Hydrothermal Synthesis of Rod Shaped Red Emitting Gd2O3:Eu3+ Phosphor.

Simple hydrothermal method can be applied for synthesizing rod shape Gd2O3:Eu3+ phosphors. X-ray diffraction, Fourier transform infrared spectroscopy and transmission electron microscopy are used for the characterizations of samples. Increase of Eu3+ concentration in Gd2O3:Eu3+ can cause red shift in the charge transfer band (CTB) of Eu - O. The nature of Eu3+ surroundings is asymmetric. It is ascertained from PL emission studies. The calculation of second order crystal field parameter from PL spectra corroborates the asymmetric environment of Eu3+. PL emission and decay lifetime studies confirm the existence of quenching due cross-relaxation. The quantum yield for Y2O3:Eu3+ (19 at.%) under 265 nm excitation is found to be 7%.

Clinical profile of infants with late onset sepsis admitted in a North East Indian tertiary care center: insights into the uncharted.

OBJECTIVES: To assess the clinical profile of infants with late onset sepsis admitted in a tertiary care hospital in North-East India. METHODS: Prospective observational study was carried out in Department of Paediatrics, Regional Institute of Medical Sciences hospital during a period of 2 years (September 2019-August 2021). RESULTS: A total of 109 patients were included in the study, of which 80 were community-acquired and 29 infants were hospital-acquired cases of late onset sepsis (LOS). The major risk factors were low socioeconomic status, prematurity, low birth weight, a history of intervention (mechanical ventilation, umbilical venous catheter, total parenteral nutrition, resuscitation) and lack of exclusive breastfeeding. The most common presenting features were decreased feeding, lethargy and respiratory distress. Blood cultures were positive in 33% of patients. Klebsiella was the most common hospital-acquired pathogen while Escherichia coli was the most common isolate in community-acquired cases. Thrombocytopenia was the most common complication. The in-hospital mortality rate was 13.7%. CONCLUSION: Low socioeconomic status, low birth weight, prematurity, invasive interventions and lack of exclusive breastfeeding are the major risk factors of LOS. The clinical signs and symptoms are varied and subtle. The mean C-reactive protein in the hospital-acquired group was significantly higher as compared to the community-acquired group. There is substantial morbidity and mortality, resulting in an increased toll on resources, therefore, an aggressive preventive and treatment approach is recommended for late onset sepsis.

SecDH: Security of COVID-19 images based on data hiding with PCA.

Nowadays, image security and copyright protection become challenging, especially after the COVID-19 pandemic. In the paper, we develop SecDH as a medical data hiding scheme, which can guarantee the security and copyright protection of the COVID-19 images. Firstly, the cover image is normalized, which offers high resistance against the geometric attacks. Secondly, the normalized principal component as embedding factor is computed, which are calculated based on principal component analysis (PCA) between cover and mark image. Thirdly, the medical image is invisibly marked with secret mark based on normalized component, redundant discrete wavelet transform (RDWT) and randomized singular value decomposition (RSVD) is introduced. Finally, Arnold cat map scheme employed to ensure the security of the watermarking system. Under the experimental evaluation, our SecDH tool is not only imperceptible, but also has a satisfactory advantage in robustness and security compared with the traditional watermarking schemes.

Genetic gain for rice yield in rainfed environments in India.

The complexity of genotype × environment interactions under drought reduces heritability, which determines the effectiveness of selection for drought tolerance and development of drought tolerant varieties. Genetic progress measured through changes in yield performance over time is important in determining the efficiency of breeding programmes in which test cultivars are replaced each year on the assumption that the new cultivars will surpass the older cultivars. The goal of our study was to determine the annual rate of genetic gain for rice grain yield in a drought-prone rainfed system in a series of multi-environment trials conducted from 2005 to 2014 under the Drought Breeding Network of Indian sites in collaboration with the International Rice Research Institute (IRRI). Our results show a positive trend in grain yield with an annual genetic yield increase of about 0.68 % under irrigated control, 0.87 % under moderate reproductive stage drought stress and 1.9 % under severe reproductive stage drought stress due to breeding efforts. The study also demonstrates the effectiveness of direct selection for grain yield under both irrigated control as well as managed drought stress screening to improve yield in typical rainfed systems. IRRI's drought breeding programme has exhibited a significant positive trend in genetic gain for grain yield over the years under both drought stress as well as favorable irrigated control conditions. Several drought tolerant varieties released from the programme have outperformed the currently grown varieties under varied conditions in the rainfed environments on farmers' fields.

