A SCIENTIFIC EVALUATION OF AYURVEDIC DRUGS IN THE MANAGEMENT OF DIABETES MELLITUS TYPE 2: AN EVIDENCE BASED REVIEW

Diabetes Mellitus (DM) is a major challenging health problem of the 21st century. Prevalence of DM is rapidly rising throughout the globe where India leads with largest number of diabetics and became “Diabetes capital of the worldâ€. It refers to a heterogenous chronic metabolic disorder that shares the phenotype of hyperglycaemia. DM is caused by a complex interaction of genetic, behavioural and environmental factors. It results due to impaired insulin secretion or insulin resistance, decreased glucose utilization and increased glucose production. It is characterized by polyuria, polydipsia, weight loss, fatigue, Dryness of mouth and throat, constipation and instance itching. Diabetes mellitus is of two types- Type I - IDDM (Jata pramehi or Sahajapramehi) Type II - NIDDM (Sthula pramehi and Apathyanimittaja pramehi).Ayurvedic management strategy of Apathayanimittajaprameha (type-2 diabetes mellitus) include Snehana (oleation), Shodhan and shaman treatments accompanied with suitable dietary and life style modification which has been found very effective. In Ayurvedic system of medicine various single herbs, herbal formulations, herbominerals and minerals are using popularly and very effectively in the treatment of Madhumeha i.e., Diabetes Mellitus type- 2. Many Ayurvedic drugs revalidated to having anti-diabetic and anti-hyperglycaemic activity by clinical and experimental study but many are awaited. In this study, the initiation have been taken to collect and compiled all the related information regarding Ayurvedic drugs used therapeutically that may facilitate further research works

A sub-pixel resolution enhancement model for multiple-resolution multispectral images

Présentation orale ayant pour titre "Super-Resolution of Sentinel-2 multispectral images"International audienceWe present a new resolution enhancement model, with application to MODIS and Sentinel-2 data. For applications like land cover monitoring, the availability of multispectral bands at multiple resolutions limits the classification accuracy at full resolution. We introduce a new model to separate pixel content from color information at high-resolution bands. This sub-pixellic model is then applied to unmix low-resolution bands. This technique drastically improves the overall land cover classification accuracy, especially in the MODIS cases, and it is particularly effective on Sentinel-2 data

Drug utilization study of antidepressant drugs in psychiatric outdoor patients at a tertiary care hospital in Southern Rajasthan

Background: The World Health Organization (WHO) defines “Drug Utilization” as the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences. Antidepressants are used to treat depressive illnesses and anxiety disorders. However, these are also employed in the pharmacotherapy of several psychiatric disorders. Very few studies were found regarding the pattern of prescription of antidepressants in outdoor patients in southern Rajasthan. So, this study has been planned to learn about the prescription pattern of antidepressant drugs as per WHO Core Drugs Prescribing indicators at a tertiary care hospital in southern Rajasthan. Methods: A cross-sectional observational study was conducted among 375 patients by convenient sampling over one year duration, in the outdoor Department of Psychiatry at RNT Medical College, Udaipur, Rajasthan. Patient’s prescriptions were analyzed for drug utilisation pattern in OPD after relevant consent. All data was compiled in MS Excel and analyzed using statistical methods. Results: Out of 375 prescriptions analyzed, 48.8% were males and 51.2% were females. Most commonly, patients had a diagnosis of depressive disorder (42.93%), followed by bipolar affective disorder (14.4%). The most common drug class prescribed was SSRI (88.86%). Escitalopram (41.65%) was the most prescribed drug, followed by Sertraline (30.51%). Conclusions: Among the prescribed antidepressants SSRIs were the most common class of drug followed by TCA. Escitalopram was the most common drug to be prescribed followed by sertraline. More than half of the patients receiving antidepressants suffered from non-depressive disorders. Monotherapy was preferred over combination therapy. All patients were prescribed generic drugs

A novel approach for optimal weight factor of DT-CWT coefficients for land cover classification using MODIS data.

