Pediatricians\u27 attitudes, experience and referral patterns regarding complementary/alternative medicine: a national survey

Abstract Background To assess pediatricians\u27 attitudes toward & practice of Complementary/Alternative Medicine (CAM) including their knowledge, experience, & referral patterns for CAM therapies. Methods An anonymous, self-report, 27-item questionnaire was mailed nationally to fellows of the American Academy of Pediatrics in July 2004. 648 of 3500 pediatricians\u27 surveyed responded (18%). Results The median age ranged from 46–59 yrs; 52% female, 81% Caucasian, 71% generalists, & 85% trained in the US. Over 96% of pediatricians\u27 responding believed their patients were using CAM. Discussions of CAM use were initiated by the family (70%) & only 37% of pediatricians asked about CAM use as part of routine medical history. Majority (84%) said more CME courses should be offered on CAM and 71% said they would consider referring patients to CAM practitioners. Medical conditions referred for CAM included; chronic problems (headaches, pain management, asthma, backaches) (86%), diseases with no known cure (55.5%) or failure of conventional therapies (56%), behavioral problems (49%), & psychiatric disorders (47%). American born, US medical school graduates, general pediatricians, & pediatricians who ask/talk about CAM were most likely to believe their patients used CAM (P \u3c 0.01). Conclusion Pediatricians\u27 have a positive attitude towards CAM. Majority believe that their patients are using CAM, that asking about CAM should be part of routine medical history, would consider referring to a CAM practitioner and want more education on CAM

MULTI-CHANNEL IMAGE SOURCE SEPARATION BY DICTIONARY UPDATE METHOD

In real world, a large set of mixed signals are available from which each source signal need to be recovered and this problem can be addressed with adaptive dictionary method. In the case of multichannel observations sparsity found to be very useful for source separation. The problem exist is that in most cases the sources are not sparsified in their domain and it will become necessary to sparsify the source by using some known dictionaries. In order to recover the sources successfully a prior knowledge of the sparse domain is required, if not available this problem can be solved by using dictionary learning technique into source separation. The proposed method, a local dictionary is adaptively learned for each source separately along with separation. This approach improves the quality of source separation both in noiseless and different noisy situations. The advantage of this method is that it denoise the sources during separation

A REVIEW ON FETAL BIOMETRY: MODERN AND AYURVEDIC PERSPECTIVE

The measurements of embryo/fetus are referred to as fetal biometry. Fetal biometric measurements reflect the growth and wellbeing of the fetus during the antenatal period. These parameters aid not only in detecting fetal anomalies but also in estimating the correct gestational age as well as to calculate the estimated date of delivery. The main biometric measurements available in a routine scan report are Crown Rump Length in the first trimester; Bi-parietal Diameter, Head Circumference, Abdominal Circumference, Femur Length in the second and third trimesters. Apart from these primary biometric measurements, secondary fetal parameters can also be assessed on demand. Measurement of parts of human body is referred to as Pramana (measurement) in Ayurveda. The Pramana (measurement) of adult human anatomy is well explained in the Ayurvedic classics under the topic of Pramana Shareera (Anthropometry) but that of Garbha (embryo/fetus) is very vague or almost nil. Details about the stages of growth and development of Garbha (embryo/fetus), it's anomalies, signs and symptoms for the assessment of fetal gender etc. have been vividly narrated in the Ayurvedic classics but the parameters to assess the measurement of Garbha is not at all sufficient to come to a satisfactory conclusion. Here an attempt has been made to explore the Ayurvedic aspects of fetal biometry apart from it's modern review.

A CRITICAL ANALYSIS OF GARBHAVRIDHI (GROWTH OF EMBRYO/FETUS) IN THE THREE TRIMESTERS

The union of Sukra (sperm) and Sonita (ovum) along with Atma (soul) in Garbhashaya (uterus) is termed as Garbha (embryo/fetus). It is formed as a result of combination of Panchamahabhutas (five elements) and Chetana (soul). Further these Panchamahabhutas (five elements) play an important role in Garbhavridhi (growth of embryo/fetus). Almost all Acharyas (scholars) of Ayurveda has similar opinion regarding the formation of Garbha (embryo/fetus). Four Garbhotpadakabhavas (factors responsible for the formation of embryo/ fetus) and six Garbhavridhikarabhavas (factors responsible for the development of embryo/fetus) aid in the formation and growth of Garbha (embryo/fetus). The developmental stages of Garbha (embryo/fetus) have been vividly narrated in Ayurveda as well as modern science. Almost all ancient scholars have described the month wise development of Garbha (embryo/fetus) but Harita has keenly observed the changes happening in weeks or a couple of days at a few instances. The concept of Garbhavridhi (growth of embryo/fetus) was of great interest to the Ayurvedic scholars; the developmental changes happening in the embryo during pregnancy is given much importance in modern parlance too. As per modern view the whole period of pregnancy can be divided into three trimesters each of which comprises of three months. Each trimester has its own milestones in the developmental aspect of embryo/fetus. The knowledge regarding the developmental events help in preventing various fetal anomalies thus aids in the formation of healthy individuals and thereby a healthy society. The basic facts pertaining to the growth, differentiation, specialization and development of an individual starting from fertilization till birth forms the core concept of this review. A keen study of both Ayurvedic and modern aspects of the developmental events during the gestational period has been attempted for a better understanding.

