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In most developing worlds, cooking with heat has been a technically feasible replacement for fuelwood in food production as the need of the hour. Cooking energy accounts for 36% of India's gross primary energy use. Non-commercial oils are used mainly by the rural and urban populations to fulfil their energy requirements. Solar cooking is one potential alternative, but it has been met with some resistance due to some obstacles. Simple box-type solar cookers are an easy way to cook food utilizing solar energy throughout the day, but cooking is not feasible all across the night-time. In this research, a box-type solar cooker with energy storage is developed, and a performance study is conducted to enable food to be cooked at odd hours. Thermal energy has been stored using phase change content (PCM). The amount of energy retained, the amount of heat lost during the charging and discharging period, and the amount of PCM needed are all calculated. Experiments were carried out with two continuous loads in a cooker with a 0.5 m2 aperture region and PCM (Erythritol). While the performance of the PCM cooker is comparable to that of a simple box-type cooker, cooking during off-sunshine hours is not feasible with the simple box-type cooker, according to the report. However, by utilizing the specially built and manufactured PCM cooker, cooking can be done at any time of day. As a result, this paper aims to summarise the research on solar cooking systems that incorporate phase shift materials (PCMs).

In order to meet the world's future energy demand, alternative renewable green energy supplies must be widely promoted. Among all DERs, the most prevalent is Solar PV for a number of important reasons. In this study, the authors analyze several elements of the Single-Phase Solar Photovoltaic Rooftop System with MATLAB. In order to analyze the characteristics of the output current, a new grid synchronization methodology has been devised. For maximum power tracking, the INC control technique has been adopted. The output of the solar DC power system has been synchronized with the grid through hysteresis current loop control. Extensive testing verifies the practicality of the proposed power grid model and promising outcomes and results.

espanolObjetivo En diciembre de 2016 la American Heart Association publico un documento expositivo concluyendo que existian datos suficientes para emitir recomendaciones basadas en la evidencia sobre la relacion entre la hipertension y la cognicion de una persona. El objetivo de este trabajo fue estudiar el efecto del incremento de la presion arterial en la funcion cognitiva. Metodos Se realizo un estudio transversal de sujetos hipertensos (casos) y normotensos (controles) entre enero de 2018 y diciembre de 2019. Dichos sujetos fueron reclutados de una muestra de conveniencia. Se considero como casos a aquellos sujetos que fueran casos conocidos de hipertension y siguieran una terapia antihipertensiva durante al menos 6 meses. Los controles fueron aquellos sujetos con presion arterial normal y que no padecieran ninguna enfermedad conocida que afectara a la cognicion. De los 413 sujetos se utilizaron en el estudio los datos procedentes de 388 (200 casos y 188 controles). Se permitio a los sujetos que descansaran durante 5minutos antes de medir su presion arterial, utilizando un esfigmomanometro de mercurio en el brazo derecho, estando el sujeto en posicion sentada. La bateria neuropsicologica consistio en pruebas de los dominios de memoria (auditiva, visual, espacial), capacidad de aprendizaje, atencion, construccion visoespacial y memoria funcional. Resultados En las pruebas neuropsicologicas los pacientes hipertensos tuvieron menores puntuaciones en los diferentes dominios. Edad, duracion de la hipertension y nivel educativo fueron los mejores factores predictivos del deterioro cognitivo en los pacientes hipertensos. Conclusion Los adultos hipertensos de mediana edad muestran una reduccion de sus funciones cognitivas en comparacion con los sujetos normotensos. EnglishObjective The American Heart association in December 2016 published a position paper concluding that there was insufficient data to make evidence-based recommendations on the relationship between hypertension and cognition of a person. The aim of the study was to study the effect of increased blood pressure on cognitive function. Methods A cross sectional study of hypertensives (cases) and normotensive (controls) was done between January 2018 and December 2019. Subjects were recruited by convenience sampling. Subjects who were known cases of hypertension and had been on antihypertensive drug therapy for at least more than six months were considered as cases. Controls were those subjects who were having normal blood pressure and not suffering from any disease known to affect cognition. Out of 413 subjects, data from 388 subjects was used in the study (200 cases, 188 controls). The subjects were allowed to rest for 5min before measuring their blood pressure. Blood pressure was measured with a mercury sphygmomanometer in the right arm with the subject in seated position. Neuropsychological battery consisted of tests for domains of memory (auditory, visual, spatial), learning ability, attention, visuo-spatial construction, working memory. Results On the neuropsychological tests, patients with hypertension had lower scores in the different domains. Age, hypertension duration, and educational level were the best predictors of cognitive impairment in patients with hypertension. Conclusion Middle aged adults with hypertension have reduced cognitive functions as compared to normotensives.

AIM: To evaluate the outcomes of patients operated for retinal detachment by scleral buckle technique done by trainee doctors pursuing postgraduate course in ophthalmology. METHODS: This study was a non-comparative retrospective case series to evaluate the demography, clinical features and outcomes of patients underwent rhegmatogenous retinal detachment (RRD) repaired by scleral buckle technique from July 2017 to February 2018 at a tertiary care center in India. Records of all these patients were screened. Statistical analyses were performed and using Fisher's exact test, Mann-Whitney test and Nominal Logistic regression. RESULTS: Totally of 41 patients were included out of which, 32 (78.04%) were males and 9 (21.95%) were females. In our study primary anatomical success rate was 95.12%, with significant visual gain. Postoperative complications were raised intraocular pressure (n=2), new breaks (n=2) and re-detachment in 2 patients which was successfully managed by pars plana vitrectomy (PPV) with internal tamponade and laser. CONCLUSION: The study showed that scleral buckle surgeries done by trainee doctors under supervision can achieve a high success rate in patients of RRD both in terms of postoperative anatomical success, visual acuity and complication rates. Thus, scleral buckle surgery can be an acceptable primary procedure for trainee doctors for management of RRD in selected cases despite the various treatment options now available.

