Therapeutic plasma exchange in neuro-immunological disorder

Background: Therapeutic plasma exchange (TPE) is an extracorporeal blood purification technique used to remove high molecular weight substances from the plasma. Examples of these substances include immune complexes, pathogenic autoantibodies, endotoxin, cryoglobulins and cholesterol-containing lipoproteins and myeloma light chains. Therapeutic Plasma exchange is a well-established therapeutic procedure most commonly used in many neuro-immunological disorders. The benefit of plasma exchange occurs by elimination of pathognomonic inflammatory mediators, including complement components, autoantibodies and cytokines. Various studied have demonstrated that TPE plays an important role in neuro-immunological disorder (eg. Guillain-Barré syndrome, myasthenia gravis and other forms of immune neuropathies).Methods: It is descriptive and prospective study on the effect of TPE in neuro-immunological disorders. TPE are studied prospectively for a period from September 2011 to August 2013. The amount of plasma to be exchanged during TPE was determined using the formula EPV = (0.065 x weight [kg]) x (1-hematocrit). TPE was performed using a Haemonetics MCS+ intermittent flow cell separator. An average of 1-1.5 plasma volume is removed on alternative days. Clinical outcome of TPE was assessed at the time of discharge.Results: A total of 138 Therapeutic plasma exchange procedure were performed on 30 patients. In which the improvement begins within days of commencing the treatments and progressed steadily so that 25 out of 30 patients who responded favourably to TPE with a manageable adverse reaction. And only 5 patients failed to respond this therapy. So the clinical outcome for therapeutic plasma exchange for Neuro-immunological cases were 83.3% and remaining 16.7% doesn’t show any improvement after five plasma exchanges.Conclusions: Therapeutic plasma exchange is a first line of management for most of the neuro-immunological disorder. In our study there was an improvement in motor performance after 3-5 plasma exchanges which are mainly due to removal of unbound antibodies from the plasma. Although the statistical power of our study was not sufficient to allow definitive conclusion, the result strongly suggest that 3-5 procedures on alternative days with 1-1.5 volume of plasma exchange gives a better result in patient with neuro-immunlogical diseases. The success of therapeutic plasma exchange also depends on composition of the replacement fluid. The risk and complication associated with procedure are also minimal and easily manageable

Demand Side Management Studies on Distributed Energy Resources: A Survey

The number of distributed environmentally friendly energy sources and generators necessitates new operating methods and a power network board to preserve or even increase the efficiency and quality of the power supply. Similarly, the growth of matriculates promotes the formation of new institutional systems, in which power and power exchanges become increasingly essential. Because of how an inactive entity traditionally organizes distribution systems, the DG’s connection inevitably changes the system’s qualifications to which it is connected. As a consequence of the Distributed Generation, this presumption is currently legal and non-existent. This article glides on demand side management and analysis on distributed energy resources. Investigation of DSM along with zonal wise classification has been carried out in this survey. Its merits and applications are also presented

Hierarchical Routing Protocols in Wireless Sensor Networks: A Survey and its Comparison

In Wireless Sensor Networks (WSN), profound research articles are presented to address the hierarchical routing protocols which reduce the energy consumption of sensor nodes and also prolong the life of the network. The state of art of this research article focus on the survey of different hierarchical routing protocols which is utilized to efficiently deliver the sensed data from source to sink node. This article presents a detailed survey on major clustering techniques LEACH, SEP, PEGASIS, and TEEN. Also, this article strongly examines about the advantages and limitations of each hierarchical routing protocol with its recent research issues. Finally, the paper concludes with some of the research issues in hierarchical routing protocols of wireless sensor networks

Demand side management studies on distributed energy resources: A survey

The number of distributed environmentally friendly energy sources and generators necessitates new operating methods and a power network board to preserve or even increase the efficiency and quality of the power supply. Similarly, the growth of matriculates promotes the formation of new institutional systems, in which power and power exchanges become increasingly essential. Because of how an inactive entity traditionally organizes distribution systems, the DG’s connection inevitably changes the system’s qualifications to which it is connected. As a consequence of the Distributed Generation, this presumption is currently legal and non-existent. This article glides on demand side management and analysis on distributed energy resources. Investigation of DSM along with zonal wise classification has been carried out in this survey. Its merits and applications are also presented.Universidad Tecnológica de Bolíva

UV-VISIBLE SPECTROSCOPIC AND FTIR ANALYSIS OF SARCOSTEMMA BREVISTIGMA, WIGHT. AND ARN

Objective:  The present study was carried out to characterize the bioactive constituents present in aerial parts of ethanolic extract of Sarcostemma brevistigma using UV-VIS and FTIR.Methods:  FTIR spectroscopy is an established timeâ€saving method to characterize and identify functional groups.Results:  The UV-VIS profile showed different peaks ranging from 200â€1044 nm with different absorption respectively. UV-VIS profile showed the peaks at 254.00 and 680.00 nm for flavonoid. FTIR spectra showed the peak at 3418.85 cm-1 for N-H group. FTIR analysis and UV-VIS analysis showed the presence of flavonoids and a phenolic compound. The FTIR spectra had amply evidenced the occurrence of OH group together with the Terpenoids, and Phenol. The FT-IR spectrum showed the presence of an amine (N-H), alkyl (C-H), nitrile (C≡N), halo formyl (C=O), alkenyl (C=C), hydroxyl (O-H), haloalkane (C-F), nitrates and carbonate compounds.Conclusion:  The results confirm the fact that this plant posse's important bioactive constituent, so further scientific investigation is needed

