Malaria "diagnosis" and diagnostics in Afghanistan.

In many malaria-endemic areas, including Afghanistan, overdiagnosis of malaria is common. Even when using parasite-based diagnostic tests prior to treatment, clinicians commonly prescribe antimalarial treatment following negative test results. This practice neglects alternative causes of fever, uses drugs unnecessarily, and might contribute to antimalarial drug resistance. We undertook a qualitative study among health workers using different malaria diagnostic methods in Afghanistan to explore perceptions of malaria diagnosis. Health workers valued diagnostic tests for their ability to confirm clinical suspicions of malaria via a positive result, but a negative result was commonly interpreted as an absence of diagnosis, legitimizing clinical diagnosis of malaria and prescription of antimalarial drugs. Prescribing decisions reflected uncertainty around tests and diagnosis, and were influenced by social- and health-system factors. Study findings emphasize the need for nuanced and context-specific guidance to change prescriber behavior and improve treatment of malarial and nonmalarial febrile illnesses

Influence of Mortar Incorporating Silica Based Waste Material on the Formation of C-S-H and Mechanical Strength Properties

Recent studies have been carried out to utilize waste glass in construction as partial cement replacement. This paper investigates the formation of Calcium Silicate Hydrate (C-S-H) and strength characteristics of mortar in which cement is partially replaced with glass powder by replacement level of 10%, 20% and 30%. Mortar cubes containing varying particle sizes in the ranges of 150-75μm, 63-38 μm and lower than 38 μm and in a water to cement ratio of 0.45 and 0.40 have been prepared. Replacement by 10% cement with glass powder reveals high compressive strength and produces more C-S-H at 28 days than other levels of replacement

Review of Progress and Prospects in Research on Enzymatic and Non- Enzymatic Biofuel Cells; Specific Emphasis on 2D Nanomaterials

Energy generation from renewable sources and effective management are two critical challenges for sustainable development. Biofuel Cells (BFCs) provide an elegant solution by combining these two tasks. BFCs are defined by the catalyst used in the fuel cell and can directly generate electricity from biological substances. Various nontoxic chemical fuels, such as glucose, lactate, urate, alcohol, amines, starch, and fructose, can be used in BFCs and have specific components to oxide fuels. Widely available fuel sources and moderate operational conditions make them promise in renewable energy generation, remote device power sources, etc. Enzymatic biofuel cells (EBFCs) use enzymes as a catalyst to oxidize the fuel rather than precious metals. The shortcoming of the EBFCs system leads to integrated miniaturization issues, lower power density, poor operational stability, lower voltage output, lower energy density, inadequate durability, instability in the long-term application, and incomplete fuel oxidation. This necessitates the development of non-enzymatic biofuel cells (NEBFCs). The review paper extensively studies NEBFCs and its various synthetic strategies and catalytic characteristics. This paper reviews the use of nanocomposites as biocatalysts in biofuel cells and the principle of biofuel cells as well as their construction elements. This review briefly presents recent technologies developed to improve the biocatalytic properties, biocompatibility, biodegradability, implantability, and mechanical flexibility of BFCs.This work was supported by the Qatar National Research Fund (a member of Qatar Foundation) under UREP grant #UREP28-052-2-020. The statements made herein are solely the responsibility of the authors

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

A review on software testing approaches for cloud applications

SummaryCloud computing has actually been invented to be the latest computing standard that will work several distinctive research areas, such as software testing. Testing cloud applications will keep its unique characteristics that involve more recent testing techniques. Software testing helps to reduce the need for hardware and software services and also provide adaptable and valuable cloud platform. Testing within the cloud platform is easily manageable based on new test models and criteria. Prioritization approach is made responsive to build much better relationship between test cases. These test cases are clustered dependent on priority level. The resources can be used properly by applying load balancing algorithm. Cloud guarantees maximum usage of existing resources. But, security defined as a primary problem in cloud. At the present time, organizations are progressively moving excited about deploying and making use of ready-prepared business applications, with particular short-term to the marketplace. The possible lack of capital budgets for software planning and on principle deployments, along with the swift progression of cloud these are the reasons why one should make the interest on business application. However, these are the interests that help make the SaaS based business application on-demand. In this paper different approaches has been discussed that will help to extend the cloud environment. Also, the study of several well-known software testing approaches

Effect of <i>Emblica officinalis </i>(Gaertn) on CCl₄ induced hepatic toxicity and DNA synthesis in Wistar rats

