Ayurvedic Management of Shwitra (Vitiligo) - A Case Study

Skin is the outer most covering of the body and is the largest organ of integumentary system. In human being, skin pigmentation (affected by melanin) varies among population and skin type can range from dry to non-dry and from oily to non-oily. In Ayurveda Bhrajak Pitta is responsible for Prabha. Any impairment in Bhrajak Pitta and Vata cause skin diseases. All skin diseases come under Kushta and Shwitra is one of them. Like other types of Kushta, Shwitra is caused due to vitiation of Tridoshas and Dhatus like Ras, Rakta, Mamsa and Meda.[1] In Modern system of medicine similar disease is described as Vitiligo. Vitiligo is a chronic auto immune disorder that causes white lesions on skin. This happens when melanocytes are destroyed causing the skin to turn milky white colour

The effect of prior walking on coronary heart disease risk markers in South Asian and European men.

Purpose: Heart disease risk is elevated in South Asians possibly due to impaired postprandial metabolism. Running has been shown to induce greater reductions in postprandial lipaemia in South Asian than European men but the effect of walking in South Asians is unknown. Methods: Fifteen South Asian and 14 White European men aged 19-30 years completed two, 2-d trials in a randomised crossover design. On day 1, participants rested (control) or walked for 60 min at approximately 50% maximum oxygen uptake (exercise). On day 2, participants rested and consumed two high fat meals over a 9h period during which 14 venous blood samples were collected. Results: South Asians exhibited higher postprandial triacylglycerol (geometric mean (95% confidence interval) 2.29(1.82 to 2.89) vs. 1.54(1.21 to 1.96) mmol·L-1·hr-1), glucose (5.49(5.21 to 5.79) vs. 5.05(4.78 to 5.33) mmol·L-1·hr-1), insulin (32.9(25.7 to 42.1) vs. 18.3(14.2 to 23.7) µU·mL-1·hr-1) and interleukin-6 (2.44(1.61 to 3.67) vs. 1.04(0.68 to 1.59) pg·mL-1·hr-1) than Europeans (all ES ≥ 0.72, P≤0.03). Between-group differences in triacylglycerol, glucose and insulin were not significant after controlling for age and percentage body fat. Walking reduced postprandial triacylglycerol (1.79(1.52 to 2.12) vs. 1.97(1.67 to 2.33) mmol·L-1·hr-1) and insulin (21.0(17.0 to 26.0) vs. 28.7(23.2 to 35.4) µU·mL-1·hr-1) (all ES ≥ 0.23. P≤0.01), but group differences were not significant. Conclusions: Healthy South Asians exhibited impaired postprandial metabolism compared with White Europeans, but these differences were diminished after controlling for potential confounders. The small-moderate reduction in postprandial triacylglycerol and insulin after brisk walking was not different between the ethnicities

OCTraN: 3D Occupancy Convolutional Transformer Network in Unstructured Traffic Scenarios

Modern approaches for vision-centric environment perception for autonomous navigation make extensive use of self-supervised monocular depth estimation algorithms that output disparity maps. However, when this disparity map is projected onto 3D space, the errors in disparity are magnified, resulting in a depth estimation error that increases quadratically as the distance from the camera increases. Though Light Detection and Ranging (LiDAR) can solve this issue, it is expensive and not feasible for many applications. To address the challenge of accurate ranging with low-cost sensors, we propose, OCTraN, a transformer architecture that uses iterative-attention to convert 2D image features into 3D occupancy features and makes use of convolution and transpose convolution to efficiently operate on spatial information. We also develop a self-supervised training pipeline to generalize the model to any scene by eliminating the need for LiDAR ground truth by substituting it with pseudo-ground truth labels obtained from boosted monocular depth estimation.Comment: This work was accepted as a spotlight presentation at the Transformers for Vision Workshop @CVPR 202

A Complete Pathway Model for Lipid A Biosynthesis in Escherichia coli.

