A Study to Assess the Effectiveness of Halotherapy in improving Airway Clearance among patients with Chronic Obstructive Pulmonary Disease admitted in Selected Wards at Rajiv Gandhi Government General Hospital, Chennai

STUDY TITLE: A study to assess the effectiveness of Halotherapy in improving airway clearance among patients with chronic obstructive pulmonary disease admitted in selected wards in Rajiv Gandhi Government General Hospital, Chennai-03. Respiratory disorder is a term that encompasses pathological conditions that affects the organ and tissues that makes gaseous exchange impairment and abnormal mucus accumulation. Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic airway disease which interfere with normal breathing. Halotherapyis also known as dry salt therapy or a form of saline solution inhalation. It means breathing a negative ion rich dry salt micro-climate, just like in natural salt mines. It is a natural safe, non-invasive, alternative therapy which is also very relaxing. NEED FOR THE STUDY: The increasing need for drug free method of treatment for respiratory diseases, halotherapy ( `halos means salt in Greek) is one of such methods. It stimulates a natural salt cave microclimate. As there is a increasing need for the drug free method to decrease the complications and side effects of drugs alternative therapies are needed. Halotherapy plays a major role in decreasing the symptoms of respiratory diseases and improving the airway clearance without any drugs and side effects. OBJECTIVES: 1. To assess the symptoms of Chronic Obstructive Pulmonary Disease in Experimental and Control group before administering Halotherapy. 2. To assess the effect of Halotherapy in improving airway clearance in experimental group. 3. To find the effect of Halotherapy in improving airway clearance of experimental by comparing control group. 4. To associate the demographic profile with the post test results. RESEARCH METHODOLOGY: Research approach: Quantitative research approach. Duration of the study: Four weeks 20.11.16 to 18.12.16. Study setting: Male and Female medical wards at RGGGH. Study design: Quasi experimental research design-Non Randomized control group design. Study population: Male and Female patients with COPD. Sample size: 60 Male and Female (Experimental-30, Control-30). Sampling technique: Convenient sampling technique. DATA COLLECTION PROCEDURE: Data collection done after approval from ethical committee, consent from participants. Airway clearance is assessed by using airway clearance assessment scale which includes respiratory rate assessment, auscultation findings of the lungs, modified 02 saturation scale, modified medical research council dyspnea scale and oxygen requirement. Halotherapy is administered by using 3% Normal Saline nebulisation twice daily for three days in experimental group only post assessment was done in both the group by using airway clearance assessment scale among patients with chronic obstructive pulmonary disease. DATA ANALYSIS: Demographic variables in categorical/dichotomous were given in frequencies with their percentages. Symptoms score was given in mean and standard deviation. Difference between experiment and control was analysed using student independent t-test. Difference between pretest and posttest was analyzed using student paired t-test. Statistical significant difference between pre and post test level of symptoms score was analyzed using extended McNemar's test. Homogeneity between experiment and control group demographic variables are analysed using chi square test.Association between level of symptoms score with demographic variables are analyzed using chi square test. Differences between pretest and posttest difference on effectiveness of study was analysed using percentage with 95% CI and mean difference with 95% Cl. Association between symptoms reduction score and Demographic variables was analysed using One way ANOVA F-test and student independent t-test. RESULTS: Findings of the study reveals that halotherapy will improve the airway clearance among patients with COPD. In selected demographic variables such as age, sex, occupation and duration of illness had significant (p=0.01) association with the post test level of airway clearance. Considering experiment group, patients are reduced 2.23 symptoms score, t= 13.62, p=0.001, this difference is statistically significant, whereas control group patients reduced 0.47 symptoms score, t=1.91, p=0.06. This difference is statistically not significant. RECOMMENDATIONS: 1. Halotherapy can be added as a routine therapy in clinical setting for improving level of airway clearance. 2. The study can be done in different setting with longer duration. DISCUSSION: Hypothesis was proved by the great statistically significance occurs after halotherapy. Oneway ANOVA F-test and student independent t-test. shows that there is an association between the post test level of airway clearance with selected demographic variables among patients with chronic obstructive pulmonary disease receiving Halotherapy. CONCLUSION: In conclusion of the study halotherapy is an effective method in improving the airway clearance in patients with chronic obstructive pulmonary disease. So it can be used as a routine therapy for clearing the airway in clinical setting