International audiencePresently, there is a need to explore the possibility to maximize the use of MODIS (Moderate Resolution Imaging Spectroradiometer) data as it has very good spectral (36 bands) and temporal resolution whereas its spatial resolution is moderate i.e. 250m, 500m, and 1km. Because of its moderate spatial resolution, its application for land cover classification is limited. Therefore, in this paper, an attempt has been made to enhance its spatial resolution and utilize the information contained in the different bands together to achieve good land cover classification accuracy, so that, in future, MODIS data can be used more effectively. For resolution enhancement, modified dual tree complex wavelet transform (DT-CWT) has been employed, where DT-CWT has been modified by critically analyzing the effect of weight factor of the DT-CWT coefficients on land cover classification. For this purpose, image statistics parameter like Mean of the image has also been considered. The proposed technique has been applied on the six bands of MODIS data which have spatial resolution of 500m. It is observed that weight factor of the high-frequency sub-bands is quite sensitive for computation of classification accuracy. Index Terms— DT-CWT, Resolution enhancement, wavelets, weights, MODIS 1.INTRODUCTION Satellite images are being used in various applications such as geoscience studies, astronomy and geographical information systems where their resolution plays a critical role but on the other hand, directly obtaining a high resolution data is an another herculean task because of high cost of sensor. Land cover classification from satellite data is a central topic in satellite imaging applications. Therefore, it becomes a necessity to develop and utilize a reliable resolution enhancement technique to obtain accurate information as much as possible as per application from the freely available moderate resolution satellite data. In this regard, many image resolution enhancement techniques have been developed which are interpolations (nearest neighbor, bilinear and bicubic) and wavelets (DWT, SWT, WZP etc.) based. Interpolation techniques [1] have been widely used for resolution enhancement but it results in loss of edges (i.e., high frequency components) of an image. Nowadays, resolution enhancement is being carried out in the wavelet domain. There are many wavelet transforms which have acquired the place. Discrete wavelet transform (DWT) [2] has also been widely used in order to preserve the high-frequency components of the image but its disadvantage is that it ends up with some ringing artifacts into the image since it is not found to be shift-invariant because of decimations and suppression of wavelet coefficients exploited by DWT. It basically suffers from four shortcomings i.e., oscillations, shift variance, aliasing and lack of directionality which can lead to some artifacts in the image and difficulties in signal modeling. Hence, the DWT has somewhat disappointed the researchers for satellite images. Therefore, in order to alleviate all these drawbacks of DWT [2,3], a new kind of wavelet was introduced by Kingsbury which is known as DT-CWT (Dual tree complex wavelet transform) [1,3]. It possesses shift-invariant property and has the capability of improving directional resolution (because of good directional sensitivity) as compared to that of the decimated DWT. That's why, DT-CWT has been employed in this paper for resolution enhancement of moderate resolution satellite images. It is foremost to discover the possibility of maximizing the use of freely available satellite data like MODIS. It consists of several bands in which different information is present, but has certain limitations as well like low spatial resolution i.e. 500m which is a major obstacle in obtaining that information accurately. Many researchers have worked on resolution enhancement techniques for visualization enhancement whereas in this paper, main motive is to enhance the land cover classification accuracy which is not reported much for satellite images like MODIS yet. Variance minimization [4] has also been explored by several researchers for weights optimization but it is somewhat 4528 978-1-5090-3332-4/16/$31.0

Radical surgery versus organ preservation via short-course radiotherapy followed by transanal endoscopic microsurgery for early-stage rectal cancer (TREC): a randomised, open-label feasibility study

