Clinical and laboratory profile of children admitted with measles in a tertiary care teaching hospital

Background: Measles is a vaccine-preventable viral illness associated with substantial childhood morbidity and mortality. Recently, changing trends in the occurrence of measles are noted like incidence in younger infants and in those who have received measles vaccine. Objectives: The objective was to study the clinical profile of children with measles and to study the usefulness of polymerase chain reaction (PCR) in diagnosing measles and to study the measles-specific immunoglobulin M (IgM) response in children with measles. Materials and Methods: This study was done in the Pediatrics Department of a Tertiary Care Center, and the study population was children up to 12 years of age admitted in the setting with a clinical diagnosis of measles during the study period and who were laboratory confirmed by PCR/IgM ELISA or both. Results: Of 173 clinically diagnosed cases, 149 laboratory confirmed cases were taken for analysis and studied. Of these, 47% of cases were below 9 months. Newborns constituted 2.01% of the total cases. The mean age was 13 months and the male:female ratio was 1.13:1. A total of 24.8% children were unimmunized, 16.77% had a single dose, and 8.72% had 2 doses of measles vaccine. Overall mortality was 0.67% and bronchopneumonia was the major complication (76.5%). Among immunized children with measles confirmed by PCR, measles-specific IgM response was reactive in 36.4% of cases. In the early phase of measles (within 3 days) confirmed by PCR, IgM response was inconclusive in 60% of cases. Conclusion: In our study, 47% of the cases of measles were below 9 months; therefore, the age of measles vaccination may be reconsidered. Among eligible cases (>9 months), 24.83% were not immunized for measles which indicates that measles immunization coverage should be increased. Among the measles cases, 25% had measles vaccination which highlights the need to check for the determinants of vaccine failure. In our study, the RT-PCR was found to be useful for early diagnosis of measles and for diagnosis in immunized children

Incentive spirometry prescription and inspiratory capacity recovery guideline for the early period after open heart surgery

Incentive spirometry (IS) is often used as lung expansion therapy for increasing postoperative IS inspiratory capacity (ISIC) in open heart surgery (OHS) patients. However, currently there is a lack of guidelines and prescription on how this therapy should be administered for these patients. Although there is some information on several patient- and surgery- related factors associated with ISIC volumes after OHS, the role of IS performance variables such as IS inspiration volumes (ISv) and IS inspiration frequency (ISf) has not been investigated. In order to formulate evidence-based IS therapy guidelines and prescription, this study investigated factors, which included ISv and ISf, to identify predictors of ISIC recovery in a cohort of OHS patients in Hospital Sultanah Aminah, Johor Bahru (HSAJB). This study involved collection of objective and precise IS performance data of 95 OHS patients using a newly developed and validated multisensor data collection device (ISDCD) for five consecutive postoperative days (POD). Data analysis identified ISv as the sole predictor of ISIC recovery which explaines 23%, 24%, 17% and 25% of variances for ISIC recovery on POD2, POD3, POD4 and POD5 respectively. Three pathways for postoperative ISIC recovery were also identified, namely for patients following the fastest pathway having the highest ISIC recovery rate of 19% for each POD, followed by 16% for the middle pathway and 12% for slowest. The findings facilitated the formulation of evidence-based IS therapy prescription and ISIC recovery guidelines from POD1 to POD4. However, these findings need to be verified further through research involving comprehensive and objective evaluation of IS performance using appropriate technology devices

Incentive spirometry prescription and inspiratorycapacity recovery guideline for early period after open heart surgery

