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Introduction: Severe hypertension in pregnancy deserves prompt recognition and urgent effective reduction in order to reduce the risk of complications such as eclampsia and HELLP syndrome and to achieve desirable neonatal outcomes. There is a need for effective and safe parenteral antihypertensive treatment. Subjects and Methods: We studied the effectiveness and safety of intravenous labetalol use in severe hypertension in pregnancy and post-partum period in a teaching hospital in Chhattisgarh in 101 women. IV labetalol was given as bolus doses till the blood pressures were controlled. Neonatal outcomes were recorded, and adverse effects such as hypotension, hypoglycemia, and neonatal asphyxia were documented. Results: Intravenous labetalol given as a single bolus of 20 mg was efficacious in controlling blood pressures in 93 out of 101 (93%) women, and the rest were controlled with 1 or 2 additional doses in 1–3 hours. No neonatal deaths happened beyond the 13 intrauterine fetal deaths at presentation. No women developed any episodes of hypotension, tachycardia of more than 100, or nausea or vomiting on labetalol. Conclusion: Intravenous labetalol, even as a single bolus dose, is highly efficacious and is free of any major adverse effects.

The unplanned growth of urbanization in towns and cities has led to variations in Land Surface Temperature (LST) as the green lands are converted into impervious structures without land cover management. In this study, an effort is made to study the transformational change in natural land cover area over the years and its impact on LST in Ernakulum District of Kerala, India. As per the current statistics from one of the reports on “Observed Rainfall Variability and Changes Over Kerala State”, by Indian Metrological Department in January 2020 shows that there is a significant decreasing trend in rainy days in many districts of Kerala which has resulted in highest temperature records in recent years. To understand the change in temperature trends in the district, Landsat data is collected for four different years 2005, 2010, 2015 and 2020 that maps Land Use and Land Cover (LULC) pattern for vegetation cover and built-up areas. It is important to interpret LULC maps as converting the vegetative land in built-up areas leads to multiple reflecting surfaces and temperature trapping which serves as the most direct way to understand the influence of global warming. The major merit of this research is (i) to interpret the temporal changes in LULC for categorizing the images in different land covers, (ii) to analyze Urban Thermal Field Variance Index (UTFVI) to quantify the urban heat island (UHI) effect in the region, (iii) to assess change in temperature by analyzing the spatio-temporal variations in mean temperatures for different land cover classes, and (iv) to analyze the trend of LST wrt to vegetation spectral index i.e., Normalized Differential Vegetation Index (NDVI) and spectral building index i.e., Normalized Difference Building Index (NDBI) to predict the percentage change in temperature in successive years using the widely used regression model. The computational simulation findings show that the percentage area of vegetated land decreases from 47.91 % to 29.04 % and the LST change analysis observed for years from 2005 to 2020 is 2.55 °C. For built up land, the percentage area is increased from 6.50 % to 15.27 % and the change in LST observed from year 2005–2020 is 4.82 °C which is a significant rise in temperature. The overall accuracy achieved for four respective years comes out to be 93, 89, 90, and 92 %. It has been observed from the analysis, that there is a change in temperature over the period of time from 2005 to 2020 b 3.45 °C. This is due to unplanned use of land cover classes that show considerable change in LULC maps that can be seen in the simulated results for a given study area. If the rate of change in area appeared to constantly change in this manner, then there is a possibility of further increase in land surface temperature and that will contribute in increase of temperature. The rise in mean LST from year 2020–2025 would be 0.5 °C and 1.0 °C for year 2030.

Background: With the growing advances in the digital world, software development demands are increasing at an exponential rate. To ensure reliability of the software, high-performance tools for bug report analysis are needed. Aim: This paper proposes a new ‘Iterative Software Reliability’ model based on one of the most recent Software Development Life Cycle (SDLC) approach. Method: The proposed iterative failure rate model assumes that new functionality enhancement occurs in each iteration of software development and accordingly design modification is made at each stage of software development. In terms of defects, testing effort, and added functionality, these changing needs in each iteration are reflected in the proposed model using iterative factors. The proposed model has been tested on twelve Eclipse and six JDT software failure datasets. Proposed model parameters have been estimated using a hybrid swarm-evolutionary algorithm. Results: The proposed model has about 32% and 55% improved efficiency on Eclipse and JDT datasets respectively as compared to other models like Jelinski Moranda Model, Shick-Wolverton Model, Goel Okumotto Imperfect Model etc. Conclusion: In each analysis done, the proposed model is found to be reaching acceptable performance and could be applied on other software failure datasets for further validation.

