Impact of media: self-medication and the rising problem of antimicrobial resistance

Antimicrobial agents (AMAs) are one of the most commonly used as well as misused drugs. Antimicrobial resistance is an important growing global health issue which needs urgent addressal.Self-medication involves the use of medicinal products by the patient to treat self-recognized disorders, symptoms, recurrent diseases, or minor health problems. Medicines for self-medication are often called over the counter (OTC) drugs, which are available without a doctor’s prescription through pharmacies, mostly in the developing countries. Self-medication particularly with antibiotics has been widely reported, leading the World Health Organization to call attention to its dangers as a cause of antimicrobial resistance

Characterization of Surface-Treated NiTi Alloy by Various Electrochemical Techniques in Phosphate-Buffered Saline

Sol–gel titania thin film coating was prepared on NiTi surfaces, modified with acidified ferric chloride solution. Nanogrids formed on chemical treatment were uniformly covered with titania coating. Cyclic voltammetry studies in phosphate-buffered saline solution revealed that sol–gel titania-coated surface displayed electrochemical properties which were similar to those observed for pure titanium. During polarization, the passive layer formed on modified NiTi was stable for potentials greater than 0.9 V. The overall resistance measured by electrochemical impedance spectroscopy for sol–gel titania surface was in the order of 10⁵ Ω, which was approximately two orders higher than bare NiTi surface. The current noise analyzed using electrochemical noise measurements was minimum after sol–gel coating, which emphasizes the better protection power of the surface from the attack of corrosive species. Dynamic impedance studies carried out on bare and titania-coated NiTi also supports the results obtained from cyclic polarization

Design and Implementation of High QoS 3D-NoC using Modified Double Particle Swarm Optimization on FPGA

One technique to overcome the exponential growth bottleneck is to increase the number of cores on a processor, although having too many cores might cause issues including chip overheating and communication blockage. The problem of the communication bottleneck on the chip is presently effectively resolved by networks-on-chip (NoC). A 3D stack of chips is now possible, thanks to recent developments in IC manufacturing techniques, enabling to reduce of chip area while increasing chip throughput and reducing power consumption. The automated process associated with mapping applications to form three-dimensional NoC architectures is a significant new path in 3D NoC research. This work proposes a 3D NoC partitioning approach that can identify the 3D NoC region that has to be mapped. A double particle swarm optimization (DPSO) inspired algorithmic technique, which may combine the characteristics having neighbourhood search and genetic architectures, also addresses the challenge of a particle swarm algorithm descending into local optimal solutions. Experimental evidence supports the claim that this hybrid optimization algorithm based on Double Particle Swarm Optimisation outperforms the conventional heuristic technique in terms of output rate and loss in energy. The findings demonstrate that in a network of the same size, the newly introduced router delivers the lowest loss on the longest path.  Three factors, namely energy, latency or delay, and throughput, are compared between the suggested 3D mesh ONoC and its 2D version. When comparing power consumption between 3D ONoC and its electronic and 2D equivalents, which both have 512 IP cores, it may save roughly 79.9% of the energy used by the electronic counterpart and 24.3% of the energy used by the latter. The network efficiency of the 3D mesh ONoC is simulated by DPSO in a variety of configurations. The outcomes also demonstrate an increase in performance over the 2D ONoC. As a flexible communication solution, Network-On-Chips (NoCs) have been frequently employed in the development of multiprocessor system-on-chips (MPSoCs). By outsourcing their communication activities, NoCs permit on-chip Intellectual Property (IP) cores to communicate with one another and function at a better level. The important components in assigning application duties, distributing the work to the IPs, and coordinating communication among them are mapping and scheduling methods. This study aims to present an entirely advanced form of research in the area of 3D NoC mapping and scheduling applications, grouping the results according to various parameters and offering several suggestions for further research

Performance of Regional Rural Banks after Amalgamation in India: Progress and Prospects

