Dengue - should we look for confirmation?

Background: Children are at great risk of dengue infection and mortality. Pediatric dengue management needs early identification and timely intervention. Objective: Evidence for case management based on clinical diagnosis without waiting for confirmation is aimed at in this study. Methods: Retrospective medical record review of pediatric clinical and confirmed dengue cases was done. Children admitted during 6 months in 2015 at Institute of Child Health, Niloufer Hospital, Hyderabad, were included in the study. 3 demographic, 32 symptom, 24 sign, and 24 investigation data were collected. Proportions of individual findings of the total number of patients in the group were compared between clinical and confirmed dengue groups. Results: Of the 13,750 admissions, 282 serologically confirmed dengue cases, 407 clinical dengue cases, 4 confirmed dengue deaths, and 24 clinical dengue deaths, making a total of 717 patient data were analyzed. Case fatality rate was 4.06% (95% confidence interval: 2.56-5.57). Except 9 out of 83 parameters, no significant differences of proportions between the groups were present. Age <5 years, seizures, altered sensorium, bradycardia, and systolic blood pressure <70 mmHg were significantly associated with increased mortality in dengue on logistic regression. Conclusions: Clinical diagnosis in the light of epidemiology, using acute pain in right hypochondrium, malena, tender hepatomegaly, centrifugal blanchable flushing, and hypotension as definite pointers of dengue avoids vagueness and is sufficient to treat dengue with escalation of fluid therapy as needed and with other supportive measures without waiting for lab support. Currently, available investigations cannot confirm dengue with accuracy in the hour of need, but they should be used for epidemiological purposes

Effects of Oxidative Stress on the Expression and Function of Inducible Nitric Oxide Synthase in Cultured Vascular Smooth Muscle Cells

The role of inducible nitric oxide synthase (iNOS) and/or nitric oxide (NO) in atherosclerosis remains elusive. Several researchers argued whether iNOS and/or NO are pathogenic or cardio protective. The pathogenesis of atherosclerosis is complex and includes mechanisms associated with inducible nitric oxide synthase (iNOS). We have demonstrated that the expression and function of iNOS may be selectively down regulated by pro-oxidants such as antimycin A and diethyl maleate (DEM). To further explore the underlying mechanisms associated with these effects we have investigated whether antimycin A and/or DEM modulated the activation of key cellular signalling molecules associated with the induction of iNOS. Expression of p38 mitogen activated kinase (MAPK) and Akt were induced by exposure to lipopolysaccharide (LPS) and interferon-gamma (IFN-). Oxidative stress (OS) was induced using antimycin A, DEM and hydrogen peroxide (H2O2). All three OS inducers caused a significant generation of free radicals whereas only antimycin A and DEM generated superoxide radical (O2-). Also nitrite production and iNOS expression may be down regulated, in part; by pro-oxidants generating O2- but not hydroxyl radicals (OH-). Antimycin A and DEM concentration dependently inhibited the phosphorylation of p38 MAPK and Akt and this was restored when the cells were pre-treated with Atorvastatin whereas H2O2 was without any significant effect. Taken together, the data suggest novel actions for both pro-oxidants and atorvastatin which may have important implications in coronary artery disease where suppression of iNOS may be deleterious and maintaining its expression may be cardio-protective

The Contributory Role of Professionalism in Shaping Contingent Workers’ OCB

Based on social exchange and psychological contract theories, Organizational citizenship behavior (OCB) is anchored on the presumption of an established, long-term relationship between an employer and employees. Thus one could conclude that contingent workers lack OCB. This study demonstrates that adding a “professionalism” construct provides correspondence in the literature that previously did not exist. Given that in advancing economies professionalism will be present in a variety of degrees in all occupations, inclusion of such a dimension can significantly strengthen and illuminate OCB studies

Building Relationships between Business Schools and Students: An Empirical Investigation into Student Retention

This study uses the relationship marketing theory of commitment and trust as a framework to investigate the issue of student retention in business schools. Structural equation modeling was used to examine relationships specified by Morgan and Hunt\u27s (1994) theory of relationship marketing. Students\u27 commitment to the business schools were determined by perceived benefits of attending the school, perceived similarity of values between the school and the students, and trust between the professors and the students. Commitment increased intentions to remain at the business school

Building Relationships Between Business Schools And Students: An Empirical Investigation Into Student Retention

This study uses the relationship marketing theory of commitment and trust as a framework to investigate the issue of student retention in business schools. Structural equation modeling was used to examine relationships specified by Morgan and Hunt's (1994) theory of relationship marketing.  Students' commitment to the business schools were determined by perceived benefits of attending the school, perceived similarity of values between the school and the students, and trust between the professors and the students.  Commitment increased intentions to remain at the business school

Formulation and In-Vitro Evaluation of Sustained Release Matrix Tablets of Gliclazide

Oral route has been the commonly adopted and most convenient route for the drug delivery. Oral route of administration has been received more attention in the pharmaceutical field, because of the more flexibility in the designing of dosage form than drug delivery design for other routes. The oral drug delivery depends on various factors such as type of delivery system, the disease being treated, the patient, the length of the therapy and the properties of the drug. Most of the oral controlled drug delivery systems (OCDDS) relay on diffusion, dissolution, or combination of both mechanisms, to release the drug in a controlled manner to the gastro intestinal tract (GIT). The physico-chemical properties include crystal nature, solubility, partition coefficient, intrinsic dissolution, etc. dosage form characteristics are controlled and optimized with respect to the physicochemical properties of the drug and relevant GI environmental factors. Other factors need to be considered are diseased state, the patient compliance & length of therapy. The goal of targeted oral drug delivery systems is to achieve better therapeutic success compared to conventional dosage form of the same drug. This could be achieved by improving the pharmacokinetic profile, patient convenience and compliance in therapy. In the present studies, matrix formulation GF9 containing HPMC K100M and ethyl cellulose were probably showing maximum retardation of drug release and it shows anomalous diffusion mechanism, for these reasons, it was considered that the formulation GF9 as best formulation among all the nine formulations. Based on release exponent (n) values, it was concluded that mechanism of drug release was found to be diffusion coupled with erosion (anomalous transport mechanism). From the stability studies, there was no significance difference in hardness, friability, drug content and in vitro release profile for the best formulation

Enhancing Infrastructure Safety: A UAV-Based Approach for Crack Detection

The imperative task of identifying and promptly detecting cracks in concrete bridges is crucial for preserving their structural health and ensuring the safety of users. Traditional bridge inspection methods heavily rely on human eyes and additional tools, demanding extensive training for inspectors and resulting in time-consuming processes. The increasing demand for Unmanned Aerial Vehicles (UAVs) has provided a transformative solution to access hard-to-reach areas efficiently. This research explores the integration of deep learning algorithms, including CNN, RCNN, Fast RCNN, Faster RCNN, and YOLO, to enhance the accuracy and efficiency of UAV-based crack detection systems. Experimental results affirm the effectiveness of these algorithms in addressing challenges such as lighting variations and small crack detection. The study aims to contribute to structural health monitoring, improving maintenance practices, and enhancing safety