respectively. Both descriptive and multivariate techniques have been used. The 'test and treat' model of HIV in India portrays a women-centric effort to ensure HIV testing as part of their ANC, resulting in a substantial increase in ever being tested for HIV. Women who are educated, living in urban areas, and in economically better households are more prone to have ever undergone HIV testing, it is a welcome change given the existing HIV scenario, with a continuously narrowing gender gap in new HIV infections (NFHS-4). Women and men having positive attitude towards stigma and discrimination to people living with HIV (PLHIV) are in better agreement to ever being tested. Further, women and men having knowledge about antiretroviral therapy (ART) are 1.6 times (p

The ageing population, increasing pollution, and lethargic life style of human beings are some of the primary reasons for the growth of healthcare sector. Indian entrepreneurs have observed this growth opportunities and providing healthcare services in multiple ways. However, the literature emphasizes that without integrating information technology in existing healthcare facilities, quality service cannot be rendered to a large number of patients. With this backdrop, the present study is a novel endeavour to explore the role of information technology in Indian healthcare services. It aims to explain the relevance and dimensions of information technology in relation to healthcare services and examines the empirical relationship between identified dimensions and some demographical factors (age, educational qualification, income, and gender).The results of this study can be beneficial to healthcare professionals, service enablers, implementing agencies, and policy makers. Limitations, further research directions and conclusions have been discussed.

Background and Aims: Breast cancer has become the most common cancer in women worldwide. Acute post-operative pain following mastectomy remains a challenge for the anaesthesiologist despite a range of treatment options available. The present study aimed to compare the post-operative analgesic efficacy of pectoral nerve (Pecs) block performed under ultrasound with our standard practice of opioids and non-steroidal anti-inflammatory drugs for mastectomy. Methods: This randomised controlled study was conducted at a tertiary care teaching hospital in India, after obtaining ethical clearance. Fifty adult female patients posted for elective unilateral modified radical mastectomy were divided into two groups as follows: Group I (general anaesthesia only) and Group II (general anaesthesia plus ultrasound-guided Pecs block), each comprising 25 patients. Post-randomisation, patients in Group I received general anaesthesia, while Group II patients received ultrasound-guided Pecs block followed by general anaesthesia after 20 min. The primary outcome was measured as patient-reported pain intensity using Visual Analogue Scale (VAS) at rest. Statistical analysis was performed using Student's t-test and Mann–Whitney U-test. Data were entered into MS Excel spreadsheet and analysis was performed using the Statistical Package for the Social Sciences version 23.0. Results: VAS score was significantly lower in Group II at rest and on abduction post-operatively at all time intervals (P < 0.001). The 24-h tramadol consumption was significantly less in Group II compared to Group I (114.4 ± 4.63 mg vs. 402.88 ± 74.22, P < 0.0001). Conclusion: Pecs block provided excellent post-operative analgesia in the first 24 h.

With the massive expansion of computing technology, the distributed architecture has received wide acceptance for their services. Moreover, IOT technology is used to develop smart applications such as smart security system, health care, smart medicals and smart houses. Due to the vibrant character of access and connectivity in IOT environment, there is mounting of risks and genesis of enormous threat to IOT environment. In proposed system, we have study the fundamental concept behind DASS approach and how to ensure strong authentication services in a distributed environment which will create snag for malicious user. Authentication is particularly a challenging issue in distributed environment due to its multi-sharing concept. DASS works on mutual authentication mechanism when two parties made conversation neither obtain any facts that it could employ to masquerade as the others to an arbiter. Finally, our work is to design the two-level security mechanisms for generating complex security system. In our propose system, work is implemented in two phases, whereas in first phase, we have used authentication process including password and signature for both ends using third party and in second phase data confidentiality using LOKI91 cryptography which is defensive from any differential cryptanalysis and enforcing the secure communication.

