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Background: Aging is a complex and universal life process. Treatment seeking behaviour in elderly is affected by socio-economic factors and by affordability, availability and accessibility of healthcare. Objectives: To study treatment-seeking behaviour of the study subjects. To compare treatment seeking behaviour among rural and urban study subjects. Methods: This was a cross-sectional study conducted in the Kanpur district. Selection of villages in rural and mohallas in urban areas was done using a multistage random sampling technique. A total of 600 subjects were studied, including 400 from urban areas and 200 from rural areas. Elderly persons>60 years of age, both males and females were included in the study. Results: Overall, out of 600 study subjects, 59.8% were taking treatment in rural areas and in urban areas 77.6% were taking treatment. In urban areas, more females availed treatment compared to rural areas. Majority of study subjects (56.5%) sought treatment from a government hospital. Only 36% subjects had health insurance. Conclusion: In Urban areas more subjects availed treatment as compared to rural areas. Majority of subjects sought treatment from government health facilities. Lack of financial support and long waiting time were major reasons for not availing health care.

β-lactam antibiotics are considered the safest bactericides, and upon wide clinical use of benzyl penicillin G in 1945, outbreaks of resistance came out. The frequent semi-synthetic strategies revealed β-lactam generations that are of broad-spectrum activity. The new agents as well as their concomitant use with known inhibitors of β-lactamases potentiate their effectiveness versus higher numbers of resistant pathogens. However, the extremely resistant pathogens are still representing a burden. Efforts had been continued to find more inhibitors of β-lactamases to combine with β-lactams to provide good management of infections by extremely resistant microbes. The purpose of this work is to overview the conventional and the recently introduced β-lactamases in clinical applications, as well as some reported effective inhibitors of β-lactamases. The review pinpoints the inhibitors that can be mixed and/or merged with the beta-lactam antibiotics to effectively treat the microbial infections producing resistant-β-lactamases. ClogP for these drugs and candidate inhibitors is introduced as suggestions to open a door for developers to admix derivatives with suitable pharmacokinetics.

The coronavirus 2 illness (Covid-19) global pandemic has resulted in severe infection causing fever, cough, shortness of breath, pneumonia and even death. WHO is monitoring intimately in coordination with scientific experts and government agencies, the transmission rate of this virus and its neoteric variants identified worldwide. Since the start of year 2020, all the health authorities of each country are working in collaboration to explore the scientific information on coronavirus and providing essential guidelines to save humans. Undoubtedly, this pandemic impacted many lives regardless of all preventive steps followed to minimize its transmission. Currently, multiple anti Covid-19 vaccines are available everywhere and government authorities are monitoring and providing the guidelines for taking booster dose of vaccine to minimize and control the transmission of different variants of this virus. It is rational to state that some of the available anti Covid-19 vaccines may not be highly efficient against new emerging variants so further investigation and research are the need of hour. Therefore, the present review portrayed the features of the novel variants and mutations of coronavirus 2 (Covid-19) and therapeutic updates associated with the effectiveness of different vaccines against new strains reported worldwide.

At this moment, liver dysfunction is a major source of destruction, and its widespreadity is accentuated in the developed republics. The liver is an imperative organ of the body and is involved in metabolism and regulation. The large number of medications, toxins, and plant-derived products has been claimed to cause liver dysfunction, which is potentially life intimidating to humans. Currently, there is a shortfall in encouraging treatment for treating patients with liver dysfunction due to the nonexistence of empathy for gesturing offenders serviceable in the pathogenesis of liver toxicity. Hepatic dysfunction is manifested by hepatic karyopyknotic, eosinophilic or acidophilic cell plasm, followed by excessive steatosis, liver injury, and oxidative degradation of lipids that cause centrilobular necrosis in hepatocytes. Different signaling mechanism, like activation of Kupffer cells, NK cells, inflammatory mediators, and ROS are associated with the pathogenesis of liver dysfunction. A good empathy of chief mechanisms is prerequisite for the scheming of novel curative medications. Consequently, animal models are being developed to impressionist hepatic ailments. From the several decades, researchers are using distinctive animal models for discovering and understanding pathogenesis of hepatic ailments and associated abusiveness. This current review has been framed to discuss numerous new and traditional experimental models for hepatotoxicity studies. Numerous animal models have been evolved to evaluate the pathogenesis and develop drugs for hepatotoxicity. Experimental modes of hepatotoxicity are influential for invention of novel molecular signaling trails for the improvement of human health.

