A critical understanding of Hridroga Nidanas and its present relevance

The global burden of diseases is changing from infectious diseases to non-communicable diseases these days. Among them cardiovascular disease is one which is tremendously increasing in this era. Accounting for 17.3 million deaths per year worldwide. Life style modifications like high caloric intake, alcohol consumption, smoking and stress are the risk factors for cardiovascular disease.  In Ayurveda all those disease come under the heading of “Hridroga”. Acharya Bhela has mentioned   Hridaya as Shirohridaya and Urohridaya. Urohridaya has been accepted in correspondence to circulation of Rasa and Rakta .As for any disease to manifest Nidanas are needed hence understanding   them is important because Nidanaparivarjana is the first line of treatment for any disease. Nidanas such as Vega Dharana, Ushnatikshna Ahara, Chinta and Abhighata leads to manifestation of Hridroga. Along with that Hridaya being mula of Rasavaha and Pranavaha Srotas Mula, Dusthi of those also lead to Hridroga. As there are different sets of Nidanas being explained in classics there is a need for critical understanding hence the present write up is aimed to provide an insight into the concept of Nidanas based on classical references and allied modern literature

Volitional pursed lips breathing in patients with stable chronic obstructive pulmonary disease improves exercise capacity

Pursed lips breathing (PLB) is used by a proportion of patients with chronic obstructive pulmonary disease (COPD) to alleviate dyspnea. It is also commonly used in pulmonary rehabilitation. Data to support its use in patients who do not spontaneously adopt PLB are limited. We performed this study to assess the acute effects of PLB on exercise capacity in nonspontaneously PLB patients with stable COPD. We performed a randomized crossover study comparing 6 - min walk test (6MWT) at baseline without PLB with 6WMT using volitional PLB. Spirometry, maximal inspiratory and expiratory mouth pressures, and diaphragmatic excursion during tidal and vital capacity breathing using B-mode ultrasonography were measured at baseline and after 10 min of PLB. A Visual Analog Scale (VAS) assessed subjective breathlessness at rest, after 6MWT and after 6MWT with PLB. p \u3c = 0.01 was considered significant. Mean + / - SD age of patients was 53.1 + / - 7.4 years. Forced expiratory volume in 1second was 1.1 + / - 0.4 L / min (38.4 + / - 13.2% predicted). Compared with spontaneous breathing, all but one patient with PLB showed a significant increment in 6MWdistance (+ 34.9 + / - 26.4 m; p = 0.002). There was a significant reduction in respiratory rate post 6MWT with PLB compared with spontaneous breathing (-4.4 + / - 2.8 per minute; p = 0.003). There was no difference in VAS scores. There was a significant correlation between improvement in 6MWT distance and increase in diaphragmatic excursion during forced breathing. The improvement was greater in patients who had poorer baseline exercise performance. PLB has an acute benefit on exercise capacity. Sustained PLB or short bursts of PLB may improve exercise capacity in stable COPD

The Monoclonal Antibody Cocktail in SARS-CoV 2: A Bonanza for Patients With Chronic Lymphocytic Leukemia?

Monoclonal antibody cocktail is currently one of the most promising approaches being studied in the management of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). We present a case of an elderly patient with coronavirus disease (COVID-19) and Chronic lymphocytic leukaemia (CLL) who had recurrent episodes of desaturation and admission in intensive care unit (ICU) despite receiving the treatment for moderate to severe COVID-19. After careful selection, weighing the benefits and risks, the patient was started on the combination of the two monoclonal antibodies, casirivimab and imdevimab. The results suggest that this could be a game changer in COVID-19 with a focused approach of management of COVID-19 positive patients especially in the vulnerable population

Ellipsis: Towards Efficient System Auditing for Real-Time Systems

System auditing is a powerful tool that provides insight into the nature of suspicious events in computing systems, allowing machine operators to detect and subsequently investigate security incidents. While auditing has proven invaluable to the security of traditional computers, existing audit frameworks are rarely designed with consideration for Real-Time Systems (RTS). The transparency provided by system auditing would be of tremendous benefit in a variety of security-critical RTS domains, (e.g., autonomous vehicles); however, if audit mechanisms are not carefully integrated into RTS, auditing can be rendered ineffectual and violate the real-world temporal requirements of the RTS. In this paper, we demonstrate how to adapt commodity audit frameworks to RTS. Using Linux Audit as a case study, we first demonstrate that the volume of audit events generated by commodity frameworks is unsustainable within the temporal and resource constraints of real-time (RT) applications. To address this, we present Ellipsis, a set of kernel-based reduction techniques that leverage the periodic repetitive nature of RT applications to aggressively reduce the costs of system-level auditing. Ellipsis generates succinct descriptions of RT applications' expected activity while retaining a detailed record of unexpected activities, enabling analysis of suspicious activity while meeting temporal constraints. Our evaluation of Ellipsis, using ArduPilot (an open-source autopilot application suite) demonstrates up to 93% reduction in audit log generation.Comment: Extended version of a paper accepted at ESORICS 202

