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Introduction: Remdesivir was the only antiviral used in the treatment of COVID-19 in the first wave of the COVID-19 pandemic, following the adaptive COVID-19 treatment trial-1 interim analysis report. However, its use in moderate to critical hospitalized COVID-19 patients continues to be controversial. Methodology: In a cohort of 1,531 moderate to critical COVID-19 patients, we retrospectively performed a nested case-control study where 515 patients on Remdesivir were compared to 411 patients with no Remdesivir. Cases and controls were matched for age, sex and severity. The primary outcome was in-hospital mortality and secondary outcomes were duration of hospital stay, need for intensive care unit (ICU), progression to oxygen therapy, progression to non-invasive ventilation, progression to mechanical ventilation, and duration of ventilation. Results: Mean age of the cohort was 57.05 + 13.5 years. 75.92% were males. Overall, in-hospital mortality was 22.46% (n = 208). There was no statistically significant difference in all-cause mortality among cases and controls (20.78% vs. 24.57%, p = 0.17). Progression to non-invasive ventilation was lower in the Remdesivir group (13.6% vs 23.7%, p < 0.001), however progression to mechanical ventilation was higher in the Remdesivir group (11.3% vs 2.7%, p value < 0.001*). In a subgroup analysis of critically ill patients, the use of Remdesivir lowered mortality (OR 0.32 95% CI: 0.13 - 0.75). Conclusions: Remdesivir did not decrease the in-hospital mortality in moderate to severe COVID-19 but decreased progression to non-invasive ventilation. Its mortality benefit in critically ill patients needs further evaluation. Remdesivir may be useful if given early in the treatment of patients with moderate COVID-19.

The objective of this study aims to find the effectiveness of use of tailored SMS medication reminders to improve patient medication adherence. An observational study was carried out over a period of 6 months in discharged patients of a tertiary care referral hospital in Kerala. 347 patients were enrolled prospectively from various departments. The subjects were randomized into intervention and control group in 1:1 ratio. Medication adherence was assessed using indirect- subjective patient interviewing method during pre and post intervention phase. From the post-intervention interview it was found that the level of adherence has significantly improved in intervention group (71.4%) compared to the control group (25%). The outcomes of the study revealed that female population (N= 158) is more likely to have metabolic diseases and this might be due to menopause, obesity, lack of exercise, diet and other lifestyles. In this study hypertension was found to be predominant (65.1%) followed by type II diabetes mellitus (55.9%) and dyslipidemia (44.4%). This study demonstrated the effectiveness of use of tailored SMS medication reminders to improve mediation adherence in patients with metabolic syndrome. Text message reminders significantly improve medication adherence and seems to be feasible for clinical use

Pathogen genomics is a critical tool for public health surveillance, infection control, outbreak investigations, as well as research. In order to make use of pathogen genomics data, it must be interpreted using contextual data (metadata). Contextual data includes sample metadata, laboratory methods, patient demographics, clinical outcomes, and epidemiological information. However, the variability in how contextual information is captured by different authorities and how it is encoded in different databases poses challenges for data interpretation, integration, and its use/re-use. The DataHarmonizer is a template-driven spreadsheet application for harmonizing, validating, and transforming genomics contextual data into submission-ready formats for public or private repositories. The tool’s web browser-based JavaScript environment enables validation and its offline functionality and local installation increases data security. The DataHarmonizer was developed to address the data sharing needs that arose during the COVID-19 pandemic, and was used by members of the Canadian COVID Genomics Network (CanCOGeN) to harmonize SARS-CoV-2 contextual data for national surveillance and for public repository submission.In order to support coordination of international surveillance efforts, we have partnered with the Public Health Alliance for Genomic Epidemiology to also provide a template conforming to its SARS-CoV-2 contextual data specification for use worldwide. Templates are also being developed for One Health and foodborne pathogens. Overall, the DataHarmonizer tool improves the effectiveness and fidelity of contextual data capture as well as its subsequent usability. Harmonization of contextual information across authorities, platforms and systems globally improves interoperability and reusability of data for concerted public health and research initiatives to fight the current pandemic and future public health emergencies. While initially developed for the COVID-19 pandemic, its expansion to other data management applications and pathogens is already underway.

