Randomized, Standard Controlled Study Evaluating the Efficacy and Safety of Habb-e-Waja‘al-Mafāṣil in Managing Cervical Spondylosis

Background and Objectives Cervical Spondylosis is a degenerative disease of intervertebral discs and adjacent vertebral bodies of the cervical region due to wear and tear changes. Neck pain, with radiculopathy, and stiffness comprises the prime features of cervical spondylosis demanding the immediate attention and respite. Despite the advancement in pharmacological, nonpharmacological and surgical interventions, the management remains unsatisfactory due to high cost, adverse effects and unusual eventualities. Hence a clinical trial was done to evaluate the efficacy of herbal formulation, Habb-e-Waja‘al-Mafāṣil (HWM), in managing cervical spondylosis (Waja‘al-‘Unuq). Methods The study is an open-labeled, randomized and standard controlled trial. Sixty diagnosed patients of age group 20 to 70 years were randomly allocated, using a computer generated chart, in test group (n=30) receiving HWM (3gm), and the control group (n=30) receiving ibuprofen 1200mg/day, orally in divided doses. The severity score of clinical symptoms and signs; pain, stiffness, swelling, restriction of movement and radiological findings were analyzed at baseline and at 30 days. Results Both HWM and ibuprofen significantly reduced the severity score of pain, stiffness, swelling, and restriction of movement (p=<0.001) associated with cervical spondylosis after completion of treatment protocol. However, no change was observed in radiological findings in either group (p=1). Comparison to control group no significant result was noticed in test group statistically (p=>0.05), except for “restriction of movement” (p=<0.05). Conclusion The herbal formulation, HWM, is equally effective to conventional treatment in managing cervical spondylosis. Therefore, HWM can be prescribed as safe and cost effective alternative treatment for cervical spondylosis

Antibiotic resistance pattern among aerobic bacterial isolates from osteomyelitis cases attending a Tertiary care hospital of North India with special reference to ESBL, AmpC, MBL and MRSA production

Background: Osteomyelitis is a common cause of morbidity in developing countries. Its treatment comprises of surgical debridement of all necrotic bone and soft tissue along with use of appropriate antimicrobial therapy. Treatment is becoming increasingly troublesome due to rise in drug resistant isolates in osteomyelitis cases. The present study was done to determine the antibiotic resistance pattern among aerobic bacterial isolates from osteomyelitis cases.Methods: 125 samples from osteomyelitis cases were aerobically cultured and isolates from culture positives were identified by standard procedures. Antimicrobial susceptibility testing was done by Kirby Bauer disk diffusion method. Staphylococcal isolates were screened for methicillin resistance and Gram negative bacilli were screened and confirmed for ESBL, AmpC and MBL production.Results: Out of 125 samples cultured, 20 were culture negative and 105 were culture positive giving rise to 120 isolates (58 Gram positive and 62 Gram negative organisms). The prevalence of methicillin resistant staphylococcal (MRS) isolates, ESBL, AmpC and MBL producers was found to be 43.1%, 51.6%, 24.2% and 14.5% respectively. All the resistant isolates were multidrug resistant, with MRS being 100% sensitive only to vancomycin, linezolid and teicoplanin, ESBL and AmpC producers being 100% sensitive only to imipenem and colistin, and MBL producers being 100% sensitive only to colistin.Conclusions: Antibiotic therapy on the basis of antibiotic susceptibility pattern helps the clinician to choose appropriate drugs leading to successful treatment and prevention of emergence and dissemination of drug resistant isolates

Empyema thoracic presenting as low back ache

AbstractA 24 years old female was presented with a 2 weeks history of fever (high grade), cough, fatigue, shortness of breath, chest pain right side and low back ache. Patient prefers to lie towards right side. CECT thorax reveals empyema thoracic with paravertebral extension. Patient was put on IV antibiotic according to culture and sensitivity. Clinical and Radiological improvement was evident after 1 week

Multiple cavitating cannon ball metastasis with primary adenocarcinoma lung: a rare case report

Multiple large round well circumscribed pulmonary nodules in lungs are known as cannon ball secondaries. There are malignant and non-malignant causes of cannon ball secondaries. In case of malignancy, they represent classical haematogenous dissemination to the lungs of a primary malignant tumor. Secondaries to lung from renal cell carcinoma and choriocarcinoma are necrotic. The less common primary tumors causing cannon ball secondaries to lung includes prostate carcinoma, synovial sarcoma, endometrial carcinoma and some gastrointestinal malignancies. Here we presented a very rare case, maybe first of its kind of multiple cavitating cannon ball secondaries where primary malignancy was in lung itself which was EGFR positive adenocarcinoma lung. This case was also rare as cavitation is largely a feature of squamous cell carcinoma lung both of primary and metastatic lung malignancy

