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Wireless sensor networks (WSNs) are the substantial parts of any Internet of Things (IoT)-based applications. A WSN is deployed to collect essential data from a specific application field in the IoT. A WSN can fail for various reasons, which can disrupt the operation of numerous IoT applications. The main threat to network failure is topology changes, node failure due to battery drain, or breakdown of the wireless nodes communication module. An effective fault tolerance mechanism for WSN can guarantee reliable data acquisition and transmission in IoT applications. This paper proposes a fault-tolerant cluster-based routing protocol for WSNs using a hybrid algorithm called FAGWO-H, which combines Firefly Optimization (FA) and Grey Wolf Optimization (GWO). FA is employed for optimal clustering, and GWO chooses the best route between the cluster head (CH) and the base station. The proposed method uses two novel fitness functions for FA and GWO. The algorithm considers the energy efficiency and fault-tolerant aspect of the sensor nodes and CHs to improve network performance while meeting QoS criteria. We assessed the effectiveness of the techniques using several WSN scenarios and compared them to the existing state of art methods. [ABSTRACT FROM AUTHOR]

Background: Complementary and alternative medicine (CAM), includes a wide range of approaches such as herbal medicine, traditional therapies, mind-body intervention, etc. Although CAM is a common practice in India, it is not being integrated into the conventional medical system. There is a paucity of data regarding the usage and acceptance of CAM by patients. Objective: The aim was to determine the knowledge, attitudes, and practice toward CAM among patients and to correlate these findings with their demographic and professional characteristics. Materials and Methods: A cross-sectional, questionnaire-based survey conducted in 100 patients attending out-patient department of a tertiary care teaching hospital. Results: Among the respondents, 79.0% were aware of CAM and 46.0 used it. Most common system used was Ayurveda (71.73%), and most common ailment for which it is used was arthritis (30.43%). Majority consulted quacks (43.47%); physicians (23.91%), friends and relatives (19.56%), and 15.21% took CAM as a self-medication. Thirty percent felt that CAM was based on scientific evidence, 25% felt it was safer than modern medicine that is significantly more in women when compared to men. Twenty-five percentage opined that CAM is more efficacious than modern medicine that is significantly more in respondents >40 years age. The most common advantages reported were complete cure, easy availability and no side-effects, whereas disadvantages include food restriction, expensive medication, symptomatic relief and effective for limited diseases. Conclusion: Majority of patients use CAM along with modern medicine without physician's advice. Hence, healthcare professionals should be aware of this while taking clinical history and treating patients that may reduce drug interactions due to use of CAM particularly in the elderly population. [ABSTRACT FROM AUTHOR]

Objective: To evaluate adherence to medication and study factors associated with nonadherence in chronic kidney disease (CKD) patients. Methods: A prospective, cross-sectional, questionnaire based study was conducted in Nephrology department of a super specialty hospital. Patients above 18 years of age, suffering from CKD from six months or more were interviewed using self-designed, semi-structured questionnaire to get information about adherence to medication, diet restriction and lifestyle modification (n = 150). Morisky medication adherence questionnaire was used to calculate overall adherence. In this higher score indicates poor adherence. Main outcome measures included prevalence of non-adherence and factors associated with the same. Results: Average number of medicines taken by each patient was 8.0+1.612 (mean+SD) per day. Non-adherence to medication schedule was reported in 34% patients. Common causes of non-adherence were high cost (21.3%), complex dosing schedule (20%), fear of adverse effects (16%). Sixty-eight% patients were not aware about importance of taking each medicine. Sixteen% stopped taking medicines due to high cost. Forty-two% suggested that government should adopt measures to provide free medicines to poor patients. In Morisky medication adherence questionnaire high, medium and low adherence was reported in 7.3%, 55.3% and 37.3% of patients, respectively. Moderately positive correlation was observed between poor adherence and number of concurrent illnesses and number of medicines taken. Conclusion: Since majority of patients were not aware about importance of taking each medicine, creating awareness about the same is essential for improving adherence to therapy. Measures to provide free medicines to non-affording patients need to be implemented since high cost was other major cause of non-adherence. [ABSTRACT FROM AUTHOR]

