A Novel Cyber Resilience Framework – Strategies and Best Practices for Today's Organizations

Cyber resilience refers to an organization's ability to maintain its essential functions, services despite cyber-attacks and swiftly recover from any disruptions. It involves proactive measures like gathering threat intelligence and managing risks, as well as reactive measures such as incident response planning, data backup and recovery. To achieve cyber resilience, organizations must implement robust cyber security measures, regularly update their incident response plans, and educate employees on safe online practices. Furthermore, having a comprehensive backup and recovery strategy in place is crucial to swiftly restore critical systems and data in the event of an attack. Overall, the proposed framework emphasizes cyber resilience as a continuous and proactive approach for managing cyber security risks and safeguarding against the growing threat of cyber-attacks

Prevalence of oral lesions associated with tobacco use among the patients visiting K.S.R. Institute of Dental Sciences & Research, Tiruchengode: A Cross Sectional Observational study

BACKGROUND: World Health Organization (WHO) predicts that tobacco deaths in India may exceed 1.5 million annually by 2020. OBJECTIVES: The aim of this study was to estimate the prevalence of tobacco use, its influences, triggers, and associated oral lesions among the patients of K.S.R Institute of Dental Science and Research, Tiruchengode, Tamilnadu, India. MATERIALS AND METHODS: A hospital based cross-sectional study was conducted from November 2016 - October 2017. Patients with tobacco habits were included in the study. Patients were interviewed through a pre-tested structured questionnaire in relation to their tobacco habits, its influences and triggers. Also clinical examination was carried out to check for any tobacco related oral lesions. RESULTS: The overall prevalence of tobacco use was 4.08%. Smoking form of tobacco was more prevalent in males (81.84%), where as smokeless form of tobacco was more prevalent in females (100%). Oral mucosal lesions was more prevalent in 51-60 years age group with 34%, subjects with secondary level of school education 39%, subjects with labourers by occupation 27.5%, subjects with no or less than 5000 income 56%. 75% males admitted that they developed the habit due to initial influence of friends, where as 41% females starterted habit because toothache. Most common trigger for tobacco use for both males (58%) and females (79%) were “after meals / with tea or coffee” (53.13%). The most common oral mucosal lesion in both the males (18%) and females (31%) was tobacco pouch hyperkeratosis. CONCLUSION: Tobacco use in different forms is one of the prime factors responsible for potentially malignant disorders and cancerous lesions. Lack of awareness regarding harmful effects is a major reason

