Effectiveness and Practicality of eKTANG as a Digital Treat-ment for Diabetes and Relevant Influence Factors

Background: This work explored the effect of eKTANG, a new healthcare mode for diabetes patients, on diabetes management. Methods: Allowing general utilization of medical service and health management based on Internet, eKTANG obtained the precise data like blood glucose and blood pressure examined by an intelligent glucometer, from which doctors and the nursing team will promptly analyze the data and return feedback to the patients. In our study, overall 204 patients receiving eKTANG management over 3 months in First Affiliated Hospital of Jinan University from May 2019 to Aug 2020 were enrolled as the research objects, with data collected from patient records. Results: Through the biochemical test on relevant indexes of blood glucose, it was observed that FBG, PBG, HbA1c, TG, TC, LDL levels after management were lower than before whereas HDL expression after were lower than before. Contrasted with substandard group, standard group performed younger age, lower proportion of the married, decreased proportion of microvascular and macrovascular complications, longer course of disease, more frequent glucose monitoring, declined time of hyperglycemia and time of alarms, elevated time of euglycemia, increased proportion of diet control, more amount of exercise and higher compliance, as the number of patients choosing oral medicine in standard group was more than substandard group. The course of disease and time of hyperglycemia were risk factors of HbA1c standard reaching whereas frequency of glucose monitoring (≥1 time/week) and time of euglycemia were protective factors. Conclusion: eKTANG effectively improved diabetes management.

Activity of imipenem/relebactam on Klebsiella pneumoniae with different mechanisms of imipenem non-susceptibility

Background and Objectives: Imipenem/relebactam (IMP/R) is a newly FDA approved β-lactam/β-lactamase inhibitor combination. Relebactam ability to restore IMP activity could differ according to the cause of imipenem non-susceptibility. Therefore, we investigated the in-vitro activity of IMP/R against Klebsiella pneumoniae with different mechanisms of imi- penem non-susceptibility. Materials and Methods: Imipenem-nonsusceptible (IMP-NS) K. pneumoniae isolates were collected and characterized for β-lactamase encoding genes by multiplex PCR. For IMP-NS carbapenemase-negative isolates, study of Ompk35 & Ompk36 gene expression was performed by reverse transcription-PCR while efflux pump activity was studied by minimum inhibitory concentration (MIC) reduction assay using efflux pump inhibitor. Susceptibility testing of K. pneumoniae to IMP and IMP/R were achieved by broth microdilution (BMD) method. Results: During the study period, 140 isolates of IMP-NS K. pneumoniae were collected. BMD method showed that relebac- tam restored IMP susceptibility in 100%, 60% and 49% of isolates that only harbor AmpC, extended spectrum beta lactamase (ESBL) and carbapenemases, respectively. IMP/R was most potent against all bla KPC and 50% of bla _producing isolates. No demonstrable activity of IMP/R against K. pneumoniae harboring metallo-β-lactamases (MBLs). Out of 18 isolates with IMP non-suceptibility due to porins loss with overproduction of ESBL and/or AmpC, 14 (77.7%) isolates were IMP/R sus- ceptible. IMP/R showed no activity against isolates with only efflux pump hyperactivity. Conclusion: Relebactam could restore IPM activity in KPC or AmpC-producing IMP/NS K. pneumoniae but with no ac- tivity against MBL- producing isolates. Relebactam activity against isolates harbouring-bla OXA-48 or with altered Ompk35 & Ompk36 gene expression and efflux pump hyperactivity need further studies. Therefore, using IMP/R antibiotic in the treat- ment of infections caused by IMP/NS K. pneumoniae should be based on its molecular profile of IMP resistance to optimize the utility of IMP/R.

