A novel framework for predicting patients at risk of readmission

Uncertainty in decision-making for patients’ risk of re-admission arises due to non-uniform data and lack of knowledge in health system variables. The knowledge of the impact of risk factors will provide clinicians better decision-making and in reducing the number of patients admitted to the hospital. Traditional approaches are not capable to account for the uncertain nature of risk of hospital re-admissions. More problems arise due to large amount of uncertain information. Patients can be at high, medium or low risk of re-admission, and these strata have ill-defined boundaries. We believe that our model that adapts fuzzy regression method will start a novel approach to handle uncertain data, uncertain relationships between health system variables and the risk of re-admission. Because of nature of ill-defined boundaries of risk bands, this approach does allow the clinicians to target individuals at boundaries. Targeting individuals at boundaries and providing them proper care may provide some ability to move patients from high risk to low risk band. In developing this algorithm, we aimed to help potential users to assess the patients for various risk score thresholds and avoid readmission of high risk patients with proper interventions. A model for predicting patients at high risk of re-admission will enable interventions to be targeted before costs have been incurred and health status have deteriorated. A risk score cut off level would flag patients and result in net savings where intervention costs are much higher per patient. Preventing hospital re-admissions is important for patients, and our algorithm may also impact hospital income

Genetic Algorithm based Application Research in Computer Network Security Evaluation

Network security is a complex systematic job. Current safety methods available are having some shortcomings like feasibility , man made interference, smaller application scope and so on. The imitation results shows that using the established evaluation model for network security assessment is simple, also eliminate the interference of human factors and can quickly find the correct results of the assessment. This article provides new ideas and methods to work for a wide-ranging evaluation of computer network security condition, specially with a certain reference value to predict and control of network security issues in the futur

Allosteric collaboration between elongation factor G and the ribosomal L1 stalk directs tRNA movements during translation

Determining the mechanism by which transfer RNAs (tRNAs) rapidly and precisely transit through the ribosomal A, P and E sites during translation remains a major goal in the study of protein synthesis. Here, we report the real-time dynamics of the L1 stalk, a structural element of the large ribosomal subunit that is implicated in directing tRNA movements during translation. Within pre-translocation ribosomal complexes, the L1 stalk exists in a dynamic equilibrium between open and closed conformations. Binding of elongation factor G (EF-G) shifts this equilibrium towards the closed conformation through one of at least two distinct kinetic mechanisms, where the identity of the P-site tRNA dictates the kinetic route that is taken. Within post-translocation complexes, L1 stalk dynamics are dependent on the presence and identity of the E-site tRNA. Collectively, our data demonstrate that EF-G and the L1 stalk allosterically collaborate to direct tRNA translocation from the P to the E sites, and suggest a model for the release of E-site tRNA

A fuzzy approach for unequal workers-task assignment with heptagonal fuzzy numbers

The problem of assigning n tasks to n workers with minimum assignment cost often arises in many practical applications. In real life, the cost of assignment may not be certain and also the number of tasks may not be always equal to the number of workers and an unbalanced situation may arise often. In this paper, the representation of the Heptagonal fuzzy number(HFN) and its arithmetic operations are reviewed and a fuzzy approach called as fuzzy row penalty method is extended within the context of Heptagonal fuzzy numbers to deal with the unbalanced Fuzzy Assignment Problems. The cost of assignment is represented by Heptagonal fuzzy numbers which are capable of incorporating the degree of satisfaction about the assignment cost. So the use of HFN is more suitable. The proposed method overcomes the limitations of existing methods and it is illustrated through numerical example

Awareness about inhalation general anaesthetics among dental students

Introduction: General anesthesia is a state of medically induced coma or unconsciousness. General anaesthetics are drugs that render a patient unresponsive and unconscious, so that the patient is unaware of surgery and does not move or feel pain while it's being carried out. The anaesthetic agent is administered through an intravenous line or the anaesthetic agent may be inhaled through a breathing mask or tube. Inhalation anesthetics are also known to be found in two forms, gaseous anesthetics and the volatile anaesthetics. The volatile anesthetics are liquids at room temperature and need vapourizers to make it suitable for the inhalation purposes. Aim:The present study aimed to assess the knowledge and awareness on inhalation anaesthesia among dental students. Materials and Methods: The present study is an online based survey conducted among the dental students.The participants were from 1st, 2nd, 3rd and 4th years of BDS. Questionnaires were prepared and distributed among dental students through an online link from the survey planet. Results and Discussion: About 62% of the students were well aware of inhalation general anaesthesia. 55% of the students were aware of nitrous oxide as inhalation general anesthetics. From the results of the survey it is clear that most of the dental students were well aware of inhalation general anaesthesia and also had proper knowledge about its complications

A Brief Synopsis of Monoclonal Antibody for the Treatment of Various Groups of Diseases

