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Background: Growing frequency and higher intensity of the various types of a natural disaster such as landslides, earthquakes, flood, cloudburst, forest fire, and lightning have been recognized to cause major losses of human life, property, resources, and environment in India. Disaster situation cannot be prevented, but the losses due to disaster can be minimized with adequate preparedness. Adolescents can share learning to their friends, families, and communities so that it is essential to meet their educational need to optimize the quality of life. Objective: The objective of this study was to assess the level of knowledge regarding disaster preparedness and develop information booklet. Materials and Methods: A cross-sectional survey method with quantitative approach was undertaken for the study. A total of 200 school-going adolescents were conveniently recruited from selected schools. Results: The statistical finding shows that the overall mean awareness score of the study participants was 11.29 ± 3.26. Percentage distribution of knowledge level shows that majority (73.5%) of adolescents had moderately adequate knowledge and 23.5% of them had inadequate knowledge, whereas only 3% of adolescents had adequate knowledge on disaster preparedness. Conclusion: Findings of the study conclude that the knowledge of adolescents regarding disaster preparedness was moderately adequate. Therefore, the study brought a need for further teaching of the adolescents regarding disaster preparedness.

SummaryBackground It is not clear whether percutaneous coronary intervention (PCI) is as effective and safe as coronary artery bypass grafting (CABG) for left main coronary artery disease. We aimed to perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) that compared PCI and CABG in left main coronary disease. Methods We searched PubMed, EMBASE, Cochrane, Scopus and relevant references for RCTs (inception through, November 20, 2016 without language restrictions) and performed meta-analysis using random-effects model. All-cause mortality, myocardial infarction, revascularization rate, stroke, and major adverse cardiac and cerebrovascular events (MACCE) were the measured outcomes. Results Six RCTs with a total population of 4700 were analyzed. There was no difference in all-cause mortality at 30-day, one-year, and five-year (1.8% vs 1.1%; OR 0.60; 95% CI: 0.26-1.39; P=.23; I2=9%) follow-up between PCI and CABG. CABG group had less myocardial infarction (MI) at five-year follow-up than PCI (5% vs 2.5%; OR 2.04; CI: 1.30-3.19; P=.002; I2=1%). Revascularization rate favored CABG in one-year (8.6% vs 4.5%; OR 2; CI: 1.46-2.73; P

Background: It is not clear whether the addition of ezetimibe to statin will result in greater reduction in coronary plaque. We aimed to perform a meta-analysis of all RCTs and prospective studies that evaluated role of dual lipid lowering strategy in atherosclerosis regression. Methods: We searched PubMed, EMBASE, Cochrane CENTRAL, Scopus and relevant references for RCTs (inception through December 20, 2015 without language restrictions) and performed meta-analysis using random effects model. Percentage change in plaque volume, change in lumen volume, percentage change in LDL, HDL and hsCRP were measured outcomes. Results: 3 RCTs and 1 prospective non randomized trial with a total population of 554 comprising mostly of Asian population were analyzed. Statin plus ezetimibe showed significantly greater lowering of plaque volume than statin alone (WMD -4.13 mm3 range of -7.42 mm3 to 0.85 mm3; p=0.01); there was a trend towards increased lumen volume in combination group without statistical significance [WMD 1.90 mm3 (-4.61 to 8.40); p=0.57).Combination strategy resulted in significantly higher percentage lowering of LDL at the end of follow up [WMD: -16.16(-22.47 to -9.85) p ≤ 0.00001]. No differences in percentage change in HDL and hsCRP were observed between two groups. Conclusion: Combination lipid lowering by statin plus ezetimibe causes significantly greater reduction in plaque volume and lowering of LDL cholesterol. Further larger studies are needed to validate the findings in all population groups.

Importance Treatment with aldosterone antagonists is recommended and has been shown to have beneficial effects in patients with ST-segment elevation myocardial infarction (STEMI) and left ventricular ejection fraction (LVEF) less than 40%. However, the role of aldosterone antagonists in patients with ejection fraction greater than 40% or without congestive heart failure is not well known. Objectives To perform a systematic review and meta-analysis using standard techniques to determine the role of therapy with aldosterone antagonists in this patient population. Data Sources PubMed, Embase, CINAHL, and Cochrane Central databases were searched and a manual search for relevant references from the selected articles and published reviews was performed from database inception through June 2017. Study Selection Randomized clinical trials that evaluated treatment with aldosterone antagonists in patients with STEMI without clinical heart failure or LVEF greater than 40% were included. Data Extraction and Synthesis Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used to conduct and report the meta-analysis, which used a random-effects model. Two investigators independently performed the database search and agreed on the final study selection. A manual search was performed for relevant references from the selected articles and published reviews. Main Outcomes and Measures The outcomes analyzed were mortality, new congestive heart failure, recurrent myocardial infarction, ventricular arrhythmia, and changes in LVEF, serum potassium level, and creatinine level at follow-up. Results In all, 10 randomized clinical trials with a total of 4147 unique patients were included in the meta-analysis. In patients who presented with STEMI without heart failure, treatment with aldosterone antagonists compared with control was associated with lower risk of mortality (2.4% vs 3.9%; odds ratio [OR], 0.62; 95% CI, 0.42-0.91; P = .01) and similar risks of myocardial infarction (1.6% vs 1.5%; OR, 1.03; 95% CI, 0.57-1.86; P = .91), new congestive heart failure (4.3% vs 5.4%; OR, 0.82; 95% CI, 0.56-1.20; P = .31), and ventricular arrhythmia (4.1% vs 5.1%; OR, 0.76; 95% CI, 0.45-1.31; P = .33). Similarly, treatment with aldosterone antagonists compared with control was associated with a small yet significant increase in LVEF (mean difference, 1.58%; 95% CI, 0.18%-2.97%; P = .03), a small increase in serum potassium level (mean difference, 0.07 mEq/L; 95% CI, 0.01-0.13 mEq/L; P = .02), and no change in serum creatinine level (standardized mean difference, 1.4; 95% CI, −0.43 to 3.24; P = .13). Conclusions and Relevance Treatment with aldosterone antagonists is associated with a mortality benefit in patients with STEMI with LVEF greater than 40% or without heart failure.