AN OPEN CLINICAL STUDY TO ASSESS THE COMBINED EFFECT OF JANUBASTHI AND MATRA BASTHI WITH SAIREYAKA TAILA IN JANUSANDHIGATAVATA W.S.R TO OSTEOARTHRITIS OF KNEE JOINT

Basti is considered the best modality of treatment in managing the disorders of Vata Dosha. As Sandhigatavata is also one among Vatavyadhi, Basti is the effective line of treatment, which is characterized by swelling, pain during flexion and extension of joints. Osteoarthritis is a common degenerative joint condition with a prevalence of about 22% to 39% in India. There is a steady rise in prevalence from age 30 such that by age 65, 80% of people will have radiographic evidence of osteoarthritis. It is caused by the degradation of the joints, the articular cartilages and subchondral bone. It is characterized by pain, stiffness and loss of flexibility of joints.1 By foregoing, Sandhi- gatavata can be readily correlated to Osteoarthritis. In contemporary medical science, they use NSAIDs for control of the symptoms. Acharya Sushrutha and Acharya Charaka have mentioned Snehana (Oleation) as a line of treat- ment in Sandhigatavata. So here an attempt is made through Janubasthi and Matrabasthi using Saireyaka Taila2 mentioned in Gada Nigraha under Vata Vyadhi for treating Janusandhigatavata in specific. Method: This study is an open-label, observational and clinical study containing 30 patients, who were posted for Janu Basti and Matra Basti with Saireyaka Taila for 9 days. The assessment was carried out before treatment, during treatment (5th day), after treatment (on 10th day) and after following up (28th day) and the gradings were noted. Results: Out of 30 patients in this study, 5 patients (17%) were getting Moderate Improvement and 25 patients (83%) were gettingGood Improvement. The overall effect of the treatment is 69.44%. Conclusion: It is concluded that the combined effect of Janubasti and Matrabasti with Saireyaka Taila is clinically and statistically significant in almost all the parameters. Keywords: Janu Basti, Matra Basti, Sandhivata, Osteoarthritis, Saireyaka Taila.

CLINICAL EVALUATION OF MATRA BASTI OF VARUN TAILA AND KANCHNAR GUGGULU IN VATASTHEELA (BPH)

Background and Objective: BPH is a senile disorder, which leads to urinary symptoms like incomplete empty- ing, urgency etc. 90 % of the males over 80 years of age have histological evidence of BPH. Acharya Sushruta has described Vatastheela, as a type of Mutraghata. Owing to the various medical and surgical complications while treating the disease, an Ayurvedic approach using classical medicines in the management of BPH is re- quired. This study was conducted clinical evaluation of Matra Basti of Varun Taila and Kanchnar Guggulu in Vatastheela (BPH). Aim: In this clinical study the aim was to evaluate the effects of Matra Basti of Varun Taila and Kanchnar Guggulu in the management of Vatastheela (BPH). Material and Methods: Random selection of patients was done from OPD of Shalya Tantra Patanjali Ayurved Hospital Haridwar. The study is approved by the ethics and research committee of the same institute vide its latter no PAC/IEC/2018-19/04 and CTRI Registrationnumber CTRI/ 2020/11/029404. Based on the Inclusion and exclusion criteria a total of 30 patients were selected. Kanchnar Guggulu 2 TAB BD for 3 months and Varun Talia 72 ml Matra Basti for 1week. Observation: As- sessment was made on subjective and objective parameters. Observations were recorded before and after treat- ment. The grading of parameters was used for statistical analysis. Results: The results showed marked relief in subjective and objective parameters. Moreover, this therapy was well accepted by all patients and did not cause any hindrance in their daily routine work during period of management. Conclusion: We can conclude that the effects of Matra Basti of Varun Taila and Kanchnar Guggulu were significant and free from any complication. Since this study was on small size sample further evaluation is needed to be done and study should be repeated with large sample for longer duration for its establishment. Keywords: Varun Taila, Kanchnar Guggulu, Vatastheela, BPH.

