Oxygen requirements in multisystem inflammatory syndrome in children admitted in tertiary care hospital of North India

Background: Study was aimed to describe the oxygen requirements among children admitted as multisystem inflammatory syndrome in children (MIS-C) in Indira Gandhi Medical College, Shimla.Methods: We conducted a cross-sectional study, from January 2021 to July 2021, in the pediatric ward of Indira Gandhi Medical College (IGMC), Shimla. Children admitted with a diagnosis of MIS-C were included. Data regarding socio-demographic factors and oxygen requirements were extracted and analyzed using Epi Info V7 software.Results: A total 31 children diagnosed as MIS-C were included. Tachypnea was present in 18 (58.1%) respiratory distress in 15 (48.4%). Optimal oxygen saturation (SpO2) more than 94% in 9 (25.8%), 93-94% in 8 (25.8%), 91-92% in 5 (16.1%), 86-90% in 2 (6.5%), 81-85% in 4 (12.9%), 75-80% in 1 (3.2%), 71-75% in 1 (3.2%) and <60% in 1 (3.2%). Oxygen at the rate of 2 l/min in 1 (3.2%), 3 l/min in 2 (6.5%), 4 l/min in 1 (3.2%), 5 l/min in 5 (16.1%) and 10 l/min in 9 (29.0%), was given through nasal prong in 1 (3.2%), Venturi mask in 3 (9.7%), NRM in 7 (22.6%) and mechanical ventilation in 7 (22.6%). Duration was for 2 days in 4 (12.9%), for 3 days in 7 (22.6%), for 4 days in 3 (9.7%), for 7 days in 1 (3.2%), for 10 days in 1 (3.2%), for 11 days in 1 (3.2%) and for 13 days in 1 (3.2%). Ventilatory support was given to 7 (22.6%), for 4 days in 2 (6.5%), for 7 days in 2 (6.5%), for 10 days in 1 (3.2%), for 11 days in 1 (3.2%) and for 13 days in 1 (3.2%).Conclusions: Oxygen is a crucial component of MIS-C therapy, children, observing a dip in SpO2 level should immediately start oxygen therapy

Quantifying primaquine effectiveness and improving adherence: a round table discussion of the APMEN Vivax Working Group.

The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Diary Thesis of a Software Developer with a focus on Azure DevOps

This diary thesis documents the daily progress of a software developer working in a multinational Information Technology services provider for the course of eight weeks. The entries written each day consist of two parts, one written at the start of the day and the second written at the end of the day. At the start of the day the author mentions all the possible tasks the author aims to finish, and at the end of the day the entries explain whether the tasks were finished or not and how the author managed to do the same. After the week, the author analyses her working and what she learned throughout the week. The thesis is written during the first professional experience of the author in the field of cloud technologies. For this reason, Azure and cloud technologies are a new subject to the author that adds to the challenge of working with DevOps. Another issue that came up was that the project ended two weeks after the thesis started. The author manages to overcome these challenges by reading more about Azure DevOps and practicing the learnings. Recording the daily tasks helped the author to understand the progress made in the eight weeks of writing the thesis. This, moreover, helped the author recognize how to improve the daily work as well as the overall productivity

Women’s needs, women’s action: toilet development in urban and rural communities of india

The desire for the toilet, one of the most basic of facilities, is expressed by many throughout India, especially women. Sixty-six percent of the urban population either do not have access to a toilet at all or must rely on bucket latrines (Pathak, p. 5). Ninety percent of the rural villages of India have no access to a toilet (Pathak, p. 4). The lack of availability of proper toilet amenities hits women the hardest in both the urban and rural sectors of India. In urban cities, workplaces, schools, and recreational areas are inadequately supplied with toilet facilities for women. Often, women must walk for kilometers before they can find proper amenities. This situation is even worse in rural areas where not only is supply limited but women, as the care-takers of the latrines, must transport water from long distances to clean facilities or dispose of waste where no toilets exist.However, there is another side to the toilet situation in India. It is one that is drastically different from the images above. It is the story of female empowerment and control of a technology to better their social positions and to build healthier communities for themselves and their families. Ironically, this empowerment stems from traditional gender roles that delineate the practices mentioned above. For example, since the women are the main caretakers of water and sanitation facilities, their role and participation assumes great significance in revolutionizing the construction, engineering, and overall availability of toilets in their societies. The women of India have turned a major obstacle, the lack of toilets, into a means of community and political empowerment. They have proven to the government of India and multinational organizations, such as the World Bank, that their expertise in toilet management is invaluable. Without their input, agencies, both governmental and non-governmental, would spend valuable resources building ineffective and unusable facilities; as proof of this three percent of latrines constructed by the government, World Bank projects, or foreign non-governmental organizations without these women’s consultation are actually usable as toilets (Paramasivan, p. 2).Specific cultural attitudes intertwined with religious beliefs and a history of colonialism and failed aid attempts have created a unique developmental discourse prevalent throughout India. This is exemplified by the technology of the toilets. These women’s humble plight to build toilets to serve their communities is challenging established western discourses defining who can be labeled a scientist or an engineer. Through their control of the toilet technology in their communities, these Indian women are showing how lay people of many cultures have valuable ideas and skills to offer the fields of science and technology.M.S., Science, Technology, and Society -- Drexel University, 200

Evaluation of the sailent features in Indian currency notes

Security features are topographies invisible to the naked eye, such as micro-printing or features visible in ultraviolet, transmitted, and oblique light. The present paper focuses on the examination of Indian currency notes such as 2000, 500, 200, 100, 50, 20, and10 in different light sources and with the help of a compound microscope. This kind of examination is very useful when it comes to distinguishing counterfeit currency from genuine one. Crime is increasing day by day, and so is the making of false currency – this study discusses the numerous security or hidden features which are invisible to the naked eye, and therefore may very well be missed by the potential perpetrator. It is the responsibility of the government along with the issuing authority to incorporate these structures into all travel and security documents, including passports, voter-id cards, and many others. These features are implemented either during the manufacturing of the paper itself (e.g., fluorescent fibres) or at the time of printing (e.g., microprinting, watermarks, and other fluorescent features)

A Voice-Activated Mobility Wheelchair Powered by Solar Energy

&lt;p&gt;A smart wheelchair gives a person independence and ease. A smart wheelchair is a mechanically driven vehicle that can be easily operated by the user's hand for self-mobility. As a result, using the wheelchair's wheels requires less effort from the user. Additionally, this makes it possible for people who are physically or visually handicapped to go from one location to another. Only the movement of the person's hands will allow the wheelchair to travel forward, backward, left, and right, even if the person's body is completely or partially paralyzed. The wheelchair and the person can communicate wirelessly. In order to operate the experimental version of our system, a joystick that is attached to a NodeMCU transmitter is used to control the wheelchair. The wheelchair can also be controlled via voice instructions sent over Bluetooth from the Dabble smartphone application. In order to move the wheels in response to user input, the L298n motor driver needs help from the joystick signals and voice commands supplied to the receiver NodeMCU. The L298n that sits in between the microcontroller and the wheels aids in converting the voltage needed to operate the wheels.&lt;/p&gt;&lt;p&gt;Keywords:- ESP32 Microcontroller, ESP8266 Microcontroller, NodeMCU, L298n Motor Driver, Dabble App, IR Sensor, Obstacle Detection.&lt;/p&gt