Influenza in Vulnerable Populations

Influenza is a ubiquitous virus that results in thousands of deaths annually, particularly in those vulnerable to it. Vulnerability is manifested in two different scenarios: when the whole population becomes susceptible, such as when resistant or rare strains start to predominate; and in the individual prone to infection, such as those at the extremes of age, from colonised populations, or with chronic disease. The first three chapters address situations that have population impact. Chapter 1 reviews literature on oseltamivir-resistance. Circulating strains are largely receptive to oseltamivir, but recently resistant strains have predominated, highlighting the need for alternative strategies. Chapter 2, a randomized controlled trial, shows no clinical or virological advantage to doubling the standard dose of oseltamivir. Chapter 3 reviews the application of polyclonal antibodies to neglected diseases like avian influenza with promising results as to safety and immunogenicity. The latter chapters focus on those who are demographically at risk. Chapter 4 asks which antiviral strategies work best to prevent and manage influenza outbreaks in aged care facilities. A protocol is proposed for treatment alone versus treatment plus prophylaxis. Obtaining participation consent is an unresolved issue. In Chapter 5, oseltamivir pharmacokinetics in infants is presented with sparse published data. Results support current dose recommendations. Chapter 6 examines among Indigenous Australians the intersection of a higher rate of both chronic disease and of severe influenza during the 2009 pandemic. The first age-standardised national analysis of government-collected data is included. With no clear correlation, results suggest effects of colonisation other than disease are responsible for higher influenza rates

Hybrid Approach for Heart Disease Detection Using Clustering and ANN

Data mining is a process of extracting data from data set and transforming it into understandable structure for further use. Data mining techniques have been applied magnificently in many fields including business, science and bio informatics, and on different types of data like textual, visual, spatial, and real-time and sensor data. Heart disease prediction is treated as most difficult task in the field of medical sciences. Heart disease detection using data mining can answer complicated queries for diagnosing heart disease and thus assist healthcare practitioners to make intelligent clinical decisions which traditional decision support systems cannot. By providing effective treatments, it also helps to reduce treatment costs. The aim of this study is to develop an artificial neural networks-based diagnostic model for heart disease using a complex of traditional and genetic factors of this disease

Evaluation of the plantar fascia in patients with diabetes mellitus : the role of sonoelastography

Purpose: It has been postulated that hyperglycaemic non-enzymatic glycation of proteins with subsequent accumulation of glycosylated end-products in tissues like the plantar fascia (PF) contributes to the development of foot ulcers in diabetics. The present study evaluates the spectrum of sonoelastographic findings in the plantar fascia in patients with type 2 diabetes mellitus (DM). Material and methods: A total of 81 patients and 32 healthy volunteers were included in the study. PF thickness was registered 1 cm distal to the attachment at the calcaneus. Greyscale ultrasonographic examination was followed by strain elastography of the PF based on which PF were qualitatively categorized into 3 grades (hard, intermediate, soft) depending on their predominant colour. Results: Patients were found to have thicker PF than healthy volunteers (p < 0.0001). Grade 2 (intermediate elasticity) PF was the most common type seen in both groups (48.44% of healthy volunteers and 57.25% of patients). However, a greater number of patients (36.64%) had grade 3, i.e. soft PF as compared to healthy volunteers (9.38%). Conclusions: To conclude, there is thickening and softening of the PF in patients with type 2 DM, supporting the hypo thesis that diabetes-induced changes occur in the tissues of the foot

Scavenging and metal chelating potential of Carthamus tinctorius L. extracts

Carthamus tinctorius leaves were extracted with methanol and distilled water. The extracts were evaluated for their potential free radical scavenging capacity using four different in vitro methods (DPPH, metal chelation, radical removal and hydrogen peroxide scavenging methods). The total phenolic content obtained for aqueous (112. 2±1.708 GAE mg/g) and for methanolic extract (89.66±2.00 GAE mg/g). In DPPH, IC50 values was found to be 176.66±2.08 and 278.33±1.52 and 310.33±1.52 for the ascorbic acid, aqueous and methanolic extract respectively. In superoxide radical scavenging IC50&nbsp;values are 381.27±1.43, 544.42±2 and 606.78±3.02 µg/ml for the ascorbic acid, aqueous and methanolic extract respectively. In the metal chelating activity, IC50 values are 385.94±3.00, 337±1 and 487±0.984 µg/ml for the EDTA, aqueous extract and methanolic extract respectively. In hydrogen peroxide scavenging, IC50 values were 261±1, 278±3.52 and 370±1 µg/ml for the ascorbic acid, aqueous extract and methanolic leaf extract of Carthamus tinctorius respectively. The correlation suggests that phenolic compounds are responsible for the antioxidant activities of leaves