Background Anti-fungal stewardship (AFS) is a less explored area of an anti-microbial stewardship (AMS) program as the patients prone to fungal infections are mostly immunocompromised, post-chemotherapy or post-transplant. In a Low-and- Middle income country (LMIC) like India, there is a dearth of Infectious Disease (ID) trained physicians and pharmacists. We aimed to study the effectiveness of a pharmacist led AFS program to ensure rational prescribing of antifungals via a post-prescription review and feedback method. Methods In this prospective interrupted time series analysis from June 2021 to November 2021, AFS was done on adult in-patients in the department of Hematology in a tertiary care teaching hospital in South India. The study had a pre-intervention phase and intervention phase of 3 months each. In the pre-intervention phase, patients on anti-fungal therapy > 48 hours were identified and base line data were collected and no recommendations were given. In the intervention phase, in those on antifungals >48 hours, appropriate recommendations were made with regard to modification and discontinuation of the anti-fungals based on patients’ clinical condition under the supervision of an ID physician. Acceptance and impact of the intervention were monitored and recorded. METHOD OF THE STUDY The study was a prospective study with 2 phases : pre-intervention and intervention. In the intervention phase, the appropriateness of the Anti-fungal therapy was analyzed and recommendations were given. Results A total of 193 patients were analyzed over 6 months, of which 107 patients with a mean age of 42.1 ± 14.2 belonged to the pre-intervention phase and 86 patients aged 40.2 ±12.6 years were in the intervention phase. There was no statistically significant difference in the in-hospital mortality [26.16% vs 23. 25% (p = 0.64)] between the two groups. In the intervention phase, 15 (17.44%) prescriptions were found to be inappropriate. Among these 66% of the recommendations were accepted by the treating physician. The days of therapy per 100 patient days were calculated for each individual anti-fungal drug and there was a significant reduction in consumption of Anidulafungin [29.648 Vs 14.28 (p < 0.0007)], Amphotericin B [42.05 Vs 22.18 (p< 0.0001)] and Voriconazole [56.41 Vs 35.77 (p< 0.00001)] in the intervention phase. Outcome measurements Conclusion A pharmacist led AFS program resulted in statistically significant reduction in the consumption of antifungals, without a significant difference in the in-hospital mortality. Disclosures Priscilla Rupali, MD, DTM&H, PFIZER: Grant/Research Support|PFIZER: Grant/Research Support.

Inadequate consumption of healthy food is an ongoing public health issue in the United States. Food availability measures of supply versus consumption of healthy foods are disconnected in many studies. There is a need for an objective assessment of the food environment in order to assess how the food supply aligns with the Healthy Eating Index (HEI). Data were collected as part of the Healthy Community Stores Case Study Project, including a refined Nutrition Environment Measures Survey for Healthy Community Stores (NEMS-HCS) and an updated Healthy Food Availability Index that aligns with the Healthy Eating Index (HFAHEI). This paper will focus on the NEMS-HCS development process, findings, and HFAHEI application. All food items were more likely to be found at grocery stores rather than corner stores. Food pricing was often above the Consumer Price Index averages for six food items. The NEMS-HCS assessment better aligned with the HEI because it included a wider variety of meats, frozen fruits and vegetables, and an increased selection of whole grains. HFAHEI scoring was inclusive of non-traditional and alternative community stores with a health focus, making it suitable for use at the local level, especially in neighborhoods where supermarkets and large chain stores are less common.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the efficacy and safety of favipiravir in patients with COVID‐19 as compared to standard of care without favipiravir.

Traumatic optic neuropathy (TON) can be classified into direct or indirect types. Direct optic injury usually results from optic nerve avulsion ,laceration or compression by fracture, fracture segment impingement or a resultant hematoma. Indirect optic injury is caused by increased intracanalicular pressure resulting in ischemia and disruption of neurofeedback channels. The prognosis of TON is usually quite poor. To date, no standardized treatment protocol has been developed for TON. In this study we are assessing the visual improvement in patients with direct TON who underwent endoscopic optic nerve decompression in the last 10 years. A retrospective study of 32 cases of optic nerve decompression for direct TON in the last 10 years. Preoperative and postoperative visual assessment were done and followed up for 3 months. There was complete improvement in vision in 17% of patients when optic nerve decompression was done within 72 h of trauma; whereas 31% cases had only partial improvement when done between 3 and 7 days. And there was no improvement when done after 7 days. Endoscopic optic nerve decompression is a minimally invasive surgery for direct traumatic optic neuropathy; with minimal or no complications when done by an experienced ENT surgeon. Other important prognostic factors include timing of surgery and preoperative visual status.Traumatic optic neuropathy (TON); mainly classified into direct and indirect types, do not have a well established treatment protocol till now.Direct type of optic neuropathy is caused by injury to optic nerve, by fracture lines or segments.TON not resolving with medical decompression is taken up for endoscopic optic nerve decompression as early as possible; preferably within 72 h.Pre operative visual status is one of the main prognostic factor along with timing of surgery; patients with at least perception of light fared way better than those with no perception of light.Patients in whom EOND was done within 72 h had better visual improvement than those in whom intervention was done after 72 h.

