Search results for: Aparna Khanna
Commenced in January 2007
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Edition: International
Paper Count: 58

Search results for: Aparna Khanna

28 Animal Welfare Violations during Treatment at Different Level of Veterinary Hospitals

Authors: Aparna Datta, Mahabub Alam

Abstract:

Animal welfare is comparatively new area of research in Bangladesh and welfare concern for animal is increasing day by day. The study was conducted to investigate the animal welfare violations during treatment at different level of hospitals in Bangladesh and India. This study was conducted between January and May, 2017. The recorded data (N=180) were categorized into eight major types of violation like - delay in starting treatment, non-specific treatment, surgery without anesthesia, use of unsterilized needle, rough and painful handling, fearful approach, multiple pricking during injection and use of blunt needle. Categorized groups were analyzed according to different hospitals like Upazila Veterinary Hospitals, Bangladesh (UVHs), SAQ-Teaching Veterinary Hospital, Bangladesh (SAQTVH) and Veterinary College and Research Institute, India (VCRI). Among all hospitals, violation during treatment more frequently occurred in UVH. Among all violations, surgery without anesthesia was only found in UVH (80%) and it was belong to considerable number of cases (80%). In the view of other major violations like - non-specific treatment was 69% in UVHs, 13% in SAQTVH and 5% in VCRI. Use of unsterilized instruments during treatment was also higher in UVHs (65%) than SAQTVH (5%) and VCRI (1%). But delay in starting treatment varied insignificantly and it was 26-42% across the different levels of hospitals. Although multiple pricking during injection was found 30% cases in UVH, but statistical variations with other level of hospitals were unnoticed (p>0.05). The findings of this study will help to take necessary steps to control violation against animal welfare during treatment. A comprehensive study considering all levels of hospitals including field treatment is also recommended to find out the welfare violations during treatment.

Keywords: animal welfare, treatment, veterinary hospitals, violations

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27 Behavior, Temperament and Food Intake of Urban Indian Adolescents

Authors: Preeti Khanna, Bani T. Aeri

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Background: Recent studies have indicated challenges that hamper health and wellbeing of a vast majority of adolescents in developing countries. Many modifiable factors like behavior and temperament related to food intake among adolescents have not been adequately explored. The aim of the proposed research is to study the impact of behavior and temperament on food intake and diet quality of adolescents. Objectives: In the present study data on dietary behavior and anthropometry of adolescent boys & girls (aged 13-16 years) studying in public schools of Delhi will be gathered to ascertain the quality of diet among adolescent boys and girls and to study the effect of behavior and temperament on diet quality of adolescents. Methods: In total, 400 adolescents will participate in this cross-sectional study. Weight and height of adolescents will be measured and BMI will be calculated. Information will be obtained on their socio-demographic profile and various factors influencing their Food Choices and diet quality such as body image perception, Behavior, temperament, locus of control and parental influence. Expected results: Several direct effects of adolescent traits and behavior on food intake will be observed. Maturational patterns and gender differences in behavior traits will be assessed. By profiling of the behavior and temperament traits, we will have a better understanding of impact of these factors on weight and eating behaviors in overweight/obese or even underweight adolescents. Conclusions: The proposed study will highlight the association of behavioral factors with nutritional status of adolescents. It will also serve as a strategic approach for the obesity prevention and health management policies designed for adolescents.

Keywords: behaviour, temperament, food intake, adolescents

Procedia PDF Downloads 239
26 A Comparative Study of Environment Risk Assessment Guidelines of Developing and Developed Countries Including Bangladesh

Authors: Syeda Fahria Hoque Mimmi, Aparna Islam

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Genetically engineered (GE) plants are the need of time for increased demand for food. A complete set of regulations need to be followed from the development of a GE plant to its release into the environment. The whole regulation system is categorized into separate stages for maintaining the proper biosafety. Environmental risk assessment (ERA) is one of such crucial stages in the whole process. ERA identifies potential risks and their impacts through science-based evaluation where it is done in a case-by-case study. All the countries which deal with GE plants follow specific guidelines to conduct a successful ERA. In this study, ERA guidelines of 4 developing and 4 developed countries, including Bangladesh, were compared. ERA guidelines of countries such as India, Canada, Australia, the European Union, Argentina, Brazil, and the US were considered as a model to conduct the comparison study with Bangladesh. Initially, ten parameters were detected to compare the required data and information among all the guidelines. Surprisingly, an adequate amount of data and information requirements (e.g., if the intended modification/new traits of interest has been achieved or not, the growth habit of GE plants, consequences of any potential gene flow upon the cultivation of GE plants to sexually compatible plant species, potential adverse effects on the human health, etc.) matched between all the countries. However, a few differences in data requirement (e.g., agronomic conventions of non-transformed plants, applicants should clearly describe experimental procedures followed, etc.) were also observed in the study. Moreover, it was found that only a few countries provide instructions on the quality of the data used for ERA. If these similarities are recognized in a more framed manner, then the approval pathway of GE plants can be shared.

Keywords: GE plants, ERA, harmonization, ERA guidelines, Information and data requirements

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25 Effect of Active Compounds Extracted From Tagetes Erecta Against Plant-Parasitic Nematodes

Authors: Deepika, Kashika Kapoor, Nistha Khanna, Lakshmi, Archna Kumar

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Plant-parasitic nematodes cause major loss in global food production and destroying at least 21.3% of food annually. About 4100 species of plant-parasitic nematodes are reported, out of this, Meloidogyne species is prominent and worldwide in distribution. Observing the harmful effects of chemical based nematicides, there is a great need for an eco-friendly, highly efficient, sustainable control measure for Meloidogyne. Therefore, In vitro study was carried out to observe the impact of volatile cues obtained from the Tagetes erecta leaves on plant parasitic nematodes. Volatile cues were collected from marigold leaves. For chemical characterization, GCMS (Gas Chromatography Mass Spectrometry) profiling was conducted. VOCs (Volatile Organic Compounds) profile of marigold indicated the presence of several types of alkanes, alkenes varying in number and quantity. Status of nematodes population by counting the live and dead individuals after applying a definite volume (100µl) of extract was recorded at different concentrations (100%, 50%, 25%) with contrast of control (hexane) during different time durations i.e.,24hr, 48hr and 72hr. Result indicated that mortality increases with increasing time (72hr) and concentration (100%) i.e., 50%. Thus, application of prominent compound present in Marigold in pure form may be tested individually or in combination to find out the most efficient active compound/s, which may be highly useful in eco-friendly management of targeted plant parasitic nematode.

