scholarly journals STUDY ON AGRYA AUSHADHI (FOREMOST SUBSTANCES) W.S.R TO CLINICAL PRACTICE IN AYURVEDA

2021 ◽  
Vol 9 (6) ◽  
pp. 1274-1282
Author(s):  
Paudel Kiran ◽  
Ramamurthy Aku ◽  
Sharma Gaurav
Keyword(s):  
Clinical Practice ◽  
Cost Effective ◽  
Single Drug ◽  
Drug Choice ◽  
Single Form

In Āyurveda, Agrya Sangraha means collection of leading or principle substances. AgryaAusadhi in Ayurveda is used to prevent diseases and maintain health. Charak Samhitā Sutrasthāna includes 152 AgryaAushadhi, Astanga Hridayam Uttarsthān includes Agrya Aushadhi and in Astanga Sangraha Sutrasthāna AgryaSangraha. Agrya Dravyas are the drugs that are used as first drug choice for the treatment of diseases. They are cost effective, eco- nomical, easy to use and safe. EkalaDravya is the dravya used in single form and single drug is mostly includes in AgryaPrakarana. The AgryaDravya mentioned in classical texts of Āyurveda are best in their respective class of action. The fact that Agrya are best drugs can be deduced from the fact that a single drug can do many functions, so a single drug will work instead of prescribing a bunch of drugs e.g. Pippali Moola will work alone for Dipana, Pāchana and Anahaprasamana and thus, no need to prescribe three different drugs each for a desired action. Keywords: Agrya, Dravyachikitshā, Aushadhi, EkalDravya

The CSF p-tau181/Aβ42 Ratio Offers a Good Accuracy “In Vivo” in the Differential Diagnosis of Alzheimer’s Dementia

2019 ◽  
Vol 16 (7) ◽  
pp. 587-595 ◽  
Author(s):  
Roberto Santangelo ◽  
Alessandro Dell'Edera ◽  
Arianna Sala ◽  
Giordano Cecchetti ◽  
Federico Masserini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Diagnosis ◽  
Fdg Pet ◽  
Amyloid Β ◽  
Cost Effective ◽  
Daily Clinical Practice ◽  
Different Types ◽  
Experimental Trials ◽  
Csf Findings

Background: The incoming disease-modifying therapies against Alzheimer’s disease (AD) require reliable diagnostic markers to correctly enroll patients all over the world. CSF AD biomarkers, namely amyloid-β 42 (Aβ42), total tau (t-tau), and tau phosphorylated at threonine 181 (p-tau181), showed good diagnostic accuracy in detecting AD pathology, but their real usefulness in daily clinical practice is still a matter of debate. Therefore, further validation in complex clinical settings, that is patients with different types of dementia, is needed to uphold their future worldwide adoption. Methods: We measured CSF AD biomarkers’ concentrations in a sample of 526 patients with a clinical diagnosis of dementia (277 with AD and 249 with Other Type of Dementia, OTD). Brain FDG-PET was also considered in a subsample of 54 patients with a mismatch between the clinical diagnosis and the CSF findings. Results: A p-tau181/Aβ42 ratio higher than 0.13 showed the best diagnostic performance in differentiating AD from OTD (86% accuracy index, 74% sensitivity, 81% specificity). In cases with a mismatch between clinical diagnosis and CSF findings, brain FDG-PET partially agreed with the p-tau181/Aβ42 ratio, thus determining an increase in CSF accuracy. Conclusions: The p-tau181/Aβ42 ratio alone might reliably detect AD pathology in heterogeneous samples of patients suffering from different types of dementia. It might constitute a simple, cost-effective and reproducible in vivo proxy of AD suitable to be adopted worldwide not only in daily clinical practice but also in future experimental trials, to avoid the enrolment of misdiagnosed AD patients.