Background Alcoholic liver disease (ALD) is a major source of alcohol-related morbidity and mortality. Heavy drinkers and alcoholics may progress from fatty liver to alcoholic hepatitis to cirrhosis. The enzyme γ-glutamyltranspeptidase (GGT) is a membrane-bound glycoprotein which catalyzes the transfer of the γ-glutamyl group from γ-glutamyl peptides to other peptides, amino acids, and water. Serum GGT activity mainly attributed to hepatobiliary system and thus is an important marker of ALD. Hence the present study is conducted to estimate and correlate the levels of GGT and osteopontin (OPN) in ALD. Aims and Objectives The objective of this study is to estimate and correlate the levels of GGT and OPN in ALD. Materials and Methods Sixty clinically diagnosed cases of ALD and sixty age- and gender-matched healthy controls were recruited for the study. Blood samples were collected from them and serum aspartate aminotransferase, serum alanine transaminases (ALTs), serum ALP levels, and plasma OPN levels were measured. Estimation of serum aspartate transaminases (AST), ALTs, and alkaline phosphatase (ALP) was assayed by standard photometric methods in autoanalyzer ERBA-XL (EM-200) using commercially available kits. OPN was estimated by using commercial kit based on enzyme-linked immunosorbent assay. Results The parameters of the liver function tests such as AST, ALT, and ALP were significantly increased in patients with ALD (p Conclusion The present study focuses on the role of GGT and OPN that are sensitive indicators of liver cell injury and are most helpful in recognizing hepatocellular diseases such as ALD, hepatitis, and liver cirrhosis. Hence, the pattern of the GGT and OPN levels elevation can be helpful diagnostically.

Purpose Agility addresses vibrant solutions for running companies to meet the dares of customers asking for high quality and low- cost goods and services. The purpose of this study is to identify the practices for the successful implementation of agile manufacturing and measure their relationship with business performance measures of the manufacturing industry. Design/methodology/approach The data for the pilot study were collected from 26 respondents through a questionnaire survey. After confirming the normality and reliability of the data, it was analyzed to examine the relationship between agile manufacturing practices and business performance measures. Findings The results show that there are strong relationships between agile manufacturing practices and business performance. Further, these attributes significantly contribute to delivering better business performance. Originality/value The study signifies the need for agile manufacturing in enhancing business performance for the growth and sustainability of the organization.

Tinospora cordifolia is a plant well known for its medicinal value in Indian ayurveda and Indian traditional medicine system. However, to prove its efficiency for the clinical utilization, more experimental data will be beneficial. In the present investigation, evaluated the immunomodulatory activity of the alcoholic extracts of Tinospora cordifolia stem on various in-vivo experimental models such as neutrophil adhesion test, phagocytic index by carbon clearance test, Hemagglutinating antibody (HA) titre and delayed type hypersensitivity (DTH) responses. The evaluation of immunomodulatory potential by oral administration of alcoholic stem extracts (50, 100, 200 and 300mg/kg b.w, p.o) evoked a significant increase in percent neutrophil adhesion to nylon fibers as well as a dose dependent increased in antibody titre values, and potentiated delayed type hypersensitivity reaction induced by sheep red blood cells and significant response towards phagocytosis in carbon clearance assay (*p

Introduction: Osteoporosis is more prevalent in women, especially following menopause. The total affected population would have been around 35 to 40 million. Morbidity due to disease includes decreased mobility, decreased quality of life, and increased risk of mortality following an osteoporotic fracture. The morbidity due to the disease may be decreased through diet, exercise, supplementation, and medication. The objective of this study is to determine the effect of 'concern for osteoporosis' and self-perceived 'risk of osteoporosis and fracture' on antiosteoporosis behaviour such as (1) calcium and vitamin D supplementation, (2) seeking medical advice, (3) undergoing bone mineral (BMD) testing, and (4) taking antiosteoporosis medication (AOM). Material And Method:The study was conducted on women attending outpatient clinic of the Obstretics and Gynaecology and Orthopaedics department. Patients were required to ll up the Global Longitudinal Osteoporosis in Women Questionnaire. Enrolled patients were contacted after one year by means of telephone calls, hospital visits and home visits and data was collected for self-reported use of supplements, self-reported seeking of medical advice regarding osteoporosis, self-reported BMD testing, and self-reported use of antiosteoporosis medications etc. Results:Total of 1562 women were enrolled for the study out of which data of only 1000 women was analyzed at end of one year. At the end of one year period 360 women reported use of Calcium and or Vitamin D. Table 4 depicts the association between the use of vitamin supplementation and concern and risk perception. Concern (P=0.61), risk perception to osteoporosis (P=0.13), and risk perception to fracture (P=0.29) were not signicantly associated with use of vitamin supplementation in the next 12 months (i.e., calcium and/or vitamin D). Concern (p=

A Delay Tolerant Network (DTN) is a network capable of handling long delays and data loss efficiently in various challenged scenarios and environments. Owing to the mentioned challenges, it becomes crucial to study how the routing protocols are designed to adapt in such networks. Currently, the research in this domain is focused on the improving the data delivery ratio and minimizing delays in the routing protocols. This paper reviews state-of-the-art routing protocols for Delay Tolerant Networks (DTNs) as well as performs their comparative analysis. DTN routing protocols are grouped into four categories viz encounter based, time based, infrastructure based and hybrid & others. This categorization depends on the information they use for relay selection routing. We have also discussed some of the inherent drawbacks such as energy consumption, delivery rates and buffer constraints of the existing routing algorithms. We have also conducted an empirical analysis and observed the performance of the most popular existing algorithms of encounter and time based category. This paper offers a widespread study of the routing protocols with their pros and cons.

CONTEXT: Effect of fluid reflux on intraocular pressure (IOP) and therapeutic benefits. AIMS: The aim of this study is to compare two intravitreal injection techniques in terms of fluid reflux, short-term IOP changes, and therapeutic effect. SETTINGS AND DESIGN: A prospective, double-blinded, randomized interventional study. SUBJECTS AND METHODS: Sixty eyes were randomly allocated to two groups (direct intravitreal injection technique and oblique intravitreal injection technique). IOP was measured before and immediately after the injection of 0.1 ml comprising of bevacizumab (1.25 mg/0.05 ml) and dexamethasone (0.2 mg/0.05 ml) and then at 30 min after the injection. Occurrence and amount of vitreous reflux were recorded. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed preinjection and 6 weeks postinjection. RESULTS: IOP (mmHg ± standard deviation) increased significantly immediately after injection to 24.30 ± 3.02 (direct intravitreal injection) and 31.50 ± 3.49 (oblique intravitreal injection). These pressure rise differed significantly between both groups (mean difference: 7.2, P < 0.0001). Thirty minutes after injection, there was no significant difference in IOP increase between the groups. Occurrence and amount of fluid reflux were significantly higher with direct intravitreal injection. There was no significant difference in BCVA and CMT outcome between both groups. CONCLUSIONS: Direct intravitreal injection technique has lower rise in IOP and higher incidence of fluid reflux than the oblique intravitreal technique. Fluid reflux does not cause a therapeutic compromise in terms of BCVA or CMT changes, so the reflux fluid must be the vitreous not the drug. Thus, direct injection technique seems to be the preferred technique.

