BRIDGING THE GAP BETWEEN GLOBAL AND LOCAL STRATEGIES OF ARCHITECTURAL CONSERVATION, EXAMPLES OF THE CURRENT SCENARIOS IN INDIA

Culture develops from a civilization and progresses through the generations in tangible and intangible forms affecting various aspects of living. It gradually becomes a rulebook that guides the way of life for some people. This holds true in the Indian Society, which is punctuated by constant incorporation of migrating people with the diverse cultures that surround India. Such illustrious past should predict augmented conservation efforts. However, that is not the case. Following the Hindu philosophy of the life cycle, buildings are allowed to be deteriorating over the passage of time. It was only much later that the occidental influence of the British Empire encouraged conservation of built heritage. Yet today these efforts are absent at the most basic levels. On one side are the international organizations such as UNESCO providing guidelines for protection of these buildings and the on the other side are the government and non-government organizations which help maintain the structures. Co-relation between the two levels of conservation are non-existent in a way that initiatives by the government focus on improving infrastructure but neglect the Risk-assessment of the buildings. Such examples will be discussed further in the paper with suggestions to improve the situation with the help of new technologies and simplified methods that include making conservation education easier for even the most rural population. The research explores avenues of diagnosis integrated in the Italian philosophy of conservation to make maintenance more easy and effective

Clinical manifestation and prevalence of peripheral neuropathy and nerve dysfunction in patients with chronic kidney disease

Background: Chronic Kidney Disease (CKD) is recognized as a major health problem. Prevalence of CKD is rising continuously; mostly CKD is affecting the elderly aged population and/or patients with diabetes and hypertension. Present study was aimed to explore clinical manifestation and evaluate the prevalence of peripheral neuropathy and peripheral nerve dysfunction in CKD patients attending our hospital with reference to the severity and duration of the CKD.Methods: The present cross sectional study was conducted in 74 patients affected with chronic kidney disease, of different age groups at the medical wards of King George Hospital, Visakhapatnam. The presence of peripheral nerve dysfunction was assessed by nerve dysfunction clinically (motor or sensory symptoms and signs) and electrophysiological nerve conduction studies.Results: Out of 74 patients, 65% of study population was suffering from chronic kidney disease with peripheral nerve dysfunction. The peripheral nerves dysfunction was more prevalent in elder age (>65 years) subjects when compared to subjects with age <65 years. Moreover, the results shown that the rate of prevalence of peripheral nerves dysfunction was observed higher in subjects with longer duration of CKD. Male subjects were affected more when creatinine clearance is <15 ml/minute. Both sexes were affected equally when creatinine clearance is between 30-59 ml/minute.Conclusion: This study enlightens the prevalence and clinical presentation of peripheral nerve dysfunction in patients with CKD. The CKD was found to cause peripheral neuropathy including overt and subclinical neuropathy, of which distal symmetrical sensory motor neuropathy was common in CKD. The prevalence of peripheral neuropathy was directly proportional to duration and severity of CKD.

Lung surfactant in subacute pulmonary disease

Pulmonary surfactant is a surface active material composed of both lipids and proteins that is produced by alveolar type II pneumocytes. Abnormalities of surfactant in the immature lung or in the acutely inflamed mature lung are well described. However, in a variety of subacute diseases of the mature lung, abnormalities of lung surfactant may also be of importance. These diseases include chronic obstructive pulmonary disease, asthma, cystic fibrosis, interstitial lung disease, pneumonia, and alveolar proteinosis. Understanding of the mechanisms that disturb the lung surfactant system may lead to novel rational therapies for these diseases

Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice

Background: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost-effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs. Methods: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients’ non-adherence. Clinical event probability, treatment pathway, resource-use and costs were extracted from literature and costing tariffs. Incremental costs and outcomes associated with each disease were incorporated additively into a composite probabilistic model and combined with adherence rates and intervention costs from the trial. Costs per extra quality-adjusted-life-year(QALY) were calculated from the perspective of NHS England, using a lifetime horizon. Results: NMS generated a mean of 0.05 (95%CI: 0.00, 0.13) more QALYs per patient, at a mean reduced cost of -£144 (95%CI: -769, 73). The NMS dominates normal practice with probability of 0.78 (ICER: - £3166 per QALY). NMS has a 96.7% probability of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Sensitivity analysis demonstrated that targeting each disease with NMS has a probability over 0.90 of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Conclusions: Our study suggests that the New Medicine Service increased patient medicine adherence compared with normal practice, which translated into increased health gain at reduced overall cost

BRIDGING THE GAP BETWEEN GLOBAL AND LOCAL STRATEGIES OF ARCHITECTURAL CONSERVATION, EXAMPLES OF THE CURRENT SCENARIOS IN INDIA

Culture develops from a civilization and progresses through the generations in tangible and intangible forms affecting various aspects of living. It gradually becomes a rulebook that guides the way of life for some people. This holds true in the Indian Society, which is punctuated by constant incorporation of migrating people with the diverse cultures that surround India. Such illustrious past should predict augmented conservation efforts. However, that is not the case. Following the Hindu philosophy of the life cycle, buildings are allowed to be deteriorating over the passage of time. It was only much later that the occidental influence of the British Empire encouraged conservation of built heritage. Yet today these efforts are absent at the most basic levels. On one side are the international organizations such as UNESCO providing guidelines for protection of these buildings and the on the other side are the government and non-government organizations which help maintain the structures. Co-relation between the two levels of conservation are non-existent in a way that initiatives by the government focus on improving infrastructure but neglect the Risk-assessment of the buildings. Such examples will be discussed further in the paper with suggestions to improve the situation with the help of new technologies and simplified methods that include making conservation education easier for even the most rural population. The research explores avenues of diagnosis integrated in the Italian philosophy of conservation to make maintenance more easy and effective