scholarly journals Production of β-Lactamase Inhibitors by Streptomyces Species

Antibiotics ◽  
2018 ◽  
Vol 7 (3) ◽  
pp. 61 ◽  
Author(s):  
Daniela Viana Marques ◽  
Suellen Machado ◽  
Valéria Ebinuma ◽  
Carolina Duarte ◽  
Attilio Converti ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Bacterial Strains ◽  
Streptomyces Species ◽  
Innovative Strategies ◽  
New Antibiotics ◽  
Microbial Products ◽  
Type Strains ◽  
Streptomyces Genus

β-Lactamase inhibitors have emerged as an effective alternative to reduce the effects of resistance against β-lactam antibiotics. The Streptomyces genus is known for being an exceptional natural source of antimicrobials and β-lactamase inhibitors such as clavulanic acid, which is largely applied in clinical practice. To protect against the increasing prevalence of multidrug-resistant bacterial strains, new antibiotics and β-lactamase inhibitors need to be discovered and developed. This review will cover an update about the main β-lactamase inhibitors producers belonging to the Streptomyces genus; advanced methods, such as genetic and metabolic engineering, to enhance inhibitor production compared with wild-type strains; and fermentation and purification processes. Moreover, clinical practice and commercial issues are discussed. The commitment of companies and governments to develop innovative strategies and methods to improve the access to new, efficient, and potentially cost-effective microbial products to combat the antimicrobial resistance is also highlighted.

scholarly journals Current Practice in Preoperative Virtual and Physical Simulation in Neurosurgery

2020 ◽  
Vol 7 (1) ◽  
pp. 7 ◽  
Author(s):  
Elisa Mussi ◽  
Federico Mussa ◽  
Chiara Santarelli ◽  
Mirko Scagnet ◽  
Francesca Uccheddu ◽  
...  
Keyword(s):  
Clinical Practice ◽  
3D Printing ◽  
Surgical Planning ◽  
Physical Simulation ◽  
Planning Process ◽  
Preoperative Planning ◽  
Cost Effective ◽  
Patient Specific ◽  
Anatomical Models ◽  
Standard Clinical Practice

In brain tumor surgery, an appropriate and careful surgical planning process is crucial for surgeons and can determine the success or failure of the surgery. A deep comprehension of spatial relationships between tumor borders and surrounding healthy tissues enables accurate surgical planning that leads to the identification of the optimal and patient-specific surgical strategy. A physical replica of the region of interest is a valuable aid for preoperative planning and simulation, allowing the physician to directly handle the patient’s anatomy and easily study the volumes involved in the surgery. In the literature, different anatomical models, produced with 3D technologies, are reported and several methodologies were proposed. Many of them share the idea that the employment of 3D printing technologies to produce anatomical models can be introduced into standard clinical practice since 3D printing is now considered to be a mature technology. Therefore, the main aim of the paper is to take into account the literature best practices and to describe the current workflow and methodology used to standardize the pre-operative virtual and physical simulation in neurosurgery. The main aim is also to introduce these practices and standards to neurosurgeons and clinical engineers interested in learning and implementing cost-effective in-house preoperative surgical planning processes. To assess the validity of the proposed scheme, four clinical cases of preoperative planning of brain cancer surgery are reported and discussed. Our preliminary results showed that the proposed methodology can be applied effectively in the neurosurgical clinical practice both in terms of affordability and in terms of simulation realism and efficacy.

scholarly journals Cost-Effectiveness of Drug Treatment for Chinese Patients With Stage I Hypertension According to the 2017 Hypertension Clinical Practice Guidelines

Hypertension ◽  
2020 ◽  
Vol 76 (3) ◽  
pp. 750-758
Author(s):  
Yan-Feng Zhou ◽  
Na Liu ◽  
Pei Wang ◽  
Jae Jeong Yang ◽  
Xing-Yue Song ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Drug Treatment ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cost Effective ◽  
Stage I ◽  
Chinese Patients ◽  
Lifetime Horizon ◽  
Hypertensive Patients