Aquatic environment is one of the important sources of active agents that own diverse biological properties. Metabolites from these sources are considered as alternate source to meet the mandate for effective medicines. Despite notable developments in cancer managing and/or treatment in the past years, there remains a vital requirement for innovative agents and/or innovating approaches to treat resistant and solid tumours. However, in the recent era there are new technological innovations in the elucidation of the structures, the semi-synthetic and synthetic approaches of the new antineoplastic compounds. Biological assays enable isolation and clinical evaluation of numerous scaffolds from the marine environment. This review gives a general summary of some anti-cancer agents with a brief description of their mechanisms of action. It sheds a view to the approved drugs, the potent scaffolds that newly modulated as antibody-drug conjugates, and the drug-candidates under clinical phases (I-III) with their status.

Background- During the COVID- 19 pandemic in the first wave, infected patients age was range from 4 weeks to 90 years and those who have more age and with comorbidities are more susceptible to develop serious illness and have high mortality rates. Objective-To study the association between survivor vs non survivor on the basis of demographic profile and high risk factors. Material & methods: This study was done in the Government Medical College, Kannauj on the COVID-19 patients who were admitted in the isolation wards, from 1st September 2020 to December 31st 2020. Statistical Analysis- Analysis was done using SPSS- 23 trial version software. Results: case fatality rate was 2.7% in this study. Most common symptoms was cough (61.0%) and among these admitted patients the most common comorbidities was hypertension (26.7%), followed by diabetes (20.7%), and COPD (14.0%) respectively. Platelets (< 0.02), post prandial blood sugar (PPBS) (< 0.01) have significant role in survivability of COVID- 19 patients. Conclusion: This study concludes that those patients who were older in age and with comorbidity especially (hypertension, COPD, high PPBS, High platelets) have poorer prognosis as compare to those without.

Floating medicines work well to increase drug absorption in the stomach. On the basis of current literature, a drug for a novel drug delivery system (NDDS) is established to explicate the floating drug delivery system (FDDS). The most recent FDDS progress involves the formulation as well as physiological aspects that may affect gastric retention and formulation. This review also discusses certain ways of producing a floating system, as well as evaluation methods, characterization, and classification for the FDDS pharmaceutical dosage form. By overcoming physiological hurdles such as short stomach residence times and unexpected gastric emptying times, scientific and technological achievements have been made in the study and development of controlled-release oral drug delivery systems in recent years. So, in general, float dose systems are key technological medication delivery systems that have a stomach-retentive nature and provide a variety of options. Floating drug delivery systems (FDDS), also known as hydro dynamically balanced systems (HBS), swelling and expanding systems, polymeric bio-adhesive systems, modified-shape systems, high-density systems, and other delayed gastric emptying devices are now used to extend the GRT. The latest technological breakthroughs of FDDS, including patented delivery methods and commercialized products, are covered in this study, as well as their advantages and future possibilities for oral controlled drug administration. Keywords- A novel drug gastrointestinal tract, types of FDDS, gastric residence time, evaluation of FDDS

Motion estimation is the basic need for the success of many video analysis algorithms such as moving object detection, human activity recognition, etc. Most of the motion estimation algorithms are prone to weather conditions and thus, they fail to estimate the motion in degraded weather. Severe weather situations like snow, rain, haze, smog, etc., degrades the performance and reliability of video analysis algorithms. In this paper, we have analyzed the effect of the haze on motion estimation in hazy videos. We propose a cascaded architecture i.e. haze removal followed by optical flow for motion estimation in hazy videos. The proposed image de-hazing network is build upon the Residual and Inception module concepts and named as ResINet. Further, an optical flow is utilized to estimate the motion information. We have carried out the visual analysis to validate the proposed approach for motion estimation in hazy videos. Also, to validate the proposed ResINet for de-hazing, we carried out the quantitative analysis on two benchmark image de-hazing datasets.

Background and Aims: Patient cooperation, sedation, anxiolysis, and topicalization are important prerequisites for the successful and safe conduct of awake intubation. Because of the pharmacological properties, opioids can facilitate this process. Fentanyl is an opioid agonist and nalbuphine is an agonist-antagonist. This study aims to compare these two opioids for their effect on sedation and intubating conditions during awake fiberoptic intubation. Material and Methods: This randomized double-blind controlled study was conducted on 62 ASA I/II patients of either sex between the age of 20 and 60 years, weight between 40 and 80 kg, with MP class I/II airways requiring general anesthesia with endotracheal intubation. All patients received standard airway topicalization and nebulization. Patients were randomly allocated to one of the two groups according to a computer-generated random number table. Group F (n = 31) received fentanyl 2 μg/kg i.v. and group N (n = 31) received nalbuphine 0.2 mg/kg i.v. over 10 min before intubation. Fiberoptic intubation was attempted and lignocaine spray and propofol boluses were administered as and when required. Hemodynamic responses and intubating conditions were recorded. Repeated measure ANOVA, McNemar test, and Chi-square test or Fischer's exact test were used for data analysis. A P < 0.05 was considered significant. Results: Cough score (P = 0.458), post-intubation score (P = 1.000), and sedation score (P = 1.000) were comparable among the two groups. Hemodynamic responses and propofol and lignocaine requirements were also comparable. Conclusion: Both fentanyl and nalbuphine provide comparable intubating conditions when used before awake fiberoptic intubation with minimal adverse effects on hemodynamic profile.

