A Comprehensive Review on Dry Eye Disease: Diagnosis, Medical Management, Recent Developments, and Future Challenges

Dry eye syndrome (DES) or keratoconjunctivitis sicca (KCS) is a common disorder of the tear film caused by decreased tear production or increased evaporation and manifests with a wide variety of signs and symptoms. The present review from interpretation of the literature gives detailed information on the prevalence, definition, causes, diagnostic tests, and medical management of dry eye disease. A number of systems contribute to the physiological integrity of the ocular surface and disruption of system may or may not produce symptoms. Therefore accurate diagnosis of dry eyes with no or minimal disruption of physiological function is necessary. The paper also discusses different colloidal drug delivery systems and current challenges in the development of topical ophthalmic drug delivery systems for treatment of KCS. Due to the wide prevalence and number of factors involved, newer, more sensitive diagnostic techniques and novel therapeutic agents have been developed to provide ocular delivery systems with high therapeutic efficacy. The aim of this review is to provide awareness among the patients, health care professionals, and researchers about diagnosis and treatment of KCS and recent developments and future challenges in management of dry eye disease

HOLISTIC APPROACH OF AYURVEDA IN THE MANAGEMENT OF EKA-KUSHTHA W. S. R. TO PSORIASIS - A CASE STUDY

Skin is the largest organ which reflects the both healthy and diseased condition of the body. According to ancient Ayurved samhitas, all the skin diseases are categorized under Kushtha roga. In modern world, skin has greater cosmetic importance leading to boost the confidence and personality of an individual as well as to attain the healthy mindset. The morbid condition of the skin should be treated earlier as it may attain Krichrasadhya or even Asadhya avastha also. Ancient Acharyas have been explained in detail the Panchakarma accompanying with variety of Shamana aushadhis and Sthanika chikitsa to treat the Kushtha rogas. In the present case study, a 37 years old female patient having symptoms resembling to Eka kushtha was treated with combine use of ancient Ayurvedic treatment protocols viz., Nidana parivarjana, Shodhana chikitsa, Shamana aushadhis and Sthanika chikitsa together with Pathyapathya. The assessment of Lakshanas was done by using WHO guidelines for Kushtha. This comprehensive approach of Ayurveda to treat the Eka kushtha helps to achieve the significant relief in symptoms of the patient

An Assessment of Accessibility and Connectivity of Some Important Places in Kolhapur City of Maharashtra: A Road Network Analysis

There are various methods to find out the accessibility and connectivity of road networks. The method that used to determine the accessibility and connectivity is quantitative or qualitative; sometime it includes both quantitative and qualitative aspects of transportation network. The degree to which any place is served by transportation network (on which it stands) defines the accessibility of that place. And the connectivity is the ratio between total number of arcs and total number of nodes in transportation network. The connectivity is directly proportional to the total number of arcs and inversely proportional to the total number of nodes. If the degree of connectivity within a transportation network is higher; then it means that transportation system will be more efficient. Therefore, the present paper attempts to access the accessibility and connectivity of road networks in Kolhapur city. The accessibility of study area is determined by the shortest path matrix. The connectivity is determined by the beta (?) index given by K.J. Kansky. After analyzing the accessibility and connectivity of study area, easily accessible and shortest paths are also suggested in order to reach the important centers very easily

Efficacy of Ayurvedic multidimentional therapy in Darunaka - A Case Study

Ancient Acharyas have stated that ‘Shira’ is one among the ‘Dashapranayatana’ and it is very much important to protect the ‘Shira’ from any external and internal trauma as all sensory organs or Indriyas are located here. Darunaka is a condition affecting the Shirotwaka and hair and it is commonly encountered in a clinical practice. It affects almost everyone mostly in the adult life. Dryness, itching, scaling of the scalp along with hair-fall are the cardinal symptoms of this disease involving mainly vitiated Vata and Kapha Doshas. In modern dermatological practice, there is no any satisfactory remedy for this irritating disorder. Hence, many patients are looking with a hope towards Ayurveda. In the present case study, a 22 years old female patient having symptoms of Darunaka was treated with Ayurvedic Chikitsa. The combine effect of Shodhana Chikitsa and Shamana Aushadhis along with Sthanika Chikitsa in the form of Lepa and Dhavana were advocated and at the same time, Nidana Parivarjana was strictly followed. The assessment of symptoms of the disease was done with the help of gradation index of symptoms of Darunaka. There was significant relief in all the complaints of patient within a period of two months

Impact of Subthalamic Deep Brain Stimulation Frequency on Upper Limb Motor Function in Parkinson's Disease

BACKGROUND: Whilst changes in the frequency of subthalamic deep brain stimulation (STN-DBS) have been proposed to improve control of tremor or axial motor features in Parkinson's disease (PD), little is known about the effects of frequency changes on upper limb motor function, particularly bradykinesia. OBJECTIVE: To investigate the acute effects of various STN-DBS frequencies (40-160 Hz, 40 Hz intervals) on upper limb motor function. METHODS: We carried out a randomised, double-blind study on 20 PD patients with chronic STN-DBS using the Simple and Assembly components of the Purdue Pegboard (PP) test and a modified upper limb version of the UPDRS-III (UL-UPDRS-III). RESULTS: There was no significant effect of frequency on bradykinesia on the Simple PP task or the UL-UPDRS-III. There was an effect of frequency on the Assembly PP score when comparing all frequencies (p = 0.019) and between 80 Hz and 130 Hz (p = 0.007), with lower frequencies yielding a better performance. Rigidity and Tremor scores were significantly reduced with higher (>80 Hz) compared to lower (40 Hz) frequencies. CONCLUSIONS: Our findings suggest that a wide range of frequencies are efficacious in improving acute upper-limb motor function. Reducing the frequency of stimulation down to 80 Hz is safe and has a similar clinical effect to higher frequencies. Therefore, a wider range of frequencies are available when it comes adjusting patients' acute settings without the risk of worsening bradykinesia

