BackgroundAlcohol withdrawal syndrome (AWS) is a distressing condition, generally controlled by benzodiazepines (BZD's). Baclofen, a gamma-aminobutyric acid-B (GABAB) agonist, has also shown promising results in controlling AWS. As there are few studies comparing the efficacy and tolerability of chlordiazepoxide with baclofen, the present study was taken up. The objective of this study was to compare efficacy and tolerability of baclofen with chlordiazepoxide in uncomplicated AWS.MethodsSixty subjects with uncomplicated AWS were randomized into two groups of 30 each, to receive baclofen (30 mg) or chlordiazepoxide (75 mg) in decremented fixed dose regime for 9 days. Clinical efficacy was assessed by Clinical Institute Withdrawal Assessment for Alcohol-Revised Scale (CIWA-Ar) and tolerability by the nature and severity of adverse events. Lorazepam was used as rescue medication. Secondary efficacy parameters were Clinical Global Impression scores, symptom-free days, and subject satisfaction as assessed by visual analog scale. This study was registered with Clinical Trial Registry-India (CTRI/2013/04/003588), also subsequently registered with WHO's ICTRP clinical trial portal.ResultsBoth baclofen and chlordiazepoxide showed a consistent reduction in the total CIWA-Ar scores. However, chlordiazepoxide showed a faster and a more effective control of anxiety and agitation requiring lesser lorazepam supplementation, and also showed a better subject satisfaction compared to baclofen. Both the drugs showed good tolerability with mild self-limiting adverse events.ConclusionThe present study demonstrates that baclofen is not as good as chlordiazepoxide in the treatment of uncomplicated AWS. However, baclofen might be considered as an alternative.

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Breast cancer is among the most widespread ailments afflicting women globally. The timely identification and accurate diagnosis are vital for successful therapy and improved prognosis. Over the past years, researchers have extensively utilized machine learning algorithms to detect breast cancer from medical images. This paper proposes an innovative hybrid clustering approach combining both k-means and Gaussian mixture models (GMM) to enhance breast cancer detection performance. By utilizing the k-means clustering approach as a basis, our algorithm generates initial cluster centers from the input data. With these results, we then proceed to implement the GMM algorithm to further refine our clustering outcomes and calculate each cluster's probability distribution accordingly. Through evaluation on publicly available mammography images, our hybrid algorithm outperformed both k-means and GMM algorithms in terms of sensitivity, specificity and area under the receiver operating characteristic curve (AUC-ROC).

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The incidence of arthritis is rising in India due to increase in the proportion of ageing population and obesity. Cruciate retaining total knee arthroplasty (TKA) is a promising mode of treatment for end stage arthritis, with excellent functional outcome. Hence, we have evaluated the functional outcome of posterior cruciate ligament retaining TKA and the problems related to the procedure at our institute.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This prospective study was conducted on 30 patients who underwent posterior cruciate ligament retaining primary TKA at a tertiary health care centre between December 2012 and May 2014. Patients were evaluated using Knee society score (knee score and function score) at regular follow up visits</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study included TKA for 42 knees in 30 patients. Indications for TKA were osteoarthritis in 37 knees and rheumatoid arthritis in 5 knees. The average follow-up period was 24 weeks. All the 42 knees had poor knee score (&lt;60) and poor functional score (&lt;60) preoperatively. Postoperatively 37 knees had excellent (80-100) and 5 knees had good knee score (70-79) whereas 22 patients had excellent (80-100), 5 patients had good (70-79), 2 patients had fair (60-69) and 1 patient had poor functional score (&lt;60). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Our study demonstrates that posterior cruciate retaining TKA is a reliable procedure with excellent functional outcome, pain relief and early return of patients to their daily activities. Posterior cruciate retaining TKA provided excellent knee society score and functional score in majority of patients.</span></p>

Purpose:The sandhigata vata described in Ayurveda causes the symptomatology such as shula, sotha, stambhana, sparsha asahyata, sputana, akunchana prasarana vedana etc. whereas the osteoarthritis described in modern science can be correlated with sandhigata vata because it also produces the features such as inflammation, pain, stiffness, limited movements and deformity in severe cases. Osteoarthritis is the 2nd most common illness with 22 29% of prevalence in global population. Presently available modern medication is causing many side and toxic effects which sometimes may need hospitalization also. Hence it requires the need to find such a therapy which gives better relief without any side or toxic effects and also natural, cost effective and easily available. Hence the non surgical biological therapeutic means such jalaukawacharana was selected.Method:Total of 20 patients were selected on the basis of selection criteria (inclusion and exclusion criteria) and then they are grouped into two i.e. 10 each in Jalukawacharana and Yogaraja guggulu group. The jalukawacharana was done with 7 day interval for about 6 sittings in 1st group where as in 2nd group yogaraja guggulu 125mg thrice a day was given for 6 weeks. For assessment, the Koos was taken as subjective and range of motion was taken as objective parameter for proper assessment and they are subjected for statistical validity.Result:After analyzing, the jalukawacharana shown significant and remarkable result in comparison with Yogaraja guguulu. The symptomatology was reduced to great extent and range of motion is also improved a lot by jalukawacharana than with yogaraja guggulu.Conclusion:The janu sandhi gata vata can correlate or compared with osteoarthritis of knee joint. The non surgical, biological therapeutic means i.e. jalukawacharana shown good result in treating with janu sandhigata vata i.e. osteoarthritis of knee joint in comparison with standard group i.e. yogaraja guggulu.