Background: Radical surgery via total mesorectal excision might not be the optimal first-line treatment for early-stage rectal cancer. An organ-preserving strategy with selective total mesorectal excision could reduce the adverse effects of treatment without substantially compromising oncological outcomes. We investigated the feasibility of recruiting patients to a randomised trial comparing an organ-preserving strategy with total mesorectal excision. Methods: TREC was a randomised, open-label feasibility study done at 21 tertiary referral centres in the UK. Eligible participants were aged 18 years or older with rectal adenocarcinoma, staged T2 or lower, with a maximum diameter of 30 mm or less; patients with lymph node involvement or metastases were excluded. Patients were randomly allocated (1:1) by use of a computer-based randomisation service to undergo organ preservation with short-course radiotherapy followed by transanal endoscopic microsurgery after 8–10 weeks, or total mesorectal excision. Where the transanal endoscopic microsurgery specimen showed histopathological features associated with an increased risk of local recurrence, patients were considered for planned early conversion to total mesorectal excision. A non-randomised prospective registry captured patients for whom randomisation was considered inappropriate, because of a strong clinical indication for one treatment group. The primary endpoint was cumulative randomisation at 12, 18, and 24 months. Secondary outcomes evaluated safety, efficacy, and health-related quality of life assessed with the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and CR29 in the intention-to-treat population. This trial is registered with the ISRCTN Registry, ISRCTN14422743. Findings: Between Feb 22, 2012, and Dec 19, 2014, 55 patients were randomly assigned at 15 sites; 27 to organ preservation and 28 to radical surgery. Cumulatively, 18 patients had been randomly assigned at 12 months, 31 at 18 months, and 39 at 24 months. No patients died within 30 days of initial treatment, but one patient randomly assigned to organ preservation died within 6 months following conversion to total mesorectal excision with anastomotic leakage. Eight (30%) of 27 patients randomly assigned to organ preservation were converted to total mesorectal excision. Serious adverse events were reported in four (15%) of 27 patients randomly assigned to organ preservation versus 11 (39%) of 28 randomly assigned to total mesorectal excision (p=0·04, χ2 test). Serious adverse events associated with organ preservation were most commonly due to rectal bleeding or pain following transanal endoscopic microsurgery (reported in three cases). Radical total mesorectal excision was associated with medical and surgical complications including anastomotic leakage (two patients), kidney injury (two patients), cardiac arrest (one patient), and pneumonia (two patients). Histopathological features that would be considered to be associated with increased risk of tumour recurrence if observed after transanal endoscopic microsurgery alone were present in 16 (59%) of 27 patients randomly assigned to organ preservation, versus 24 (86%) of 28 randomly assigned to total mesorectal excision (p=0·03, χ2 test). Eight (30%) of 27 patients assigned to organ preservation achieved a complete response to radiotherapy. Patients who were randomly assigned to organ preservation showed improvements in patient-reported bowel toxicities and quality of life and function scores in multiple items compared to those who were randomly assigned to total mesorectal excision, which were sustained over 36 months’ follow-up. The non-randomised registry comprised 61 patients who underwent organ preservation and seven who underwent radical surgery. Non-randomised patients who underwent organ preservation were older than randomised patients and more likely to have life-limiting comorbidities. Serious adverse events occurred in ten (16%) of 61 non-randomised patients who underwent organ preservation versus one (14%) of seven who underwent total mesorectal excision. 24 (39%) of 61 non-randomised patients who underwent organ preservation had high-risk histopathological features, while 25 (41%) of 61 achieved a complete response. Overall, organ preservation was achieved in 19 (70%) of 27 randomised patients and 56 (92%) of 61 non-randomised patients. Interpretation: Short-course radiotherapy followed by transanal endoscopic microsurgery achieves high levels of organ preservation, with relatively low morbidity and indications of improved quality of life. These data support the use of organ preservation for patients considered unsuitable for primary total mesorectal excision due to the short-term risks associated with this surgery, and support further evaluation of short-course radiotherapy to achieve organ preservation in patients considered fit for total mesorectal excision. Larger randomised studies, such as the ongoing STAR-TREC study, are needed to more precisely determine oncological outcomes following different organ preservation treatment schedules. Funding: Cancer Research UK

Quantification of CpG island methylation in the human large bowel

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