Knowledge, stress and adopted coping strategies of parents of children having congenital adrenal hyperplasia: An exploratory survey

Background: Congenital adrenal hyperplasia (CAH) is an inherited disorder of adrenal glands, the most common type being due to a deficiency of the enzyme 21-α-hydroxylase. Girls affected with it are virilized to a variable extent. The taboo associated with ambiguous genitalia in female babies poses an immense societal pressure on parents for keeping the disease a secret. Objective: The aim of the study was to generate the evidence on the knowledge, stress, and coping strategies used by the parents of CAH children. Methodology: In a cross-sectional descriptive survey using mixed methods approach, 30 parents of children with CAH attending the outdoor department of pediatric medicine and surgery in a tertiary care hospital were enrolled. The CAH knowledge questionnaire, parental stress scale (PSS), and COPE inventory were the standardized tools used along with demographic profile sheet to assess the knowledge of parents related to CAH, stress, and coping strategies used by them. Results: Majority of the parents (67%) had poor knowledge (<7) and moderate stress (42-65) scores. Knowledge and stress were negatively correlated (r=−0.39, p=0.035). Coping strategies used by the parents in dealing with stress in moderate amount were mainly problem-focused (active coping [60%] and planning [60%], instrumental social support [53%], suppression of competing activities [50%]), and emotion-focused (positive reinterpretation [60%], emotional social support [67%], acceptance [53%], and religious coping [50%]). Less useful coping strategies such as focus on and venting of emotions, behavioral disengagement, mental disengagement, humor, and substance abuse were not used by the majority parents. Conclusion: Parents of children with CAH had poor knowledge and moderate stress related to the disease condition of their children and were using problem focused and emotion focused coping strategies to reduce their stress

Image Inpainting with Improved Storage Capability using DCT

Nowadays, tremendous amount of digital media is generating but having grazes on it. In this paper we proposed new idea to remove the graze from image, called image inpainting where in, Exemplar based image inpainting follows discrete cosine transform . The exemplar based image inpainting is based on copy-and-paste texture synthesis for reconstructing damaged parts of an image. Based on exemplar-matching techniques performance and speed of algorithm increases but size of image is also increases so, we proposed discrete cosine transform for reducing the size of image, removing noise and ultimately provides it good quality of image

Comparison and Evaluation of Prefabricated Mouthguards and Replaced Customized Mouthguards in Children of Bhopal

To assess the change in perspective, when prefabricated mouthguards were replaced with customized mouthguards among children in Bhopal, Madhya Pradesh. Materials and Method: This survey was conducted among children between 8 to 18 years age in two phases. The first phase included a 10 item questionnaire to be filled by athletes participating in different sports which consisted of three sections a) mouthguard awareness b) reasons for not wearing a mouthguard and the third section consisted of c) evaluating the level of acceptance of customised mouthguards. The latter part of the survey was completed after 25 randomly selected participants who were made to use customised mouthguards to evaluate the acceptability for the same. The statistical analysis was performed using the SPSS (21.0 version; Inc., Chicago IL, USA) for descriptive and multivariate analysis, and the level of statistical significance used in this study was at P < 0.005 Results: Use of contact mouthguard was more significant (P-value was 0.0001.) when the use of mouthguards were compared with  non contact sports. It was found that custom made mouthguards are more comfortable than prefabricated one with significant difference (P= 0.051). Conclusion: Custom made mouthguards can prevent dental and orofacial injuries better than the preformed mouthguards. So considering the high level of willingness to wear mouthguards efforts should be made towards increasing the awareness on its benefits. The players were comfortable with custom made mouthguards so it can be proposed to the government officials to make their use mandatory with some subsidy to decrease the number of accident

AYUSH-64 as an adjunct to standard care in asymptomatic, mild, and moderate COVID-19: A systematic review and meta-analysis