Background Injecting drug users (IDUs) are at higher risk of acquiring sexually transmitted infections (STIs) and untreated STIs makes IDUs and their partners vulnerable to HIV infection in India especially in case of existing stigma/discrimination and violence against them. This study aims to interlink the stigma, violence and STI/HIV among IDUs. Methods Data from Integrated biological and behavioural survey (IBBS), 2014–15, conducted among male IDUs in India, has been used in this study. IDUs in IBBS were operationally defined as Men, aged 15 years or more, who has used any psychotropic (addictive/mind altering) substance or drug for recreational or non-medical reasons through injections, at least once in the last 3 months. A total of 3175 interviewed IDUs from Manipur, Nagaland and Maharashtra has been analysed by descriptive and multivariate analysis. Results Portray that Widowed/divorced/separated IDUs, those who were living alone, and those who had initiated injecting drug use below age 18 years were more likely to suffer general stigma, stigma at health facility and physical violence. IDUs those who have started injecting drug within the first year of drug use were more likely to suffered stigma at health facility (35%) and physical violence (32%). Prevalence of STI was higher among those IDUs who were facing the general stigma (19.2%), stigma at health facility (21.4%) and physically beaten (26%) because of their IDUs status. Multivariate analysis revealed that IDUs who were facing general stigma, violence and experienced at least one STI symptom were significantly 1.33 (p Conclusion Existing HIV prevention programmes and service providers should have addressed the existing stigma/discriminations and violence associated with their STI/HIV status among IDUs in India. The critical groups of IDUs needs urgent programme to address the micro and macro level determinants that shape their risk environments. Disclosure No significant relationships.

Background The government of India adopted the Test and Treat model of human immunodeficiency virus (HIV) prevention. This study has made an attempt to explore the effectiveness of the Test and Treat approaches by analyzing the knowledge and testing of HIV among male and female. Methods The study has used last two rounds of National Family Health Survey data, providing community-based insights in the testing of HIV. Descriptive and multivariate techniques have been used to analyze the nationally representative sample of 69,751 men and 124,385 women in 2005–06 and 103,411 men and 121,118 women age 15–49 in 2015–16 respectively. Results Women, who are educated, residing in urban areas, and from better economically households are more prone to have knowledge of place of HIV testing and also have ever undergone HIV testing than their men counterparts. It is a welcome change given the existing HIV scenario, with a continuously narrowing gender gap in new HIV infections. Women and men having positive attitude towards stigma and discrimination to people living with HIV (PLHIV) are in better agreement to ever being tested. Further, women and men having knowledge about antiretroviral therapy (ART) are 1.6 times (p Conclusion This study concluded that HIV testing and treatment has improved considerably over the last decade among women and men. Despite an enhancement in coverage of HIV testing, the existing disparities in HIV testing and treatment require policy instruments with an integrated approach. Government should work in close collaboration with communities/key stakeholders, and efficiently use their resources to provide evidence-based HIV prevention and treatment interventions. Disclosure No significant relationships.

Background Modern Indian society has witnessed rapid socio-cultural transformation where loosening of cultural values is observed at all levels. In the era of transition, traditional norms and values are at change where young male individuals are found to be associated with high-risk multi-partner sexual behaviour. This study intends to determine the changes in magnitude and predictors of such high-risk sexual behaviour among men in India. Methods The sample of 74,369 and 112,122 men aged 15–54 from two rounds of the National Family Health Survey (NFHS) conducted during 2005–2006 (NFHS-3) and 2015–2016 (NFHS-4) has been used. The economic inequalities in the prevalence of high-risk sexual behaviour have been analysed using poor-rich ratio, and concentration index (CI) in addition to adjusted effects of major correlates through multiple logistic-regressions. Results The burden of high-risk sexual behaviours over the last decade remains disproportionately higher among younger, unmarried, urban men and mainly from better economically households. Despite tremendous efforts of the governments in condom promotion as part of HIV/AIDS prevention programme, the improvements in condom use over the last decade, has not yet reached to the desired level. The disparities in high-risk sexual behaviour among men, coming from rich and poor households have been narrowed over the last decade. However, there are few states like Andhra Pradesh, Assam and Orissa where socio-economic inequalities in high-risk sexual behaviour have been increased. The findings also underline an apparent paradox in the relationship between knowledge of HIV/AIDS and indulgence into high-risk sexual behaviour and adopting safe sexual practices. Conclusion It is recommended that all HIV prevention programmes in India should promote the concept of men as the responsible sexual partner. This concept may be promoted among young and unmarried men by reinforcing the shift from violence to respect and projecting the condom as sexual stimuli rather than a means of disease prevention. Disclosure No significant relationships.

