Search results for: Sanjay Kumar Behera

Authors: Mrinal Kanti Bhowmik, Kakali Das Jr., Barin Kumar De, Debotosh Bhattacharjee

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Breast cancer is the most common cancer and a leading cause of death for women in the 35 to 55 age group. Early detection of breast cancer can decrease the mortality rate of breast cancer. Mammography is considered as a ‘Gold Standard’ for breast cancer detection and a very popular modality, presently used for breast cancer screening and detection. The screening of digital mammograms often leads to over diagnosis and a consequence to unnecessary traumatic & painful biopsies. For that reason recent studies involving the use of thermal imaging as a screening technique have generated a growing interest especially in cases where the mammography is limited, as in young patients who have dense breast tissue. Tumor is a significant sign of breast cancer in both mammography and thermography. The tumors are complex in structure and they also exhibit a different statistical and textural features compared to the breast background tissue. Fractal geometry is a geometry which is used to describe this type of complex structure as per their main characteristic, where traditional Euclidean geometry fails. Over the last few years, fractal geometrics have been applied mostly in many medical image (1D, 2D, or 3D) analysis applications. In breast cancer detection using digital mammogram images, also it plays a significant role. Fractal is also used in thermography for early detection of the masses using the thermal texture. This paper presents an overview of the recent aspects and initiatives of fractals in breast cancer detection in both mammography and thermography. The scope of fractal geometry in automatic breast cancer detection using digital mammogram and thermogram images are analysed, which forms a foundation for further study on application of fractal geometry in medical imaging for improving the efficiency of automatic detection.

Keywords: fractal, tumor, thermography, mammography

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Authors: Alok Kumar, Hari Ram, Lebin Thomas, Ved Pal Singh

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Organic solvent tolerant amylases and proteases of microbial origin are in great demand for their application in transglycosylation of water-insoluble flavanoids and in peptide synthesizing reaction in organic media. Most of the amylases and proteases are unstable in presence of organic solvent. In the present work two different bacterial strains M-11 and VP-07 were isolated from the soil sample of a dairy farm in Delhi, India, for the efficient production of extracellular amylase and protease through their screening on starch agar (SA) and skimmed milk agar (SMA) plates, respectively. Both the strains (M-11 and VP-07) were identified based on morphological, biochemical and 16S rRNA gene sequencing methods. After analysis through Ez-Taxon software, the strains M-11 and VP-07 were found to have maximum pairwise similarity of 98.63% and 100% with Bacillus subtilis subsp. inaquosorum BGSC 3A28 and Bacillus anthracis ATCC 14578 and were therefore identified as Bacillus sp. UKS1 and Bacillus sp. UKS2, respectively. Time course study of enzyme activity and bacterial growth has shown that both strains exhibited typical sigmoid growth behavior and maximum production of amylase (180 U/ml) and protease (78 U/ml) by these strains (UKS1 and UKS2) was commenced during stationary phase of growth at 24 and 20 h, respectively. Thereafter, both amylase and protease were tested for their tolerance towards organic solvents and were found to be active as well stable in p-xylene (130% and 115%), chloroform (110% and 112%), isooctane (119% and 107%), benzene (121% and 104%), n-hexane (116% and 103%) and toluene (112% and 101%, respectively). Owing to such properties, these enzymes can be exploited for their potential application in industries for organic synthesis.

Keywords: amylase, enzyme activity, industrial applications, organic solvent tolerant, protease

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Authors: Nitesh Kumar, Adel Elrasheed, Antonio Gagliardilugo

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Introduction and aims: PRP has been increasing in popularity over the past decade. It is used in many facets of medicine and dentistry such as osteoarthritis, hair loss, skin rejunavation, healing of tendons after injury. Due to the increasing popularity of PRP in third molar surgery in dentistry, this study aims to identify the role of platelet rich plasma and its function in third molar surgery. Methodology: Three databases were chosen to source the articles for review: pubmed, science direct, and Cochrane. The keywords “platelet rich plasma”, “third molar extraction” and “wisdom tooth extraction” and literature review were used to search for relevant articles. Articles that were not in English were omitted and only systematic reviews relevant to the study were collected. All systematic reviews abstracts pertinent to the study were read by two reviewers to avoid bias. Results/statistics: 20 review articles were obtained of which 13 fulfilled the criteria. The Amstar tool validified the strength of these review articles. There is strong evidence in the literature that PRP in third molar surgery decreases post op pain, swelling and recovery time. 20 review articles were obtained of which 13 fulfilled the criteria. The Amstar tool validified the strength of these review articles. There is strong evidence in the literature that PRP in third molar surgery decreases post op pain, swelling and recovery time. Conclusions/clinical relevance: Platelet rich plasma plays a crucial role in patient recovery following the extraction of third molars and should be considered and offered as a routine part of third molar therapy.

