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Background: To assess the impact of orally given itopride and levosulpride on non-ulcer dyspepsia. Materials and Methods: A total of 120 patients were divided equally into two groups, with 60 patients in each group. Group A consists of 60 patients. Subjects were randomly allocated to receive a 50 mg dose of itopride hydrochloride, administered three times per day prior to meals. Contrarily, Group B received a 75 mg dose of Levosulpiride, which was likewise administered three times daily prior to meals. The therapy regimen was adhered to for a duration of two weeks, and then continued for a total of three months. This study included individuals between the ages of 18 and 60 (both males and females) who had symptoms of non-ulcer dyspepsia, such as bloating or pain in the upper abdomen, nausea, and heartburn, lasting for a minimum of 12 weeks. Results: After two weeks of therapy, the Itopride group had 46.66% of patients experiencing remarkable or full reduction of symptoms, 30% experiencing moderate relief, 16.67% experiencing little relief, and 6.67% experiencing no improvement. Within the Levosulpiride group, 40% of participants saw significant or total alleviation, 36.67% experienced moderate alleviation, 15% experienced little alleviation, and 8.33% experienced no alleviation. Both medications demonstrated efficacy, however, the Itopride group had a greater proportion of significant or full alleviation. Incidents with negative consequences were documented and compared between the two groups. Within the Itopride group, 13.33% of patients had minor gastrointestinal discomfort, 8.33% experienced headaches, and 3.33% experienced dizziness. Within the Levosulpiride group, 15% of participants had minor gastrointestinal distress, 5% reported headaches, and 8.33% reported dizziness. Both groups saw a comparable occurrence of minor negative effects, while the Levosulpiride group had a significantly greater occurrence of dizziness. Before and after therapy, a series of biochemical tests were performed, including a hemogram, blood urea nitrogen (BUN), serum creatinine, liver function tests (AST, ALT, γ-GT, Alk. Phos), bilirubin, total cholesterol, fasting blood sugar (FBS), and QT-interval. Conclusion: Our investigation showed that both Itopride and Levosulpiride are effective in relieving symptoms of non-ulcer dyspepsia, and they have a comparable safety profile. However, Itopride shown a much higher incidence of persons achieving substantial or complete relief from symptoms. [ABSTRACT FROM AUTHOR]

Dentistry diseases are worldwide concern with the fact that 5% of medical budget is spent on it. Dental diagnosis requires frequent visits to clinic and multiple personal check‐ups by an expert. This delays the process of diagnosis as well as introduces the danger of oral infection spread. Automation is boon to speed up the process of diagnosis, reduce expert's involvement and help in handling volume of patients. In situations like pandemic as seen in this decade, computer based automatic systems in health have proven their importance and necessity. For dental diagnosis, images are useful tool for better anatomical views and accurate decision of treatment. However, manual dental analysis increases load on dentists for initial check‐up that can be easily performed with automated systems or self‐kits. Oral cavity is a dental illness, if not identified and treated on time may lead to other serious ailments. This work presents a framework that performs tooth image classification for cavity and non‐cavity with new bag of features (NBoF) method. NBoF method is an attempt to improve the performance of bag of features (BoF) using the proposed reinforcement Aquila optimization (RAO) and weighted Bayesian Gaussian mixture modelling (WBGMM). An analysis of the performance of the NBoF using the proposed RAO and WBGMM is conducted using standard metrics. The comparative study of results proves that the proposed NBoF method outperforms the existing state‐of‐the‐art algorithms. [ABSTRACT FROM AUTHOR]

Follicular regulatory T cells (Tfr) can play opposite roles in the regulation of germinal center (GC) responses. Depending on the studies, Tfr suppress or support GC and B cell affinity maturation. However, which factors determine positive vs. negative effects of Tfr on the GC B cell is unclear. In this study, we show that GC centrocytes that express MYC up-regulate expression of CCL3 chemokine that is needed for both the positive and negative regulation of GC B cells by Tfr. B cell-intrinsic expression of CCL3 contributes to Tfr-dependent positive selection of foreign Ag-specific GC B cells. At the same time, expression of CCL3 is critical for direct Tfr-mediated suppression of GC B cells that acquire cognate to Tfr nuclear proteins. Our study suggests that CCR5 and CCR1 receptors promote Tfr migration to CCL3 and highlights Ccr5 expression on the Tfr subset that expresses Il10. Based on our findings and previous studies, we suggest a model of chemotactically targeted checkpoint control of B cells undergoing positive selection in GCs by Tfr, where Tfr directly probe and license foreign antigen-specific B cells to complete their positive selection in GCs but, at the same time, suppress GC B cells that present self-antigens cognate to Tfr. [ABSTRACT FROM AUTHOR]

