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Hypertension is severe high blood pressure caused by a stressful lifestyle, in which the blood vessels have persistently elevated pressure, making it difficult for the heart to pump. Because of this increased pressure on the heart, the pressure on the blood vessels that supply the different tissues and organs of the body increases and can damage the corresponding organs. It is an early stage of pathogenesis and a risk factor for the development of diseases affecting, for example, the heart, brain, kidneys, etc. Many people with hypertension are undiagnosed for a long time or until diagnosed incidentally, so it can be considered a silent killer. About 1.13 billion people worldwide suffer from hypertension, so normalizing abnormally high blood pressure is a difficult task. In Ayurveda, systemic hypertension can be understood as the participation of vitiated Doshas, ​​​​​​where Vata and Pitta are the dominant Tridoshas, ​​​​​​which prevent the movement of these Doshas in the respective Srotas. The concept of Avarana (occlusion in Dosha functioning in a normal state) gives a better understanding of hypertension, which should be considered for better results in Ayurvedic treatment of diseases. Therefore, an attempt will be made here to understand hypertension from Ayurvedic concepts and to discuss the management of this condition from an Ayurvedic perspective.

Breastfeeding the baby is the most important practice that promotes optimal growth and development of the infant. World Health Organization has recommended exclusive Breastfeeding for the first six months. Breastfeeding not only promotes Infant health and wellbeing but also protects the mother from developing illnesses. There is a compelling need to understand the level of awareness, perceptions and attitude towards breastfeeding and also develop programs to ensure that the knowledge is translated to practice in the postnatal phase. This review highlights the level of knowledge, attitude and perceptions towards breastfeeding, factors influencing the breastfeeding practices, Breastfeeding and its relation to Mental health of new mothers and the various initiatives launched by the Government to promote awareness on breastfeeding.

The advancement of data innovation has sparked emotional changes across the board. The administrations of libraries and data science benefited from these advances. Libraries have been automated, and they are currently transitioning to being paperless or virtual. Modern ideas are incorporated to acknowledge various contemporary advancements in the calling as well as to encourage the sharpening inside the libraries. In this article, a diagram illustrates how cloud computing operates in library services and the fundamental idea behind it.

The present study focuses on synthesis of novel high-performance acrylic acid (AA) grafted polyethersulfone (PES) ultrafiltration (UF) membranes for purification of small therapeutic biomolecules such as urea, insulin, and cobalamin. The membranes were indigenously synthesized by adding polyethylene glycol (PEG) of 6 kDa M.Wt. as a pore former and subsequent grafting of AA using 2 to 6 wt.% concentrations under UV-induced photo grafting. Scanning electron microscopy reveals that the PEG additive profoundly influences the pore density on the membrane surface. FTIR spectra confirm the graft polymerization of AA with the PES substrate. Separation performance of the grafted membranes was evaluated to establish the trade-off between the degree of grafting and MWCO. From the experimental results, the pure water flux (PWF) of 6% grafted PES membrane was enhanced from 8.5 (PES [0] [6]) to 18.20 l m−2 h−1 (PES [6 +] [6]) in the presence of PEG pore former, respectively. The grafting concentration window of 2–6% resulted in selective membranes to altogether remove uremic toxins into the permeate with retention of high molecular size proteins. Hence, 5 and 6 wt.% AA grafted membranes exhibited > 90% rejection for insulin and cobalamin biomolecules along with 24.5 and 23.8 l m−2 h−1 bar−1 permeability towards urea, respectively. The process results correlate well with the MWCO values of membranes ranging from 1 to 10 kDa. This work provides the efficacy of these grafted membranes for potential application in the downstream processing of therapeutic biomolecules such as insulin and cobalamin.

Background: The need for oxygen, as well as the scarcity caused by the second wave of the Corona epidemic, has caused everyone to reconsider the sustainability and self-sufficiency of oxygen. Medical oxygen therapy is a standard treatment for patients with severe Covid manifestations. Ensuring a consistent supply of oxygen to meet the rising demand for oxygen must be planned at the national, state, and institutional levels. Aim: In this article we would like to emphasise the importance of oxygen adequacy. Materials and Methods: This narrative review covers the methods of estimating oxygen requirements of a hospital, and the alternate oxygen sources available, highlighting the role of oxygen concentrators in a low resource settings. Conclusion: Oxygen concentrators specially as pressure swing adsorption plants can be used by hospitals as a main source of oxygen being both economical, as well as reducing the dependency on refilling and transport. Key Messages: Planning the oxygen resources for a hospital should include primary, secondary and reserve sources, among all these the oxygen concentrator plays a vital role both being economical in the long run as well as making the hospital largely independent of logistic issues. Keywords: Covid 19, Health resources, Oxygen consumption.

