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One of the most common symptoms in the orofacial region is pain. Trigeminal neuralgia is characterized by pain affecting the trigeminal nerve and its related areas of distribution and is known to have significant impact on the quality of life. Misdiagnosis of trigeminal neuralgia has been reported by dentists in several previous studies in the literature. With this rationale, the aim of the present study is to determine the most commonly involved nerve branch and the side affected in trigeminal neuralgia patients. The present retrospective study involved 72 patients diagnosed with trigeminal neuralgia who reported from October 2013 to October 2014. Data regarding the age of onset, gender, side of involvement was analyzed from their clinical records. Out of the 72 patients, males were 42(58.3%) and females were 30(41.7%). In our study, a total of 56 % (i.e., 40) patients showed involvement on the right and 44% (i.e., 32) (i.e, 32) patients on the left side of the face. In this retrospective study, ophthalmic branch (V1) was affected only in 3 patients. Mandibular nerve (V3) alone was involved in 24 patients. Involvement of all the three divisions V1, V2 and V3 was seen in 16(22.3%) of patients. Clinical similarities of trigeminal neuralgia that have an impact on different populations were demonstrated in this study. Detailed history and proper identification of involved nerve branch play an important role in the diagnostic accuracy and treatment satisfaction. Most involved branch in our study was the mandibular (V3) branch and the most affected side was the right side. Correlation of systemic factors with trigeminal neuralgia can be attempted in future research.

Background The secretome of the dental pulp mesenchymal stem cells (DPMSCS-S) have an array of regenerative potential and could aid in the rehabilitation of cancer patients post-therapeutic interventions, although caution is required as DPMSC-S have shown to augment prostate cancer cells. Thus, it is vital to assess if these pro-carcinogenic effects extend to other cancer types. Objective To assess if DPMSC-S has any pro-carcinogenic effect on oral cancer, breast cancer, and melanoma cell lines. Materials and methods Conditioned media obtained from the isolated and characterized DPMSC (DPMSC-CM) were profiled using bead-based multiplex assay. AW13515 (oral cancer), MDA-MB-231 (breast cancer), and A-375 (melanoma) cell lines were exposed to 20%, 50%, and 100% DPMSC-CM for 24, 48, and 72 h. DPMSC-CM effect on the cancer cell properties and secretome were assessed. Results DPMSC-CM augmented invasion, adhesion, multi-drug resistance, DNA repair, and mitochondrial repair in AW13516 through upregulation of growth factors Ang-2, EGF, M−CSF, PDGF-AA, PDGF-BB, pro-inflammatory cytokines TNF-α, IL-2, downregulation of anti-inflammatory cytokine TGF-β1, and pro-inflammatory cytokine IL-4. In MDA-MB-231, invasion, and multi-drug resistance were augmented through upregulation of growth factors EGF, EPO, G-CSF, HGF, M−CSF, PDGF-AA, and pro-inflammatory cytokine TNF-α, CXCL10, IL-12p70. EMT, invasion, migration, and adhesion were augmented in A-375 through upregulation of growth factors Ang-2, EGF, PDGF-BB, TGF-α, pro-inflammatory cytokines TNF-α, and IL-17A. Conclusion DPMSC-CM can augment the carcinogenic properties of oral cancer, breast cancer, and melanoma cells, further animal model studies are required to validate our in-vitro findings.

Optimal nutrition is crucial for honey bee colony growth and robust immune systems. Honey bee nutrition is complex and depends on the floral composition of the landscape. Foraging behavior of honey bees depends on both colony environment and external environment. There are significant gaps in knowledge regarding honey bee nutrition, and hence no optimal diet is available for honey bees, as there is for other livestock. In this review, we discuss (1) foraging behavior of honey bees, (2) nutritional needs, (3) nutritional supplements used by beekeepers, (4) probiotics, and (5) supplemental forage and efforts integrating floral diversity into cropping systems.

Brain–computer interface (BCI) can permit individuals to use their thoughts as the sole means to control objects such as smart homes and robots. While BCI is a promising interdisciplinary tool, researchers are confronting network lifetime as an obstacle to further development. Furthermore, the medium access control (MAC) protocol is the bottleneck of the network reliability. There are many standards for MAC protocols that can be utilized for productive and dependable transmission by altering the control parameters. Modifying these parameters is another source of concern due to the scarcity in knowledge about its effect. In addition, there is no instrument accessible to receive and actualize these parameters on transmitters embedded inside the cerebrum. In this article, we give the transmission instrument to both ultrahigh-frequency (UHF) radio frequency identification (RFID) and ultra-wideband (UWB) signals for multiple transmitters and ultrasonic technology mimicking the neural dusts by modifying the superframe structure. In this article, a hybrid MAC protocol is proposed, and the results show that the traffic received can be increased by 700% for UHF-RFID and more than 100% for UWB and ultrasonic technology. Comparative results for wireless channel MAC protocols using these different transmission techniques are discussed in terms of network delay, data dropped, traffic sent, and traffic received.

OBJECTIVE:The goal of this study is to predict the long term LV function in RV apical paced patients. BACKGROUND:We have used the GLS measured by 2D STE, as a tool to predict the patients who are at high risk of developing pacing induced LV dysfunction (PIVD) or pacing induced cardiomyopathy (PCMP). METHOD: A prospective study conducted in the cardiology department of Government Rajaji Hospital, Madurai, including 47 patients of AV block or sinus node dysfunction with preserved ejection fraction undergoing RV apical pacing. This study population was followed up with serial trans thoracic 2D echocardiography with GLS by STE for a period of 12 months for the development of PIVD (PCMP). RESULTS: Of the study population, 42.5% (n=20) developed PIVD at 12 months and these patients had a signicant fall in their GLS values at one month post pacing. (GLS -16.94% vs -17.60%; p=0.02). CONCLUSION: GLS, a novel echocardiographic parameter can be used as a tool in predicting the decline in ejection fraction following pacemaker implantation with potential to predict the development of PIVD. GLS at one month post pacing had a high predictive accuracy for identifying those who developed PIVD later in the follow up.