Keywords: plant-parasitic nematode, meloidogyne, tagetes erecta, volatile organic compounds

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24 Pretreatment of Aquatic Weed Typha latifolia with Sodium Bisulphate for Enhanced Acid and Enzyme Hydrolysis for Production of Xylitol and Bioethanol

Authors: Jyosthna Khanna Goli, Shaik Naseeruddin, Hameeda Bee

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Employing lignocellulosic biomass in fermentative production of xylitol and bioethanol is gaining interest as it is renewable, cheap, and abundantly available. Xylitol is a polyol, gaining its importance in the food and pharmacological industry due to its low calorific value and anti-cariogenic nature. Bioethanol from lignocellulosic biomass is widely accepted as an alternative fuel for transportation with reduced CO₂ emissions, thus reducing the greenhouse effect. Typha latifolia, an aquatic weed, was found to be promising lignocellulosic substrate as it posses a high amount of sugars and does not compete with arable lands and interfere with food and feed competition. In the present study, xylose from hemicellulosic fraction of typha is converted to xylitol by isolate Jfh5 (Candida. tropicalis) and cellulose part to ethanol using Saccharomyces cerevisiaeVS3. Initially, alkali pretreatment of typha using sodium hydroxide, potassium hydroxide, ammonium hydroxide, calcium hydroxide, sodium bisulphate and sodium dithionate for overnight (18h) at room temperature (28 ± 2°C), resulted in maximum delignification of 75% with 2% (v/v) sodium bisulphate. Later, pretreated biomass was subjected to acid hydrolysis with 1%, 1.5%, 2%, and 3% H₂SO₄ at 110 °C and 121°C for 30 and 60 min, respectively. 2% H₂SO₄ at 121°C for 60 min was found to release 13.5 g /l sugars, which on detoxification and fermentation produced 8.1g/l xylitol with yield and productivity of 0.65g/g and 0.112g/l/h respectively. Further enzymatic hydrolysis of the residual substrate obtained after acid hydrolysis released 11g/l sugar, which on fermentation with VS3 produced 4.9g/l ethanol with yield and productivity of 0.22g/g and 0.136g/l/h respectively.

Keywords: delignification, xylitol, bioethanol, acid hydrolysis, enzyme hydrolysis

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23 Prostitution in Colonial Bengal: Autobiographical Articulations and Fictional Representations

Authors: Aparna Bandyopadhyay

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The proposed paper will examine how prostitution produced a vast corpus of literature in colonial Bengal. This corpus included autobiographical accounts by prostitutes themselves. While the authenticity of some of these has, at times, been doubted by contemporary observers, the sheer magnitude of such narrative prose demands critical attention. Many of these autobiographical narratives focused on the prostitute’s early life within respectable society and then proceeded to delineate the transgressions and the inescapable chain of circumstances that eventually rendered her a prostitute. Significantly, these serve to corroborate the findings of official investigations regarding the circumstances that led upper-caste Hindu women in Bengal to embrace prostitution in this period. The literary corpus that dwelt on prostitution also included a vast volume of fiction penned by celebrated writers. These foregrounded a prostitute as the central protagonist, telling the life-stories of prostitutes and the circumstances that made them what they were. Novels and short stories often represented the prostitute as an affective being – an individual capable of deep emotions despite her profession. She was seldom a person who had voluntarily embraced prostitution. She was always a figure of helplessness and suffering, a woman whose desire to love and be loved transcended the carnality of her livelihood. She was an outcast, but she experienced the entire repertoire of emotions experienced by her respectable counterparts. The proposed paper will examine the trends and characteristics of the available repertoire of prostitute-oriented literature in late colonial Bengal. It will begin by focusing on the existing perspectives on the origins of prostitution in late colonial Bengal. It will proceed to discuss the literary corpus supposedly penned by prostitutes themselves and then focus on the manner in which some of the stalwarts of high literature represented the prostitute in their literary creations.

Keywords: emotions, literature, prostitution, transgression

Procedia PDF Downloads 108
22 Preparation Static Dissipative Nanocomposites of Alkaline Earth Metal Doped Aluminium Oxide and Methyl Vinyl Silicone Polymer

Authors: Aparna M. Joshi

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Methyl vinyl silicone polymer (VMQ) - alkaline earth metal doped aluminium oxide composites are prepared by conventional two rolls open mill mixing method. Doped aluminium oxides (DAO) using silvery white coloured alkaline earth metals such as Mg and Ca as dopants in the concentration of 0.4 % are synthesized by microwave combustion method and referred as MA ( Mg doped aluminium oxide) and CA ( Ca doped aluminium oxide). The as-synthesized materials are characterized for the electrical resistance, X–ray diffraction, FE-SEM, TEM and FTIR. The electrical resistances of the DAOs are observed to be ~ 8-20 MΩ. This means that the resistance of aluminium oxide (Corundum) α-Al2O3 which is ~ 1010Ω is reduced by the order of ~ 103 to 104 Ω after doping. XRD studies reveal the doping of Mg and Ca in aluminium oxide. The microstructural study using FE-SEM shows the flaky clusterous structures with the thickness of the flakes between 10 and 20 nm. TEM images depict the rod-shaped morphological geometry of the particles with the diameter of ~50-70 nm. The nanocomposites are synthesized by incorporating the DAOs in the concentration of 75 phr (parts per hundred parts of rubber) into VMQ polymer. The electrical resistance of VMQ polymer, which is ~ 1015Ω, drops by the order of 108Ω. There is a retention of the electrical resistance of ~ 30-50 MΩ for the nanocomposites which is a static dissipative range of electricity. In this work white coloured electrically conductive VMQ polymer-DAO nanocomposites (MAVMQ for Mg doping and CAVMQ for Ca doping) have been synthesized. The physical and mechanical properties of the composites such as specific gravity, hardness, tensile strength and rebound resilience are measured. Hardness and tensile strength are found to increase, with the negligible alteration in the other properties.

