The medicine was then subjected to pre clinical studies (Acute and sub acutr toxicity studies) as per the protocol and the safety of the drug was ensured. The qualitative and quantitative bio chemical studies were done at the bio chemistry lab of National Institute of Siddha and IIT Chennai respectively. Among the 60 cases screened at the OPD of department of Maruthuvam NIS, 40 cases were recruited for the trial as per the inclusion and exclusion criteria. Clinical diagnosis of Azhal keel vayu was made by Siddha and Modern methodology.
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Ø I, Dr.S.G.Senthil kumar studying M.D(Siddha) in National Institute of Siddha, Chennai. The disease called Mathumegam (Type-2 Diabetes Mellitus) becomes heterogeneous group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin resistance or both. It includes the symptoms like, frequent urination, increased thirst, increased hunger, general tiredness and burning feet. This condition is being treated in NIS with many siddha formulations. As a part of M.D(Siddha) research programme and developing new efficacious medicine, we propose to study the Atthippattaiyathi kasayam formulation for treating the condition. This formulation has been mentioned in siddha literature and empirical evidence with contemporary tools is required for documentation. You can receive medicines free of cost. The duration of treatment period is 40 days. You have to visit NIS every 10 days and collect drugs for 10 days. The diagnosis tests will be carried out free of cost. We will assess the effect of treatment after completion of 40 days of treatment using clinical and lab parameters.
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Taking part in this study is voluntary. No compensation will be paid to you for taking part in this study. You can choose not to answer any specific question. There is no specific benefit for you if you take part of in this study, but you will be under our clinical monitoring and specific attention will be given for your help. Taking part in this study may be of benefit to the community, as it may help us to develop medicine for Kumba Vaatham. In case of any adverse symptoms during the treatment passing loosey stools,irritation in the stomach , indigestion which is expected for few patients during the treatment, shall be reported to PIs and care will be taken in NIS for relief. You can withdraw from the study at the midst of treatment period, if you are not interested to continue and you will receive our usual treatment without condition.
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Taking part in this study is voluntary. No compensation will be paid to you for taking part in this study. You can choose not to answer any specific question. There is no specific benefit for you if you take part of in this study, but you will be under our clinical monitoring and specific attention will be given for your help. Taking part in this study may be of benefit to the community, as it may help us to develop medicine for Cegana Vaatham. In case of any adverse symptoms during the treatment passing loosey stools,irritation in the stomach , indigestion which is expected for few patients during the treatment, shall be reported to PIs and care will be taken in NIS for relief. You can withdraw from the study at the midst of treatment period, if you are not interested to continue and you will receive our usual treatment without condition.
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Taking part in this study is voluntary. No compensation will be paid to you for taking part in this study. You can choose not to answer any specific question. There is no specific benefit for you if you take part in the study, but you will be under our clinical monitoring and specific attention will be given for your health. Taking part in the study may be of benefit to the community, as it may help us to develop medicine for swasakasam. In case of any adverse symptoms during the treatment which is expected for few patients during the treatment, shall be reported to PIs and care will be taken in NIS for relief. You can withdraw from the study at the midst of treatment period, if you are not interested to continue and you will receive our usual treatment without condition.
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crystalline mineral materials within the kidney or urinary tract. It includes the symptoms like, pain in the back region, radiating towards the groins and lower abdomen, painful urination, scanty urination, nausea, vomiting and may also pass the urine with blood. This condition is being treated in NIS with many siddha formulations. As a part of M.D(S) research programme and developing new efficacious medicine, we propose to study the karpoora silasathu parpam formulation for treating the condition. This formulation has been mentioned in siddha literature and empirical evidence with contemporary tools is required for documentation. You can receive medicines free of cost. The duration of treatment period is 48 days. You have to visit NIS every week and collect drugs for 7 days. The diagnosis tests will be carried out free of cost. However, a particular test USG Abdomen has to be taken from outside lab and charges to be borne by you. We will assess the effect of treatment after completion of 48 days of treatment using clinical and lab parameters.
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Each training session covered the potential benefits of PAL, the specifics of the skill being taught and/or learned during PAL activity (clinical examination, con- sultation, communication, critical writing, presentation) and an opportunity to interact, develop and practise giv- ing constructive feedback to each other (written and/or verbal). An open discussion about issues and topics which may emerge through PAL experiences, including expectations (roles and behaviour) was also encouraged during the training sessions . In collaboration with each health professions unit coordinators, PAL training was conducted in face to face settings for between 1 to 4 h and was delivered by the 1st (SC), 4th (HW) and 5th (PN) authors of the PAL project team.