Nocardiosis is a rare infection of the lung, brain and skin and can be a localized or disseminated infection. Here, we report a case of a 56-year-old male patient who presented with a right testicular torsion for which right orchiectomy was done in the hospital. In the post-operative period, patient developed increased respiratory insufficiency and was intubated. Chest X-ray revealed bilateral fluffy opacities most likely due to infective etiology. Endotracheal tube aspirate sample was sent for Gram staining and culture, organism present showed characteristics like Nocardia. MALDI-TOF identified organism as Nocardia otitidiscaviarum. The patient was treated with cotrimoxazole and ceftriaxone. His clinical condition improved. We report this case because Nocardia otitidiscaviarum is a rare cause of pulmonary nocardiosis and although there is high mortality reported in nocardiosis, early diagnosis because of the availability of advanced diagnostic technology and prompt treatment can help save the patient. [ABSTRACT FROM AUTHOR]

The analysis of an M/M/1/N feedback working vacation queueing system with reneging is presented in this paper. Customers may become impatient and even disappointed when they see a long line. In the literature on queueing, customer dissatisfaction caused on by unsatisfactory service is referred as feedback. In the case of feedback, customers retry services after receiving unsatisfactory or incomplete. First, we create the equations for the steady-state probabilities using the Markov process method. The steady-state probabilities are then solved by the matrix method. We then provide some system performance measures. We create a cost model using performance analysis. Finally, we give some numerical examples to show how the various model parameters affect the system’s behaviour. [ABSTRACT FROM AUTHOR]

Introduction: Among regional anaesthetic techniques, Single shot caudal epidural block is the oldest and the most widely used technique with the drawback of short postoperative analgesia. Transversus Abdominis Plane (TAP) block under ultrasound guidance has been reported in recent studies as an easy and safe alternative to caudal block with added advantage of longer postoperative analgesia. Aim: This study was undertaken to compare the efficacy of the Ultrasound-guided TAP block with the Caudal epidural block in providing intra-operative and post-operative pain relief in children undergoing inguinal herniotomy. Materials and methods: Eighty children satisfying the inclusion criteria were included in the study. After obtaining informed consent from the parents/guardian of the patients, they were randomly allocated into two groups, Group T receiving USG-guided TAP Block with 0.5ml/kg of 0.25% bupivacaine and Group C receiving Caudal Epidural Block with 1ml/kg of 0.25% bupivacaine, with forty patients in each. Result: The duration of post-operative analgesia with TAP block group (517 mins) was significantly longer than Caudal block group (258 mins)(p value<0.05). The TAP block group had significant reduction in pain scores at 3, 4 and 5 hours postoperatively in comparison to Caudal group. The pain scores were lower in TAP block group compared to Caudal group at all observational times up to 24 hours after surgery. The mean analgesic requirement in the first 24 post-operative hours was significantly higher in Caudal group(396.75mg) when compared to TAP block group(217.1mg)(p value<0.05). Conclusion: Ultrasound-guided TAP block provided prolonged post-operative pain relief than single shot Caudal epidural block and reduced the mean analgesic consumption in the first 24 post-operative hours after inguinal herniotomy in children of age 1-6 years. Caudal epidural block provided better intra-operative analgesia than USG guided TAP block for inguinal hernia repair. [ABSTRACT FROM AUTHOR]

Background: Post-operative pain is of great concern in pediatric age group. Intravenous dexamethasone has been found to be promising in reducing post-operative pain when administered as an adjuvant to epidural anaesthesia in abdominal and orthopedic surgeries. However, little is known about its efficacy in children receiving caudal block for postoperative pain relief. Aims and Objectives: This study aimed to evaluate the analgesic efficacy of intravenous dexamethasone as an adjuvant to caudal block in children posted for infraumbilical surgeries. Materials and Methods: This interventional, double-blinded, randomized controlled study included 110 children aged 1–5 years with American Society of Anesthesiologists Grade I and II undergoing elective infraumbilical surgeries. To test our hypothesis, the superiority of intravenous dexamethasone was compared with the control group. All children received caudal bupivacaine 0.25% (1 mL/kg). Children were randomly allocated to two groups to receive: normal saline 0.075 mL/kg (Group C) and IV dexamethasone 0.3 mg/kg (0.075 mL/kg) (Group D). Post-operative pain scores (Face, Legs, Activity, Cry, and Consolability [FLACC] score), duration of analgesia, postoperative analgesic consumption, and intraoperative hemodynamics were compared. Results: FLACC score was found to be higher in Group C than Group D at all times. The mean FLACC score was significantly less with the study drug compared to the control group (P<0.001). The time to request for first rescue analgesia was significantly less in Group C as compared to Group D (4.01±0.69 h vs. 5.51±0.50 h, P=0.019). The mean total analgesic consumed in the first 24 h was significantly higher in Group C than in Group D (666.09±174.69 mg vs. 384.55±125.04 mg, P=0.015). Hemodynamic parameters were comparable in both the groups. Conclusion: Intravenous administration of dexamethasone 0.3 mg/kg as an adjunct to caudal bupivacaine 0.25% provides significantly longer duration of post-operative analgesia and lesser total analgesic consumption compared to the use of caudal bupivacaine 0.25% alone. [ABSTRACT FROM AUTHOR]