Maize (Zea mays L.) is the most widely grown cereal in the world, accounting for 1,116.34 MT of production in 2019/2020. In Africa, this crop represented approximately 56% of the total cultivated area from 1990 to 2005. About 50% of the African population depends on maize as a staple food and source of carbohydrates, protein, iron, vitamin B, and minerals. Lately, maize has become a cash crop which contributes to the improvement of farmers' livelihoods. For example, the Strategic Plan for Agricultural Transformation (SPAT) III outlined that fertilizer availability in Rwanda should increase to 55,000 MT per year, while fertilizer use should increase from 30 kg/ha in 2013 to 45 kg/ha for the 2017/18 cropping season. Only inorganic fertilizers are currently being used in maize production in Rwanda. This research was conducted to assess the effects of liquid (CBX: Complete Biological Extract) and granular fertilizers on maize crop yields in Rwanda. The study was conducted in the fields of the Rwanda Agriculture and Animal Resources Development Board (Rubona Station) during the 2018/2019 cropping season. Analysis of variance (ANOVA) was used to determine whether differences between treatments were statistically significant, with the threshold for statistical significance set at p < 0.05. Aboveground biomass differed significantly between treatments, with maximum and minimum values of 11,475 kg and 7,850 kg, respectively, being observed. Furthermore, the harvest index differed significantly between treatments, with minimum and maximum values of 0.2136 and 0.33, respectively, being observed. Grain yield also differed significantly between treatments, with the highest value (3,053 kg/ha) observed for a treatment which applied liquid and granular fertilizer at equal proportions (treatment 8), and the lowest one was found in treatment 3 with 1,852 kg/ha. In this study, the gap between the lowest and highest grain yields was about 39.3%. In conclusion, the combination of organic liquid fertilizer and granular fertilizer can significantly increase the grain yield of maize in Rwanda.

Post-surgical recurrence and metastasis remain to be the major concern in oncology. The absence of any therapeutic modality during the interim period between the surgical intervention and initiation of conventional radiotherapy and chemotherapy allows the residual cancer cells to proliferate, culminating in recurrence and/or metastasis. Introducing a therapeutic modality during this interim period could suppress the proliferation of the residual tumor cells. Further, as the detrimental effects of conventional chemotherapy and radiotherapy drastically reduce the patient’s quality of life, use of therapeutic modality with localized effect can reduce the risk of systemic toxicity. Thus, the present manuscript reviews the potential use of scaffold-mediated local chemotherapy in oncology. Its localized effect would prevent systemic toxicity, while the scaffold serves as an ideal vehicle for the sustained targeted delivery of therapeutic agents.

Background and objective: Spinal anaesthesia is the most common technique of regional anaesthesia used for lower abdominal and lower limb surgeries. Bupivacaine is the commonly administered drug. Ropivacaine, is an amino amide local anaesthetic, which has less cardiovascular and central nervous systems toxicity compared with bupivacaine. This study is undertaken to compare plain and hyperbaric solutions of ropivacaine in spinal anaesthesia. Methods: 80 patients of ASA I/II physical status undergoing elective lower abdominal and lower limb surgeries were randomised into 2 groups. Group C (n=40) patients received 3ml of 0.75% plain ropivacaine with 0.4 ml of normal saline and Group D (n=40) patients received 3 ml of 0.75% plain ropivacaine with 0.4 ml of 25% dextrose. Hemodynamic parameters, time of onset and duration of sensory and motor blockade, maximum height of block, total duration of sensory and motor blockade and time to mobilise were recorded. Results: Hemodynamic parameters were comparable between the two groups except at few intervals. Demographic data and duration of surgery were comparable. The onset of block to T10 in group C 10.1 ± 1.6 min, group D 4.6 ± 0.9 (p value

Background: Pharmacological factors used to induce insulin resistance (IR) in in vitro models may not mimic the full in vivo features of type 2 diabetes mellitus (T2DM). This study aimed to examine the ability of diabetic serum (DS) to induce IR and investigate whether adipose-derived mesenchymal stem cell conditioned medium (ADMSC-CM) reverses DS-induced IR. Methods: DS was obtained from newly diagnosed T2DM patients. IR was induced in differentiated 3T3-L1 cells by employing dexamethasone, tumor necrosis factor alpha (TNF-α), palmitate and DS. Glucose uptake (2-[N-[7-nitrobenz-2-oxa-1,3-diazol-4-yl] amino]-2-deoxyglucose(2-NBDG) uptake assay), intracellular levels of reactive oxygen species (ROS), and superoxide radicals (O2−) (fluorescence microscopy and fluorometry) were analyzed in control and experimental samples. mRNA expression of key genes involved in glucose transport and inflammation were analyzed by using reverse transcription polymerase chain reaction (RT-PCR). Pro-inflammatory cytokines and phospho-insulin receptor substrate (IRS) (Ser-307) protein expression were analyzed by fluorescence activated cell sorter analysis. Statistical significance was determined by using one-way ANOVA followed by Tukey's multiple comparison tests. Results: ADMSC-CM significantly increased the DS-mediated decrease in 2-NBDG uptake (11.01 ± 0.50 vs. 7.20 ± 0.30, P