Secondary Observer System for Detection of Microaneurysms in Fundus Images Using Texture Descriptors.

The increase of diabetic retinopathy patients and diabetic mellitus worldwide yields lot of challenges to ophthalmologists in the screening of diabetic retinopathy. Different signs of diabetic retinopathy were identified in retinal images taken through fundus photography. Among these stages, the early stage of diabetic retinopathy termed as microaneurysms plays a vital role in diabetic retinopathy patients. To assist the ophthalmologists, and to avoid vision loss among diabetic retinopathy patients, a computer-aided diagnosis is essential that can be used as a second opinion while screening diabetic retinopathy. On this vision, a new methodology is proposed to detect the microaneurysms and non-microaneurysms through the stages of image pre-processing, candidate extraction, feature extraction, and classification. The feature extractor, generalized rotational invariant local binary pattern, contributes in extracting the texture-based features of microaneurysms. As a result, our proposed system achieved a free-response receiver operating characteristic score of 0.421 with Retinopathy Online Challenge database.

MODERN APPROACHES IN MANAGEMENT OF CHILDREN WITH CHRONIC HEPATITIS B IN REMISSION OF ACUTE LYMPHOBLASTIC LEUKEMIA.

The aim of the study is to assess the effectivity of the drug «Betargin¼ in complex management of patients with chronic hepatitis B (CHB) in remission of acute lymphoblastic leukemia (ALL). The research had shown the results of treatment of 41 children with CHB in remission of ALL aged from 3 to 17 years old, who were on dispensary observation in Vinnytsia Regional Children's Clinical Infectious Diseases Hospital during 2013-2017 years. Patients were devided into the following groups: the comparison group (group A), which included 18 children with CHB in remission of ALL, who received basis therapy; the main group (group B) which consisted of 23 patients with CHB in remission of ALL, who got betaine arginine complex («Betargin¼) in addition to basis therapy. The control group was formed out of 30 healthy children. Determination of effectivity of the proposed treatment regimen was performed by studying the indicators of cholestasis, cytolysis, hepatocellular insufficiency, and lipid metabolism. To assess the liver's fibrosis level and necroinflammatory activity we used the determination of the level of plasma osteopontin in the serum using the enzyme-linked immunosorbent assay (ELISA) method: Human Osteopontin Quantikine (RDD systems, Dos Too, Minneapolis, MS, USA). The verification of the diagnosis of CHB was based on the detection of specific markers of HBV-infection in blood using ELISA and PCR analysis. During our scientific research we established that using betaine arginine complex in management of CHB in remission of ALL led to considerable improvement of children's general condition, namely due to reducing (p<0,05) the incidence of asthenovegetative (8.6% against 33.3% in the comparison group), dyspeptic (13.1% against 38.8%) as well as pain syndromes (4.3% against 11%) and hepatomegaly (13.1% against 38.8%). The activity of ALT in the main group was in 1.6 times less (p<0,05) than in comparison group at the end of the course of treatment. «Betargin¼ has an antifibrotic effect which is confirmed by a decrease in the level of plasma osteopontin up to 104,92 ng/ml against 178,15 ng/ml in the comparison group (p<0,05).

Comparison of two multifraction radiotherapy schedules in management of painful bone metastases: A single institution prospective study.