The study was planned to systematically review the available evidence from randomized controlled trials on the efficacy and safety of AYUSH-64 in managing COVID-19. Electronic databases such as PubMed, Ayush Research Portal, DHARA, Cochrane CENTRAL, etc. were searched from December 2019 to October 2021, and updated in February 2022. The risk of bias was assessed through the RoB2 tool. Meta-analysis was done with the Review Manager 5.4 tool. The quality of cumulative evidence was evaluated through the GRADE approach. This study includes five RCTs with 420 participants. The risk of bias was assessed as low for most of the studies. The results demonstrated that AYUSH-64 administration as an adjunct to standard care was significantly better compared to standard care alone for asymptomatic, mild, and moderate COVID-19 in terms of clinical recovery (OR= 2.35; 95% CI= 1.33 to 4.16; p=0.003), and mean time to clinical recovery (SMD= -0.67; 95% CI= -1.16 to -0.18; p=0.007). There was no statistically significant difference between groups in SARS-CoV-2 clearance assessed by RT-PCR assay (OR= 1.21; 95% CI= 0.51 to 2.88; p=0.66). The overall incidence of adverse events showed no significant difference between groups (p=0.65). The quality of evidence was assessed as moderate for clinical recovery and low for SARS-CoV-2 clearance. Meta-analysis of five RCTs demonstrated that AYUSH-64 as an adjunct to standard care hastens clinical recovery and is safe in asymptomatic, mild, and moderate COVID-19. However, more robust RCTs would be required to generalize the results of this systematic review

Design of Active Filter Using Substrate Integrated Waveguide

In this project we have designed circuit models for Substrate Integrated Waveguide (SIW) filter at X band with a bandwidth of 1 GHz. These equivalent models are designed in ADS using lumped and semi-lumped approach. Based on these models a 3D structure of the filter is designed in CST. This design is fabricated on a Rogers 5880 substrate using photolithography and corresponding measurements are done to compare with simulations. In the second half of the project SIW filter is used with an active element to achieve non negative insertion loss. This can be achieved by using a negative resistance element such as Gunn Diode, Tunnel Diode etc. Gunn diode model is designed using JFETs which is integrated with the filter to demonstrate active filtering. Alternatively another method is explored using PHEMTS. PHEMT used in this case is VMMK 1225 from Avago Technologies

Critical Performance Analysis of The Health Insurance Sector In India During Covid-19 Outbreak: ---7th International Conference on Embracing Change & Transformation Innovation and Creativity

Introduction: Health insurance is one of the main non-life insurance sectors, which contributes nearly 29% of general insurance premium income. Almost every industry in the world has been affected by the COVID-19 outbreak and its associated lockdowns, including the Indian insurance industry, which makes a significant contribution to a nation's Gross Domestic Product (GDP) and economic development. Objectives: This review of literature aims to critically evaluate the performance of Indian health insurance companies along with examining various opportunities and challenges during the time of COVID-19 pandemic. Method: The present study is a combination of both exploratory and descriptive literature review types and was entirely based on published secondary data. Literature searches were performed using Google Scholar, Research Gate, ProQuest, and Scopus databases for articles published between 2020 and 2022. The study also used various annual reports of the Insurance Regulatory and Development Authority of India (IRDAI), the internet, newspaper articles, and company websites for the study. Results: Even though there was a lack of literature on this topic, 19 articles were identified for review based on the keyword search that most closely matched the topic of the study. The study assesses the effectiveness of various Indian health insurance companies using four key metrics: gross health premium income, incurred claim ratio, number of policies issued or covered and amount of claim paid. Results of the study have shown that as more people get health insurance during the COVID-19 pandemic, there is a notable growth seen in the overall performance of the health insurance business. Conclusion: Health insurers faced both opportunities and challenges as a result of the COVID-19 pandemic, including the imperative need to develop more customer-centric new products and services that enable them to provide a significant health insurance benefit to the large untapped population of the Indian market. *(The paper presented at the 7th International Conference on Embracing Change & Transformation Innovation and Creativity 26-28 May 2022

Sonographic assessment of predictors of depth of the corner pocket for ultrasound-guided supraclavicular brachial plexus block

Background and Aims: There is wide variation in depth of brachial plexus in patient population at supraclavicular region. We plan to find the depth of the corner pocket and correlate it with age, weight, height and body mass index (BMI). Material and Methods: After approval from Ethics Committee, right-sided supraclavicular region of volunteers was scanned. Once an optimal image, which included subclavian artery, pleura, first rib and nerve bundles, was obtained, the "corner pocket" was kept in the middle of the screen and the image was frozen. Depth of the corner pocket from the skin was measured. Thereafter longest distance (LD) approximating needle trajectory was calculated. The Pearson correlation was used to calculate the relation between these two distances and various predictors such as weight, height, and BMI. Results: Mean shortest distance that is, vertical distance from skin to corner pocket for all volunteers was found to be 1.7 ± 0.8 cm and the mean LD that is, distance traveled by needle entering 1 cm from the edge of foot process to the corner pocket in an in-plane approach was 3.7 ± 0.2 cm. We did not find any significant correlation between age, height versus measured distances. However, significant correlation (0.11) was found between weights, BMI versus two lengths. Conclusion: Prescanning of supraclavicular region for estimating depth of corner pocket should be done before choosing an appropriate size needle. Furthermore, the needle should not be advanced more than the predicted corner pocket depth