Percutaneous patent foramen ovale closure (PFOC) is a possible treatment option for patients with stroke. The studies evaluating PFOC versus medical therapy (MT) showed mixed results. To evaluate the efficacy and safety of PFOC vs. MT in patients presenting with stroke, we performed a meta-analysis

Stroke continues to be a major cause of morbidity and mortality in atrial fibrillation (AF) patients. Oral anticoagulation (OAC) provides protection against stroke and peripheral embolization in AF but significant proportion of patients could not be started on anticoagulation because of bleeding complications. Left atrial appendage harbors clot in about 90% of nonvalvular AF. The advent of left atrial appendage occlusion (LAAO) techniques has provided these patients with alternative to OAC for stroke prophylaxis. Multiple LAAO devices are currently available with Watchman and Amulet being the most commonly used in clinical practice. Randomized studies are available for Watchman device only. Data on Amplatzer Cardiac Plug, Amulet and Lariat devices are limited by the paucity of randomized data. Long-term data on different LAAO techniques are showing promising results. Device related thrombosis continues to be a serious complication associated with LAAO. Future studies should look into comparative effectiveness between different LAAO techniques, optimal patient selection, risk of complications, and anticoagulant treatment after LAAO. This article aims to provide current available evidence on efficacy and safety of different LAAO devices and future prospective.

Social Media has taken the world by surprise at a swift and commendable pace. With the advent of any kind of circumstances may it be related to social, political or current affairs the sentiments of people throughout the world are expressed through their help, making them suitable candidates for sentiment mining. Sentimental analysis becomes highly resourceful for any organization who wants to analyse and enhance their products and services. In the airline industries it is much easier to get feedback from astute data source such as Twitter, for conducting a sentiment analysis on their respective customers. The beneficial factors relating to twitter sentiment analysis cannot be impeded by the consumers who want to know the who's who and what's what in everyday life. In this paper we are classifying sentiment of Twitter messages by exhibiting results of a machine learning algorithm using R and Rapid Miner. The tweets are extracted and pre-processed and then categorizing them in neutral, negative and positive sentiments finally summarising the results as a whole. The Naive Bayes algorithm has been used for classifying the sentiments of recent tweets done on the different airlines.

Background: Transradial access (TRA), compared to femoral access, is preferred for coronary procedures due to reduced access-related bleeding and mortality. Radial artery occlusion (RAO) is a known complication of TRA, and precludes its use as a future access site, conduit for CABG or for

Precambrian Terrains and Mountain Building Processes.- Cratons of the Indian Shield.- The Young and Old Fold Belts.- Aravalli Mountain Belt.- Central Indian Fold Belts.- Singhbhum Fold Belt.- Eastern Ghats Mobile Belt.- Pandyan Mobile Belt.

Tin‐bismuth (Sn‐Bi) oxide films prepared by spray‐pyrolysis techniques were characterized by in situ conversion electron Mossbauer spectrometry in an atmosphere of CO and CH4. The isomer shift of Sn4+ in Sn‐Bi oxide decreased at 250 °C and 400 °C in CO and CH4 atmospheres, respectively. An electrical resistance change was also observed at about 250 °C in CO atmosphere, which showed a selective behavior towards CO gas in comparison to CH4 and C2H5OH gases. These results show that CO gas interacted with bulk as well as with the surface of Sn‐Bi oxide at low temperature. The increase in the sensitivity of CH4 and C2H5OH at temperatures around 400 °C at the expense of selectivity towards CO was interpreted in terms of surface as well as bulk interactions, and also the catalytic enhancement by reaction of decomposed products from CH4 and C2H5OH.

State spending growth rules and an alternative for Connecticut

It is very difficult precisely to define the term feudalism, which is attributed to stages of historical development far removed from one another in time and place, such as the Interregnum (2475-z260 B.C.) after the Old Kingdom in Egypt and the Chou period in China (C. 22 zzC. z2o B.C.); but generally it is applied to society in mediaeval Europe, from the 5th to the 15th century A.D. It is therefore in the light of certain broad features of feudalism in the last sense that we will investigate the origins of feudalism in India. From the post-Maurya period, and especially from Gupta times, certain political and administrative developments tended to feudalise the state apparatus. The most striking development was the practice of making land grants to the brahmainas, a custom which was sanctified by the injunctions laid down in the Dbarmaidstras, the didactic portions of the Epic, and the Purdnas; the Anusdsana Parva of the Mahbbhdrata devotes a whole chapter to the praise of making gifts of land (bbhlmiddna-praiazmsd). The early Pili texts of the pre-Maurya period refer to the villages granted to the brdhmanas by the rulers of Kosala and Magadha, but they do not mention the abandonment of any administrative rights by the donors. The same is the case with the earliest epigraphic record of a land-grant, a Satavahana inscription of the ist century B.C., which refers to the grant of a village as a gift in the aivamedha sacrifice.) Surprisingly enough, administrative rights were perhaps given up for the first time in the grants made to Buddhist monks by the Sitavihana ruler Gautamiputra Satakarini in the 2nd century A.D. The land granted to them could not be entered by royal troops, molested by government

(1985). How feudal was Indian feudalism? The Journal of Peasant Studies: Vol. 12, Feudalism and Non‐European Societies, pp. 19-43.