A Combined Dual Leader and Relay Node Selection for Markov Cluster Based WSN Routing Protocol

The major challenge in Wireless Sensor Networks (WSNs) is to increase the node’s lifespan and decrease energy utilization. To avoid this issue, many Clustering Routing Protocols (CRPs) have been developed, where Cluster Head (CH) in each cluster accumulates the data from each other node and transfers it to the sink through Relay Nodes (RNs). But both CHs and RNs dissipate more energy to aggregate and transfer data. As a result, it is vital to choose the appropriate CHs and RNs concurrently to reduce energy utilization. Hence, this article proposes a Weighted Markov Clustering with Dual Leader and Relay node Selection based CRP (WMCL-DLRS-CRP) in WSNs. This protocol aims to lessen energy dissipation during inter- and intra-cluster communication. Initially, a Markov Clustering (MCL) algorithm is applied by the sink to create nodes into clusters based on a threshold distance. Then, a dual leader selection scheme is proposed to elect dual CHs in each cluster according to the node weighting factor that considers the node’s remaining energy, the distance between CHs and sink, the distance among all nodes, and abundance. Also, an RN selection scheme is proposed to choose the appropriate RNs based on a new Predicted Transmission Rate (PTR) factor. Moreover, the elected RNs transfer the data from the CHs to the sink, resulting in a tradeoff between the node’s energy utilization and lifetime. At last, extensive simulations illustrate that the WMCL-DLRS-CRP achieves better network performance compared to the existing protocols

A Novel Design of Hybrid Monopole Rectangular Microstrip Antenna for WLAN and Wi-MAX Applications

This article describes a novel design and development of hybrid monopole rectangular microstrip antenna (HMRMSA) for WLAN and Wi-MAX applications. This antenna operates for the frequency range of2.07 to 6.72 GHz and showing a impedance bandwidth of 145%. The antenna structure consists of hybrid triangular shape model. At the bottom surface a partially ground plane is placed to achieve single wideband. The proposed antenna is fabricated using low cost FR4 substrate material. The antenna is excited through 50 ? microstrip line. The simulated and experimental results are demonstrates which are in good agreement with each other.The proposed antenna satisfies the -10dB impedance bandwidth requirements tocovering WLAN and Wi-MAX applications

UNDERSTANDING THE CONCEPT OF VIKRUTHI VISHAMA SAMVETHA

Ayurveda is a science with holistic approach in the management of different diseases. Dravya is the entity which has been given with prime importance for its role in the prevention and treatment of different ailments. Generally Dravya act according to Rasa, Guna, Virya and Vipaka. In some other conditions the action of Dravya cannot be expressed or explained with the help of Rasa, Guna, Virya and Vipaka. Diseases will be manifested because of the involvement of single Dosha or in combination with other Dosha or all three together. It will be easy to understand the symptomatology of Ekadoshaja Vyadhi but situation will be little typical and difficult to understand in case of two (Samsargaja) or three (Sannipataja) Dosha involvement in few diseases like Sannipataja Jwara. In such conditions concept of Vikruthi Visama Samavetha is helpful. In this paper an effort will be made to understanding the concept of Vikruthi Visama Samavetha

Analysis of medication errors in medicine ward of medical college teaching hospital, Mandya

Background: Medication errors are one of the most common types of medical error that is seen in hospitalised patients. Since medication error is one of the growing concerns of healthcare issue and have implications on patient safety, the purpose of this study was to identify medication error and in turn would help to create awareness among healthcare professionals and provide safety to the patients.Methods: Study was initiated after obtaining approval from the Institutional Ethics Committee. The study was done for a period of 1 year between June 2016 and May 2017. Clinical data and data regarding the medication that was prescribed, transcribed, dispensed, administered was collected and was analysed for various types of medication errors during the different stages of medication use process.Results: A total of 351 subjects were recruited in the study for assessing medication error. About 2,283 drugs were prescribed among 351 patients. Maximum number of drugs was administered through parenteral route (50.3%). Medication error was most common during the prescribing stage (51.4%) followed by transcribing stage (39.1%), administration stage (6.9%), and dispensing stage (2.6%). On an average 6 drugs were prescribed per patient. Total of about 5411 errors have occurred out of which 98.8% of errors were preventable, 1.2% of errors were non-preventable. Cardiovascular system (21.9%) and endocrine and renal system (21.9%) was commonly affected due to the medication errors.Conclusions: Medication errors are one of the commonest problems of the healthcare system should be identified and documented and their causes should be studied in order to develop systems that minimize the recurrence

Comparative antioxidant and antimicrobial studies of cold and hot bark hydromethanolic extract of Couroupita guianensis Aubl