PurposeLogistics is the part of the supply chain (SC) that plans, executes and handles forward and reverse movement and storage of products, services and related information, in order to respond to customers' needs effectively and efficiently. The main concern for logistics is to ensure that the correct product is placed at the right time. This paper introduces a linear model of shipping focused on decision-making, which includes configuration of shipping network, choosing of transport means and transfer of individual customer shipments through a particular transport system.Design/methodology/approachIn this study, authors try to address the problem of supply chain network (SCN) where the primary goal is to determine the appropriate order allocation of products from different sources to different destinations. They also seek to minimize total transportation cost and inventory cost by simultaneously determining optimal locations, flows and shipment composition. The formulated problem of getting optimal allocation turns out to be a problem of multi-objective programming, and it is solved by using the max-addition fuzzy goal programming approach, for obtaining optimal order allocation of products. Furthermore, the problem demand and supply parameters have been considered random in nature, and the maximum likelihood estimation approach has been used to assess the unknown probabilistic distribution parameters with a specified probability level (SPL).FindingsA case study has also been applied for examining the effectiveness and applicability of the developed multi-objective model and the proposed solution methods. Results of this study are very relevant for the manufacturing sector in particular, for those facing logistics issues in SCN. It enables researchers and managers to cope with various types of uncertainty and logistics risks associated with SCN.Research limitations/implicationsThe principal contribution of the proposed model is the improved modelling of transportation and inventory, which are affected by different characteristics of SCN. To demonstrate computational information of the suggested methods and proposed model, a case illustration of SCN is provided. Also, environmentalism is increasingly becoming a significant global concern. Hence, the concept proposed could be extended to include environmental aspects as an objective function or constraint.Originality/valueEfficient integration of logistical cost components, such as transportation costs, inventory costs, with mathematical programming models is an important open issue in logistics optimization. This study expands conventional facility location models to incorporate a range of logistic system elements such as transportation cost and different types of inventory cost, in a multi-product, multi-site network. The research is original and is focused on case studies of real life.

Background Management of patients with interstitial lung disease (ILD) requires subspecialized, comprehensive, multidisciplinary care. The Pulmonary Fibrosis Foundation established the Care Center Network (CCN) in 2013 with identified criteria to become a designated CCN site. Despite these criteria, the essential components of an ILD clinic remain unknown. Research Questions How are ILD clinics within the CCN structured? What are the essential components of an ILD clinic according to ILD physician experts, patients, and caregivers? Study Design and Methods This study had three components. First, all 68 CCN sites were surveyed to determine the characteristics of their current ILD clinics. Second, an online, three-round modified Delphi survey was conducted between October and December 2019 with 48 ILD experts participating in total. Items for round 1 were generated using expert interviews. During rounds 1 and 2, experts rated the importance of each item on a 5-point Likert scale. The a priori threshold for consensus was more than 75% of experts rating an item as important or very important. In round 3, experts graded items that met consensus and ranked items deemed essential for an ILD clinic. Third, ILD patient and caregiver focus groups were conducted and analyzed for content to determine their perspectives of an ideal ILD clinic. Results Forty items across four categories (members, infrastructure, resources, and multidisciplinary conference) achieved consensus as essential to an ILD clinic. Patient and caregiver focus groups identified three major themes: comprehensive, patient-centered medical care; expanded access to care; and comprehensive support for living and coping with ILD. Interpretation The essential components of an ILD clinic are well-aligned between physician experts and patients. Future research can use these findings to evaluate the impact of these components on patient outcomes and to inform best practices for ILD clinics throughout the world.

In stroke, there is paralysis or weakness of one side of the body including upper limb, trunk and lower limb leading to the disturbances in the trunk muscles. Trunk is often neglected part in the stroke rehabilitation, trunk training exercises and Swiss ball exercises results in better recruitment of trunk muscles thus improving sitting balance. To compare the effect of core strengthening exercises on Swiss ball and Conventional exercise, to improve trunk balance in hemiplegic patients following stroke. A total number of 70 subjects were screened as per inclusion and exclusion criteria. The subjects were divided into two groups, Group-A received core strengthening exercises on Swiss ball along with conventional treatment and Group-B received core strengthening exercises along with conventional treatment. Subjects showed improvement in trunk balance following 6 weeks of core strengthening exercises.Post-intervention the TIS, BBA and MBI score of both groups improved but the Group-A improved more significantly than Group-B. The level of significance was P