Background: Targeted therapies have prolonged the survival of patients with metastatic renal cell carcinomas (RCC). However, the majority of patients with metastatic RCC develop treatment resistance and disease progression. The programmed cell death protein 1 inhibitors offer a new ray of hope for such patients. Objectives: The primary objective of this study was to evaluate the overall survival (OS) of patients with relapsed metastatic RCC treated with immunotherapy in the second-line setting. The secondary objectives were to assess the safety profile and objective response rate (ORR) for nivolumab. Materials and Methods: This retrospective study was conducted in the Department of Medical Oncology at the Max Institute of Cancer Care, a tertiary care center in Delhi, India. Patients with histologically proven stage IV RCC who had progressed on first-line tyrosine kinase inhibitors (TKIs) and treated with at least four cycles of nivolumab at our center between December 2015 and January 2019 were enrolled in the study. The OS, progression-free survival (PFS), immune-mediated adverse events (irAEs), and ORR were determined. Results: Out of 50 patients with metastatic RCC who progressed on first-line TKIs, 19 received immunotherapy with nivolumab. The median age of the patients was 62 years (range, 31–71 years); the male-to-female ratio was 2:1. The median follow-up time and duration of treatment were 11 months (range, 2–23) and 4.5 months (95% confidence interval [CI], 3.52–5.96), respectively, and 8 (42.1%) patients were alive at the time of analysis. The median OS was 13 months (95% CI, 10.4–15.5) from the start of nivolumab therapy, and the median PFS was 8 months (95% CI, not evaluable). The best response was progressive disease in 47.3%; the ORR was 26.3%. Grade 1/2 and grade 3/4 adverse events were observed in 68.4% and 10.5% of the patients, respectively. Adverse events of any grade were reported in 13 (68.6%) patients. Fatigue and hypothyroidism were the most frequently observed irAEs associated with nivolumab and occurred in 4 (21%) and 11 (57.8%) patients, respectively. Four (15.7%) patients developed grade 1 pruritus. No fatal toxicities were recorded. Conclusion: Nivolumab is efficacious and safe as a second-line treatment option for metastatic RCC in Indian patients.

ABSTRACT The toxicity of tenofovir alafenamide (TAF) hemifumarate (HF) was evaluated when administered by continuous subcutaneous (s.c.) infusion via an external infusion pump for 28 days to rats and dogs. The toxicokinetics of TAF and two metabolites, tenofovir (TFV) and tenofovir diphosphate (TFV-DP) were also evaluated. After administration of TAF HF in rats and dogs, primary systemic findings supported an inflammatory response that was considered minimal to mild. Gross pathology and histopathologic evaluation of tissue surrounding the s.c. infusion site revealed signs of inflammation, including edema, mass formation, fibrosis, and mononuclear cell inflammation in groups receiving ≥300 μg/kg/day in rats and ≥25 μg/day in dogs. Although these changes were observed in animals receiving vehicle, the severity was greater in animals receiving TAF HF. Changes in the local tissue were considered a TAF HF-mediated exacerbation of an inflammatory response to the presence of the catheter. In rats, systemic and local findings were considered not adverse due to their low severity and reversibility; therefore, the “no observed adverse effect level” (NOAEL) was set at 1,000 μg/kg/day. Because none of the systemic findings were related to systemic exposure to TAF, the systemic NOAEL was set at 250 μg/kg/day in dogs. Due to the severity of the observations noted, a NOAEL for local toxicity could not be established. Although these results might allow for exploration of tolerability and pharmacokinetics of s.c. administered TAF HF in humans, data suggest a local reaction may develop in humans at doses below a clinically relevant dose. IMPORTANCE Human immunodeficiency virus (HIV) infection continues to be a serious global human health issue, with ∼38 million people living with HIV worldwide at the end of 2019. HIV preexposure prophylaxis (PrEP) has introduced the use of antiretroviral therapies as another helpful tool for slowing the spread of HIV worldwide. One possible solution to the problem of inconsistent access and poor adherence to HIV PrEP therapies is the development of subcutaneous (s.c.) depots or s.c. implantable devices that continuously administer protective levels of an HIV PrEP therapy for weeks, months, or even years at a time. We evaluate here the toxicity of tenofovir alafenamide, a potent inhibitor or HIV replication, after continuous s.c. infusion in rats and dogs for HIV PrEP.

