THE COMBINED EFFECT OF VARABHRIHATYADI KASHAYA AND SARAPUNKHA LEPA IN CHRONIC TONSILLITIS IN CHILDREN

Children with the clinical features of Chronic Tonsillitis coming under the age group 3-12 years were included in the study. The patients were randomly allocated in to the study group and control group using simple random sampling technique. In the study group the dose of Varabrihatyadi Kashaya was fixed as follows, in the age group 3-6 years: 10ml bd before food, in the age group 6-9 years: 20ml bd before food, in the age group 9-12 years: 30ml bd before food. Sarapunkha lepa was applied around the neck where enlarged lymph nodes were found. Frequency of paste was fixed as two times daily and at each time, it is kept until it becomes dry. At the same time those in the control group were subjected to external application of Sarapunkha lepa only. Both the groups were followed for a period of 1 month after the scheduled course of intervention. Routine blood investigations were also carried out before and after the study. The data were analyzed using the most appropriate statistical tests. Significant changes were obtained in the clinical parameters in the study group used for assessment such as recurrent attacks of sore throat, pain in the throat, pain on swallowing, difficulty in swallowing, halitosis, mouth breathing, hoarseness of voice, chocking spells at night, size of the tonsil, congestion of pillars, oedema of the uvula, deviation of the uvula and lymph node enlargement. There was a significant change in the routine blood investigations also. Moreover the trial drug sustained its potential action even during the follow up period. The effect of control drug was insignificant. The final evaluation proved that combination of Varabhrihathyadi Kashaya and Sarapunkha lepa was effective in reducing the signs and symptoms of Chronic Tonsillitis in children of 3-12 yrs age group

Phase ambiguity of the threshold amplitude in pp -> pp\pi^0

Measurements of spin observables in pp -> {\vec p}{\vec p}\pi^0 are suggested to remove the phase ambiguity of the threshold amplitude. The suggested measurements complement the IUCF data on {\vec p}{\vec p} -> pp\pi^0 to completely determine all the twelve partial wave amplitudes, taken into consideration by Mayer et.al. [15] and Deepak, Haidenbauer and Hanhart [20].Comment: 4 pages, 1 table

Non-normality and nonlinearity in thermoacoustic instabilities

Analysis of thermoacoustic instabilities were dominated by modal (eigenvalue) analysis for many decades. Recent progress in nonmodal stability analysis allows us to study the problem from a different perspective, by quantitatively describing the short-term behavior of disturbances. The short-term evolution has a bearing on subcritical transition to instability, known popularly as triggering instability in thermoacoustic parlance. We provide a review of the recent developments in the context of triggering instability. A tutorial for nonmodal stability analysis is provided. The applicability of the tools from nonmodal stability analysis are demonstrated with the help of a simple model of a Rjike tube. The article closes with a brief description of how to characterize bifurcations in thermoacoustic systems

Patterns of Treatment for Psychiatric Disorders Among Children and Adolesecents in Mississippi Medicaid

The nature of services for psychiatric disorders in public health systems has been understudied, particularly with regard to frequency, duration, and costs. The current study examines patterns of service reception and costs among Medicaid-covered youth newly diagnosed with anxiety, depression, or behavioral disturbance in a large data set of provider billing claims submitted between 2015–2016. Eligibility criteria included: 1) identification of an initial diagnosis of a single anxiety, unipolar mood, or specific behavioral disorder; 2) continuous Medicaid eligibility over the duration of the time period studied; and 3) under 18 years of age on the date of initial psychiatric diagnosis. The final cohort included 7,627 cases with a mean age of 10.65 (±4.36), of which 58.04% were male, 57.09% were Black, 38.97% were White, and 3.95% were of other ethnicities. Data indicated that 65.94% of the cohort received at least some follow-up services within a median 18 days of diagnosis. Of those, 54.27% received a combination of medical and psychosocial services, 32.01% received medical services only, and 13.72% received psychosocial services only. Overall median costs for direct treatment were $576.69, with wide discrepancies between the lowest (anxiety =$308.41) and highest (behavioral disturbance = $653.59) diagnostic categories. Across all categories the frequency and duration of psychosocial services were much lower than would be expected in comparison to data from a well-known effectiveness trial. Overall, follow-up to psychiatric diagnosis could be characterized as highly variable, underutilized, and emphasizing biomedical treatment. Understanding more about these patterns may facilitate systematic improvements and greater cost efficiency in the future

AYURVEDIC MANAGEMENT OF UNEXPLAINED INFERTILITY- A CASE STUDY

Infertility is a condition in which successful pregnancy has not occurred, despite normal intercourse over 12 months. The cause of female infertility is multifactorial. Ayurveda assures normal pregnancy by proper maintenance of Garbha Samgraha samagris and normalcy of mind. All the causes of female infertility come under the imbalance of Garbha Samgraha Samagri and mind factors. In this case report patient suffered from primary infertility since six years, after allopathic consultation came for ayurvedic treatment. From detailed history involvement of vitiated Vatha, Agnimandhya and stressful mind was noticed. She was treated with Chiruvilwadi kashayam, Dhanwantharam gulika, Jeerakarishtam, Kumaryasavam and Manasamithravatakam for one month.  Took follicular study on next cycle and revealed post ovulatory status on 16th day of cycle. Advised Phalasarpis, Dhanwantharam Gulika and Manasamithravatakam for two weeks. Patient came with positive urine pregnancy test after one week of missed period. The line of treatment followed in this case was to maintain Agni, normalize Vatha and assure proper health to mind. During the second half of the cycle Garbhasthapana medicines were administered. Patient took Dhanwantharam gulika and phalasarpis throughout the first trimester along with regular ante natal check up. Continued Dhanwantharam gulika up to 36 weeks and started Sukhaprasavagritham upto delivery from 36 weeks onwards. She delivered a female baby on 06.05.2018

A prospective analytical study comparing the effectiveness of Mannheim Peritonitis Index, APACHE-II and P- Possum in predicting the mortality of patients with perforative peritonitis.