Background: Chemotherapy is fraught with serious and troublesome adverse effects, of which nausea and vomiting appears earliest and is the most disturbing. Therefore, this study was planned to investigate the antiemetic drug regimens used for chemotherapy-induced nausea vomiting (CINV) in patients with breast cancer receiving highly emetogenic chemotherapy (HEC). Subjects and Methods: An observational follow-up study was conducted to assess the efficacy of antiemetic regimens in breast cancer patients receiving HEC. A total of 71 newly diagnosed patients with breast cancer were included in the study. Patients were assessed for nausea by the visual analog scale, and a history of emetic episodes and need for rescue medication were recorded at 0 h, 6 h, 24 h, 48 h, and 120 h post-chemotherapy till three cycles. Results: The patients were prescribed a combination of ondansetron and dexamethasone (n = 23, n = 17, and n = 13 in first, second, and third cycle, respectively) or a combination of aprepitant, ondansetron, and dexamethasone (n = 48, n = 54 and n = 56 in the first, second, and third cycle, respectively). The intensity of nausea was higher for the patients who were prescribed ondansetron and dexamethasone regimen as compared to patients prescribed aprepitant additionally. Complete response, i.e., no emesis and no rescue medication, was higher in triple-drug regimen (52% vs. 0.4%, 63% vs. 17.6%, and 69% vs. 23% in three cycles, respectively). Conclusion: The control of CINV was better with a combination of aprepitant, ondansetron, and dexamethasone as compared to a regimen without aprepitant.

Ashmariis one among the eight most difficult to cure diseases (Ashtamahagada) described in Ayurveda classical texts.The symptomatology ofAshmariresembles the clinical features of Urolithiasis mentioned in the contemporary medical science. Urolithiasis is third most common disease of the urinary tract. Conventional management of Urolithiasis does not have any effect on the pathogenesis of this disease and therefore, recurrence of disease occurs very commonly. Ayurveda has more radical approach and wide range of options in the management of urolithiasis. A 23-year old Indian male student presented with the complaints of pain in right side of abdomen, burning and difficulty in micturition since last 15 days. Per abdomen examination elicited tenderness on right lumbar region of abdomen and around right renal angle. No other abnormality detected during general and systemic examination. Ultrasonography (whole abdomen) revealed multiple right renal calculi (largest being 6.9 mm). On Ayurvedic parlance, the present case was diagnosed as Ashmari based on the signs and symptoms. Patient was prescribed the Ayurvedic medicines,Gokshuradi GugguluandVarunadi Kashayaon OPD basis.Patient was advised to follow-up initially after 07 days and later after every fortnight. Improvement in clinical features was there within 07 days. Patient showed complete relief in his complaints on third follow-up visit. Repeat Ultrasonography scan did not revealed any renal calculus. Clinically also,Gokshuradi gugguluandVarunadi Kashayahas provided complete relief in pain, burning micturition and dysuria. It can be concluded thatGokshuradi gugguluandVarunadi Kashayamay lead to disintegration and expulsion of calculi and thus provide relief in signs and symptoms ofAshmari. This case illustrates the effective conservative management ofAshmariwith Ayurvedic medicines with no adverse events and no episode of recurrence even after one year. &nbsp

PurposeThe study aims at empirically investigating and prioritizing the critical barriers for the successful implementation of agile manufacturing in the medium- and large-scale Indian manufacturing industries.Design/methodology/approachA literature review of peer-reviewed journals and discussion with experts is used to identify 17 barriers to the implementation of agile manufacturing. An empirical survey is then conducted to collect data regarding the agile manufacturing barriers and is further analyzed using the factor analysis and vlsekriterijumska optimizacija i kompromisno resenje (VIKOR).FindingsBased on the survey of empirical data, the investigated critical barriers were reduced in five critical categories, as follows: Managerial constraints, technological constraints, human resource–related constraints, operational constraints and organizational culture-related constraints, which are further ranked in terms of their severity using VIKOR. This research advocates the development of a strategy for addressing the most critical barriers instead of focusing on all for the successful implementation of agile manufacturing.Originality/valueThis work contributes to agile manufacturing literature by the structured presentation of the barriers to implement agile manufacturing in the Indian manufacturing industry. It also extends the integrated factor analysis and VIKOR method to investigate and rank the barriers.

Today, health is a human right in India, and the government is working hard for universalization of health services provision till the grassroots. Health without accountability is a challenging task in hand, and recently, state governments drafted a bill toward public health system to move in the strengthened direction of accountability mechanism. Accountability is the quality or state of being accountable, and it is an important component of the health-care reforms in India. This article provides more nuanced understanding of accountability which includes the specification of accountability, conceptual framework of accountability, and its potential approaches for how accountability is viewed today in India with reference to the Central, State, District, and other stakeholders. It examines the role of accountability in making accountable health plans, and its relationship governance/ownership structures as a key component of health-care reforms as improved accountability is a major element in improving the health system performance. The article elaborates on the definition of accountability in terms of answerability and sanctions and distinguishes the three types of accountability, namely financial, performance, and political/democratic. The article describes three accountability-enhancing strategies, namely reducing the pilferage, assuring acquiescence with procedures and standards, and improved learning from the past experience. The recent events in Indian health care put forward a serious issue on how accountability can be fixed if health mishaps happened and how we can make our health plans accountable to the needs and aspiration for the people of India. Overall, the accountability is discouraging and more needs to be done to enhance the accountability compliance in India.

PurposeThe concept of agile manufacturing is becoming critically important to manufacturing industry due to rapid industrialization, fluctuating customer demand, and turbulent business environment. The aim of this study is to prioritize the attributes for successful implementation of agile manufacturing using a combined analytical hierarchy process (AHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach in Indian manufacturing industry.Design/methodology/approachThe current study identifies eight agile manufacturing attributes through literature review and discussion with subject experts. The experts from different manufacturing industry have been asked to provide data for pairwise comparison of attributes. Afterward, an integrated AHP and TOPSIS approach is employed. The AHP is used to drive the priority weights of the attributes, and TOPSIS is used for prioritizing the attributes for successful implementation of agile manufacturing.Findings“Information technology,” “human resource management-related issues,” “customer-related issues,” “leadership support,” and “organizationalc related-issues” have been ranked as the top five significant and contributing attributes, which can pave the path for top management to concentrate on the critical areas and allocate significant resources to ensure successful implementation of agile manufacturing.Originality/valueThis research integrates AHP and TOPSIS to prioritize the attributes for successful implementation of agile manufacturing, which are further validated by comparing the ranks obtained through respective approach and sensitivity analysis.