PRECIS Glaucoma can cause disturbance in psychological and emotional functioning of patients, leading to anxiety and depression, even early in the disease. Identification and management of these problems should be included as a part of the holistic approach for patient care. PURPOSE To assess the prevalence of anxiety and depression in patients with primary glaucoma using a standard validated questionnaire. METHODS A cross-sectional prevalence study was carried out on 200 patients attending the glaucoma outpatient clinic at a tertiary care eye hospital in Pune, India. After obtaining written consent, all patients underwent a thorough ophthalmic examination. Those with primary glaucoma were included in the study and classified on the basis of the Hodapp-Parrish-Anderson criteria. Participants were asked to respond to the Hospital Anxiety and Depression Scale (HADS) questionnaire and responses were analyzed statistically. RESULTS Mean HADS- Anxiety (HADS-A) score was 4.5 (SD 3.4) while HADS-Depression (HADS-D) was 4.1 (SD 3.8). Severity of disease was associated with significantly higher HADS scores. Mean HADS-A scores were 3.1 (SD 2.9) mild glaucoma, 4.4 (SD 2.6) for moderate and 7.7 (SD 3.0) for advanced disease (P

In the current scenario, the words Artificial Intelligence and Virtual Intelligence are the familiar ones among students of all ages. This study analyzes the usage of virtual intelligence during the pandemic period. The students of higher education mostly adopted the present way of teaching by using technology. A Positive approach to virtual Intelligence is exhibited in this study. 142 samples were collected by using a convenient sampling method through the well-framed questionnaire for the data analysis.

The development of nanoparticles (NPs) and their incorporation into the membrane matrix for water and wastewater treatment is an emerging research area in modern times. Greywater (GW) treatment is gaining significant mileage of late owing wide variety of uses in nonpotable domestic and other industrial applications. The present study focuses on the indigenously synthesized titanium dioxide (TiO2) NPs and their amalgamation of 1–5% (wt) into polyphenyl sulfone (PPSU) mixed matrix membranes (MMMs) i.e., PPSU-T0 to T5 for GW purification by ultrafiltration (UF) process. The 3% (wt) of TiO2-loaded MMMs were optimized based on the results obtained from scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), 40.20% of porosity, and 31.14 nm pore size by 49.4° contact angle with an outstanding performance of 16.97 MPa tensile strength, besides 10.71% of elongation-at-break, along with 92.59 L/m2 h permeation and 99.43% of bovine serum albumin (BSA) rejection with an 89.50% of flux recovery. In addition to this, the optimized membrane exhibited a low fouling tendency with a minimal flux declination, which helps in GW treatment. From the experimental results, the PPSU-T3 achieved a maximum flux of 45.63 L/m2 h, with 80% water recovery by the removal of 95.54% turbidity, 94.20% color, 95.54% TSS and complete E. coli bacterial eradication at an applied pressure of 2 bar. Based on these observations, it can be deduced that the UF membrane played a vital role in GW purification, which can be further extended to desalination, surface water purification, protein concentration, and pre-treatment for nanofiltration (NF) and reverse osmosis (RO) applications. The findings of this study; therefore, shall emerge as a viable alternative for freshwater consumption in vulnerable water-scared areas, besides using it in gardening, laundry, washing, and other industrial applications.

Vyanga is one of the Kshudraroga1, characterized by the presence of painless, bluish-black patches on face. On the basis of clinical features, it can be compared with Facial melasma. Melasma is characterized by dark, discolored patches on skin. It's also called chloasma. It typically occurs in the face and symmet-rical, with matching marks on both sides of the face. Area of the body which exposed to sun can also de-velop melasma. According to Ayurveda, vitiated Dosha mainly Pitta along with Vata produce blackish patches on the face which is called Vyanga. Vyanga is Rakta Pradoshaj Vikar and in its Doshas involved is Udana Vayu, Bhajrak Pitta and Dushya Rasa and Rakta Dhatu, as this condition disturbed our mental and physical state. In modern medical science, topical steroids have been described in the management of faci-al melasma. However, the topical steroids are may cause adverse effects such as irritation, rashes etc. and are expensive too. Ayurveda treatment includes Abhyanga with Taila, Lepa, Pradeha, Nasya, Rak-tamokshana etc. Ayurveda mentions a good number of drugs like Kusthaghna, Kandughna, Raktasho-dhaka, Twakprasadaka and Varnyakara properties e.g. Arjuna, Nimba, Manjistha are helpful in manage-ment and can produce cutaneous depigmentation that remove the blackish discoloration of skin.