Keywords: PRP, third molar, extractions, wisdom teeth

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Authors: Kumari Kajal, Muthu Kumar Sampath, Hare Ram Singh

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In this context, the formulation and characterization of collagen silver lipid nanoparticles (CSLNs) were studied for their capacity to serve as fillers/matrix materials used in cosmeceutical applications. The CSLNs were prepared following a series of studies, such as X-ray diffraction (XRD), field-emission scanning electron microscopy (FESEM) coupled with energy-dispersive X-ray spectroscopy (EDS), Fourier-transform infrared spectroscopy FT-IR; thermogravimetric analysis (TGA); and differential scanning calorimetry (DSC). The studies confirmed the structural integrity of nanoparticles, their cargo and thermal stability. The biological functionality of CSLNs was studied by carrying out in vitro & in vivo studies. The antibacterial effect, hemocompatibility and anti-inflammatory characteristics of these fibers were systematically investigated. The toxicological assays included oral toxicity in mice and aquatic life tests with the fish Danio rerio model. The morphology of the nanoparticles was confirmed using high-resolution transmission electron microscopy (HR-TEM). The report found that CSLNs had strong antimicrobial effects, unmatched hemocompatibility, and low or absent inflammatory reactions, which makes them perfect candidates for cosmeceutical applications. The toxicological evaluations evinced a good safety record without any significant adverse effects in both murine and Danio rerio models. This research reveals the efficient way of CSLNs to the efficacy and safety of dermaceuticals.

Keywords: collagen silver lipid nanoparticles (CSLNs), cosmeceuticals, antimicrobial activity, hemocompatibility, in vitro assessment, in vivo assessment.

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Authors: Kanika S. Raheja, A. Pandey, Shaila Bahl, Pratik Kumar, S. P. Lochab

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The subject of undertaking for this paper is the study of BaSO4 nanophosphor doped with Europium in which mainly the concentration of the rare earth impurity Eu (0.05, 0.1, 0.2, 0.5, and 1 mol %) has been varied. A comparative study of the thermoluminescence(TL) properties of the given nanophosphor has also been done using a well-known standard dosimetry material i.e. TLD-100.Firstly, a number of samples were prepared successfully by the chemical co-precipitation method. The whole lot was then compared to a well established standard material (TLD-100) for its TL sensitivity property. BaSO4:Eu ( 0.2 mol%) showed the highest sensitivity out of the lot. It was also found that when compared to the standard TLD-100, BaSo4:Eu (0.2mol%) showed surprisingly high sensitivity for a large range of doses. The TL response curve for all prepared samples has also been studied over a wide range of doses i.e 10Gy to 2kGy for gamma radiation. Almost all the samples of BaSO4:Eu showed a remarkable linearity for a broad range of doses, which is a characteristic feature of a fine TL dosimeter. The graph remained linear even beyond 1kGy for gamma radiation. Thus, the given nanophosphor has been successfully optimised for the concentration of the dopant material to achieve its highest TL sensitivity. Further, the comparative study with the standard material revealed that the current optimised sample shows an astonishingly better TL sensitivity and a phenomenal linear response curve for an incredibly wide range of doses for gamma radiation (Co-60) as compared to the standard TLD-100, which makes the current optimised BaSo4:Eu quite promising as an efficient gamma radiation dosimeter. Lastly, the present phosphor has been optimised for its annealing temperature to acquire the best results while also studying its fading and reusability properties.