EFFICACY OF AN AYURVEDIC INTERVENTION IN THE MANAGEMENT OF URETERIC CALCULI: A CASE STUDY

Urinary calculi is one of the most common and painful urological disorder of the urinary tract affecting 10-12 % of the population. It is characterized by frequent micturition, intermittent pain occasionally radiates to flanks, sweating and restlessness during the pain. Most of the patients taking allopathic medicine but calculi was not expel or crushed from the urinary tract. Endoscopic procedures such as ureterostomy, percutaneous nephrolithiotomy and extracorporeal shockwave lithotripsy or other surgical procedures is the treatment of choice in case of ureteric calculi in the conventional system. Non-invasive and safe study had designed for the management of this entity. In the present study, An Ayurvedic intervention Chandraprabha Vati (500 mg ) and Swetparpati (250 mg) along with decoction of natural herbs 30 ml twice in a day for 90 days used for ureteric calculi. The response to the treatment is encouraging by symptoms relief and through lower abdomen ultrasonography (USG). Ureteric calculi has expel from the tract through this management.

Assessment of total phenolic content and antioxidant potentiality of selected Indian folk medicinal plants by spectrophotometric method

Natural antioxidant capacity of five important folk medicinal plants measured in vitro. Total phenolic content (TPC), flavonoid content (FC) and free radical scavenging capacity of ethanolic, methanolic and aqueous leaf extracts of Lippia alba (LA), Annona squamosa (AS), Hyptis suaveolens (HS), Commiphora wightii (CW) and Milletia pinnata (MP) was assessed using spectrophotometric method. Folin ciocalteu and aluminium chloride method employed to optimise TPC and FC. Free radical scavenging potentiality of leaf extracts was assessed using Ferrous ion chelation (FIC), 2, 2'-diphenyl-1-picrylhydrazyl (DPPH•) scavenging, Hydroxyl (OH•) radical scavenging (HRS) and Superoxide (O- 2) radical scavenging (SRS) methods. Results revealed that the TPC (96.22±5.85 to 519.23±34.90 ?g GAE/gm dry weight) were found significant in aqueous extracts from all the plants except AS (p&lt;0.05). For FC (?g QCE/gm dry weight), ethanol was found optimum for LA (463.94±6.49), CW (289.99±2.70) and MP (347.47±4.50) whereas, aqueous was found more appropriate for rest two plants were found significant instead of ethanol and methanol (all p&lt;0.05). The lowest IC50 (?g/ml) were recorded from A. squamosa (27.72±8.95), H. suaveolens (27.78±0.88), C. wightii (27.18±0.16) and M. pinnata (27.30±0.03). All plants have reflected a high antioxidant capacity; however, the highest antioxidant activity was reported from ethanolic extract of H. suaveolens followed by L. alba, A. squamosa, C. wightii and M. pinnata. Hence, these studies show that all folk medicinal plants contain potential antioxidant bioactive compounds

Tuberculous Aortic Root Abscess in a child: A case report

Although tuberculous aortitis is fairly common in adults, tuberculous mycotic aneurysm of aorta is rare withinvolvement of aortic root being very uncommon. The diagnosis depends on a combination of clinical criteria,including persistent fever and bacteraemia and echocardiographic confirmation. Because of the rarity of aorticroot abscess in children, there is no consensus on a treatment strategy. We describe a 10-year-old male whopresented with fever, abdominal pain and headache, and was found to have disseminated tuberculosis and aorticroot abscess with mycotic aneurysm. Due to the presence of evidence of tuberculosis elsewhere in the body(multiple tuberculomas in brain, granulomas in liver, lichen scrofulosorum over abdomen), therapy with antituberculousdrugs was started to which the patient responded partially, but later died suddenly at home

