રવિ-ભાણ સંપ્રદાયના હરિજન સંત કવિઓઃ એક વિવેચનાત્મક અધ્યયન

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Will Herbal-Paracetamol \u3cem\u3eCombination\u3c/em\u3e Drug Prevent both Liver and Kidney Disease? - Results and Possibilities

An attempt has been made to briefly review the existing information on herbal compounds which could combat acetaminophen (paracetamol) toxicity. A careful perusal of literature revealed that acetaminophen overdose not only damages liver but also the kidney. Nevertheless, the kidney was badly ignored in studies aimed at preventing paracetamol toxicity with herbal drugs. On account of such major neglect, so far no herbal-paracetamol combination could be made. Milk thistly is only well researched drug which appears as a suitable future candidate, but its action towards the kidney must be studied. The importance of such studies in the future is discussed

An Evaluation of the Genotoxic Effects of Seed Decoction of Cassia tora L. (Leguminosae) in Allium cepa Model

Cytological effects of Cassia tora seed decoction were evaluated in Allium cepa root tip cells. Bulbs were grown in pure tap water (controls, Gr. I) and also in six concentrations (0.15 mg/ml, 0.31 mg/ml, 0.62 mg/ml, 1.25 mg/ml, 2.5 mg/ml and 5 mg/ml) of C.tora seed decoction in tap water (experimental, Grs. II). Parameters of study were \u27mean root length\u27 and morphology i.e. colour and shape of root tips at 72 hr of cultivation and \u27mitotic Index\u27, chromosomal aberrations and abnormal mitosis at 48 hr of cultivation. Physico-chemical characterization of decoction was also made. No changes in the morphology of root tips occurred at any concentration of C.tora seed decoction, however, change in color did occur at all concentrations. Mitotic index and mean root length remained unaffected at first two concentrations but all higher four concentrations caused progressive mitodepression hence a decline in root growth occurred. No abnormal mitosis and no chromosomal aberration occurred at all at any concentration. Results suggest that water soluble constituents of C.tora seeds could only lower mitosis but not caused any adverse genotoxic effects in mitotically dividing A.cepa root cells under laboratory condition

Economic evaluation protocol of a short, all-oral bedaquiline-containing regimen for the treatment of rifampicin-resistant tuberculosis from the STREAM trial

Introduction: A December 2019 WHO rapid communication recommended the use of 9-month all-oral regimens for treating multidrug-resistant tuberculosis (MDR-TB). Besides the clinical benefits, they are thought to be less costly than the injectable-containing regimens, for both the patient and the health system. STREAM is the first randomised controlled trial with an economical evaluation to compare all-oral and injectable-containing 9–11-month MDR-TB treatment regimens. Methods and analysis: Health system costs of delivering a 9-month injectable-containing regimen and a 9-month all-oral bedaquiline-containing regimen will be collected in Ethiopia, India, Moldova and Uganda, using ‘bottom-up’ and ‘top-down’ costing approaches. Patient costs will be collected using questionnaires that have been developed based on the STOP-TB questionnaire. The primary objective of the study is to estimate the cost utility of the two regimens, from a health system perspective. Secondary objectives include estimating the cost utility from a societal perspective as well as evaluating the cost-effectiveness of the regimens, using both health system and societal perspectives. The effect measure for the cost–utility analysis will be the quality-adjusted life years (QALY), while the effect measure for the cost-effectiveness analysis will be the efficacy outcome from the clinical trial. Ethics and dissemination: The study has been evaluated and approved by the Ethics Advisory Group of the International Union Against Tuberculosis and Lung Disease and also approved by ethics committees in all participating countries. All participants have provided written informed consent. The results of the economic evaluation will be published in a peer-reviewed journal. Trial registration number: ISRCTN18148631

Economic evaluation of shortened, bedaquiline-containing treatment regimens for rifampicin-resistant tuberculosis (STREAM stage 2) : a within-trial analysis of a randomised controlled trial