Keywords: doped aluminium oxide, methyl vinyl silicone polymer, microwave synthesis, static dissipation

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21 Shear Strength and Consolidation Behavior of Clayey Soil with Vertical and Radial Drainage

Authors: R. Pillai Aparna, S. R. Gandhi

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Soft clay deposits having low strength and high compressibility are found all over the world. Preloading with vertical drains is a widely used method for improving such type of soils. The coefficient of consolidation, irrespective of the drainage type, plays an important role in the design of vertical drains and it controls accurate prediction of the rate of consolidation of soil. Also, the increase in shear strength of soil with consolidation is another important factor considered in preloading or staged construction. To our best knowledge no clear guidelines are available to estimate the increase in shear strength for a particular degree of consolidation (U) at various stages during the construction. Various methods are available for finding out the consolidation coefficient. This study mainly focuses on the variation of, consolidation coefficient which was found out using different methods and shear strength with pressure intensity. The variation of shear strength with the degree of consolidation was also studied. The consolidation test was done using two types of highly compressible clays with vertical, radial and a few with combined drainage. The test was carried out at different pressures intensities and for each pressure intensity, once the target degree of consolidation is achieved, vane shear test was done at different locations in the sample, in order to determine the shear strength. The shear strength of clayey soils under the application of vertical stress with vertical and radial drainage with target U value of 70% and 90% was studied. It was found that there is not much variation in cv or cr value beyond 80kPa pressure intensity. Correlations were developed between shear strength ratio and consolidation pressure based on laboratory testing under controlled condition. It was observed that the shear strength of sample with target U value of 90% is about 1.4 to 2 times than that of 70% consolidated sample. Settlement analysis was done using Asaoka’s and hyperbolic method. The variation of strength with respect to the depth of sample was also studied, using large-scale consolidation test. It was found, based on the present study that the gain in strength is more on the top half of the clay layer, and also the shear strength of the sample ensuring radial drainage is slightly higher than that of the vertical drainage.

Keywords: consolidation coefficient, degree of consolidation, PVDs, shear strength

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20 Socio-Demographic Factors and Testing Practices Are Associated with Spatial Patterns of Clostridium difficile Infection in the Australian Capital Territory, 2004-2014

Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

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Background: Clostridium difficile infections (CDIs) have been on the rise globally. In Australia, rates of CDI in all States and Territories have increased significantly since mid-2011. Identifying risk factors for CDI in the community can help inform targeted interventions to reduce infection. Methods: We examine the role of neighbourhood socio-economic status, demography, testing practices and the number of residential aged care facilities on spatial patterns in CDI incidence in the Australian Capital Territory. Data on all tests conducted for CDI were obtained from ACT Pathology by postcode for the period 1st January 2004 through 31 December 2014. Distribution of age groups and the neighbourhood Index of Relative Socio-economic Advantage Disadvantage (IRSAD) were obtained from the Australian Bureau of Statistics 2011 National Census data. A Bayesian spatial conditional autoregressive model was fitted at the postcode level to quantify the relationship between CDI and socio-demographic factors. To identify CDI hotspots, exceedance probabilities were set at a threshold of twice the estimated relative risk. Results: CDI showed a positive spatial association with the number of tests (RR=1.01, 95% CI 1.00, 1.02) and the resident population over 65 years (RR=1.00, 95% CI 1.00, 1.01). The standardized index of relative socio-economic advantage disadvantage (IRSAD) was significantly negatively associated with CDI (RR=0.74, 95% CI 0.56, 0.94). We identified three postcodes with high probability (0.8-1.0) of excess risk. Conclusions: Here, we demonstrate geographic variations in CDI in the ACT with a positive association of CDI with socioeconomic disadvantage and identify areas with a high probability of elevated risk compared with surrounding communities. These findings highlight community-based risk factors for CDI.

Keywords: spatial, socio-demographic, infection, Clostridium difficile

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19 Space Utilisation during Meal Preparation in an Indian Kitchen Belonging to Middle-Income Group Family

Authors: Poonam Magu, Kumud Khanna, P. Seetharaman

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A kitchen is a major workplace in any home. A large variety of tasks, mainly related to meal preparation is performed here. The types of activities performed are varied and vast. In a way, it is the activities performed that determine the way the space within the kitchen is going to be utilised. A study was conducted in 510 Indian kitchens belonging to middle-income group families living in Delhi. It was conducted in three phases. In the first phase, 510 non-working homemakers were interviewed and questions pertaining to their personal characteristics, meal preparation and physical aspects related to the kitchen were asked. In the second phase, the technique of Path Process Chart was developed. Subsequently, a sub-sample of 50 homemakers was selected from the larger group. The activity of meal preparation was carried out by the homemakers themselves in their kitchens. A time and motion study was conducted using the technique of Path Process Chart. The results were analysed using the appropriate analysis sheets and conclusions were drawn. It was found that the entire kitchen and more specifically, the counter had been 'divided' into a number of workplaces. These workplaces were being used either for performing operations or for the purpose of storage. In many cases, it was used for both. On the whole, in 50 kitchens studied, 21 workplaces were identified which were used for performing operations related to meal preparation and 17 for storage It was also observed that almost the entire kitchen was used for the purpose of storage of some item or the other. The major workplaces where operations were performed were the range, workplaces to the right and left of range and sink and workplaces to the right or left of the sink. The same workplaces were also used for the purpose of storage. There were some workplaces outside the kitchen too, which were used for operations or storage. These were the dining table, courtyard or balcony, bedroom cupboard. On the whole, the range centre and the sink centre were found to be the two most important centres in an Indian kitchen belonging to urban middle-income group family.

