467 research outputs found
Detection of Hidden Wormhole Attack in Wireless Sensor Networks using Neighborhood and Connectivity Information
Wireless sensor networks (WSNs) have inspired many applications such as military applications, environmental monitoring and other fields. WSN has emergence in various fields, so security is very important issue for sensor networks. Security comes from attacks. Due to the wireless and distributed nature anyone can connect with the network. Among all possible attacks, wormholes are very hard to detect because they can cause damage to the network without knowing the protocols used in the network. It is a powerful attack that can be conducted without requiring any cryptographic breaks. Wormholes are hard to detect because they use a private, out-of-band channel invisible to the underlying sensor network. In this paper we have proposed a wormhole detection protocol based on neighborhood and connectivity information. Performance analysis shows that our proposed approach can effectively detect wormhole attack with less storage cost. Keywords: Wireless sensor network, wormhole, out-of-band, security, neighborhood
Prescription and cost-analysis of antiemetic medication use in pediatric wards: a prospective observational study
Background: Use of anti-emetic drugs in pediatric population is often warranted, but choice of drug remains questionable within pediatricians. Objective of current study is: to study prescribing pattern and to calculate cost of antiemetic drug therapy in pediatric wards.Methods: A prospective, observational study was conducted in pediatric wards of a tertiary care hospital of over 14 monthâs duration. Institutional ethics committee approval was obtained and written informed consent of parents/guardians was taken. Data of any pediatric patient receiving anti-emetic agent were included in the study.Results: A total of 218 prescriptions were collected. Mean age of patients was 4.39±3.16 (range 4 months to 12 years). Gastroenteritis was the most frequently diagnosed disease in 137(63%) patients. Domperidone was prescribed in 52.4% and ondansetron in 47.6% children. Oral liquid dosage formulation was prescribed in 109 (48.4%) followed by solid dosage form 47 (20.9%). Mean cost of domperidone therapy was 25.34±6.55 INR and for ondansetron it was 36.62±17.94 INR.Conclusions: Gastroenteritis was most frequent indication for use of anti-emetics. Domperidone pharmacotherapy was cheaper and most frequently prescribed than ondansetron
Successful Ayurvedic management of Hepatic Cirrhosis Complex with Ascites - A Case Study
Hepatic cirrhosis of liver is an inflammatory condition of the liver caused by various factors specially excessive alcohol consumption over an extended period of time. When alcohol gets processed in the liver, it produces highly toxic chemicals. These chemicals can fatally injure the liver cells. Normally the treatment is too much time consuming, difficult and inadequate Ayurvedic treatment serves as a promising different modality. In present study the case of alcoholic cirrhosis complicated with Ascites is presented. The patient was given Ayurvedic treatment with Vardhamana Pippali, Katuki Churna, Punarnavadi Kvatha, Bhrungaraja Panchanga Churna, Arogyavardhini Rasa, Mixture of Bhumyamalaki Panchanga Churna, Sharpunkha Mula Churna and Sveta Parpati. This treatment approach has improved condition of patient greatly by bringing hepatitis from Child-Pugh stage C to stage B with improvement in sign and symptoms as well as in ascetic condition
Comparison of efficacy and safety of thiocolchicoside and pregabalin in the treatment of acute non-specific low back pain: an open label randomized prospective study
Background: The present study was undertaken to study the efficacy and safety of thiocolchicoside, a centrally acting skeletal muscle relaxant, GABA mimetic drug and pregabalin, an anti-epileptic, GABA mimetic drug in the treatment of acute non-specific low back pain.Methods: The study was carried out at the orthopaedic outpatient department of our hospital. 80 patients were included during the study period of two months. Out of the 80, 40 were given pregabalin 75 mg 1hs and the rest were given thiocolchicoside 8 mg bd by the prescribing doctor. Patients, aged between 18-60 years having non-radiating low back pain for less than 7 days were selected. The data was collected in a proforma which included the patientâs details and the prescribed drugs. The patients were also given notepads to record adverse effects. On day 1, the pain was measured on visual analogue scale. After a week, follow up was done and decrease in pain was measured on the visual analogue scale.Results: There was significant difference between pre and post visual analogue scale score in both the groups with a p-value of less than 0.0001. But the difference between the two groups was not statistically significant (p-value 0.0664). In both the groups, patients did not report any adverse effects. Pregabalin has a slower onset than thiocolchicoside however has better efficacy. In India, where the drug abuse risk is higher, pregabalin is a safer choice as skeletal muscle relaxants (thiocolchicoside) should not be given for more than a week.Conclusions: Pregabalin has better efficacy in treatment of acute non-specific low back pain as compared to thiocolchicoside
Surface warming during the 2018/Mars Year 34 Global Dust Storm
The impact of Marsâ 2018 Global Dust Storm (GDS) on surface and nearâsurface air temperatures was investigated using an assimilation of Mars Climate Sounder (MCS) observations. Rather than simply resulting in cooling everywhere from solar absorption (average surface radiative flux fell 26 Wmâ2), the globallyâaveraged result was a 0.9 K surface warming. These diurnallyâaveraged surface temperature changes had a novel, highly nonâuniform spatial structure, with up to 16 K cooling/19 K warming. Net warming occurred in low thermal inertia (TI) regions, where rapid nightâtime radiative cooling was compensated by increased longwave emission and scattering. This caused strong nightside warming, outweighing dayside cooling. The reduced surfaceâair temperature gradient closely coupled surface and air temperatures, even causing local dayside air warming. Results show good agreement with MCS surface temperature retrievals. Comparisons with the 2001 GDS and freeârunning simulations show that GDS spatial structure is crucial in determining global surface temperature effects
