Introduction: Accurate age estimation is of utmost importance in several branches of life, be it disaster victim identification (DVI), sports, fashion, education, and many more. Several studies/formulas have been proposed over the years from various parts of the world and amongst them, Cameriere's method of age estimation is now being accepted globally, and the related work is still one of the most thought about. Aim: The aim of this study was to access the relationship between dental age (DA) and chronological age using Cameriere and Demirjian age estimation method in the north Indian population and develop a population-specific regression formula and validate it in the north Indian population. Materials and Methods: Orthopantomograms (OPG) of 762 children of north India with age groups between 7 and 16 years were collected. Seven left permanent mandibular teeth were analyzed using both Cameriere and Demirjian's age estimation method. The resultant data were subjected to statistical analysis. Results: The mean differences between CAge and DAge with age were 1.21 (males), 0.14 (males) and 1.72 (females), 0.28 (females) respectively, which shows significant disparity, wherein Demirjian follows overestimation and Cameriere follows the underestimation trend. Therefore, we modified these methods using the linear regression model. Conclusion: The modified Demirjian and Cameriere formula after validation shows a better fit in the north Indian state of the Uttar Pradesh population.

Effective management of hypertension in low- and middle-income settings is a persistent public health challenge. This study examined supply- and demand-side barriers to receiving quality care and achieving effective hypertension management in rural Bihar, India. A state-representative household survey collected information from adults over 30 years of age on characteristics of the hypertension screening, diagnosis, and management services they received. A linked provider assessment determined the percent of providers who provided quality hypertension care (i.e., had a functioning BP measurement device, measured a patient’s BP, could correctly diagnose hypertension, had at least one first-line antihypertension medication, and could prescribe correctly based on standard guidelines). Patients were linked with their provider to determine the quality-adjusted coverage of hypertension management and logistic regression analysis was conducted to determine characteristics associated with receiving quality care. A total of 14,386 patients and 390 providers were studied. Nearly a quarter (22.5%) of adults had never had their BP measured before and 8.1% of adults reported a previous hypertension diagnosis. Less than one third (31.0%) of all interviewed providers demonstrated ability to provide quality hypertension care, and quality varied between provider types (14.8% of private homeopathic, 25.2% of informal, 40.0% of private modern medicine, and 60.0% of public providers gave quality care). While 95.8% of diagnosed individuals received some treatment, only 10.9% of patients received care from quality local providers. Nearly 45% of individuals with hypertension received care from non-local providers. Individuals from the general caste with comorbidities living in villages with more high-quality providers were most likely to receive quality care from a local provider. Whereas the coverage of services for individuals diagnosed with hypertension is high, the quality of these services is suboptimal for economically and socially vulnerable populations, which limits effective management and control of hypertension in rural Bihar. Efforts should be targeted towards providers to initiate quality treatment upon diagnosis, including correct prescription of antihypertensives.

Introduction: Sleep has significant adverse consequences for breathing and gas exchange in patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess sleep patterns in patients with stable COPD. Patients and methods: Patients with stable COPD were recruited from a tertiary care hospital. Data collected included demographic profile, clinical characteristics of COPD, neck circumference, Epworth sleepiness scale (ESS) score, and sleep variables using polysomnography. Results: Of recruited 40 patients, 12 fulfilled the inclusion criteria. The mean age of the patients was 57.42 ± 10.98 years and 11 were males. Eight patients (66.7%) had moderately severe COPD, three mild, and one severe COPD. Eleven patients had a normal ESS score. None had excessive day-time sleepiness. High numbers of arousal and sleep-stage change characterized major sleep fragmentation were reported in these individuals. Apnea–hypopnea index was normal, that is, 3.2 ± 1.9 (mean ± standard deviation [SD]). The total sleep time with hemoglobin saturation under 90% (T90) was 48.17 ± 5.79 minutes (mean ± SD). Hemoglobin saturation fell more in rapid eye movement (REM) sleep (87.1% ± 5.5%) than non-REM sleep (88.6% ± 4.8%). Sleep-onset latencies were 19.21 ± 4.68 (mean ± SD) minutes and REM latency was 126 ± 9.39 (mean ± SD) minutes. The mean %wake stage, mean% Stage 1 sleep, and mean% Stage 2 sleep were prolonged in most patients, whereas REM sleep was decreased in all patients. Conclusion: Sleep is characterized by major sleep fragmentation even in patients with stable COPD. Extent and duration of desaturation during sleep are significant. Wake stage, Stage 1, and Stage 2 sleep are prolonged in most patients. REM sleep is decreased in all patients.

