Non-convex clustering using expectation maximization algorithm with rough set initialization

An integration of a minimal spanning tree (MST) based graph-theoretic technique and expectation maximization (EM) algorithm with rough set initialization is described for non-convex clustering. EM provides the statistical model of the data and handles the associated uncertainties. Rough set theory helps in faster convergence and avoidance of the local minima problem, thereby enhancing the performance of EM. MST helps in determining non-convex clusters. Since it is applied on Gaussians rather than the original data points, time required is very low. These features are demonstrated on real life datasets. Comparison with related methods is made in terms of a cluster quality measure and computation time

Comparison of Staplers vs Sutures gastrojejunostomy in terms of anastomotic time and leakage

Objective: To compare the outcome of use of staplers versus sutures in gastrojejunostomy in terms of mean anastomotic time and anastomotic leakage.Methodology: This randomized controlled trial was conducted in surgical unit - I. Services hospital Lahore from 01-10-2014 to 31-12-2015. After approval from ethical committee, Non purposive convenient sampling technique was used.60 patients were selected for study and equally divided in two equal groups. In Group A, sutured gastrojejunostomy and in Group B, stapled gastrojejunostomy was performed. Anastomotic time (minutes) and anastomotic leakage were noted in both groups. Anastomotic time was calculated from start of anastomosis till completion. SPSS version 20 was used for data analysis. Hypothesis was tested by student T test and chi square test was used to show association between different variables. P value less than 0.05 was considered as significant.Results: In this study 63.33 % (N=38) patients were females and 36.66 % (N=22) were males. Anastomotic time was calculated to be 24.8 ± 2.78 min in Group A (Sutured) and 14.87 ± 2.98 min in Group B (Stapled) with a p-value of 0.00001 which is highly significant. 10% (N=03) patients had anastomotic leakage in Group A (Sutured) as compared to 3.33 % (N=01) patients in Group B (Stapled) with P value = 0.3 which is statistically insignificant.Conclusion: Stapled gastrojejunostomy is better due to reduced mean anastomotic time. Although there is decreased frequency of anastomotic leakage than sutured gastrojejunostomy but it is not statistically significant

Comparison of Staplers vs Sutures gastrojejunostomy in terms of anastomotic time and leakage

Objective: To compare the outcome of use of staplers versus sutures in gastrojejunostomy in terms of mean anastomotic time and anastomotic leakage.Methodology: This randomized controlled trial was conducted in surgical unit - I. Services hospital Lahore from 01-10-2014 to 31-12-2015. After approval from ethical committee, Non purposive convenient sampling technique was used.60 patients were selected for study and equally divided in two equal groups. In Group A, sutured gastrojejunostomy and in Group B, stapled gastrojejunostomy was performed. Anastomotic time (minutes) and anastomotic leakage were noted in both groups. Anastomotic time was calculated from start of anastomosis till completion. SPSS version 20 was used for data analysis. Hypothesis was tested by student T test and chi square test was used to show association between different variables. P value less than 0.05 was considered as significant.Results: In this study 63.33 % (N=38) patients were females and 36.66 % (N=22) were males. Anastomotic time was calculated to be 24.8 ± 2.78 min in Group A (Sutured) and 14.87 ± 2.98 min in Group B (Stapled) with a p-value of 0.00001 which is highly significant. 10% (N=03) patients had anastomotic leakage in Group A (Sutured) as compared to 3.33 % (N=01) patients in Group B (Stapled) with P value = 0.3 which is statistically insignificant.Conclusion: Stapled gastrojejunostomy is better due to reduced mean anastomotic time. Although there is decreased frequency of anastomotic leakage than sutured gastrojejunostomy but it is not statistically significant

Efficacy of Kabab Chini (Piper cubeba Linn) in Chronic Kidney Disease: A Randomized Controlled Clinical Trial