Immunomodulators for Curtailing COVID-19: a Positive Approach

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is highly infectious, spreading swiftly from man to man which has not been previously recognized in humans. World Health Organization (WHO) on February 11, 2020 named the infection as COVID-19 as an acronym for ‘coronavirus disease-2019’ and on March 11, 2020 declared the outbreak as pandemic. It affects all the people without discrimination, however, older, immune compromised are more susceptible. The virus chiefly spread through droplet infection from infected person to healthy one by coughing, sneezing or with infected hands when touched to eyes, nose or mouth. Symptoms of the infection range from mild to severe ones. In severe cases (approx. 14% of cases) fever typically of high grade (104oF), breathlessness, pneumonia and severe acute respiratory syndrome may appear. So far no specific treatment or vaccine for novel coronavirus-2019 is there. From the past and recent past experiences we have learnt that herbal medicines have proven beneficial against various dreadful viral infections. Assessment of immune enhancing herbs in this paper may definitely be helpful for the body to fight COVID-19 infection. Keywords:   Severe acute respiratory syndrome coronavirus-2, COVID-19, Pneumonia, Immune, Herb

Direct Power Control based on Point of Common Coupling Voltage Modulation for Grid-Tied AC Microgrid PV Inverter

In this paper, a direct power control (DPC) approach is proposed for grid-tied AC MG’s photovoltaic (PV) voltage source inverter (VSI) to regulate directly active and reactive powers by modulating microgrid’s (MG) point of common coupling (PCC) voltage. The proposed PCC voltage modulated (PVM) theory-based DPC method (PVMT-DPC) is composed of nonlinear PVM, nonlinear damping, conventional feedforward, and feedback PI controllers. For grid synchronization rather than employing phase-locked-loop (PLL) technology, in this study, direct power calculation of the PCC voltage and current is adopted. Subsequently, at PCC, the computed real and reactive powers are compared with reference powers in order to generate the VSI’s control signals using sinusoidal pulse width modulation (SPWM). Because of the absence of the PLL and DPC method adoption, the suggested controller has a faster convergence rate compared to traditional VSI power controllers. Additionally, it displays nearly zero steady-state power oscillations, which assures that MG’s power quality is improved significantly. To validate the proposed PVMT-DPC method’s performance real-time simulations are conducted via a real-time digital simulator (RTDS) for a variety of cases. The results demonstrate that PV VSI using the suggested PVMT-DPC approach can track the reference power quicker (0.055 s) along with very low steady-state power oscillations, and lower total harmonic distortion (THD) of 1.697% at VSI output current.© The Authors. Published by IEEE. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License. For more information, see https://creativecommons.org/licenses/by-nc-nd/4.0/This research has been supported by the University of Vaasa under the Centralized Intelligent and Resilient Protection Schemes for Future Grids Applying 5G (CIRP-5G) research project funded by Business Finland with Grant No. 6937/31/2021. Some parts of this work were done in the SolarX research project funded by Business Finland with Grant No. 6844/31/2018.fi=vertaisarvioitu|en=peerReviewed

Clinicoepidemiological profile and outcome in patients of covid 19 with normal chest x-ray: study of 51 patients

Background: Covid 19 was declared a pandemic by WHO on 11 March 2020. Patients usually have pneumonia on chest x-ray at time of presentation however many patients also do not develop pneumonia and have normal chest x-ray.Methods: A total of 51 patients above the age of 15 years diagnosed with covid 19 by RT PCR of nasopharngeal/oropharyngeal samples were included in the study. History of symptoms onset was recorded, chest x-ray and haematological investigations were done of all patients.Results: A total of 51 patients >15 years of age were included in the study. 28 were male and 23 were female patients. Maximum number of patients were in age group 15-30 years. Most common presenting complain was fever (49% patients). Most common comorbidity was diabetes mellitus. There was no mortality reported in patients with normal chest x-ray.Conclusions: We conclude from the current study that patients with normal chest x-ray at the time of presentation have a very good outcome

Recent Development in Electricity Price Forecasting Based on Computational Intelligence Techniques in Deregulated Power Market

The development of artificial intelligence (AI) based techniques for electricity price forecasting (EPF) provides essential information to electricity market participants and managers because of its greater handling capability of complex input and output relationships. Therefore, this research investigates and analyzes the performance of different optimization methods in the training phase of artificial neural network (ANN) and adaptive neuro-fuzzy inference system (ANFIS) for the accuracy enhancement of EPF. In this work, a multi-objective optimization-based feature selection technique with the capability of eliminating non-linear and interacting features is implemented to create an efficient day-ahead price forecasting. In the beginning, the multi-objective binary backtracking search algorithm (MOBBSA)-based feature selection technique is used to examine various combinations of input variables to choose the suitable feature subsets, which minimizes, simultaneously, both the number of features and the estimation error. In the later phase, the selected features are transferred into the machine learning-based techniques to map the input variables to the output in order to forecast the electricity price. Furthermore, to increase the forecasting accuracy, a backtracking search algorithm (BSA) is applied as an efficient evolutionary search algorithm in the learning procedure of the ANFIS approach. The performance of the forecasting methods for the Queensland power market in the year 2018, which is well-known as the most competitive market in the world, is investigated and compared to show the superiority of the proposed methods over other selected methods.© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).fi=vertaisarvioitu|en=peerReviewed