Sink mechanism for significantly low level of ozone over the Arabian Sea during monsoon

Measurement of surface ozone over the Arabian Sea during the southwest monsoon season (June-September) of 2002 has shown an unusually low level of ozone with an overall average of 9 nmol/mol. Such a low level of ozone could not be explained by simulations using a three-dimensional chemistry transport model, Model for Ozone and Related Tracers (MOZART), which accounts for the known processes of advective transport and includes a standard photochemical mechanism. Thus, for the Arabian Sea region, we propose for the first time that destruction of ozone by reactive halides released from sea salt aerosols is the sink mechanism which played a crucial role in ensuring the significantly low ozone level over the Arabian Sea. Theoretical calculations constrained by observations have shown that, on average, ozone losses due to catalytic action of halogens and due to photolysis plus chemical reaction amount to 2.15 nmol mol-1d-1 and 4.64 nmol mol-1d-1, respectively

Demographics and the Cost of Pharmaceuticals in a Private Third-Party Prescription Program

Objective: To compare variance in the cost of pharmaceuticals attributable to demographic variables with variance explained by plan characteristics, using prescription claims data within various therapeutic categories, and to examine differences in average cost of pharmaceuticals among demographic variables after controlling for covariates. Design: Retrospective, cross-sectional study. Data Collection: Data for this study were obtained from 1996 prescription claims information for the commercial population administered by a Rhode Island-based pharmacy benefit management (PBM) company. Six therapeutic categories with the highest expenditures were analyzed. Information on claims for six drug categories was extracted using database management software. Statistical analyses using multiple regression and analysis of covariance were carried out. Results: Plan characteristics outperformed demographic variables sixteenfold for all drug categories combined in explaining variance in cost of pharmaceuticals among plan enrollees. Average cost of pharmaceuticals differed among demographic variables such as age, gender, location, and place of employment after controlling for average wholesale price and days supply. Conclusions: The results obtained in this study have practical significance in the determination of capitation rates when utilization history of prospective members is not available. In this situation, managed care organizations (MCOs) or PBMs may have to set capitation rates based solely on eligibility data. Significant differences in average drug costs among the members based on place of employment suggest that benefit managers should consider differentiating capitation rates according to their clients\u27 businesses. Finally, the data from this study indicated that commercial members residing in Tennessee had the lowest average cost of pharmaceuticals among all states evaluated. The fact that one PBM manages more than 80% of the TennCare prescription program along with a significant commercial client base suggests that a spillover effect may exist

Thermodynamic properties and structural stability of thorium dioxide

Using density functional theory (DFT) calculations, we have systematically investigated the thermodynamic properties and structural stabilities of thorium dioxide (ThO$_2$). Based on the calculated phonon dispersion curves, we calculate the thermal expansion coefficient, bulk modulus, and heat capacities at different temperatures for ThO$_2$ under the quasi-harmonic approximation. All the results are in good agreement with corresponding experiments proving the validity of our methods. Our theoretical studies can help people more clearly understand the thermodynamic behaviors of ThO$_2$ at different temperatures. In addition, we have also studied possible defect formations and diffusion behaviors of helium in ThO$_2$, to discuss its structural stability. It is found that in intrinsic ThO$_2$ without any Fermi energy shifts, the interstitial Th$_i^{4+}$ defect other than oxygen or thorium vacancies, interstitial oxygen, and any kinds of Frenkel pairs, is most probable to form with an energy release of 1.74 eV. However, after upshifting the Fermi energy, the formation of the other defects also becomes possible. For helium diffusion, we find that only through the thorium vacancy can it happen with the small energy barrier of 0.52 eV. Otherwise, helium atoms can hardly incorporate or diffuse in ThO$_2$. Our results indicate that people should prevent upshifts of the Fermi energy of ThO$_2$ to avoid the formation of thorium vacancies and so as to prevent helium caused damages.Comment: 11 pages, 11 figure

Web Document Clustering Using Document Index Graph

Document Clustering is an important tool for many Information Retrieval (IR) tasks. The huge increase in amount of information present on web poses new challenges in clustering regarding to underlying data model and nature of clustering algorithm. Document clustering techniques mostly rely on single term analysis of document data set. To achieve more accurate document clustering, more informative feature such as phrases are important in this scenario. Hence first part of the paper presents phrase-based model, Document Index Graph (DIG), which allows incremental phrase-based encoding of documents and efficient phrase matching. It emphasizes on effectiveness of phrase-based similarity measure over traditional single term based similarities. In the second part, a Document Index Graph based Clustering (DIGBC) algorithm is proposed to enhance the DIG model for incremental and soft clustering. This algorithm incrementally clusters documents based on proposed clusterdocument similarity measure. It allows assignment of a document to more than one cluster. The DIGBC algorithm is more efficient as compared to existing clustering algorithms such as single pass, K-NN and Hierarchical Agglomerative Clustering (HAC) algorithm