Effect of Shirish versus Diclofenac Sodium in PostOperative Pain Management - A Randomized Comparative Clinical Trial

Introduction: Post-operative pain is physiological pain which is caused due to tissue trauma. Drugs such as NSAIDs (Non Steroidal Anti Inflammatory Drugs) and Opioids are used for post-operative pain management but are associated with their own drawbacks. Shirish has been in use in Ayurvedic practice for analgesia. It is known to relieve pain and can be used to supplement anesthesia and also get rid of adverse effect of modern analgesic drugs. Aims and Objective: To study the comparative effect of Shirish and Diclofenac sodium in post-operative pain management. Materials and Methods: Randomized clinical trial with Group A (Control Group: Tab Diclofenac sodium 50 mg as a single dose) and Group B (Trial Group: Cap Shirish 500 mg as a single dose). Those who had undergone surgeries like hernia, appendicitis operation under spinal anesthesia were selected as per inclusion criteria. Vitals, desirable effect and undesirable effect, total surgical time, the assessment criteria observed and recorded. Results: Cap. Shirish does not show any undesirable or serious ill effects and altered values of vitals as per statistical analysis. As per visual assessment scale, pain felt by Trial group was earlier than control group. Conclusions: Shirish Vati has analgesic property but its analgesic property and pain threshold capacity is lesser than those of Diclofenac Sodium

Mel-Frequency Cepstral Coefficients and Convolutional Neural Network for Genre Classification of Indigenous Nigerian Music

Music genre classification is a field of study within the broader domain of Music Information Retrieval (MIR) that is still an open problem. This study aims at classifying music by Nigerian artists into respective genres using Convolutional Neural Networks (CNNs) and audio features extracted from the songs. To achieve this, a dataset of 524 Nigerian songs was collected from different genres. Each downloaded music file was converted from standard MP3 to WAV format and then trimmed to 30 seconds. The Librosa sc library was used for the analysis, visualization and further pre-processing of the music file which includes converting the audio signals to Mel-frequency cepstral coefficients (MFCCs). The MFCCs were obtained by taking performing a Discrete Cosine Transform on the logarithm of the Mel-scale filtered power spectrum of the audio signals. CNN architecture with multiple convolutional and pooling layers was used to learn the relevant features and classify the genres. Six models were trained using a categorical cross-entropy loss function with different learning rates and optimizers. Performance of the models was evaluated using accuracy, precision, recall, and F1-score. The models returned varying results from the classification experiments but model 3 which was trained with an Adagrad optimizer and learning rate of 0.01 had accuracy and recall of 75.1% and 84%, respectively. The results from the study demonstrated the effectiveness of MFCC and CNNs in music genre classification particularly with indigenous Nigerian artists

A Miniaturized and Highly Sensitive Microwave Sensor Based on CSRR for Characterization of Liquid Materials

In this work, a miniaturized and highly sensitive microwave sensor based on a complementary split-ring resonator (CSRR) is proposed for the detection of liquid materials. The modeled sensor was designed based on the CSRR structure with triple rings (TRs) and a curve feed for improved measurement sensitivity. The designed sensor oscillates at a single frequency of 2.5 GHz, which is simulated using an Ansys HFSS simulator. The electromagnetic simulation explains the basis of the mode resonance of all two-port resonators. Five variations of the liquid media under tests (MUTs) are simulated and measured. These liquid MUTs are as follows: without a sample (without a tube), air (empty tube), ethanol, methanol, and distilled water (DI). A detailed sensitivity calculation is performed for the resonance band at 2.5 GHz. The MUTs mechanism is performed with a polypropylene tube (PP). The samples of dielectric material are filled into PP tube channels and loaded into the CSRR center hole; the E-fields around the sensor affect the relationship with the liquid MUTs, resulting in a high Q-factor value. The final sensor has a Q-factor value and sensitivity of 520 and 7.032 (MHz)/Er) at 2.5 GHz, respectively. Due to the high sensitivity of the presented sensor for characterizing various liquid penetrations, the sensor is also of interest for accurate estimations of solute concentrations in liquid media. Finally, the relationship between the permittivity and Q-factor value at the resonant frequency is derived and investigated. These given results make the presented resonator ideal for the characterization of liquid materials.Publicad

Design and evaluation of a flexible dual-band meander line monopole antenna for on- and off-body healthcare applications

The human body is an extremely challenging environment for wearable antennas due to the complex antenna-body coupling effects. In this article, a compact flexible dual-band planar meander line monopole antenna (MMA) with a truncated ground plane made of multiple layers of standard off-the-shelf materials is evaluated to validate its performance when worn by different subjects to help the designers who are shaping future complex on-/off-body wireless devices. The antenna was fabricated, and the measured results agreed well with those from the simulations. As a reference, in free-space, the antenna provided omnidirectional radiation patterns (ORP), with a wide impedance bandwidth of 1282.4 (450.5) MHz with a maximum gain of 3.03 dBi (4.85 dBi) in the lower (upper) bands. The impedance bandwidth could reach up to 688.9 MHz (500.9 MHz) and 1261.7 MHz (524.2 MHz) with the gain of 3.80 dBi (4.67 dBi) and 3.00 dBi (4.55 dBi), respectively, on the human chest and arm. The stability in results shows that this flexible antenna is sufficiently robust against the variations introduced by the human body. A maximum measured shift of 0.5 and 100 MHz in the wide impedance matching and resonance frequency was observed in both bands, respectively, while an optimal gap between the antenna and human body was maintained. This stability of the working frequency provides robustness against various conditions including bending, movement, and relatively large fabrication tolerances

Design Of Helical Antenna For Next Generation Wireless Communication

This study proposes a novel helical antenna design for next generation applications. The strip helical antenna is prescribed for next generation wireless communication and wideband applications that offer circular polarization and a wide bandwidth. In fact, the proposed helical antenna suits 5.8 GHz frequency by using Teflon material. The newly-designed strip was printed on a substrate and rolled into a helix shape to achieve circular polarization without impedance matching. This antenna is meant for wideband wireless communication applications. A wide bandwidth of 2.7 GHz with 5.8 GHz resonant frequency was attained through the use of helical antenna on Teflon substrate. The proposed antenna on Teflon substrate recorded a gain of 8.97 dB and 92% efficiency. The antenna design parameters and the simulated results were retrieved using Computer Simulation Technology software (CST). The measurement result of return loss displayed mismatch at 5.22 GHz due to manual fabrication. This developed antenna may be applied for a number of wireless applications, including Wideband, Ultra-wideband, and 5G

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112