Keywords: gamma radiation, nanoparticles, radiation dosimetry, thermoluminescence

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Authors: Mamta Bulla, Vinay Kumar

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The transition to renewable energy sources is essential due to the finite limitations of conventional fossil fuels, which contribute significantly to environmental pollution and greenhouse gas emissions. Traditional energy storage solutions, such as batteries and capacitors, are also hindered by limitations, particularly in capacity, cycle life, and energy density. Conventional supercapacitors, while able to deliver high power, often suffer from low energy density, limiting their efficiency in storing and providing renewable energy consistently. Renewable energy sources, such as solar and wind, produce power intermittently, so efficient energy storage solutions are required to manage this variability. Advanced materials, particularly those with high capacity and long cycle life, are critical to developing supercapacitors capable of effectively storing renewable energy. Among various electrode materials, vanadium pentoxide (V₂O₅) offers high theoretical capacitance, but its poor conductivity and cycling stability limit practical applications. This study explores the hydrothermal synthesis of a V₂O₅-carbon nanotube (CNT) composite to overcome these drawbacks, combining the high capacitance of V₂O₅ with the exceptional conductivity and mechanical stability of CNTs. The resulting V₂O₅-CNT composite demonstrates enhanced electrochemical performance, showing high specific capacitance of 890 F g⁻¹ at 0.1 A g⁻¹ current density, excellent rate capability, and improved cycling stability, making it a promising candidate for next-generation supercapacitors, with significant improvements in energy storage efficiency and durability.

Keywords: cyclability, energy density, nanocomposite, renewable energy, supercapacitor

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Authors: Asaduzzaman Rimon, Pankaj Kumar Jha, Abdullah Al Mansur, Mohammad Mofizul Islam, Nasrin Sultana Juyena, Farida Yeasmin Bari

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This study was conducted to determine the effects of multi-species skim milk based extenders on sperm quality at 5ºC with the advancement of preservation time. Altogether forty ejaculates, 8 ejaculates for each of the 5 home-made semen extenders: cow skim milk (CSM), goat skim milk (GSM), sheep skim milk (SSM), buffalo skim milk (BSM) and commercial dried skim milk (CDSM) were examined for motility, plasma membrane integrity and normal morphology % of sperm at 0, 24, 48, 72, 96 and 120 hours, respectively. Sperm motility was significantly decreased (P < 0.05) with the increase of preservation time. There were no significant difference in motility % among CSM (84.0±1.4, 82.3±2.1), GSM (84.5±1.0, 82.5±0.6) and CDSM (85.0±80.3±1.3) extenders at 0 and 24 hours, respectively. However, the motility in GSM extender was significantly higher than BSM, SSM and CDSM extender at 48, 72, 96 and 120 hours. The plasma membrane integrity % at 0 hour had no significant difference among the extenders. But, the plasma membrane integrity % in GSM (84.3±0.9, 81.8±1.3, 78.0±2.2, 74.8±0.5, 72.0±1.4) and CSM (82.8±0.5, 80.8±1.0, 78.0±1.4, 73.5±1.7, 70.3±0.5) extenders were significantly higher than BSM (81.0±1.4, 76.3±2.5, 72.5±1.7, 63.8±2.5, 54.0±4.6), SSM (78.5±1.5, 75.0±1.6, 71.5±2.4, 64.3±1.7, 56.5±2.4) and CDSM extenders (78.3±2.4, 75.8±3.9, 72.5±3.3, 64.8±1.0, 60.5±3.3) at 24, 48, 72, 96 and 120 hours, respectively. The sperm morphology % had no significant difference at 0 hour among the extenders but were significantly higher in GSM (83.0±0.8, 81.3±1.5, 79.3±1.3, 73.0±2.2, 70.3±1.3) and CSM (81.5±1.7, 79.3±1.5, 75.8±1.5, 70.3±1.3, 66.3±1.5) than BSM (79.0±1.2, 75.0±1.4, 69.5±1.7, 64.5±3.1, 56.8±2.2), SSM (79.8±1.3, 76.8±2.1, 71.3±3.0, 66.0±2.7, 60.3±4.5) and CDSM (80.0±1.6, 77.0±2.2, 72.0±2.5, 66.3±2.5, 62.0±4.0) extenders at 24, 48, 72, 96 and 120 hours, respectively. The motility, plasma membrane integrity and normal morphology % of sperm had shown no significant difference between GSM and CSM but were found to be higher in GSM extenders. In the end, we concluded from the above study that the goat milk based extenders (GSM) had optimum sperm preserving quality. However, further studies are required to validate followed by fertility rate.

