Treatment outcome of tuberculosis patients under directly observed treatment short-course and factors affecting the outcome in tertiary care hospital

Background: Revised National Tuberculosis Control Programme (RNTCP) based on Directly Observed Treatment Short-course (DOTS) strategy has been made available in entire country by March 2006. Given high rate of unfavourable treatment outcomes reported in some provinces, there is a need to analyse outcomes and identify possible trends and associated risk factors that can help for improvement in RNTCP.Methods: After getting Institutional Ethics Committee (IEC) approval, total of 76 cases diagnosed and treated for Tuberculosis (TB) under Category I of RNTCP were recruited from January to March 2017. All patients were followed up for six months from date of initiating the treatment. The data was obtained from TB treatment register, by patient visit and regular follow-up. The information collected include age and gender of patient, category of treatment, date of treatment initiation, initial sputum conversion, outcome of treatment and date of outcome.Results: Out of total 76 patients, 64 (84.21%) were cured, 5 (6.57%) were lost to follow-up, 4 (5.26%) were failed to treat, 1 (1.32%) patient was died, 1 (1.32%) patient had completed treatment but status was unknown and 1 (1.32%) patient was not evaluated because of transfer. Overall treatment outcome of TB patients under DOTS was matching goal of RNTCP with cure rate of 84.21%.Conclusions: Efforts by DOT providers, adequate patient education, motivating ones in need can bring positive outcomes. In this region, DOTS center is at good working condition in terms of functionality as well as ethically. Gender, age group, residence and initial culture colony did not significantly affect treatment outcome

A comparative evaluation of structured and unstructured forms of viva voce for internal assessment of undergraduate students in Pharmacology

Background: The study was designed to identify value of structured viva (SV) as an assessment tool, to ascertain its correlation with unstructured viva (UV) and to find relationship between viva and theory examination results.Methods: This prospective and observational study was conducted on a total of 135 students of the 2nd professional MBBS. All students faced two viva sessions (SV and UV), each of 10 marks on same topics in general pharmacology and autonomic nervous system. Time limit per student was 10 minutes. SV was conducted on pre-validated, standardized cards (n=40) with 5 questions in each card and 0.5 marks of each question. By draw of lots to be performed by students themselves, each student was given 4 cards. One week prior to the viva, the theory examination of 40 marks on same topics was conducted.Results: The mean marks of all students in SV (3.46±1.44) were significantly lower (P <0.0001) than those of UV (4.61±2.02). There was significant less deviation of mean marks in all groups of SV (P <0.05). The mean percentage marks of SV (34.63±14.37%) had similarities with results of theory examination (34.67±10.49%) (P=0.9720), while the difference between mean percentage marks of UV (46.15±20.19%) and theory was statistically highly significant (P <0.0001).Conclusions: SV increases objectivity and reduces subjectivity as compared to UV because of similar pattern of questions, difficulty levels and standardised scoring system. SV provides an opportunity to measure how well students can apply knowledge. Thus, SV can be used for formative and summative assessment

Cognitively-inspired Agent-based Service Composition for Mobile & Pervasive Computing

Automatic service composition in mobile and pervasive computing faces many challenges due to the complex and highly dynamic nature of the environment. Common approaches consider service composition as a decision problem whose solution is usually addressed from optimization perspectives which are not feasible in practice due to the intractability of the problem, limited computational resources of smart devices, service host's mobility, and time constraints to tailor composition plans. Thus, our main contribution is the development of a cognitively-inspired agent-based service composition model focused on bounded rationality rather than optimality, which allows the system to compensate for limited resources by selectively filtering out continuous streams of data. Our approach exhibits features such as distributedness, modularity, emergent global functionality, and robustness, which endow it with capabilities to perform decentralized service composition by orchestrating manifold service providers and conflicting goals from multiple users. The evaluation of our approach shows promising results when compared against state-of-the-art service composition models.Comment: This paper will appear on AIMS'19 (International Conference on Artificial Intelligence and Mobile Services) on June 2

A Comprehensive Review of the Genetic and Epigenetic Contributions to the Development of Fibromyalgia

This narrative review summarizes the current knowledge of the genetic and epigenetic contributions to the development of fibromyalgia (FM). Although there is no single gene that results in the development of FM, this study reveals that certain polymorphisms in genes involved in the catecholaminergic pathway, the serotonergic pathway, pain processing, oxidative stress, and inflammation may influence susceptibility to FM and the severity of its symptoms. Furthermore, epigenetic changes at the DNA level may lead to the development of FM. Likewise, microRNAs may impact the expression of certain proteins that lead to the worsening of FM-associated symptoms