Keywords: kitchen, workplace, meal preparation, path process chart

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18 Speech Identification Test for Individuals with High-Frequency Sloping Hearing Loss in Telugu

Authors: S. B. Rathna Kumar, Sandya K. Varudhini, Aparna Ravichandran

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Telugu is a south central Dravidian language spoken in Andhra Pradesh, a southern state of India. The available speech identification tests in Telugu have been developed to determine the communication problems of individuals having a flat frequency hearing loss. These conventional speech audiometric tests would provide redundant information when used on individuals with high-frequency sloping hearing loss because of better hearing sensitivity in the low- and mid-frequency regions. Hence, conventional speech identification tests do not indicate the true nature of the communication problem of individuals with high-frequency sloping hearing loss. It is highly possible that a person with a high-frequency sloping hearing loss may get maximum scores if conventional speech identification tests are used. Hence, there is a need to develop speech identification test materials that are specifically designed to assess the speech identification performance of individuals with high-frequency sloping hearing loss. The present study aimed to develop speech identification test for individuals with high-frequency sloping hearing loss in Telugu. Individuals with high-frequency sloping hearing loss have difficulty in perception of voiceless consonants whose spectral energy is above 1000 Hz. Hence, the word lists constructed with phonemes having mid- and high-frequency spectral energy will estimate speech identification performance better for such individuals. The phonemes /k/, /g/, /c/, /ṭ/ /t/, /p/, /s/, /ś/, /ṣ/ and /h/are preferred for the construction of words as these phonemes have spectral energy distributed in the frequencies above 1000 KHz predominantly. The present study developed two word lists in Telugu (each word list contained 25 words) for evaluating speech identification performance of individuals with high-frequency sloping hearing loss. The performance of individuals with high-frequency sloping hearing loss was evaluated using both conventional and high-frequency word lists under recorded voice condition. The results revealed that the developed word lists were found to be more sensitive in identifying the true nature of the communication problem of individuals with high-frequency sloping hearing loss.

Keywords: speech identification test, high-frequency sloping hearing loss, recorded voice condition, Telugu

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17 A Contemporary Advertising Strategy on Social Networking Sites

Authors: M. S. Aparna, Pushparaj Shetty D.

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Nowadays social networking sites have become so popular that the producers or the sellers look for these sites as one of the best options to target the right audience to market their products. There are several tools available to monitor or analyze the social networks. Our task is to identify the right community web pages and find out the behavior analysis of the members by using these tools and formulate an appropriate strategy to market the products or services to achieve the set goals. The advertising becomes more effective when the information of the product/ services come from a known source. The strategy explores great buying influence in the audience on referral marketing. Our methodology proceeds with critical budget analysis and promotes viral influence propagation. In this context, we encompass the vital bits of budget evaluation such as the number of optimal seed nodes or primary influential users activated onset, an estimate coverage spread of nodes and maximum influence propagating distance from an initial seed to an end node. Our proposal for Buyer Prediction mathematical model arises from the urge to perform complex analysis when the probability density estimates of reliable factors are not known or difficult to calculate. Order Statistics and Buyer Prediction mapping function guarantee the selection of optimal influential users at each level. We exercise an efficient tactics of practicing community pages and user behavior to determine the product enthusiasts on social networks. Our approach is promising and should be an elementary choice when there is little or no prior knowledge on the distribution of potential buyers on social networks. In this strategy, product news propagates to influential users on or surrounding networks. By applying the same technique, a user can search friends who are capable to advise better or give referrals, if a product interests him.

Keywords: viral marketing, social network analysis, community web pages, buyer prediction, influence propagation, budget constraints

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16 Fluid Prescribing Post Laparotomies

Authors: Gusa Hall, Barrie Keeler, Achal Khanna

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Introduction: NICE guidelines have highlighted the consequences of IV fluid mismanagement. The main aim of this study was to audit fluid prescribing post laparotomies to identify if fluids were prescribed in accordance to NICE guidelines. Methodology: Retrospective database search of eight specific laparotomy procedures (colectomy right and left, Hartmann’s procedure, small bowel resection, perforated ulcer, abdominal perineal resection, anterior resection, pan proctocolectomy, subtotal colectomy) highlighted 29 laparotomies between April 2019 and May 2019. Two of 29 patients had secondary procedures during the same admission, n=27 (patients). Database case notes were reviewed for date of procedure, length of admission, fluid prescribed and amount, nasal gastric tube output, daily bloods results for electrolytes sodium and potassium and operational losses. Results: n=27 based on 27 identified patients between April 2019 – May 2019, 93% (25/27) received IV fluids, only 19% (5/27) received the correct IV fluids in accordance to NICE guidelines, 93% (25/27) who received IV fluids had the correct electrolytes levels (sodium & potassium), 100% (27/27) patients received blood tests (U&E’s) for correct electrolytes levels. 0% (0/27) no documentation on operational losses. IV fluids matched nasogastric tube output in 100% (3/3) of the number of patients that had a nasogastric tube in situ. Conclusion: A PubMed database literature review on barriers to safer IV prescribing highlighted educational interventions focused on prescriber knowledge rather than how to execute the prescribing task. This audit suggests IV fluids post laparotomies are not being prescribed consistently in accordance to NICE guidelines. Surgical management plans should be clearer on IV fluids and electrolytes requirements for the following 24 hours after the plan has been initiated. In addition, further teaching and training around IV prescribing is needed together with frequent surgical audits on IV fluid prescribing post-surgery to evaluate improvements.

Keywords: audit, IV Fluid prescribing, laparotomy, NICE guidelines

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15 Transit Facility Planning in Fringe Areas of Kolkata Metropolitan Region

Authors: Soumen Mitra, Aparna Saha

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The perceived link between the city and the countryside is evolving rapidly and is getting shifted away from the assumptions of mainstream paradigms to new conceptual networks where rural-urban links are being redefined. In this conceptual field, the fringe interface is still considered as a transitional zone between city and countryside, and is defined as a diffused area rather than a discrete territory. In developing countries fringe areas are said to have both rural and urban characteristics but are devoid of basic municipal facilities. Again, when the urban core areas envelopes the fringe areas along with it the character of fringe changes but services are not well facilitated which in turn results to uneven growth, rapid and haphazard development. One of the major services present in fringe areas is inter-linkages in terms of transit corridors. Planning for the appropriate and sustainable future of fringe areas requires a sheer focus on these corridors pertaining to transit facility, for better accessibility and mobility. Inducing a transit facility plan enhances the various facilities and also increases their proximity for user groups. The study focuses on the western fringe region of Kolkata metropolis which is a major source of industrial hub and housing sector, thus converting the agricultural lands into non-agricultural use. The study emphasizes on providing transit facilities both physical (stops, sheds, terminals, etc.) and operational (ticketing system, route prioritization, integration of transit modes, etc.), to facilitate the region as well as accelerate the growth pattern systematically. Hence, the scope of this work is on the basis of prevailing conditions in fringe areas and attempts for an effective transit facility plan. The strategies and recommendations are in terms of road widening, service coverage, feeder route prioritization, bus stops facilitation, pedestrian facilities, etc, which in turn enhances the region’s growth pattern. Thus, this context of transit facility planning acts as a catalytic agent to avoid the future unplanned growth and accelerates it towards an integrated development.