Background: Monoclonal antibodies have gained attention in developing countries owing to its benefits portrayed by few clinical trials. However, no studies until now have been undergone in India. Methods: A retro-prospective comparative observational study was conducted in symptomatic COVID19 patients to evaluate the impact of Casirivimab and Imdevimab antibody cocktail in the high-risk population. Through an extensive data retrieval for 6 months, 152 samples were documented and sorted into test (Casirivimab and Imdevimab treated patients, n = 79) and control (Non- Casirivimab and Imdevimab treated individuals, n = 73) subsets. The research had two phases; first, estimation of mechanical ventilation and high flow oxygen requirement and mortality in samples amidst the treatment, and second was the post COVID19 patients' feedback through validated (Cronbach's alpha coefficient = 0.7) questionnaire that evaluated their health and vaccination status, and treatment satisfaction. Results: We noticed lesser requisite for mechanical ventilation (6.3%; p

Background The COVID-19 pandemic has sparked a surge in the use of virtual communication tools for delivering clinical services for many non-urgent medical needs allowing telehealth or telemedicine, to become an almost inevitable part of the patient care. However, most of patients with vascular disease may require face-to-face interaction and are at risk of worse outcomes if not managed in timely manner. Objective We aimed to describe the utilization of telemedicine services in the outpatient vascular surgery clinics in a tertiary hospital. Methods A retrospective analysis of data on all vascular outpatient encounters during 2019 and 2020 was conducted and compared to reflect the pattern of practice prior to and during the COVID-19 pandemic. Results The study showed that 61% of the total patient encounters in 2020 were reported through teleconsultation. Females were the majority of patients who sought the virtual vascular care. Consultations for the new cases decreased from 29% to 26% whereas, the follow-up cases increased from 71% to 74% in 2020 (p = 0.001). The number of procedures performed in the vascular outpatient clinics decreased by 46% in 2020 when compared to 2019. This decrease in procedures was more evident in the duration from February 2020 to April 2020 in which the procedures decreased by 97%. The proportion of procedures represented 22.6% of the total encounters in 2019 and 10.5% of the encounters during 2020, (p = 0.001). Conclusions Teleconsultation, along with supporting practice guidelines, can be used to maximize the efficiency of care in vascular surgery patients during the pandemic and beyond. Adoption of the ‘hybrid care’ which combines both virtual and in-person services as an ongoing practice requires evidence obtained through audits and studies on patients and healthcare providers levels. It is essential to establish a clear practice that ensures patient’s needs.

There has been an increased demand for Energy Storage Systems (ESS) as they power most of today's remote devices and are needed to sustain the ongoing transportation electrification revolution to curb pollution levels. State-of-Charge (SOC) and State-of-Health (SOH) assessment of batteries is vital to prevent unexpected shutdown of battery powered consumer electronics and to determine the expected range from an Electric Vehicle. SOC & SOH estimators demand high-quality curated battery parameter data such as current, temperature and voltage over several charge/discharge cycles. Experiments needed to collect such data are expensive and tedious. Lack of diversity in open access battery datasets have hindered research in this area. This paper is focused on synthetic generation of battery parameters from sparse datasets. The goal is to produce high-fidelity heterogeneous time-series datasets which help to overcome the problem of lack of data in the ESS domain.