BACKGROUND: Metastatic disease of bone is a common complication of most of the advanced malignancies. The majority of patients with bone metastases (BM) experience pain during their disease course and pain control can significantly improve their quality of life. Radiotherapy (RT) is an important modality in the management of BM and different schedules are followed worldwide. AIM: The aim of this study was to compare two multi-fractionated RT regimens (30Gy in 10 fractions and 20Gy in 5 fractions) with respect to the patient's performance, response and pain score in palliative management of painful BM. METHODS: This prospective observational study was undertaken between October 2015 and September 2017 at a government medical college in central India. Two fractionation regimens (30 Gy/10 fractions and 20 Gy/5 fractions) were used to treat 50 patients with painful BM (n = 25 in each arm). Patients were treated on telecobalt machine and response assessment done in terms of complete/partial/intermediate response and pain progression. Assessment was performed at one, two and three months post treatment. Statistical analysis was done using Fisher's exact test, student t-test and Chi-square test. A value of P < 0.05 was considered significant. RESULTS: There were 9 males (36%) and 16 females (64%) in arm A, and 15 males (60%) and 10 females (40%) in arm B. The median age was 47.50 years (range 28-81 years) in arm A and 54 years (range 34-85 years) in arm B. There was no statistically significant difference between the two groups in terms of pain palliation at a 1 month (p = 0.73), 2 month (p = 0.75) or 3 month (p = 0.71) follow up. In addition, the mean performance scores at the end of 3rd month in the 2 arms did not show any statistically significant difference (p = 0.51). CONCLUSION: A shorter treatment schedule (5 fractions) was equally efficacious as the standard schedule (10 fractions) in our setting. With the advantage of shorter overall treatment time and avoidance of re-irradiation, this schedule may be favourable for high volume centres.

Quantitative Assessment of Muscle Activity and Joint Load in Braced and Unbraced Osteoarthritis Knee by External Strain Gauge Sensor.

OBJECTIVES: Altered biomechanics leads to the development of degenerative joint disease. The joint pressure and dynamic loading varies during activities of daily living. The study was undertaken to assess the muscle activation pattern of the medial and lateral knee compartments (tibiofemoral joint) during gait in osteoarthritis subjects without and with knee brace undergoing either exercise therapy or balance therapy. The joint load was assessed by the strain gauge transducer and the weight shift pattern is taken as an indicator for the muscle activation pattern. METHODS: In a prospective design study on 57 male subjects diagnosed osteoarthritis knee with Kellagren-Lawrennce scale walked barefooted with and without designed offloader knee brace on a level surface for three minutes. The subjects were allocated in two different study groups i.e. Conventional (exercise therapy) (Control Group, n=31) and Structured Neuromuscular Postural Training (SNPT) group (Balance therapy) (Study Group, n=26). The subjects were sub grouped as pre-elderly (40-60 Years) and elderly (>61 years) group in both. The quantitative assessment of muscle activity and joint loading with and without knee brace was done using designed strain gauge sensor instrument. The pressure changes of strain gauges of muscles around the knee joint viz. vastus medialis (VM), vastus lateralis (VL), semi membranosus/tendinosus (Medial Hamstring) (MH), Biceps Femoris (Lateral Hamstring) (LH), gastro-soleus (GS) and tibialis anterior (TA) muscles during normal gait were observed at baseline and 6 weeks follow up after undergoing exercise therapy or balance therapy treatment as per allocation of study groups. The digital values from MATLAB were recorded and analyzed. RESULTS: At the end of 6 weeks conventional/SNPT (structured neuromuscular postural training) treatments, medial hamstring muscle activity showed significant difference (p<0.001) in pre-elderly subgroup, while significant difference was seen in vastus laterals (VL), medial hamstring (MH) (p<0.005) and lateral hamstring (LH) muscles (p<0.001) in elderly subgroup. Further, the muscle co-contraction has been higher for vastus medialis-medial hamstring (VM-MH) pair compared to vastus lateralis-lateral hamstring (VL-LH) pair without brace at baseline. The application of offloader valgus knee brace significantly increases VL-LH co-contractions in magnitude and decreases in VM-MH co-contractions at 6 weeks follow up. CONCLUSION: Muscle activity increased in medial hamstring both in pre-elderly and elderly subjects. While, Vastus Laterals and lateral hamstring showed increased activities in elderly subjects. Hence, balance training and the application of off loader knee brace will be helpful to redistribute the load on medial tibiofemoral compartment.