Sonographic assessment of predictors of depth of the corner pocket for ultrasound-guided supraclavicular brachial plexus block

Background and Aims: There is wide variation in depth of brachial plexus in patient population at supraclavicular region. We plan to find the depth of the corner pocket and correlate it with age, weight, height and body mass index (BMI). Material and Methods: After approval from Ethics Committee, right-sided supraclavicular region of volunteers was scanned. Once an optimal image, which included subclavian artery, pleura, first rib and nerve bundles, was obtained, the "corner pocket" was kept in the middle of the screen and the image was frozen. Depth of the corner pocket from the skin was measured. Thereafter longest distance (LD) approximating needle trajectory was calculated. The Pearson correlation was used to calculate the relation between these two distances and various predictors such as weight, height, and BMI. Results: Mean shortest distance that is, vertical distance from skin to corner pocket for all volunteers was found to be 1.7 ± 0.8 cm and the mean LD that is, distance traveled by needle entering 1 cm from the edge of foot process to the corner pocket in an in-plane approach was 3.7 ± 0.2 cm. We did not find any significant correlation between age, height versus measured distances. However, significant correlation (0.11) was found between weights, BMI versus two lengths. Conclusion: Prescanning of supraclavicular region for estimating depth of corner pocket should be done before choosing an appropriate size needle. Furthermore, the needle should not be advanced more than the predicted corner pocket depth

Advances and challenges in the use of chitosan and its derivatives in biomedical fields: A review

Chitosan is known to possess excellent properties such as biodegradability, biocompatibility, antimicrobial activity and less toxicity due to which it has applications in various fields. Another important benefit of chitosan is that it can be processed into different forms like membranes, sponges, gels, scaffolds, microparticles, nanoparticles, nanofibers and 3D printed constructs. For these reasons, chitosan has found to be highly advantageous in biomedical field. The reactive amino and hydroxyl groups in its chemical structure make it an ideal candidate for a wide range of applications. However, the compromising mechanical strength of chitosan limits its applications, which can be improved using nanotechnology. Chitosan based nanocomposites have gained significant attention in the last two decades. In the present review, we discuss the advantages of chitosan based nanocomposites for biomedical applications majorly tissue engineering, wound dressing and drug delivery. This review emphasizes on recent findings concerning the use of innovative chitosan based nanocomposites in biomedical applications. It also covers brief overview of chitosan, its extraction, structure and modifications and its  in vitro and in vivo efficacy. Then, a detailed summary of recent progress in biomedical applications are presented. Current chitosan based nanocomposite as product in market, future perspectives and challenges are also discussed

Ameliorating impaired cardiac function in myocardial infarction using exosome-loaded gallic-acid-containing polyurethane scaffolds

Myocardial infarction (MI) can be tackled by implanting cardiac patches which provide mechanical support to the heart. However, most tissue-engineered scaffolds face difficulty in attenuating oxidative stress, maintaining mechanical stability, and regenerating damaged cardiomyocytes. Here, we fabricated elastic cryogels using polyurethane modified with antioxidant gallic acid in its backbone (PUGA) and further coated them with decellularized extracellular matrix (dECM) to improve adhesiveness, biocompatibility and hemocompatibility. The scaffold was functionalized with exosomes (EXO) isolated from adipose-derived stem cells having regenerative potential. PUGA-dECM + EXO was tested in a rat model with induced MI where echocardiography after 8 weeks of implantation showed significant recovery in treatment group. Histological analysis revealed a decrease in fibrosis after application of patch and promotion of angiogenesis with reduced oxidative stress was shown by immunostaining. Expression of cardiac tissue contractile function marker was also observed in treatment groups. Thus, the proposed biomaterial has a promising application to be utilized as a patch for cardiac regeneration. More detailed studies with larger animal species are needed for using these observations for specific applications