Introduction: The classification of ovarian tumours, both benign and malignant, into numerous categories is a proof for the ever expanding number of new lesions being added every year. This heterogeneity of ovarian lesions is the initiating factor to conduct this retrospective study to evaluate the frequency and age distribution of ovarian lesions in our tertiary centre. Materials and Methods: This is a retrospective study conducted in the Department of pathology, Government Thiruvarur medical college, Thiruvarur, Tamil Nadu between the period Jan ‘2016 to Dec’2017.The clinical details along with the gross and histopathological diagnosis cases with ovarian lesions were compiled and analysed to arrive at the percentage of distribution of various lesions. Results: Out of 144 cases studied, benign, borderline and malignant ovarian tumours were 79.85%, 3.47% and 16.65% respectively. Benign tumours peaked between third and fourth decades, while malignant tumours were seen commonly after fifth decade. Surface epithelial tumours were common (84%) followed by germ cell tumours (7.64%) and sex cord stromal tumours (4.16%). Serous cystadenoma was more common than mucinous cystadenoma followed by mature cystic teratoma. Serous cystadenocarcinoma was the most common malignancy in our study. Keywords: Surface epithelial tumour, Germ cell tumours, Sex cord stromal tumours.

Objective: The majority of histopathological specimens from the gynaecological department includes uterine cervix biopsy. A retrospective study was conducted for 2 years to evaluate the incidence and age wise distribution of various uterine cervical lesions (neoplastic and non-neoplastic) by histopathological examination. Materials and Methods: The study was conducted in the Department of Pathology, Government Thiruvarur Medical College, Thiruvarur, Tamil Nadu over a period of two years from January 2016 to December 2017. A total of 1672 specimens were analyzed from both hysterectomy and biopsy specimens. The specimens received were formalin fixed, dehydrated in graded alcohols, embedded in paraffin wax and subsequently stained by hematoxylin and eosin stains. Results: Among the 1672 specimens, non-neoplastic lesions occupied the major part 1298(77.63%) followed by neoplastic lesions 374(22.37%). The most common histological findings among the cervix biopsy was chronic nonspecific cervicitis-1094(84.28%). However, other inflammatory lesions reported, includes chronic cervicitis with squamous metaplasia 52 (4.01%); papillary endocervicitis 34(2.62%), bartholin cyst was present in 14(1.07%). Benign endocervical polyp and leiomyomatous polyp were reported with equal incidence each of 24 (6.42%). Cervical malignancies include cervical intraepithelial neoplasia, CIN-I: 62(16.58%), CIN-II: 32 (8.55%), CIN-III: 56(14.98%). The most common cervical malignancy was squamous-cell carcinoma 170(45.45%), moderately differentiated type being the frequent. The other rare malignancies included adenocarcinoma, serous cell carcinoma and glassy cell carcinoma of cervix. Conclusion: Carcinoma of cervix is easily curable disease with advent of early diagnostic and screening procedures. Our study emphasizes the significance and implementation of protocols for early diagnosis by proper screening procedures of patients with cancer of the cervix thereby seeking timely treatment which improv

In the Present scenario, cloud computing is an emerging trend. It involves different types of techniques and it provides Virtual and IT-related innovative applications and services through the internet.(Rakesh, 2017) In the modern era of cloud computing, the entire library services and applications depends upon cloud computing & also performs as a boon for libraries. Cloud computing is an important thing for users and it plays a vital role in the major fields of library and information centre and library professionals. In this paper, I have described applications and services at library and information centre in the era of cloud computing. (Nagalakshmi et al., 2013) Being the newest technology, cloud computing, had created more interest in library collections, services and applications, and systems will be driven into cloud computing and (Maitra & Mudholkar, 2011) with the quick growth of cloud computing many libraries and knowledge canters are moving towards cloud computing activity...n addition, it also explained both advantages and disadvantages. The purpose of this study may be helpful in classifying and stimulating future developments in the (Kaushik et al., 2013) library and information centre and library services and applications using cloud computing in the modern era.

