A REVIEW ARTICLE ON KRIMI WITH CONTEMPORARY ASSESSMENT

Krimi exist its importance in Medical science from ages. Starting from Rig Veda to Samhita Krimi is accepted as a causative factor of diseases. Though there is mention of non-pathological Krimi in the texts, but elaboration not done. Whereas, there is wide narration of pathological Krimi found in different Samhita. Description of etiologies, habitat, nomenclature, morphology, and clinical conditions produced due to Krimi is done by different Acharyas. The clinical conditions produced due to Krimi in host may be broadly categorized under GIT ailments, skin ailments and features of Anemia. Regarding management of Krimi, there is sufficient explanation of treatment principles in Samhita. Various research works have been done concerning treatment aspects of Krimi. These clinical studies emphasize the effect of herbal, mineral or herbomineral drug preparations on certain parasite or protozoan. Only few studies have been done in Ayurveda to find out the type of Krimi infection/infestation based on the division of Krimi. Some research workers had tried to correlate the Krimi with few parasites only. The correlation of Krimi with the contemporary infectious microbes may be done by examining the resemblance of their habitat, morphology and effect on host. But it is a difficult task to correlate Krimi with modern due to lack of detail description of individual Krimi. Under the word Krimi all micro organisms like bacteria, virus, parasite, and fungus can be included. In this article effort has been made to describe the concept of Krimi from different Ayurvedic treatises and also to correlate them with similar microbes and parasites based on their habitat and effect on human body

Decision Tree Algorithm for Breast Cancer Detection

A major form of cancer affecting women around the world is breast cancer. This underscores the importance of early detection for optimal treatment outcomes. This paper addresses the challenge of correctly classifying tumors as malignant or benign in light of the fact that breast cancer is a significant component of cancer cases around the world. As a breast cancer detection algorithm, there are several advantages to using this decision tree algorithm. Decision trees provide insight into the importance of features, which in turn allows for the identification of key factors that contribute to the classification of breast cancer. In addition to that, decision trees are able to deal with both numerical and categorical features, so they are suitable for a variety of breast cancer data sets. It is also important to note that decision trees are less sensitive than other algorithms when it comes to outliers and missing data. To begin with, decision trees provide insight into the importance of features, which allows for the identification of key factors that contribute to the classification of breast cancers. A decision tree can also be used to analyze both numerical and categorical features, making it more versatile for the analysis of breast cancer data in general. The decision tree algorithm, on the other hand, has a lower sensitivity to outliers and missing data than some other algorithms. As a result of utilizing performance metrics to assess the effectiveness of algorithms, it was found that the Decision Tree Algorithm was more effective at detecting breast cancer than other algorithms

Community Control of Hypertension and Diabetes (CoCo-HD) program in the Indian states of Kerala and Tamil Nadu : a study protocol for a type 3 hybrid trial

Introduction: India grapples with a formidable health challenge, with an estimated 315 million adults afflicted with hypertension and 100 million living with diabetes mellitus. Alarming statistics reveal rates for poor treatment and control of hypertension and diabetes. In response to these pressing needs, the Community Control of Hypertension and Diabetes (CoCo-HD) program aims to implement structured lifestyle interventions at scale in the southern Indian states of Kerala and Tamil Nadu. Aims: This research is designed to evaluate the implementation outcomes of peer support programs and community mobilisation strategies in overcoming barriers and maximising enablers for effective diabetes and hypertension prevention and control. Furthermore, it will identify contextual factors that influence intervention scalability and it will also evaluate the program’s value and return on investment through economic evaluation. Methods: The CoCo-HD program is underpinned by a longstanding collaborative effort, engaging stakeholders to co-design comprehensive solutions that will be scalable in the two states. This entails equipping community health workers with tailored training and fostering community engagement, with a primary focus on leveraging peer supportat scale in these communities. The evaluation will undertake a hybrid type III trial in, Kerala and Tamil Nadu states, guided by the Institute for Health Improvement framework. The evaluation framework is underpinned by the application of three frameworks, RE-AIM, Normalisation Process Theory, and the Consolidated Framework for Implementation Research. Evaluation metrics include clinical outcomes: diabetes and hypertension control rates, as well as behavioural, physical, and biochemical measurements and treatment adherence. Discussion: The anticipated outcomes of this study hold immense promise, offering important learnings into effective scaling up of lifestyle interventions for hypertension and diabetes control in low- and middle-income countries (LMICs). By identifying effective implementation strategies and contextual determinants, this research has the potential to lead to important changes in healthcare delivery systems. Conclusions: The project will provide valuable evidence for the scaling-up of structured lifestyle interventions within the healthcare systems of Kerala and Tamil Nadu, thus facilitating their future adaptation to diverse settings in India and other LMICs.Peer reviewe

Compliance with Medication amongst Persons with Diabetes Mellitus during the COVID-19 Pandemic, Kerala, India: A Cross Sectional Study

Compliance with medication in persons with diabetes mellitus (DM) has been a challenge during the COVID-19 pandemic, leading to poor glycemic control and higher risk of complications. In the state of Kerala, India, 20–25% of adults have DM. Our cross-sectional study aimed to assess medication compliance and factors associated with poor compliance in DM persons attending selected primary care government facilities in Kerala during the COVID-19 pandemic. Persons registered with DM for >6 months were consecutively interviewed between August and September 2021. Poor compliance was defined as answering “No” to one or more of three questions related to access and intake of medication two weeks prior to and the day before the interview. Factors independently associated with poor compliance were assessed using adjusted prevalence ratios (aPr) and 95% confidence intervals. Of the 560 DM persons included, 209 (37%) exhibited poor compliance. Factors associated with poor compliance were age 19–45 years (aPr 1.4, 1.1–1.9); inability to be blood glucose tested during the COVID-19 pandemic (aPr 3.6, 2.9–4.3); not having COVID-19 (aPr 1.4, 1.0–1.9); and being double vaccinated against COVID-19 (aPr 1.4, 1.1–2.0). Focused attention must be paid to these groups to improve medication compliance and prevent DM complications and severe COVID-19-related disease