The role of software reliability and quality improvement is becoming more important than any other issues related to software development. To date, we have various techniques that give a prediction of software reliability like neural networks, fuzzy logic, and other evolutionary algorithms. A genetic algorithm has been explored for predicting software reliability. One of the important aspects of software quality is called software reliability, thus, software engineering is of a great place in the software industry. To increase the software reliability, it is mandatory that we must design a model that predicts the fault and error in the software program at early stages, rectify them and then increase the functionality of the program within a minimum time and in a low cost. There exist numerous algorithms that predict software errors such as the Genetic Algorithm, which has a very high ability to predict software bugs, failure and errors rather than any other algorithm. The main purpose of this paper is to predict software errors with so precise, less time-consuming and cost-effective methodology. The outcome of this research paper is showing that the rates of applied methods and strategies are more than 96 percent in ideal conditions.

Introduction: The reported prevalence of gestational diabetes mellitus (GDM) varies widely across India. Given the short-term, long-term, and multigenerational health impacts of GDM, understanding its frequency and risk factors is important for population screening strategies. We estimated the prevalence of GDM and determined associated risk factors in rural, central India, where data is sparse. Methods: We conducted a cross-sectional study of a convenience sample of 575 pregnant women attending antenatal care (ANC) clinics at Jan Swasthya Sahyog's (JSS) outreach clinics in rural Chhattisgarh, India. Study participants underwent a non-fasting 75g oral glucose tolerance test (OGTT) between 24-28 weeks gestation. Using Diabetes in Pregnancy Study Group of India (DIPSI) criteria, a 2-hour post-OGTT glucose ≥140 mg/dL was used to diagnose GDM. Results: We found 11 patients (1.9%) who met diagnostic criteria for GDM. Median age, systolic blood pressure, and diastolic blood pressure were higher in those with GDM (26 vs 23 years, p = 0.02; 117 vs 106 mmHg, p = 0.04, 77 vs 68 mmHg, p < 0.01, respectively). Pre-hypertension was associated with increased odds of GDM on multivariate analysis (OR 4.0, 95% CI: 1.1, 14.8). BMI was not associated with GDM. With appropriate management there were no differences in fetal complications between GDM and normal glucose tolerance (NGT) groups. Conclusions: In rural, central India the prevalence of GDM was 1.9% in the absence of traditional risk factors such as increased BMI. Further research is needed to define the applicability of optimal screening strategies in such settings.

The serendipitous discovery of osseointegration and the subsequent development of dental implants have irrefutably marked an epoch-making point of inflection in not only the basic approach of the clinicians toward treating edentulism but also in the attitudes and preferences of the patients in getting their oral rehabilitation issues resolved. This decisive shift also triggered explosive research targeting improvement in various aspects of dental implants. However, initial success in osseointegration does not necessarily translate into success in long-term function. A successfully osseointegrated implant may be afflicted with early or late complications in due course of service. Of these, peri-implantitis (PI) is considered one of the most common causes of implant failure. For the treatment of peri-implant diseases (mucositis and PI), various conservative and surgical approaches are available. Mucositis and moderate forms of PI can be contained effectively using conservative methods. These include the administration of systemic and local antibiotics alone or in conjunction with other treatment modalities such as nonsurgical therapy which consists of mechanical debridement of the affected areas, irrigation with antiseptics (such as chlorhexidine, saline, and 10% hydrogen peroxide) with or without surface decontamination, laser-supported therapy, photodynamic therapy as well as light-activated disinfection also known as photodynamic antimicrobial chemotherapy along with maintaining adequate plaque control. In cases with advanced PI, surgical therapies are more effective than conservative approaches. Open flap debridement can be done, and depending on the configuration of the defect, regenerative therapies such as guided tissue regenerative and the use of bone graft materials may be applicable for defect filling whereas resective surgery can be considered for the elimination of peri-implant lesions.

Under-nutrition is a known risk factor for TB and can adversely affect treatment outcomes. However, data from India are sparse, despite the high burden of TB as well as malnutrition in India. We assessed the nutritional status at the time of diagnosis and completion of therapy, and its association with deaths during TB treatment, in a consecutive cohort of 1695 adult patients with pulmonary tuberculosis in rural India during 2004 - 2009.Multivariable logistic regression was used to obtain adjusted estimates of the association of nutritional status with deaths during treatment. At the time of diagnosis, median BMI and body weights were 16.0 kg/m(2)and 42.1 kg in men, and 15.0 kg/m(2)and 34.1 kg in women, indicating that 80% of women and 67% of men had moderate to severe under-nutrition (BMI