CLINICAL COMPARATIVE STUDY IN THE MANAGEMENT OF KASHTARTAVA W.S.R. PRIMARY DYSMENORRHOEA WITH RUTUKARI VATI AND KUMARYASAVA

Adolescence is the rapid growing period when mainly the physical changes are important. 95% girls attain menarche at the age group of 10 to 16 yrs, the peak being 13yrs. Among them, not less than 50% of female are said to experience some discomfort or pain in relation to menstruation. Kashtartava is a symptom mentioned in various Yoni vyapads, Vata being the main causative factor for this condition, which is commonly compared with dysmenorrhoea by cotemporary science. Conventional treatment of primary dysmenorrhoea consists of non-steroidal and anti-inflammatory drugs, hormonal therapy which causes unwanted side effects. Hence Rutukari Vati which is mentioned in Bheshaja Samhita for Kashtartava having the properties like, Vedanashamaka, Arthavajanana have been selected for the planned study. Design of Study: A Single blind comparative clinical study of two groups, trial and control, consisting of 15 subjects in each with pre-test and post-test design. Group A was given Rutukarivati and Group B was given Kumaryasava 25ml twice daily after food. Result: Rutukarivati contains most of the drugs with Tiktha and Katu rasa, Usnaveerya property and Vatakaphahara property; it is effective in controlling pain and regularizing the cycle. On comparison of overall effect of both groups has more significant result but percentage wise group A is more effective than group B. Mild increase in amount of bleeding was noted in patients in group A. It may be because of most of the ingredients in Rutukarivati are Artavajanana and Apanavatashaman. &nbsp

The SPTPoL extended cluster survey

We describe the observations and resultant galaxy cluster catalog from the 2770 deg2 SPTpol Extended Cluster Survey (SPT-ECS). Clusters are identified via the Sunyaev-Zel'dovich (SZ) effect and confirmed with a combination of archival and targeted follow-up data, making particular use of data from the Dark Energy Survey (DES). With incomplete follow-up we have confirmed as clusters 244 of 266 candidates at a detection significance ξ ≥ 5 and an additional 204 systems at 4 4 threshold, and 10% of their measured SZ flux. We associate SZ-selected clusters, from both SPT-ECS and the SPT-SZ survey, with clusters from the DES redMaPPer sample, and we find an offset distribution between the SZ center and central galaxy in general agreement with previous work, though with a larger fraction of clusters with significant offsets. Adopting a fixed Planck-like cosmology, we measure the optical richness-SZ mass (l - M) relation and find it to be 28% shallower than that from a weak-lensing analysis of the DES data-a difference significant at the 4σ level-with the relations intersecting at λ = 60. The SPT-ECS cluster sample will be particularly useful for studying the evolution of massive clusters and, in combination with DES lensing observations and the SPT-SZ cluster sample, will be an important component of future cosmological analyses

Surgical site infections after emergency hernia repair: substudy from the Management of Acutely Symptomatic Hernia (MASH) study

Introduction Acutely symptomatic abdominal wall and groin hernias (ASH) are a common acute surgical presentation. There are limited data to guide decisions related to surgical repair technique and use of antibiotics, which can be driven by increased risk of surgical site infection (SSI) in this group. This study aims to report rates of SSI following ASH repair and explore the use of patient-reported outcome measure reporting in this setting. Methods An 18-week, UK-based, multicentre prospective cohort study (NCT04197271) recruited adults with ASH. This study reports operatively managed patients. Data on patient characteristics, inpatient management, quality of life, complications, and wound healing (Bluebelle score) were collected. Descriptive analyses were performed to estimate event rates of SSI and regression analysis explored the relationship between Bluebelle scores and SSI. The 30 and 90-day follow-up visits assessed complications and quality of life. Results The MASH study recruited 273 patients, of whom 218 were eligible for this study, 87.2 per cent who underwent open repair. Mesh was used in 123 patients (50.8 per cent). Pre- and postoperative antibiotics were given in 163 (67.4 per cent) and 28 (11.5 per cent) patients respectively. There were 26 reported SSIs (11.9 per cent). Increased BMI, incisional, femoral, and umbilical hernia were associated with higher rates of SSI (P = 0.006). In 238 patients, there was a difference in healthy utility values at 90 days between patients with and without SSI (P = 0.025). Also, when analysing 191 patients with Bluebelle scores, those who developed an SSI had higher Bluebelle values (P < 0.001). Conclusion SSI is frequent in repair of acutely symptomatic hernia and correlates with BMI and site of hernia

Circumstances and Consequences of Falls in Community-Living Elderly in North Bangalore Karnataka

Background: Falls are one of the causes of injuries and non-communicable diseases associated with old age. Falls lead to 20-30% of mild to severe injuries and are underlying cause of 10-15% of all emergency departments. Knowledge of the circumstances and consequences of falls is important for understanding the etiology and prevention of falls. Material and Methods: A community based cross sectional study was conducted for a period of one year. Complete enumerations of all the elderly were undertaken by house-to-house visit and a sample of 416 elderly was taken by simple random sampling. A pretested semistructured questionnaire was administered. Data was analyzed using SPSS version 17.Results: Prevalence of falls was 29.8 %, about 82.3% of the old had a single episode of fall, 17.7% had recurrent falls in a year. The fall rate was higher 65.7% among old, 26.3% in young old and 20.0% in very old, outdoor falls constituted 57.2%, indoor falls 42.8%. About 81.4% had one or the other form of injury. Injury rate was 82% in females and 80% in males. Statistically significant higher fall rate of 47.8% falls was seen with elderly who had fear of falling than those without fear of fall with 11.8%. Bruises, internal injuries were commonest (48.5%) and (13.8%) of injuries resulted in fractures.18.4% had difficulty in carrying out activities of daily living, deformity was observed in 12.6%, and residual disability in 10.6% of the elderly. Conclusion: The morbidity due to falls includes injuries, fractures, restricted mobility. The results of this study reflect on the circumstances observed in the indoor and outdoor falls like falls on the footpath, in the bathroom, while using stairs etc. The consequences like bruises and internal injuries followed by sprains, cuts and fractures have been observed. The study suggests possible ways of preventing falls

Methods to enhance the quality of bi-level origin–destination matrix adjustment process

The quality of Origin–Destination matrix (OD) estimation depends on number of factors including the selection of appropriate upper-level function of bi-level formulation, constraints to the OD flows, and suitable solution algorithm. Addressing these aspects, the study first explored different upper-level formulations using two types of traffic information: traffic counts and sub-path flows. Second, it investigated the effects of OD constraints on the quality of solution. Third, it proposed modified genetic algorithm (MGA) to address the computational limitations of traditional genetic algorithm (GA). The study findings were as follows: a) Using symmetric mean absolute percentage error (SMAPE) to match traffic counts showed greater improvements in the OD quality; b) The estimates improved as more number of OD pairs were known to have a-priori knowledge about their flows with higher confidence levels; c) The MGA approach outperformed GA in terms of computational efficiency, and gradient descent (GD) in terms of solution quality.</p