L1014F-kdr Mutation in Indian Anopheles subpictus (Diptera: Culicidae) Arising From Two Alternative Transversions in the Voltage-Gated Sodium Channel and a Single PIRA-PCR for Their Detection.

Leucine-to-phenylalanine substitution at residue L1014 in the voltage-gated sodium channel, target site of action for dichlorodiphenyltrichloroethane (DDT) and pyrethroids, is the most common knockdown resistance (kdr) mutation reported in several insects conferring resistance against DDT and pyrethroids. Here, we report presence of two coexisting alternative transversions, A>T and A>C, on the third codon position of L1014 residue in malaria vector Anopheles subpictus Grassi (species A) from Jamshedpur (India), both leading to the same amino acid substitution of Leu-to-Phe with allelic frequencies of 19 and 67%, respectively. A single primer-introduced restriction analysis-polymerase chain reaction (PIRA-PCR) was devised for the identification of L1014F-kdr mutation in An. subpictus resulting from either type of point mutation. Genotyping of samples with PIRA-PCR revealed high frequency (82%) of L1014F-kdr mutation in the study area.

Status of DDT and pyrethroid resistance in Indian Aedes albopictus and absence of knockdown resistance (kdr) mutation.

BACKGROUND & OBJECTIVES: Aedes albopictus is one of the vectors for dengue and chikungunya and emergence of pyrethroid resistance in this species could be of a major concern in controlling the vector. This study reports insecticide susceptibility status of Ae. albopictus to DDT and pyrethroids in some Indian populations and status of presence of knockdown resistance (kdr) mutations. METHODS: Three to four day old adult female Ae. albopictus collected from Delhi, Gurgaon (Haryana), Hardwar (Uttarakhand), Guwahati (Assam) and Kottayam (Kerala) were bio-assayed with DDT (4%), permethrin (0.75%) and deltamethrin (0.05%) impregnated papers using WHO standard susceptibility test kit. Mosquitoes were PCRgenotyped for F1534C kdr-mutation in the voltage-gated sodium channel (VGSC) gene. DDT and pyrethroid resistant individuals were sequenced for partial domain II, III and IV of VGSC targeting residues S989, I1011, V1016, F1534 and D1794 where kdr mutations are reported in Ae. aegypti. RESULTS: Adult bioassays revealed varying degree of resistance against DDT among five populations of Ae. albopictus with corrected mortalities ranging between 61 and 92%. Kerala and Delhi populations showed incipient resistance against permethrin and deltamethrin respectively. All other populations were susceptible for both the synthetic pyrethroids. None of the kdr mutations was detected in any of DDT, deltamethrin and permethrin resistant individuals. INTERPRETATION & CONCLUSION: Ae. albopictus has developed resistance against DDT and there is emergence of incipient resistance against pyrethroids in some populations. So far, there is no evidence of presence of knockdown resistance (kdr) mutation in Ae. albopictus.

Enhanced expression of Toll-like receptors 2 and 4, but not 9, in spleen tissue from patients with visceral leishmaniasis.

Toll-like receptor (TLR) signalling is involved in first-line defence against Leishmania parasites by triggering NF-κB activation and downstream production of proinflammatory cytokines. Experimental models of visceral leishmaniasis (VL) support a protective role for TLRs 2, 4 and 9 in host immune responses to Leishmania infection. There are limited data available on expression of these TLRs in human VL, particularly in sites of infection, such as the spleen. This study aimed to determine whether the expression of mRNA encoding the expression of TLRs 2, 4 and 9 was altered in VL and compare expression patterns in splenic biopsies and peripheral blood mononuclear cells.

Comparison of three PCR-based assays for the non-invasive diagnosis of malaria: detection of Plasmodium parasites in blood and saliva.

