EFFICACY OF PATRA POTTALI SWED & JANUBASTI IN OSTEOARTHRITIS W.S.R. TO KNEE JOINT (JANU-SANDHIVATA)

Osteoarthritis (OA) is a chronic degenerative disease in male while it affects female in younger age. Life style play major role in OA. In Osteoarthritis (Sandhigata vata) pain, swelling, restricted movements of joints are common clinical features. The insidious starting is with aching pain in the joint and relieved by the rest. The other associated symptom is stiffness, which aggravated after a long rest and subsides after by active movement. In this trial entitled efficacy of Patra pottli swed & Janubasti in osteoarthritis w.s.r. to knee joint (Janu-sandhivata) Patra pottali swed & janu basti are selected to treat the Osteoarthritis of knee joint (Janu sandhigata vata) for 90 patients. All the 90 patients were divided in three groups of 30 patients in each group with an Patra Pottali Swed (Nirgundi Patra), Janubasti (Dashmooladi tail) & combined therapy (Patra Pottali Swed & Janu basti).Swedan is indicated in Kapha vata pradhan vyadhi. swedan helps in remove stiffness, pain, heaviness and coldness. In this trail both therapy Patra pottali sed and Kati basti have based on Swedan properties. Acharya charak mentioned in Sagni swed (sankar swed) for Pottali seed. Both therapy are special indicate in Group– A (Patra Pottali Swed) & Group – B (Janubasti) are mild beneficial, statistically significant & Group – C (Patra Pottali Swed & Janu basti) is moderate beneficial, statistically highly significant

Review of causes of stillbirths in a rural referral hospital: a cross sectional study

Background: The birth of a newborn after twenty-eight completed weeks of gestation weighing 1,000 gm or more, with baby showing no signs of life after delivery is a still born’’. Such death includes both antepartum and intrapartum death. Stillbirths (SB) are the largest contributor to perinatal mortality. Of the estimated 3 million stillbirths which occur yearly, the vast majority are in developing countries, with rates in many developing countries ten-fold higher than elsewhere.Methods: Descriptive (cross sectional) study was conducted at tertiary referral hospital in rural area of Maharashtra from September 2015 to August 2017. Out of total 3235 deliveries during study period 64 mothers giving birth to 66 cases of still birth (2 cases of twins) satisfied the inclusion criteria and studied to find out prevalence, causes and high-risk factor association with stillbirth.Results: Stillbirth rate in our study was 20.4/1000 deliveries. 56.25% patients were in the 21-25 years age group.9.3% were illiterate while 57.81% had education below 12th standard. Most patients were from low socioeconomic status and 57.81% were unregistered. Stillbirth was more common in Para (2-4), premature baby and with male sex preponderance in our study. Most patients 90.62% were delivered vaginally. Preeclmpsia, Abruption, Anaemia were common high-risk factor associated with stillbirth.54.6% cases were unexplained stillbirth while IUGR was noted in 23.4% cases and other causes noted were prematurity, congenital anomaly, cord and placental causes were found in our study.Conclusions: A significant proportion of stillbirths are preventable by adequate antenatal care. Female literacy and health education, adequate antenatal care, identification of high-risk cases, and timely referral needs to be emphasized among the medical and paramedical personnel at the first point of contact with the pregnant women

A NOVEL QSAR MODEL FOR EVALUATING AND PREDICTING THE INHIBITION ACTIVITY OF H1-RECEPTOR ANTAGONISTS: A SERIES OF THIENOPYRIMIDINE DERIVATIVES

ABSTRACT A Quantitative Structure Activity Relationship (QSAR) study has been established using combination of most influencing physiochemical parameters viz. thermodynamic, electronic, geometric & quantum mechanical descriptors, and H1-antihistaminic activity of a series of thienopyrimidines, the novel Histamine H1 receptor antagonists. Genetic function approximation (GFA) technique was used to identify the descriptors that have influence on biological activity. Dipole, AlogP 98, Jurs and LUMO descriptors were found to influence biological activity significantly. Lipophilicity of compounds was found to have a significant role in H1 Histaminic inhibition along with other thermodynamic, spatial and electronic descriptors. Positive contribution of Dipole, AlogP 98 descriptors suggests that molecules with lipophilic-electronic substituents are more likely to improve the potency. Developed models were found to be significant and predictive as evidenced from their internal and external cross-validation statistics.   Keywords: H1-receptor antagonists; thienopyrimidines; molecular descriptor; genetic function approximations; cross-validation; quantitative structure activity relationship Abbreviations: QSAR : Quantitative structure activity relationship GFA    : Genetic function approximation LOF    : Friedman’s lack of fit VIF     : Variance inflation factor Â

Angle-Closure Detection in Anterior Segment OCT based on Multi-Level Deep Network

Irreversible visual impairment is often caused by primary angle-closure glaucoma, which could be detected via Anterior Segment Optical Coherence Tomography (AS-OCT). In this paper, an automated system based on deep learning is presented for angle-closure detection in AS-OCT images. Our system learns a discriminative representation from training data that captures subtle visual cues not modeled by handcrafted features. A Multi-Level Deep Network (MLDN) is proposed to formulate this learning, which utilizes three particular AS-OCT regions based on clinical priors: the global anterior segment structure, local iris region, and anterior chamber angle (ACA) patch. In our method, a sliding window based detector is designed to localize the ACA region, which addresses ACA detection as a regression task. Then, three parallel sub-networks are applied to extract AS-OCT representations for the global image and at clinically-relevant local regions. Finally, the extracted deep features of these sub-networks are concatenated into one fully connected layer to predict the angle-closure detection result. In the experiments, our system is shown to surpass previous detection methods and other deep learning systems on two clinical AS-OCT datasets.Comment: 9 pages, accepted by IEEE Transactions on Cybernetic