Systolic/diastolic blood pressure of 130 to 139/80 to 89 mm Hg has been defined as stage I hypertension by the 2017 Hypertension Clinical Practice Guidelines. Drug treatment is recommended for stage I hypertensive patients aged ≥65 years without cardiovascular disease in the 2017 Hypertension Clinical Practice Guidelines but not in the 2018 Chinese guidelines. However, the cost-effectiveness of drug treatment among this subgroup of Chinese patients is unclear. This study developed a microsimulation model to compare costs and effectiveness of drug treatment and nondrug treatment for the subgroup of stage I hypertensive patients over a lifetime horizon from a government affordability perspective. Event rates of mortality and cardiovascular complications were estimated from 3 cohorts in the Chinese population. Costs and health utilities were obtained from the national statistics report and published literature. The model predicted that drug treatment generated quality-adjusted life-years of 13.52 and associated with expected costs of $6825 in comparison with 13.81 and $7328 produced by nondrug treatment over a lifetime horizon among stage I hypertensive patients aged ≥65 years without cardiovascular disease. At a willingness-to-pay threshold of $8836/quality-adjusted life-year (the GDP per capita in 2017), drug treatment only had a 1.8% probability of being cost-effective compared with nondrug treatment after 10 000 probabilistic simulations. Sensitivity analysis of treatment costs, benefits expected from treatment, health utilities, and discount rates did not change the results. Our results suggested that drug treatment was not cost-effective compared with nondrug treatment for stage I hypertensive patients aged ≥65 years without cardiovascular disease in China.

scholarly journals Physiotherapy and low back pain - part 1 outcomes research in the quest for evidence

2002 ◽  
Vol 58 (3) ◽  
Author(s):  
L. D. Bardin
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Outcome Measures ◽  
Outcomes Research ◽  
Controlled Trial ◽  
Cost Effective ◽  
Low Back ◽  
Major Health Problem ◽  
Effective Interventions

Low back pain (LBP) is one of the most common and costlyconditions treated by physiotherapists and is acknowledged as a major health problem. Much published research on LBP is of poor design and  optimal outcome measures are not selected for LBP patients. Effective and cost-effective interventions for LBP, particularly chronic LBP, need to be identified using appropriate, valid, reliable and responsive measures of  outcome.  These outcome measures should reflect the biopsychosocial model necessary for evaluating the broad impact of LBP, in particular chronic LBP, on a patient’s life. Outcomes research is a feasible and affordable analysis of clinical practice as it occurs, and provides an opportunity to evaluate the effectiveness of interventions for LBP. This is in contrast to a randomised, controlled trial (RCT) that evaluates efficacy under controlled conditions that often do not reflect clinical practice. Using a battery of outcome measures appropriate for measuring change in the LBP population, outcomes research has the potential to identify effective and cost-effective interventions, promote and influence further research, and contribute to the demand for evidence-based practice.

Integrating Non-Technological and Technological Peripheral Biofeedback in Counseling

2017 ◽  
Vol 39 (2) ◽  
pp. 163-179 ◽  
Author(s):  
Jamie E. Crockett ◽  
Diane L. Gill ◽  
Tammy H. Cashwell ◽  
Jane E. Myers
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Self Regulation ◽  
Empirical Support ◽  
Cost Effective ◽  
Mental Health Counselors ◽  
Client Outcomes ◽  
Promising Direction ◽  
Response System ◽  
Stress Response System

Neurocounseling, the integration of neurobiology into the practice of counseling, is gaining attention and empirical support within the counseling field. Clients and clinical mental health counselors appear eager for effective mind–body tools that are accessible during, between, and beyond sessions. Peripheral biofeedback encompasses a host of such interventions, including technological (e.g., heart rate variability feedback) and non-technological (e.g., observation) approaches. Non-technological approaches are cost-effective tools that can enhance the efficacy of other counseling approaches and may serve to improve client outcomes. Integrating non-technological and technological peripheral biofeedback is a promising direction for clinical practice. In this article, the authors provide an overview of the key components of the stress-response system, the neurobiology of breath and self-regulation, and the related elements of peripheral biofeedback. The authors describe a case example, identify gaps in the knowledge base, and explore the implications for clinical practice and research.

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