Background In India, sexually transmitted infections (STIs) and HIV, take an enormous toll on women’s sexual/reproductive health, yet preventive programmes are lacking as married women’s risks are frequently underestimated. Husbands continue to be the greatest source of STIs including HIV to their wives. Being able to negotiate safe sex is critical to the prevention of HIV/AIDS and other STIs. Therefore, the present study has mainly focused to analyze the women’s attitudes toward safer-sex negotiation if husband has a STI and associated risk of STI/HIV among married women in India. Methods National Family Health Survey (NFHS-4, 2015–16) collected information from a nationally representative sample of 121,118 women age 15–49 years has been analyzed by using descriptive and multivariate techniques. Women were asked that a wife is justified in refusing to have sexual intercourse with her husband if he has a STI. Results Overall 78% of women agree that a wife is justified in refusing to have sex with her husband if he has a STI. A higher proportion of women who were agreed that a wife is justified to negotiate sex were from 25–29 years of age, residing in urban area, those who were higher educated and belongs to highest wealth quintile. Results revealed that the likelihood of a woman holding this belief increased with her autonomy, as measured by participation in household decision making and rejection of wife beating (p Conclusion Our findings suggest that sexual health education programmes may be more effective if they include strategies to address social norms and cultural practices that limit women’s autonomy in society. Disclosure No significant relationships.

Background Breaking the silence on menstruation is essential for women and girls to achieve and exercise their full potential. The study explores the linkages between women empowerment, utilization of hygienic methods during menstruation, and its effect on reproductive tract infections (RTI) among women aged 15–24 years in India. Methods The study used the fourth round of Indian Demographic and Health Survey (NFHS-4), 2015–16. The information regarding the different dimensions of women empowerment has been collected from 122,351 women at the state level. Overall, 42,912 women aged 15–24 years surveyed in the state module were questioned regarding menstruation hygiene methods and different dimensions of women's empowerment. Bivariate and multivariate statistical techniques have been utilized to draw inferences from the data. Results Findings reveal that about 60% of women aged 15–24 utilized hygienic methods during menstruation in India. Owning a bank account, using mobile phones, and household decision-making emerged as significant factors that lead to the adoption of hygienic practices. Lack of menstrual hygiene method was found to result in adverse outcomes like RTI symptoms (genital sore/ulcer and had genital discharge) Conclusions The study concludes that the different dimensions of women empowerment are essential in accelerating the level of practicing hygienic menstruation methods and providing assistance against diverse malpractices and taboos attached to it. The existing approach for the use of menstrual hygiene methods should focus on women's right to decide on their own life and health.

The present research aims to decode the ties between marriages within blood relation (consanguineous marriages) and childhood stunting in India using the latest round of National Family Health Survey, conducted during 2015–16. The present study utilizes data on 192,357 ever-married women age 15–49 years and 14,707 children under age five years from National Family Health Survey, India, 2015–16. To draw inferences from the data, bivariate and multivariable logistic regression has been utilized. A Propensity Score Matching technique has been used to understand the causal linkages between consanguineous marriages and childhood stunting. The prevalence of childhood stunting was higher among male child (40%) compared to the female child (38%) among women who have married their blood relatives. The findings hint’s a significant association between consanguineous marriages and childhood stunting. Multivariable regression and propensity score matching results also show that childhood stunting was significantly higher in consanguineous marriages compared to non-consanguineous marriages in the country. Thus, to reduce childhood stunting among children born to women married to their blood relatives, measures like premarital and pre-conception counselling need to be taken for the individuals opting for consanguineous marriages.