Context: Diagnostic accuracy of various difficult airway predictors in anticipating difficult intubation have been studied in literature. Aims: To identify the best combination of bedside difficult airway tests in anticipating difficult intubation. Settings and Design: In this study 200 patients between the ages18 -70 years, of American Society of Anaesthesiologists grade I II, posted for elective surgeries under general anaesthesia with intubation were enrolled. Materials and Methods: Modified Mallampati Grade, Thyromental Distance, Upper Lip Bite Test were noted on airway examination. Intubation difficulty during general anaesthesia was assessed by observing Cormack Lehane Grade, number of intubation attempts, use of external laryngeal pressure, Gum elastic bougie. Statistical Analysis used: Airway parameters of 200 patients were analysed in SPSS 20 software for sensitivity, specificity, positive predictive values, negative predictive values in individual tests and in various combinations with each other. Results: Among 200 patients, incidence of difficult intubation was 7% (14 patients). Patients needing two or more attempts for intubation, gum elastic bougie, external laryngeal pressure were five, eight and 30 respectively. Modified Mallampati Grade had sensitivity 64.3%, specificity 79%. Upper lip bite test had sensitivity 71.4%, specificity 41.9%. Combination of Modified Mallampati Grade with Upper Lip Bite Test had sensitivity 64.3%, specificity 84.9%, positive predictive value 80.9% which were statistically significant. Conclusions: Modified Mallampati Grade, Upper Lip Bite test individually and as combination have better diagnostic value, compared to other airway parameters, in predicting difficult intubation. Keywords: Airway predictors, Difficult airway, General anaesthesia, Incidence, Intubation.

This study is in detail about the furious intention to use mobiles and their applications for the establishment of government Services & emergency handling. Our problem identified in Villages that resists the enhancement of a village is their Livelihood. The Livelihood addresses all aspects such as Hospitality, Employment, and Occupation like Agriculture, Daily needs, Transport, Gas-Tele Communication lines, and even cable connections along with ration goods. Hence our justification towards the increase in Livelihood of Villages will damn enhance both their income and prosperity in a gradual way. Our Solution in constructing a Vehicle hailing projects all around the village especially in major spots like bus stops, hospitals, the street ends with a microphone to connect them with the service Centre at the rural end, which not only supports them in handling emergency cases and urgent transport needs but also enhances the income of village by increasing their prosperity and employment status. Hence to give a one-in solution to this, we came up with a vehicle-hailing concept that will support all common man free of cost at his foot-step. The findings through demographics and Survey analysis revealed that networking and performance parameters are the key tool determinants influencing the general & repeated use of our App. The results of this paper have proved practical contributions to the concept of Vehicle hailing apps and practical resources to decision-makers in the development and establishment of Vehicle hailing in rural villages.

Reactive power optimization is one of the major problems of concern in smart grid (SG) environment. Although several techniques have been proposed for reactive power optimization, demand side management (DSM) plays a vital role in smart grid networks. The main idea of this work is to address reactive power optimization by developing a smart controller for DSM by effective monitoring of real power loss in the smart grid network. The proposed smart controller is developed by formulating the DSM as an optimization problem and obtaining its solution by applying elephant herd optimization–firefly (EHO–FF) evolutionary algorithm. Further, the proposed smart controller for DSM aims to meet the power demand and limit the power flow in transmission network by adding distributed generation (DGs) units at optimal locations. The proposed work aims to improve the energy efficiency and voltage profile in the power grid network when operating under different load scenarios. The benchmark IEEE 30 bus system consisting of 6 generating units, 41 transmission lines with total load of 283.4 MW and 126.2 MVAR is used as the test system in this work. The test system is subjected to varying load pattern for 24 h in a typical day. The performance of the proposed smart controller is evaluated on the bench mark IEEE 30 bus system through program code developed in MATLAB environment. The simulation results have proved that the proposed smart controller for DSM minimizes the power loss and improves the voltage profile significantly by incorporating DG units in optimal locations. The effectiveness of the EHO–FF algorithm is analyzed by comparing the results obtained with PSO and bAT algorithm.

This article has been focused on the design of the artificial neural network with fuzzy inference system (ANFIS) for the speed control of permanent magnet synchronous motor (PMSM). PMSM is widely used in industrial applications such as robotic manipulators and machine tools due to the high efficiency, high torque to weight ratio and smaller size. One of the efficient control strategies of PMSM is based on ANFIS. ANFIS is very popular technique to deal with uncertainties. System dynamics in such cases can be compared with combining the proportional–integral–derivative (PID) with the Sliding Mode Controller (SMC). Simulations have been performed in MATLAB to validate the performance of the proposed model, and comparisons are made with ANFIS, SMC–PID and PID controllers compared to other controllers reported in the benchmark of the proposed controller’s efficiency. The proposed adaptive neuro-fuzzy-dependent results indicate good transient efficiency. Robustness against the robustness of adaptive neuro-fuzzy-based PID and SMC–PID controllers is satisfactory in terms of easy settling time, zero peaks overflow and zero steady state error. The simulation results have been implemented in MATLAB 2019b, and experimental results are implemented in BD63030.