Diabetes is a chronic metabolic disorder of the endocrine system characterized by an increase in blood glucose level. Several factors, such as pancreatic damage, oxidative stress, infection, genetic factor, obesity, liver dysfunction, play a vital role in the pathogenesis of diabetes, which further leads to serious diabetic complications. The diabetic wound is one such complication where the wound formation occurs, especially due to pressure and its healing process is disrupted due to factors, such as hyperglycemia, neuropathy, nephropathy, peripheral vascular disease, reduction of blood flow, atherosclerosis, impaired fibroblast. The process of wound healing is delayed due to different abnormalities like alteration in nitric oxide level, increase in aldose reductase, sorbitol, and fructose. Therefore, diabetic wound requires more time to heal as compared to the normal wound. Healing time is delayed in diabetic wound due to many factors, such as stress, decreased oxygenation supply, infection, decreased blood flow, impaired proliferation and migration rate, impaired growth factor production, impaired keratinocytes proliferation and migration, and altered vascular endothelial mediators. The current treatment for diabetic wounds includes wound patches, oxygenation therapy, hydrogel patches, gene therapy, laser therapy, and stem cell therapy. Medications with phytoconstituents are also one way to manage the diabetic wound, but it is not more effective for quick healing. The objective of this review is to understand the potential of various management options which are available for diabetic wound, with a special focus on biological cells.

Diabetes mellitus is the 7th leading cause of death worldwide. Diabetes can affect the organ systems and lead to serious complications, majorly categorized as macrovascular complications, microvascular complications, and diabetic wounds. Foot ulcer develops in 15-25% diabetic patients. In diabetic wound, there is an impairment in growth factor, neuropeptide, matrix metalloproteinases, angiogenesis, and immune system. Many approaches are being experimented to manage this major complication of diabetic foot, but unfortunately with lower success rate. Stem cell is an upcoming field which is being explored in the world of diabetes. Hence, this review is designed to understand the basic pathogenesis and complications of types of diabetes and the role of stem cells in a diabetic wound and the benefits related to it.

The increasing adoption of transmission of medical images through internet in healthcare has led to several security threats to patient medical information. Permitting quiet data to be in peril may prompt hopeless harm, ethically and truly to the patient. Accordingly, it is important to take measures to forestall illicit access and altering of clinical pictures. This requests reception of security components to guarantee three fundamental security administrations – classification, content-based legitimacy, and trustworthiness of clinical pictures traded in telemedicine applications. Right now, inside created symmetric key cryptographic capacities are utilized. Pictorial model-based perceptual image hash is used to provide content-based authentication for malicious tampering detection and localization. The presentation of the projected algorithm has been evaluated using performance metrics such as PSNR, normalized correlation, entropy, and histogram analysis, and the simulation results show that the security services have been achieved effectively.

Fractures of surgical neck of the humerus represent 25% of the proximal part of humerus. Neer described three types of fracture of the surgical neck: angled, translated/separated and comminuted. Proximal humeral nail and PHILOS plate fixation for the surgical neck of humeral fractures offers good anatomic fracture reduction and stable primary fixation to ensure rapid fracture healing and imme­diate post-operative functional therapy without prolonged immobilization. Objective: To assess and compare the functional outcome and the fracture union of surgical neck of humerus fractures using proximal humeral nail and PHILOS plate. Material and Method: Prospective Comparative study was conducted at Bapuji and Chigateri General hospital attached to JJM Medical college, Davangere for a period of two years from July2018 to July 2020.60 adult patients with surgical neck of humerus fractures who were willing for surgery were admitted during the period of study and followed up for 12 months. Result: In our study most patients were Female (60%) out of 60 patient. The mean age being 58 years in Group1 and 47.66 years in Group 2. Most of the case were road traffic accident comprising of 65% in Group 1 and self fall 63% in Group 2. In this study,70% of the patients presented with 2-part fracture, 30% with 3-part fracture in Group 1 and 50% of each fracture pattern in Group 2. In this study, according to Neer’s score of patients had excellent 9(30%), satisfactory outcome 17(56.66%), and unsatisfactory outcome 4(13.33%) in Group 1 patients and, excellent result in 6(20%) cases, 20 cases (66.66%) had satisfactory outcome and unsatisfactory outcome 4(13.33%) in Group 2. Conclusion: Surgical neck of humerus treated with PHN offers minimally invasive, cosmetically acceptable scar, stable and axial fixation with minimal soft tissue damage, early mobilization, where as in PHILOS provide rigid and stable fixation in most of communited fractures.

Diffuse idiopathic skeletal hyperostosis is a non inflammatory systemic disease affecting axial skeleton which results in ossification and calcification of spinal ligaments and entheses. The pathophysiology of the disease is poorly understood. The closest differential diagnosis for DISH remains ankylosing spondylitis. Further research is necessary to treat the disease and to improve the prognosis and quality of life of patients affected with DISH. This article reports a patient with DISH and its management in a tertiary care hospital. Keywords: Forestier’s disease, Diffuse idiopathic skeletal hyperostosis, Calcification, Ossification, Anterior longitudinal ligament, Candle wax, Ankylosing spondylitis, Syndesmophytes.

Introduction: Recently the idea of “Orthobiologics” leads to development of less invasive procedures and accelerated treatments which enhances functional recovery of musculoskeletal disorders. The desired therapeutic effect of autologous platelet rich plasma is facilitated by the ability of IL-1-Ra to limit the destructive inflammatory intra-articular (IA) actions of IL-1?. Objectives: To evaluate the efficacy and functional outcome of autologous PRP injection and homologous platelet lysate to reduce pain, improve joint function and enhance quality of life in patients with early knee osteoarthritis and to investigate the advantages and disadvantages of PRP and homologous platelet lysate. Material and Methods: A total of 121 cases of early osteoarthritis were equally divided into PRP and homologous platelet lysate group. Each patient in both groups has been given ultrasound guided PRP and homologous platelet lysate on day 0, at the end of 4 weeks and 8 weeks and all the patients were followed for up to one year. Treatment outcome measures were assessed at each visit using VAS and WOMAC scores. Results: A statistically significant improvement is observed with VAS and WOMAC score in knee osteoarthritis patients over 12 months with greater advantages over homologous platelet lysate. The overall reduction of pain and enhanced joint function was observed within 1 week, 3 months and 12 months after the initial injection. Conclusion: Homologous platelet lysate has the potential to offer chondroprotective and molecular approach in treating pain and functionality in patients with mild and moderate knee osteoarthritis with greater advantages over autologous platelet rich plasma. Keywords: Platelet rich plasma; Homologous platelet lysate; Osteoarthritis; VAS score; WOMAC score.