Purpose The purpose of this paper is to investigate the effects of agile manufacturing practices on business performance of Indian medium and large-scale manufacturing industry. Design/methodology/approach A survey questionnaire was designed to attain the research objectives. Agile manufacturing questionnaire was sent to around 500 randomly selected manufacturing organizations in the northern spectrum of India through e-mails and posts, out of which 154 usable responses have been received. This study investigates the inter-relationships between various agile manufacturing implementation practices and business performance measures using various statistical techniques. This paper deploys Games–Howell hoc test to establish the statistical significance of business performance improvements, progressively accrued over a reasonable period of time, through holistic agile manufacturing implementation. Findings The paper validates the contribution of agile manufacturing toward realization of the significant improvements in various business performance measures such as customer-related achievements, financial achievements, business-related achievements, operational achievements, employee-related achievements, and supplier-related achievements. Further, the discriminant validity test has been used in this paper for classifying highly successful and moderately successful organizations. Research limitations/implications The paper only concentrated on manufacturing organizations in northern India. The results of this paper cannot generalize across all the sectors and spectrum of Indian manufacturing organizations. Originality/value This paper develops an insight into the strong potential of agile manufacturing implementation practices in affecting business performance measures.

Leadership skills in a public health professional (PHP) are more important today in view of rapidly changing disease pattern, higher priority to universal health coverage, health in all policies, health being demanded as a human right, and emergence of pandemics from zoonotic diseases. Most of us become accidental leaders as we never receive training in leadership skills. This not only undermines the effectiveness of PHP but also undermines the credibility of public health as a specialty. Jim Collin's five levels of leadership are useful to understand the various levels of leadership for a PHP. Technical excellence which denotes first level of leadership is necessary but not sufficient to become a leader. One needs team work, emotional competencies, prioritization ( first things first), listening skills, advocacy, negotiation, networking skills, along with conviction, commitment, and courage to do what one thinks is right. Leadership is a life-long journey, not a destination. Being engaged in leadership for more than a decade, I developed a three domain leadership capacity development model very useful in designing and conducting leadership development trainings to develop leadership skills among PHPs, academicians, and health researchers.

It has been noted that college education and their library services are the necessity of present days because colleges are providing education and shaping our youths for tomorrow's best citizens. Therefore, college libraries are also expected to provide minimum services so that they could learn and develop themselves into the best citizens. However, it is seen that due to privatization of the education, more and more colleges are emerging in society but their library services are not up to the standards. This paper discusses the collection, staffing pattern, and the library services being provided to their users by private degree colleges in Bijnor.

An unprecedented pandemic of Corona Virus Disease 2019 (COVID 19) has overwhelmed the health systems of countries across the world. The government and other scientific bodies are providing authentic information to educate the public and promote desirable behavior to prevent new infections and reduce deaths. COVID-19 pandemic is the first in human history in which social media and new digital technologies are being used as key tools to inform the public. However, there is a lot of misinformation also being spread through these channels. Misinformation is false, inaccurate, or misleading information that is communicated regardless of an intention to deceive. Access to social media has improved substantially, which has contributed to spread of misinformation. Today, anybody can write anything on social media such as Twitter, WhatsApp, Facebook, TikTok, YouTube etc without any evidence or falsely attribute the wrong information to well-known experts or renowned institutions. They may be doing it to support their own biases or malign the government purposefully or innocently without checking authenticity. The number of mentions in media for Ebola were 11.1 million, for MERS, 23.2 million, HIV, 40 million, SARS, 56.2 million and COVID19 it has crossed 1.1 billion.3. A google search for COVID 19 on 08 June 2021 gave 5340 million hits compared to 216 million for a much older disease HIV/AIDS. This editorial is an attempt to help spot the false information and deal with it.

Oil & gas companies leverage value of information to deliver asset performance from their portfolio to achieve their strategic targets. This requires a transparent, consistent, and balanced reporting of any subsurface project's technical evaluation. To undertake such quality assurance and to build confidence in any evaluation, peer reviews are an essential element of the generally accepted industry standard procedure. Peers aim to review work to identify deficiencies due to inadequate technical investigation, recognize cost effective opportunities and advise for any additional technical work.Any international upstream oil & gas company will deal with various subsurface challenges, especially for a new field. A standardization of peer assists and peer reviews by qualitative analysis has been designed, starting with development projects. Checklists help quality assurance in a structured manner by organizing the facts into a framework, and they are intended to serve two main purposes: (1) Assist the systematic review of the subsurface work to request further technical assistance if necessary, and (2) Aid the review of various subsurface disciplines to ensure that the data supports the appropriate conclusions.It is important to streamline the technical assurance process within any organization. Ideally, informal peer assists concentrate on specific discipline interactions before a formalized technical peer review. A set of review checklists has been developed to aid Geophysicists, Geologists, Petrophysicists, and Reservoir Engineers in their review of subsurface projects. The checklist for a field development project consists of 213 subsurface standards in total: 60 Geophysical, 36 Geological, 62 Petrophysical and 55 Reservoir Engineering standards. Each discipline review is then followed by two key recommendations: (1) further work is required or not, and/or (2) a recommendation to proceed to the next phase is made or not. Because of the high level of detail for the analysis of each subsurface discipline, it is recommended that the checklists be used as part of an informal peer assist rather than a formal peer review. For each discipline, a summary of the outcome is agreed between the project member and the peer (typically a subject matter expert). The use of such qualitative analysis is a big step in the right direction to resolve issues of detailed technical assurance before the formal peer review. Such integration of the subsurface approach drives better business decisions.A case study is presented to show how this systematic approach was used and how the results are consistent, comparable, encompassing and objective. This paper outlines a clear and concise method that has been tried and tested and that allows for relevant technical work to be presented at the correct decision gates and thereby allow data evaluation to be done in a more ordered and efficient way, and this would be of interest to organizations that are required to undertake several review steps prior to project execution.

Many innovations are made mainly for the individual with a disability. The primary aim of the effort is to solve the issue faced by the world's dumb people. It's application-specific, where we solve a dumb medical attendant's issues. The project's main aim is to develop an instrument to answer consumer inquiries in the medical store, which works as an electronic voice device. A Raspberry PI 3 with a keyboard and speaker are suggested. In the Raspberry Pi, a text-to-speech coder is used. The stupid person needs to input the response through a keyboard, depending on the client query. The value is transformed in audio output by pressing the key equivalent. The response time is 2.6 seconds.

The most abundant and widely used renewable energy source is solar energy. A solar panel is a cell that converts the sun's UV radiation into electric energy. In the past decade, the usage of solar panels has increased dramatically, with uses in both commercial and industrial settings. In large-scale solar energy conversion systems, more solar panels are used. Solar panels are often placed on the rooftops of buildings or on the exteriors of structures. Additional dust particles are generated as a consequence of air pollution and direct contact with the outdoors. The throughput and yield of electric energy production are easily affected by these dust particles. Large-scale companies should clean their solar panels on a regular basis. Cleaning each panel is a labor-intensive and time-consuming process. To overcome the aforementioned limitation, the proposed approach is contemporary. It builds a remote-control robot that we can operate with our phones. An Arduino-based autonomous robot is connected to mobile phones using Bluetooth technology. It will be more compact, allowing time and labor to be saved. For large-scale solar panel systems, it is very efficient.