On-site earthquake early warning: a partially non-ergodic perspective from the site effects point of view

We introduce in the on-site earthquake early warning (EEW) a partially non-ergodic perspective from the site effects point of view. We consider the on-site EEW approach where the peak ground velocity (PGV) for S waves is predicted from an early estimate, over the P waves, of either the peak-displacement (PD) or cumulative squared velocity (IV2). The empirical PD-PGV and IV2-PGV relationships are developed by applying a mixed-effect regression where the site-specific modifications of ground shaking are treated as random effects. We considered a large data set composed of almost 31 000 selected recordings in central Italy, a region struck by four earthquakes with magnitude between 6 and 6.5 since the 2009 L’Aquila earthquake. We split the data set into three subsets used for calibrating and validating the on-site EEW models, and for exemplifying their application to stations installed after the calibration phase. We show that the partially non-ergodic models improve the accuracy of the PGV predictions with respect to ergodic models derived for other regions of the world. Moreover, considering PD and accounting for site effects, we reduce the (apparent) aleatory variability of the logarithm of PGV from 0.31 to 0.36, typical values for ergodic on-site EEW models, to about 0.25. Interestingly, a lower variability of 0.15 is obtained by considering IV2 as proxy, which suggests further consideration of this parameter for the design of on-site EEW systems. Since being site-specific is an inherent characteristic of on-site EEW applications, the improved accuracy and precision of the PGV predicted for a target protection translate in a better customization of the alert protocols for automatic actions

The waveform similarity approach to identify dependent events in instrumental seismic catalogues

In this paper, waveform similarity analysis is adapted and implemented in a declustering procedure to identify foreshocks and aftershocks, to obtain instrumental catalogues that are cleaned of dependent events and to perform an independent check of the results of traditional declustering techniques. Unlike other traditional declustering methods (i.e. windowing techniques), the application of cross-correlation analysis allows definition of groups of dependent events (multiplets) characterized by similar location, fault mechanism and propagation pattern. In this way the chain of intervening related events is led by the seismogenetic features of earthquakes. Furthermore, a time-selection criterion is used to define time-independent seismic episodes eventually joined (on the basis of waveform similarity) into a single multiplet. The results, obtained applying our procedure to a test data set, show that the declustered catalogue is drawn by the Poisson distribution with a degree of confidence higher than using the Gardner and Knopoff method. The declustered catalogues, applying these two approaches, are similar with respect to the frequency–magnitude distribution and the number of earthquakes. Nevertheless, the application of our approach leads to declustered catalogues properly related to the seismotectonic background and the reology of the investigated area and the success of the procedure is ensured by the independence of the results on estimated location errors of the events collected in the raw catalogue

Numerical and experimental analysis of a hybrid material acoustophoretic device for manipulation of microparticles.

Acoustophoretic microfluidic devices have been developed for accurate, label-free, contactless, and non-invasive manipulation of bioparticles in different biofluids. However, their widespread application is limited due to the need for the use of high quality microchannels made of materials with high specific acoustic impedances relative to the fluid (e.g., silicon or glass with small damping coefficient), manufactured by complex and expensive microfabrication processes. Soft polymers with a lower fabrication cost have been introduced to address the challenges of silicon- or glass-based acoustophoretic microfluidic systems. However, due to their small acoustic impedance, their efficacy for particle manipulation is shown to be limited. Here, we developed a new acoustophoretic microfluid system fabricated by a hybrid sound-hard (aluminum) and sound-soft (polydimethylsiloxane polymer) material. The performance of this hybrid device for manipulation of bead particles and cells was compared to the acoustophoretic devices made of acoustically hard materials. The results show that particles and cells in the hybrid material microchannel travel to a nodal plane with a much smaller energy density than conventional acoustic-hard devices but greater than polymeric microfluidic chips. Against conventional acoustic-hard chips, the nodal line in the hybrid microchannel could be easily tuned to be placed in an off-center position by changing the frequency, effective for particle separation from a host fluid in parallel flow stream models. It is also shown that the hybrid acoustophoretic device deals with smaller temperature rise which is safer for the actuation of bioparticles. This new device eliminates the limitations of each sound-soft and sound-hard materials in terms of cost, adjusting the position of nodal plane, temperature rise, fragility, production cost and disposability, making it desirable for developing the next generation of economically viable acoustophoretic products for ultrasound particle manipulation in bioengineering applications