A REVIEW ON OVERVIEW OF WORLDWIDE INTEROPERABILITY FOR MICROWAVE ACCESS (WIMAX) INNOVATION AND ITS FUTURE UTILIZATIONS

This paper introduces the elements of the Worldwide Interoperability for Microwave Access (WiMAX) innovation and future utilizations of WiMAX. It is a connection oriented wireless network that assures Quality of Service (QoS) for all users in the network. By comparing WiMAX with the popular Wi-Fi, 3G and LTE in the market, it analyzes the current situation and future development trend of WiMAX in terms of the difference in technology and applications. WiMAX will become the most prominent technology for Broadband Wireless Access (BWA). The next generation WMAN networks, using the WiMAX as the core technology is evolving as a 4G technology for providing ubiquitous computing solutions. In not a similar way like wireless LANs, WiMAX networks integrate various QoS mechanism at the Media Access Control (MAC) level for secured service for voice, data and video. The unique architecture of the WiMAX MAC and PHY layer that uses OFDMA to allocate multiple channels with different modulation schemes. A few references have been incorporated towards the completion of this paper for those eager to know in brief about certain points

Our experience with liver and spleen elastography in the prediction of oesophageal varices

Background: Variceal bleeding is an important cause of mortality in patients with chronic liver disease (CLD). The gold standard for detection and grading of oesophageal varices (EV) is upper gastrointestinal endoscopy. However, it is expensive, time-consuming and invasive. Objectives: This study aimed to find any association between splenic shear wave velocity (SWV) measured by acoustic radiation force imaging (ARFI) and the presence of EV. Method: The quasi-experimental study included 50 patients with CLD and 50 subjects without CLD as the control group. Both underwent upper abdominal ultrasonography followed by elastographic assessment on a Siemens Acuson S2000TM ultrasound system. A comparison of the findings was made between the control and patient groups. Results: Both groups had similar hepatic size while patients with CLD had larger splenic size and area (p  0.05). The CLD patients had higher mean hepatic and splenic SWV compared with the control group (p  0.05). The mean splenic size and splenic SWV were higher in patients with varices than in those without varices (p  0.05). Conclusion: Chronic liver disease causes significant increase in liver and splenic stiffness with splenic SWV values being higher for patients with varices emphasising the role of elastography as a non-invasive predictor for the presence of EVs. Splenic SWV had the highest sensitivity and specificity, which was augmented by a combination of hepatic and splenic SWV. Thus, splenic SWV alone or in combination with hepatic SWV is a useful technique for prediction of the presence of EVs. Contribution: This study aims to find an alternative non-invasive and cost-effective technique for screening of EV

Morphology of Atmospheric Particles over Semi-Arid Region (Jaipur, Rajasthan) of India: Implications for Optical Properties

The regional dust morphology and spectral refractive indices (RIs; governed by hematite, Fe2O3 content at short wavelengths) are key elements for ascertaining direct radiative forcing of mineral dust aerosols. To provide morphological features of background mineral dust from a semi-arid zone in the vicinity of the Thar Desert, we carried out an expedition to the Jaipur city during late winter of 2012. Morphological analysis reveals the predominance of "Layered", "Angular" and "Flattened" particles, while the frequency distribution of a total of 235 dust particles shows the aspect ratio, AR and circularity parameter, CIR (measures of particle's non-sphericity) typically similar to 1.4 and similar to 0.8, respectively. Sensitivity analysis at 550 nm wavelength reveals the equivalent sphere model may underestimate Single Scattering Albedo, SSA for the dust with low (similar to 1.1%) hematite by similar to 3.5%. Both underestimation (by similar to 5.6%) and overestimation (up to 9.1%) are probable in case of dust with high hematite content (similar to 5.68%). In addition, the effect of AR on the dust scattering is significant in case of dust with high hematite content. More such regionally representative dust morphological data are required for better estimation of regional radiative forcing of mineral dust aerosols