Plant Cell Cultures : Biofactories for the Production of Bioactive Compounds

Plants have long been exploited as a sustainable source of food, flavors, agrochemicals, colors, therapeutic proteins, bioactive compounds, and stem cell production. However, plant habitats are being briskly lost due to scores of environmental factors and human disturbances. This necessitates finding a viable alternative technology for the continuous production of compounds that are utilized in food and healthcare. The high-value natural products and bioactive compounds are often challenging to synthesize chemically since they accumulate in meager quantities. The isolation and purification of bioactive compounds from plants is time-consuming, labor-intensive, and involves cumbersome extraction procedures. This demands alternative options, and the plant cell culture system offers easy downstream procedures. Retention of the metabolic cues of natural plants, scale-up facility, use as stem cells in the cosmetics industry, and metabolic engineering (especially the rebuilding of the pathways in microbes) are some of the advantages for the synthesis and accumulation of the targeted metabolites and creation of high yielding cell factories. In this article, we discuss plant cell suspension cultures for the in vitro manipulation and production of plant bioactive compounds. Further, we discuss the new advances in the application of plant cells in the cosmetics and food industry and bioprinting.Peer reviewe

Efficacy of plasma vascular endothelial growth factor in monitoring first-line chemotherapy in patients with advanced non-small cell lung cancer

Background: Along with the development of new cancer therapeutics, more effective tools for the estimation of response to therapy and prediction of disease progression are required for the better management of inoperable cancer patients. Methods: We studied 134 newly diagnosed and primarily untreated advanced non-small cell lung cancer patients and 100 controls. Forty two patients received platinum-based chemotherapy. Plasma VEGF levels were quantified in all samples at baseline and also before second and third chemotherapy cycle in 42 patients and correlated with response to therapy as assessed by computed tomography after the third chemotherapy cycle. Results: We observed that, patients who went into remission had significantly lower baseline VEGF levels before second and third cycles of chemotherapy when compared with patients with no change and progression. Plasma VEGF levels showed a greater decrease from cycle 1 to 2 and from cycle 1 to 3 in patients who showed remission in comparison to those with no change or progression. Plasma VEGF levels before the second cycle detected poor response to therapy with a sensitivity and specificity of 76.9% and 75.0%, respectively (area under the ROC curve = 0.724). Early prediction of disease progression was achieved with a sensitivity and specificity of 71.4% for plasma VEGF before cycle 2 (area under the ROC curve = 0.805). The kinetics of VEGF form cycle 1 to 2 and cycle 1 to 3 also gave significant information for predicting disease progression as well as insufficient therapy response. Conclusion: Monitoring of plasma VEGF levels during the course of first-line chemotherapy could identify patients who are likely to have insufficient response to therapy and disease progression at an early stage. This may help in individualizing treatment and could lead to better management of the advanced stage lung cancer

Association of body mass index, hand grip strength and quality of life with response to anti-tubercular therapy in adult patients of pulmonary and extra-pulmonary tuberculosis

Background: Monitoring of anti-tubercular therapy (ATT) response necessary for successful completion of ATT regimen. Presently available monitoring tools are invasive and have limitations. This study undertaken to see whether non-invasive tools like body mass index (BMI), hand grip strength (HGS) and quality of life (QOL) can serve as a reliable tool for monitoring ATT response.Methods: The 50 patients of tuberculosis were monitored for BMI, HGS and QOL via WHOQOL-BREF questionnaire and analyzed at baseline, 2 months and 6 months of starting ATT.Results: BMI HGS increased significantly at 2 months and 6 months compared to baseline with ATT. Physical and social domain of WHOQOL-BREF increased at 2 and 6 months with ATT, other domains shown no significant changes.Conclusions: Monitoring of BMI, handgrip strength and QOL can be a cost-effective tool for monitoring ATT response, both in pulmonary and extra pulmonary tuberculosis