A Study on Fetal Biometry in Third Trimester in Relation to Maternal Prakruti

Fetal biometry refers to the various measurements obtained from sonography which denotes the development of the fetus in a particular period of growth. These measurements describe normal growth of fetal structures and are used to estimate the age and to monitor fetal growth. The biometric measurements attain an optimum value in the third trimester and any abnormality in the range of the values in this particular period can predict fetal anomalies as well.[1] Prakruti (constitution) is the inborn character reflected on the individual which forms the basis of one’s personality.[2] It is a group of characters inherited by an individual depending on the predominance of Dosha (humor) prevailing at the time of conception and which remains with him or her throughout life.[3] Out of the many factors which influence the growth and development of fetus, Prakruti has an important role to play. Hence an effort has been made to know the influence of maternal Prakruti on fetal biometry in the third trimester of pregnancy

Review on investigation of corrosion behavior of reinforced concrete with supplementary cementitious materials

Cement concrete is the most widely used material for various constructions. Properly designed and prepared concrete results in good strength and durability. Sometime these mixes are found to be inadequate, hence variety of admixtures are used along with cement. A certain percentage of cement will be replaced separately with metakaolin and silica fumes. Hence the flexural strength test of concrete and evaluation of corrosion behavior of the reinforcement can be performed. The study of flexural property of concrete will be conducted at 7 or 28 days characteristic strength with different replacement level of cement (i.e.0%, 5%, 10%, 15%, 20%). Corrosion behavior of reinforcement will be evaluated based on half-cell potential. Concrete samples will be cured in either fresh water of 4% NaCl saline water for 7 or 28 days of curing period. We assumed that the addition of silica fumes and metakaolin will improve the flexural strength characteristics of concrete and corrosion resistivity of reinforcement. Keywords: Flexural strength, corrosion, metakaolin, silica fumes

Study on Cardiovascular Risk Factors and its Management in Type II Diabetic Patients