Oil-in-water microemulsion encapsulation of antagonist drugs prevents renal ischemia-reperfusion injury in rats

Developing new therapeutic drugs to prevent ischemia/reperfusion (I/R)-induced renal injuries is highly pursued. Liposomal encapsulation of spironolactone (SP) as a mineralocorticoid antagonist increases dissolution rate, bioavailability and prevents the drug from degradation. In this context, this work develops a new formulation of oil-in-water type microemulsions to enhance the bioavailability of SP. The size of the SP-loaded microemulsion was about 6.0 nm by dynamic light scattering analysis. Briefly, we investigated the effects of nano-encapsulated SP (NESP) on renal oxidative stress, biochemical markers and histopathological changes in a rat model of renal I/R injury. Forty eight male Wistar rats were divided into six groups. Two groups served as control and injury model (I/R). Two groups received “conventional” SP administration (20 mg/kg) and NESP (20 mg/kg), respectively, for two days. The remaining two groups received SP (20 mg/kg) and NESP (20 mg/kg) two days before induction of I/R. At the end of the experiments, serum and kidneys of rats underwent biochemical, molecular and histological examinations. Our results showed that I/R induces renal oxidative stress, abnormal histological features and altered levels of renal biomarkers. Administration of SP in healthy animals did not cause any significant changes in the measured biochemical and histological parameters compared to the control group. However, SP administration in the I/R group caused some corrections in renal injury, although it could not completely restore I/R-induced renal oxidative stress and kidney damage. On the contrary, NESP administration restored kidney oxidative injury via decreasing renal lipid peroxidation and enhancing glutathione, superoxide dismutase and catalase in kidneys of the I/R group. The deviated serum levels of urea, creatinine, total proteins and uric acid were also normalized by NESP administration. Furthermore, NESP protected against renal abnormal histology features induced by I/R. Therefore, NESP has beneficial effects in preventing kidney damage and renal oxidative stress in a rat model of I/R, which deserves further evaluations in the future

Long Memory in Earthquake Time Series: The Case Study of the Geysers Geothermal Field.

The present study aims at proving the existence of long memory (or long-range dependence) in the earthquake process through the analysis of time series of induced seismicity. Specifically, we apply alternative statistical techniques borrowed from econometrics to the seismic catalog of The Geysers geothermal field (California), the world’s largest geothermal field. The choice of the study area is essentially guided by the completeness of the seismic catalog at smaller magnitudes (a drawback of conventional catalogs of natural seismicity). Contrary to previous studies, where the long-memory property was examined by using non-parametric approaches (e.g., rescaled range analysis), we assume a fractional integration model for which the degree of memory is defined by a real parameter d, which is related to the best known Hurst exponent. In particular, long-memory behavior is observed for d > 0. We estimate and test the value of d (i.e., the hypothesis of long memory) by applying parametric, semi-parametric, and non-parametric approaches to time series describing the daily number of earthquakes and the logarithm of the (total) seismic moment released per day. Attention is also paid to examining the sensitivity of the results to the uncertainty in the completeness magnitude of the catalog, and to investigating to what extent temporal fluctuations in seismic activity induced by injection operations affect the value of d. Temporal variations in the values of d are analyzed together with those of the b-value of the Gutenberg and Richter law. Our results indicate strong evidence of long memory, with d mostly constrained between 0 and 0.5. We observe that the value of d tends to decrease with increasing the magnitude completeness threshold, and therefore appears to be influenced by the number of information in the chain of intervening related events. Moreover, we find a moderate but significant negative correlation between d and the b-value. A negative, albeit weaker correlation is found between d and the fluid injection, as well as between d and the annual number of earthquakes.post-print4396 K