BACKGROUND: India bears the highest burden of tuberculosis (TB), i.e., about one-fourth of the total burden. Of the musculoskeletal TB, spinal TB affects half of the patients. Pharmacological treatment in the form of AKT is the mainstay of treatment of spinal TB, but surgery has its own role to play as an adjunct to AKT in selected cases. Various surgical methods and approaches are mentioned in literature. We studied the efficacy and safety of posterior only approach for decompression and internal fixation in treating thoracic and lumbar spinal TB in adults. MATERIALS AND METHODS: In this prospective randomized control study, we treated twenty patients with thoracic-lumbar TB with single-stage posterior only debridement, decompression, and transpedicular screw fixation. Preoperative and postoperative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), kyphosis angle, visual analog scale (VAS) score and Frankel neurological grading, intraoperative blood loss, and duration of surgery were compared. Correction in kyphosis angle and loss of kyphosis angle at final follow-up was assessed. RESULTS: Sixteen male and four female patients with mean age 37.9 years were treated. Average follow-up was 14.95 months. Thirteen patients had two level involved; seven had single level. The average duration of surgery was 155 min (standard deviation [SD] 23.951). Preoperative average increase in ESR was 39.4 mm/h (SD 9.046) and 24.15 mm/h (SD 3.787) at 3 weeks. Average preoperative CRP was 15.7 mg/L (SD 5.398) and 9.05 mg/L (SD 3.456) at 3 weeks. Average preoperative kyphosis angle was 24.7° (SD 6.822) corrected to an average of 10.1° (SD 3.932) postoperative. At final follow-up, there was a mean loss of 1.4° of kyphosis angle. The average blood loss was 722.75 ml; the average duration of surgery was 228.5 min. The pain VAS dropped significantly from 7.05 (SD 1.468) to 3.9 (SD 1.209). At final follow-up, VAS was 1.7 (SD 0.864). All the patients had good neurological recovery except one. CONCLUSIONS: Single-stage posterior-only procedure is safe and effective for management of thoracolumbar spinal TB.

Airway management in the presence of a large intraoral swelling is always challenging. We report a young boy with a huge ranula occupying the entire oral cavity and protruding from the mouth. Our planned and strategic approach in a resource-limited setting included prior consultation with the ENT surgeon for aspiration of swelling if needed before intubation. Good topical airway anaesthesia followed by gentle videolaryngoscopy resulted in successful airway management.

Plantar heel pain is a common pain condition encountered in clinical practice. The common etiologies include plantar fasciitis, calcaneal spur, calcaneus stress fracture, systemic causes, and trauma. Neurogenic causes, including entrapment at the tarsal tunnel or Baxter's nerve entrapment, can contribute to the heel pain and should not be overlooked. In this case report, we describe a patient with severe heel pain, presenting with overlapping features of plantar fasciitis and neuropathic pain. Magnetic resonance imaging suggested Baxter's nerve entrapment, and a subsequent ultrasound-guided hydrodissection of Baxter's nerve provided long-lasting pain relief.