Incentive spirometry (IS) is often used as lung expansion therapy for increasing postoperative IS inspiratory capacity (ISIC) in open heart surgery (OHS) patients. However, currently there is a lack of guidelines and prescription on how this therapy should be administered for these patients. Although there is some information on several patient- and surgery- related factors associated with ISIC volumes after OHS, the role of IS performance variables such as IS inspiration volumes (ISv) and IS inspiration frequency (ISf) has not been investigated. In order to formulate evidence-based IS therapy guidelines and prescription, this study investigated factors, which included ISv and ISf, to identify predictors of ISIC recovery in a cohort of OHS patients inHospital Sultanah Aminah, Johor Bahru (HSAJB). This studyinvolved collection of objective and precise IS performance data of 95 OHS patients using a newly developed and validated multisensor data collection device (ISDCD) for five consecutive postoperative days (POD). Data analysis identified ISv as the sole predictor of ISIC recovery which explaines 23%, 24%, 17% and 25% of variances for ISIC recovery on POD2, POD3, POD4 and POD5 respectively. Three pathways for postoperative ISIC recovery were also identified, namelyfor patients following the fastest pathway having the highest ISIC recovery rate of 19% for each POD, followed by 16% for the middle pathway and 12% for slowest. The findings facilitated the formulation of evidence-based IS therapy prescription and ISIC recovery guidelines from POD1 to POD4. However, these findings need to be verified further through research involving comprehensive and objective evaluation of IS performance using appropriate technology devices

Dietary supplementation of Cinnamomumverum J. Presl and Curcuma longa L. extract on growth performance, antioxidant and metabolic enzymes activities in experimental rats

242-248Cinnamomumverum J. Presl and Curcuma longa L. have many biologically active metabolites, such as sterpenoids, phenolics with proven health benefits. The present study was undertaken to analyze the effect of cinnamon and turmeric extract on growth, blood parameters, and metabolic enzyme activities of albino Wistar rats. Methanol extract of cinnamon and turmeric mixture was supplemented in rat feed at 2.5 and 5% concentration, respectively and administered for 30 days. During the course of study, body weight, feed given, feed consumed data were collected at regular intervals. After the experimental period, animals were sacrificed, tissues separated, homogenized and assayed for the activity of catalase, superoxide dismutase (SOD), glutathione-s-transferase (GST), lactate dehydrogenase (LDH), malate dehydrogenase (MDH), alanine aminotransferase (AAT) and aspartate aminotransferase (AST). The results showed significant increase in liver catalase activity of treated animals and no significant changes in LDH, MDH, ALT and AST. No abnormalities were observed in the histopathology staining of tissue section. Overall, output of the present study could be useful for production of spices based antioxidant rich products for human health

A simple upper limb rehabilitation trainer

Stroke is a leading cause of disability which can affect shoulder and elbow movements which are necessary for reaching activities in numerous daily routines. To maximize functional recovery of these movements, stroke survivors undergo rehabilitation sessions under the supervision of physiotherapists in healthcare settings. Unfortunately, these sessions may be limited due to staff constraints and are often labor-intensive. There are numerous robotic devices which have been developed to overcome this problem. However, the high cost of these robots is a major concern as it limits their cost-benefit profiles, thus impeding large scale implementation. This paper presents a simple and low cost interactive training module for the purpose of upper limb rehabilitation. The module, which uses a conventional mouse integrated with a small DC motor to generate vibration instead of any robotic actuator, is integrated with a game-like virtual reality system intended for training shoulder and elbow movements. Three games for the module were developed as training platforms, namely: Triangle, Square and Circle games. Results from five healthy study subjects showed that their performances improved with practice and time taken to complete the Triangle game was the fastest of the three

Enhanced Novel Technique for Mobile Cloud To Support Confidentiality and Security

In this work, a hierarchical access control method using a modified hierarchical attribute-based encryption (M-HABE) and a modified three-layer structure is proposed. Varying from the current ideal models, for example, the HABE algorithm and the first three-layer structure, the novel plan principally centres around the information handling, putting away and getting to, which is intended to guarantee the application clients with legitimate access experts to get relating detecting information and to confine restrict illegal and unapproved lawful clients access the information, the proposed promising worldview makes it to a great degree reasonable for the portable distributed computing based worldview. What ought to be underlined is that the most imperative feature of all in the proposed paper can be depicted as that the altered three-layer structure is intended for unravelling the security issues outlined previously

