Evaluation of non-invasive ventilation compliance in obstructive sleep apnea syndrome or obesity hypoventilation syndrome patients: an observational study

Background: Recent times have seen the rise in obstructive sleep apnea syndrome/obesity hypoventilation syndrome (OSAS/OHS) patients across the globe. Availability of sleep study centers, questionnaires, and more awareness have made the diagnosis of OSAS/OHS early. But still, the majority of patients suffer from morbidity associated with OSAS/OHS despite the better diagnosis, the most common cause being non-adherence to (CPAP). This needs to be addressed more vigilantly and with utmost importance for successful management of OSAS/OHS.Methods: This is an observational study, we selected patients by reviewing sleep study records at a tertiary care center (Rohilkhand medical college and hospital) in Bareilly, India. All diagnosed patients with OSAS/OHS (i.e. AHI >5) were telephoned and enquired about symptoms and non-invasive ventilation (NIV) use. They were evaluated using a self-designed questionnaire.Results: In our study, we had total of 49 OSAS/OHS patients with mean age of 50.6 years and mean BMI of 35.63. Male patients were 37 (75.5%) and at the time of diagnosis AHI (mean) was 60.67 events/hour. In NIV users there were 24 patients (48.97%), 22 patients (91.7%) feel they have been benefitted from CPAP and 2 patients (8.3%) do not feel benefit from CPAP (NIV) use. Among NIV users there was significant drop of AHI (mean) to 8.07. Among NIV users there was a reduction in symptoms like excessive day time sleepiness in 18 patients (81.81%), witnessed apnea in 15 patients (88.23%), snoring in 21 patients (91.30%), blood pressure in 3 patients (21.42%), blood sugar levels in 2 patients (20%), morning headache in 5 patients (83.30%), depressive mood in 2 patients (40%), perceived memory loss in 3 patients (33.3%), sense of choking in 17 patients (94.4%) and weight loss in 19 patients (76%).Conclusions: CPAP significantly improves symptoms and provides objective as well as subjective benefit to OSAS/OHS patients but still significant proportion of patients hesitate to initiate the therapy. Poor education/awareness regarding OSAS/OHS and non-availability of affordable CPAP remains the leading cause of non-compliance. There is a need for early education, reinforcement and affordable CPAP therapy

The physiological study of Twak Upadhatu w.s.r. to Skin

In Samhitas Twak/Twacha is described as outermost protective layer of body as well as largest sensory organ of body. According to Acharya Charaka, Twacha is the Mula of Mansavaha Srotas and Updhatu of Mansadhatu. Acharya Sushrut and Acharya Charak very minutely described its layers according to their functions and also diseases which are related to those layers. Modern health science described skin in detail according to division of cell. Skin, the largest organ of human body, holds significant importance in maintaining normal human physiological condition. The conceptual aspect of skin needs to be understood because skin disorder is outer exhibition of some kind of internal pathology. The ancient science of Ayurveda has noted its features ages back. Ayurveda, the “Science of Life”, is a real wealth of medical sciences. In Ayurvedic oldest text Sushruta Samhita- Shareer sthana, Acharya Sushruta has mentioned five sensory organs i.e. Gyanendriyas. Sparshanendriya is one of them whose Adhishthana is Twacha (skin). As we know, skin is the largest sense organ of the body which sense touch, pain, pressure, temperature etc. It is also known as “The First Line of Defense”. Ayurveda is real wealth of medical sciences which gives preference to prevention of health in healthy person and provides best treatment to diseased one. It believes in complete elimination of root cause of disorder rather than short-term relief. Skin is the largest and first site visible organ of body which acquires 1.5-2 square meter surface area of the body. It is not merely protecting covering but it is reflection of the internal system of the body

DYNAMIC TELEMETRY PROFILE ENFORCEMENT IN A CONTROLLER NETWORK

Because telemetry processing can involve high resource usage, such processing is typically provided via a cloud infrastructure. However, there are drawbacks to current implementations involving such cloud infrastructure processing. For example, such processing typically follows standard processing patterns. Yet, with the increasing complexity of different network use cases, there are scenarios that would benefit from dynamic telemetry processing. Presented herein are techniques through which multiple device telemetry profiles can allow a cloud controller to dynamically match a telemetry profile to specific conditions for a tenant network. Each telemetry profile may include selections for data processing through priority and secured queues. Additionally, the cloud controller may have reverse telemetry policies to push reverse telemetry to the customer edge when original usage telemetry data is retrieved, processed, and/or transferred

The physiological study of Prakopavastha of Shatkriyakala w.s.r. to Seasons (Ritu’s)