Mutations in p53, p53 protein overexpression and breast cancer survival

p53 is an important tumor-suppressor gene that encodes p53 protein, a molecule involved in cell cycle regulation, and has been inconsistently linked to breast cancer survival. Using archived tumor tissue from a population-based sample of 859 women diagnosed with breast cancer between 1996–1997, we determined p53 mutations in exons 5–8 and p53 protein overexpression. We examined the association of p53 mutations with overexpression and selected tumor clinical parameters. We assessed whether either p53 marker was associated with survival through 2002, adjusting for other tumor markers and prognostic factors. The prevalence of protein overexpression in the tumor was 36% (307/859) and any p53 mutation was 15% (128/859). p53 overexpression was positively associated with the presence of any p53 mutation (odds ratio (OR)=2.2, 95% confidence interval (CI)=1.5–3.2), particularly missense mutations (OR=7.0, 95%CI=3.6–13.7). Negative estrogen and progesterone receptor status (ER/PR) was positively associated with both p53 protein overexpression (OR = 2.6, 95% CI = 1.7–4.0), and p53 mutation (OR = 3.9, 95% CI = 2.4–6.5). Any p53 mutation and missense mutations, but not p53 protein overexpression, were associated with breast cancer-specific mortality (Hazard ratio HR=1.7, 95%CI=1.0–2.8; HR=2.0, 95%CI=1.1–3.6, respectively) and all-cause mortality (HR=1.5, 95%CI=1.0–2.4; HR=2.0, 95%CI=1.2–3.4, respectively); nonsense mutations were associated only with breast cancer-specific mortality (HR=3.0, 95%CI=1.1–8.1). These associations however did not remain after adjusting for ER/PR status. Thus, in this population-based cohort of women with breast cancer, although p53 protein overexpression and p53 mutations were associated with each other, neither independently impacted breast-cancer specific or all-causing mortality after considering ER/PR status

Associations between Polycyclic Aromatic Hydrocarbon–Related Exposures and p53 Mutations in Breast Tumors

Background: Previous studies have suggested that polycyclic aromatic hydrocarbons (PAHs) may be associated with breast cancer. However, the carcinogenicity of PAHs on the human breast remains unclear. Certain carcinogens may be associated with specific mutation patterns in the p53 tumor suppressor gene, thereby contributing information about disease etiology. Objectives: We hypothesized that associations of PAH-related exposures with breast cancer would differ according to tumor p53 mutation status, effect, type, and number. Methods: We examined this possibility in a population-based case–control study using polytomous logistic regression. As previously reported, 151 p53 mutations among 859 tumors were identified using Surveyor nuclease and confirmed by sequencing. Results: We found that participants with p53 mutations were less likely to be exposed to PAHs (assessed by smoking status in 859 cases and 1,556 controls, grilled/smoked meat intake in 822 cases and 1,475 controls, and PAH–DNA adducts in peripheral mononuclear cells in 487 cases and 941 controls) than participants without p53 mutations. For example, active and passive smoking was associated with p53 mutation–negative [odds ratio (OR) = 1.55; 95% confidence interval (CI), 1.11–2.15] but not p53 mutation–positive (OR = 0.77; 95% CI, 0.43–1.38) cancer (ratio of the ORs = 0.50, p < 0.05). However, frameshift mutations, mutation number, G:C→A:T transitions at CpG sites, and insertions/deletions were consistently elevated among exposed subjects. Conclusions: These findings suggest that PAHs may be associated with specific breast tumor p53 mutation subgroups rather than with overall p53 mutations and may also be related to breast cancer through mechanisms other than p53 mutation

Associations between Polycyclic Aromatic Hydrocarbon–Related Exposures and p53 Mutations in Breast Tumors

BackgroundPrevious studies have suggested that polycyclic aromatic hydrocarbons (PAHs) may be associated with breast cancer. However, the carcinogenicity of PAHs on the human breast remains unclear. Certain carcinogens may be associated with specific mutation patterns in the p53 tumor suppressor gene, thereby contributing information about disease etiology.ObjectivesWe hypothesized that associations of PAH-related exposures with breast cancer would differ according to tumor p53 mutation status, effect, type, and number.MethodsWe examined this possibility in a population-based case–control study using polytomous logistic regression. As previously reported, 151 p53 mutations among 859 tumors were identified using Surveyor nuclease and confirmed by sequencing.ResultsWe found that participants with p53 mutations were less likely to be exposed to PAHs (assessed by smoking status in 859 cases and 1,556 controls, grilled/smoked meat intake in 822 cases and 1,475 controls, and PAH–DNA adducts in peripheral mononuclear cells in 487 cases and 941 controls) than participants without p53 mutations. For example, active and passive smoking was associated with p53 mutation–negative [odds ratio (OR) = 1.55; 95% confidence interval (CI), 1.11–2.15] but not p53 mutation–positive (OR = 0.77; 95% CI, 0.43–1.38) cancer (ratio of the ORs = 0.50, p < 0.05). However, frameshift mutations, mutation number, G:C→A:T transitions at CpG sites, and insertions/deletions were consistently elevated among exposed subjects.ConclusionsThese findings suggest that PAHs may be associated with specific breast tumor p53 mutation subgroups rather than with overall p53 mutations and may also be related to breast cancer through mechanisms other than p53 mutation

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations