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Aim and objective: In the present scenario the medicine system from the west has started acknowledging the importance and wisdom of the ancient medicine system such as Siddha, Ayurvedha, Unani. There are many diseases that need surgical procedures till date, so in order to find a probable cure now a paradigm shift is really important. Tonsillitis is an infection of the tonsils associated with a sore throat, difficulty in swallowing, fever, etc. Still, surgical removal of tonsils is one of the most frequent procedures during childhood. In the Siddha system of medicine tonsillitis can be compared with Virana silatham. To evaluate the effect of Siddha medicine in the management of tonsillitis. Materials and Methods: The subject approached Out Patient Department of Siddha Clinical Research Unit(SCRU),under Central Council for Research in Siddha(CCRS), Safdarjung Hospital Campus, New Delhi with symptoms of sore throat, ear pain, difficulty in swallowing, sleep apnoea, which involved problems of breathing at night and foul smell from the mouth for past four months systemically. Discussion: The manifestation of symptoms and their severity depends on the extent of involvement of Uyir thathukkal (Vali,Azhal, Iyyam). Though the disease is Iyyam and Azhal predominant, there is derangement of Iyyam and Azhal Dosham in Virana silatham. Results: In this case, the subject showed a marked improvement as depicted in the photographs taken at different levels of treatment, also there was a significant improvement noted in both subjective and objective parameters. By adopting the Siddha treatment approach with an external treatment modality an attempt is made to bring about satisfactory results.

BACKGROUND: Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy. Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively.METHODS: We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis. The primary end point was recurrent infection (new episode after initial clinical cure) within 12 weeks after infusion in the modified intention-to-treat population.RESULTS: In both trials, the rate of recurrent C. difficile infection was significantly lower with bezlotoxumab alone than with placebo (MODIFY I: 17% [67 of 386] vs. 28% [109 of 395]; adjusted difference, -10.1 percentage points; 95% confidence interval [CI], -15.9 to -4.3; PCONCLUSIONS: Among participants receiving antibiotic treatment for primary or recurrent C. difficile infection, bezlotoxumab was associated with a substantially lower rate of recurrent infection than placebo and had a safety profile similar to that of placebo. The addition of actoxumab did not improve efficacy. (Funded by Merck; MODIFY I and MODIFY II ClinicalTrials.gov numbers, NCT01241552 and NCT01513239 .).

Conventional video surveillance systems require infrastructure including expensive servers with capability to process images and store video recordings. These surveillance systems produce and need to store a huge amount of data and to execute in real time to detect safety events. The problems of the anti-social activities which gradually increasing across the country especially in the urban areas in recent times which lead to the need for technological innovations in the security and surveillance system. The proposed system is based on cloud computing. In this paper the application has been modelled and simulated using iFogSim. The results predicts that the fog-based model is more secured and efficient compared to cloud computing parameter energy consumption. The proposed system helps to increase the effectiveness of the intelligent agencies and thereby increase crime safety at public places.

This study investigates the effect of post heat treatment on the microstructure and mechanical properties of IS2062 steels. Similar metal joints of IS2062 weldments are prepared by using MIG welding process. This melting is occurring at edges of the plates because of sufficient amount of heat energy is passing over the plate per unit time and density of energy is supplied to the wire. In this connection, heating and cooling of weldment some of the disturbances in metallurgical and mechanical point of view. To overcome we will choose suitable post weld heat treatment to avoid the disturbances and improve industrial requirement irrespective of the mechanical, microstructure of the weldment. The objective is to determine the optimum post weld heat treatment method for the IS2062 steel. After welding, the effects of post weld heat treatment on weld metal microstructure and mechanical properties including weldment tensile strength, impact and hardness over the room temperature range 32°C are investigated. In particular this study the effect of these properties to understand estimate heat treatments on the tensile impact, Hardness materials are considered as weldments before heat treatment and after post weld heat treatment.

During the welding process change of chemical and physical reactions due to the flow of heat in the weldments are varied with respect to rate of cooling time and weld axis. In the dissimilar welded joints, at the welded portion it can be exist in more than one crystalline form and the carbon atom is only 1/30th size of the iron atom. The weldments are underlying their properties so to achieve the better results that are possible through heat treatment processes.

Tungsten Inert Gas (TIG) welding process is generally used for welding of aluminum alloys. TIG process is generally preferred because it produces a very high quality weld. Distortion is the major problem in welding of thin sections. This distortion is controlled in pulsed and magnetic arc oscillation TIG process. The metallurgical advantages of pulsed TIG welding are grain refinement in fusion zone, reduced width of HAZ, less distortion, control of segregation, reduced hot sensitivity and residual stresses. It was observed that pulsed TIG welding produces finer grain structure of weld metal than conventional TIG welding (without arc pulsation). The mechanical properties (Hardness) and microstructure characteristic of weld metal depends upon the microstructure of the weld. The microstructure of the weld depends upon pulsed parameters peck current, base current, pulse frequency, pulse duration. The objective of present project is to achieve better mechanical properties. So, controlling of pulsed parameter is needed in this investigation. An increase in the pulse frequency has been found to refine the grain structure of weld metal especially when welding is done using short pulse duration. Long pulse duration lowers the pulse frequency up to which refinement of constituents in weld metal takes place. Effect of the pulse frequency on the grain structure was found to be determined by pulse duration. For a given pulse frequency, long pulse duration produced a coarser structure than short pulse duration. An increase in the peak current coarsened the grain structure.