Development of a novel device for monitoring incentive spirometry performance

Lung atelectasis caused by shallow breathing patterns is common after cardiac, thoracic and upper abdominal surgeries. A common method used to address this problem is to encourage patients to perform breathing exercises using incentive spirometers in the postoperative period. However, to be effective, this procedure must be repeated regularly so that adequate lung volumes can be maintained to prevent atelectasis. Current models of single-use, low-cost incentive spirometers do not have features that can track and store data on breathing exercises. This makes it difficult to monitor patients’ breathing exercises effectively. We present here a device designed to be interfaced with the Spiro-ball incentive spirometer and programmed to monitor the incentive spirometry performance. Laboratory based validation performed indicate that there were no significant differences between the value obtained from the device and manual reading; p-value > 0.05 and root-mean-square error (RMSE) is 3.882. The device was able to retrieve and display pertinent data on incentive spirometry performance. It was also able to correctly track and register random sets of inspiration data through different dates and timelines. Being a separate entity which is reusable, it does not add to the cost of the single-use incentive spirometer

Dietary supplementation of CinnamomumverumJ.Presl and Curcuma longa L. extract on growth performance, antioxidant and metabolic enzymes activities in experimental rats

Cinnamomumverum J. Presl and Curcuma longa L. have many biologically active metabolites, such as sterpenoids, phenolics with proven health benefits. The present study was undertaken to analyze the effect of cinnamon and turmeric extract on growth, blood parameters, and metabolic enzyme activities of albino wistar rats. Methanol extract of cinnamon and turmeric mixture was supplemented in rat feed at 2.5 and 5% concentration, respectively and administered for 30 days. During the course of study, body weight, feed given, feed consumed data were collected at regular intervals. After the experimental period, animals were sacrificed, tissues separated, homogenized and assayed for the activity of catalase, superoxide dismutase (SOD), glutathione-s-transferase (GST), lactate dehydrogenase (LDH), malate dehydrogenase (MDH), alanine aminotransferase (AAT) and aspartate aminotransferase (AST). The results showed significant increase in liver catalase activity of treated animals and no significant changes in LDH, MDH, ALT and AST. No abnormalities were observed in the histopathology staining of tissue section. Overall, output of the present study could be useful for production of spices based antioxidant rich products for human health

Correlation of Interleukin-17 and 23 Inflammatory Markers with Genetically Transmitted Spondyloarthritis Patients at a Tertiary Care Facility, South India

Human leukocyte antigens (HLA) are genetically derived proteins in the major histocompatibility complex. They help distinguish “self” and “non-self” antigens and are essential in interacting with the immune cells inside the body. The present research work examines the prevalence of HLA-B27 among patients suspected of Spondyloarthritis (SpA), which has also been correlated with Interleukin-17/23 Inflammatory Markers and other clinical manifestations and was carried out between August 2017 to January 2021. The patient’s blood samples were collected and tested for HLA-B27 and Interleukin-17/23 inflammatory markers. Among 289 SpA patients, 60% (172) were males, and 40% (117) were females, with a ratio of 1.5:1. Ankylosing Spondylitis (65.1%) was found to be the most prevalent subgroup of SpA among the patients, closely followed by reactive arthritis (21%), psoriatic arthritis (10.7%), undifferentiated spondyloarthritis (2.1%), and inflammatory bowel disease with associated arthritis (1%). HLA-B27 was found to be positive in 54% (156) out of 289 patients. Normal IL-17 ranges were seen in 42% of HLA-B27- positive patients, while increased IL-17 was seen in 58% of the population with positive HLA-B27 cases. IL-23 was found within normal ranges in 40% of positive HLA-B27 cases, while it was found to be increased in 60% of the positive HLA-B27 positive subjects. We concluded that HLA-B27 was found to be positive among more than half of the patient population with SpA. The early detection of HLA-B27 may aid in changing lifestyle to prevent Spondyloarthritides