430-436A single dose of CCl4 (1 ml/kg body weight, po in corn oil) increased the levels of SGOT (serum glutamate oxaloacetate transaminase), SGPT (serum glutamate pyruvate transaminase), LDH (lactate dehydrogenase), glutathione-S-transferase and depletion in reduced glutathione, glutathione peroxidase and glutathione reductase. It also caused enhancement in the levels of lipid peroxidation (LPO) and DNA synthesis. There was also pathological deterioration of hepatic tissue as evident from multi vacuolated hepatocytes containing fat globules around central vein. The pretreatment of E. officinalis for 7 consecutive days showed a profound pathological protection to liver cell as depicted by univacuolated hepatocytes. Pretreatment with E. officinalis at doses of 100 and 200 mg/kg body weight, prior to CCl4 intoxication showed significant reduction in the levels of SGOT, SGPT, LDH, glutathione-S-transferase , LPO and DNA synthesis. There was also increase in reduced glutathione, glutathione peroxidase and glutathione reductase. The results suggest that E. officinalis inhibits hepatic toxicity in Wistar rats

PMKBEA: A Process Model Using Knowledge Base Software Engineering Approach

ABSTRACT INTRODUCTION There are many different methods and techniques used to direct the Software development process and most real-world models are customized adaptations of the generic models. Since each is designed for a specific purpose or reason, most of them have similar goals and share many common tasks. This process model will help the developer to get his work done on time which shall satisfy the client. We did not fall back in ignoring the basic principles of waterfall model in designing our system as it serves as a base for most of the process models. Software professionals and the clients, share a common goal for building information systems that effectively support business process objectives. In order to ensure the cost-effectiveness, quality systems are developed which address an organization&apos;s business needs. Process models can direct the project&apos;s life cycle. In proposed process model we have also used a knowledge base approach as it reflects the changing need of the customers. As customers demand faster results, more involvement in the development process and the inclusion of measures to determine risks, effectiveness, and methods for developing systems, keep changing dynamically. In addition, the software and hardware tools used in the industry keep changing substantially. Knowledge base is a centralized repository for information: a public library, a database of related information about a particular subject. In relation to information technology (IT), a knowledge base is a machine-readable resource for the dissemination of information, generally online or with th

Khamiras, a natural cardiac tonic: An overview

The Unani system of Medicine (Unanipathy), which originated in Greece, is based on the principles proposed by Galen, a Greek practitioner. Since then, many Arab and Persian scholars have contributed to the system. Among them Ibn-e-Sina, an Arab philosopher and Physicist who wrote ‘Kitab-al-shifa’ are worth mentioning. This system has an extensive and inspiring record in India. It was introduced in India around the tenth century A.D with the spread of Islamic civilization. At present, Unanipathy has become an important part of the Indian system of Medicine. Unani medicines have been used since ancient times, as medicines for the treatment of various ailments. In spite of the great advances observed in modern medicine in recent decades, Unani drugs still make an important contribution to healthcare. The Unani system of medicine is matchless in treating chronic diseases like arthritis, asthma, mental, cardiac, and digestive disorders, urinary infections, and sexual diseases. The medicines administered go well with the temperament of the patient, thus speeding up the process of recovery and also reducing the risk of drug reaction. The Unani system of medicine recognizes the influence of the surroundings and ecological conditions on the state of health of human beings. The system aims at restoring the equilibrium of various elements and faculties of the human body. It has laid down six essential prerequisites for the prevention of diseases and places great emphasis, on the one hand, on the maintenance of proper ecological balance, and on the other, on keeping water, food, and air free from pollution. These essentials, known as ‘Asbab-e-Sitta Zarooriya’, are air, food, and drink, bodily movement and repose, psychic movement and repose, sleep and wakefulness, and excretion and retention. The Unani system is a secular system in temperament and is popular among the masses. In Unani medicine, although the general preference is for single drugs, compound formulations are also used in the treatment of various complex and chronic disorders. In the light of the present knowledge, this review is a small effort to discuss the efficacious nature of ‘Khamira’, a semi-solid preparation, which is traditionally used for cardiac ailments, such as, palpitations, weakness of the heart, and so on. On the basis of their constituents these are named as, Khamira Aabresham, Khamira Gaozaban, Khamira Marwareed, and so on. Khameeras are also used as general tonics for other vital organs like the liver and brain. In view of the increasing number of cardiac diseases, a thorough evaluation of this ancient work on Khamira is of special significance