The biometrics is now a days trending security method used in the industries. The face recognition is one way of applying biometrics, and liveness detection is add on security to the system which will help the security system to identify between the fake and the real identities. In this case the fake identities are photographs as printed media. And mobile or tablet as display devices. The entire system is developed on the raspberry pi board because of it efficiency with powerful architecture and theportability.

Determining a suitable, adaptive region of interest (ROI) automatically for extracting information related to cardiac activity (signal-ROI/S-ROI), and another containing information on ambient light-fluctuation (background-ROI/B-ROI, as close as possible to the signal-ROI ), and robust signal processing are important in webcam based heart-rate (HR) estimation – in real life situations. We describe a novel method of automatically determining both the ROIs. The forehead is the candidate for the S-ROI, due to its uniformity and minimum vulnerability for deformation. We first identify the skin-pixels within the face-region detected by the Viola-Jones (VJ) algorithm. The forehead-region, and a uniform sub-rectangle within it not containing hair – determined by using variance as a measure – yields the S-ROI. The B-ROI – consisting of 3 rectangles – each of the same size as that of S-ROI, at the two sides and the top of the VJ-rectangle – is used to generate a reference signal for an adaptive noise-cancellation scheme. The situation arising from (possibly simultaneous) facial expressions deforming the S-ROI , is addressed – by extracting the phase sequence associated with the analytic representation of the signal. Experiments conducted with 21 healthy subjects, using this novel array of techniques, have produced good correspondence with the ground truth obtained from a standard finger-pulse transducer – as reflected by the Bland-Altman plot.

Context: Prevalence of obesity increasing worldwide, including in the rural populations. Waist circumference (WC) and body mass index (BMI) are closely related in measuring obesity. Measuring WC is easier than measuring height and weight for calculating BMI. Therefore, WC measurement can be used as obesity detecting tool. Aims: The aim of the study is to estimate the prevalence of obesity in a rural population and to assess the sensitivity and specificity of WC values for identifying obesity. Settings and Design: It was a cross-sectional study conducted in rural places of North Karnataka. Material and Methods: Height, weight, and WC of each participant were measured. WC was measured at the midpoint between the inferior margin of the last rib and iliac crest. Statistical Analysis Used: Statistical analyses were performed using MedCalc for Windows. The area under the receiver operating characteristics derived by plotting 100 specificity along the X-axis and sensitivity along the Y-axis. Results: Abdominal obesity measured by WC showed that 114 participants were obese with a prevalence of 36.08%. Prevalence of obesity by taking BMI of ≥25 kg/m2 as cutoff showed 15.82%. We found that presently recommended WC cutoff value for males had 66.67% sensitivity and for females had 89.47% sensitivity to diagnose obesity. Conclusions: WC can be used as screening tool for identifying obesity. Considerable variation in sensitivity was found among different studies. Unlike BMI, universal cutoff may not be possible with WC. More studies are needed to assess the relationship of different obesity surrogates to cardiovascular morbidity and mortality.

Introduction: Succinylcholine is a short acting neuromuscular blocking age nt.. It has its own side effects which includes dysrhythmias, hyperkalemia, postoperative myalgias, etc. The incidence of muscle pain ranges from 0.2 to 89% and thus the need for the study. Materials and Methods: 60 adult patients are included in this prospective , randomised , double blind study who are scheduled to undergo elective surgery under general anaesthesia. Two groups were made randomly and Patients received either oral aspirin 600mg one hour before surgery or intravenous diazepam fifteen minutes before induction. Appropriate statistical tests were applied. Results: Status of muscle pain was recorded at 1st , 6th, 12th and 24th post operative period. Myalgia at 6th, 12th and 24th hour was significantly reduced in aspirin group compared to diazepam group. No difference was seen at one hour. Conclusion: It was concluded that aspirin prevents succinylcholine induced myalgia more effectively than diazepam in postoperative period. Keywords: Aspirin, Diazepam, Myalgia, Succinyl choline.

Costing system is an essential part of a company. Determining the accurate cost of a product or service is extremely important for the profitability and performance of a company. Over the years, different approaches and models have been developed to estimate the cost of the product manufactured. However, their models were found to be inadequate in the correct value of the product cost. In the last decade, activity-based costing (ABC) has been successfully adopted by many companies worldwide. Nonetheless, because of its high maintenance and setup cost, it has been abandoned and a new time-driven activity-based costing (TDABC) model has been developed. Though adopted by many large scale-manufacturing industries, TDABC has not been implemented in small scale manufacturing companies due to unavailability of resources and also ignorance about its implementation. This paper presents a model for the application of TDABC in the small scale manufacturing industry. The model is implemented in a furniture manufacturing company for the estimation of product cost. The cost obtained from the TDABC is compared with the traditional costing system and established the accuracy of TDABC over the traditional costing system. Along with the case study, this paper also discusses the different data results obtained from TDABC and its utility for the managers and the decision makers.