The conventional molecular diagnosis of malaria uses 18S rRNA-based PCR assay employing blood samples. This assay presents limitation in terms of long turnaround time and increased chances of false-positive results. Here, we evaluated one-step singleplex or multiplex PCR assay based on high copy species-specific consensus repeat sequences (CRS) along with standard 18S rRNA nested PCR (18S n-PCR) assay to detect P. falciparum and P. vivax infection using blood and saliva samples from Indian febrile patients. Out of 327 patients, 187 were found to be positive for malaria parasites by microscopic examination of peripheral blood smears. Among these 130 were P. vivax and 57 were P. falciparum cases. The 18S n-PCR assay and CRS PCR assay identified 186 out of 187 cases (99.4 %). Multiplex CRS PCR assay detected Plasmodium in 176 out of 187 cases (94.1 %). Both singleplex and multiplex CRS PCR assay identified 6 mixed infection cases, while 18S n-PCR assay detected 10 mixed infection cases of P. vivax and P. falciparum, which were not recognized by microscopy. Non-invasive Plasmodium detection rate with DNA derived from saliva samples was highest for 18S n-PCR (87.36 %), followed by singleplex CRS (81 %) and multiplex CRS PCR assay (70.5 %). Specificity for P. vivax and P. falciparum detection for all assays was 98.48 % and 100 % respectively. Detection rate for P. vivax in saliva correlated with parasite density for CRS target-based assays. The species-specific CRS PCR, either as a singleplex or multiplex assay, can have an impact on diagnosis and epidemiological studies in malaria.

Legal and Ethical Issues Associated With Challenges in the Implementation of the Electronic Medical Record System and Its Current Laws in India.

Electronic health records (EHR) have revolutionized healthcare by providing efficient access to patient information, but their implementation poses various challenges. This paper examines the ethical and legal issues surrounding EHR adoption, particularly focusing on the healthcare landscape in India. Ethical considerations, including patient autonomy, confidentiality, beneficence, and justice, must guide EHR implementation to protect patient rights and privacy. Legal issues such as medical errors, malpractice, data breaches, and billing inaccuracies underscore the importance of robust policies and security measures. Threats to EHRs, such as phishing attacks, malware, encryption vulnerabilities, and insider threats, emphasize the need for comprehensive cybersecurity strategies. Overcoming challenges in EHR implementation requires meticulous planning, financial investment, staff training, and stakeholder support. Despite the complexities involved, the benefits of EHR adoption in improving patient care and operational efficiency justify the efforts required to address legal, ethical, and technical concerns. Embracing EHRs while mitigating associated risks is essential for delivering high-quality healthcare in the digital age.

Three-Dimensional Conformal Radiotherapy Versus Image-Guided Intensity Modulated External Beam Radiotherapy in Locally Advanced Cervical Cancer: A Phase III Randomized Control Study.

AIMS: The standard treatment of locally advanced cervical carcinoma is radical chemoradiation followed by brachytherapy which has improved survival. Hence, a major concern is our attempt to reduce the incidence of acute and late toxicities. IMRT has been shown to reduce toxicities. In this study, we have compared 3DCRT with IG-IMRT using patient-specific margins to evaluate tumor control as well as OAR-related toxicities. MATERIALS AND METHODS: This was a single institution prospective phase III randomised control study including patients of squamous cell carcinoma of cervix (stage II-IIIB, FIGO 2009) without pelvic lymph node involvement. All patients were simulated using intermediate bladder filling protocol and those in the IG-IMRT arm, underwent additional scans with full and empty bladder to assess the range of internal motion and generate individualised ITV margin. EBRT dose of 46Gy/23#/4.5 weeks was delivered with weekly concurrent cisplatin followed by brachytherapy. All toxicities during EBRT and till 3 months post brachytherapy were considered acute toxicity. Post-treatment, patients were followed up every 2 months for first 2 years and then once every 6 months. Disease-related outcomes were assessed with clinical examination and symptom-directed imaging. RESULTS: Two hundred patients were screened for inclusion and of them, 89 patients in 3DCRT and 84 patients in IG-IMRT arms were considered for final analysis. The baseline characteristics were comparable in both arms, majority of patients in both arms having stage II disease. For OARs, all dosimetric parameters were significantly better in the IG-IMRT arm. Acute radiation induced toxicities (dermatitis, genito-urinary and gastrointestinal toxicities) were significantly less in the IG-IMRT arm. The local, pelvic, and distant control were comparable in both arms. CONCLUSION: Based on our experience, the use of IG-IMRT with patient-specific ITV margins results in reduction in acute OAR toxicities in patients without compromising on tumor control.