Epithelial ovarian cancer has become the most frequent cause of deaths among gynecologic malignancies. Our study elucidates the diagnostic performance of Risk of Ovarian Malignancy Algorithm (ROMA), Human epididymis secretory protein 4 (HE4) and cancer antigen (CA125). To compare the diagnostic accuracy of ROMA, HE-4 and CA125 in the early diagnosis and screening of Epithelial Ovarian Cancer. Literature search in electronic databases such as Medicine: MEDLINE (through PUBMED interface), EMBASE, Google Scholar, Science Direct and Cochrane library from January 2011 to August 2020. Studies that evaluated the diagnostic measures of ROMA, HE4 and CA125 by using Chemilumincence immunoassay or electrochemiluminescence immunoassay (CLIA or ECLIA) as index tests. Using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). We included 32 studies in our meta-analysis. We calculated AUC by SROC, pooled estimated like sensitivity, specificity, likelihood ratio, diagnostic odds ratio (DOR), Tau square, Cochran Q through random effect analysis and meta-regression. Data was retrieved from 32 studies. The number of studies included for HE4, CA125 and ROMA tests was 25, 26 and 22 respectively. The patients with EOC were taken as cases, and women with benign ovarian mass were taken as control, which was 2233/5682, 2315/5875 and 2281/5068 respectively for the markers or algorithm. The pooled estimates of the markers or algorithm were sensitivity: ROMA (postmenopausal) (0.88, 95% CI 0.86–0.89) > ROMA (premenopausal) 0.80, 95% CI 0.78–0.83 > CA-125(0.84, 95% CI 0.82–0.85) > HE4 (0.73, 95% CI 0.71–0.75) specificity: HE4 (0.90, 95% CI 0.89–0.91) > ROMA (postmenopausal) (0.83, 95% CI 0.81–0.84) > ROMA (premenopausal) (0.80, 95% CI 0.79–0.82) > CA125 (0.73, 95%CI 0.72–0.74), Diagnostic odd’s ratio ROMA (postmenopausal) 44.04, 95% CI 31.27–62.03, ROMA (premenopausal)-18.93, 95% CI 13.04–27.48, CA-125-13.44, 95% CI 9.97–18.13, HE4-41.03, 95% CI 27.96–60.21 AUC(SE): ROMA (postmenopausal) 0.94(0.01), ROMA (premenopausal)-0.88(0.01), HE4 0.91(0.01), CA125-0.86(0.02) through bivariate random effects model considering the heterogeneity. Our study found ROMA as the best marker to differentiate EOC from benign ovarian masses with greater diagnostic accuracy as compared to HE4 and CA125 in postmenopausal women. In premenopausal women, HE4 is a promising predictor of Epithelial ovarian cancer; however, its utilisation requires further exploration. Our study elucidates the diagnostic performance of ROMA, HE4 and CA125 in EOC. ROMA is a promising diagnostic marker of Epithelial ovarian cancers in postmenopausal women, while HE4 is the best diagnostic predictor of EOC in the premenopausal group. Our study had only EOC patients as cases and those with benign ovarian masses as controls. Further, we considered the studies estimated using the markers by the same index test: CLIA or ECLIA. The good number of studies with strict inclusion criteria reduced bias because of the pooling of studies with different analytical methods, especially for HE4. We did not consider the studies published in foreign languages. Since a few studies were available for HE4 and CA125 in the premenopausal and postmenopausal group separately, data were inadequate for sub-group analysis. Further, we did not assess these markers' diagnostic efficiency stratified by the stage and type of tumour due to insufficient studies.

Covid or Corona Virus, a term ruling the world from past two years and causes a huge destruction in all countries. One of the most important Covid disease identification method is Lung based Computed Tomography (CT) image scanning, in which it provides an effective disease identification means in clear manner. However, this Lung CT image based disease detection principles are complex to health care representatives and doctors to predict the Covid disease accurately. Several manual errors and medical flaws are raised day-by-day, so that a new systematic methodology is required to identify the Covid disease effectively with respect to machine learning principles. The machine learning principles are most popular to identify the respective disease efficiently as well as classify the disease in accurate manner without any time consumption. The infected portions of the chest are identified accurately and report to the respective person without any delay. In this paper, a new machine learning strategy is introduced called Hybrid Disease Detection Principle (HDDP), in which it is derived from the two classical machine learning algorithms called Convolutional Neural Network (CNN) and the AdaBoost Classifier. Both these algorithms are integrated together to produce a new strategy called HDDP, in which it process the lung CT image based on the machine learning factors such as pre-processing, feature extraction and classification. Based on these effective image processing strategies the proposed algorithm handles the CT images to predict the Covid disease and report to the respective user with proper accuracy ratio. This paper intends to provide effcient disease predictions as well as provide a sufficient support to medical people and patients in fine manner to assist them with modern classification algorithms.

The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, teaching and research related to diagnostic imaging in women's healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. They are not intended to establish a legal standard of care because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (info@isuog.org).

Background Emerging and reemerging pathogens are global challenges for public health and the pandemic of Coronavirus disease 2019is a reemerging case of an infectious disease caused by Severe Acute Respiratory Syndrome-Corornavirus-2. Health care worker worldwide are at higher risk worldwide and the situation is the same in Nepal. The knowledge and attitude of health workers will certainly mark the outcome towards this pandemic. So, this study aims to assess the knowledge and attitude of community health workers towards the prevention of COVID-19 virus. Methods A descriptive cross-sectional study was carried out among the community health workers of various provinces of Nepal. A semi-structured, self-administered questionnaire was prepared in Google form and circulated to the sampled health workers through various social media platforms like face book, messenger, Instagram and g-mails. A total of 650 invitations were send and among them 420 responded and among them only 399 provided complete response. Responses containing anonymized data was collected analyzed in using SPSS-version-20. The results were interpreted and was checked with various demographic and enabling factors using chi-square test and logistic regression model. Also, ethical approval was taken from NHRC (Nepal Health Research Council (protocol registration number: 360/2020P) prior to the conduction of study. Results Out the total sample size of 450, we took 399 responses taking into consideration all the inclusion criteria. So, from 399 valid response, 230 (47.6%) were males and 169 (42.4%) were females. 380 (95.2%) employed participants thought that wearing PPE will reduce the chances of getting COVID-19, majority of the participants 80.5% (321) responded that COVID-19 will successfully be controlled and staffs receiving excellent support from palika had high knowledge level. Knowledge level was significantly associated with the enabling factor “support from palika” (P = 0.045).45.9% of the respondents had no availability of COVID-19 response medical items for prevention of COVID-19 at their respective health facilities. Also the logistic regression analysis revealed that the odds of knowledge level was 2 times higher (AOR=1.913 at 95% CI: 1.266-2.891) compared to the female participants (Ref- female). Conclusions Proper and adequate knowledge and attitude towards COVID-19 is a paramount in the prevention and control of SARS-COV-2. Health care workers are knowledgeable about COVID-19 and are proactively practicing the preventive measures to minimize the spread of infection but some lack optimistic attitude. Hence, the constantly updated educational programs related to COVID-19 will surely contribute to improving the healthcare workers knowledge and attitude towards COVID-19.

