Political Connection, Public Good Activism and Network in India: An Analysis of RSBY Health Scheme

Researchers have the view that functional and representative democratic political institutions have long characterized the role of the Institution in the development of the country and India. This paper brings the political economy issue, and the role of the institution played in obtaining Rashtriya Swasth Bima Yojana (RSBY) health insurance scheme card in India. The objective is to analyse the role of village and household characteristics in obtaining RSBY scheme card holding in rural India. Also, to examine the role of political connection, public good activism and network of the household in enrolment in RSBY scheme. This study uses the Indian Human Development Survey (IHDS), 2011-12 data. The method of analysis is the bi-variate and logistic regression. This study found that the network and variable related to information availability, i.e. household with a membership of caste association and attending of a public meeting are more likely to enroll in RSBY scheme. There is not much difference of RSBY card holding between the household that has a political connection, and household that does not have a political connection. Social group result does have an unexpected result of the ST population have less than national level card holder. The village level characteristics like Pradhan caste and reservation of the seat is positively linked to RSBY card holding. A Village that has implemented Janani Suraksha Yojana (JSY) scheme their household have less percentage of RSBY card holder that village

Myxoid liposarcoma originating in the anterior mediastinum

Myxoidliposarcomas ofthe head and neck aremostly metastaticin nature, with the primarylesion usually in lower extremities or retroperitoneum. Primary mediastinal liposarcomas are even rare Although there have been previous cases reporting their incidence, there is no evidence of any case comprising of both the neck and the mediastinal region yet. We here present a case of a 43 year old male with a primary liposarcoma of the myxoid subtype originating in the anterior mediastinumThis is the first time such a case haspres ented in literature. The patient presented with a right sided neck swelling associated with pain and shortness of breath upon lying down.CT neck revealed an enhancing mass extending from right cervical regionto axilla and enca sing the subclavian artery and involving a portion of the right lung. The patient underwent wide local excision of the mass along with chemo radiotherapy to prevent recurrenc

Pharmacological Inhibition of Class III Alcohol Dehydrogenase 5: Turning Remote Ischemic Conditioning Effective in a Diabetic Stroke Model

The restoration of cerebral blood flow (CBF) to achieve brain tissue oxygenation (PbtO2 ) is the primary treatment for ischemic stroke, a significant cause of adult mortality and disability worldwide. Nitric oxide (NO) and its bioactive s-nitrosylated (SNO) reservoirs, such as s-nitrosoglutathione (GSNO), induce hypoxic vasodilation to enhance CBF during ischemia. The endogenous pool of SNOs/GSNO is enhanced via the activation of endothelial NO synthase (eNOS/NOS3) and by the suppression of class III alcohol dehydrogenase 5 (ADH5), also known as GSNO reductase (GSNOR). Remote ischemic conditioning (RIC), which augments NOS3 activity and SNO, is an emerging therapy in acute stroke. However, RIC has so far shown neutral effects in stroke clinical trials. As the majority of stroke patients are presented with endothelial dysfunctions and comorbidities, we tested the hypothesis that NOS3 dysfunction and diabetes will abolish the protective effects of RIC therapy in stroke, and the prior inhibition of GSNOR will turn RIC protective. Our data demonstrate that RIC during thrombotic stroke failed to enhance the CBF and the benefits of thrombolysis in NOS3 mutant (NOS3+/−) mice, a genetic model of NOS3 dysfunction. Interestingly, thrombotic stroke in diabetic mice enhanced the activity of GSNOR as early as 3 h post-stroke without decreasing the plasma nitrite (NO2 −). In thrombotic stroke, neither a pharmacological inhibitor of GSNOR (GRI) nor RIC therapy alone was protective in diabetic mice. However, prior treatment with GRI followed by RIC enhanced the CBF and improved recovery. In a reperfused stroke model, the GRI–RIC combination therapy in diabetic mice augmented PbtO2 , a translatory signature of successful microvascular reflow. In addition, RIC therapy unexpectedly increased the inflammatory markers at 6 h post-stroke in diabetic stroke that were downregulated in combination with GRI while improving the outcomes. Thus, we conclude that preexisting NOS3 dysfunctions due to comorbidities may neutralize the benefits of RIC in stroke, which can be turned protective in combination with GRI. Our findings may support the future clinical trial of RIC in comorbid stroke. Further studies are warranted to test and develop SNO reservoirs as the blood-associated biomarker to monitor the response and efficacy of RIC therapy in stroke

