Protective Role of Herbal Drugs in Diabetic Neuropathy: An Updated Review

Medicinal plants play a beneficial role in health care and are commonly used in preventing and testing diseases and specific ailments. The advantage associated with herbals plants are numerous and cannot be ignored as they have less adherence issues and are accepted widely by the population due to greater belief in Ayurveda since ancient times. Neuropathic pain has immersed as a serious threat to patient that occurs by damaging the blood vessels leading to morbidity and mortality. The present review paper aims in providing an account of various herbal plants that could be employed in treatment of neuropathic pain

Electrical Flows for Polylogarithmic Competitive Oblivious Routing

Oblivious routing is a well-studied paradigm that uses static precomputed routing tables for selecting routing paths within a network. Existing oblivious routing schemes with polylogarithmic competitive ratio for general networks are tree-based, in the sense that routing is performed according to a convex combination of trees. However, this restriction to trees leads to a construction that has time quadratic in the size of the network and does not parallelize well. In this paper we study oblivious routing schemes based on electrical routing. In particular, we show that general networks with $n$ vertices and $m$ edges admit a routing scheme that has competitive ratio $O(\log^2 n)$ and consists of a convex combination of only $O(\sqrt{m})$ electrical routings. This immediately leads to an improved construction algorithm with time $\tilde{O}(m^{3/2})$ that can also be implemented in parallel with $\tilde{O}(\sqrt{m})$ depth.Comment: ITCS 202

Human Chorionic Gonadotropin Influences Systemic Autoimmune Responses

Immunopathological outcomes in Systemic Lupus Erythematosus (SLE; or lupus) are believed to be autoantibody-mediated. Conditions which promote a Th2 skew (such as pregnancy) should encourage antibody production, worsening antibody-mediated diseases while ameliorating Th1/Th17-mediated diseases. Although an increased propensity toward autoreactivity can be observed in pregnant lupus patients and in pregnant lupus-prone mice, whether a unique human pregnancy-specific factor can contribute to such effects is unknown. This study assessed whether human chorionic gonadotropin (hCG, a pregnancy-specific hormone of diverse function) at physiological concentrations could mediate stimulatory influences on immune parameters in non-pregnant, lupus-prone mice, in light of the hormone's ameliorating effects on Th1-mediated autoimmunity in murine models. Results demonstrate that administration of hCG heightened global autoreactivity in such mice; antibodies to dsDNA, RNP68, Protein S, Protein C, β2-glycoprotein 1, and several phospholipids were enhanced, and hormone administration had adverse effects on animal survival. Specifically in splenic cell cultures containing cells derived from lupus-prone mice, hCG demonstrated synergistic effects with TLR ligands (up-modulation of costimulatory markers on B cells) as well as with TCR stimuli (enhanced proliferative responses, enhanced levels of cytokines, and the phosphorylation of p38). In both instances, enhanced synthesis of lupus-associated cytokines was observed, in addition to the heightened generation of autoantibodies reactive toward apoptotic blebs. These results suggest that selective transducive, proliferative, and differentiative effects of hCG on adaptive immune cells may drive autoreactive responses in a lupus environment, and may also potentially provide insights into the association between the presence of higher hCG levels (or the administration of hCG) with the presence (or appearance) of humoral autoimmunity

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Prevalence of Anemia in Children of Rural Population of Northern State of India