Lipid A is a highly conserved component of lipopolysaccharide (LPS), itself a major component of the outer membrane of Gram-negative bacteria. Lipid A is essential to cells and elicits a strong immune response from humans and other animals. We developed a quantitative model of the nine enzyme-catalyzed steps of Escherichia coli lipid A biosynthesis, drawing parameters from the experimental literature. This model accounts for biosynthesis regulation, which occurs through regulated degradation of the LpxC and WaaA (also called KdtA) enzymes. The LpxC degradation signal appears to arise from the lipid A disaccharide concentration, which we deduced from prior results, model results, and new LpxK overexpression results. The model agrees reasonably well with many experimental findings, including the lipid A production rate, the behaviors of mutants with defective LpxA enzymes, correlations between LpxC half-lives and cell generation times, and the effects of LpxK overexpression on LpxC concentrations. Its predictions also differ from some experimental results, which suggest modifications to the current understanding of the lipid A pathway, such as the possibility that LpxD can replace LpxA and that there may be metabolic channeling between LpxH and LpxB. The model shows that WaaA regulation may serve to regulate the lipid A production rate when the 3-deoxy-D-manno-oct-2-ulosonic acid (KDO) concentration is low and/or to control the number of KDO residues that get attached to lipid A. Computation of flux control coefficients showed that LpxC is the rate-limiting enzyme if pathway regulation is ignored, but that LpxK is the rate-limiting enzyme if pathway regulation is present, as it is in real cells. Control also shifts to other enzymes if the pathway substrate concentrations are not in excess. Based on these results, we suggest that LpxK may be a much better drug target than LpxC, which has been pursued most often

Ethnic differences in the association between blood pressure components and chronic kidney disease in middle aged and older Asian adults

10.1186/1471-2369-14-86BMC Nephrology141

Cost-effectiveness of reducing salt intake in the Pacific Islands: protocol for a before and after intervention study

BackgroundThere is broad consensus that diets high in salt are bad for health and that reducing salt intake is a cost-effective strategy for preventing chronic diseases. The World Health Organization has been supporting the development of salt reduction strategies in the Pacific Islands where salt intakes are thought to be high. However, there are no accurate measures of salt intake in these countries. The aims of this project are to establish baseline levels of salt intake in two Pacific Island countries, implement multi-pronged, cross-sectoral salt reduction programs in both, and determine the effects and cost-effectiveness of the intervention strategies.Methods/DesignIntervention effectiveness will be assessed from cross-sectional surveys before and after population-based salt reduction interventions in Fiji and Samoa. Baseline surveys began in July 2012 and follow-up surveys will be completed by July 2015 after a 2-year intervention period.A three-stage stratified cluster random sampling strategy will be used for the population surveys, building on existing government surveys in each country. Data on salt intake, salt levels in foods and sources of dietary salt measured at baseline will be combined with an in-depth qualitative analysis of stakeholder views to develop and implement targeted interventions to reduce salt intake.DiscussionSalt reduction is a global priority and all Member States of the World Health Organization have agreed on a target to reduce salt intake by 30% by 2025, as part of the global action plan to reduce the burden of non-communicable diseases. The study described by this protocol will be the first to provide a robust assessment of salt intake and the impact of salt reduction interventions in the Pacific Islands. As such, it will inform the development of strategies for other Pacific Island countries and comparable low and middle-income settings around the world.<br /