Cloud computing provides the on demand services to cloud users over the internet. Lots of datacenters have been present across the web to fulfill the needs and the services of the users on demand, so there is need to properly schedule the user’s tasks to the Virtual machines (VM) used in the datacenters. Scheduling algorithm must be such that it minimizes the consumption of energy, makespan time and also increase overall performance. This paper describes a Deadline based Energy Efficient Scheduling Algorithm (DEESA) that has been proposed for task and VM scheduling. Proposed work in this paper aims that task of all the users must be completed within their deadlines. All the tasks and Virtual machines have been classified into three dynamic queues to increase the scheduling efficiency. Experimental work has been done in the Cloudsim simulator by setting resource parameters. Results of proposed algorithm indicate that it can effectively minimize the consumption of energy and makespan time as compared with existing scheduling algorithms.

Emerging zoonoses are the product of socio economic and anthropogenic environmental changes. As human societies continue to develop, pathogens from animal hosts have continued to spill over into our population However, Peri-urban ecosystems remain neglected in the country. With a subsequent increase in demand for food, there has been an expansion of formal and informal livestock-based food production sectors in these areas. The increasing close contact between animals and humans in both work and living environments creates hot spots in peri-urban areas, thereby increasing vulnerability to zoonotic disease transmission and other health hazards associated with food safety, water, and sanitation-related diseases. This paper explores the efforts made by different research bodies to reduce the prevalence of zoonotic diseases in peri-urban areas.

High voltage electric burns can cause various ocular injuries and may manifest in the form of conjunctival hyperemia, corneal opacities, uveitis, miosis, spasm of accommodation, cataract, retinal edema, papilledema, choroidal rupture, chorio-retinal necrosis/atrophy, retinal detachment and optic atrophy. The involvement of crystalline lens exclusively with sparing of other ocular structures is rare. We report a case of 16 year old male with bilateral total cataract after electrical injury by over-head high tension electric transmission cable accidentally falling on patient's head 6 months back. B scan showed no abnormality in both the eyes. The intra ocular pressure in both the eyes was within normal limits. Patient underwent lens aspiration with posterior chamber intraocular lens (PCIOL) implantation in both the eyes, under peribulbar anaesthesia (with an interval of 1 week between both the operations). Intra-operative and post-operative period were uneventful. Post operative BCVA was 6/6 in both eyes and fundus examination was within normal limits. Outcomes after surgery are very good if not associated with other ocular lesion like optic atrophy, chorio-retinal lesion, uveitis etc. This observation should encourage the ophthalmologist to undertake surgery for electric cataract, where necessary.

Purpose In the past, the insufficiency of the traditional business practices to meet vibrant customer demands in continuously changing business environment has severely affected organizational competitiveness. The purpose of this paper is to develop and propose a new framework for smoother and effective implementation of agile manufacturing by identifying and integrating a set of significant agility principles and techniques. Design/methodology/approach The present work proposed a framework for agile manufacturing by deploying the comparative analysis of 17 frameworks published in peer-reviewed journals. Findings The proposed conceptual framework constitutes of eight pillars for agile manufacturing implementation. The proposed framework relies on a strong foundation of leadership support. The roof of the proposed framework of agile manufacturing is supported by the pillars constituted of seven elements, an industry must deploy for successfully implementing agile manufacturing, namely, human resource-related issues, organizational culture-related issues, supplier-related issues, customer-related issues, innovation, concurrent engineering and information technology. Originality/value This work is the first attempt, in the best knowledge of the authors, to employ comparative analysis for critically analyzing a wide range of agile manufacturing frameworks. The findings of this study will assist researchers and managers in agile manufacturing implementation in more a smoother and effective way in manufacturing industries.

Purpose The purpose of this paper is to investigate the existing literature on agile manufacturing (AM) to pinpoint critical success factors (CSFs) affecting the successful implementation of agile manufacturing systems. Design/methodology/approach The study focused on empirical articles published in peer-reviewed journals from 1991 to 2019 (July). In total, 37 empirical studies were shortlisted for analysis as the reliability and validity of the constructs were critically tested using various statistical methods. Further, “Pareto analysis” tool was employed to sort and arrange the factors critical for smoother and effective implementation of AM, in descending order according to their frequency of occurrence. Findings The present work scrutinizes 37 research papers, resulting in 33 CSFs that affect AM implementation. Using Pareto analysis, 8 CSFs are regarded as “vital few,” which account for 82.66 percent of occurrence, and the remaining 25 CSFs are regarded as “useful many,” which account for 17.34 percent of occurrence. The managers must focus on successful deployment of “vital few” CSFs, as they are more critical in achieving business excellence through the successful implementation of AM, in comparison to other 25 “useful many” CSFs. Originality/value To the best knowledge of authors, this work is the first attempt to employ Pareto analysis for critically analyzing a wide range of AM CSFs studies. The findings of this study will assist researchers and managers in AM implementation in a more smoother and effective way in manufacturing industries.

Purpose The purpose of this paper is to examine the contribution of agile manufacturing (AM) initiatives in the Indian manufacturing industry and their influence on the business performance enhancement. Design/methodology/approach A survey questionnaire was designed to attain the research objectives. The variables included in the questionnaire were adapted from the elaborated literature review and validated through discussion held with practitioners, academicians and the industry experts. AM questionnaire was sent to approximately 500 randomly selected manufacturing organizations in the northern spectrum of India through e-mails and posts, out of which 154 usable responses were received. Findings The study identified that the Indian manufacturing industry has been reasonably successful in improving the business performance by implementing AM initiatives and has successfully reaped the benefits of AM implementation. Originality/value The present work develops an insight into the prevailing AM practices adopted by Indian manufacturing organizations. The study calculated the percent point score for each issue of AM initiative with respect to the Indian manufacturing industry and highlighted its impact on the enhancement of business performance.