Digital healthcare technologies are transforming the face of prosthetic care. Millions of people with limb loss around the world do not have access to any form of rehabilitative healthcare. However, digital technologies provide a promising solution to augment the range and efficiency of prosthetists.The goal of this review is to introduce the digital technologies that have the potential to change clinical methods in prosthetic healthcare. Our target audience are researchers who are unfamiliar with the field of prostheses in general, especially with the newest technological developments. This review addresses technologies for: scanning of amputated limbs, limb-to-socket rectification, additive manufacturing of prosthetic sockets, and quantifying patient response to wearing sockets. This review does not address biomechatronic prostheses or biomechanical design practices.Digital technologies will enable affordable prostheses to be built on a scale larger than with today's clinical practices. Large technological gaps need to be overcome to enable the mass production and distribution of prostheses digitally. However, recent advances in computational methods and CAD/CAM technologies are bridging this gap faster than ever before. We foresee that these technologies will return mobility and economic opportunity to amputees on a global scale in the near future.

Since 2019 the world facing a critical situation known as pandemic and many suggested to go for lockdown. But that didn't work as the period was not ending and still continued. The vaccination could be the only practical solution for ending this pandemic situation. So it is essential that the detailed analysis of vaccination worldwide and it is very important than concentrating on the restrictions and creating awareness by advertising the scenario to the public. This paper analyzes vaccination status and suggests the vaccination distribution methods to be followed to end the lockdown soon by using machine learning techniques. Based on the proposed prophet algorithm, it is predicted that the people vaccinated per 100 would be increased to 97.12% with an accuracy of 98.51% and further lockdowns will not be necessary if the vaccination rate maintained as of now.

The scarcity of human cadaver islets for transplantation in patients with Diabetes Mellitus (DM) has necessitated the search for alternative islet sources. With advancing islet biology research, Islet-Like Clusters (ILCs) derived from stem cells have demonstrated potential for treating DM and in novel drug discovery programs for drug and cytotoxicity testing. In vitro differentiation of ILCs from stem cells also provides an opportunity to mimic the in vivo islet developmental pathways. In vitro derived ILCs are often considered immature as they do not respond to glucose challenges efficiently. However, the in vitro and in vivo performance of ILCs can be improved by pharmacological preconditioning. In this review, we discuss how ILCs generated from human postnatal tissues can be utilized as an in-vitro model to study cytotoxicity, drug screening and enhancement of transplantation efficacy. The use of human cadaver islets is not permitted for research purposes in India. Under these restrictions, the application of ILCs in drug screening and their role in complementing, reducing, and replacing animal testing will evolve as a reliable platform for in vitro screening as well as for stem cell-based treatment in DM.

Dysregulation of angiogenesis is a phenomenon observed in several disorders such as diabetic foot, critical limb ischemia and myocardial infarction. Mesenchymal stromal cells (MSCs) possess angiogenic potential and have recently emerged as a powerful tool for cell therapy to promote angiogenesis. Although bone marrow-derived MSCs are the primary cell of choice, obtaining them has become a challenge. The placenta has become a popular alternative as it is a highly vascular organ, easily available and ethically more favorable with a rich supply of MSCs. Comparatively, placenta-derived MSCs (PMSCs) are clinically promising due to their proliferative, migratory, clonogenic and immunomodulatory properties. PMSCs release a plethora of cytokines and chemokines key to angiogenic signaling and facilitate the possibility of delivering PMSC-derived exosomes as a targeted therapy to promote angiogenesis. However, there still remains the challenge of heterogeneity in the isolated populations, questions on the maternal or fetal origin of these cells and the diversity in previously reported isolation and culture conditions. Nonetheless, the growing rate of clinical trials using PMSCs clearly indicates a shift in favor of PMSCs. The overall aim of the review is to highlight the importance of this rather poorly understood cell type and emphasize the need for further investigations into their angiogenic potential as an alternative source for therapeutic angiogenesis.

Obesity induced metabolic dysregulation results in cluster of chronic conditions mainly hyperglycemia, hyperinsulinemia, dyslipidemia, diabetes, cardiovascular complications and insulin resistance. To investigate the effect of i.m. injection of human adipose tissue derived mesenchymal stem cells and its secretome in correcting obesity induced metabolic dysregulation in high fat diet fed obese model of mice and understand its mechanism of action. We injected human adipose tissue derived mesenchymal stem cells (ADMSCs) suspension (CS), conditioned medium (CM) and the cell lysate (CL) intramuscularly in high fat diet (HFD)-induced C57BL/6 mice. Metformin was used as a positive control. ADMSCs were traced in vivo for its bio distribution after injection at different time points. ADMSCs-treated mice exhibited remarkable decrease in insulin resistance as quantified by HOMA-IR and triglyceride glucose index with concomitant decrease in oxidized LDL and IL6 as compared with the untreated control. CS injection showed improvement in glucose tolerance and reduction in fatty infiltration in the liver, macrophage infiltration in adipose and hypertrophy of the islets resulting from HFD. Upregulation of miRNA-206, MyoD and increase in protein content of the skeletal muscle in CS-treated mice indicates plausible mechanism of action of ADMSCs treatment in ameliorating IR in HFD mice. Of all the three treatments, CS was found to be the best. ADMSCs were found to have migrated to different organs in order to bring about the correction in dysregulated metabolism induced by obesity. Our results open up a novel treatment modality for possible therapeutic usage in human subjects by employing autologous or allogeneic ADMSCs for the better management of obesity induced metabolic dysregulation.

Gout is a disorder of purine metabolism a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot, and swollen joint. Pain typically comes on rapidly, reaching maximal intensity in less than twelve hours. The first metatarsophalangeal joint is affected in about half of cases. It may also result in tophi, renal stones, or urate nephropathy.1 Commonly, but very large tophi are unusual in chronic gout. Here we present 52 years male patient presenting with unusually large tophi over bilateral foot, with raised serum uric acid levels. In a untreated cases of chronic gout, patients can develop severe destructive poly articular involvement and tophi. Treatment aims at control of serum uric acid levels which can cause regression of tophi. And surgical excision of very large tophi. Keywords: Gout, Arthritis, Tophi, Surgical excision.