Introduction: India carries the highest burden of anemia, particularly in children and women. Children at the grow ing stage are at the risk of nutrition depletion, hence anemia. Fewer data are available on the prevalence of anemia in growing children of age 10-14 years. It is important to intervene early and track this group. The objective of the present study was to estimate the prevalence of anemia and its correlation to age, gender and body mass index in children of rural area of Ghaziabad, Uttar Pradesh, India. Method: Total 600 children of 5-13 years age group were included in this study. A detailed questionnaire was used to collect the health details of the children and socioeconomic status of the parents. Hemoglobin was determined by the calibrated Hemoglobin analyzer. Body mass index values were calculated based on the measurements of weight and height of the children. Results: Prevalence of anemia as per WHO standards in these children was 57.67%. Results of the study population reveal that anemia in this region is more prevalent in girls (68%) when compared to boys (47.3%). However, associa tion between body mass index and hemoglobin was not statistically significant in the present study. Conclusions: Our results suggest that increased prevalence of anemia in the children of rural area is associated with multiple nutrient deficiencies. Nutritional interventions, evaluation of predisposing risk factors and increased coverage of supplementation programme are recommended measures that can be adopted to control anemia in children.Introducción: India soporta la mayor carga de anemia, especialmente en niños y mujeres. Hay menos datos disponibles sobre la prevalencia de anemia en niños en crecimiento de 10 a 14 años. Es importante intervenir temprano y rastrear a este grupo. El objetivo del presente estudio fue estimar la prevalencia de anemia y su correlación con la edad, sexo e índice de masa corporal en niños del área rural de Ghaziabad, Uttar Pradesh, India. Método: Se incluyó un total de 600 niños de entre 5 y 13 años. Se utilizó un cuestionario detallado para recopilar datos de salud de los niños y el estado socioeconómico de los padres. Se midió peso talla y se calculó el índice de masa corporal. Se midió la hemoglobina mediante analizador calibrado. Resultados: La prevalencia de anemia según los estándares de la OMS en estos niños fue de 57,67%. Los resultados revelan que la anemia en esta región es más prevalente en las niñas (68%) en comparación con los niños (47,3%). Sin embargo, la asociación entre el índice de masa corporal y la hemoglobina no fue estadísticamente significativa en el presente estudio. Conclusiones: Nuestros resultados sugieren que el aumento de la prevalencia de anemia en los niños del área rural está asociado con múltiples deficiencias de nutrientes. Las intervenciones nutricionales, la evaluación de los factores de riesgo predisponentes y una mayor cobertura del programa de suplementación son medidas recomendadas que se pueden adoptar para controlar la anemia en los niños

Implementation of Secure Authentication Mechanism for LBS using best Encryption Technique on the Bases of performance Analysis of cryptographic Algorithms

ABSTRACT Today's location-sensitive service relies on user's mobile device to determine its location and send the location to the application. With the growth of the importance and of the audience of location-base

Formulation and Evaluation of Orodispersible Tablets Containing Co-Crystals of Modafinil

Background: Modafinil is a CNS stimulant used to treat Narcolepsy, sleepiness and other disorders related to sleep. It is a BCS class II drug having poor aqueous solubility. Objective: This study was aimed to formulate and evaluate orodispersible tablets of containing co-crystals of Modafinil for the improvisation of critical attributes of the product such as dissolution rates, solubility and oral bioavailability. Methods: Co-crystals were prepared by dry grinding method using Sodium acetate, Nicotinic acid, Benzoic acid, Urea and Succinic acetate as co-formers. Tablets were compressed by using direct compression method using SSG, Crospovidone, and Croscarmellose sodium as super disintegrants in different concentration. Results: Pre-formulation studies were performed and evaluation of prepared co-crystals revealed that Co-crystals formulated with sodium acetate showed best results. The manufactured orodispersible tablets were evaluated for different parameters including weight variation, hardness, thickness, friability, drug content, In-vitro disintegration and In-vitro dissolution studies. Formulation F2 shows significant change in dissolution rate and also helped to increase the solubility of poorly water soluble drugs and both of them i.e. solubility and percentage of drug release are the key factors to exhibit the efficiency of the drug. Formulation of co-crystal with sodium acetate in 1:1 ratio showed highest drug content (97.97%), while Benzoic acid in ratio 1:2 showed least drug content (56.48%). Conclusion: According to the result obtained, an orodispersible tablet containing co-crystals of modafinil enhances the dissolution rate, solubility and hence increases the therapeutic efficacy and could be considered convenient oral delivery systems to enhance the drug bioavailability. Keywords: Co-crystal, Oro-dispersible, Sodium acetate, Narcolepsy, Sleepines