An Ultraviolet C-Band LED device for disinfection of air, articles, and indoor environment

<div> <div> <div> <p>Background: Commonly used items like wallets, keys, and phones are both tricky and impractical to disinfect from the dangers of harmful microbes. This study demonstrates the efficacy of UVC-LED technology in creating an efficient, useful, and practical solution.</p><p>Methods: As a demonstration of the efficacy of the UVC-LED light (275 nm), a panel of UVC LEDs was fabricated and was driven with a constant current electronic driver. Staphylococcus aureus and Escherichia coli were placed on Petri dishes, and placed 38 cm away from the UVC-LED panel. UVC flux measured at the petri dishes was 0.093 mW/cm2 . The method involved exposing both the bacteria to UVC treatment for 4 and 8 minutes. For each petri dish, the number of colony forming units were compared before and after the treatment and compared to the control.</p><p>Results: A significant reduction in colony forming unit (cfu) counts was found in all samples for both sets of bacteria: 97.9% in the 4 minutes treat- ment(22.3 mJ/cm2), and 99.9% in the 8 minutes treatment(44.6 mJ/cm2).</p><p>Conclusion: UVC-LED technology offers an effective, simple and inexpensive approach for disinfection. </p> </div> </div> </div>

An Ultraviolet C-Band LED device for disinfection of air, articles, and indoor environment

<div> <div> <div> <p>Background: Commonly used items like wallets, keys, and phones are both tricky and impractical to disinfect from the dangers of harmful microbes. This study demonstrates the efficacy of UVC-LED technology in creating an efficient, useful, and practical solution.</p><p>Methods: As a demonstration of the efficacy of the UVC-LED light (275 nm), a panel of UVC LEDs was fabricated and was driven with a constant current electronic driver. Staphylococcus aureus and Escherichia coli were placed on Petri dishes, and placed 38 cm away from the UVC-LED panel. UVC flux measured at the petri dishes was 0.093 mW/cm2 . The method involved exposing both the bacteria to UVC treatment for 4 and 8 minutes. For each petri dish, the number of colony forming units were compared before and after the treatment and compared to the control.</p><p>Results: A significant reduction in colony forming unit (cfu) counts was found in all samples for both sets of bacteria: 97.9% in the 4 minutes treat- ment(22.3 mJ/cm2), and 99.9% in the 8 minutes treatment(44.6 mJ/cm2).</p><p>Conclusion: UVC-LED technology offers an effective, simple and inexpensive approach for disinfection. </p> </div> </div> </div>

The possibility of simultaneous combined skin grafting during the installation of synthetic implants after cranial trepanation

Introduction. Over the past 20 years, with an increase in the number of decompression trepanations in the Russian Federation and abroad, the number of cranioplasties performed has increased. Despite the development of technology, these surgical interventions are inevitably accompanied by a number of complications (up to 36 %), including the for‑ mation of skin defects. The choice of the optimal algorithm for the treatment of skin defects after cranioplasty remains the subject of debate.The purpose of the publication is to demonstrate by a clinical example the possibility of simultaneous combined skin grafting during the installation of synthetic implants after cranial trepanation, as well as to analyze the outcomes and com‑ plications of such operations.Materials and methods. For the period 2017–2019 under our supervision there were 42 patients after craniotomy, 32 of which were cranioplasty, and 10 plastic surgery of the defects of the scalp after removal of synthetic implants. In the course of the analysis, the structure and terms of surgical interventions, the length of hospitalization, the frequen‑ cy and structure of complications, as well as the timing of their development were studied.The article presents one of the cases of treatment and simultaneous installation of a titanium plate, combined skin grafting in a patient who has undergone previously decompressive craniotomy, cranioplasty with protacryl.Results. Simultaneous cranioplasty with skin grafting was performed in 3 out of 42 patients. The average hospitalization time after such an intervention was significantly less than with two‑stage plastic surgery (28.0 ± 3.9 and 52.0 ± 2.7 days, respectively, p <0.05). There were no complications in the postoperative period after a single‑stage plastic surgery, but after a two‑stage one, 2 cases of divergence of the wound edges and the formation of fistulas above the implants were registered.Conclusion. The data obtained illustrate that, given the technical feasibility, as well as the satisfactory condition of the skin flap, simultaneous cranioplasty with combined skin grafting can be one of the methods of choice in the treat‑ ment of extensive defects in the skin of the head and skull.