Keywords: chilled semen, indigenous ram, multi-species skim milk based extenders, preservation

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Authors: Sudhir Kumar Singh, Debashish Chakravarty

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Slope stability analysis is an important aspect in the field of geotechnical engineering. It is also important from safety, and economic point of view as any slope failure leads to loss of valuable lives and damage to property worth millions. This paper aims at mitigating the risk of slope failure by studying the effect of different joint sets on the stability of mine pit slopes under the influence of various external factors, namely degree of saturation, rainfall intensity, and seismic coefficients. Supervised machine learning approach has been utilized for making accurate and reliable predictions regarding the stability of slopes based on the value of Factor of Safety. Numerous cases have been studied for analyzing the stability of slopes using the popular Finite Element Method, and the data thus obtained has been used as training data for the supervised machine learning models. The input data has been trained on different supervised machine learning models, namely Random Forest, Decision Tree, Support vector Machine, and XGBoost. Distinct test data that is not present in training data has been used for measuring the performance and accuracy of different models. Although all models have performed well on the test dataset but Random Forest stands out from others due to its high accuracy of greater than 95%, thus helping us by providing a valuable tool at our disposition which is neither computationally expensive nor time consuming and in good accordance with the numerical analysis result.

Keywords: finite element method, geotechnical engineering, machine learning, slope stability

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Authors: Arpit K. Shrivastava, Nirmal K. Mohakud, Subrat Kumar, Priyadarshi S. Sahu

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Acute diarrhea is one of the major causes of morbidity and mortality among children less than five years of age. Multiple etiologies have been implicated for infectious gastroenteritis causing acute diarrhea. In our study fecal samples (n=165) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies such as Rotavirus, Adenovirus, Diarrhoeagenic Escherichia coli (EPEC, EHEC, STEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. The overall results from our study showed that 57% of children below 5 years of age with acute diarrhea were positive for at least one infectious etiology. Diarrhoeagenic Escherichia coli was detected to be the major etiological agent (29.09%) followed by Rotavirus (24.24%), Shigella (21.21%), Adenovirus (5.45%), Cryptosporidium (2.42%), and Giardia (0.60%). Among the different DEC strains, EPEC was detected significantly higher in <2 years children in comparison to >2 years age group (p =0.001). Concurrent infections with two or more pathogens were observed in 47 of 160 (28.48%) cases with a predominant incidence particularly in <2-year-old children (66.66%) compared to children of 2 to 5 years age group. Co-infection of Rotavirus with Shigella was the most frequent combination, which was detected in 17.94% cases, followed by Rotavirus with EPEC (15.38%) and Shigella with STEC (12.82%). Detection of multiple infectious etiologies and diagnosis of the right causative agent(s) can immensely help in better management of acute childhood diarrhea. In future more studies focusing on the detection of cases with concurrent infections must be carried out, as we believe that the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea.

Keywords: children, co-infection, infectious diarrhea, Odisha

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Authors: Sandeep J. Kumar

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Urbanisation is considered as the primary driver of land use and land cover change that has direct link to population and economic growth. In India, as well as in other developing countries, cities are urbanizing at an alarming rate. This unprecedented and uncontrolled urbanisation can result in urban sprawl. Due to a number of factors, urban sprawl is recognised to be a result of poor planning, inadequate policies, and poor governance. Urban sprawl may be seen as posing a threat to the development of sustainable cities. Hence, it is very essential to manage this. Planning for predicted future growth is critical to avoid the negative effects of urban growth at the local and regional levels. Thiruvananthapuram being the capital city of Kerala is a city of economic success, challenges, and opportunities. Urbanization trends in the city have paved way for Urban Sprawl. This thesis aims to formulate a framework to combat the emerging urban sprawl in the city of Thiruvananthapuram. For that, the first step was to quantify trends of urban growth in Thiruvananthapuram city using Geographical Information System(GIS) and remote sensing techniques. The technique and results obtained in the study are extremely valuable in analysing the land use changes. Secondly, these change in the trends were analysed through some of the critical factors that helped the study to understand the underlying issues of the existing city structure that has resulted in urban sprawl. Anticipating development trends can modify the current order. This can be productively resolved using regional and municipal planning and management strategies. Hence efficient strategies to curb the sprawl in Thiruvananthapuram city have been formulated in this study that can be considered as recommendations for future planning.