Supplemental Nutrition Assistance Program (SNAP) enrollment has increased dramatically during the COVID19 economic crisis Currently, one in three households with children experiences food insecurity, the greatest prevalence in modern times 1 SNAP effectively reduces poverty and improves food insecurity,2 and the current recession has increased many US households' reliance on federal nutrition programs These new developments have intensified ongoing public debate about the most effective program designs for promoting food security and dietary quality SNAP fruit and vegetable (FV) incentives aim to improve diet quality for participants by providing matching funds for FVs purchased with electronic benefit transfer (EBT) SNAP incentives encourage healthy eating behaviors by subsidizing FV purchase and consumption FV incentives have been piloted nationwide, providing important evidence than can inform optimal program design However, incentives are not uniformly available to all SNAP participants, and there are currently insufficient federal resources appropriated to expand incentives nationwide We review the scientific evidence base for FV incentives and their correlation with healthy eating behaviors, highlight potential challenges for scaling FV incentive programs, and explain the public health opportunity associated with nationwide expansion of evidencebased FV incentives

OBJECTIVES: Greater number and increased frequency of farmers’ markets are an important strategy to improve community-level diet quality by increasing fruit and vegetable availability, yet fall short of addressing health disparities due to a predominantly affluent, white clientele. Introducing Supplemental Nutrition Assistance Program (SNAP) financial incentives at farmers’ markets increases patronage and sales amongst people with economic disadvantage, however SNAP participant incentive program awareness and farmers’ market sales remain low. This study examined whether a digital campaign promoting SNAP incentive programs increases farmers’ market SNAP participation. METHODS: This study was a parallel RCT, with randomization of zip codes to receive (a) digital promotions or (b) no additional promotions. The study sample included target zip codes (n = 96) near New England farmers’ markets with SNAP incentive programs (n = 23). The intervention was a 13-week campaign, placing digital ads on Facebook and the Fresh EBT app promoting SNAP incentive program savings at farmers’ markets. The study measured farmers’ market SNAP shopping patterns and sales as well as digital campaign delivery and engagement. Data were collected July 1 – September 30, 2020. RESULTS: The digital campaign reached 251,966 people, generated 2 million impressions, and resulted in 12,849 clicks. During Summer 2020, zip codes randomized to receive digital promotions had 33.1 SNAP transactions (SE: 6.9) and control zip codes had 18.1 transactions (SE: 4.3), or 82% more transactions associated with promotions (P = 0.068). There were also more new customers from promotion zip codes (10.8 [SE = 2.5] customers) than control zip codes (5.7 [SE = 1.4] customers), or 90% more new customers (P = 0.075). SNAP and incentive sales were higher from promotion zip codes ($1392 [SE: $306]) than control zip codes ($949 [SE: $273]), or 47% greater (P = 0.284), but sales differences were not statistically significant unless controlling for Summer 2019 farmers’ market sales. CONCLUSIONS: Digital SNAP incentive program promotions can increase farmers’ market SNAP participation, the primary study outcome, leveraging SNAP to expand farmers’ market reach and associated nutrition benefit to historically marginalized populations. FUNDING SOURCES: USDA Food Insecurity Nutrition Incentives Program.

In the United States, low-income, underserved rural and urban settings experience poor access to healthy, affordable food. Introducing new food outlets in these locations has shown mixed results for improving healthy food consumption. The Healthy Community Stores Case Study Project (HCSCSP) explored an alternative strategy: supporting mission-driven, locally owned, healthy community food stores to improve healthy food access. The HCSCSP used a multiple case study approach, and conducted a cross-case analysis of seven urban healthy food stores across the United States. The main purpose of this commentary paper is to summarize the main practice strategies for stores as well as future directions for researchers and policy-makers based on results from the prior cross-case analyses. We organize these strategies using key concepts from the Retail Food Environment and Customer Interaction Model. Several key strategies for store success are presented including the use of non-traditional business models, focus on specific retail actors such as store champions and multiple vendor relationships, and a stores’ role in the broader community context, as well as the striking challenges faced across store locations. Further exploration of these store strategies and how they are implemented is needed, and may inform policies that can support these types of healthy retail sites and sustain their efforts in improving healthy food access in their communities.

