A CLINICAL STUDY TO EVALUATE THE EFFECT OF KARPASASTHYADI TAILA NASYA, PHYSIOTHERAPY AND A COMBINATION OF BOTH IN CERVICAL SPONDYLOSIS

Present era is a period of modernization and fast life. Due to the advancement in life style people undergo many unwanted practices like faulty dietetic habits, improper sitting posture, continuous work in one posture and overexertion, load bearing movements during travelling and sports all these factors create undue pressure and compressive injury to the spine and also responsible for early degenerative changes in bodily tissue which play an important role in producing disease like cervical spondylosis. In this way, this disease is now becoming a significant threat to the working population due to its progressive nature. The Nasya Karma is considered as the best procedure for diseases of head and neck. Physiotherapy provides several benefits in relieving pain and spasm. It can help to maintain the strength of the neck muscles and improve the flexibility of the neck through therapeutic neck exercises and other form of treatment such as manipulation, US, SWD, IFT etc. These two different modes of treatment having its own importance in the management of cervical spondylosis so the present study has been conducted to evaluate the combined effects of these therapies. Results & Conclusion: All the three groups have given a highly significant improvement in reducing the signs and symptoms of cervical spondylosis. While comparing, it was also statistically proved that Nasya along with Physiotherapy is more effective than either Nasya or Physiotherapy alone in reducing the signs and symptoms of cervical spondylosis

Porokeratosis ptychotropica: a rare case report with unusual presentation

Porokeratosis is a rare disorder of epidermal keratinization characterized clinically by annular plaque with thread like hyperkeratotic border with a central groove that expand centrifugally and this border corresponds to coronoid lamellae histologically which are the columns of parakeratosis that overlie an epidermal invagination with loss of granular layer and dyskeratosis of upper spinous keratinocytes. The disorder was erroneously named porokeratosis because the coronoid lamella was initially described as being present over a sweat pore, which is a fixed structure that cannot expand peripherally. Five primary clinical variants have been described: classic porokeratosis of mibelli, disseminated superficial actinic porokeratosis, linear porokeratosis, punctate porokeratosis and porokeratosis palmaris et plantaris disseminate. Porokeratosis ptychotropica one of the rare variants of porokeratosis described by lucker et al which has been added recently in the classification. It is characterized clinically by symmetrical verrucous papules and plaques resembling psoriasis plaque in the gluteal cleft, buttocks and rarely extends to genitalia and histologically by multiple coronoid lamella. We report a case of 43year old female, presented with 10years duration of pruritic raised skin lesion over the left gluteal region. Dermatological examination revealed single well defined erythematous scaly plaque with central atrophy, hyperpigmentation and peripheral thread like elevated border. Histopathological examination revealed multiple coronoid lamella which is the hallmark for porokeratosis ptychotropica, confirmed the diagnosis. The patient was treated with 5-fluorouracil cream. we report this case due to its rarity and the unusual presentation of single plaque of porokeratosis ptychotropica

Portfolio optimisation with higher moments of risk at the Pakistan Stock Exchange

Stock markets play an important role in spurring economic growth and development through diversification opportunities. However, diversification cannot be truly achieved if we continue to ignore additional dimensions of risk, namely skewness and kurtosis. This study incorporates higher moments of risk to form a mean-varianceskewness-kurtosis based framework for portfolio optimisation. Inclusion of higher moments in optimisation framework acknowledges the risk of asymmetric returns and fat-tail risk and can help investors in formulating optimal portfolios of stocks which can be significantly divergent from the ones they obtain through the Markowitz meanvariance optimisation. Our results confirm the presence of tradeoff between returns and additional dimensions of risk in Pakistan Stock Exchange (PSX) and strongly suggest including them in the optimisation framework to avoid sub-optimal decisions and to curtail exposure towards higher moments of risks

Anatomical variations of sinonasal region: a CT scan study

Multislice CT is currently the imaging modality of choice for evaluating PNS & adjacent structures. Such a method has been increasingly utilized in the assessment of anatomical variations, allowing their accurate identification with high anatomical details. Some anatomical variations may predispose to sinonasal disease, constituting areas of high risk for injuries & complications during surgical procedures. Therefore, the recognition of such variations is critical in the preoperative evaluation for endoscopic surgery

Achieving provider engagement: providers' perceptions of implementing and delivering integrated care

The literature on integrated care is limited with respect to practical learning and experience. Although some attention has been paid to organizational processes and structures, not enough is paid to people, relationships, and the importance of these in bringing about integration. Little is known, for example, about provider engagement in the organizational change process, how to obtain and maintain it, and how it is demonstrated in the delivery of integrated care. Based on qualitative data from the evaluation of a large-scale integrated care initiative in London, United Kingdom, we explored the role of provider engagement in effective integration of services. Using thematic analysis, we identified an evolving engagement narrative with three distinct phases: enthusiasm, antipathy, and ambivalence, and argue that health care managers need to be aware of the impact of professional engagement to succeed in advancing the integrated care agenda

A Novel Programmable CMOS Fuzzifiers Using Voltage-to-Current Converter Circuit

This paper presents a new voltage-input, current-output programmable membership function generator circuit (MFC) using CMOS technology. It employs a voltage-to-current converter to provide the required current bias for the membership function circuit. The proposed MFC has several advantageous features. This MFC can be reconfigured to perform triangular, trapezoidal, S-shape, Z-Shape, and Gaussian membership forms. This membership function can be programmed in terms of its width, slope, and its center locations in its universe of discourses. The easily adjustable characteristics of the proposed circuit and its accuracy make it suitable for embedded system and industrial control applications. The proposed MFC is designed using the spice software, and simulation results are obtained

Dependence of Physical Parameters of Compound Semiconductors on Refractive Index

Interesting relationships have been found between refractive index, plasmon energy, electronic polarisability, bond length, microhardness, bulk modulus, force constants and lattice energy. An attempt has been made for the first time to correlate only one physical parameter with others. The calculated values are in good agreement with the experimental values as well as with the values reported in the literature. Refractive index data is the only one parameter required to estimate all the above parameters

Optical Coherence Tomography: Clinical Applications in Medical Practice

Optical Coherence Tomography (OCT) is a success story of scientific and technological co-operation between a physicist and a clinician. The concept of cross-sectional imaging revolutionalized the applicability of OCT in the medical profession. OCT is a non-contact, topographic, biomicroscopic device that provides high resolution, cross-sectional digital images of live biological tissues in vivo and in real time. OCT is based on the property of tissues to reflect and backscatter light involving low-coherence interferometry. The spatial resolution of as little as 3 microns or even less has allowed us to study tissues almost at a cellular level. Overall, OCT is an invaluable adjunct in the diagnosis and follow up of many diseases of both anterior and posterior segments of the eye, primarily or secondary to systemic diseases. The digitalization and advanced software has made it possible to store and retrieve huge patient data for patient services, clinical applications and academic research. OCT has revolutionized the sensitivity and specificity of diagnosis, follow up and response to treatment in almost all fields of clinical practice involving primary ocular pathologies and secondary ocular manifestations in systemic diseases like diabetes mellitus, hypertension, vascular and neurological diseases, thus benefitting non-ophthalmologists as well. Systemically, OCT is proving to be a helpful tool in substantiating early diagnosis in diseases like multiple sclerosis and drug induced retinopathies by detecting early changes in morphology of the retinal nerve fiber layer