INTRODUCTION: Cardiovascular disease (CVD) is the leading cause of ill-health and mortality in people with type two diabetes (T2DM).Type two DM is associated with twice the risk of incident coronary heart disease (CHD) and ischemic stroke and 2–4 times increased risk of CHD and stroke mortality compared with diabetes-free individuals.1 Changes in the human environment, behavior, and lifestyle are contributing to the upsurge in the incidence of diabetes. However, better management has resulted in a longer survival of patients with diabetes, but it is accompanied by long-term chronic complications due to hyperglycemia Individuals with diabetes most often die of cardiovascular disease (CVD) rather than from a cause uniquely related to diabetes, such as ketoacidosis or hypoglycemia2 . Diabetic patients have a twofold to six fold higher incidence of cardiovascular disease than non-diabetic population. Furthermore, diabetic patients with CVD sustain a worse prognosis for survival than CVD patients without diabetes and their quality of life also depreciates. Therefore, diabetes has been considered as having a risk equivalent to a non-diabetic patient with preexisting heart disease. Identification of patients at risk for CVD could felicitate the prevention or retardation of cardiovascular events. OBJECTIVE OF THE STUDY: 1. To evaluate drug utilization pattern in diabetic patients 2. Assess the risk factors associated with CVD in type 2 diabetic patients 3. Evaluate the primary and secondary management of CVD in type 2 DM 4. Assess the therapy of CVD prevention in type II DM patients. 5. Evaluate the drug interaction in the prescription RESULTS AND DISCUSSION: The proposed work entitled “Study on Cardiovascular Risk Factors and its Management in Type II DM patients” was a carried out in a 750 bedded multispecialty hospital, in the department of General medicine and Cardiology. The study was carried out during November 2016 to October2017. A total of 103 patients were included in the study based on the inclusion and exclusion criteria, among them 64 (62%) were males and 39 (37.86%) were females. [Table No- 1].The age categorization was done in which, it was found that 7 (3.8%) belonged to the age group of 30-40 followed by 9 (8.73) in the age group of 40-50 , 28 (27.1%) in the age group of 50-60, and 59 (57.2%) of them were 60 years. ASSESSMENT OF PREVALENCE OF CARDIOVASCULAR DISEASES: Among the study population 73(70.87%) patients were found to be suffering from CVD and 30 (29.1%) were non CVD patients. [Table No- 3].The various types of CVD suffered by patients were analyzed , it was found that majority of them were diagnosed with IHD 30 (42%), followed by CAD 24 (32.8%), Stroke 6 (8.21%) and CCF 7 (9.58%), and ACS 6(5.82%), . [Table No- 4].This result reveals that IHD and CAD are the most common CVDs among study population in Type II DM patients. A similar study conducted Anurag S Lekar et al (2013) revealed that IHD is the major disease suffered by their study population. CATEGORIZATION OF DRUG PRESCRIBED FOR DM: The study population was prescribed with various classes of anti-diabetic medications. The drug utilization pattern reveals that majority of the study population has received insulin therapy for 56 (54.36%)patients followed by thiazolidinediones 15.5 (14.56%), sulfonyl ureas 14 (13.59%) and biguanides 7 (6.79%). DRUGS PRESCRIBED FOR CVD PATIENTS: The CVD agents utilized by the study population was analyzed which has been classified into 11 categories. A total of 315 drugs were prescribed. Among which, the most frequently prescribed drug class was anticoagulants 132 (41.90%), followed by dyslipidemic agents 56 (17.77%), antianginals 31 (9.84%), diuretics 30 (9.52%), beta adrenergic blockers 16 (5.07%), cardiotonic agents 14 (4.44%), calcium channel blockers 10 (3.17%), angiotensin antagonists 8 (2.53%), antiarrhythmics 7 (2.22%) and alpha + beta adrenergic blockers 6 (1.90%). (Table No -6 ).A similar study conducted by Ittaman SV et al (2014) reported that anticoagulant therapy is well-accepted as an agent for the prevention of cardiovascular events. CONCLUSION: Current study results reveals patient with Type II Diabetes are either having one of the CVD or they are at high risk of developing CVD in future. Therefore, CVD prevention in such patients is mandatory. The CVD prevention therapy is long term management that may even continue for life time depending on the patient condition. Aspirin and Clopidogrel are the most widely used drugs in CVD prevention. Aspirin and Clopidogrel are having high chance of forming resistance in Type 2 Diabetic patients. Hence the use of aspirin and clopidogrel necessitates monitoring the effectiveness of these drugs CVD prevention. Clinical pharmacist has a great responsibility in such monitoring and preventing such resistance that occurs with the use of aspirin and clopidogrel. The results also implicates there is a high prevalence rate of CVD in Type 2 diabetic patients. The incidence of CVD would have reduced if proper patient education and management are implemented. It is essential to follow guidelines such as ADA and AHA continuous monitoring by Clinical Pharmacist for reducing rate of CVD in Type 2 Diabetic patients. Hence the study concluded that implementation of pharmaceutical care activities in Type 2 diabetic patients will ensure safe and efficient CVD prevention therapy

ANTIMICROBIAL POTENTIAL OF BIOSYNTHESIZED SILVER NANOPARTICLE AGAINST HUMAN PATHOGEN PSEUDOMONAS AERUGINOSA AND KLEBSIELLA PNEUMONIAE

 Objectives: The main objective of this investigation was to evaluate the potential of water extract from pteridophytes (Adiantum raddianum, Acrostichum aureum, and Christella dentata) in synthesizing silver nanoparticles (AgNPs) through eco-friendly routes and accessing their antibacterial activity.Methods: Water extract from pteridophytes (A. raddianum, A. aureum, and C. dentata) was used for synthesizing AgNPs. AgNPs formation was confirmed from the plasmonic absorbance spectra. Antimicrobial potential of synthesized particles was evaluated against human bacterial pathogens Staphylococcus aureus, Proteus species, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. The results were statistically validated using two-way ANOVA. Most active AgNPs were characterized using high-resolution transmission electron microscopy to access the morphology and size.Results: Water extract from the pteridophytes is capable of synthesizing AgNPs through green synthetic routes. AgNPs synthesized using water extract from A. raddianum showed a significant activity against P. aeruginosa followed by K. pneumoniae. These AgNPs possessed spherical morphology with size ranging between 10 and 20 nm.Conclusion: Novel bioactive formulations, particularly effective against P. aeruginosa and K. pneumoniae, can be developed through eco-friendly methods using water extract of A. raddianu