In this paper, we examine asymmetric effects of tourism on economic growth in Papua New Guinea (PNG) using quarterly data from 2008Q1 to 2019Q4 (n = 48). The asymmetric nonlinear autoregressive distributed lag (NARDL) model is utilized for this purpose. Causality testing is conducted with an asymmetric VAR model. Estimates from the NARDL model reveal that periods of tourism expansion are positively associated with economic growth. Negative shocks of tourism have an insignificant effect on economic growth. The estimates provide some support for the tourism-led growth hypothesis but only for tourism expansions confirming the asymmetric relationship.

Most tourists return home with a souvenir purchased after a holiday. Studies on souvenirs have mainly focussed on either the demand or supply perspective. This research integrates both perspectives to achieve a more holistic understanding of souvenirs in the Pacific context. This paper compares souvenir purchase behaviour of cruise ship visitors and overnight tourists. The research also examines the main reasons micro-entrepreneurs sell souvenirs and the meanings they attach to souvenirs. Overnight tourists have a deeper understanding and appreciation for souvenirs compared to cruise ship visitors. Suppliers provide souvenirs to sustain their culture, as well as for economic reasons.

Objectives Responding to pandemics is challenging in pluralistic health systems. This study assesses COVID-19 knowledge and case management of informal providers (IPs), trained practitioners of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) and Bachelor of Medicine, Bachelor of Surgery (MBBS) medical doctors providing primary care services in rural Bihar, India.Design This was a cross-sectional study of primary care providers conducted via telephone between 1 and 15 July 2020.Setting Primary care providers from 224 villages in 34 districts across Bihar, India.Participants 452 IPs, 57 AYUSH practitioners and 38 doctors (including 23 government doctors) were interviewed from a census of 1138 primary care providers used by community members that could be reached by telephone.Primary outcome measure(s) Providers were interviewed using a structured questionnaire with choice-based answers to gather information on (1) change in patient care seeking, (2) source of COVID-19 information, (3) knowledge on COVID-19 spread, symptoms and methods for prevention and (4) clinical management of COVID-19.Results During the early days of the COVID-19 pandemic, 72% of providers reported a decrease in patient visits. Most IPs and other private primary care providers reported receiving no COVID-19 related engagement with government or civil society agencies. For them, the principal source of COVID-19 information was television and newspapers. IPs had reasonably good knowledge of typical COVID-19 symptoms and prevention, and at levels similar to doctors. However, there was low stated compliance among IPs (16%) and qualified primary care providers (15% of MBBS doctors and 12% of AYUSH practitioners) with all WHO recommended management practices for suspect COVID-19 cases. Nearly half of IPs and other providers intended to treat COVID-19 suspects without referral.Conclusions Poor management practices of COVID-19 suspects by rural primary care providers weakens government pandemic control efforts. Government action of providing information to IPs, as well as engaging them in contact tracing or public health messaging can strengthen pandemic control efforts.

Composting of municipal solid waste (MSW) as a part of Bio-processing is of much concern. Since it gives sanitary approach for processing as well as enables geochemical cycling of the nutrients. However, due to the quality of the compost formed, there is no sufficient demand for it. Moreover, due to low yield of compost and mechanization used in its preparation, the resultant cost is not affordable by the farmers. Pretreatment of MSW with NaOH and Na2CO3, as observed from chemical oxygen demand of the supernatant shows more carbon solubilization from the waste.

Background: Febrile seizures are commonly seen in children and about one-third of the children develop a recurrence of febrile seizures. Objectives: The main objective is to study the risk factors associated with recurrence of febrile seizures in Indian children. Methods: This prospective, longitudinal study was carried out in the Department of Pediatrics, GSVM Medical College, Kanpur. All children, 6 months to 5 years of age, attending the department from February 2015 to January 2016 presenting with first febrile seizures were included in the study and followed up for recurrence. Results: Of 528 children, 174 (32.9%) had recurrence and 354 (67.1%) had a single episode of febrile seizures. Recurrence was more in children <18 months (41.3%) as compared to children ≥18 months (24.1%). Children with temperature 101°F during the seizure had a recurrence rate of 52.5% while recurrence was seen in only 17.2% in children with temperature ≥105°F. There was a significant declining trend of recurrence with increase in temperature. Recurrence was significantly more common in children with a family history of febrile seizures (45.5%) as compared to those without family history (27.8%). Multiple logistic regression analysis revealed that younger age at onset of first seizure, lower temperature during the seizure, brief duration between the onset of fever and the initial seizure, and family history of febrile seizures were risk factors significantly associated with recurrence of febrile seizures in children. Conclusion: Younger age at first seizure, short duration of fever before the onset of first febrile seizure, lower temperature at onset, and family history of febrile seizures are risk factors of recurrence of febrile seizures in children.