Objective: To evaluate adherence to medication and study factors associated with nonadherence in chronic kidney disease (CKD) patients. Methods: A prospective, cross-sectional, questionnaire based study was conducted in Nephrology department of a super specialty hospital. Patients above 18 years of age, suffering from CKD from six months or more were interviewed using self-designed, semi-structured questionnaire to get information about adherence to medication, diet restriction and lifestyle modification (n = 150). Morisky medication adherence questionnaire was used to calculate overall adherence. In this higher score indicates poor adherence. Main outcome measures included prevalence of non-adherence and factors associated with the same. Results: Average number of medicines taken by each patient was 8.0+1.612 (mean+SD) per day. Non-adherence to medication schedule was reported in 34% patients. Common causes of non-adherence were high cost (21.3%), complex dosing schedule (20%), fear of adverse effects (16%). Sixty-eight% patients were not aware about importance of taking each medicine. Sixteen% stopped taking medicines due to high cost. Forty-two% suggested that government should adopt measures to provide free medicines to poor patients. In Morisky medication adherence questionnaire high, medium and low adherence was reported in 7.3%, 55.3% and 37.3% of patients, respectively. Moderately positive correlation was observed between poor adherence and number of concurrent illnesses and number of medicines taken. Conclusion: Since majority of patients were not aware about importance of taking each medicine, creating awareness about the same is essential for improving adherence to therapy. Measures to provide free medicines to non-affording patients need to be implemented since high cost was other major cause of non-adherence. [ABSTRACT FROM AUTHOR]

Objectives: Health-related quality of life (QOL) is an important outcome in epilepsy treatment. Very few studies have been carried out on the quality of life in epilepsy (QOLIE-31) in India. The present study aimed to determine the level of health-related QOLIE-31 in patients of epilepsy. Materials and Methods: This was a cross-sectional, questionnaire-based study conducted in a tertiary care teaching hospital. Respondents were adults aged at least 18-year-old with a diagnosis of epilepsy. QOLIE-31 was used for collecting data on health-related QOL. The unpaired t-test or one-way analysis of variance was used to compare means of QOL scores between groups. Results: Totally, 60 patients of epilepsy were included in the study. The mean (standard deviation) total score of QOLIE-31 was 64.61. A score of cognitive and medication effect were significantly better in carbamazepine group as compared to valproate group. Conclusions: Patients on monotherapy had a better QOL as compared to patients receiving polytherapy. [ABSTRACT FROM AUTHOR]

Objectives: Patients with chronic kidney disease (CKD) suffer with multiple comorbidities and complications like secondary hyperparathyroidism and hyperphosphotemia. Altered mineral metabolism contributes to bone disease and cardiovascular disease. In patients of CKD, despite dietary phosphorus restriction, phosphate binders (PBs) are recommended to control phosphorous level. No studies about the utilization pattern of PBs in CKD patients have been reported from India. This study analyses the current prescribing trends in the management of CKD patients undergoing tertiary care with focus on PBs. Materials and Methods: This cross-sectional, observational study was conducted in nephrology department of a government super speciality hospital over 8-month period from January to August 2011. Demographic, clinical, and medication details were collected in a specially designed proforma. Results: A total 111 prescriptions were included in the study. Average number of drugs per prescription was 9.47. About 41.53% of the prescribed drugs were from the World Health Organization essential medicines list. Out of total prescribed drugs (1052), most commonly prescribed were vitamins and minerals (24.71%), cardiovascular drugs, (22.14%), and hematopoietic agents (20.15%). Considering individual drugs, five most commonly prescribed drugs were multivitamins (14.82%), iron (8.65%), folic acid (8.55%), calcium carbonate (8.17%), and calcitriol (5.60%). A total of 11.02% of prescribed drug were PBs. Among PBs, calcium carbonate was the most frequently prescribed and sevelamer was the least prescribed PB. No patient was prescribed lanthanum carbonate. Conclusion: This study identified a wide variety of drug classes including PBs prescribed in CKD patients. Although sevelamer hydrochloride has less side effects as compared to calcium salts, it was less prescribed since it is costlier. [ABSTRACT FROM AUTHOR]