In current trends, Internet-based portable system is on the huge demand, and in coming future, it will be the most demanded technology among the smart society. It is very difficult to say that entire world will use the smart technology but majority of the developed and developing countries will base on smart work, using smart technology. The people can control their smart devices from remote location and can be causation free with security issues, which is associated with their valuables and other belongings. But all these are not so easy to implement practically to solve security pitfall and other issues to maintain reliable usage of smart devices. Here, in our proposed system, we are providing data security on data layer by using the concept of excessive cryptography and implementing the integrated approach of two cryptography techniques, i.e. TBF-transposition and blowfish cryptography techniques which can make powerful security barrier against the vulnerability and can stop the illegal usage of data. Here first of all, the plain text will go through transposition after that blowfish block cipher technique will be applied on consequential value from transposition outcome. This application will use in highly sensitive security purpose over the smart secure communication as we know that security issues are major challenges among smart devices where the data is more sensitive, and if it will go to wrong hands, there will be loss of human life in some cases. Finally, our work will contribute to integrate the crypto techniques for maintaining more security without breach of services.

Demand side management in smart grid environment with smart meters, renewable energy sources, different kind of consumers etc. is a complex problem. To optimize the problem game theory methodology is used. Game theory approach provide win-win situation between consumers and utilities. Objective of the paper is to find the Nash equilibrium between consumer and utility when utility is supplied through green energy sources. Mathematical modeling of consumption and utilization derived a Nash equilibrium point where consumer and utility both get maximum payoffs. Results shows that energy consumption cost is reduce by applying game theory approach.

Purpose: Treatment-seeking behaviors and economic burden because of health expenditure are widely discussed issues in India, and more so in recent times. The aim of this study is to identify health problems of tannery workers and their treatment-seeking behavior and their health expenditure. Data and Methods: The primary data used in this article were collected through a cross-sectional household survey of 284 male tannery workers in the Jajmau area of Kanpur city in the state of Uttar Pradesh, during January–June 2015. Results: Findings of the study revealed that around 36% of the tannery workers and 42% of non-tannery workers received treatment as outpatients in government/municipal hospital in the first spell of treatment. The secondary source of treatment was pharmacy/drug stores for 30% of the tannery workers and 24% of the non-tannery workers, an indication that a substantial proportion takes treatment without consulting a qualified medical practitioner; it also highlights that almost one-third of the tannery and non-tannery workers visited private health facility despite poor economic condition. It is evident that a substantial proportion of tannery and non-tannery workers are visiting private/non-governmental organization/trust hospital despite their poor financial situation. Conclusion: There is an urgent need to reinstate people's faith in public health facilities by developing professionalism, integrity, and accountability among different levels of health functionaries and frontline workers with the support of credible, transparent, and responsible regulatory environment.

Introduction Violence and mobility are increasingly being recognised as critical risk factors contributing to the spread of HIV and sexually transmitted infections worldwide. The objective of the study is to assess the independent and combined associations of mobility and physical violence with sexual risk behaviours and HIV/STI prevalence among female sex workers (FSWs) in urban Andhra Pradesh, India. Methods A cross-sectional survey the Behavioural Tracking Survey (BTS) –2014 conducted with key populations FSWs (n=2400), in undivided Andhra Pradesh state in India was used here. Bivariate, Chi-square, and Binary logistic regression statistical techniques were used for analysis. Results Approximately 18% of FSWs in urban Andhra Pradesh reported ever experienced physical violence, out of them, 69% experienced physical violence in the past one year and 52% travelled outside for sex work in the past one year. Mobile FSWs were more likely to report physical violence compared to their counterparts (72% vs. 62%, p Conclusion The findings conclude that mobility and violence were independently associated with sociodemographic, risky sexual behaviour and STI/HIV infection. Remarkably, the combined association of mobility and violence posed greater STI/HIV risk than their independent effect. These results indicate that there is a need for the provision of an enabling environment and safe spaces for FSWs who are mobile, to enhance existing efforts to reduce the spread of HIV/AIDS.