Impact of an antimicrobial utilization program on antimicrobial use at a large teaching hospital: A randomized controlled trial
BACKGROUND: Multidisciplinary antimicrobial utilization teams (AUT) have been proposed as a mechanism for improving antimicrobial use, but data on their efficacy remain limited. OBJECTIVE: To determine the impact of an AUT on antimicrobial use at a teaching hospital. DESIGN: Randomized controlled intervention trial. SETTING: A 953-bed public university-affiliated urban teaching hospital. PATIENTS: Patients who were prescribed selected antimicrobial agents (piperacillin-tazobactam, levofloxacin, or vancomycin) by internal medicine ward teams. INTERVENTION: Twelve internal medicine teams were randomized monthly: 6 teams to intervention group (academic detailing by the AUT), and 6 teams to a control group given indication-based guidelines for prescription of broad spectrum antimicrobials (standard of care) during a 10-month study period. MEASUREMENTS: Proportion of appropriate empiric, definitive (therapeutic), and end antimicrobial (overall) usage. RESULTS: A total of 784 new prescriptions of piperacillin-tazobactam, levofloxacin, and vancomycin were reviewed. The proportion of appropriate antimicrobial prescriptions written by the intervention teams was significantly higher than prescribed by the control teams: 82% vs. 73% for empiric (RR=1.14, 95% CI 1.04â1.24), 82% vs. 43% for definitive (RR=1.89, 95% CI 1.53â2.33), and 94% vs. 70% for end antimicrobial usage (RR=1.34, 95% CI 1.25â1.43). In a multivariate analysis, teams that received feedback from the AUT alone (aRR=1.37, 95% CI 1.27â1.48) or from both the AUT and the ID consult service (aRR=2.28, 95% CI 1.64â3.19) were significantly more likely to prescribe end antimicrobial usage appropriately compared to control teams. CONCLUSIONS: A multidisciplinary AUT which provides feedback to prescribing physicians was an effective method in improving antimicrobial use
Latent tuberculosis screening and treatment in HIV: highly acceptable in a prospective cohort study
Background: People living with HIV (PLWH) are at increased risk of re-activation of latent tuberculosis infection (LTBI). Although UK and international guidelines identify this group as a priority for LTBI screening and treatment, data on attitudes of PLWH to this policy recommendation are lacking. / Methods: A five-point, Likert-style questionnaire was administered to PLWH to assess views and intentions towards accepting LTBI screening and treatment. Subsequent interferon-Îł release assay (IGRA) testing was offered, and chemoprophylaxis if required. Influencing demographic and psychological associations with planned, and actual, testing and treatment uptake were assessed using multivariable logistic regression. / Results: 444 out of 716 (62%) patients responded. 417 out of 437 (95.4%) expressed intention to accept LTBI testing. The only significant association was the perceived importance of testing to the individual (adjusted odds ratio (aOR) 8.98, 95% CI 2.55-31.67). 390 out of 393 (99.2%) accepted appropriate IGRA screening; 41 out of 390 (10.5%) were positive. 397 out of 431 (92.1%) expressed intention to accept chemoprophylaxis, associated with perceived importance of treatment (aOR 3.52, 95% CI 1.46-8.51), a desire to have treatment for LTBI (aOR 1.77, 95% CI 0.99-3.15) and confidence in taking treatment (aOR 3.77, 95% CI 1.84-7.72). Of those offered chemoprophylaxis, 36 out of 37 (97.3%) accepted and 34 out of 36 (94.4%) completed treatment. There were no correlates with actual screening acceptance. / Conclusions: LTBI is common amongst PLWH, highlighting the importance of robust screening and treatment programmes. This study shows that screening and treatment for LTBI is highly acceptable to PLWH and provides strong, objective evidence for policy-makers developing guidelines in this cohort
A qualitative assessment of factors influencing acceptance of a new rotavirus vaccine among health care providers and consumers
Asymmetric impacts on Marsâ polar vortices from an equinoctial Global Dust Storm
Mars possesses dynamical features called polar vortices: regions of cold, isolated air over the poles circumscribed by powerful westerly jets which can act as barriers to transport to dust, water, and chemical species. The 2018 Global Dust Storm was observed by multiple orbiters and offers a valuable opportunity to study the effects of such a storm on polar dynamics. To this end, we assimilate data from the Mars Climate Sounder and Atmospheric Chemistry Suite into a Mars Global Climate Model. We find that the storm had asymmetrical hemispherical impacts, with the northern vortex remaining relatively robust while the southern vortex was substantially diminished in its intensity. We propose that this asymmetry was due both to the stormâs latitudinal extent, as it extended further south than north, and to its equinoctial timing, occurring as the southern vortex was already decaying. We show that both polar vortices, in particular the northern, were reduced in ellipticity by the storm. There was a wellâcorrelated reduction in stationary topographic wave activity at high latitudes in both hemispheres. We demonstrate that the characteristic elliptical martian polar vortex shape is the pattern of the stationary waves, which was suppressed by the shifting of the polar jet away from regions of high mechanical forcing (north) or reduction of polar jet intensity by a reduced meridional temperature gradient (south). These asymmetric effects suggest increased transport into the southern (but not northern) polar region during Global Dust Storms at northern autumn equinox, and more longitudinally symmetric transport around both poles
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