India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.
India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.
In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.
Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.
One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.
One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.
Introduction: Loco-regional anesthesia role is increasingly important in surgery, especially in postoperative pain control. Using ultrasound-guided techniques has made the loco-regional approach increasingly safe and manageable, guaranteeing excellent analgesic results and patient compliance. This bibliometric research aimed to identify the most influential papers on the adductor canal blocks and outline their characteristics. Methods: All articles published from 1980 to 2022 were included in the Web of Science, PubMed, and Scopus databases and found using the keywords “Adductor canal block” or “Saphenous nerve block” or “Peripheral nerve block” or “Hunter canal block” or “Subsartorial canal block” or “ACB” or “Knee” or “TKR” or “TKA” or “Analgesia” or “Arthroplasty” or “Replacement” in the title section had bibliometric analysis performed. The first 25 papers were selected and analyzed by the number of citations. The correlation between numerical variables was evaluated using the Pearson Correlation coefficient. Results: Literature screening found 252 publications. One hundred ten were only about the adductor canal block. Of these, 25 articles were selected for our bibliometric study, published in 8 different journals and with a total number of citations equal to 1.457. “Regional Anesthesia and pain medicine” journal – with 9 articles – was the one that produced the most. There was a significant strong correlation between the n. of citations and the citation rate (R = 0.84, p < 0.001). Conclusion: The purpose of this study is to be a guide on regional anesthesia and, particularly, on adductor canal block, making the most effective as well as the most cited articles available to anesthesiologists or other researchers interested in this topic.
Background and Aim: Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated. Methods: This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student’s t-test and the continuous one with χ2. Statistical significance was set at a p-value lower than 0.05. Results: No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2. Conclusion: No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.
Background: Cubital tunnel syndrome (CuTS) is the second most common nerve entrapment syndrome of the upper extremity after carpal tunnel syndrome. In situ decompression (ISD) and ulnar nerve transposition (UNT) are the major surgery methods in practice for the treatment of CuTS. However, controversies exist over the efficacy and safety of these methods. Aim: The objective of the study was to compare the short- and long-term clinical outcomes in patients treated with ISD and UNT surgery. Method: This was a retrospective study comprising 56 patients who underwent either ISD or UNT at Naresuan University Hospital between January 2013 and December 2022. Data on age, sex, hand involved, duration of the surgery, duration of the symptoms including the clinical outcomes such as elbow range of motion (ROM), quick disabilities of the arm, shoulder, and hand (QuickDASH), McGowan grade (MGG), Visual Analog Scale (VAS) for pain scores, motor and sensory conduction velocity (MCV1, MCV2, and SCV), and Tinel's sign were collected during the two-week, one-month, three-month, and six-month follow-ups post-surgery. Results: Of the 56 patients in the study, 62.5% were female. The number of patients aged <60 years was higher in both groups. The mean age of patients in the ISD group was 49.07±6.13 years, while in the UNT group, it was 51.5±7.04 years. After one month, 53.57% and 32.14% of the patients recovered to MGG 1 in the ISD and UNT groups, respectively. The majority of the patients had MGG 1 six months after the surgery. The QuickDASH score and pain scores of the patients improved during all follow-ups, but no statistical significance was revealed when the two techniques were compared. Conclusion: The study found that both the ISD and UNT were efficient and safe in treating CuTS. Further study with the inclusion of parameters such as revision surgery and complications would be vital.
Carpal tunnel syndrome (CTS) is caused by the shortening of the median nerves in the wrist, resulting in hand pain and paralysis necessitating surgical operation for relief. Conventional open carpal tunnel release (CTR) procedures, involving long incisions, often lead to complications, delaying patients' recovery for weeks or months. Therefore, mini-incision surgery has emerged as a preferred option, offering reduced pain, smaller wounds, and improved appearance. This study aimed to compare the outcomes of modified mini-incision surgery for CTS before and after the operation. It was a retrospective study involving 80 patients, with data collected from medical records pre-and post-operation, specifically at the 2 nd week, 3 rd month, 6 th month, 12 th month, and 24 th month intervals. Variables included operation time, incision length, pinch strength, gripping strength, two-point discrimination (2-PD), visual analogue scale (VAS), Levine score, quick disabilities of the arm, shoulder and hand (Quick-DASH), wound pain, and pillar pain. Data were analyzed using descriptive statistics and logistic regression, with a significant level of 0.05. The mean incision length was 11.54 mm. At the 2-week post-operative mark, the pinch strength was 5.43, gripping strength was 14.96, 2-PD was 5.84, the VAS score was 2.86, the Levine symptom was 3.84, and the DASH score was 69.43. There was a relationship (p-value<0.05) between preoperative and postoperative measures for pinch strength, gripping strength, 2-PD, and Levine symptom condition. The study on 80 patients who underwent modified mini-incision surgery for CTS at Naresuan University Hospital in Phitsanulok, Thailand, found that these parameters showed significant improvement postoperatively. Patients demonstrated good recovery and condition 2 weeks after the mini-incision surgery for CTS.
Lateral epicondylitis, commonly known as Tennis Elbow, affects approximately 1-3% of the population. Despite the absence of histological evidence of inflammation in the affected tissue, the term “epicondylitis” implies inflammation. The Extensor Carpi Radialis Brevis (ECRB) muscle is primarily affected, and the condition is attributed to excessive use of this muscle. Non surgical treatment options, such as rest, physiotherapy, cortisone injection, platelet-based therapies, and restricted movements, are recommended. Surgical intervention is suggested for cases involving physical impairment or chronic pain. This review aims to provide healthcare professionals with an understanding of the condition, including its causes, symptoms, diagnosis, and treatment planning options.
Background: While osteoporosis increases the risk of fragility fractures, bisphosphonate has been proven to increase bone strengthand reduce the risk of vertebral and non-vertebral fractures. In addition to its efficacy, substituting the brand with generic medication isa strategy to optimize healthcare expenditures. This study aimed to evaluate the efficacy of generic alendronate treatment and assesspotential adverse events in patients with osteoporosis.Materials and Methods: A retrospective review was conducted on 120 patients who met the indications for osteoporosis treatment,received weekly generic alendronate (70 mg) for >1 year, and underwent evaluation through standard axial dual-energy X-rayabsorptiometry (DXA). The outcomes of this study were the percent change in bone mineral density (BMD) at the lumbar spine,femoral neck, and total hip after one year of treatment. The major adverse events occurring during medication that led to thediscontinuation of drug administration were documented.Results: Most patients were female (96.7%) with an average age of 69.0 ± 9.3 years. The percent change in BMD increased at all sitesafter one year of generic alendronate treatment (lumbar spine: 5.6 ± 13.7, p-value <0.001; femoral neck: 2.3 ± 8.3, p-value = 0.023;total hip: 2.1 ± 6.2, p-value = 0.003), with over 85% of patients experiencing increased or stable BMD. Three patients discontinued themedication due to adverse effects: two had dyspepsia, and one had persistent myalgia.Conclusion: Generic alendronate may be considered an effective antiresorptive agent for osteoporosis treatment with a low incidenceof adverse effects
Acharya Prafulla Chandra College
Tamil Nadu Agricultural University
Mgm University