Introduction: Although, diphtheria is eliminated in many developed countries by effective immunization, diphtheria still continues to be endemic in India and is the leading cause of morbidity and mortality, especially in rural parts of North Karnataka. The objective of the present study is to recognize the clinical profile, morbidity and mortality pattern of diphtheria and to study their immunization status as a hospital based observational study performed in paediatric intensive care unit. Materials and Methods: This study is a hospital based observational study from April 2018 to August 2018 at a tertiary care referral PICU, S.Nijalingappa Medical College and HSK hospital, Bagalkot, Karnataka. The cases were analysed with respect to demographic details, clinical features, immunization status, complications and mortality. Results: The study consisted of 22 children who presented with features suggestive of diphtheria, 90% were >5years of age with male to female ratio of 1.2:1. Of the 22 children 4 (18.2%) children were completely immunized, and 18(81.8%) were partially immunized/not immunized. All patients presented with fever, membrane in throat and throat pain (100%) followed by bull neck 54.5%, dysphagia 36.36%, epistaxis 9% and Airway obstruction 4.54%. Alberts stain was positive in 18 cases (81.8%) and throat swab culture positive in 16 cases (72.7%). Myocarditis was the commonest complication (63.6%) followed by palatal palsy (13.63%), shock (4.5%) and stroke (4.5%). Case fatality rate was 18.18%. Conclusion: Shifting of occurrence of diphtheria in the age group of >5 years suggest the need to improve and strengthen the immunization program specially the booster doses. Keywords: Diphtheria, Immunization, Myocarditis, Stroke.

The evolution of smart city services and applications requires a more efficient wireless infrastructure to provide the needed data rate to users in a high-density environment with high mobility, satisfying at the same time the request for high-connectivity and low-energy consumption. To address the challenges in this new network scenario, we propose to opportunistically rely on the increasing number of connected vehicles in densely populated urban areas. The idea is to support the macro base station (BS) with a secondary communication tier composed of a set of smart and connected vehicles that are in movement in the urban area. As a first step towards a comprehensive cost-benefit analysis of this architecture, this paper considers the case where these vehicles are equipped with femto-mobile access points (fmAPs) and constitute a mobile out-of-band relay infrastructure. We first study this network system with a continuous time model, in which three techniques to select an fmAP (if more than one is available) are proposed and the maximal feasible gain in the data rate is characterized as a function of the vehicle density, average vehicle speeds, handoff overhead cost, as well as physical layer parameters. We then introduce a time slotted model, in which we consider a more realistic communication channel, with an exponential path loss model, and we investigate the tradeoff between energy consumption and expected data rate, as a function of the system parameters. The analytical and simulation results, with both the continuous and time slotted models, provide a first benchmark characterizing this architecture and the definition of guidelines for its future realistic study and implementation.

Quality has always been an issue of utmost concern for every technical education institute. There have been a lot of theoretical studies conducted that presented various methods of measuring quality of higher and technical education institutes. This paper presents a quantitative method to measure service quality of technical education institutes focusing on its academic aspects and taking into account various stakeholders such as Students, Teaching staff and the Industry. The paper presents a step-by-step process of stakeholder requirement assessment, their translation to service features, key processes and finally to key activities which are the suggestions to the management to take proper decisions and actions. Three distinct House of Qualities of Service Planning, Process Planning and Activity Planning have been presented in the paper to present a comprehensive model, which can be applied practically across the technical institutes. Uniqueness of the paper is that these three stakeholders are considered together for planning the service quality of technical institutes.

Purpose The purpose of this paper is to present a procedure to implement time-driven activity-based costing (TDABC) using Maynard Operation Sequence Technique (MOST). In this paper three research questions are addressed: How can MOST be used to frame time equations? How can MOST be used for the improvement of productivity? How can TDABC cost information be used? Design/methodology/approach Case study research was performed at a manufacturing industry. Data have been collected for overhead distribution. The overhead cost was distributed on activity. Time equations are framed using MOST. Cost of activity is assigned to the product using time equations. Findings The proposed system simplifies the process of implementation of TDABC using MOST. This system not only determines the cost but also identifies the area where cost is consumed. It also identifies opportunity for productivity improvement. Research limitations/implications The case study was conducted in a manufacturing industry. The proposed methodology is suitable for manufacturing industry where standard work procedure is adapted. Practical implications The study explains the implementation of TDABC using MOST using a case study and results are meticulously discussed from a management point of view for appropriate decision making. Originality/value Besides the articles published so far dealing with the implementation of TDABC, no research was found on the implementation of TDABC using MOST.

The self-organizing network is envisioned as a key technology to future wireless networks, especially for densely deployed small cell scenarios. Self-healing (SH) is an essential functionality to allow the networks to automatically detect and compensate for cell outages, which typically occur when unexpected network failures arise. In this paper, reaping the benefits of machine learning, we propose a novel SH framework in ultra dense small cell networks for meeting the demands of low-cost and fast network operation, quality of service (QoS), and energy efficiency. The proposed SH scheme comprises small cell outage detection (SCOD) and small cell outage compensation (SCOC) to enable self-healing in ultra dense small cell networks. Based on the context information of the partial key performance indicator (KPI) statistics, we propose a novel SCOD algorithm to detect the outage by applying support vector data description (SVDD) approach. The SCOD algorithm detects a small cell outage efficiently considering two situations: KPIs available situation and non-KPIs available situation. Furthermore, in order to compensate the small cell outage, SCOC is formulated as a network utility maximization problem to optimally compensate for the outaged zone in small cell network. A distributed compensation algorithm with low computational complexity is developed to balance the load of small cell networks, considering the QoS provision for users. Simulation results demonstrate that the proposed SH scheme can detect the small cell outage efficiently and can achieve an optimized QoS performance when compensating for the detected small cell outage.