Isolated tuberculous thyroiditis as solitary thyroid nodule

Isolated involvement of the thyroid by tuberculosis is very rare as reported in literature. We are presenting a case of isolated tuberculous thyroiditis presented as a solitary thyroid nodule. The patient was treated with anti-tuberculous regimen and he responded well with disappearance of the nodule and normalization of the thyroid scan

Evaluation of quality of warfarin therapy by assessing patient\u27s time in therapeutic range at a tertiary care hospital in Pakistan

Objective: To assess the time in therapeutic range in patients on warfarin anti-coagulation therapy. Methods: The retrospective chart review was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients having undergone anti-coagulation with warfarin from January 2013 to April 2015. To determine the mean time in therapeutic range, Rosendaal method was used. Association of time in therapeutic range with the composite outcome, bleeding and thromboembolic events was also assessed. Percentage of patients with time in therapeutic range \u3c60% was calculated. Results: There were 92 patients whose median time in therapeutic range was 34.9% (interquartile range: 20.0- 55.7). Overall, 71(77.2%) patients had time in therapeutic range below 60% which had statistically significant correlation with the composite outcome (p\u3c0.05). Number of comorbids was significant in predicting time in therapeutic range and patients with time in therapeutic range\u3c 60% (p\u3c0.05). Conclusion: Subjects had poor anti-coagulation quality. It might be prudent to move towards novel oral anticoagulant drugsas the first choice for therapeutic anti-coagulation

Paediatric respiratory isolation: A challenge for a secondary care hospital! A service innovation project

Objective: The aim of this project was to broaden the secondary care hospital\u27s scope of services and provide safe, effective and quality care for the patient presenting with measles.Methods: Six Sigma DMAIC [define measure, analyze, improve, and control (DMAIC)] methodology was used in this quality improvement project. The quality project was started in October 2015 using a Gantt chart quality tool.Results: The paediatric team with the support of administration of the hospital has established isolation rooms and devised a policy for the care and management of patient with airborne infection to avoid cross transmission. During six months period after establishment of isolation room there were sixty two suspected or confirmed measles cases who were admitted in our hospital, out of them only 4(6.4%) of patients were referred because of their sick condition and need of ventilator support. Further, the percentage of patient\u27s satisfaction level also improved from 60 to 80%.Conclusions: After this clinical service innovation, there was significant reduction in referrals of measles patients to another hospital and consequently there was an increase in the patient\u27s satisfaction

Designing EthAKUL: A mobile just-in-time learning environment for bioethics in Pakistan

In developing countries such as Pakistan, bioethics has not been included in mainstream thinking in medical education. The authors’ experiences suggest that current methods of teaching bioethics are problematic as students are unable to translate theory to practice. Alternative pedagogies, such as just-in-time learning (JiTL) using mobile devices, may be able to foster the development and implementation of ethical reasoning among nurses, doctors, and medical and nursing students. This research was conceived to determine the effectiveness of mobile JiTL – anytime, anyplace learning through mobile devices – for teaching bioethics. After obtaining ethical clearance, a participatory design (PD) approach was adopted to ensure input from all stakeholders for the design of ‘EthAKUL’, comprising a mobile app, five modules and just-in-time pedagogy. The name of the app is an acronym evoking ethics, learning and the university where the project originated. As a part of the design process, three PD workshops were held with junior doctors, nurses, nursing students, medical students and bioethics teaching faculty, and five meetings were held with faculty members, to discuss functional specifications and user-acceptance testing of the app. The feedback related to the nature of common ethical issues encountered in clinical settings, the existing process of teaching and learning bioethics, and the requested features of the app were recorded. These data sets were analyzed and synthesized into functional and technical specifications for the mobile app. The software programmers developed the app with the close involvement of the stakeholders. The development of teaching content continued alongside this process. While this enabled EthAKUL’s developers to incorporate needs of all stakeholders, challenges were encountered in the process relating to the pragmatic and conceptual aspects of JiTL, ML and PD. We discuss the implications of this research in bringing about transformative changes in higher education