Couroupita guianensis, known by its common name as cannon ball tree, belongs to Lecythidaceae family, native of south and central America, India and Sri lanka. It’s been in use in traditional medicine and worshipped as sacred tree in india. With the importance of tree in various medicinal aspects as per the reports the present investigation was carried to access the phytochemical components, free radical scavenging and antimicrobial activity of cold and hot hydromethanolic extracts from the barks of medicinally important Couroupita guanensis. Phytochemical screening revealed the presence of total antioxidants, flavonoids, phenols and phytosterols in both cold and hot extracts. Quantitative estimations of the phytochemicals revealed the presence of high contents of total antioxidant activity (598.4 µg/ml), phenol content activity of (417.52 µg/ml) and phytosterols of (133.92 µg/ml) in cold hydromethanolic extracts compared to the hot hydromethanolic extract. The presence of high flavonoid content (417.52 µg/ml) was recorded in hot extract compared to the cold extract. Hot extract gave more scavenging activity with IC50 value (33.5 µg/ml). ABTS radical scavenging activity was found to be more in cold extract with IC50 values (24. µg/ml). Antimicrobial assay showed activity with B. cereus (13.00±0.00mm) and S.aureus (15.00±0.00mm) bacteria showed maximum zone of inhibition compared to the hot extract whereas C. albicans (13.00±O.00mm) showing maximum zone of inhibition compared to the cold extract and was not sensitive to any other fungal forms tested. This investigation pays way to consider Couroupita guianensis, with highly potential antioxidant and antimicrobial components, be used in pharmaceutical companies for the development of phytomedicine for the therapy and treatments

Adolescent Neuroblastoma of Lower Limb

Neuroblastoma is an embryonic tumour of neural crest origin, commonly seen in children with upper abdomen involvement. Rarely neuroblastomas present in adolescents and adults involving lower limb. Histopathologically neuroblastoma of lower limb can be confused with other small round cell tumour especially with Ewing’s sarcoma and rhabdomyosarcoma. A 16 year old male presented with 15x11cm swelling, pain and multiple discharging sinuses of right leg since 4 months. Routine haematological and biochemical analysis were within normal limits. Radiology of right leg showed large soft tissue swelling encompassing the pathological fracture of tibia and bowing of fibula. Fine needle aspiration of the swelling revealed malignant small round cell tumour. Histopathology revealed poorly differentiated neuroblastoma of lower limb. The immunohistochemistry of Synaptophysin and Chromogranin were positive and CD 99 was negative. Neuroblastoma diagnosed at unusual site with uncommon age has poor prognosis. Hence, one must keep in mind the differential diagnosis of neuroblastoma as one of the differential diagnosis in evaluating the soft tissue tumours of lower limb

Antibiotic Stewardship Implementation and Antibiotic Use at Hospitals With and Without On-site Infectious Disease Specialists.

BackgroundMany US hospitals lack infectious disease (ID) specialists, which may hinder antibiotic stewardship efforts. We sought to compare patient-level antibiotic exposure at Veterans Health Administration (VHA) hospitals with and without an on-site ID specialist, defined as an ID physician and/or ID pharmacist.MethodsThis retrospective VHA cohort included all acute-care patient admissions during 2016. A mandatory survey was used to identify hospitals' antibiotic stewardship processes and their access to an on-site ID specialist. Antibiotic use was quantified as days of therapy per days present and categorized based on National Healthcare Safety Network definitions. A negative binomial regression model with risk adjustment was used to determine the association between presence of an on-site ID specialist and antibiotic use at the level of patient admissions.ResultsEighteen of 122 (14.8%) hospitals lacked an on-site ID specialist; there were 525 451 (95.8%) admissions at ID hospitals and 23 007 (4.2%) at non-ID sites. In the adjusted analysis, presence of an ID specialist was associated with lower total inpatient antibacterial use (odds ratio, 0.92; 95% confidence interval, .85-.99). Presence of an ID specialist was also associated with lower use of broad-spectrum antibacterials (0.61; .54-.70) and higher narrow-spectrum β-lactam use (1.43; 1.22-1.67). Total antibacterial exposure (inpatient plus postdischarge) was lower among patients at ID versus non-ID sites (0.92; .86-.99).ConclusionsPatients at hospitals with an ID specialist received antibiotics in a way more consistent with stewardship principles. The presence of an ID specialist may be important to effective antibiotic stewardship

Antibiotic stewardship implementation and patient-level antibiotic use at hospitals with and without on-site Infectious Disease specialists.

Many US hospitals lack Infectious Disease (ID) specialists, which may hinder antibiotic stewardship efforts. We sought to compare patient-level antibiotic exposure at Veterans Health Administration (VHA) hospitals with and without an on-site ID specialist, defined as an ID physician and/or ID pharmacist. This retrospective VHA cohort included all acute-care patient-admissions during 2016. A mandatory survey was used to identify hospitals' antibiotic stewardship processes and their access to an on-site ID specialist. Antibiotic use was quantified as days of therapy (DOT) per days-present and categorized based on National Healthcare Safety Network definitions. A negative binomial regression model with risk adjustment was used to determine the association between presence of an on-site ID specialist and antibiotic use at the level of patient-admissions. Eighteen of 122 (14.8%) hospitals lacked an on-site ID specialist; there were 525,451 (95.8%) admissions at ID hospitals and 23,007 (4.2%) at non-ID sites. In the adjusted analysis, presence of an ID specialist was associated with lower total inpatient antibacterial use [OR 0.92, (95% CI, 0.85-0.99)]. Presence of an ID specialist was also associated with lower use of broad-spectrum antibacterials [OR 0.61 (95% CI, 0.54-0.70)] and higher narrow-spectrum beta-lactam use [OR 1.43 (95% CI, 1.22-1.67)]. Total antibacterial exposure (inpatient plus post-discharge) was lower among patients at ID versus non-ID sites [OR 0.92 (95% CI, 0.86-0.99)]. Patients at hospitals with an ID specialist received antibiotics in a way more consistent with stewardship principles. The presence of an ID specialist may be important to effective antibiotic stewardship