Introduction: Selection of graft for primary anterior cruciate ligament reconstruction have long been a topic of controversy. Among the vast range of graft options, hamstring autograft is most commonly used and quadriceps tendon autograft is less common. Purpose: To compare the functional outcomes in quadriceps tendon graft and quadruple hamstring graft in primary anterior cruciate ligament reconstruction. Materials and Methods: Thirty patients with post traumatic anterior cruciate ligament injury were taken into study. All 30 patients were randomised and two group were made. Group H Included 15 patients in which ACL reconstruction was done using quadruple hamstring graft and Group Q included 15 patients in which ACL reconstruction was done using quadriceps tendon graft. All patients were prospectively analysed. In post-operative period all patients were treated with standardized rehabilitation protocol and were evaluated at 6 weeks, 3 months and 6months by Lysholm knee score, quadriceps weakness, extension lag, quadriceps wasting, anterior drawer test, Lachman test and pivot shift test and compared. Results: Mean difference in extensor lag between both groups was 1.07(p value 4.48), - 0.22(p value 3.59) and - 0.32(p value 2.28) at first, second and third follow-up but was not significant. Mean difference in quadriceps strength between both groups was 4.10(p value 0.172), 2.04(p value 0.955) and - 2.46(p value 0.218) at first, second and third follow-up but was not significant. Mean difference in quadriceps wasting between both groups was - 0.29(p value 0.380), - 0.33(p value 0.349) and - 0.26(p value 0.217) at first, second and third follow-up but was not significant. Mean difference in Lysholm knee score between both groups was 4.10(p value 0.172), 2.04(p value 0.955) and - 2.46 (p value 0.218) at first, second and third follow up but was not significant. No significant difference was found in both groups. Conclusion: All the patients in whom ACL reconstruct

Objective: Anterior cruciate ligament (ACL) is the most common ligament to be replaced in the knee joint and ACL reconstruction (ACLR) is one of the most commonly performed surgery in orthopaedics nowadays. This study evaluated short term results of anterior cruciate ligament reconstruction with quadruple hamstring autograft using adjustable loop endobutton for femoral fixation and Bio absorbable interference screw for tibial fixation. Material and methods: 40 patients were operated for ACL reconstruction using quadruple autologous hamstring graft with adjustable loop endobutton and bio interference screw. Following the surgery the patients undergone standard rehabilitation protocol. The patients were followed up in OPD and their functional outcomes were measured by Lysholm scoring and IKDC scoring at 2 weeks, 8 weeks, 12 weeks, 24 weeks. Result: A total of 40 patients were evaluated in which there were 36 male patients and 4 female patients with a mean age of 26.75±5.95 and 25.25±7.27. The mean Lysholm score were 89.62±8.90 at 24 weeks of follow up compared to 79.38±11.32 at preoperative. The mean IKDC score were 85.06±9.35 at 24 weeks of follow up compared to 56.703±12.27 at preoperative. Conclusion: Arthroscopic ACL reconstruction and graft fixation using adjustable loop endobutton for the femoral end fixation and bioabsorbable interference screw fixation at the tibial end give an excellent result with minor complications. Keywords: ACL reconstruction, adjustable loop endobutton, hamstring graft.

Background Breast carcinoma is one of the commonest cancer in women accounting for major health burden worldwide. Metabolic syndrome is a known risk factor of non-alcoholic steatohepatitis (NASH) as well as breast carcinoma. APRI (Aspartate aminotransferase to platelet ratio index), a known non-invasive marker of liver fibrosis and steatohepatitis has never been studied in patients of metabolic syndrome with breast carcinoma. Breast carcinoma has various modifiable risk factors such as obesity and alcohol consumption. Hence, we compared APRI score in patients with breast carcinoma in order to establish a possible correlation. Aims and Objectives Our primary objective was to study APRI (Aspartate aminotransferase to platelet ratio index) score in patients of breast carcinoma with and without metabolic syndrome. The secondary objective was to study APRI score in post-menopausal women with breast carcinoma. Material and Method This prospective observational study included 151 patients of breast carcinoma, these patients were sub grouped into two, with and without metabolic syndrome and pre and post-menopausal women. Multiple demographic and biochemical parameters including APRI score were studied in these groups. The sensitivity and specificity of APRI score was calculated in these groups. Results A total of 151 patients of breast carcinoma were included in the study group.53.64% patients with breast carcinoma had metabolic syndrome. The mean values of AST (Aspartate aminotransferase), BMI (Body mass index), FBS (Fasting blood sugar) and APRI score were significantly higher in the patients with metabolic syndrome. More than 50% patients of breast carcinoma belonged to the post-menopausal age group. Mean values of AST (aspartate aminotransferase), BMI (body mass index), FBS (fasting blood sugar) and APRI were higher in this group. The area under the receiver operating characteristics (ROC) curve of APRI score of metabolic syndrome patients was 0.93 and that of post-menopausal women was 0.82. Conclusion APRI score can be used as a surrogate marker of metabolic syndrome in patients with breast carcinoma. It is also useful in planning preventive strategies in patients with breast carcinoma especially in post-menopausal age group.

Introduction: Chronic lumbar radiculopathy is defined as a clinical syndrome of back and leg pain companied by sensory, reflex, or motor deficits in a nerve root distribution lasting for more than 12 weeks. Lumbar radiculopathy mostly occurs due to a prolapsed disc. Both surgical and non-surgical treatments are available. This prospective analytic study was designed to assess the efficacy of selective nerve root block with corticosteroids in the management of pain associated with prolapsed lumbar intervertebral disc that didn’t get relief from non-surgical pharmacological treatment. Materials and Methods: 40 Known cases of lumbar PIVD not responding to pharmacological treatment were given c- arm guided root block for respective nerve root and the results were evaluated using the visual analogue scale (VAS), Oswestry Disability Scale (ODI)and straight leg raising (SLR) test over the period of 1,3,6, and 12 months. Results: Total of 40 patients were included in the study out of which 29 (72.5%) were male and 11 (27.5%) were female. Average Age was 36.73±10.8 ranging 18–62 years. The average duration of pain was 13.08±4.1 months. The initial VAS was 7.65±0.5 which was reduced to 4.07±0.9 at final follow up after 1 year of treatment. The average SLR was increased to average 65.8 ± 5.3% t final follow up from average 41 ± 12.8% at initiation of treatment. The initial ODI score was78.20±2.8 which was reduced to 41.70±5.5 at final follow up. All the parameters taken to assess the therapeutic effects of SNRB showed statistically significant change from initial values to final values. Conclusion: Our study has shown that selective nerve root block is an easy and safe method with better short-term, mid- term, and long-term pain relief and improvement in functional disability in cases of lumbar intervertebral disc herniation. It can be given by a trained interventionist /orthopedic surgeon. Keywords: Lumbar PIVD, Root block, ODI.