Bi-directional Brain–Computer Interfacing (BBCI) faces major challenges due to, in part, the difficulty of transmission of Electro-corticographical (ECoG) signals from the brain to external devices. For human subjects, safety and convenience would be greatly increased if we could replace the wired interface between the electrodes and the extra-cutaneous receiver with a wireless interface. All the technology that we have today using wires to connect the transmitter which setting on top of the electrodes with a reader located on the scalp which can create brain infection due to scar tissue and that might lead to serious brain injury. We have eliminated this risk by using passive transmitter setting on the electrode and transmit wirelessly to a reader sitting on the scalp using a back-scatter technique which shows a great potential in BCI Applications. This paper investigates the feasibility of passive Ultra High Frequency Radio Frequency Identification (UHF–RFID) for wireless communication between multiple transmitters inside the brain that collect vital data continuously and transmit them to an external controller located on the scalp outside the brain in order to design wireless communication channel inside the human brain considering network lifetime and minimize power consumption. Also, we emphasize the effect of increasing number of transmitters to maximize the throughput. Extensive literature survey shows that there is exists no model has been made for invasive BBCI applications based on UHF passive RFID. Results are presented with calculated Received Signal Strength (RSSI), Signal to Noise Ratio (SNR), Channel Capacity, Maximum number of the electrode, and Path Loss. These analyses are essential for building a brain–computer interface application. We showcase theoretical and experimental results based on a phantom model of the human brain using passive RFID as the implantable transmitter operating in UHF range. Based on these values we have concluded that UHF–RFID is a viable technology with multiple transmitters to a depth of 4 cm.

Background Aquaponics are food production systems advocated for food security and health. Their sustainability from a nutritional and plant health perspective is, however, a significant challenge. Recirculated aquaculture systems (RAS) form a major part of aquaponic systems, but knowledge about their microbial potential to benefit plant growth and plant health is limited. The current study tested if the diversity and function of microbial communities in two commercial RAS were specific to the fish species used (Tilapia or Clarias) and sampling site (fish tanks and wastewaters), and whether they confer benefits to plants and have in vitro antagonistic potential towards plant pathogens. Results Microbial diversity and composition was found to be dependent on fish species and sample site. The Tilapia RAS hosted higher bacterial diversity than the Clarias RAS; but the later hosted higher fungal diversity. Both Tilapia and Clarias RAS hosted bacterial and fungal communities that promoted plant growth, inhibited plant pathogens and encouraged biodegradation. The production of extracellular enzymes, related to nutrient availability and pathogen control, by bacterial strains isolated from the Tilapia and Clarias systems, makes them a promising tool in aquaponics and in their system design. Conclusions This study explored the microbial diversity and potential of the commercial RAS with either Tilapia or Clarias as a tool to benefit the aquaponic system with respect to plant growth promotion and control of plant diseases.

Introduction: Tobacco contains several genotoxic agents including N-nitrosamine which has the potential to cause significant nuclear damage. Nuclear blebbing is a form of protrusion on the nuclear membrane and could potentially be caused by tobacco-induced genotoxicity and is closely associated with malignancy. Thus, the present study aimed to assess if tobacco-associated oral potentially malignant disorders including oral submucous fibrosis (OSF) and oral leukoplakia have a higher nuclear blebbing frequency than patients with normal oral mucosa with no history of tobacco use. Methods: The sample consisted of patients with OSF (n = 30) and oral leukoplakia (n = 10) and normal oral mucosa (n = 10). Exfoliated cells collected from the study groups were smeared on a clean microscopic slide and stained by May-Grunwald-Giemsa stain. A baseline frequency of nuclear blebbing was evaluated using a bright-field microscope with a ×100 objective. The number of nuclear blebbing per 1,000 epithelial cells was recorded and expressed in percentage. ANOVA, the Mann-Whitney U test, and Spearman’s correlation were used to analyze the data. Results: The mean rank of distribution of nuclear blebbing showed significant difference between all 3 groups, with the highest frequency noted in leukoplakia, followed by oral submucous and normal oral mucosa. Within OSF, the frequency of nuclear blebbing significantly increased from early stage to advanced stage. In OSF, a statistically significant positive linear correlation was noted between duration (in years), frequency (per day) of tobacco use, clinical grading, and nuclear blebbing. Discussion/Conclusions: The frequency of nuclear blebbing was significantly higher in oral potentially malignant disorders than normal mucosa. Nuclear blebbing also exhibited a strong dose- and time-dependent correlation with tobacco usage and clinical staging in OSF. The nuclear blebbing frequency could be a noninvasive, economic tool to assess malignant risk in tobacco-induced oral potentially malignant disorders.

WHO projects that diabetes will be the 7th major cause leading death in 2030. Diabetic Retinopathy caused by leakage of blood or fluid from the retinal blood vessels and it will damage the retina. For detection and extraction of non-proliferative diabetic retinopathy lesion we have invent the new wavelet filter. The proposed filter give the good extraction result as compare to exiting wavelet filter. In proposed algorithm, we have extract the microaneurysms, hemorrhages, exudates and retinal blood vessels. After extraction of lesions, grading is done by using feed forward neural network. The proposed algorithm achieves sensitivity of 98%, specificity of 92% and accuracy of 98%.

Magnetic resonance image is a greatly developed medical representation system, cynical to generate prominent renowned imagery of human being and there part. It gives feature in sequence to analyze the disease. MRI play significant role to give in turn innovative scope intended such precede representation. Inventive image of MRI are usually comprise squat disparity. It is dense intended in favor of health center to analyze them. Escalating the difference of representation, it resolve exist simple designed in favor to analyze a complete in sequence. This manuscript compares special method of development of brain MRI by histogram based technique and by using different statistical measures.