Keywords: feeder route, fringe, municipal planning, transit facility

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14 Tapping Traditional Environmental Knowledge: Lessons for Disaster Policy Formulation in India

Authors: Aparna Sengupta

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The paper seeks to find answers to the question as to why India’s disaster management policies have been unable to deliver the desired results. Are the shortcomings in policy formulation, effective policy implementation or timely prevention mechanisms? Or is there a fundamental issue of policy formulation which sparsely takes into account the cultural specificities and uniqueness, technological know-how, educational, religious and attitudinal capacities of the target population into consideration? India was slow in legislating disaster policies but more than that the reason for lesser success of disaster polices seems to be the gap between policy and the people. We not only keep hearing about the failure of governmental efforts but also how the local communities deal far more efficaciously with disasters utilizing their traditional knowledge. The 2004 Indian Ocean tsunami which killed 250,000 people (approx.) could not kill the tribal communities who saved themselves due to their age-old traditional knowledge. This large scale disaster, considered as a landmark event in history of disasters in the twenty-first century, can be attributed in bringing and confirming the importance of Traditional Environmental Knowledge in managing disasters. This brings forth the importance of cultural and traditional know-how in dealing with natural disasters and one is forced to question as to why shouldn’t traditional environmental knowledge (TEK) be taken into consideration while formulating India’s disaster resilience policies? Though at the international level, many scholars have explored the connectedness of disaster to cultural dimensions and several research examined how culture acts as a stimuli in perceiving disasters and their management (Clifford, 1956; Mcluckie, 1970; Koentjaraningrat, 1985; Peacock, 1997; Elliot et.al, 2006; Aruntoi, 2008; Kulatunga, 2010). But in the Indian context, this field of inquiry i.e. linking disaster policies with tradition and generational understanding has seldom received attention of the government, decision- making authorities, disaster managers and even in the academia. The present study attempts to fill this gap in research and scholarship by presenting an historical analysis of disaster and its cognition by cultural communities in India. The paper seeks to interlink the cultural comprehension of Indian tribal communities with scientific-technology towards more constructive disaster policies in India.

Keywords: culture, disasters, local communities, traditional knowledge

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13 A Comparative Study of the Alternatives to Land Acquisition: India

Authors: Aparna Soni

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The much-celebrated foretold story of Indian city engines driving the growth of India has been scrutinized to have serious consequences. A wide spectrum of scholarship has brought to light the un-equalizing effects and the need to adopt a rights-based approach to development planning in India. Notably, these concepts and discourses ubiquitously entail the study of land struggles in the making of Urban. In fact, the very progression of the primitive accumulation theory to accumulation by dispossession, followed by ‘dispossession without development,’ thereafter Development without dispossession and now as Dispossession by financialization noticeably the last three developing in a span of mere three decades, is evidence enough to trace the centrality and evolving role of land in the making of urban India. India, in the last decade, has seen its regional governments actively experimenting with alternative models of land assembly (Amaravati and Delhi land pooling models, the loudly advertised ones). These are publicized as a replacement to the presumably cost and time antagonistic, prone to litigation land acquisition act of 2013. It has been observed that most of the literature treats these models as a generic large bracket of land expropriation and do not, in particular, try to differentially analyse to granularly find a pattern in these alternatives. To cater to this gap, this research comparatively studies these alternative land, assembly models. It categorises them based on their basic architecture, spatial and sectoral application, and governance frameworks. It is found that these alternatives are ad-hoc and fragmented pieces of legislation. These are fit for profit models commodifying land to ease its access by the private sector for real estate led growth. The research augments the literature on the privatization of land use planning in India. Further, it attempts to discuss the increasing role a landowner is expected to play in the future and suggests a way forward to safeguard them from market risks. The study involves a thematic analysis of the policy elements contained in legislative/policy documents, notifications, office orders. The study also derives from the various widely circulated print media information. With the present field-visit limitations, the study relies on documents accessed open-source in the public domain.

Keywords: commodification, dispossession, land acquisition, landowner

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12 Time and Energy Saving Kitchen Layout

Authors: Poonam Magu, Kumud Khanna, Premavathy Seetharaman

Abstract:

The two important resources of any worker performing any type of work at any workplace are time and energy. These are important inputs of the worker and need to be utilised in the best possible manner. The kitchen is an important workplace where the homemaker performs many essential activities. Its layout should be so designed that optimum use of her resources can be achieved.Ideally, the shape of the kitchen, as determined by the physical space enclosed by the four walls, can be square, rectangular or irregular. But it is the shape of the arrangement of counter that one normally refers to while talking of the layout of the kitchen. The arrangement can be along a single wall, along two opposite walls, L shape, U shape or even island. A study was conducted in 50 kitchens belonging to middle income group families. These were DDA built kitchens located in North, South, East and West Delhi.The study was conducted in three phases. In the first phase, 510 non working homemakers were interviewed. The data related to personal characteristics of the homemakers was collected. Additional information was also collected regarding the kitchens-the size, shape , etc. The homemakers were also questioned about various aspects related to meal preparation-people performing the task, number of items cooked, areas used for meal preparation , etc. In the second phase, a suitable technique was designed for conducting time and motion study in the kitchen while the meal was being prepared. This technique was called Path Process Chart. The final phase was carried out in 50 kitchens. The criterion for selection was that all items for a meal should be cooked at the same time. All the meals were cooked by the homemakers in their own kitchens. The meal preparation was studied using the Path Process Chart technique. The data collected was analysed and conclusions drawn. It was found that of all the shapes, it was the kitchen with L shape arrangement in which, on an average a homemaker spent minimum time on meal preparation and also travelled the minimum distance. Thus, the average distance travelled in a L shaped layout was 131.1 mts as compared to 181.2 mts in an U shaped layout. Similarly, 48 minutes was the average time spent on meal preparation in L shaped layout as compared to 53 minutes in U shaped layout. Thus, the L shaped layout was more time and energy saving layout as compared to U shaped.