Mission-driven, independently-owned community food stores have been identified as a potential solution to improve access to healthy foods, yet to date there is limited information on what factors contribute to these stores’ success and failure. Using a multiple case study approach, this study examined what makes a healthy community food store successful and identified strategies for success in seven community stores in urban areas across the United States. We used Stake’s multiple case study analysis approach to identify the following key aims that contributed to community store success across all cases: (1) making healthy food available, (2) offering healthy foods at affordable prices, and (3) reaching community members with limited economic resources. However, stores differed in terms of their intention, action, and achievement of these aims. Key strategies identified that enabled success included: (1) having a store champion, (2) using nontraditional business strategies, (3) obtaining innovative external funding, (4) using a dynamic sourcing model, (5) implementing healthy food marketing, and (6) engaging the community. Stores did not need to implement all strategies to be successful, however certain strategies, such as having a store champion, emerged as critical for all stores. Retailers, researchers, philanthropy, and policymakers can utilize this definition of success and the identified strategies to improve healthy food access in their communities.

Electrohysterogram (EHG) is a noninvasive approach for recording the electrical activity of the uterine muscles (myometrium). It is also known as Uterine Electromyogram (Uterine-EMG). Since it is a non-invasive alternative, it is a safe and painless procedure to monitor uterine activity. In this paper, a wavelet transformation technique was used to preprocess the raw EHG signal, to remove artifacts present in it. A secondary time series was computed from the peak intervals of the EHG signals. This was followed by the extraction of the non-linear features from this time series. The classification of labor and non-labor signals was performed with a KNN algorithm. An accuracy of 90.32% was achieved with the KNN model. With supervised learning models, labor contractions were correctly identified in women who had just entered their third trimester but had not crossed the 37th week mark. With this knowledge, potential cases of preterm births could be identified. This knowledge could assist doctors in premeditating the prevention of still-births.

Background Behavioral and psychological symptoms of dementia (BPSD) influence older persons’ quality of life. Non-pharmacological interventions such as individualized music (iM) are promising to reduce BPSD and sustain interpersonal connectedness that contributes to quality of life. The purpose of this study was to assess the practicalities (e.g., process, results) of iM activities application on older adults over 65 years of age diagnosed with dementia living in residential care facilities. Our objectives were to: a) evaluate the recruitment process; b) explore the process of iM activity implementation; c) assess the clinical significance of the outcomes. Methods A concurrent mixed methods feasibility study designed and was conducted in two residential care facilities in British Columbia, Canada to assess the practicalities (i.e., recruitment, acceptability of the intervention, adherence to it, and clinical significance) of iM activities implementation on older adults diagnosed with dementia living in residential care facilities. Data were collected from residents, their families and staff using administrative records, observations, surveys, and interviews. Our primary outcomes were affect and quality of life. Results The observed iM activities were feasible, acceptable and adhered to by residents with clinical significance. Specifically, about 47% of eligible residents, their families and staff agreed to participate in and completed the study (recruitment); approximately 86% of participants enthusiastically received and were satisfied with the iM activity (acceptability); more than 70% of participants completed at least seven of the nine iM sessions (adherence); about 55% of participants experienced an increase in positive affect scores and 29% had a decrease in negative affect scores after the intervention; more than 43% of participants had a reduction in BPSD (clinical significance). Finally, participants reported improvement of quality of life and positive effects of iM intervention and provided insights and suggestions to improve it. Conclusions Individualized music activities can be successfully implemented (i.e., feasible, acceptable, adherent) with significant clinical outcomes. Participants reported positive affect emotions, increase in quality of life and well-being. With this feasibility study, we developed a process to identify challenges and their solutions that may assist us in a following pilot study with similar iM intervention.

In this contribution, our aim is to study the linear and non-linear optical activity and their variation with the addition/removal of electron withdrawing and electron donating groups in hexafluorinated dithienylethenes (HFDTE). By varying the terminal groups in the parent HFDTE, we have considered 16 closed-open pairs of substituted HFDTE and studied their electronic structures, one and two-photon absorption spectra and static first hyperpolarizability. All the calculations have been performed using the state-of-the-art linear and quadratic response theory within the framework of TD-DFT methods. RI-CC2 method is used as a reference to validate the applicability of TD-DFT method.

The protocols for managing intractable idiopathic epistaxis have evolved with advances in endoscopic techniques. Transnasal endoscopic sphenopalatine artery ligation (TESPAL) has been the treatment of choice for idiopathic intractable epistaxis. If TESPAL fails, transantral ligation of internal maxillary artery (IMA) used to be the dictum along with radiological interventions. Here we discuss about the role of endoscopic IMA ligation in cases of failed TESPALs. Retrospective study at a tertiary hospital was performed. 28 cases of intractable idiopathic epistaxis underwent TESPAL in our institution of which 2 cases had rebleed. We also had two referred cases of failed TESPALS. Of this 4 patients, three patients underwent endoscopic IMA ligation and one patient underwent selective embolisation. All the patients who underwent endoscopic IMA ligation for failed TESPAL had no further episodes of epistaxis. One patient who underwent selective embolization also had no further episodes of bleed but had transient facial pain and trismus. When TESPAL fails, endoscopic IMA ligation can be considered as an alternative procedure before resorting to embolization.