The performance of an insulation system depends on the degradation of Electrical breakdown strength. Study of their behaviour can gives a useful information regarding the state of the insulation system. The Electrical grade insulating presspapers are obtained from quality cellulose fibers to meet the insulation requirements of motor, capacitor, and transformer manufacturers. Among these, presspapers are mainly used as an insulation for power and distribution transformers. In this paper, the presspapers are prepared by means of water soluble insulating polymers specifically polyvinyl alcohol and povidone (Polyvinylpyrrolidone) and experimental investigations have been carried out to determine the electrical breakdown strength of different grades of insulating presspapers and impregnated presspapers at various temperature of virgin transformer oil and atmospheric air. A system model consisting of presspapers and transformer oil with uniform field electrode arrangement was tested for its behaviour. The system was allowed to age till failure of the sample occurred in the form of a puncture. Series of experiments have performed on presspapers and oil immersed presspapers under laboratory conditions, 40°C and 90°C. Results are then analysed with the view of separately understanding the impact of breakdown strength of insulating presspapers in a transformer.

BACKGROUND Epilepsy is the most common neurological disorder affecting 60 million people worldwide and in an estimated 40% of whom it is genetically determined. Idiopathic epilepsies are those in which genetic aetiology is likely or proven. An alteration of GABA-ergic neurotransmission has been implicated as an aetiologic factor in epileptogenesis, while LGI-4 (Leucine Rich Glioma Inactivated 4) is not homologous to any known ion channel and the mechanism by which it causes epilepsy is unknown. LGI-4 belongs to a super family LRR (Leucine Rich Repeats) proteins and suspected to have a role in peripheral nerve myelination. The authors aimed to determine whether genetic variations in the GABRG2 and LGI-4 gene confers susceptibility to idiopathic epilepsy and febrile seizures or not. MATERIALS AND METHODS In this case control study, samples of 30 cases and 42 controls were taken. Allelic frequencies were expressed as a percentage of the total number of alleles. Genotypes and allelic frequencies for c.588C/T in fifth exon of gene GABRG2 (SNP211037, Asn196Asn) and c.1914GC/AT located in ninth exon of the gene LGI-4 were compared in both groups. RESULTS Association analysis of GABRG-2 polymorphism between CC, CT and TT genotypes statistically showed insignificant result as chi(2) value was 0.12 and p value was > 0.05. Association analysis of LGI-4 polymorphism between GC/GC, GC/AT and AT/AT genotypes statistically showed insignificant result as chi(2) value was 0.51 and p value was > 0.05. CONCLUSION It was concluded that GABRG2 and LGI-4 polymorphisms were not the susceptibility factors for idiopathic epilepsies and febrile seizures.

Background: It is believed that welders are at a greater risk of developing cataract. In this study, we have endeavored to look for definite evidence for this issue.Materials and Methods: A study was conducted on male welders and control subjects (not engaged in welding) from construction companies and welding workshops in Kishanganj, Bihar. A questionnaire was used to gather information about their work and lifestyle, as also their occupational, medical, and ocular histories. Cataract was identified by external examination and ophthalmoscopy.Results: The study was conducted on 37 welders and 100 controls. The study showed that the welders were at the higher risk of developing cataract.Conclusions: Our study shows that the incidences of cataract were higher in welders than in controls. However, the exact cause behind this increased prevalence of cataract in welders could not be elucidated in this study. Yet, it can be suggested that the welders need more rigorous eye protection.