Keywords: kitchen layout, meal preparation, path process chart technique, workplace

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11 Electrodeposition of Silicon Nanoparticles Using Ionic Liquid for Energy Storage Application

Authors: Anjali Vanpariya, Priyanka Marathey, Sakshum Khanna, Roma Patel, Indrajit Mukhopadhyay

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Silicon (Si) is a promising negative electrode material for lithium-ion batteries (LiBs) due to its low cost, non-toxicity, and a high theoretical capacity of 4200 mAhg⁻¹. The primary challenge of the application of Si-based LiBs is large volume expansion (~ 300%) during the charge-discharge process. Incorporation of graphene, carbon nanotubes (CNTs), morphological control, and nanoparticles was utilized as effective strategies to tackle volume expansion issues. However, molten salt methods can resolve the issue, but high-temperature requirement limits its application. For sustainable and practical approach, room temperature (RT) based methods are essentially required. Use of ionic liquids (ILs) for electrodeposition of Si nanostructures can possibly resolve the issue of temperature as well as greener media. In this work, electrodeposition of Si nanoparticles on gold substrate was successfully carried out in the presence of ILs media, 1-butyl-3-methylimidazolium-bis (trifluoromethyl sulfonyl) imide (BMImTf₂N) at room temperature. Cyclic voltammetry (CV) suggests the sequential reduction of Si⁴⁺ to Si²⁺ and then Si nanoparticles (SiNs). The structure and morphology of the electrodeposited SiNs were investigated by FE-SEM and observed interconnected Si nanoparticles of average particle size ⁓100-200 nm. XRD and XPS data confirm the deposition of Si on Au (111). The first discharge-charge capacity of Si anode material has been found to be 1857 and 422 mAhg⁻¹, respectively, at current density 7.8 Ag⁻¹. The irreversible capacity of the first discharge-charge process can be attributed to the solid electrolyte interface (SEI) formation via electrolyte decomposition, and trapped Li⁺ inserted into the inner pores of Si. Pulverization of SiNs results in the creation of a new active site, which facilitates the formation of new SEI in the subsequent cycles leading to fading in a specific capacity. After 20 cycles, charge-discharge profiles have been stabilized, and a reversible capacity of 150 mAhg⁻¹ is retained. Electrochemical impedance spectroscopy (EIS) data shows the decrease in Rct value from 94.7 to 47.6 kΩ after 50 cycles of charge-discharge, which demonstrates the improvements of the interfacial charge transfer kinetics. The decrease in the Warburg impedance after 50 cycles of charge-discharge measurements indicates facile diffusion in fragmented and smaller Si nanoparticles. In summary, Si nanoparticles deposited on gold substrate using ILs as media and characterized well with different analytical techniques. Synthesized material was successfully utilized for LiBs application, which is well supported by CV and EIS data.

Keywords: silicon nanoparticles, ionic liquid, electrodeposition, cyclic voltammetry, Li-ion battery

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10 Evidence-Based Health System Strengthening in Urban India: Drawing Insights from Rapid Assessment Study

Authors: Anisur Rahman, Sabyasachi Behera, Pawan Pathak, Benazir Patil, Rajesh Khanna

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Background: Nearly half of India’s population is expected to reside in urban areas by 2030. The extent to which India's health system can provide for this large and growing city-based population will determine the country's success in achieving universal health coverage and improved national health indices. National Urban Health Mission (NUHM) strive for improving access to primary health care in urban areas. Implementation of NUHM solicits sensitive, effective and sustainable strategies to strengthen the service delivery mechanisms. The Challenge Initiative for Healthy Cities (TCIHC) is working with the Government of India and three provincial states to develop effective service delivery mechanisms for reproductive, maternal, newborn and child health (RMNCH) through a health systems approach for the urban poor. Method: A rapid assessment study was conceptualized and executed to generate evidence in order to address the challenges impeding in functioning of urban health facilities to deliver effective, efficient and equitable health care services in 7 cities spread across two project States viz. Madhya Pradesh and Odisha. Results: The findings of the assessment reflect: 1. The overall ecosystem pertaining to planning and management of public health interventions is not conducive. 2. The challenges regarding population dynamics like migration keeps on influencing the demand-supply-enabling environment triangle for both public and private service providers. 3. Lack of norms for planning and benchmark for service delivery further impedes urban health system as a whole. 4. Operationalization of primary level services have enough potential to meet the demand of slum dwellers at large. 5. Lack of policy driven strategies on how to integrate the NUHM with other thematic areas of Maternal, Newborn & Child Health (MNCH) and Family Planning (FP). 5. The inappropriate capacity building and acute shortage of Human Resources has huge implication on service provisioning and adherence to the service delivery protocols. Conclusion: The findings from rapid assessment are aimed to inform pertinent stakeholders to develop a multiyear city health action plan to strengthen the health systems in order to improve the efficacy of service delivery mechanism in urban settings.

Keywords: city health plan, health system, rapid assessment, urban mission

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9 Pregnancy Outcome in Women with HIV Infection from a Tertiary Care Centre of India

Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

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Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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8 Predicting Susceptibility to Coronary Artery Disease using Single Nucleotide Polymorphisms with a Large-Scale Data Extraction from PubMed and Validation in an Asian Population Subset

Authors: K. H. Reeta, Bhavana Prasher, Mitali Mukerji, Dhwani Dholakia, Sangeeta Khanna, Archana Vats, Shivam Pandey, Sandeep Seth, Subir Kumar Maulik

