Efficacy of topical recombinant epidermal growth factor as compared to Povidone Iodine on chronic diabeic foot ulcers

Background: Diabetic foot ulcer is a common surgical complication in patient of diabetes mellitus. It is the most frequent reason for hospitalization for patients with diabetes. Still the ideal material for dressing is not known.  This study has been conducted to compare the efficacy of topical application of Povidone- Iodine with recombinant epidermal growth factor in  chronic diabetic foot ulcers of size 5 to 10 cm2. Methods: Diabetic foot ulcers which were non-healing for more than 3 months were  randomized into two groups of 30 each. Clinical examination of the ulcer and limb was  done. Ischemic ulcers, ulcers with gangrene or associated osteomyelitis were excluded. One group  had received Povidone iodine  (Betadine 10% solution) soaked dressing while other group was dressed with  Recombinant Epidermal Growth Factor gel (Eugraf 150 mcg gel) dressing  twice weekly for 12 weeks. At the end of twelve weeks ulcers were assessed for healing. Results:There were total 60 cases from Jan 2014 till Dec 2014. Age range from 45 to 70 yrs (mean age 55 yrs). There were 45 males and 15 females (M: F:  3:1).  The ulcers were developed  most commonly in foot in 48 patients ( 80%) followed by  in lower leg around ankle in 06 patients ( 10%)  and in 10 % of cases involved foot and leg both.  Six (20%) patients on Povidone- Iodine dressing group showed complete wound healing while 23 (76%) patients on recombinant epidermal growth factor dressing group showed complete wound healing. Dressing with recombinant epidermal growth factor is the more effective than Povidone iodine dressing (P<. 001). Average healing time for complete healing for completely healed ulcers was 11 weeks in  Povidone-Iodine Dressing and 8 weeks in Recombinant epidermal growth factor  dressing group. Conclusion: Recombinant epidermal growth factor dressing is the significantly effective dressing in comparison to Povidone-Iodine in diabetic foot  non healing ulcers of size 5 to 10 cm in size. Average time of complete healing of diabetic foot  non healing ulcers is less with topical application of Recombinant epidermal growth factor  soaked dressing as compared to Povidone – Iodine dressings

Concept of a system for Addressing Bad Publicity in Social Media Using Knowledge in Business Process Models

In this work in progress research paper we describe a concept of a computerized system which can help in addressing the issue of bad publicity on blogs posted on platforms such as tumblr or wordpress, twitter, facebook and/or other public internet forums such as CNET. There are three parts to solve the problem. First, identifying and searching the web for such comments and creating a bag of words from every such comment. Second, creating an index of words occurring on process models and assign them weightage in different process models based on their frequency of occurrence. Third, to create an association between the bag of words derived from the comment and the process models using the index of words. Once the comment is associated to process model it can be directed to the process model owner for appropriate action. Thus knowledge inside the process models is used for directing the complaints towards relevant executives. This invention can also help in other similar uses such as software maintenance, automated process support, help desk etc where requests in natural language can be automatically assigned to relevant person based on their job description or process description or process map

Annotated Speech Corpus for Low Resource Indian Languages: Awadhi, Bhojpuri, Braj and Magahi

In this paper we discuss an in-progress work on the development of a speech corpus for four low-resource Indo-Aryan languages -- Awadhi, Bhojpuri, Braj and Magahi using the field methods of linguistic data collection. The total size of the corpus currently stands at approximately 18 hours (approx. 4-5 hours each language) and it is transcribed and annotated with grammatical information such as part-of-speech tags, morphological features and Universal dependency relationships. We discuss our methodology for data collection in these languages, most of which was done in the middle of the COVID-19 pandemic, with one of the aims being to generate some additional income for low-income groups speaking these languages. In the paper, we also discuss the results of the baseline experiments for automatic speech recognition system in these languages.Comment: Speech for Social Good Workshop, 2022, Interspeech 202

Concurrent variations of median and musculocutaneous nerves and their clinical correlation – a cadaveric study

Variations of median nerve, musculocutaneous nerve and their communicating branches are of interest for anatomists and surgeons. These variations may be vulnerable to damage in surgical procedures. We examined median nerve and musculocutaneous nerve concurrently in 58 cadavers, i.e. 116 superior extremities, and found median nerve innervating muscle of the anterior compartment of arm in the absence of musculocutaneous nerve in 11.2% superior extremities, splitting of median nerve in the arm into median nerve proper and musculocutaneous nerve in 5.12% superior extremities, and communication between median and musculocutaneous nerves in 20.7% superior extremities. Knowledge of such anatomical variations is helpful for surgeons treating neoplasm or repairing trauma

Morpho-biochemical characterization of a RIL population for seed parameters and identification of candidate genes regulating seed size trait in lentil (Lens culinaris Medik.)