Заболевания щитовидной железы. Диффузный токсический зоб

ЗОБ ДИФФУЗНЫЙ ТОКСИЧЕСКИЙЩИТОВИДНОЙ ЖЕЛЕЗЫ БОЛЕЗН

Tetralogy of Fallot with rheumatic mitral stenosis: A case report

<p>Abstract</p> <p>Introduction</p> <p>Rheumatic and congenital heart diseases account for the majority of hospital admissions for cardiac patients in India. Tetralogy of Fallot is the most common congenital heart disease with survival to adulthood. Infective endocarditis accounts for 4% of admissions to a specialized unit for adult patients with a congenital heart lesion. This report is unique in that a severe stenotic lesion of the mitral valve, probably of rheumatic aetiology, was noted in an adult male with Tetralogy of Fallot.</p> <p>Case presentation</p> <p>An unusual association of rheumatic mitral stenosis in an adult Indian male patient aged 35 years with Tetralogy of Fallot and subacute bacterial endocarditis of the aortic valve is presented.</p> <p>Conclusion</p> <p>In this case report the diagnostic implications, hemodynamic and therapeutic consequences of mitral stenosis in Tetralogy of Fallot are discussed. In addition, the morbidity and mortality of infective endocarditis in adult patients with congenital heart disease are summarized. The risk of a coincident rheumatic process in patients with congenital heart disease is highlighted and the need for careful attention to this possibility during primary and follow-up evaluation of such patients emphasized.</p

Research into the effect Of SGLT2 inhibition on left ventricular remodelling in patients with heart failure and diabetes mellitus (REFORM) trial rationale and design

Background Heart failure (HF) and diabetes (DM) are a lethal combination. The current armamentarium of anti-diabetic agents has been shown to be less efficacious and sometimes even harmful in diabetic patients with concomitant cardiovascular disease, especially HF. Sodium glucose linked co-transporter type 2 (SGLT2) inhibitors are a new class of anti-diabetic agent that has shown potentially beneficial cardiovascular effects such as pre-load and after load reduction through osmotic diuresis, blood pressure reduction, reduced arterial stiffness and weight loss. This has been supported by the recently published EMPA-REG trial which showed a striking 38 and 35 % reduction in cardiovascular death and HF hospitalisation respectively. Methods The REFORM trial is a novel, phase IV randomised, double blind, placebo controlled clinical trial that has been ongoing since March 2015. It is designed specifically to test the safety and efficacy of the SLGT2 inhibitor, dapagliflozin, on diabetic patients with known HF. We utilise cardiac-MRI, cardio-pulmonary exercise testing, body composition analysis and other tests to quantify the cardiovascular and systemic effects of dapagliflozin 10 mg once daily against standard of care over a 1 year observation period. The primary outcome is to detect the change in left ventricular (LV) end systolic and LV end diastolic volumes. The secondary outcome measures include LV ejection fraction, LV mass index, exercise tolerance, fluid status, quality of life measures and others. Conclusions This trial will be able to determine if SGLT2 inhibitor therapy produces potentially beneficial effects in patients with DM and HF, thereby replacing current medications as the drug of choice when treating patients with both DM and HF

Comparison of acromio-axillo-suprasternal notch index with thyromental height test to predict difficult visualization of larynx

Background: Securing and maintaining a patent airway for the conduct of general anesthesia are a major concern for an anesthesiologist. Unanticipated difficult intubation in anesthetized patients is the main cause of morbidity or mortality. Several predictors are proposed to anticipate difficult tracheal intubation, but no predictor is found to be 100% accurate. Acromio-axillo-suprasternal notch index (AASI) is a recent addition to the list of predictors. Aims and Objectives: The current study compared the usefulness of AASI and thyromental height test (TMHT) as predictors of difficult visualization of larynx (DVL). Materials and Methods: Following approval by the Institutional Ethics Committee and CTRI registration, written informed consent was taken. The study was conducted on 300 patients aged 18–65 years belonging to American Society of Anesthesiologists’ physical status I and II, with modified Mallampati (MMP) Scores of 1 and 2, over a period of 6 months. Preoperatively all patient’s airway was evaluated using AASI and TMHT. The DVL during direct laryngoscopy was noted as assessed by Cormack and Lehane grading. We compared the sensitivity and specificity for DVL with regard to AASI and TMHT. Results: The incidence of unanticipated DVL was 14%. The sensitivity, specificity, positive predictive value, and negative predictive value of AASI were 86.4%, 38.1%, 89.6%, and 31.4%, respectively, and for TMHT, they were 94.6%, 4.8%, 85.9%, and 12.5%, respectively. Pearson correlation coefficient was r = −0.068 (P=0.243) when AASI was compared with TMHT. Conclusion: AASI was found to be less sensitive when compared to TMHT and there was statistically no significant correlation between the two parameters to predict the DVL