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Introduction Research has demonstrated a connection between coronary artery disease (CAD) and genetics. We did a deep literature mining using both bioinformatics and manual efforts to identify the susceptible polymorphisms in coronary artery disease. Further, the study sought to validate these findings in an Asian population. Methodology In first phase, we used an automated pipeline which organizes and presents structured information on SNPs, Population and Diseases. The information was obtained by applying Natural Language Processing (NLP) techniques to approximately 28 million PubMed abstracts. To accomplish this, we utilized Python scripts to extract and curate disease-related data, filter out false positives, and categorize them into 24 hierarchical groups using named Entity Recognition (NER) algorithms. From the extensive research conducted, a total of 466 unique PubMed Identifiers (PMIDs) and 694 Single Nucleotide Polymorphisms (SNPs) related to coronary artery disease (CAD) were identified. To refine the selection process, a thorough manual examination of all the studies was carried out. Specifically, SNPs that demonstrated susceptibility to CAD and exhibited a positive Odds Ratio (OR) were selected, and a final pool of 324 SNPs was compiled. The next phase involved validating the identified SNPs in DNA samples of 96 CAD patients and 37 healthy controls from Indian population using Global Screening Array. ResultsThe results exhibited out of 324, only 108 SNPs were expressed, further 4 SNPs showed significant difference of minor allele frequency in cases and controls. These were rs187238 of IL-18 gene, rs731236 of VDR gene, rs11556218 of IL16 gene and rs5882 of CETP gene. Prior researches have reported association of these SNPs with various pathways like endothelial damage, susceptibility of vitamin D receptor (VDR) polymorphisms, and reduction of HDL-cholesterol levels, ultimately leading to the development of CAD. Among these, only rs731236 had been studied in Indian population and that too in diabetes and vitamin D deficiency. For the first time, these SNPs were reported to be associated with CAD in Indian population. Conclusion: This pool of 324 SNP s is a unique kind of resource that can help to uncover risk associations in CAD. Here, we validated in Indian population. Further, validation in different populations may offer valuable insights and contribute to the development of a screening tool and may help in enabling the implementation of primary prevention strategies targeted at the vulnerable population.

Keywords: coronary artery disease, single nucleotide polymorphism, susceptible SNP, bioinformatics

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7 Improving Working Memory in School Children through Chess Training

Authors: Veena Easvaradoss, Ebenezer Joseph, Sumathi Chandrasekaran, Sweta Jain, Aparna Anna Mathai, Senta Christy

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Working memory refers to a cognitive processing space where information is received, managed, transformed, and briefly stored. It is an operational process of transforming information for the execution of cognitive tasks in different and new ways. Many class room activities require children to remember information and mentally manipulate it. While the impact of chess training on intelligence and academic performance has been unequivocally established, its impact on working memory needs to be studied. This study, funded by the Cognitive Science Research Initiative, Department of Science & Technology, Government of India, analyzed the effect of one-year chess training on the working memory of children. A pretest–posttest with control group design was used, with 52 children in the experimental group and 50 children in the control group. The sample was selected from children studying in school (grades 3 to 9), which included both the genders. The experimental group underwent weekly chess training for one year, while the control group was involved in extracurricular activities. Working memory was measured by two subtests of WISC-IV INDIA. The Digit Span Subtest involves recalling a list of numbers of increasing length presented orally in forward and in reverse order, and the Letter–Number Sequencing Subtest involves rearranging jumbled alphabets and numbers presented orally following a given rule. Both tasks require the child to receive and briefly store information, manipulate it, and present it in a changed format. The Children were trained using Winning Moves curriculum, audio- visual learning method, hands-on- chess training and recording the games using score sheets, analyze their mistakes, thereby increasing their Meta-Analytical abilities. They were also trained in Opening theory, Checkmating techniques, End-game theory and Tactical principles. Pre equivalence of means was established. Analysis revealed that the experimental group had significant gains in working memory compared to the control group. The present study clearly establishes a link between chess training and working memory. The transfer of chess training to the improvement of working memory could be attributed to the fact that while playing chess, children evaluate positions, visualize new positions in their mind, analyze the pros and cons of each move, and choose moves based on the information stored in their mind. If working-memory’s capacity could be expanded or made to function more efficiently, it could result in the improvement of executive functions as well as the scholastic performance of the child.

Keywords: chess training, cognitive development, executive functions, school children, working memory

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6 'Utsadhara': Rejuvenating the Dead River Edge into an Urban Activity Space along the Banks of River Hooghly

Authors: Aparna Saha, Tuhin Ahmed

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West Bengal has a number of important rivers, each with its distinctive character and a story. Traditionally, cities have ‘divulged’ to rivers at the river edges and rivers have been an inseparable part of the urban experience. Considering the research aspect, the area is taken in Barrackpore, a small but important outgrowth of Kolkata Municipal Association, West Bengal. Barrackpore, at present, has ample inadequate public open spaces at the neighborhood level where people of different socio-cultural, economic, and religious backgrounds can come together and engage in various leisure activities, but there is no opportunity either, where people can learn about and explore the rich history of the settlement. Pertaining to these issues forms the backdrop of this research paper which has been conceptualized as a place from space that will bring people back to the river and increase community interactions and will also celebrate and commemorate towards the historical importance of the river and its edges. The entire precinct bordering the river represents the transition from pre-independence (Raj era) to Sepoy phase (Swaraj era), finally culminating into the Gandhian philosophy which is being projected into the already existing Gandhi Ghat. The ultimate aim of the paper entitled ‘Utsadhara- Rejuvenating the dead river edge into an urban activity space along the banks of river Hooghly’ is to create a socio-cultural space keeping the heritage identity intact through judicious use of the water body. Also, a balance is kept between the natural ecosystem and the cosmetic development of the surrounding open spaces. It can be duly achieved by the aforementioned methodology provided in the document, but mainly it would focus into preserving the historic ethnicity of the place by holding its character through various facts and figures as well as features. Most importantly the natural topography of the place is left intact. The second priority is given in terms of hierarchy of well connected public plazas, podiums where people from different socio-economic backgrounds irrespective of age and sex could socialize and reach towards venturing into a cordial relationship with one another. The third priority is to provide a platform for the common mass for showcasing their skills and talent through different art and craft forms which in turn would enhance their individual self and also the community as a whole through economic rise. Apart from this here some spaces are created in accordance to different age groups or class of people. The paper intends to see the river as a major multifunctional public space to attract people for different activities and re-establish the relationship of the river with the settlement. Hence, it is apprehended that the paper is not only intended to a simple riverfront conservation project but unlike others it is a place which is created for the people, by the people and of the people towards a holistic community development through a sustainable approach.