Background: Chronic Kidney Disease (CKD) is a major public health problem with a global prevalence of approximately 13% with the majority stage 3 and is a global threat to health in general and for developing countries in particular, because therapy is expensive and life-long. In India 90% patients cannot afford the cost of treatment for CKD, over 1 million people worldwide alive on dialysis or with a functioning graft. It is the need of the time to find alternate treatment to control CKD. Hence this study aims to evaluate clinically the efficacy of Kabab Chini (Piper cubeba) in CKD stage 1-3 and also to compare the effectiveness of the marketed drug NEERI KFT® scientifically. Objectives: To evaluate the efficacy of Kabab Chini (Piper cubeba) in chronic kidney disease (CKD) stage 1-3 patients. Methods: In this open-labeled randomized controlled clinical trial, 30 participants, randomly allocated to two groups, received 4 g of either sufoof (powder) of Kabab Chini in a divided dose thrice a day (Test group, n=15) or 10 mL of Syrup NEERI-KFT three times a day (Control group, n=15) for 42 days. The objective parameters were serum creatinine, blood urea (BU), estimated glomerular filtration rate (eGFR), and urine routine and microscopy, whereas subjective parameters were anorexia, easy fatigability, and edema. Objective and subjective parameters were assessed at weekly follow-ups, and safety parameters were assessed at baseline and after 42 days. Results: Intragroup data suggest significant improvements in anorexia, easy fatigability, and eGFR in both groups (P=0.001), whereas the intragroup serum creatinine value was significantly reduced in the test (P=0.028) and control (P=0.256) groups. No significant improvement in edema and albumin was observed in both groups (P>0.05). The test drug was found to be tolerable with no adverse effects. Conclusion: The results of the present study revealed that Kabab Chini is effective in reducing serum creatinine, eGFR, anorexia, and easy fatigability moderately superior to Syrup NEERI-KFT® with respect to efficacy without any adverse effect and accepted alternate hypothesis

Bacterial contamination of Saudi Arabian paper currency: A report from Al-Kharj

Background: Currency is a public support tool for exchange of commodity and services. It’s prevalent practice for acquiring bread to broast and bath to bed has connected all human being together irrespective of race and occupation. Currency notes along with their denomination values also carry pathogens if contaminated and will act as an agent for infection transference. Therefore the objective of this cross-sectional study was to assess the load microbial pathogens of paper currency collected in selected public places of Al-Kharj, Saudi Arabia.Methods: Currency notes under study were assessed through microbiological culture, microscopic and biochemical visualization techniques.Results: The results from this cross-sectional study suggested that lower the currency denominations higher was the microbial contaminations, frequency percentage was lower with higher isolations. Small eateries were the biggest source of contaminated currency from the ten selected centres. Percentage microorganism occurrence for Bacillus sp., Staphylococcus sp., Klebsiella sp. and E. coli was 56.84%, 25.03%, 13.40% and 04.71% respectively in all currency notes under study.Conclusions: The outcomes of this study revealed that currency notes can be a source for microbe transmission causing infectious diseases represent public health hazards to the community and individuals

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Soyflour fractions in breadmaking and their interaction with wheat flour components

Digitized by Kansas Correctional Industrie

Kaiphal (Myrica nagi): A Botanical Origin Drug (Dawa) of Unani Medicine for Prevention and Treatment of Common Disorders

Myrica nagi is a celebrity medicinal plant that is distributed in sub-Himalayan regions and holds several pharmacological actions and therapeutic effects along with their economic usage. In Unani System of Medicine (USM), it is well known, as Kaiphal and used in the prevention and the management of several common disorders viz. Amraz-i-Riya (Respiratory disease), Amraz-i-Hazam (Gastrointestinal disease), Amraz-i-Aasab (Nervine disease), and Amraz-i-Bawl (genitourinary disease). Recent clinical studies evaluate that the Kaiphal consist of numerous phytoconstituents viz. tannins, flavonoids, phenolic acids, terpenes, glycosides, amino acids, steroids, and volatile oils. These phytoconstituents are responsible for varieties of pharmacological actions viz. Anti-inflammatory, Anti-Oxidant, Anti-Allergic, Anti-helminthic, Neuroprotective, Nephroprotective, Anti-hypertensive, Anticancer, and Anxiolytic. Conventionally, different parts of Kaiphal are used in asthma, allergic disorder, inflammatory diseases, neurological disorders, renal disease, and cancer. The physicians of USM described properties and therapeutics uses of Kaiphal but data on safety and efficacy are limited and also lack of attraction of researcher toward a preclinical and clinical trial. Therefore, this review updated the knowledge about pharmacological and therapeutic effects, ethnomedicinal uses, adverse effects, prevention and treatment of common disorders and also focused on future research in the prospective era. Keyword: Kaiphal, Myrica nagi, USM, Phytoconstituents, Asthm

Spontaneous pnemomedastinum in acute severe asthma

Spontaneous medastinal emphysema, as a complication of acute severe asthma, is an uncommon entity. It usually runs a benign course and resolves spontaneously without any surgical intervention. Recognition of this complication is critical, as it has to be differentiated from other life threatening ones including oesophageal rupture, Boerhave\u2032s syndrome, acute coronary syndrome and pulmonary embolism. This case is being presented to emphasize its recognition in the differential diagnosis of complications arising from acute severe asthma and to present its management strategy in detail