A study of post operative complications after thyroid surgery

INTRODUCTION: Thyroidectomy is a common operation with an extremely low mortality1. It is associated with specific morbidities which are related to the experience of the surgeon, however2. Very low surgical morbidity rates for thyroidectomy are reported in specialised centers. In competent hands, thyroid surgery is associated with few complications and no fatality. Post operative complications may be as insignificant as edema of the flap or as dangerous and life threatening as hemorrhage or respiratory obstruction. The majority are avoidable with sound surgical technique and good preoperative preparation. With proper preoperative management, the patient will be euthyroid at the time of surgery. If the patient is hyperthyroid, laryngeal edema may result, producing respiratory obstruction. Careless technique may result in massive haemorrhage, recurrent laryngeal nerve paralysis, or both, causing respiratory embarrassment. Lack of experience or of attention to technical details may involve removal of too little or too much thyroid tissue or possibly all parathyroids, resulting in myxedema, recurrent hyperthyroidism, or parathyroid deficiency. Complication rates associated with thyroid surgery can be evaluated only through analysis of case studies and follow up data. The present study reports the clinical audit of thyroid surgery for adult patients undertaken at the Tirunelveli Medical college hospital Tirunelveli. The complications of Thyroidectomy are highlighted and compared to published data. AIMS AND OBJECTIVES: 1. The aim of the study is to compare complication rates of Bilateral sub total thyroidectomy (SBT), near total thyroidectomy (NTT) Hemithyroidectomy (Total lobectomy and isthmusectomy), and Total thyroidectomy (TT) in cohort of patients undergoing surgery for various thyroid disorders. 2. To compare complication rates after thyroidectomy for benign diseases and malignant diseases. 3. To identify ways to avoid the post operative complications. MATERIALS AND METHODS: One hundred and seventeen patients who underwent thyroid surgery, for various thyroid disorders, at the Tirunelveli Medical College Hospital, Tirunelveli, Tamilnadu, India between August 2003 to December 2005 were studied. Operations were performed by various professors, Assistant professors and also by surgical post graduates supervised by senior surgeons using various surgical techniques. Indications for surgery in this study group include forty five patients with non toxic multinodular goitre (MNG), twenty two patients with toxic multinodular goitre, thirty four patients with nontoxic solitary nodular goitre, thirteen patients with carcinoma, two patients with recurrent goitre and one patient with colloid goitre. Of these one hundred and seven patients were female and ten patients were male. These patients were broadly divided in to two categories based on the diagnosis and treatment modality. For all selected patients a thorough history was elicited followed by a complete physical examination. The basic biochemical and hematological investigations were done for all patients. It was decided to request special investigations like thyroid hormone profile and serum calcium estimation only in selected cases, where a disturbance in the functional status was suspected. Vocal cords were examined pre operatively by indirect laryngoscope in all the patients, whereas post operative vocal cord examination was performed only when hoarseness occurred. Patients were classified as having hypocalcaemia (hyperparathyroidism) if both clinical and biochemical (a fall in corrected serum calcium concentration below 8 mg/dl and or the need for calcium supplementation)23 supportive evidence were present. FNAC was done for all patients. Based on the Final diagnosis, the treatment was given as advised by the experts. OBSERVATION AND RESULTS: A total of one hundred and seventeen patients, aged between sixteen and sixty one years underwent thyroid surgery during the study period. Patients included one hundred and seven women and ten men (Females : Male, 10.7:1). Histopathological diagnosis for each case and the number of patients undergoing each type of operation is detailed in table 1. Surgical morbidity associated with thyroidectomy undertaken during the study period is detailed in table 3. Post operative hemorrhage occurred in four patients (3.42%) in which three patients, had total thyroidectomy ( 3/177 , 2.56%) and another one patient (0.85%) under went bilateral subtotal thyroidectomy of which two patients (1.71%) required urgent re exploration and others resolved spontaneously without drainage. Two patients where shifted to Intensive surgical care unit with endotracheal tube insitu due to respiratory difficulty (1.71%) and both of them were recovered well and extubated within 24 hours without any respiratory distress. The incidence of temporary recurrent laryngeal nerve palsy was found to be one each (0.85%) in total thyroidectomy and near total thyroidectomy, and three patients (2.56%) in bilateral subtotal thyroidectomy. No patients in this study group developed bilateral recurrent laryngeal nerve palsy. There were two patients (1.71%), who underwent total thyroidectomy, developed superior laryngeal nerve paresis. The incidence of temporary hyperparathyroidism was high at 5.98% (7) and 1.71% (2) of patients treated by total thyroidectomy and bilateral subtotal thyroidectomy respectively. Those patients who underwent hemithyroidectomy and near total thyroidectomy did not have hypoparathyroidism. Post operative wound infection occurred in four patients (3.42%) of which three patients (2.56%) underwent bilateral subtotal thyroidectomy and one patient (0.85%) underwent Hemithyroidectomy. After surgical drainage the wound was resutured several days later when the infection had resolved. Seroma occurred in one patient (0.85%) who underwent bilateral subtotal thyroidectomy for nontoxic multinodular goiter. Edema of flap occurred in one patient (0.85%) who underwent bilateral subtotal thyroidectomy for toxic goitre. Oesophageal injury occured in only one patient (0.85%) who underwent bilateral subtotal thyroidectomy for nontoxic multinodular goiter. (Patient had coexistent para pharyngeal pouch). There were two deaths (1.71%) noted in this series and out of which one is due to thyroid storm (0.85%) associated with hemorrhage ad respiratory obstruction in female patient who underwent bilateral subtotal thyroidectomy for toxic goiter. Another death occurred in a male patient who underwent total thyroidectomy for carcinoma thyroid. CONCLUSION: The following conclusions are drawn from this study 1. This study shows that the total thyroidectomy or hemithyroidectomy can be done with very low complication rate in cases of benign thyroid disease affecting the whole gland. 2. Hypoparathyroidism however, is a relatively common and significant complication than the recurrent laryngeal nerve injury after surgery for thyroid disorders. 3. Thyroid carcinoma, recurrent goiter, toxic goiter and total thyroidectomy are risk factors for post operative complication. 4. Complication rates are similar for bilateral subtotal thyroidectomy and total thyroidectomy, and there is a risk of recurrence with bilateral subtotal thyroidectomy. Because total thyroidectomy carries a risk of complication similar to that for bilateral subtotal thyroidectomy, it is not logical to avoid total resections. Therefore near total or total thyroidectomy may be the operation of choice for multinodular goiter. 5. Complications and sequelae of thyroid surgery can yet be reduced by careful evaluation of the surgical and medical therapeutic options have more precise surgical indications, a thorough knowledge of the surgical anatomy, a rigorous surgical technique, a systematic dissection of recurrent laryngeal nerve and parathyroid gland in case of bilateral operation and meticulousness during the procedure. 6. I conclude that the operative skills and experience determine the complication rates rather than the type of operative procedure