Comparative susceptibilities of species T and U of the Anopheles fluviatilis complex to Plasmodium vinckei petteri sporogony.

Anopheles fluviatilis James is an important malaria vector in Indian subcontinent. An. fluviatilis exists as a complex of three sibling species, of which two species, T and U, have been colonized so far. Attempts were made to study the comparative susceptibility of species T and U of the An. fluviatilis complex to rodent malaria parasite Plasmodium vinckei petteri by using Anopheles stephensi Liston as calibrator for variable infectivity in different isolates. An. stephensi, which was used as control, became readily infected, with 60-65% mosquitoes carrying developing oocysts, whereas in species T and species U, approximately 50 and 63%, respectively, of mosquitoes carried oocyts. An. fluviatilis species T was found comparatively less susceptible to P. v. petteri sporogonic development compared with species U. Moreover, significantly lesser sporozoites rate (11%) was observed in species T compared with 31% in species U. Species T and species U are not considered as malaria vectors in India in the field. However, in the laboratory, both these species are able to support the malaria sporogony.

An efficient multi-level pre-processing algorithm for the enhancement of dermoscopy images in melanoma detection.

In this paper, a multi-level algorithm for pre-processing of dermoscopy images is proposed, which helps in improving the quality of the raw images, making it suitable for skin lesion detection. This multi-level pre-processing method has a positive impact on automated skin lesion segmentation using Regularized Extreme Learning Machine. Raw images are subjected to de-noising, illumination correction, contrast enhancement, sharpening, reflection removal, and virtual shaving before the skin lesion segmentation. The Non-Local Means (NLM) filter with lowest Blind Reference less Image Spatial Quality Evaluator (BRISQUE) score exhibits better de-noising of dermoscopy images. To suppress uneven illumination, gamma correction is subjected to the denoised image. The Robust Image Contrast Enhancement (RICE) algorithm is used for contrast enhancement, and produces enhanced images with better structural preservation and negligible loss of information. Unsharp masking for sharpening exhibits low BRISQUE scores for better sharpening of fine details in an image. Output images produced by the phase congruency-based method in virtual shaving show high similarity with ground truth images as the hair is removed completely from the input images. Obtained scores at each stage of pre-processing framework show that the performance is superior compared to all the existing methods, both qualitatively and quantitatively, in terms of uniform contrast, preservation of information content, removal of undesired information, and elimination of artifacts in melanoma images. The output of the proposed system is assessed qualitatively and quantitatively with and without pre-processing of dermoscopy images. From the overall evaluation results, it is found that the segmentation of skin lesion is more efficient using Regularized Extreme Learning Machine if the multi-level pre-processing steps are used in proper sequence.

Hybrid multi-kernel SVM algorithm for detection of microaneurysm in color fundus images.

Diabetic retinopathy (DR) is a chronic disease that may cause vision loss in diabetic patients. Microaneurysms which are characterized by small red spots on the retina due to fluid or blood leakage from the weak capillary wall often occur during the early stage of DR, making screening at this stage is essential. In this paper, an automatic screening system for early detection of DR in retinal images is developed using a combined shape and texture features. Due to minimum number of hand-crafted features, the computational burden is much reduced. The proposed hybrid multi-kernel support vector machine classifier is constructed by learning a kernel model formed as a combination of the base kernels. This approach outperforms the recent deep learning techniques in terms of the evaluation metrics. The efficiency of the proposed scheme is experimentally validated on three public datasets - Retinopathy Online Challenge, DIARETdB1, MESSIDOR, and AGAR300 (developed for this study). Studies reveal that the proposed model produced the best results of 0.503 in ROC dataset, 0.481 in DIARETdB1, and 0.464 in the MESSIDOR dataset in terms of FROC score. The AGAR300 database outperforms the existing MA detection algorithm in terms of FROC, AUC, F1 score, precision, sensitivity, and specificity which guarantees the robustness of this system.