The Prayojana of Ayurveda is of two types, maintenance of health a healthy person, by adopting the Ritucharya, Dincharya and Sadvritta and curing of a disease of diseased Person, by adopting therapeutic measures. Kriya means Action or treatment. Kala means time or period. Shatkriyakala means ‘Appropriate time periods to take action/treatment. Acharya Susrutha has narrated detail idea of Shatkriyakala in 21st chapter of Sutrasthana. Shatkriyakala include six stages viz. Sanchaya, Prakopa, Prasara, Sthansamshraya, Vyaktavastha and Bhedavastha. Shatkriyakala is distinctive concept of Ayurveda. By knowing the process of Shatkriyakala the disease process can be arrest at initial stage and avoid the probabilities of complications. Acharya Sushruta already mentions the Kriyakala helps the physician to adopt line of treatment by seeing the vitiated Dosha condition by his intellect and knowledge. So, we can say that the physician who diagnose a disease and treat according to Shatkriyakala will be become a successful Practitioner

Comparison of BACTEC MGIT with conventional methods for detection of Mycobacteria in clinically suspected patients of extra pulmonary tuberculosis in a tertiary care hospital

Background: Tuberculosis is an important public health problem in India and globally.  Extra pulmonary tuberculosis (EPTB) constitutes for approximately 15 to 20 per cent of all cases of tuberculosis in immunocompetent patients and accounts for more than 50 per cent of the cases in HIV- positive individuals. Main problem with the extra-pulmonary tuberculosis is the paucibacillary nature of the specimen, which makes the diagnosis difficult and delay the treatment. With this in background, this study aimed at the isolation of Mycobacteria from clinical specimens of patients suspected of extra pulmonary tuberculosis using BACTEC MGIT, Lowenstein Jensen (LJ) media and direct acid-fast bacilli smear examination.Methods: A total of 66 samples were processed for direct AFB smear examination, and culture on MGIT and LJ media. Acid fast staining of the specimens was done using the Ziehl-Neelsen method.Results: Among 66 specimens, MGIT gave a higher yield of mycobacteria (46.9%), lower contamination rate (3%) and shorter time to positive culture as compared to LJ media.Conclusions: MGIT gives higher yield and faster results

Comprehensive survey on nanobiomaterials for bone tissue engineering applications

One of the most important ideas ever produced by the application of materials science to the medical field is the notion of biomaterials. The nanostructured biomaterials play a crucial role in the development of new treatment strategies including not only the replacement of tissues and organs, but also repair and regeneration. They are designed to interact with damaged or injured tissues to induce regeneration, or as a forest for the production of laboratory tissues, so they must be micro-environmentally sensitive. The existing materials have many limitations, including impaired cell attachment, proliferation, and toxicity. Nanotechnology may open new avenues to bone tissue engineering by forming new assemblies similar in size and shape to the existing hierarchical bone structure. Organic and inorganic nanobiomaterials are increasingly used for bone tissue engineering applications because they may allow to overcome some of the current restrictions entailed by bone regeneration methods. This review covers the applications of different organic and inorganic nanobiomaterials in the field of hard tissue engineering

Solar Power Plant Location Selection Problem by using ELECTRE-III Method in Pythagorean Neutrosophic Programming Approach (A case study on Green Energy in India)

India dropped its target of 500 GW of renewable energy capacity fossil fuel sources by 2030. Its responsibilities the United Nations Framework Convention Climate Change [UNFCCC],and reducing radiations by one billion tonnes by the end of the decade at the COP26 conference, held in Glasgow in November 2022. Researchers are continually searching for inexhaustible and reasonable energy sources. Solar energy is one of the greenest sources of energy and is also one of the cleanest. The most important factor in using solar energy is the location of the solar power plant. The main objective of this study is to find the best location for a new solar power plant in a specific region called Bundelkhand region of Uttar Pradesh in India. Here we offer an extension of ELECTRE III method as two-phase Pythagorean neutrosophic elimination and choice translating reality PN-ELECTRE-III) method to adapt with fuzzy, ambiguous, unsure, and indeterminate criteria. The Pythagorean neutrosophic numbers [PNNs] used by the group decision support system of PN-ELECTRE III to measure performance of the alternatives. The options are entirely outclassed in the subsequent stage in view of the past stage's evaluations of them. By defining PNN we describe the technique of indifference threshold functions, preference treshold and veto threshold functions, which provide a more stable basis to drop outranking relations. By calculating the concordance credibility, discordance credibility and net credibility degrees of each alternative, the ranking module of the PN-ELECTRE III approach is made simpler. In order to confirm the applicability of the strategy suggested in this paper, the location selection problem for solar plants is finaly solved