Summary Background Two randomised, placebo-controlled trials—BENCHMRK-1 and BENCHMRK-2—investigated the efficacy and safety of raltegravir, an HIV-1 integrase strand-transfer inhibitor. We report final results of BENCHMRK-1 and BENCHMRK-2 combined at 3 years (the end of the double-blind phase) and 5 years (the end of the study). Methods Integrase-inhibitor-naive patients with HIV resistant to three classes of drug and who were failing antiretroviral therapy were enrolled. Patients were randomly assigned (2:1) to raltegravir 400 mg twice daily or placebo, both with optimised background treatment. Patients and investigators were masked to treatment allocation until week 156, after which all patients were offered open-label raltegravir until week 240. The primary endpoint was previously assessed at 16 weeks. We assessed long-term efficacy with endpoints of the proportion of patients with an HIV viral load of less than 50 copies per mL and less than 400 copies per mL, and mean change in CD4 cell count, at weeks 156 and 240. Findings 1012 patients were screened for inclusion. 462 were treated with raltegravir and 237 with placebo. At week 156, 51% in the raltegravir group versus 22% in the placebo group (non-completer classed as failure) had viral loads of less than 50 copies per mL, and 54% versus 23% had viral loads of less than 400 copies per mL. Mean CD4 cell count increase (analysed by an observed failure approach) was 164 cells per μL versus 63 cells per μL. After week 156, 251 patients (54%) from the raltegravir group and 47 (20%) from the placebo group entered the open-label raltergravir phase; 221 (47%) versus 44 (19%) completed the entire study. At week 240, viral load was less than 50 copies per mL in 193 (42%) of all patients initially assigned to raltegravir and less than 400 copies per mL in 210 (45%); mean CD4 cell count increased by 183 cells per μL. Virological failure occurred in 166 raltegravir recipients (36%) during the double-blind phase and in 17 of all patients (6%) during the open-label phase. The most common drug-related adverse events at 5 years in both groups were nausea, headache, and diarrhoea, and occurred in similar proportions in each group. Laboratory test results were similar in both treatment groups and showed little change after year 2. Interpretation Raltegravir has a favourable long-term efficacy and safety profile in integrase-inhibitor-naive patients with triple-class resistant HIV in whom antiretroviral therapy is failing. Raltegravir is an alternative for treatment-experienced patients, particularly those with few treatment options. Funding Merck Sharp & Dohme.

BENCHMRK-1 and -2 are ongoing double-blind phase III studies of raltegravir in patients experiencing failure of antiretroviral therapy with triple-class drug-resistant human immunodeficiency virus infection. At week 96 (combined data), raltegravir (400 mg twice daily) plus optimized background therapy was generally well tolerated, with superior and durable antiretroviral and immunological efficacy, compared with optimized background therapy alone.

Background: Raltegravir (MK-0518) is an inhibitor of human immunodeficiency virus type 1 (HIV-1) integrase active against HIV-1 susceptible or resistant to older antiretroviral drugs. Methods: We conducted two identical trials in different geographic regions to evaluate the safety and efficacy of raltegravir, as compared with placebo, in combination with optimized background therapy, in patients infected with HIV-1 that has triple-class drug resistance in whom antiretroviral therapy had failed. Patients were randomly assigned to raltegravir or placebo in a 2:1 ratio. Results: In the combined studies, 699 of 703 randomized patients (462 and 237 in the raltegravir and placebo groups, respectively) received the study drug. Seventeen of the 699 patients (2.4%) discontinued the study before week 16. Discontinuation was related to the study treatment in 13 of these 17 patients: 7 of the 462 raltegravir recipients (1.5%) and 6 of the 237 placebo recipients (2.5%). The results of the two studies were consistent. At week 16, counting noncompletion as treatment failure, 355 of 458 raltegravir recipients (77.5%) had HIV-1 RNA levels below 400 copies per milliliter, as compared with 99 of 236 placebo recipients (41.9%, P

Background: We evaluated the efficacy of raltegravir and the development of viral resistance in two identical trials involving patients who were infected with human immunodeficiency virus type 1 (HIV-1) with triple-class drug resistance and in whom antiretroviral therapy had failed. Methods: We conducted subgroup analyses of the data from week 48 in both studies according to baseline prognostic factors. Genotyping of the integrase gene was performed in raltegravir recipients who had virologic failure. Results: Virologic responses to raltegravir were consistently superior to responses to placebo, regardless of the baseline values of HIV-1 RNA level; CD4 cell count; genotypic or phenotypic sensitivity score; use or nonuse of darunavir, enfuvirtide, or both in optimized background therapy; or demographic characteristics. Among patients in the two studies combined who were using both enfuvirtide and darunavir for the first time, HIV-1 RNA levels of less than 50 copies per milliliter were achieved in 89% of raltegravir recipients and 68% of placebo recipients. HIV-1 RNA levels of less than 50 copies per milliliter were achieved in 69% and 80% of the raltegravir recipients and in 47% and 57% of the placebo recipients using either darunavir or enfuvirtide for the first time, respectively. At 48 weeks, 105 of the 462 raltegravir recipients (23%) had virologic failure. Genotyping was performed in 94 raltegravir recipients with virologic failure. Integrase mutations known to be associated with phenotypic resistance to raltegravir arose during treatment in 64 patients (68%). Forty-eight of these 64 patients (75%) had two or more resistance-associated mutations. Conclusions: When combined with an optimized background regimen in both studies, a consistently favorable treatment effect of raltegravir over placebo was shown in clinically relevant subgroups of patients, including those with baseline characteristics that typically predict a poor response to antiretroviral therapy: a high HIV-1 RNA level, low CD4 cell count, and low genotypic or phenotypic sensitivity score. (ClinicalTrials.gov numbers, NCT00293267 and NCT00293254.)