A STUDY ON HYPERPHOSPHATEMIA AND EFFECT OF SEVELAMER ON CARDIAC ENZYME LEVELS IN CHRONIC KIDNEY DISEASE PATIENTS

Objective: Chronic Kidney Disease (CKD) is characterized by progressive loss of kidney function over a period of time. Sevelamer hydrochloride is a phosphate binding agent used to control serum phosphate levels in End Stage Renal Disease (ESRD) patients with hyperphosphatemia. Since hyperphosphatemia is associated with acute myocyte injury and elevation of cardiac biomarkers. ESRD patients treated with sevelamer hydrochloride display reduced cardiac biomarker levels due to a decrease in serum phosphate. Therefore, the study was designed to evaluate the effect of sevelamer hydrochloride on cardiac enzyme levels. Methods: This retrospective observational study was carried out in the nephrology department of a multispecialty hospital for a period of two months. Clinical and biochemistry reports of 30 ESRD patients were collected in designed case report forms. All statistical analysis was carried out using International Business Machines-Statistical Package for the Social Sciences, version 17 (IBM SPSS 17) Statistics package.Results: No significant difference in cardiac enzymes between sevelamer-treated and untreated groups was observed. Hence, further prospective studies on sevelamer hydrochloride are necessary to determine their activity in preventing hyperphosphatemia-induced acute myocyte injury.Conclusion: A direct correlation was observed between cardiac enzyme markers and phosphate levels. However, sevelamer at conventional doses was not found to be effective in reducing acute cardiomyocytes injury caused by hyperphosphatemia. Hence, higher doses sevelamer or other modalities achieving normal serum phosphorous levels are necessary for preventing cardiac damage due to hyperphosphatemia in ESRD patients.Keywords: ESRD, Hyperphosphatemia, Sevelamer, Cardiomyocytes injury

Bipolar Neutrosophic Convolutional Neural Networks For Child Malnutrition Prediction Through Neutrosophic Set Domain.

Specifically, epistemic uncertainty, which reflects the model's lack of knowledge about the data, is the sort of uncertainty that has a significant impact on the performance of deep learning models employed for malnutrition prediction. The uncertainty in malnutrition dataset must be successfully resolved by enhancing deep learning architecture. To solve the issue of uncertainty information’s in malnutrition, Bipolar Neutrosophic Convolutional Neural Networks (BNCNN) is developed for extracting different deep features to generate predictive uncertainty estimates.  A bipolar neutrosophic set is characterized by the positive-membership degree, where is a truth-membership function, indeterminacy-membership function, and falsity-membership function, and the negative-membership degree, where is a truth-membership function, indeterminacy-membership function, and falsity-membership function. Compared to Convolutional Neural Networks, the Bipolar neutrosophic is produced more accuracy results

An educational interventional study to compare conventional versus peyton’s method in training medical students on antenatal examination skills

Background: Introduction of competency based medical education in India has made it imperative to teach and assess clinical skills in a uniform manner. Antenatal Examination is one of the core competency under Obstetrics and Gynaecology. We need to use effective instructional methods to teach skills. In this study, we have compared Peyton’s ‘four step approach’ with the conventional ‘see one, do one’ approach.Methods: A quasi- randomized crossover study with educational intervention was done among 49 medical students. They were divided into two groups (A and B). Students of group A were first trained on Antenatal examination using Conventional method and evaluated. With a gap of one week, they were re-trained on the same skill using Peyton’s method and re-evaluated again; the vice versa was for done in group B. Mann Whitney test was used to compare the difference in score between the two groups of students (A and B) and Wilcoxon Signed Ranks test was used to compare the student’s perception of both teaching methods.Results: The mean score obtained by students after the first training by Peyton’s (24.08±2.31) was greater than Conventional method (20.32±3.59) which was found to be statistically significant (Z=-3.54, p<0.5). Following the second training i.e crossover of the training technique, the marks obtained by both group of students were almost the same. Students perceived Peyton’s methods to be more interesting, interactive, better understanding and recall over conventional.Conclusions: Peyton’s method was found to be superior over conventional method of training medical students in Antenatal examination

Minimizing Energy Consumption Using Internet of Things

Now a days using of internet is growing faster. All things are connected using internet. Internet of things means connecting all the devices using internet. These issues become crucial in large scale of IoT environments which are composed of thousands of distributed devices. The more number of distributed systems consumes more amount of energy. This paper is to minimize energy during data transfer and to minimize loss of packets and time delay. In this we are using Ant Colony Optimization algorithm for clustering the data nodes and transferring data with less energy consumption