For the past three decades India's banking system has several outstanding achievements to its credit. The most striking is its extensive reach. It is no longer confined to only metropolitans or cosmopolitans in India. In fact, Indian banking system has reached even to the remote corners of the country. This is one of the main reasons for India's growth process. The government's regular policy for Indian banks since 1969 has paid rich dividends with the nationalization of 14 major private banks of India. Regional Rural Banks started their development process on 2 October 1975 with the formation of a single bank—Prathama Grameen Bank. The RRBs mobilize financial resources from rural/semi-urban areas and grant loans and advances mostly to small and marginal farmers, agricultural labourers and rural artisans. The area of operation of RRBs is limited to the area as notified by GoI covering one or more districts in the State. In this context, the present study is an attempt to examine the impact of amalgamation on physical performance of RRBs during post-amalgamation period

Lingual abscess: a rarity

Abscess of the tongue seems to be a rare clinical entity and is a potentially life threatening infection. This acute enlargement of the tongue can present as an emergency, due to an air-way compromise and disseminated infection to other regions. Thus, a tongue abscess should be considered in all cases of acute tongue swellings, especially when host defenses are severely impaired. In acute cases the diagnosis of tongue abscess can be reached clinically. In later cases, culture and smear analysis are useful diagnostic tools, whereas antibiotics provide considerable amelioration of symptoms. Although none of our cases were life threatening, but we could able to diagnose these cases, based on their classic clinical symptoms and all three cases were confirmed by using standard diagnostic tool. They were put on antibiotics and anti-inflammatory drugs for the relief of symptoms followed by the local drainage. The following article explains pathophysiology, differential diagnosis and management of these tongue abscess cases in detail

The prevalence of tongue lesions in Libyan adult patients

This is the first ever-detailed study of tongue diseases in Libyan population, where the tongue conditions found in 320 patients (9.2%) of 3,460 consecutive patients screened in the department of Oral Medicine and Oral Diagnosis at faculty of dentistry, Benghazi Libya. Both sexes were affected almost equally and only 25 patients were aware of their tongue disease. Forty patients had one or more systemic illness, 34 of them was on regular medications. Fissured tongue was the most prevalent condition, as it has been found in 155(48.4%) patients, depapillated tongue in 82(25.6%) patients and geographic tongue in 55(17.2%) patients, other disease conditions were found in a lesser number of patients. Fifty-four patients had painful tongue conditions; other complaints included malodor, speech interferences or swallowing difficulties. Most conditions were confined to the tongue and in more than 90%, there had been involvement of the dorsum of the tongue. Fortunately, most tongue conditions can easily be diagnosed on clinical grounds by any experienced clinician, hence, the histopathological examination and other investigations are needed in only few cases. There is a wide variation in the prevalence of most of tongue diseases worldwide due to the lack of uniformity in criteria of the studies. Thus, more studies are needed in this regard

A comparative study of efficacy and safety of combination of indacaterol and tiotropium versus formoterol and budesonide in moderate to severe COPD

Background: COPD patients suffer persistent airflow obstruction and exacerbation despite treatment with LABA and ICS. Presently LABA+LAMA is least tested combination hence we want to compare efficacy and safety of combination of indacaterol and tiotropium versus formoterol and budesonide in moderate to severe COPD.Methods: This was an open labelled, parallel group trial involving 60 patients. of moderate to severe COPD having baseline postbronchodilator FEV1 ≥30% predicted and less than 80% predicted already on some kind of COPD treatment were included and, efficacy on lung function (FEV1)  and  safety in two  groups, indacaterol+tiotropium once daily dpi versus formoterol+budesonide twice daily bd dpi were testedi24 hours postdose (trough) DPI in symptomatic patients of COPD of moderate to severe grade. Statistical analysis was done using repeated measures of ANOVA followed by Turkeys test. P value less than 0.05 were considered statistically significant.Results: Patient with baseline/post bronchodilator FEV1 ≥30% predicted and less than 80% predicted were included. The mean age was 55±5 years. At 4 weeks mean±SEM in peak FEV1 in indacaterol+tiotropium was 85.77±4.002 and in formoterol+budesonide was 77.33±5.598. At 12 weeks, mean ±SEM in peak FEV1 in indacaterol+tiotropium was 112.30±4.69 and formoterol+budesonide was 103±6.35. At 24 weeks, mean ±SEM in peak FEV1 in indacaterol+tiotropium= 125.3±5.18 and formoterol+budesonide=112.7±5.89. Adverse events were less in indacaterol+tiotropium group. No serious adverse event occurred. Indacaterol+tiotropium once daily is efficacious and safe as compared to formoterol+budesonide twice daily with less exacerbation.Conclusions: In patients having poorly controlled COPD despite background therapy (LABA, etophylline+theophylline, etc.) the introduction of indacaterol+tiotropium once daily compared to formoterol+budesonide twice daily DPI significantly improved the FEV1 by sustained bronchodilation, decreased exacerbation and is safe. Further studies are needed to assess quality of life and cost analysis