Keywords: urbanisation, urban sprawl, geographical information system(GIS), thiruvananthapuram

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Authors: Rohit Kumar Shrivastava, Amalia Thomas, Nathalie Vriend, Stefan Luding

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A mechanical wave or vibration propagating through granular media exhibits a specific signature in time. A coherent pulse or wavefront arrives first with multiply scattered waves (coda) arriving later. The coherent pulse is micro-structure independent i.e. it depends only on the bulk properties of the disordered granular sample, the sound wave velocity of the granular sample and hence bulk and shear moduli. The coherent wavefront attenuates (decreases in amplitude) and broadens with distance from its source. The pulse attenuation and broadening effects are affected by disorder (polydispersity; contrast in size of the granules) and have often been attributed to dispersion and scattering. To study the effect of disorder and initial amplitude (non-linearity) of the pulse imparted to the system on the coherent wavefront, numerical simulations have been carried out on one-dimensional sets of particles (granular chains). The interaction force between the particles is given by a Hertzian contact model. The sizes of particles have been selected randomly from a Gaussian distribution, where the standard deviation of this distribution is the relevant parameter that quantifies the effect of disorder on the coherent wavefront. Since, the coherent wavefront is system configuration independent, ensemble averaging has been used for improving the signal quality of the coherent pulse and removing the multiply scattered waves. The results concerning the width of the coherent wavefront have been formulated in terms of scaling laws. An experimental set-up of photoelastic particles constituting a granular chain is proposed to validate the numerical results.

Keywords: discrete elements, Hertzian contact, polydispersity, weakly nonlinear, wave propagation

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Authors: Sudhir Kumar, V. R. Sinha

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Water in oil topical microemulsions of 5-FU were developed and optimized using face centered central composite design. Topical w/o microemulsion of 5-FU were prepared using sorbitan monooleate (Span 80), polysorbate 80 (Tween 80), with different oils such as oleic acid (OA), triacetin (TA), and isopropyl myristate (IPM). The ternary phase diagrams designated the microemulsion region and face centered central composite design helped in determining the effects of selected variables viz. type of oil, smix ratio and water concentration on responses like drug content, globule size and viscosity of microemulsions. The CCD design exhibited that the factors have statistically significant effects (p<0.01) on the selected responses. The actual responses showed excellent agreement with the predicted values as suggested by the CCD with lower residual standard error. Similarly, the optimized values were found within the range as predicted by the model. Furthermore, other characteristics of microemulsions like pH, conductivity were investigated. For the optimized microemulsion batch, ex-vivo skin flux, skin irritation and retention studies were performed and compared with marketed 5-FU formulation. In ex vivo skin permeation studies, higher skin retention of drug and minimal flux was achieved for optimized microemulsion batch then the marketed cream. Results confirmed the actual responses to be in agreement with predicted ones with least residual standard errors. Controlled release of drug was achieved for the optimized batch with higher skin retention of 5-FU, which can further be utilized for the treatment of many dermatological disorders.

Keywords: 5-FU, central composite design, microemulsion, ternanry phase diagram

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Authors: Thinakar Mani Balusamy, Venkateswaran A. R., Bharat Narasimhan, Ratnakar Kini S., Kani Sheikh M., Prem Kumar K., Pugazhendi Thangavelu, Arun Murugan, Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal, Amit Soni

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Background and Aims: The liver is integral to lipid metabolism, and a compromise in its function leads to perturbations in these pathways. In this study, we hope to determine the correlation between CLD severity and its effect on lipid parameters. We also look at the etiology-specific effects on lipid levels. Materials and Methods: This is a retrospective cross-sectional analysis of 250 patients with cirrhosis compared to 250 healthy age and sex-matched controls. Severity assessment of CLD using MELD and Child-Pugh scores was performed and etiological details collected. A questionnaire was used to obtain patient demographic details and lastly, a fasting lipid profile (Total, LDL, HDL cholesterol, Triglycerides and VLDL) was obtained. Results: All components of the lipid profile declined linearly with increasing severity of CLD as determined by MELD and Child-Pugh scores. Lipid levels were clearly lower in CLD patients as compared to healthy controls. Interestingly, preliminary analysis indicated that CLD of different etiologies had differential effects on Lipid profiles. This aspect is under further analysis. Conclusion: All components of the lipid profile were definitely lower in CLD patients as compared to controls and demonstrated an inverse correlation with increasing severity. The utilization of this parameter as a prognosticating aid requires further study. Additionally, preliminary analysis indicates that various CLD etiologies appear to have specific effects on the lipid profile – a finding under further analysis.