A major challenge to high-resolution, closed-loop Brain Computer Interfaces (BCIs) is the availability of implantable technologies facilitating vastly parallel, large-scale access to cortical neural data representing complex, naturalistic tasks or sophisticated therapeutic neuromodulation. The current technological bottleneck is scalability of systems employing intra or epicortical electrode arrays with hard-wired tethers and bulky implant packaging. We address these challenges by employing an approach relying on spatially-distributed, completely wireless clusters of autonomous microscale neural interfaces, where each microdevice provides a single bidirectional channel (read-out and write-in) of neural access, and occupies a volume

The use of the internet has grown extremely over the last two decades, resulting in the proliferation of massive volumes of data on the internet. Since there is so much data available online, researchers are interested in the Question Answering era, in which users ask questions and obtain correct answers. A classic NLP programme is answering questions although work on some Indian regional languages, such as Tamil, Punjabi, Hindi, Malayalam, and Bengali, is ongoing; there is little work available for Question Answering (QA) Systems in Marathi. The construction of a text corpus, question generation, and question classification for a Marathi question answering method were the key topics of this paper.

Background: Although, the nasopharyngeal swabs (NPS) are considered as gold standard for the clinical diagnosis of SARS-CoV-2 virus in the COVID-19 disease, they pose several limitations such as high risk of exposure, discomfort to the patients and requirement of trained healthcare professionals. Several studies have explored ‘Saliva’ as an alternate clinical specimen for the SARS-CoV-2 and IgG detection, reporting varied degree of sensitivity of detection. This study was aimed to investigate the influence of method of saliva collection on the sensitivity of SARS-CoV-2 detection. Methods: We performed a cross sectional study where patients were screened for the COVID-19 infection. Saliva was collected by four different methods (Expectoration, drooling, gargling and by using salivary swabs). SARS-CoV-2 viral load in the paired saliva and NPS were determined by using the reverse transcriptase quantitative PCR (RT-qPCR). IgG levels were assayed in the serum and saliva of the COVID-19 patients by nephelometry and ELISA resp. Findings: Out of 350 patients screened, 43 patients were included in the study which was found to be positive for COVID-19 as evidenced by RT-PCR in the NPS (positivity rate-12.2%). Expectorated saliva exhibited 78.5% sensitivity (11 out of 14 patients, median CT (saliva e gene 27.0±6.03 vs NPS e gene 29.5.0±6.18, p=NS). Drooling method showed 22.2% sensitivity (2 out 9 patients, median CT (saliva e gene 30.5±0.7 vs NPS e gene 30.0±1.5, p=NS)) whereas salivary swab method yielded 21.42% sensitivity (3 out 14 patients, median CT (saliva e gene 29.0±5.1vs NPS e gene 29.0±5.1, p=NS)). We found lowest sensitivity (16.66%) in the gargled saliva (1 out of 6 patients, median CT (saliva e gene, 24±7.5 vs NPS e gene 14.0, p=NS)). Furthermore, the sensitivity of SARS-CoV-2 detection was reduced to 18.1% (2 out of 9 patients) and 0.0% (0 out 3 patients) in the saliva collected by salivary swab and gargling method above the CT value 25.0 (NPS). Interestingly, salivary IgG showed better concordance with viral load as compared to the serum IgG (R 2 0.23 vs 0.04, p=0.044). Interpretation: Expectorated saliva is a better specimen as compared to the drooling, gargling and salivary swabs for SARS-CoV-2 viral detection for the diagnosis of COVID-19. Exposure of saliva to the upper and lower respiratory track may be the primary explanation to our findings. Also, salivary IgG can be a better predictor of the viral load as compared to the blood IgG. However, our finding needs to be confirmed in the larger sample size of the COVID-19 patients. Funding Statement: In house funding was given by Dr. D.Y. Patil Vidyappeth, Pimpri, Pune (India) to carry out the study. Declaration of Interests: All the authors declare no conflict of interest. Ethics Approval Statement: This study was approved by the Institutional Ethics Committee of Dr. D. Y. Patil Medical College and Hospital, Pune (India) (DYPV/EC/599/2020).

Diabetes is the one of the major disease in the world. Peripheral neuropathy is the most common form of diabetics. In that it firstly affected to feet and legs and followed by hands and arms. In peripheral neuropathy the most common sign is it changes the temperature of feet and toes. In this paper we discuss about the system that is designed to monitor foot temperature of the person with the help of ds18b20 temperature sensors. This system is designed using the Raspberry Pi for taking input from the user. The project details are discussed in this paper.

Renal dysfunction is very common among patients with chronic liver disease, and concomitant liver disease can occur among patients with chronic kidney disease. The spectrum of clinical presentation and underlying etiology is wide when concomitant kidney and liver disease occur in the same patient. Management of these patients with dual onslaught is challenging and requires a team approach of hepatologists and nephrologists. No recent guidelines exist on algorithmic approach toward diagnosis and management of these challenging patients. The Indian National Association for Study of Liver (INASL) in association with Indian Society of Nephrology (ISN) endeavored to develop joint guidelines on diagnosis and management of patients who have simultaneous liver and kidney disease. For generating these guidelines, an INASL-ISN Taskforce was constituted, which had members from both the societies. The taskforce first identified contentious issues on various aspects of simultaneous liver and kidney diseases, which were allotted to individual members of the taskforce who reviewed them in detail. A round-table meeting of the Taskforce was held on 20–21 October 2018 at New Delhi to discuss, debate, and finalize the consensus statements. The evidence and recommendations in these guidelines have been graded according to the Grading of Recommendations Assessment Development and Evaluation (GRADE) system with minor modifications. The strength of recommendations (strong and weak) thus reflects the quality (grade) of underlying evidence (I, II, III). We present here the INASL-ISN Joint Position Statements on Management of Patients with Simultaneous Liver and Kidney Disease.