Strengthening primary health care in rural western India-team based approach

Background: Non-communicable diseases (NCDs), such as cardiovascular diseases (CVDs), diabetes, have taken an epidemic form. With a huge population and existing sedentary lifestyle, in developing countries like India, there exists a struggle to deliver quality chronic care. A reorganization of systems in healthcare service delivery is crucial to improve primary healthcare. We have reported our model to address primary healthcare service delivery in rural settings. The SPARSH team-based care approach is designed with the objective of improving adherence to anti-hypertensive and anti-diabetic medications to improve blood pressure (BP) and blood sugar (BS) control among hypertension (HTN) and diabetes mellitus (DM) patients. Methods: This is a descriptive study describing a model and array on interventions delivered through a team-based care approach from 2016 till 2020 by Shree Krishna Hospital, Karamsad across three districts in Gujarat. Data was collected on case record forms and later was analysed using Microsoft excel. Results: From the financial year of 2016 till 2020 patients enrolled in SPARSH increased from 932 till 1920 for availing treatment and ongoing care. A total of 108 training sessions were conducted and facilitated by a senior member of SPARSH. Average monthly cost of treatment for hypertensive, diabetic and patients with both conditions was Rs. 38, 78 and 130 respectively. Conclusions: Our model described here can be tested for effectiveness through a rigorous community trial focusing on objective outcome measures such as BP control and glycemic control

Improving Service Delay in Smart Parking System in Smart Cities with 5G

Rapid urbanization and population growth leads to substantial increase in vehicular traffic while reducing empty spaces. This necessitates an enhanced parking systems to efficiently address the parking space management. The smart city and Internet of Things (IoT) holds a very high potential to solve this problem. However, the data traffic generation at the edge is increasing rapidly. Tremendous growth in IoT is putting a high congestion on cloud services. To ease up the congestion issue, we have proposed an efficient fog-based communication model for the smart city parking management. In this work, we have proposed a parking system management model based on 5G with low latency and green communication. Our model reduces congestion at the cloud and enable faster processing by addressing the parking system locally. Furthermore, our model finds out the nearby parking without putting additional load to the cloud. Simulation result shows the performance efficiency of the proposed model in terms of response time, average cost and service delay

Phytosome: a novel dosage form for herbal drug delivery

Phytosome is a complex of a natural active ingredient and phospholipids. The term ‘Phyto’ means plant while ‘some’ means cell like structure. It is claimed that phytosome increases absorption of "conventional herbal extracts" or isolated active principles both orally as well as topically. In this era phytosome gain popularity as a potential drug delivery device due to excessive demand and utility of herbs or herb based medicines. This advance technology offers amenities like improved absorption, enhanced delivery & increased bioavailability of herbal extracts. These drug-phospholipid complexes can be fabricated in the form of solution, suspension, emulsion, syrup, lotion, gel, cream, aqueous micro dispersions. Standardized plant extracts, mainly polar phytoconstituents like flavonoids, terpenoids, tannins, xanthones shall be introduced in form of phytosome

Modelling passenger car equivalency at an urban midblock using stream speed as measure of equivalence

The effect of traffic volume and its composition on Passenger Car Equivalency (PCE) of different vehicle types in a mixed traffic stream is investigated taking an urban mid-block section as the case study. The reduction in stream speed caused by marginal increment in traffic volume by a vehicle type is compared with that of caused by an old technology car, for the estimation of PCE of that vehicle type. A Neural Network (NN) approach is explored for capturing the underlying non-linear effects of traffic volume and its composition level on the stream speed. It is found that PCE of a vehicle type varies in a non-linear manner with total traffic volume and compositional share of that vehicle type in the traffic stream. The speed model using NN technique alone could establish the variation of PCE with vehicle type, traffic volume and its composition

Antihyperlipidemic potential of herbals

One of the most widespread diseases in the world is Coronary Heart Disease (CHD). It is also one of the most preventable. This review explores the management of CHD through changes in dietary modifications, lifestyle, and the use of dietary supplements and botanical

Assessment of the pharmacokinetics, safety, and tolerability of levothyroxine sodium in healthy Indian volunteers