Background: Serum interleukin (IL)-6 has been found to be associated with sleep quality, mood, and survival in patients with solid tumors. Results in these studies were confounded by knowledge of diagnosis to study subjects. Moreover, such data among subjects with hematological malignancies and data regarding restless legs syndrome is limited. The present study was, therefore, conducted to assess the sleep quality, depression, and restless leg syndrome in hematological malignancies and to study if there is any role of IL6 associated with it. Methods: Sixty-six subjects having hematological malignancy were included in this study after excluding the potential confounders. Sleep quality was examined using Pittsburg Sleep Quality Index, depression by the Patient Health Questionnaire-9. Diagnosis of RLS was made through clinical examination. Serum for measurement of IL-6 was collected at baseline and after 1 month of initiation of chemotherapy. Patients were followed up for 6 months. Results: Average age of study subjects was 50.16 years with male predominance. Nearly 22.7% had clinical depression, 28.8% had poor quality sleep, and restless legs syndrome (RLS) was reported in 6.1% cases. Nearly 22.7% patients died at 6 months. Disturbed sleep at baseline was associated with depression (odds ratio [OR] =7.89) and poor 6 months survival. Serum IL-6 did not show any association with sleep quality, restless-legs-syndrome, and depression. However, baseline high level of serum IL-6 (OR = 26.06) and low level after chemotherapy (OR = 0.03) were associated with poor survival at 6 months. Conclusion: Poor quality sleep, depression, and RLS are prevalent among adult subjects with hematological malignancies. Sleep disturbance, high pretreatment inflammatory and lowering of inflammatory load after chemotherapy increase likelihood for poor prognosis. Serum IL-6 did not show any association with sleep quality, restless legs syndrome and depression.

The various surgical options for lacrimal tract reconstruction include canaliculodacryocystorhinostomy; fundal transposition; Conjunctivodacrocystorhinostomy with Jones tube; and in extreme cases conjunctivo-rhinostomy (CR) for total lacrimal bypass. The first three require partial lacrimal tract presence/ integrity while CR is indicated when the canaliculi and/or sac are nonfunctional. This report describes a novel technique of minimally invasive CR through a predominantly endoscopic endonasal approach and further discusses its advantages over other established techniques.

The traditional electrical grids deals with generation, transmission and distribution have one-way communication and are centered around the distributor. They also lack in routing and interconnection of different types of generations which lead to a reduction in the reliability of supply. Hence to overcome this issue we propose the comprehensive architecture of Smart Grid and it’s Observation and control using the Internet of Things (IoT) and Cloud Technology. We have Integrated the different sources of energy (thermal and renewable) in a system and introduces the automatic routing of electric power according to peak and low demand. It also incorporates the smart metering facility using IoT and Cloud Technology. It can gather, send and receive the real-time data, which provide two-way communication of data of power being consumed at customer’s end to the service producer. The whole data can be stored, accessed and analyzed on the very secured and customized API platform. We have built and thoroughly tested demonstration model of our project having Wi-Fi-based smart meter, which helped us to monitor and control the electric power and to enhance the reliability of the system.

Many Stramenopile species belonging to oomycetes from the genus Saprolegnia infect fish, amphibians, and crustaceans in aquaculture farms and natural ecosystems. Saprolegnia parasitica is one of the most severe fish pathogens, responsible for high losses in the aquaculture industry worldwide. Most of the molecules reported to date for the control of Saprolegnia infections either are inefficient or have negative impacts on the health of the fish hosts or the environment resulting in substantial economic losses. Until now, the whole proteome of S. parasitica has not been explored for a systematic screening of novel inhibitors against the pathogen. The present study was designed to develop a consensus computational framework for the identification of potential target proteins and their inhibitors and subsequent experimental validation of selected compounds. Comparative analysis between the proteomes of Saprolegnia, humans and fish species identified proteins that are specific and essential for the survival of the pathogen. The DrugBank database was exploited to select food and drug administration (FDA)-approved inhibitors whose high binding affinity to their respective protein targets was confirmed by computational modeling. At least six of the identified compounds significantly inhibited the growth of S. parasitica in vitro. Triclosan was found to be most effective with a minimum inhibitory concentration (MIC100) of 4 μg/ml. Optical microscopy showed that the inhibitors affect the morphology of hyphal cells, with hyper-branching being commonly observed. The inhibitory effects of the compounds identified in this study on Saprolegnia’s mycelial growth indicate that they are potentially usable for disease control against this class of oomycete pathogens. Similar approaches can be easily adopted for the identification of potential inhibitors against other plant and animal pathogenic oomycete infections.

Label smoothing has been shown to be an effective regularization strategy in classification, that prevents overfitting and helps in label de-noising. However, extending such methods directly to seq2seq settings, such as Machine Translation, is challenging: the large target output space of such problems makes it intractable to apply label smoothing over all possible outputs. Most existing approaches for seq2seq settings either do token level smoothing, or smooth over sequences generated by randomly substituting tokens in the target sequence. Unlike these works, in this paper, we propose a technique that smooths over \emph{well formed} relevant sequences that not only have sufficient n-gram overlap with the target sequence, but are also \emph{semantically similar}. Our method shows a consistent and significant improvement over the state-of-the-art techniques on different datasets.

In addition to maternal mortality, information on maternal near miss and severe maternal morbidity are important in maternal healthcare. We aimed to determine the incidence, causes and outcome of severe maternal morbidity and near miss, and the sociodemographic and obstetric factors associated with these at a tertiary care teaching hospital in Delhi.Women admitted with severe maternal morbidity and near miss, as defined by the WHO study group, were included in the study. The incidence ratio of near miss and severe morbidity in the hospital was determined, and a case-control study was conducted to study the factors associated with the occurrence of near miss. Information was obtained from hospital records and interviews, using a semi-structured open-ended questionnaire.The incidence ratio of near miss was 6.85/ 1000, and severe morbidity was 11.38/1000 live births. Hypertensive disorders and haemorrhage were the common causes of cases of near miss and severe morbidity. Coagulation dysfunction (62%) was the most common organ dysfunction, followed by uterine dysfunction (22%). Older age (odds ratio [OR] 2.01, confidence interval [CI] 1.02-3.93), the absence of formal education (OR 2.05, CI 1.11-3.75),18 years of age at marriage (OR 2.01, CI 1.21-3.32), lower income (OR 3.8, CI 1.88-7.64), gravida of four or more (OR 2.25, CI 1.21-4.17) and residence outside Delhi (OR 9.31, CI 4.36-19.90) were significant predictors of near miss. Sepsis, hypertensive disorders and haemorrhage were the most common underlying conditions in women who died. The foetal outcome was a live birth in 64% of near-miss cases and 62% among severe morbidity.The burden of severe maternal morbidity and near miss is high. These need to be identified and managed at the earliest.