The seed size and shape in lentil (Lens culinaris Medik.) are important quality traits as these influences the milled grain yield, cooking time, and market class of the grains. Linkage analysis was done for seed size in a RIL (F5:6) population derived by crossing L830 (20.9 g/1000 seeds) with L4602 (42.13 g/1000 seeds) which consisted of 188 lines (15.0 to 40.5 g/1000 seeds). Parental polymorphism survey using 394 SSRs identified 31 polymorphic primers, which were used for the bulked segregant analysis (BSA). Marker PBALC449 differentiated the parents and small seed size bulk only, whereas large seeded bulk or the individual plants constituting the large-seeded bulk could not be differentiated. Single plant analysis identified only six recombinant and 13 heterozygotes, of 93 small-seeded RILs (<24.0 g/1000 seed). This clearly showed that the small seed size trait is very strongly regulated by the locus near PBLAC449; whereas, large seed size trait seems governed by more than one locus. The PCR amplified products from the PBLAC449 marker (149bp from L4602 and 131bp from L830) were cloned, sequenced and BLAST searched using the lentil reference genome and was found amplified from chromosome 03. Afterward, the nearby region on chromosome 3 was searched, and a few candidate genes like ubiquitin carboxyl-terminal hydrolase, E3 ubiquitin ligase, TIFY-like protein, and hexosyltransferase having a role in seed size determination were identified. Validation study in another RIL mapping population which is differing for seed size, showed a number of SNPs and InDels among these genes when studied using whole genome resequencing (WGRS) approach. Biochemical parameters like cellulose, lignin, and xylose content showed no significant differences between parents and the extreme RILs, at maturity. Various seed morphological traits like area, length, width, compactness, volume, perimeter, etc., when measured using VideometerLab 4.0 showed significant differences for the parents and RILs. The results have ultimately helped in better understanding the region regulating the seed size trait in genomically less explored crops like lentils

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016

Microbiological flora, demography and presentation of liver abscess: A changing trend

Objective: A prospective study in Rohilkhand region to analyse the causative organism for liver abscesses which might be helpful in planning the management of liver abscesses. Methods: Patients who were diagnosed to have liver abscess of size 5 cm or more and aspiration of pus was done either by percutaneous or by pig tail insertion were included in the study. The study includes all the patients who came in OPD or admitted in the hospital. The study was conducted for a period of one year. Results: The prevalence of liver abscess shows male predominance. Age dependency with significantly higher prevalence in the age group of 35 to 55 years. Right upper quadrant pain, fever and anorexia was seen in 64 (91%), 55 (78 %) and 50 (71 %) cases respectively. Patients with amoebic liver abscesses were more associated with diarrhea and cough while fever, pain in right upper abdomen and nausea or vomiting was more associated with pyogenic liver abscesses. The most common organism cultured was Klebsiella pneumoniae (23.3%) followed by Escherichia coli (13.3%)..The detection of E. histolytica in aspirated pus was 70 % while only 10 % in stool samples. Conclusion: Pyogenic liver abscess can be monomicrobial or polymicrobial and may be associated with amoebic liver abscess. Abscesses, which were previously thought to be “sterile” or cryptogenic, may in fact be caused by anaerobic organisms that were not previously identified secondary to inadequate technique. Compared to pyogenic liver abscesses, patients with amoebic abscesses are often younger, more acutely ill and are usually from high prevalence areas. The sensitivity of PCR was higher as compared with microscopy in this study in detecting E. Histolytica

Intravitreal bevacizumab (Avastin) treatment of diffuse diabetic macular edema in an Indian population

<b>Background:</b> To report the anatomic and visual acuity response after intravitreal bevacizumab (Avastin) in patients with diffuse diabetic macular edema. <b> Design:</b> Prospective, interventional case series study. <b> Materials and Methods:</b> This study included 20 eyes of metabolically stable diabetes mellitus with diffuse diabetic macular edema with a mean age of 59 years who were treated with two intravitreal injections of bevacizumab 1.25 mg in 0.05 ml six weeks apart. Main outcome measures were 1) early treatment diabetic retinopathy study visual acuity, 2) central macular thickness by optical coherence tomography imaging. Each was evaluated at baseline and follow-up visits. <b> Results: </b> All the eyes had received some form of laser photocoagulation before (not less than six months ago), but all of these patients had persistent diffuse macular edema with no improvement in visual acuity. All the patients received two injections of bevacizumab at an interval of six weeks per eye. No adverse events were observed, including endophthalmitis, inflammation and increased intraocular pressure or thromboembolic events in any patient. The mean baseline acuity was 20/494 (log Mar=1.338&#x00B1;0.455) and the mean acuity at three months following the second intravitreal injection was 20/295 (log Mar=1.094&#x00B1;0.254), a difference that was highly significant (<i> P</i> =0.008). The mean central macular thickness at baseline was 492 &#x00B5;m which decreased to 369 &#x00B5;m (<i> P</i> =0.001) at the end of six months. <b> Conclusions:</b> Initial treatment results of patients with diffuse diabetic macular edema not responding to previous photocoagulation did not reveal any short-term safety concerns. Intravitreal bevacizumab resulted in a significant decrease in macular thickness and improvement in visual acuity at three months but the effect was somewhat blunted, though still statistically significant at the end of six months