Continuous wavelet transform on local fields

The main objective of this paper is to define the mother wavelet on local fields and study the continuous wavelet transform (CWT) and some of their basic properties. its inversion formula, the Parseval relation and associated convolution are also studied

DOES RISPERIDONE LONG ACTING INJECTABLE DEPOT (RLAI) REDUCE NUMBER OF ADMISSIONS TO HOSPITAL

Background: Adherence to treatment is a major issue in relapse prevention in schizophrenia. Injectable depot has been claimed to improve non-adherence. A study in the North of England has shown that risperidone long acting injectable form has reduced number of admissions and number of days stayed in hospital. Our study aimed to replicate the previous study in the South of England. Methods: A retrospective study was conducted in the South Essex Foundation University NHS trust. We selected every fifth patient on the Hospital Pharmacy list for risperidone long acting injectable (RLAI). We collected information on. Age, sex, diagnosis and medication ,regular follow up, investigation of each patient which included weight, FBS, S. lipid and hormones at the start of treatment, at three months and six months intervals. We recorded reasons for starting RLAI. Number of antipsychotics prescribed before RLAI, illness duration, number of admissions and days stayed in hospital in each episode before and after RLAI. Patients were included if they stayed for one year or on RLAI. Results: We reviewed 65 case notes. The most common reason for starting RLAI was non compliance. 80% of our sample had the illness for more than five years. Half of them had physical morbidity. After RLAI was commenced there was a significant association with number and length of admissions. Conclusions: We have found an association between prescription of RLAI and reduction in number and length of admission. This needs to be confirmed in a randomised controlled trial

Lessons from diagnosis-prescribing and antibiotic resistance surveillance in Ujjain, India : the lull before the storm

Background: The evolution of antibiotic resistance is a global public health crisis building over decades. In this build-up antibiotic use has been the main driver for antibiotic resistance. To develop context-specific interventions, effective surveillance of antibiotic use and resistance are needed in counties like India, which have witnessed a rapid rise in resistance recently and where the need for effective antibiotics is high. Aim: The main aim of this thesis is to increase the knowledge regarding antibiotic prescribing patterns and prevalence of resistance in an Indian setting, so as to identify targets for interventions aimed to improve clinical practice for common infections. Methods: This thesis includes five cross-sectional studies. Paper I and paper II describes the patterns of antibiotic prescribing for outpatients with suspected infectious aetiology and among admitted patients, respectively. The defined daily doses (DDDs) were calculated per 1000 patients per diagnosis considered in paper I. Focus of infection specific DDDs were calculated per 100 patient days in paper II. In paper III, prescriptions for children with diarrhoea were analysed for adherence to treatment guidelines and factors associated with adherence were explored. In paper IV healthy children were screened for nasal carriage of S. aureus to identify factors associated with nasal carriage and to describe the resistance patterns. Paper V describes the antibiotic susceptibility pattern of pathogens isolated from patients with suspected infections. Antibiotic susceptibility testing was performed by Kirby-Bauer diskdiffusion method. All the studies were done using structured, pilot tested questionnaires. Results: Overall antibiotic prescribing was 66.3%, 3732 out of 5623 outpatients (Paper I) and 92%, 5531 out of 6026 admitted patients (Paper II). Quinolones were the most frequently prescribed antibiotic group among outpatients and third generation cephalosporins among the admitted patients (Paper I and II). For diarrhoea in children only 6 out of 843 prescriptions adhered completely to treatment guidelines. Oral rehydration solution (ORS) was prescribed for 58%, ORS with zinc for 22% and antibiotics for 71% of the cases (Paper III). The prevalence of nasal carriage of S. aureus was 98 out of 1562 i.e. 6.3% (95% confidence interval [CI] 5.1-7.5). Of these, 16.3% were methicillin-resistant S. aureus (MRSA). Overcrowding was associated with nasal carriage of S. aureus (Paper IV). Among pathogens (n=716) isolated form admitted patients (n=2568), Gram-negative pathogens predominated (62%). Extendedspectrum β-lactamase (ESBL) production in E. coli isolates (n=149) was 69% (95% CI 61.6–76.6) and in K. pneumoniae isolates (n=107), 41% (95% CI 31.6–50.5). MRSA constituted 30% of all S. aureus isolates (n=221). Conclusions: The targets identified for interventions were: high antibiotic prescribing rates for diarrhoea (Paper I, II and III) and upper respiratory tract infection (Paper I). Other targets include, longer than recommended duration of prophylaxis (86% of 1846 patients) and lack of distinction between prophylaxis and therapy among surgical patients, irrational antibiotic prescribing in gastroenteritis, overuse of quinolones and lack of use of penicillin in pneumonia, overuse of quinolones and lack of use of doxycycline and macrolides in genital infections, and overreliance on antibiotics in treating skin and soft tissue infections (Paper II). The high rate of antibiotic prescribing among admitted patients together with the high rates of ESBL producing pathogens shows urgent need to curb antibiotic use when there is no indication for it (Paper V)

Clinical efficacy of Panchatikta Kshira Basti in the management of Gridhrasi

The study was undertaken to evaluate the clinical efficacy of Panchatikta Kshira Basti in the management of Sciatica. Panchatikta Kshira Basti contains Guduchi (Tinospora cardiofolia). Nimba (Azadirakta indica) Vasa (Adhathoda vasica), Kantakari (Solanum Surrattense), Patola (Trichosanthes dioica), Kshira (Milk) Goghrita (Ghee), Madhu (Honey), Saindhava (Salt). This remedy prove extremely beneficial as it can be performed on the OPD and IPD basis, gives significant relief in the symptoms e.g. radiating pain, stiffness, twitching sensation. The subjective parameters like Pain, SLR, VAD, VDS etc., were used to score clinical outcome. The average clinical improvement was calculated by proper statistical treatment. Our experience with this modality has been encouraging as the response pattern is good in considerably short duration of treatment. The patient improves gradually after 4 weeks of treatment. The sustained improvement with Basti presents a window of opportunity in the clinical management of Sciatica. Ideally this technique should be practically taught to the physicians and should be evaluated scientifically using principles of biophysics and nerve conduction studies