Background: The STREAM stage 2 trial assessed two bedaquiline-containing regimens for rifampicin-resistant tuberculosis: a 9-month all-oral regimen and a 6-month regimen containing an injectable drug for the first 2 months. We did a within-trial economic evaluation of these regimens. Methods: STREAM stage 2 was an international, phase 3, non-inferiority randomised trial in which participants with rifampicin-resistant tuberculosis were randomly assigned (1:2:2:2) to the 2011 WHO regimen (terminated early), a 9-month injectable-containing regimen (control regimen), a 9-month all-oral regimen with bedaquiline (oral regimen), or a 6-month regimen with bedaquiline and an injectable for the first 2 months (6-month regimen). We prospectively collected direct and indirect costs and health-related quality of life data from trial participants until week 76 of follow-up. Cost-effectiveness of the oral and 6-month regimens versus control was estimated in four countries (oral regimen) and two countries (6-month regimen), using health-related quality of life for cost-utility analysis and trial efficacy for cost-effectiveness analysis. This trial is registered with ISRCTN, ISRCTN18148631. Findings: 300 participants were included in the economic analyses (Ethiopia, 61; India, 142; Moldova, 51; Uganda, 46). In the cost-utility analysis, the oral regimen was not cost-effective in Ethiopia, India, Moldova, and Uganda from either a provider or societal perspective. In Moldova, the oral regimen was dominant from a societal perspective. In the cost-effectiveness analysis, the oral regimen was likely to be cost-effective from a provider perspective at willingness-to-pay thresholds per additional favourable outcome of more than US$4500 in Ethiopia,$1900 in India, $3950 in Moldova, and$7900 in Uganda, and from a societal perspective at thresholds of more than $15 900 in Ethiopia,$3150 in India, and $4350 in Uganda, while in Moldova the oral regimen was dominant. In Ethiopia and India, the 6-month regimen would cost tuberculosis programmes and participants less than the control regimen and was highly likely to be cost-effective in both cost-utility analysis and cost-effectiveness analysis. Reducing the bedaquiline price from$1·81 to $1·00 per tablet made the oral regimen cost-effective in the provider-perspective cost-utility analysis in India and Moldova and dominate over the control regimen in the provider-perspective cost-effectiveness analysis in India. Interpretation: At current costs, the oral bedaquiline-containing regimen for rifampicin-resistant tuberculosis is unlikely to be cost-effective in many low-income and middle-income countries. The 6-month regimen represents a cost-effective alternative if injectable use for 2 months is acceptable. Funding: USAID and Janssen Research & Development

Continuous action with a neurobiologically inspired computational approach reveals the dynamics of selection history

Everyday perception-action interaction often requires selection of a single goal from multiple possibilities. According to a recent framework of attentional control, object selection is guided not only by the well-established factors of perceptual salience and current goals but also by selection history. Yet, underlying mechanisms linking selection history and visually-guided actions are poorly understood. To examine such interplay and disentangle the impact of target and distractor history on action selection, we employed a priming-of-popout (PoP) paradigm combined with continuous tracking of reaching movements and computational modeling. Participants reached an odd-colored target among homogeneous distractors while we systematically manipulated the sequence of target and distractor colors from one trial to the next. We observed that current reach movements were significantly influenced by the interaction between attraction by the prior target feature and repulsion by the prior distractor feature. With principal component regression, we found that inhibition led by prior distractors influenced reach target selection earlier than facilitation led by the prior target. In parallel, our newly developed computational model validated that current reach target selection can be explained best by the mechanism postulating the preceded impact of previous distractors followed by a previous target. Such converging empirical and computational evidence suggests that the prior selection history triggers a dynamic interplay between target facilitation and distractor inhibition to guide goal-directed action successfully. This, in turn, highlights the necessity of an explicitly integrated approach to determine how visual attentional selection links with adaptive actions in a complex environment