Automated government form filling for aged and monolingual people using interactive tool.

PURPOSE: The Government of India offers various schemes for various classes of citizens. Most of the application forms of schemes to be filled are in English and it is observed that monolingual individuals find it difficult to access and fill the forms. This paper addresses the challenges faced by monolingual individuals in India, particularly the elderly, people with impairments, and those from marginalized communities. The proposed work is to create an interactive system called "Dhvani" voicebot, specifically designed for the Kannada language. It helps users in identifying suitable government schemes and fills forms in English. MATERIALS AND METHODS: The proposed system is developed using the RASA chatbot framework and NLP techniques to comprehend user utterances. RNN and SVM algorithms are employed to ensure smooth conversation flow and interaction with the users. To enhance scheme suggestion accuracy, a knowledge graph is created, containing relevant data on government schemes. RESULTS: The intent classification model achieves an accuracy of 97%, indicating its ability to accurately understand user intentions. The integration of a knowledge graph improves the accuracy of scheme identification and suggestion to users. The system automates the process of filling out government scheme forms based on user inputs. CONCLUSION: Dhvani voicebot system presents a practical solution to address the challenges faced by monolingual individuals in accessing government schemes in India. The high accuracy of intent classification and the use of a knowledge graph contribute to the system's effectiveness. The study suggests that this system can be extended to other languages.

An automated tool called "Dhvani" will solve the problem of aged, illiterate and physically challenged persons filling forms in post offices and banks. Most of the schemes, pension funds, cash withdrawal, cash deposit is through these organizations. So. the tool makes the process easier for the above mention persons without the help of others.An intent recognition and interactive tool developed in Kannada Language which is widely spoken in Karnataka, India. The digital resources available in Kannada Language is very sparce.Use of technology like interactive tool, Knowledge graph, RNN and SVM are used in the development of the tool.Government scheme recommendation interactively makes the users to choose the scheme faster in an interactive way.The form is filled automatically and can be edited to rectify mistakes.

Role of IL 6 as a biomarker in the diagnosis of tuberculous meningitis - A systematic review.

Background: Tuberculous meningitis (TBM) is the most common and serious form of central nervous system tuberculosis (TB) with high morbidity and mortality. Following the encounter of tubercle bacilli by microglial cells, inflammatory process sets in and series of cytokines are secreted such as tumor necrosis factor, interleukin-6 (IL6), and interferon γ. The following study was undertaken with the aim of systemically reviewing the diagnostic and prognostic evidence of IL6 in TBM. Methods: After a thorough search of databases for the articles with IL6 association in TBM published from 2001 onwards to September 2021. Articles were identified and assessed according to the inclusion and exclusion criteria. Excel spreadsheets were used for the extraction of data and analysis. Results: A total of 10 studies were included for review which focused on IL6 in the role of TBM diagnosis. All the age group persons of both sexes were included in the study. The experiment was conducted mostly in the developing countries. The range of measured IL6 values was very wide and difficult to interpret. Conclusion: TBM patients' IL 6 was higher than healthy controls in all the studies mentioned, but the results of cerebrospinal fluid IL6 and serum IL6 were less consistent. Due to a small number of prospective studies, it was not possible to analyze the IL6 cut-off value to diagnose TB. Further studies are required to provide information on IL6 as biomarker in the diagnosis of TBM.

Consumption of spine by tuberculosis in the era of directly observed treatment, short-course and genomic diagnosis.