Monoclonal antibodies (mAbs) are increasingly being prescribed to patients and investigated in the field of medicine and research. This class of medication is unique due to its ability to be engineered into targeting a specific receptor. Numerous studies and reviews have reported the efficacy, potency, and clinical usage of mAbs in the treatment of a variety of diseases ranging from autoimmune disorders to malignant cancers. However, very few publications classify and provide a brief synopsis of mAbs that includes their pharmacological profiles, mechanisms of action, uses, and side effects in a concise manner. Therefore, this review aims to classify the current mAbs drugs used in clinical practice according to system diseases by providing a brief summary for each of them. For example, regarding cardiovascular disorders, mAbs such as Abciximab, Bevacizumab, and Digoxin Immune Fab will be reviewed. Denosumab, used to treat musculoskeletal disorders, will be also discussed. In addition, mAbs such as Adalimumab, Eculizumab, Natalizumab used in autoimmune disorders and Alemtuzumab, Trastuzumab, Cetuximab, and Rituximab that are prescribed for tumors will be reviewed. Finally, we shall discuss two mAbs that are IL-6 antagonists, Tocilizumab and Siltuximab, which are in ongoing clinical trials as potential treatments of COVID-19. The mAbs have profound benefits against chronic and malignant conditions, and the overall purpose of this review is to illustrate the basic pharmacological profiles of mAbs that physicians may find useful in establishing their management protocols

A Hospital-based Observational Study of Type 2 Diabetic Subjects from India

Aim: The aim of this study was to describe the profile of the subjects with type 2 diabetes mellitus (T2DM) to obtain aclear picture from Western India, that would help in management of diabetes. Methods: An observational study wasconducted with newly diagnosed 622 type 2 diabetic subjects attending Dept. of Diabetology, All India Institute ofDiabetes and Research and Yash Diabetes Specialties Centre (Swasthya), Ahmedabad during the period from August 2006 to January 31, 2009. Subjects completed an interviewer-administered comprehensive questionnaire, which included variables such as sociodemographic presenting symptoms, risk profile (hypertension, obesity, dyslipidemia and glycemic status), family history of diabetes, physical activity and behavioral profile. Blood pressure, body mass index (BMI), glycosylated hemoglobin (HbA1c) and fasting lipid profile were measured. Descriptive and bivariate analyses were carried out using SPSS version 11.5. Results: A total of 622 T2DM cases with mean age (years) 47.7 ± 10.9 were studied. Of these, 384 (62%) were male. The majority of T2DM subjects were obese (68%) and 67% had positive family history of diabetes. Renal dysfunctions and vision impairment were found in 10% (62/622) and 9% (57/622), respectively in T2DM subjects. The mean HbA1c level was 9.02% ± 1.67 and good glycemic control (HbA1c level <7%) was achieved only in 7.4% T2DM subjects. The Chi-square (χ2) analysis showed that higher BMI (≥25 kg/m2) is significantly associated with hypertension among T2DM subjects (p < 0.01). There were statistically significant differences between male and female study subjects with respect to mean age, BMI, waist and hip circumference and mean low-density lipoprotein (LDL) level (p < 0.05). Conclusions: The present study revealed that obesity, family history of diabetes, dyslipidemia, uncontrolled glycemic status, sedentary lifestyles and hypertension were more prevalent in T2DM subjects. Hence, the overall risk profile was very poor and needs improvement. The characterization of this risk profile will contribute in defining more effective and specific strategies for screening and controlling T2DM in Western India

A Study on Kaba Yoni Rogam (Candida Albicans)