A recession is narrowing of an economic cycle and it is referred as slowdown of economic action. The macro economic factors varies during recessions. There will be a fall in production, employment, GDP, investment, capacity utilization, spending, household income, inflation and business fall. The rate of unemployment and bankruptcies rise during recession. Due to adverse supply shock there will be a drop in consumption and there will be a bursting of economic buddle. Even though owing business organizations is not without struggles, the rewards they earn often worth it. Every entrepreneur enjoy great freedom and flexibility in comparison with a regular employee. With a right kind of state of mind and proper understanding of hardship with are to be faced, a proper plan is required to tackle the ups and down in the journey of Entrepreneurship with respect of Small Scale sector. One of the biggest challenges faced by small firms is its difficulty to reach break even. It often takes 2 to 3 years for small businesses to accomplish their goals. Especially during recession, small business organizations often hit the hardest. Reduced spending power, inadequate preparedness for recession, budget constraints etc., are making it impossible for small business to endure. The present article offers various suggestions for small businesses to manage during recession.

Gridhrasi is one among the Shoola Pradhana Vataja Nanatmaja Vyadhi, intervening with the functional ability of low back and lower limbs. Low back pain is the major cause of morbidity throughout the world affecting mainly young adults. This is a Combined Clinical Study of Dashamoola Kashaya Adhokayaseka, Astakatvara Taila Matra Basti and Kamsakhya Guggulu. In the present study total 30 patients having Gridhrasi were included. Patients were selected randomly from the OPD and IPD of BVVS Ayurved Hospital, Bagalkot. Case Performa was prepared with all points of history taking, physical examination and X-ray to confirm the diagnosis as mentioned in our classics and modern science. Management-1]Dashamoola Kashaya Adhokayaseka 30 minutes for 8 days. 2]Astakatvara Taila Matra Basti 48ml for 8 days. 3]Kamsakhya Guggulu 1gm/day for 30 days after food. Results and Concliusion – Dashamoola Kashaya Adhokayaseka, Astakatvara Taila Matra Basti and Kamsakhya Guggulu have significant therapeutic value in Gridhrasi.

Purpose: The aim of this study was to determine whether the introduction of a structured short-term phacoemulsification training program improved the ICO-OSCAR (International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric) score and the learning curve of the trainees and decreased the complication rates of the cases. Methods: This study was a retrospective, observational study conducted in a tertiary eye care hospital in India. The study was conducted from March 2018 to October 2019 based on a structured phacoemulsification training program introduced in January 2019. The trainees enrolled in the phacoemulsification training program were divided into two groups: Group 1 (n = 33), who underwent training before the introduction of the structured program, and Group 2 (n = 29), who underwent the training after the introduction of the structured training program. Each trainee performed 20 cases. Group 1 training consisted of wet-lab and phacoemulsification surgeries. Group 2 training program comprised three modules over 5 weeks and a preassessment examination. Premodule 1 imparted cognitive skills; Module 1 was on structured wet-lab, Module 2 was about phacoemulsification step surgery, and Module 3 had independent complete surgeries. Group 2 also underwent compulsory Observation of cases being performed in the operation theater, surgical video recording review, and formative feedback. Mean OSCAR score comparison was done for both the groups. The OSCAR score was also calculated case-wise to obtain the learning curve with respect to the entry and exit levels, by classifying the trainees in each group as Novice, Beginner, Advanced Beginner, or Competent. A comparison of the posterior capsular rupture (PCR) rates and vision at discharge of all the cases was done. Results: Group 2 had a significantly better mean OSCAR score than Group 1 (4.03 and 3.43, respectively; P < 0.001). The PCR rate of the cases was significantly lower in Group 2 than in Group 1 (9.14% and 20.30%, respectively; P < 0.001). Group 2 had a significantly better visual acuity outcome of the cases than Group 1. Group 1 started as Novice (OSCAR score: 2), whereas Group 2 started as Beginner (OSCAR score: 3). Group 2 reached the Advanced Beginner level eight to 10 cases prior to Group 1. Conclusion: A structured training curriculum can make a significant difference in the training experience of the trainees and enable better surgical outcomes and a decrease in the complication rates.