Photo physical studies of PVP arrested ZnS quantum dots

Monodispersed polyvinylpyrrolidone (PVP) arrested ZnS quantum dots (QDs) having diameter in range similar to 2-5 nm are synthesized by a colloidal precipitation method using PVP as the stabilizing agent. X-ray diffraction (XRD), transmission electron microscopy (TEM), high resolution transmission electron microscopy (HRTEM), selective area electron diffraction (SAED) and Fourier transform infrared (FT-IR) spectroscopy are probed to investigate the structural information. The optical properties are studied using diffuse UV-visible reflectance and photoluminescence (PL) spectroscopy techniques. TEM images as well as XRD reflection peak broadening indicate the nanometer size particles formation with cubic (sphalerite) phase within the polymer matrix. Optical absorbance studies reveal an excitonic peak at around similar to 310 nm dictates the effect of quantum confinement effect in the ZnS QDs. PL emission spectra for ZnS QDs in PVP exhibit four emission peaks at similar to 382 nm, similar to 414 nm, similar to 480 nm and similar to 527 nm are observed. These excitonic emissions from ZnS QDs are caused by the interstitial sulfur/Zn vacancies and surface states

Costs and cost-effectiveness of the Kerala pilot screening programme for diabetic retinopathy in the public health system

Background/objectives The Government of Kerala initiated a pilot screening programme for diabetic retinopathy in 16 Family Health Centres in Thiruvananthapuram district in 2019 in collaboration with the ORNATE India project. The evaluation of this pilot included a study of its costs and cost-effectiveness to inform decisions about extending the programme throughout Kerala. Subjects/methods The participants comprise all 5307 people who were screened for diabetic retinopathy under the pilot programme for whom data could be collected. Results The costs of the pilot programme are estimated at INR 11.3 million (including INR 1.9 million costs to individuals) and the benefits at 514 QALYs, slightly over one QALY per person treated. The cost per QALY was INR 22,000, which is well below India’s Gross National Income per person. Conclusions Kerala’s 2019 pilot screening programme for diabetic retinopathy was highly cost-effective

Burden of Diabetic Retinopathy amongst People with Diabetes Attending Primary Care in Kerala: Nayanamritham Project

Background: The burden of diabetic retinopathy (DR) in people attending the public health sector in India is unclear. Thirty percent of the population in India is reliant on public healthcare. This study aimed to estimate the prevalence of DR and its risk factors in people with diabetes in the non-communicable disease registers who were attending the family health centres (FHCs) in the Thiruvananthapuram district in Kerala. Methods: This cross-sectional study was conducted over 12 months in 2019 within the framework of a pilot district-wide teleophthalmology DR screening programme. The age- and gender-adjusted prevalence of any DR and sight-threatening DR (STDR) in the whole sample, considering socio-demography, lifestyle and known clinical risk groups, are reported. Results: A total of 4527 out of 5307 (85.3%) screened in the FHCs had gradable retinal images in at least one eye. The age and gender standardised prevalence for any DR was 17.4% (95% CI 15.1, 19.7), and STDR was 3.3% (95% CI 2.1, 4.5). Ages 41–70 years, males, longer diabetes duration, hyperglycaemia and hypertension, insulin users and lower socio-economic status were associated with both DR outcomes. Conclusions: The burden of DR and its risk factors in this study highlights the need to implement DR screening programs within primary care to reduce health inequality

Chronic exposure to chewing tobacco selects for overexpression of stearoyl-CoA desaturase in normal oral keratinocytes

Chewing tobacco is a common practice in certain socio-economic sections of southern Asia, particularly in the Indian subcontinent and has been well associated with head and neck squamous cell carcinoma. The molecular mechanisms of chewing tobacco which leads to malignancy remains unclear. In large majority of studies, short-term exposure to tobacco has been evaluated. From a biological perspective, however, long-term (chronic) exposure to tobacco mimics the pathogenesis of oral cancer more closely. We developed a cell line model to investigate the chronic effects of chewing tobacco. Chronic exposure to tobacco resulted in higher cellular proliferation and invasive ability of the normal oral keratinocytes (OKF6/TERT1). We carried out quantitative proteomic analysis of OKF6/TERT1 cells chronically treated with chewing tobacco compared to the untreated cells. We identified a total of 3,636 proteins among which expression of 408 proteins were found to be significantly altered. Among the overexpressed proteins, stearoyl-CoA desaturase (SCD) was found to be 2.6-fold overexpressed in the tobacco treated cells. Silencing/inhibition of SCD using its specific siRNA or inhibitor led to a decrease in cellular proliferation, invasion and colony forming ability of not only the tobacco treated cells but also in a panel of head and neck cancer cell lines. These findings suggest that chronic exposure to chewing tobacco induced carcinogenesis in non-malignant oral epithelial cells and SCD plays an essential role in this process. The current study provides evidence that SCD can act as a potential therapeutic target in head and neck squamous cell carcinoma, especially in patients who are users of tobacco