Comparison of efficacy, safety and cost-effectiveness of clotrimazole 1% cream and sertaconazole 2% cream in patients suffering from of mild to moderate tinea corporis, attending tertiary care hospital out-patient department: a randomized, open-labeled, comparative, parallel group trial

Background: Tinea corporis is a common dermatophytic infection of the body involving keratin layer of skin. This lesion presents as an annular plaque with an advancing border along with central clearing. Clotrimazole is topical, conventional imidazole antifungal drug and has given good efficacy in tinea corporis. Sertaconazole is new topical imidazole antifungal claimed to be superior to old topical imidazoles in tinea corporis. The aim of this study was to compare efficacy, safety and cost effectiveness of topical antifungals, clotrimazole 1% cream and sertaconazole 2% cream in patients suffering from mild to moderate tinea corporis attending out-patient department of tertiary care hospital in Vidarbha region of Maharashtra.Methods: This was a prospective, comparative, randomized trial with 2 parallel treatment arms of 4 weeks duration. Patients were diagnosed on the basis of clinical evaluation and microscopic findings of KOH mount. Hundred patients were randomly assigned into two groups of clotrimazole 1% cream, and sertaconazole 2% cream with 50 patients in each group. Evaluation was carried out at baseline, 1st week, 2nd week and 4th week for efficacy parameters viz. itching, erythema and scaling, physician’s global assessment (PGA), safety and cost effectiveness.Results: Topical sertaconazole 2% cream was highly efficacious and superior to clotrimazole 1% cream in improvement of clinical parameters, PGA and mycological cure at the end of the treatment phase. At end of the follow-up phase both the trial drugs were effective with no recurrence or relapse of tinea corporis. However, clotrimazole 1% cream was safe and cheaper.Conclusions: Topical clotrimazole 1% cream and sertaconazole 2% were effective and well tolerated in patients of tinea corporis. Effectiveness of sertaconazole was early and superior with tolerable side-effects. However, clotrimazole was cost-effective

Post-valuation quality check of multiple-choice questions

Background: Multiple choice questions find important place in assessment in medical curriculum. Each MCQ is called item. Item analysis is quality check of MCQs after valuation of response sheets. This serves to recognize flaws in MCQs so that the given questions can be preserved in question bank, modified or deleted. Methods: 140 medical students of second MBBS were assessed pharmacology through 20 single best response type MCQ. Post exam validation of MCQs was done by item analysis. Each item was analyzed for level of difficulty, ability of the question to discriminate between poor and good performing students and distracter effectiveness.Results: Score ‘1’ was given for correct and ‘0’ for incorrect or no response. The mean score of the test was found to be 10.58±2.48, with a range 5-18. The whole test had an acceptable difficulty level with 43.25±17.81 mean difficulty index. The discrimination index of the whole test was found to be 0.123±0.184 mean PBI correlation coefficient, which is not satisfactory. Out of 60 distractors, 51 were found to be functional, hence distractor efficiency of the given test was 85%±19.96% which is acceptable.Conclusions: 60% questions were found to be ideal and 25% were acceptable with revision of stem or options. One question was easy with poor discrimination which needs major modification in construct or subject to be placed in question bank while another one question was difficult but had negative biserial index which needs to be deleted from the question bank

Common Coronary Anomalies on MDCT

Coronary artery anomalies are rare, and the incidence is around 1 to 2% in the general population. Majority of the patients are asymptomatic and detected while investigating another clinical issue. A few anomalies may be life-threatening due to the malignant course with potential for ischemia and even sudden death. Multidetector computed tomography (MDCT) has high accuracy in detecting these anomalies because of volume rendering (VR) and multiplanar reconstruction (MPR). ‘High take-off’, origin of the coronary artery from the opposite or noncoronary cusp with anomalous course and coronary artery fistula are three most frequent anomalies. MDCT can be a useful screening tool in the study of coronary anomalies