Efficient and secure image encryption using key substitution process with discrete wavelet transform

Over the past few years, there has been a rise in the utilization of chaotic encryption algorithms for securing images. The majority of chaos-based encryption algorithms adhere to the conventional model of confusion and diffusion, which typically involves either implementing multiple encryption rounds or employing a single round of intricate encryption to guarantee robust security. However, such kind of approaches reduces the computational efficiency of the encryption process but compromises security. There is a trade-off between security and computational efficiency. Prioritizing security may require high computational processes. To overcome this issue, a key substitution encryption process with discrete wavelet transform (KSP-DWT) is developed in the proposed image encryption technique (IET). Based on KSP-DWT and IET, the abbreviation of the proposed work is used in this paper as KSP-DWT-IET. The proposed KSP-DWT algorithm employs a key scheming technique to update the initial keys and uses a novel substitution method to encrypt digital images of different sizes. Additionally, the integration of DWT can result in the compression of frequency sub-bands of the source image, leading to lower computational overheads without compromising the security of the encryption. The KSP-DWT-IET performs a single encryption round and is highly secure and efficient. The simulation results and security analysis conducted on KSP-DWT-IET confirm its effectiveness in ensuring high-security image encryption while minimizing computational overhead. The proposed encryption technique undergoes various security analyses, including entropy, contrast, correlation, energy, NPCR (Number of Pixel Changes Rate), UACI (Unified Average Change Intensity) and computational complexity. The statistical values obtained for such parameters are 7.9991, 10.9889, 0.0001, 0.0152, 33.6767, and 33.6899, respectively, which indicate that the encryption technique performs very well in terms of security and computational efficiency. The proposed encryption scheme is also analyzed for its computational time in addition to its security. The analysis shows that the scheme can efficiently encrypt images of varying sizes with a high level of security in a short amount of time (i.e., 2 ms). Therefore, it is feasible to use this encryption scheme in real-time applications without causing any significant delays. Moreover, the key space of the proposed encryption scheme is large enough (i.e. Keyspace ) to resist the brute force attack

Microwave-vacuum extraction technique as a green and clean label technology: kinetics, efficiency analysis, and effect on bioactive compounds

Grape pomace is a rich source of bioactive compounds and dietary fiber. This study aims to valorize the grape pomace by microwave-vacuum-assisted drying and extraction, which is a novel, green, and clean label technology. The drying and extraction of bioactive compounds from the grape pomace was optimized using response surface methodology. Box-Behnken design was used for three process variables, i.e., time, power, and vacuum levels. The highest drying rate was observed (5.53 g/100 g min after 10 min of drying) at the combination of 80 W and 20 inHg. This combination significantly reduced the drying time (25%) and resulted in the highest yield (64.5%) of bioactive compounds. Equally, changes in moisture ratio behavior were rapid under these processing conditions. Furthermore, Midilli model (R2 = 0.999, RMSE = 0.002, SSE = 3.71 × 10−6) was the best to justify the fitness of experimental values with predicted values. In addition, the diffusion coefficient, activation energy, and extraction yield were increased with increase in power and pressure. The concentration of bioactive components was higher in dried pomace compared to the extract. The extraction was successfully achieved without the use of solvent and the characteristics of extracted phenolics remained unaltered. Based on these findings, the microwave-vacuum-assisted drying and extraction process can be claimed as a sustainable approach.Universidade de Vigo/CISUGAxencia Galega de Innovación | Ref. IN607A2019/0