This is a prospective analytical study done on 50 patients with perforative peritonitis in Govt Rajaji Hospital, Madurai. The objective of the study was to analyse Mannheim Peritonitis Index, APACHE-II and p-POSSUM by comparing Discriminatory ability, Positive predictive value, Sharpness of prediction and Reliability of prediction. Online calculators were used to calulate risk of mortality and statistical analysis was done with SPSS Version 15 for Windows. It was found that APACHE-II had the best positive predictive value, and discriminatory ability followed by p-POSSUM and MPI. APACHE-II also had the best positive predictive value followed by p-POSSUM and MPI. None of the scores had a very good sharpness and they were quite reliable in predicting the risk of mortality

समुद्रातील पिंजऱ्यात करावयाच्या मत्स्यशोतिसाठी स्थळ आणि प्रजाती यांची निवड

Cage culture is an utilisation of existing water bodies with little or no economic costs. The selection of a suitable site for a cage farm is indispensible for their effective function, particularly in relation to proper water quality within the cage and reduced environmental impacts around the cage and for the economic viability of the cage farm. The natural tolerance of species should be studied for assessment of suitable site

Various nonlinear models and their identification, equalization and linearization

System identification is a pre-requisite to analysis of a dynamic system and design of an appropriate controller for improving its performance. The more accurate the mathematical model identified for a system, the more effective will be the controller designed for it. The identification of nonlinear systems is a topic which has received considerable attention over the last two decades. Generally speaking, when it is difficult to model practical systems by mathematical analysis method, system identification may be an efficient way to overcome the shortage of mechanism analysis method. The goal of the modeling is to find a simple and efficient model which is in accord with the practical system. In many cases, linear models are not suitable to present these systems and nonlinear models have to be considered. Since there are nonlinear effects in practical systems, e.g. harmonic generation, intermediation, desensitization, gain expansion and chaos, we can infer that most control systems are nonlinear. Nonlinear models are more widely used in practice, because most phenomena are nonlinear in nature. Indeed, for many dynamic systems the use of nonlinear models is often of great interest and generally characterizes adequately physical processes over their whole operating range. Thus, accuracy and performance of the control law increase significantly. Therefore, nonlinear system modeling is much more important than linear system identification. We will deal with various nonlinear models and their processing

Do Formulation and Dose of Long-Term Opioid Therapy Contribute to Risk of Adverse Events among Older Adults?

Background: Chronic non-cancer pain (CNCP) is highly prevalent in older adults and long-term opioid therapy (LTOT) has been used to manage chronic pain. However, the safety of LTOT among older adults with CNCP is not well-established and there is a need to identify therapy-related risk factors of opioid-related adverse events among older adults. Objective: To evaluate the relationship between opioid dose and formulation and the risk of opioid-related adverse events among Medicare-eligible older adults on LTOT. Design: Nested case-control study. Participants: Older Medicare beneficiaries (N=35,189) who received \u3e 3 opioid prescriptions with a total days-supply of \u3e45 days within a 90-day period for CNCP between 2012 and 2016. Main Measures: This study utilized Medicare 5% medical and prescription claims data. Outcome measures included opioid-induced respiratory depression (OIRD), opioid overdose, all-cause mortality, and a composite outcome, defined as the first occurrence of any of the previous three events. Key independent variables were opioid formulation and opioid dose (measured in morphine milligram equivalents (MME)) prescribed during LTOT. Key Results: Seventy-four OIRD, 133 overdose, 982 all-cause mortality, and 1122 composite outcome events were observed during follow-up. In unadjusted analyses, the use of combination opioids (OR: 4.52 [95%CI: 1.51–13.47]) was significantly associated with OIRD compared to short-acting (SA) opioids. In adjusted analyses, opioid-related adverse events were significantly associated with the use of LA (overdose OR: 13.00 [95%CI: 1.30–130.16] and combination opioids (overdose OR: 6.27 [95%CI: 1.91–20.55]; mortality OR: 2.75 [95%CI: 1.87–4.04]; composite OR: 2.82 [95%CI: 2.01–3.96]) when compared to SA opioids. When compared to an average dose of less than 20 MME, outcomes were significantly associated with doses of 20–50 MME (mortality OR: 1.61 [95%CI: 1.24–2.10]; composite OR: 1.59 [95%CI: 1.26–2.01]) and \u3e50 MME (mortality OR: 1.99 [95%CI: 1.28–3.10]; composite OR: 2.09 [95%CI: 1.43–3.04]). Conclusions: Older adults receiving medically prescribed opioids at higher doses and those using LA and combination of LA and SA opioids are at increased risks for opioid-related adverse events, highlighting the need for close patient supervision