HOLISTIC APPROACH IN MANAGEMENT OF AMAVATA W.S.R. TO CHAKRADATTA CHIKITSA SIDDHANTHA – A CASE STUDY

The impairment of Agni plays a very important role in Amavata. The name itself says there is the involvement of Ama and Vata. The Kha-vaigunya is observed mainly in Shleshmasthana (Asthisandhi) which results in Amavata. Use of Ayurvedic Diagnostics tools and then deciding Ayurvedic treatment helps to treat it in a natural way without any side effects and recurrence. Chikitsa Siddhanta as mentioned by Acharya Chakradatta for management of Amavata, consists of Langhana, Swedana, use of medicines having Tikta, Katu Rasa and Deepana property, Virechana, Snehapana and Basti. These modalities work mainly as Amapachana, Vatashamana, Strotoshodhana and Sthana Balya. Based on this Chikitsa Siddhanta, along with Langana, Swedana, Deepana, Pachana; Vaitaran Basti was administered in a case of Amavata which was successfully treated. Vaitaran Basti is also given by Chak- radatta. Marked improvements were observed in signs, symptoms and RA factor after treatment. During the treat- ment, complications were not observed. Keywords: Amavata, Ama, Chakradatta, Vaitaran basti, RA factor.

Role of Autophagy in Phosphatidyl- Glycerol Facilitated Cholesterol Clearance from the Endolysosomal System of Npc-1 Deficient Cells

Niemann Pick Type C (NPC) Disease is a rare lysosomal storage disorder in which one of the genes that codes for either the NPC-1 or NPC-2 pro-tein is mutated, causing cell lysosomes to accumu-late cholesterol and lipids. Previous studies discov-ered that a unique late endosomal/lysosomal phos-pholipid, lysobisphosphatidic acid (LPBA), is in-volved in cholesterol clearance from late endo-somes. It has also been shown that exogenous treat-ment of the NPC-1 deficient cells with LBPA’s precur-sor, phosphatidylglycerol (PG), leads to LBPA enrich-ment and subsequent endolysosomal cholesterol clearance. Autophagy is a mechanism of cellular clearance in the endolysomal system and we are in-terested to see if it is a partial route in cholesterol clearance during PG treatment of NPC-1 deficient cells. To do so, we silenced the gene that codes for an essential protein in the autophagy pathway, mak-ing the cells autophagy deficient. We then treated the cells with PG, measured the amount of choles-terol clearance in those cells, and compared it to cells with normal autophagy. We found significantly less cholesterol clearance by PG in cells with defec-tive autophagy, confirming that autophagy is in-volved as a partial route in cholesterol clearance dur-ing PG treatment, but not enough of a difference to conclude that it is a major underlying mechanism.

Comparison between Adding Intravenous Neostigmine and Atropine versus Intravenous Hydrocortisone for Conservative Treatment of Postdural Puncture Headache After spinal Anaesthesia For Elective Caesarean Section

Background Postdural puncture headache (PDPH) lacks a standard evidence-based treat- ment. A patient treated with neostigmine for severe PDPH And anther patient treated with hydrocortisone prompted this study. Objective To assess and compare the efficacy of intravenous neostigmine and atropine versus intravenous hydrocortisone as an adjuvant to conservative treatment of PDPH after spinal anaesthesia for elective caesarean section. Patients and Methods This study was carried out in Ain Shams University hospitals for six months (from February 2019 to August 2019) on 60 patients who presented with post dural puncture headache after elective caesarean section under spinal anaesthesia Results In this study, we compared the efficacy of hydrocortisone and neostigmine with conventional methods. All of the three groups (neostigmine, hydrocortisone and conventional methods) were effective in lowering VAS scores at 24, 48 and 72 h after headache's onset but neostigmine alleviated the pain more effectively and with rapid onset. The mean VAS score was significantly lower in neostigmine group compared with others 2, 6, 24, 48 and 72h after start of medications (p &lt; 0.001 for all of them) and significantly lower in hydrocortisone group compared with Conventional group 6, 24, 48, and 72h (p &lt; 0.001 for all of them). Conclusion neostigmine and hydrocortisone are both useful and safe in management of PDPH but neostigmine is more effective in this regard.