AIM AND OBJECTIVES: AIM: The aim of the dissertation work is to find the efficacy of treatment for Kabha yoni rogam (Candida albicans) with siddha drugs Reval Chinni Choornam and Karpoora Silasathu Parpam. OBJECTIVES OF THE STUDY: 1. To study the clinical course of the disease kabha yoni rogam – Vellai Noi with observation on Aetiology, classification, pathology, diagnosis, differential diagnosis, prognosis, complication and treatment by siddha aspect. 2. To screen the clinical methods of diagnosis by our siddhars and to know how the disease manifests due to deranged Mukkutrams, Poripulangal, Ezhu udal thathukkal and Envagai thervugal. 3. To have an idea about the incidence of the disease with age, occupation, economic status, habits, hereditary and clinical conditions. 4. To research with detailed clinical investigations. 5. To have a clinical trial on “Kabha yoni rogam” with Siddha Medicines, 6. Reval Chinni Choornam, 2.5g t.d.s with milk. 7. Karpoora Silasathu Parpam 130mg with ghee. 8. To evaluate the pharmacological effects of the trial medicines. 9. To use the modern parameters to confirm the diagnosis and prognosis of the Disease. SUMMARY: The clinical study on Kabha Yoni Rogam (Vaginal candidiasis) with the administration of the siddha drugs Reval Sinni Choornam and Karpoora Silasathu Parpam was carried out at Ayothidoss Pandithar Hospital Of National Institute of Siddha, Chennai-600 047. A total of 30 OPD patients were under my observation. The duration of treatment was fixed as 24 days. Clinical and pathological assessments were carried out on the basis of both siddha and medical systems. SUMMARY: The results on the studies summarized as follows: • Among the 30 cases, the maximum cases were in the age group of 31 to 35. • The case history reveals that most of the patients were of poor socioeconomic group. • From the history, it was seen that the incidence of Kabha yoni rogam is found to be more in Neithal Thinai and during Pinpanikalam and Elavenilkalam. • On examination the Uyirthathus deranged in maximum cases were: Vali → Abanan, Viyanan and Samanan. Azhal → Sathagam and Analagam. Iyyam → Kledagam and Santhigam. • Among Udal thathus saaram and suronitham were affected in most of the patients, senner, oon, kozhuppu in some of the cases. • Naadi showed Vadhapitham predominantly, Kabha vadham and Pitha vadham in some cases. • In most of the cases ESR was found to be raised and urine deposits were present. • Microscopial study of vaginal smear showed positive for Candida albicans for all the patients. • 30 patients were given. • Reval Chinni Choornam, 2.5g t.d.s with milk for seven days. • Karpoora Silasathu Parpam, 130mg b.d with ghee for 24 days. • The responses were assessed once in six days in the OPD and recorded in the proforma. The patients responded to the medicines showing gradual decrease in signs and symptoms. Also the medicines have been subjected to • Toxicological study. • Microbiological study. • Biochemical study. The above studies show that the drug acts well in Kaba Yoni Rogam and there is no toxicity. CONCLUSION: This study shows the efficacy of the drugs Reval Sinni Choornam and Karpoora silasathu parpam in curing kabha yoni rogham and opened a new chapter for further studies for infections. The Clinical, Microbiological, Toxicological and Biochemical studies show that the above drugs are free from toxicity and clearly emphasise the effectiveness of the drug

A Hospital-based Observational Study of Type 2 Diabetic Subjects from Gujarat, India

The aim of this observational study was to describe the profile of subjects with type 2 diabetes mellitus from Gujarat, India. The study was performed with newly-diagnosed 622 type 2 diabetic subjects who attended the Department of Diabetology, All India Institute of Diabetes and Research and Yash Diabetes Specialties Centre (Swasthya), Ahmedabad, during August 2006–January 2009. The subjects completed an interviewer-administered questionnaire. The questionnaire included variables, such as sociodemographic factors, presenting symptoms, risk profile (hypertension, obesity, dyslipidaemia, and glycaemic status), family history of diabetes, physical activity, and behavioural profile. Blood pressure, body mass index (BMI), glycosylated haemoglobin levels, and fasting lipid profile were measured. Descriptive and bivariate analyses were carried out using the SPSS software (version 11.5). In total, 622 type 2 diabetes mellitus (T2DM) cases with mean age of 47.7±10.9 years were studied. Of the 622 subjects, 384 (62%) were male. The majority (68%) of the T2DM subjects were obese, and 67% had a positive family history of diabetes. Renal dysfunctions and vision impairment were, respectively, found in 10% (n=62) and 9% (n=57) of the 622 T2DM subjects. The mean HbA1c level was 9.02±1.67%, and good glycaemic control (HbA1c level <7%) was achieved only in 7.4% of the T2DM subjects. Results of chi-square analysis showed that higher BMI (≥25 kg/m2) was significantly associated with hypertension among the T2DM subjects (p<0.01). There were significant differences (p<0.05) between male and female subjects with respect to mean age, BMI, waist and hip-circumference, and mean low-density lipoprotein (LDL) level. The results revealed that many factors, such as obesity, fami-ly history of diabetes, dyslipidaemia, uncontrolled glycaemic status, sedentary lifestyles, and hypertension were prevalent among the T2DM subjects. The characterization of this risk profile will contribute to designing more effective and specific strategies for screening and controlling T2DM in Gujarat, India

A rare case of spinal hydatid cyst (echinococcosis) presenting with paraparesis

Spinal hydatid cysts, although rare, can lead to debilitating neurological deficits if not promptly diagnosed and managed. We present an intriguing case of a 60-year-old male who presented with sudden-onset paraplegia, an unusual manifestation of spinal hydatid disease. The clinical complexity of paraplegia prompted a comprehensive diagnostic journey involving clinical, and radiological evaluations. Imaging studies unveiled a large hydatid cyst within the spinal canal, with epidural extension compressing the spinal cord. Surgical intervention was undertaken, and the cyst was successfully excised, leading to partial neurological recovery. This case serves as a reminder of the diverse clinical presentations of hydatid cysts and highlights the significance of maintaining a high index of suspicion in endemic regions. Early diagnosis, tailored management, and heightened awareness are pivotal in averting irreversible neurological damage and enhancing patient outcomes in such challenging cases