The durability of oral diabetic medications: Time to A1c baseline and a review of common oral medications used by the primary care provider.

Introduction:Cost of generic medications has risen more in the past few years than any other time in history. While medical insurance covers much of these costs, health care professionals can better provide medications that have the longest duration of action when compared to placebo-treated controls. This will save health care costs and improve prescribing accuracy. Methods:Papers in PubMed were identified with keywords placebo. The study must be at least 2 years in length to evaluate the change in A1c over time. The primary endpoint was time to A1c neutrality (return of A1c to baseline at a maximum dose of single oral agent). A medication would be considered at neutrality if the 95% CI crossed baseline. Time to neutrality was averaged for each medication within the class and each summarized for class effect. Results:Effective therapy for the DPP-4 and sulfonylurea classes of medications are 3-4 years as compared to a 5-year time to A1c neutrality for metformin usage. In comparison, the projected time to A1c neutrality was approximately 6-8 years for rosiglitazone and pioglitazone. While only a few studies have been published in the SGLT-2 class of medication, the time to A1c neutrality was also 6-8 years with Canagliflozin and full dosage of Empagliflozin. Conclusion:Metformin appears to have a 5-year duration of effect before the A1c returns to baseline. The sulfonylureas and DPP-4 inhibitors class of medications have one of the shortest durability which ranges between 3.3 to 4.4 years. In contrast, the SGLT-2 class of medication and the TZD class of medications has a projected time to A1c neutrality from 6-8 years. Diabetic duration of therapy as compared to placebo should be listed with those medications tested so the provider can choose wisely

USE OF ELECTRONIC INFORMATION RESOURCES AMONG RESEARCH SCHOLARS IN ALAGAPPA UNIVERSITY, KARAIKUDI: A CASE STUDY

The Study analysed that use of Use of Electronic Information Resources among Research Scholars in Alagappa University. The data were collected with the help of a questionnaire designed for gathering the Research Scholars opinions about the electronic information resources. Sample survey was used as the study method. It is the most commonly used convenience random sampling method. 60.71% of the respondents belong to Female category, 28.57% of the respondents belong to the age group of 29-34, 61.90, of the respondents belong to the category of Ph.D., study 36.90% respondents belong to the using the e-resource daily, 25% respondents belong to the purpose of to get books issue/ return, study 23.80 % respondents belong to the using the e-resource E-books,25% respondents belong to the purpose of to get books issue/ return, 28.57% respondents belong to the access of Department, 42.86% respondents Using E-Resources of Course work,25% respondents Save Time, 42.86% respondents’ use of E-Resources in Monthly, 46.43% respondents satisfied

USE OF ELECTRONIC INFORMATION RESOURCES AMONG RESEARCH SCHOLARS IN ALAGAPPA UNIVERSITY, KARAIKUDI: A CASE STUDY

The Study analysed that use of Use of Electronic Information Resources among Research Scholars in Alagappa University. The data were collected with the help of a questionnaire designed for gathering the Research Scholars opinions about the electronic information resources. Sample survey was used as the study method. It is the most commonly used convenience random sampling method. 60.71% of the respondents belong to Female category, 28.57% of the respondents belong to the age group of 29-34, 61.90, of the respondents belong to the category of Ph.D., study 36.90% respondents belong to the using the e-resource daily, 25% respondents belong to the purpose of to get books issue/ return, study 23.80 % respondents belong to the using the e-resource E-books,25% respondents belong to the purpose of to get books issue/ return, 28.57% respondents belong to the access of Department, 42.86% respondents Using E-Resources of Course work,25% respondents Save Time, 42.86% respondents’ use of E-Resources in Monthly, 46.43% respondents satisfied

Study of mode of delivery and fetal outcome in pregnancies with oligohydramnios

Background: The significance of amniotic fluid volume as a marker of fetal status is an ongoing turn of events. Oligohydramnios causes adverse fetal outcomes like meconium-stained liquor, meconium aspiration syndrome, fetal heart rate abnormalities, poor APGAR scores, fetal growth restriction and fetal prematurity. It is associated with maternal hypertension, infections, and placental insufficiency. It causes maternal complication because of increased incidence of induction of labour and operative intervention.Methods: Hundred cases of oligohydramnios were included in our study conducted at the Navodaya medical research, hospital and research centre, during a period of two years after obtaining the informed consent of patients and institutional ethical clearance. All gravidas were included with a gestational age greater than 28 weeks with singleton pregnancies with oligohydramnios. Associated fetal and maternal risk factors were observed. The amniotic fluid index (AFI) was measured by ultrasound. The nonstress test, the fetal biophysical profile and the Doppler study were carried out to evaluate the fetal condition. Then we have observed for delivery and fetal outcome.Results: Incidence of oligohydramnios was 2.85% in our study. The 53% of cases had LSCS while 47% had normal delivery. Fetal distress was the commonest indication for LSCS. Poor neonatal APGAR score was 16.9% in LSCS while 36% in vaginal delivery.Conclusions: From the above study, the caesarean delivery seems to be a safer mode of delivery than vaginal delivery because it is associated with a good perinatal outcome

Nontuberculous Mycobacterium (NTM) Infection in Aquatic Workers with Purified Protein Derivative (PPD) and Gold QuantiFERON Tests.

Background: Nontuberculous mycobacteria (NTM) infections are commonly caused by Mycobacterium marinum and fortuitum with M. marinum more likely to cause skin infections. Aquatic environments are a potential source of contact with M. marinum and fortuitum. Patients with NTM infections may present with positive tuberculin purified protein derivative (PPD) and/or gold QuantiFERON tests. However, PPD cannot differentiate between NTM infection and other tuberculous infections caused by different mycobacterial strains. We present a patient a marine biologist who was asymptomatic and presented for further evaluation as she has a h/o positive PPD and gold QuantiFERON test. Methods: Patient informed consent was obtained for this case report. Results: A 31 years old, healthy, female marine biologist employed in an aquatic environment presented to the clinic with a positive PPD and a positive gold QuantiFERON test. Her job exposes her to sea creatures that maybe infected with Mycobacterium marinum and fortuitum. She denied any history that was suggestive of tuberculous infection. A referral was made to specialist service for further evaluation at which time a repeat gold QuantiFERON test was performed and was noted to be positive. Following this work up, the patient preferred to follow a conservative treatment approach to monitor for any symptoms of active tuberculosis and seek follow up as needed. Conclusion: Clinicians should not downplay the importance of aquatic occupations and hobbies in patients who exhibit positive PPD and gold QuantiFERON test. Healthcare providers should consider NTM infection in their differential diagnosis when examining patient populations exposed to aquarium water, saltwater, and freshwater environments. Preventative apparel like waterproof gloves can protect the exposed skin from infection. Clinicians can prevent NTM infections by increasing awareness and promoting prevention measures in at-risk populations, particularly since infection can be prevented from appropriate protective attire

INFORMATION LITERACY SKILLS IN THE USE OF ELECTRONIC RESOURCES AMONG RESEARCH SCHOLARS OF ALAGAPPA UNIVERSITY KARAIKUDI: A STUDY

The study aimed to finding the use Information literacy skills in the use of electronic resources among Research scholars in Alagappa University, Karaikudi. 100 questionnaires were distributed to the research scholars of Alagappa University, Karaikudi, Out of 100 questionnaires distributed, 89 were returned with full particulars. 58.43% were female, 28.57% of the respondents belong to the age group of 29-34, 32.58% respondents Using E-Resources of project work, 24.71 % respondents belong to the using the e-resource E-Journals, 40.44% respondents belong to the using the e-resource daily, 33.70% of the respondents Simple key, 40.44% Copy/ Paste function if available online, 43.82% of the respondents Using search engine, 41.57% of the respondent search terms By title, 38.20% of the respondents The department should immediately start information literacy program

Enriched Model of Case Based Reasoning and Neutrosophic Intelligent System for DDoS Attack Defence in Software Defined Network based Cloud

Software Defined Networking in Cloud paradigm is most suitable for dynamic functionality and reduces the computation complexity. The routers and switches located at the network's boundaries are managed by software-defined netwrking (SDN) using open protocols and specialised open programmable interfaces. But the security threats often degrade the performance of SDN due to its constraints of resource usage. The most sensitive components which are vulnerable to DDoS attacks are controller and control plane bandwidth. The existing conventional classification algorithms lacks in detection of new or unknown traffic packets which are malicious and results in degradation of SDN performance in cloud resources. Hence, in this paper double filtering methodology is devised to detect both known and unknown pattern of malicious packets which affects the bandwidth of the control panel and the controller. The case-based reasoning is adapted for determining the known incoming traffic patterns before entering the SDN system. It classifies the packets are normal or abnormal based on the previous information gathered. The traffic patterns which is not matched from the previous patterns is treated as indeterministic packet and it is defined more precisely using the triplet representation of Neutrosophic intelligent system. The grade of belongingness, non-belongingness and indeterminacyis used as the main factors to detect the new pattern of attacking packets more effectively. From the experimental outcomes it is proved that DDoS attack detection in SDN based cloud environment is improved by adopting CBR-NIS compared to the existing classification model

A Survey on Contribution of Data Mining Techniques and Graph Reading Algorithms in Concept Map Generation

Concept maps are a pictorial representation of concepts found in data and it shows relationship between concepts. These Concept map help us to understand the whole data content, makes it easily readable and memorable. They are used to deliver complex data in an understandable form (map, tree, graph, etc), which is used for a better understanding and decision making for researchers and business, etc. This paper discusses the recent researches about concept maps and data mining techniques, and graph reading algorithms used for concept map generation

INFORMATION LITERACY SKILLS IN THE USE OF ELECTRONIC RESOURCES AMONG RESEARCH SCHOLARS OF ALAGAPPA UNIVERSITY KARAIKUDI: A STUDY

The study aimed to finding the use Information literacy skills in the use of electronic resources among Research scholars in Alagappa University, Karaikudi. 100 questionnaires were distributed to the research scholars of Alagappa University, Karaikudi, Out of 100 questionnaires distributed, 89 were returned with full particulars. 58.43% were female, 28.57% of the respondents belong to the age group of 29-34, 32.58% respondents Using E-Resources of project work, 24.71 % respondents belong to the using the e-resource E-Journals, 40.44% respondents belong to the using the e-resource daily, 33.70% of the respondents Simple key, 40.44% Copy/ Paste function if available online, 43.82% of the respondents Using search engine, 41.57% of the respondent search terms By title, 38.20% of the respondents The department should immediately start information literacy program