GREEN SYNTHESIS AND CHARACTERIZATION OF SILVER NANOPARTICLES FROM WITHANIA SOMNIFERA (L.) DUNAL

The metal nanoparticle synthesis is highly explored the field of nanotechnology. The biological methods seem to be more effective because of slowreduction rate and polydispersity of the final products. The main aim of this study is too the rapid and simplistic synthesis of silver nanoparticlesby Withania somnifera Linn. at room temperature. The exposure of reaction mixtures containing silver nitrate and dried leaf powder of W. somniferaresulted in reduction of metal ions within 5 minutes. The extracellular synthesized silver nanoparticles were characterized by ultraviolet-visible,infrared (IR) spectroscopy, X-ray diffraction studies, zeta potential, Fourier transform IR, and scanning electron microscopy. The antibacterial andantifungal studies showed significant activity as compared to their respective standards. From the results, W. somnifera sliver nanoparticle has attainedthe maximum antimicrobial against clinical pathogens and also seen very good stability of nanoparticle throughput processing. As we concluded, thistype of naturally synthesized sliver nanoparticle could be a better green revolution in medicinal chemistry.Keywords: Antimicrobial activity, Silver nanoparticles, Withania somnifera

Replication stress and chromatin context link ATM activation to a role in DNA replication

ATM-mediated signaling in response to DNA damage is a barrier to tumorigenesis. Here we asked whether replication stress could also contribute to ATM signaling. We demonstrate that, in the absence of DNA damage, ATM responds to replication stress in a hypoxia-induced heterochromatin-like context. In certain hypoxic conditions, replication stress occurs in the absence of detectable DNA damage. Hypoxia also induces H3K9me3, a histone modification associated with gene repression and heterochromatin. Hypoxia-induced replication stress together with increased H3K9me3 leads to ATM activation. Importantly, ATM prevents the accumulation of DNA damage in hypoxia. Most significantly, we describe a stress-specific role for ATM in maintaining DNA replication rates in a background of increased H3K9me3. Furthermore, the ATM-mediated response to oncogene-induced replication stress is enhanced in hypoxic conditions. Together, these data indicate that hypoxia plays a critical role in the activation of the DNA damage response, therefore contributing to this barrier to tumorigenesis

(Benzyl­amine)chloridobis(ethane-1,2-diamine)cobalt(III) dichloride hemihydrate

In the title compound, [CoCl(C2H8N2)2(C7H9N)]Cl2·0.5H2O, there are two crystallographically independent cations and anions and one water mol­ecule in the asymmetric unit. Both CoIII ions are bonded to two chelating ethylenediamine ligands, one benzylamine molecule and one chloride ion. The crystal packing is through N—H⋯O, N—H⋯Cl and O—H⋯Cl inter­actions

Chloridobis(ethane-1,2-diamine)(4-methyl­aniline)cobalt(III) dichloride monohydrate

In the title compound, [CoCl(C2H8N2)2(C7H9N)]Cl2·H2O, the CoIII ion has a distorted octa­hedral coordination environment and is surrounded by four N atoms in an equatorial plane, with the other N and Cl atoms occupying the axial positions. The crystal packing is stabilized by N—H⋯O, N—H⋯Cl and O—H⋯Cl inter­actions

Intracellular granzyme A expression of peripheral blood lymphocyte subsets in pulmonary tuberculosis

Cell-mediated immunity is a key weapon of host defence against tuberculosis (TB). Granzyme A (GzmA), a serine protease, present in the granules of cytotoxic cells induces caspase-independent cell death. We estimated the proportion of GzmA producing lymphocyte subsets in peripheral blood from 59 normal healthy volunteers and 48 pulmonary TB (PTB) patients using flow cytometry. When compared with normal healthy subjects, we observed a significantly higher percentage of GzmA-positive CD56+ cells (P = 0.01) in PTB patients. However, when the absolute number was compared between the two groups, a significantly decreased number of GzmA-expressing CD16+ (P = 0.01) and CD56+ (P = 0.0001) cells was observed in patients and this could be explained by the significantly reduced number of total lymphocytes (P = 0.0009) seen in the patients. There was no significant difference in the number of CD4+ and CD8+ GzmA double-positive cells between the two study groups. CD56 is a natural killer cell marker and these cells represent innate immune response to TB. We report an increased percentage of CD56+ cells expressing GzmA in TB patients, which shows the relevance of the GzmA-mediated pathway of apoptosis in immunity against Mycobacterium tuberculosis

Spatio-Temporal Dynamics of Caddisflies in Streams of Southern Western Ghats

The dynamics of physico-chemical factors and their effects on caddisfly communities were examined in 29 streams of southern Western Ghats. Monthly samples were collected from the Thadaganachiamman stream of Sirumalai Hills, Tamil Nadu from May 2006 to April 2007. Southwest and northeast monsoons favored the existence of caddisfly population in streams. A total of 20 caddisfly taxa were collected from 29 streams of southern Western Ghats. Hydropsyche (Trichoptera: Hydropsychidae) were more widely distributed throughout sampling sites than were the other taxa. Canonical correspondence analysis showed that elevation was a major variable and pH, stream order, and stream substrates were minor variables affecting taxa richness. These results suggested that habitat heterogeneity and seasonal changes were stronger predictors of caddisfly assemblages than large-scale patterns in landscape diversity