Keywords: holistic community development, public activity space, river-urban precinct, urban dead space

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5 Professional Learning, Professional Development and Academic Identity of Sessional Teachers: Underpinning Theoretical Frameworks

Authors: Aparna Datey

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This paper explores the theoretical frameworks underpinning professional learning, professional development, and academic identity. The focus is on sessional teachers (also called tutors or adjuncts) in architectural design studios, who may be practitioners, masters or doctoral students and academics hired ‘as needed’. Drawing from Schön’s work on reflective practice, learning and developmental theories of Vygotsky (social constructionism and zones of proximal development), informal and workplace learning, this research proposes that sessional teachers not only develop their teaching skills but also shape their identities through their 'everyday' work. Continuing academic staff develop their teaching through a combination of active teaching, self-reflection on teaching, as well as learning to teach from others via formalised programs and informally in the workplace. They are provided professional development and recognised for their teaching efforts through promotion, student citations, and awards for teaching excellence. The teaching experiences of sessional staff, by comparison, may be discontinuous and they generally have fewer opportunities and incentives for teaching development. In the absence of access to formalised programs, sessional teachers develop their teaching informally in workplace settings that may be supportive or unhelpful. Their learning as teachers is embedded in everyday practice applying problem-solving skills in ambiguous and uncertain settings. Depending on their level of expertise, they understand how to teach a subject such that students are stimulated to learn. Adult learning theories posit that adults have different motivations for learning and fall into a matrix of readiness, that an adult’s ability to make sense of their learning is shaped by their values, expectations, beliefs, feelings, attitudes, and judgements, and they are self-directed. The level of expertise of sessional teachers depends on their individual attributes and motivations, as well as on their work environment, the good practices they acquire and enhance through their practice, career training and development, the clarity of their role in the delivery of teaching, and other factors. The architectural design studio is ideal for study due to the historical persistence of the vocational learning or apprenticeship model (learning under the guidance of experts) and a pedagogical format using two key approaches: project-based problem solving and collaborative learning. Hence, investigating the theoretical frameworks underlying academic roles and informal professional learning in the workplace would deepen understanding of their professional development and how they shape their academic identities. This qualitative research is ongoing at a major university in Australia, but the growing trend towards hiring sessional staff to teach core courses in many disciplines is a global one. This research will contribute to including transient sessional teachers in the discourse on institutional quality, effectiveness, and student learning.

Keywords: academic identity, architectural design learning, pedagogy, teaching and learning, sessional teachers

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4 Pediatric Drug Resistance Tuberculosis Pattern, Side Effect Profile and Treatment Outcome: North India Experience

Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

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3 The Effect of Post Spinal Hypotension on Cerebral Oxygenation Using Near-Infrared Spectroscopy and Neonatal Outcomes in Full Term Parturient Undergoing Lower Segment Caesarean Section: A Prospective Observational Study

Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

Abstract:

Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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2 Endometrial Biopsy Curettage vs Endometrial Aspiration: Better Modality in Female Genital Tuberculosis

Authors: Rupali Bhatia, Deepthi Nair, Geetika Khanna, Seema Singhal

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Introduction: Genital tract tuberculosis is a chronic disease (caused by reactivation of organisms from systemic distribution of Mycobacterium tuberculosis) that often presents with low grade symptoms and non-specific complaints. Patients with genital tuberculosis are usually young women seeking workup and treatment for infertility. Infertility is the commonest presentation due to involvement of the fallopian tubes, endometrium and ovarian damage with poor ovarian volume and reserve. The diagnosis of genital tuberculosis is difficult because of the fact that it is a silent invader of genital tract. Since tissue cannot be obtained from fallopian tubes, the diagnosis is made by isolation of bacilli from endometrial tissue obtained by endometrial biopsy curettage and/or aspiration. Problems are associated with sampling technique as well as diagnostic modality due to lack of adequate sample volumes and the segregation of the sample for various diagnostic tests resulting in non-uniform distribution of microorganisms. Moreover, lack of an efficient sampling technique universally applicable for all specific diagnostic tests contributes to the diagnostic challenges. Endometrial sampling plays a key role in accurate diagnosis of female genital tuberculosis. It may be done by 2 methods viz. endometrial curettage and endometrial aspiration. Both endometrial curettage and aspirate have their own limitations as curettage picks up strip of the endometrium from one of the walls of the uterine cavity including tubal osteal areas whereas aspirate obtains total tissue with exfoliated cells present in the secretory fluid of the endometrial cavity. Further, sparse and uneven distribution of the bacilli remains a major factor contributing to the limitations of the techniques. The sample that is obtained by either technique is subjected to histopathological examination, AFB staining, culture and PCR. Aim: Comparison of the sampling techniques viz. endometrial biopsy curettage and endometrial aspiration using different laboratory methods of histopathology, cytology, microbiology and molecular biology. Method: In a hospital based observational study, 75 Indian females suspected of genital tuberculosis were selected on the basis of inclusion criteria. The women underwent endometrial tissue sampling using Novaks biopsy curette and Karmans cannula. One part of the specimen obtained was sent in formalin solution for histopathological testing and another part was sent in normal saline for acid fast bacilli smear, culture and polymerase chain reaction. The results so obtained were correlated using coefficient of correlation and chi square test. Result: Concordance of results showed moderate agreement between both the sampling techniques. Among HPE, AFB and PCR, maximum sensitivity was observed for PCR, though the specificity was not as high as other techniques. Conclusion: Statistically no significant difference was observed between the results obtained by the two sampling techniques. Therefore, one may use either EA or EB to obtain endometrial samples and avoid multiple sampling as both the techniques are equally efficient in diagnosing genital tuberculosis by HPE, AFB, culture or PCR.

Keywords: acid fast bacilli (AFB), histopatholgy examination (HPE), polymerase chain reaction (PCR), endometrial biopsy curettage

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1 Effects on Inflammatory Biomarkers and Respiratory Mechanics in Laparoscopic Bariatric Surgery: Desflurane vs. Total Intravenous Anaesthesia with Propofol

Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

Abstract:

Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

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