Introduction HCV is the most common virus affecting the world’s 16 million injection drug users (IDUs). It is estimated that close to 3 million IDUs are living with HIV and some studies indicate that over 90% of IDUs infected with HIV are also infected with HCV. The main objective of the study is to determine the correlates of HIV, HCV, and HIV/HCV co-infection among injecting drug users in three states of India. Methods Data were obtained from a bio-behavioural survey- Integrated Behavioural and Biological Assessment (2009–10) (n=1977) in the high prevalence of HIV states of India among injecting drug users, Manipur, Maharashtra, and Nagaland. The respondent-driven sampling method was used to collect the eligible respondent. Dependent variables for this study was HIV prevalence, HCV prevalence, and HIV/HCV co-infection. Bivariate and multivariate binary logistics regression were used for the analysis. Results The prevalence of HIV, HCV and HIV/HCV co-infection varies from 15 percent to 45 percent among IDUs. It was reported that there was the significant association between HIV, HCV and HIV/HCV co-infection and socio-demographic and risky injecting behaviour. Further Multivariate analysis shows that these infections were more probable among IDUs,1–5 years of schooling, widowed/separated/divorced, longer duration of drug use and drawing-up drug solution from a common container. Further, Longer duration between first drug use and first injecting drugs use (AOR=2.1, p Conclusion The study concludes that HIV, HCV, and HIV/HCV co-infection were highly prevalent among IDUs because of their risky injecting behaviour. HIV prevention program should also focus on the prevention of coinfection with HIV/HCV.

Introduction Men who have sex with men (MSM) in India are a core risk group for HIV. Heavy alcohol consumption is associated with increased sexual risk-taking behaviours in many cultures, in particular among MSM. This study illustrates the prevalence and correlates of Alcohol use among MSM by their sociodemographic, sexual risk and other characteristics in Andhra Pradesh, India. Methods Data from a Behavioural Tracking Survey 2014 conducted with key populations MSM in undivided Andhra Pradesh state in India was used. The survey was conducted in the three districts (Warangal, Karim Nagar, and Nalgonda). A stratified random sampling method used to select the MSM for the survey. The total 1200 MSM were selected for the study. Descriptive statistics (proportions) and bivariate analysis were used to describe the strength and association of MSM’ socio-demographic/behavioural characteristics and the dependent variable. For the bivariate analysis, the p-value was calculated by using the chi-square test. Binary logistics regression was used to determine the factor associated with ever consumption of alcohol among MSM. Results In Andhra Pradesh, of the 1200 MSM who were interviewed, around 69% of MSM had ever used alcohol. Approximately 31 percent MSM reported that they had experienced discrimination at public places and 11.2 percent of said that they are mentally depressed. There is the significant association between ever used of alcohol and sociodemographic, sexual risk and other characteristic (p Conclusions HIV-related prevention Programme among MSM in India should also focus on alcohol use and related problems in multilevel context.

Introduction Injecting Drug Users in India are at the duel risk of needle sharing and risky sexual behaviour, becoming more vulnerable to STI and HIV. Although injecting drug users constitute a risk group in themselves, there is also an overlap between drug addiction and those involved in sex work. Individuals who fall into both categories are therefore particularly vulnerable to HIV and are perhaps doubly stigmatised. Thus, studying the interface of injecting drug use and risky sexual behaviour is important to curb the pace of STI/HIV epidemic among IDUs. Methods Data were obtained from two rounds of integrated biological and behavioural assessments (IBBA) conducted in 2006–07 and 2009–10 where 2,075 IDUs in round-1 and 1977 in round-2 were sampled. Data from both rounds were pooled. Bivariate and multivariate analysis were used for the study. Results Data from 4052 IDUs from 6 districts of Manipur, Nagaland, and Maharashtra, were analysed. The mean age of IDUs in round-1 was 26 years and 29 years in round-2. The majority of the IDUs were illiterate, unmarried, employed in two consecutive rounds. IDUs’s duration between first drug use to first injecting drug use ≥2 years were 14 times higher during round-2. HIV and any STI symptoms in the round-2 show the declining pattern. IDUs having the main regular partner and shared needle/syringe were less likely to consistency in condom use with different type of female partners across the rounds. Logistics regression analysis of experienced any STI symptom in the past 1 year indicate that IDUs, literate (AOR=1.878, p Conclusions Harm reduction and needle exchange program should also focus on the risky behaviour of injecting drug users through peer-based approach.