BACKGROUND: Extra Pulmonary Tuberculosis (EPTB) is a significant health problem in both developing and developed countries. Spinal tuberculosis (STB) is one of the significant forms of EPTB lacking epidemiological data. The present study was conducted to study the clinical, radiological, microbiological and histopathological features, treatment and outcome of Spinal tuberculosis. METHODS: This study was conducted for a duration of 19 years, from 2000 to 2018 at the department of Neuromicrobiology, NIMHANS, Bengaluru. It comprised of 252 patients with STB. All patients were diagnosed with the clinical features and confirmed by radiological, microbiological and histopathological findings. RESULTS: Results were tabulated and statistically studied. The most common age group is 30-40 years with male preponderance. Most patients presented with motor paraplegia/para paresis (99.6%). Thoracic spine was the most common vertebra affected (47.62%). The commonest imaging feature is soft tissue collection (81.74%). Most common histopathological feature was necrotising granulomatous inflammation (65.87%). Microbiology reports showed growth of Mycobacterium tuberculosis (MTB) in 29.76%, Ziehl Neelsen (ZN) smear showed acid fast bacilli (AFB) in 25.79%. Anti tubercular drugs and surgery were advised in 55.55% patients and only anti TB drugs for 39.28%. The entire course of anti tubercular treatment (ATT) was completed in 60.71% and 4.76% were defaulters. CONCLUSION: Spinal tuberculosis is a global disease, timely diagnosis with clinical, imaging, microbiological, histopathological features and complete course of anti-tubercular treatment along with symptomatic treatment appears to be safe and effective.

Effect of liberal versus restrictive fluid therapy on intraoperative lactate levels in robot- assisted colorectal surgery.

BACKGROUND AND AIMS: Minimally invasive and robotic surgeries need lesser fluid replacement but the role of restricted fluids in robotic surgeries other than prostatic surgeries has not been clearly defined. Our primary aim was to evaluate the effects of a restrictive fluid regimen versus a liberal policy on intra-operative lactate in robotic colorectal surgery. Secondary outcomes were need for vasopressors, extubation on table, post-operative renal functions and length of ICU (LOICU) stay. METHODS: American society of anaesthesiologists (ASA) physical status I-II patients scheduled for robot-assisted colorectal surgery were randomised into one of two groups, receiving either 2 mL/kg/h (Group R) or 4mL/kg/h, (group L). Fluid boluses of 250 ml were administered if mean arterial pressure (MAP) <65 mmHg or urine output <0.5 ml/kg/h. Norepinephrine was added for the blood pressure after 2 fluid boluses. Surgical field was assessed by modified Boezaart's scale and surgeon satisfaction by Likert scale. RESULTS: Demographics and baseline renal functions were comparable. Adjusted intra-operative lactate at 2 h, 4 h, and 6 h and need for noradrenaline and post-operative creatinine were similar. One patient in the group L was ventilated due to hypothermia. The field was better at the 4 h in group R and comparable at other time points. The LOICU stay was longer in Group L. CONCLUSION: The use of restrictive fluid strategy of 2 mL/kg/h (group R) does not increase lactate levels or creatinine, improves surgical field at 4 h and shortens ICU stay in comparison to a liberal 4 mL/kg/h (group L) in robotic colorectal surgery.

Geriatric Patients with Hip Fracture: Frailty and Other Risk Factors Affecting the Outcome.

BACKGROUND: Hip fracture is a devastating health-care problem in a geriatric patient, leading to high mortality and morbidity. Preoperative risk assessment in the geriatric patient is often inexact because of the difficulty in measuring their poor physiologic reserves. AIMS: The primary objective was to find the association of modified frailty index (MFI) with 90-day mortality in geriatric patients who received anesthesia for fractured hip. Secondary objectives were to assess the association of preoperative waiting time with the 90-day mortality and the correlation of preexisting medical conditions with poor functional outcome among the survivors. SETTINGS AND DESIGNS: This prospective, observational study was conducted at a tertiary care institution. SUBJECTS AND METHODS: In this prospective observational study, done over a period of 1 year, 60 geriatric patients aged ≥65 years who received anesthesia for fractured hip and fulfilled selection criteria were recruited. The association of MFI with 90-day mortality and the correlation of preexisting comorbidities with poor functional outcome among the survivors were assessed. STATISTICAL ANALYSIS USED: Independent sample t-test, Mann-Whitney test, and odds ratio were used as applicable. RESULTS: Total 60 patients were available for analysis as two patients dropped off from final 62 on follow up, fifty three patients survived after 90 days. MFI and 90-day mortality showed a significant direct correlation with P < 0.0001. However, no association was found between the preoperative waiting time and 90-day mortality. Preexisting medical conditions showed a significant association of dementia with total dependence afterward with a P = 0.02. CONCLUSION: There is significant statistical correlation of MFI with the 90-day mortality in the geriatric hip-fractured patients undergoing surgery.