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The prime role of UK medical schools is to support the development of a future workforce ready to fulfil the requirements of the UK National Health Service (NHS) and we believe our curriculum is well placed to do this. This includes a focus on key areas of need, currently around primary care, mental health care in a variety of clinical contexts and the need to train for work with an aging population. Integration of mental health alongside physical health problems in CBL cases from phase 1 onwards supports the development of a holistic approach and interest in mental health issues in addition to careers in psychiatry. Most CBL cases also include a primary care element which is presented in a positive way, promoting general practice as a positive career choice as suggested by Wass. (Wass, Gregory, & Petty-Saphon, 2016)A good proportion of Warwick graduates continue to enter specialist training in these underserved specialities compared to other schools (GMC, 2017). From phase 2 onwards many cases focus on patients with multiple co-morbidities and frailty, within a social, societal and family context, who require an integrated and collaborative approach to their care and represent the types of patients that graduates will be predominantly caring for in foundation training and beyond.
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Second, a limitation of the validation using the PreVI- LIG dataset is that this dataset only contains ventilated preterm infants and their available parameters during the first days of life. Today more and more infants are initially managed without invasive ventilation. Although these preterm infants often have decreased need for sup- plemental oxygen or mechanical ventilation in the first postnatal week, many infants have a pulmonary deterior- ation in the second postnatal week, with an increased need for supplemental oxygen and respiratory support, and many will eventually develop BPD . Ideally, the identified prediction models should be validated using a dataset of both ventilated and non-ventilated preterm in- fants from a recently collected multicenter cohort, defin- ing the outcome BPD according to recent established criteria that include the severity of the diagnosis. The PreVILIG dataset did not access the severity of BPD, and furthermore no prediction model with extensive ventila- tor parameters could be validated after the third day of life. However, the strength of the PreVILIG dataset is the large number of included patients, with comparable mean gestational age compared to the best five perform- ing models, in an IPD database containing detailed in- formation on clinical data and respiratory support during the first week after birth. Even when the limita- tions of this dataset are taken into account, those predic- tion models that have adequate generalizability should perform similarly in this dataset, as if it were a mixed dataset of both ventilated and non-ventilated infants. To assess the risk of bias due to non-randomly missing values, the calculations were rerun after multiple impu- tations. Overestimation of the discriminative perform- ance due to this bias seems implausible, because these analyses showed little change in the AUC values for each model.
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counterparts. This could presuppose that pre- clinical students face a lot of stress in that phase of study and are in more dire need of a mentor to provide guidance through it. It was found that the clinical students had overtime developed coping strategies to manage their academic and personal life challenges in the medical and dental school based on the series of questions asked to assess their degree of need for mentoring. Therefore, despite their having a higher level of awareness on mentoring and a lower prevalence of mentoring relationships, a higher proportion of the clinical students seemed not to have so much need for mentoring again. This is a critical finding and it is hoped that the clinical students have not in any way given up on their training institution to providing them a solution for their academic and personal challenges.
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There is, however, a significant cautionary note with respect to the use of MSMs for this unifying purpose. Specifically, an emphasis on precise and detailed prediction as a means of judging the adequacy and validity of MSMs generates the same limitations that afflict experimental biology: trying to enhance precision by reducing or eliminating output variability or noise functions to restrict the denominator space represented by the MSM and reduces its generalizing capability. This phenomenon most often manifests with over-fit and tightly parameterized, brittle models; therefore overcoming this trap requires employing the concept of using widely bounded parameter spaces as part of the description of a MSM, and utilizing experimental/clinical data that incorporates outliers that reflect a sparse sampling of the wider behavioral denominator space.
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For the outcome variables, multivariable genera- lized linear models were used to statistically adjust for pre-index characteristics while accounting for the within-patient correlation among patients with mul- tiple episodes by using random effect. The models were adjusted for age, gender, payer type, inpatient admissions during the pre-index period, anxiety disorder, depression disorder, alcohol/substance abuse disorder, and anti-anxiety medication use. For probability of resource use, a model with a binomial distribution and logit link was used to compare dif- ferences in the probability of hospitalization while controlling for pre-index characteristics. For patients with at least one hospitalization, a model with a gamma distribution  with log link was used to compare differences in hospitalization costs while controlling for pre-index characteristics. P values <.05 were considered, a priori, to be statistically significant. All analyses were completed with SAS version 9.3 (SAS Institute, Cary, NC).
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Because of the widespread and growing use of endoscopy and biopsy, the diagnosis of IBD-indeterminate is, in most cases, based on microscopic and clinical features when no definitive diagnostic features of either CD or UC can be found. The continued presence of IBD-indeterminate diag- noses supports the concept that IBD represents a spectrum of diseases rather than just two entities, CD and UC, and over time, the concept of IBD-indeterminate has evolved.