Background: Few studies have assessed the pharmacokinetics of various marketed formulations of levothyroxine available in the Indian market. Here, we assessed the pharmacokinetics and safety of Thyronorm® 100 in healthy Indian volunteers.Methods: The primary and secondary objectives were to determine the pharmacokinetic profile and to monitor safety and tolerability of 600 µg of levothyroxine, respectively. Eligible subjects received a single oral dose of 6×100 µg of levothyroxine, and pharmacokinetic profiles were monitored up to 432 hours post-dose. Safety assessments included exposure of study drug and incidence of adverse events (AEs) and serious AEs. The mean plasma concentration of LT4 versus time profile was presented on both untransformed and log-transformed scales.Results: Of 20 enrolled subjects, 1 was discontinued due to an AE of pain, unrelated to study drug. The mean [standard deviation (SD)] age and body mass index of subjects were 35.7 (6.33) years and 25.0 (3.0) kg/m2, respectively. Following baseline correction, the mean maximum observed drug concentration (Cmax) and area under the plasma concentration-time curve measured to the last quantifiable concentration (AUC0-t) of free thyroxine were found to be 68.4 (12.09) ng/ml and 6760.0 (2065.05) ng×hr/ml, respectively, with an elimination half-life (t1/2) of 205.6 (180.26) hrs and a residual area of 24.6%. The median time to first observed maximum drug concentration (Tmax) was 2.5 (1.5-2.5) hrs.Conclusions: These parameters were in accordance with those of other marketed formulations and confirmed the pharmacokinetics and safety of Thyronorm® 100 in healthy volunteers from India

Genetic variability of attachment (G) and Fusion (F) protein genes of human metapneumovirus strains circulating during 2006-2009 in Kolkata, Eastern India

<p>Abstract</p> <p>Background</p> <p>Human metapneumovirus (hMPV) is associated with the acute respiratory tract infection (ARTI) in all the age groups. However, there is limited information on prevalence and genetic diversity of human metapneumovirus (hMPV) strains circulating in India.</p> <p>Objective</p> <p>To study prevalence and genomic diversity of hMPV strains among ARTI patients reporting in outpatient departments of hospitals in Kolkata, Eastern India.</p> <p>Methods</p> <p>Nasal and/or throat swabs from 2309 patients during January 2006 to December 2009, were screened for the presence of hMPV by RT-PCR of nucleocapsid (N) gene. The G and F genes of representative hMPV positive samples were sequenced.</p> <p>Results</p> <p>118 of 2309 (5.11%) clinical samples were positive for hMPV. The majority (≈80%) of the positive cases were detected during July−November all through the study period. Genetic analysis revealed that 77% strains belong to A2 subgroup whereas rest clustered in B1 subgroup. G sequences showed higher diversity at the nucleotide and amino acid level. In contrast, less than 10% variation was observed in F gene of representative strains of all four years. Sequence analysis also revealed changes in the position of stop codon in G protein, which resulted in variable length (217-231 aa) polypeptides.</p> <p>Conclusion</p> <p>The study suggests that approximately 5% of ARTI in the region were caused by hMPV. This is the first report on the genetic variability of G and F gene of hMPV strains from India which clearly shows that the G protein of hMPV is continuously evolving. Though the study partially fulfills lacunae of information, further studies from other regions are necessary for better understanding of prevalence, epidemiology and virus evolution in Indian subcontinent.</p

Mean platelet volume as a marker of Kawasaki disease in children

Background: Kawasaki disease (KD) is a clinical diagnosis, with common confusion among other causes of febrile illnesses.&nbsp;There are no confirmatory laboratory parameters for diagnosing KD. Objective: To investigate whether low mean platelet volume&nbsp;(MPV) is associated more with fever due to KD than due to the other common causes. Methods: This retrospective case-control&nbsp;study was done on febrile children between 6 months and 6 years of age admitted from January 2015 to January 2017. The MPV&nbsp;values of 28 KD and 50 non-KD febrile children admitted to our hospital were obtained from the hospital records. The diagnosis&nbsp;of KD was accepted only when (1) two pediatricians had agreed upon the diagnosis independently based on the American Heart&nbsp;Association guidelines 2004, (2) no other cause of fever coexisted with KD in a particular patient, and (3) prompt clinical response&nbsp;within 48 h of administration of intravenous immunoglobulin. Using suitable statistical software, the range of MPV in KD fever and&nbsp;non-KD fevers was compared. Results: MPV was lower in the KD group (9.75±0.98 femtoliter) than in the non-KD fever group&nbsp;(11.14±1.53 femtoliter). From the receiver operating characteristic curve, it was found that at MPV ≤10.0 fl, KD can be diagnosed&nbsp;with 75% sensitivity and 80% specificity. This means that lower the value of MPV, lower is the probability that a non-KD patientwill be wrongly diagnosed as KD. Conclusion: Our study shows that low MPV is associated with KD. Hence, a low MPV can raise&nbsp;the index of suspicion for KD in febrile children, especially in cases of incomplete KD. Further, prospective studies involving larger&nbsp;sample size are needed to ascertain its diagnostic utility