Background and Aim: Psoriasis is an immunologically mediated chronic inflammatory skin disease. Altered platelets in psoriasis patients may have a role in predisposition to cardiovascular complications. The aim of this study is to study the platelet count (PLT) and indices in patients with psoriasis and to correlate platelet indices with Disease Area Severity Index score. Materials and Methods: The study was done in a tertiary care hospital. It was performed on 42 psoriasis patients (study group) and twenty healthy controls. Lifestyle factors, PLTs, and platelet indices were compared between psoriasis cases and controls. Correlation between these parameters and Psoriasis Area Severity Index (PASI) score was also studied in psoriasis patients. Chi-square test was applied to compare the categorical data from patients and controls. Spearman's rank correlation was used to correlate lifestyle factors with the severity of disease. Pearson's correlation coefficient was used to find the correlation between PASI and platelet parameters. Results: We found that PASI correlated with smoking (P = 0.042) and levels of psychological stress (P = 0.002). PLT (P = 0.043) and plateletcrit (P = 0.043) were significantly higher in the study group, whereas platelet distribution width (PDW) (P = 0.05) was lower in the study group. We found a significant correlation of PASI with PDW (P = 0.031), mean platelet volume (P = 0.050). and PLCR (0.028). Conclusion: Lifestyle factors such as smoking and levels of psychological stress play a significant role in psoriasis disease severity. There is a correlation of PLT and platelet indices with the pathogenesis and manifestation of disease.

Tetrology of Fallot's (TOF) is the most common cause of cyanotic congenital heart disease, and accounts for 10% of all congenital heart diseases. Right to left shunting and hyperviscosity of blood predisposes these patients to brain abscess. Perioperative management of these patients with uncorrected TOF for noncardiac surgery is a challenge for the anesthesiologists owing to the long-term effects of hypoxia and decreased pulmonary blood flow, resulting in considerable modification of the physiology and neurological complications. We are hereby reporting the anaesthetic management of an 8 year old child with uncorrected TOF presenting with multiple brain abscesses who underwent craniotomy with uneventful recovery.

Ramesh Soundararajan and Kuldeep Singh. 2016. Winning on HR Analytics: Leveraging Data for Competitive Advantage. SAGE Publications, Pp 244, ₹425, ISBN: 9789386042415.

Electrical drives are hefty tool have major contribution in most of the industrial and nonindustrial motion control applications. The electrical drive connected through a flexible shaft with a load can be modeled as a two inertia motor system. The proposed work deals with an easy-to-tune controller design strategy for two inertia motor system based on coefficient diagram method. Three speed control strategies namely PID, PID-P and I-PD have been designed based on coefficient diagram method. Pole placement techniques based state space controller has also been designed. The design principles and analytical tuning methods of the controllers are presented. All the four control strategies are compared with each other. The simulation results show the stability, reliability and robustness of the proposed controller, in comparison to PID and state space controllers used commonly.

Reverse logistics (RL), which refers to the distribution activities involved in product returns, has recently received much attention because many companies are using it as a strategic tool to serve their customers and can generate good revenue. An efficient reverse distribution structure may lead to a significant return on investment as well as a significantly increased competitiveness in the market. Therefore, analysis of the interaction among the major barriers, which hinder or prevent the application of reverse logistics, is a crucial issue. Existing models have focused on diagnosing these barriers independently. As a result, the holistic view in understanding the barriers is not accounted for. This paper utilizes the Interpretive Structural Modeling (ISM) methodology to understand the mutual influences among the barriers so that those driving barriers, which can aggravate few more barriers and those independent barriers, which are most influenced by driving barriers, are identified.