Self-reported measures of physical disability assess dif- ficulty, inability or degree of assistance required to per- form specific tasks of mobility, household management or personal care. However, because people with pre- clinical disability due to impairment are still able to accomplish a task under certain circumstances without perceiving a difficulty, the above measures may not be sensitive enough to recognise early functional decline [11,13]. Although research has shown that objective measures of physical performance, such as lower extre- mity muscle strength and walking speed, are good pre- dictors of pre-clinical disability in older adults , self report measures are often the only feasible approach to identifying disability for both research or population health purposes. For this reason an effective self reported measure was developed by Fried and colleagues that identifies individuals in the pre-clinical stage of dis- ability by report of modification of their method of per- forming mobility tasks which compensate for the impact of underlying health changes. Fried and colleagues found self report of task modification and performance measures to be independent and strong predictors of incident mobility disability. The test re-test reliability and predictive validity have been reported in studies of older American women , late middle aged African Americans , and older sedentary Finnish people ; all three studies involved community dwelling participants.
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To date, there are virtually no clinical trials that rely on imaging strategies discussed in this manuscript to increase efficacy or evaluate safety. This is perhaps due to the fact that OVs are new to the clinical field and will require time for implementing these tools as part of a study. The leading imaging tool to date is NIS. Although both MV- and VSV- expressing NIS have been in clinical trial for the past few years (Table 1), little is known about the effect of NIS on patients at the immune system level. This is not only because the stages of these trials are classified as early (i.e., Phase I or II), but also due to absence of data from these trials. In fact, only 2 trials are currently classified as “active” which means at least another few years before any conclusions can be drawn. Another factor currently not being tested for in these trials is the combination with radioiodine, which could increase the therapeutic efficacy of the OV expressing NIS as shown in animal models. 40 Hopefully, future clinical
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ABSTRACT: Stroke remains world’s second leading cause of mortality; and globally most frequent cause of long-lasting disabilities. The ischaemic pathophysiologic cascade leading to neuronal damage consists of peri-infarct depolarization, excitotoxicity, inflammation, oxidative stress, and apoptosis. Despite plethora of experimental evidences and advancement into the development of treatments, clinical treatment of acute stroke still remains challenging. Neuro- protective agents, as novel therapeutic strategy confer neuro-protection by targeting the pathophysiologic mechanism of stroke. The aim of this review is discussion of summary of the literature on stroke pathophysiology, current preclinical research findings of neuroprotective agents in stroke and possible factors that were responsible for the failure of these agents to translate in human stroke therapies.
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The importance of appropriate empathy in health professionals is well recognised, and empathy is highly valued by the community as a component of the doctor- patient interaction. It is also of major importance to students and to the profession, as loss of empathy can be associated with lower professional satisfaction and burnout , and may adversely impact on professional standards. A loss of empathy by medical students as they progress through their studies has been reported by authors in a number of countries, occurring particularly in the clinical years of the course. However the evidence is mixed; for example, schools in Japan , Portugal , Australia  and United Kingdom  have demon- strated little or no loss of empathy in their students, while studies in Iran , New Zealand , and North America (Florida, Boston ; Philadelphia ) have shown it to be a common issue. A systematic review by Neumann et al. in 2011  concluded (from mostly American data) that empathy decline during medical school and residency compromises development of professionalism and may threaten health care quality.
Clinical audit is an effective tool for assessing and improving the clinical care provided to patients. Good guidance has previously been provided in the veterinary literature as to how to conduct clinical audit in veterinary practice (Mosedale 1998; Viner 2009, 2010, 2012; Dunn 2012; RCVS Knowledge 2015). These resources go in-depth into how you might conduct audit and the types of topics you might choose. The combination of the limited veterinary evidence- base and the reality of practice, however, makes traditional clinical audit as per the framework derived from the medical field, challenging to implement in the veterinary setting. We discuss some of the contentious issues relating to the application of clinical audit in veterinary practice and examine the benefits of utilising audit to improve patient care.
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So far, no toxoid vaccine has been prepared worldwide for Escherichia coli O157:H7, hence no comparison could be made with literature studies. When comparison was made with efficiency of two types of prepared vaccines in this study, namely toxoid and whole-cell vaccine, both were believed to have lost its pathogenicity as validated by pre-clinical in-vitro studies and clinical animal studies but whole-cell vaccine has proved to show much higher efficiency than toxoid vaccine. However, this is just a preliminary confirmation before proceeding to human volunteer level studies.
Gerontological education has changed over time from a traditional medical model, or illness focus, to a wellness focus in nursing curricula (King, 2005). Previous to this philosophical shift, “opportunities to address wellness in older adults were ignored, and opportunities to optimize function devalued” (King, 2005, p. 3). Currently, many nursing programs across Canada aim to emphasize wellness and healthy aging throughout the curriculum, promoting the use of best practice guidelines and current research evidence when planning and implementing care for elders (Canadian Association of Schools of Nursing [CASN], 2014). Although this is positive, King (2005) identified nursing programs as populated with students and clinical instructors who have negative attitudes towards the care of older adults, noting further change is still necessary.
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