After China, Europe, and the United States, India is the fourth largest market for tyres in the world. Tyres manufactured in Indian are being exported to more than 100 countries in the world, including the most astute regions such as US and European nations. Covid-19 has pressed a reset button for all the businesses. It began as a health emergency, but has transmuted into an existential crisis for most of the industries. There is no doubt, the formats for doing businesses would change. Being a progressive sector of Indian manufacturing, tyre industry is riding the waves of change. New concepts such as contactless services are already being implemented as a measure of safety. While the global supply chain addresses the disruptions that the pandemic has caused, Indian tyre industry has the potential to lead in manufacturing at a global level, taking into consideration of the policy changes related to Prime Minister’s call to build a self-reliant India. This paper explores the current status of tyre industry, factors that contribute to higher productivity in the industry, challenges faced by it and the prospects of the industry in moving towards ‘Atmanirbhar Bharat’.

BackgroundThe first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1.MethodsMARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site’s local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient.DiscussionA mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform.We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation.

Several phytoceuticals and extracts of medicinal plants are reported to mitigate deleterious effects of ionizing radiation. The potential of hydro-alcoholic extract of Clerodendron infortunatum (CIE) for providing protection to mice exposed to gamma radiation was investigated. Oral administration of CIE bestowed a survival advantage to mice exposed to lethal doses of gamma radiation. Radiation-induced depletion of the total blood count and bone marrow cellularity were prevented by treatment with CIE. Damage to the cellular DNA (as was evident from the comet assay and the micronucleus index) was also found to be decreased upon CIE administration. Radiation-induced damages to intestinal crypt cells was also reduced by CIE. Studies on gene expression in intestinal cells revealed that there was a marked increase in the Bax/Bcl-2 ratio in mice exposed to whole-body 4 Gy gamma radiation, and that administration of CIE resulted in significant lowering of this ratio, suggestive of reduction of radiation-induced apoptosis. Also, in the intestinal tissue of irradiated animals, following CIE treatment, levels of expression of the DNA repair gene Atm were found to be elevated, and there was reduction in the expression of the inflammatory Cox-2 gene. Thus, our results suggest a beneficial use of Clerodendron infortunatum for mitigating radiation toxicity.

Single logic style based decoder consumes more no of transistors, more power. Mixed logic design is alternative to this. Mixed logic style combines different logic style in one circuit. Hence a circuit gets advantage of different logic style.2-4 mixed decoder with enable offers low power compared to conventional CMOS logic style. Circuits are simulated using T-spice at 32nm technology node. Proposed decoder shows a 12% reduction in power.

Background: Chronic rhinosinusitis (CRS) with its classical symptoms of nasal obstruction, nasal discharge, and headache is relatively a common disease in otorhinolaryngology practice. The objectives of the present study was to correlate the operative findings in such patients with the CT findings, using the Perioperative sinus endoscopy (POSE) scoring system and to correlate the maximum scores obtained in the POSE scoring system and Lund-Mackay scoring system.Methods: A prospective study was conducted from January 2014 to March 2015 in 50 patients suffering from chronic rhinosinusitis who underwent endoscopic sinus surgery in the age group of 36-60 years of age. Results: Agger nasi cells were the most common wandering ethmoid cell detected (90%) followed by various types of frontal cells (54%), Haller cells (26%) and least commonly Onodi cells (12%). Almost perfect agreement was obtained for rest of the criteria which included middle turbinate status, ethmoid cavity mucosal edema and ethmoid cavity polypoid change. Lund-Mackay scoring system was used to score findings in the CT scan and POSE scoring system used to score peroperative findings in the study and this study reveals excellent correlation (Pearson correlation value of 0.879).Conclusions: Novel POSE scoring is a new entity which has the potential to be a valid system to score preoperative and perioperative findings. In the current study POSE scoring shows excellent correlation with Lund Mackay scoring which is an established scoring system used in the evaluation CT scan.