Background: Sildenafil citrate (Viagra) is a drug commonly used for the treatment of impotence and pulmonary hypertension. There have been reports of adverse ocular side effects on the administration of these drugs. However, the reports are not consistent, and also very few studies have been done in India and practically none from Eastern India.Materials and Methods: Standard equipment for visual acuity, visual field, tonometry, Vitreal study, retina and fundus, ocular computerized tomography, electroretinogram, visually evoked potential, fundus fluorescent angiography was used. 100 patients to be put on sildenafil for their medical problem were studied for ocular status and then again after 6 months' sildenafil therapy. 100 healthy persons were also studied before and after giving placebo. The results of the two groups were compared, analyzed, and inference drawn.Results: About 7 out of test subjects receiving sildenafil had errors in refraction, compared to 5 in controls. Obviously, this was not clinically significant. Only two of those receiving sildenafil reported bluish visual flush that also only those receiving sildenafil in high doses, that is, 100 mg or above. Only one in the test population reported diplopia. 7 of the test subjects showed conjunctival redness. Cataract was noted in none, either in controls or test subjects. Vitreal pathology in the form of vitreal detachment or traction was observed in 3 test subjects. In 4 of the test subjects, intraocular pressure was raised. Paramacular edema was found in two test subjects. Retinal ischemic features were detected in 11 test subjects who received sildenafil for more than 6 months in any dose. Our findings tallied well with studies from abroad, and the main side effects we encountered were conjunctival injection and ischemic ocular retinopathy.Conclusion: Mentionable acute side effect of sildenafil is bluish visual flash. Some clinically significant patterns of effects, following long-term administration, are also recognized, of which retinal ischemic blockade is the most prominent one.

Context: Oxidative stress plays a key role in the patho-physiology of hypertension. (-)-Epicatechin has many important biological properties. Objective: The present study was undertaken to evaluate effect of (-)-epicatechin on protein carbonyl content in gender-based hypertensive patients and normal subjects. Methods: The study was carried out on 83 normal (male: 42; female: 41) and 62 hypertensive subjects (male: 32; female: 30). In vitro effect on (-)-epicatechin and L-ascorbic acid was estimated on protein carbonyl content. Results: Result showed a significant (p < 0.001) increase in protein carbonyl content in hypertensive patients but no gender-based difference was observed. (-)-epicatechin shows significant (p < 0.001) dose-dependent effect as compared to L-ascorbic acid, which is manifested as decrease in protein carbonyl content. Conclusion: We hypothesizes that a higher intake of (-)-epicatechin may provide protection against hypertension in males and females.

Amphotericin B (AmB) was formulated in tripalmitin based nanosize lipid particles (emulsomes) stabilized by egg phosphatidylcholine (PC) for macrophage targeting for the treatment of visceral leishmaniasis (VL). Emulsomes were prepared by cast film technique followed by sonication to obtain particles of nanometric size range and further modified by anchoring them with macrophage-specific ligand (p-aminophenyl-α-D-mannoside, PAM). The surface modified emulsomes and their plain counterparts were characterized for size, shape, entrapment efficiency, zeta-potential, in-vitro drug release and ligand binding specificity. The antileishmanial activity of AmB-deoxycholate (AmB-Doc) and emulsome entrapped AmB was tested in vitro in Leishmania donovani infected macrophage-amastigote system (J774A.1 cells), which showed higher efficacy of PAM-anchored AmB emulsomes (TPEs-PAM) over plain AmB emulsomes (TPEs) and AmB-Doc. The in vivo antileishmanial activity of the AmB (0.5 and 1mg/kg respectively) was tested against VL in L. donovani infected hamsters in which formulation TPEs-PAM eliminated intracellular amastigotes of L. donovani within splenic macrophages more efficiently (52.44 ± 3.9 % and 68.03 ± 4.2 % parasite inhibition, PI) than the formulation TPEs (32.86 ± 2.4 % and 39.66 ± 3.8 % PI) and AmB-Doc (20.98 ± 2.10 % and 24.43 ± 3.55 % PI). We concluded that PAM-anchored emulsomes could fuse with the macrophages of liver and spleen due to ligand-receptor interaction and could target the bioactives inside them. Our results suggest that these newer formulations (plain and ligand-anchored emulsomes) are a promising alternative to the conventional AmB-Doc formulation for the treatment of VL.

MIMO antenna is a combination of multiple antenna elements. It has a signal processing capability to optimize its radiation reception pattern which automatically chan ge in response to the signal environment. This paper prov ides comprehensive review on various evolutionary algorit hms which are used for adaptation. The weights of the smart an tenna array are adapted to maximize the output in desired direc tion and minimize the signals in undesired direction. Adapti ve beam forming algorithm is used for track corresponding u sers automatically. This paper discuss about Non-blind beam forming algorithm i.e.. Least Mean Square, and Blind beam fo rming algorithm i.e.. Constant Modulus Algorithm and Sample Matrix Inversion. The algorithms are simulated for MIMO en vironment by using MATLAB. Beam forming can be used for either ra dio or sound waves. It has found numerous applications in r adar, sonar, seismology, wireless communication, radio astronomy, speech and biomedicine. Keywords— Smart antenna, Beam forming, Least Mean Squa re, Constant Modulus Algorithm , Sample Matrix Inversion.