Keywords: CLD, cholesterol, HDL, LDL, lipid profile, triglycerides, VLDL

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Authors: Anjula Negi, Sanjay Gupta

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Paradigms studied inform inadequacies of financial resources, be it to finance metro rails for construction or to meet operational revenues or to derive profits in the long term. Funding sustainability is far and wide for much-needed public transport modes, like urban rail or metro rails, to be successfully operated. India embarks upon a sustainable transport journey and has proposed metro rail systems countrywide. As an emerging economic leader, its fiscal constraints are paramount, and the land value capture (LVC) mechanism provides necessary support and innovation toward development. India’s metro rail policy promotes multiple methods of financing, including private-sector investments and public-private-partnership. The critical question that remains to be addressed is what factors can make such mechanisms work. Globally, urban rail is a revolution noted by many researchers as future mobility. Researchers in this study deep dive by way of literature review and empirical assessments into factors that can lead to the adoption of LVC mechanisms. It is understood that the adoption of LVC methods is in the nascent stages in India. Research posits numerous challenges being faced by metro rail agencies in raising funding and for incremental value capture. A few issues pertaining to land-based financing, inter alia: are long-term financing, inter-institutional coordination, economic/ market suitability, dedicated metro funds, land ownership issues, piecemeal approach to real estate development, property development legal frameworks, etc. The question under probe is what are the parameters that can lead to success in the adoption of land value capture (LVC) as a financing mechanism. This research provides insights into key parameters crucial to the adoption of LVC in the context of Indian metro rails. Researchers have studied current forms of LVC mechanisms at various metro rails of the country. This study is significant as little research is available on the adoption of LVC, which is applicable to the Indian context. Transit agencies, State Government, Urban Local Bodies, Policy makers and think tanks, Academia, Developers, Funders, Researchers and Multi-lateral agencies may benefit from this research to take ahead LVC mechanisms in practice. The study deems it imperative to explore and understand key parameters that impact the adoption of LVC. Extensive literature review and ratification by experts working in the metro rails arena were undertaken to arrive at parameters for the study. Stakeholder consultations in the exploratory factor analysis (EFA) process were undertaken for principal component extraction. 43 seasoned and specialized experts participated in a semi-structured questionnaire to scale the maximum likelihood on each parameter, represented by various types of stakeholders. Empirical data was collected on chosen eighteen parameters, and significant correlation was extracted for output descriptives and inferential statistics. Study findings reveal these principal components as institutional governance framework, spatial planning features, legal frameworks, funding sustainability features and fiscal policy measures. In particular, funding sustainability features highlight sub-variables of beneficiaries to pay and use of multiple revenue options towards success in LVC adoption. Researchers recommend incorporation of these variables during early stage in design and project structuring for success in adoption of LVC. In turn leading to improvements in revenue sustainability of a public transport asset and help in undertaking informed transport policy decisions.

Keywords: Exploratory factor analysis, land value capture mechanism, financing metro rails, revenue sustainability, transport policy

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Authors: Vijay S. Katta, Vinod Kushwah, Rudraksh Tiwari, Mulayam Singh Gaur, Priti Dimri, Ashok Kumar Sharma

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The formation process of seismic activities because of abrupt slip on faults, tectonic plate moments due to accumulated stress in the Earth’s crust. The prediction of seismic activity is a very challenging task. We have studied the changes in surface latent heat temperatures which are observed prior to significant earthquakes have been investigated and could be considered for short term earthquake prediction. We analyzed the surface latent heat temperature (SLHT) variation for inland earthquakes occurred in Chamba, Himachal Pradesh (32.5 N, 76.1E, M-4.5, depth-5km) nearby the main boundary fault region, the data of SLHT have been taken from National Center for Environmental Prediction (NCEP). In this analysis, we have calculated daily variations with surface latent heat temperature (0C) in the range area 1⁰x1⁰ (~120/KM²) with the pixel covering epicenter of earthquake at the center for a three months period prior to and after the seismic activities. The mean value during that period has been considered in order to take account of the seasonal effect. The monthly mean has been subtracted from daily value to study anomalous behavior (∆SLHT) of SLHT during the earthquakes. The results found that the SLHTs adjacent the epicenters all are anomalous high value 3-5 days before the seismic activities. The abundant surface water and groundwater in the epicenter and its adjacent region can provide the necessary condition for the change of SLHT. To further confirm the reliability of SLHT anomaly, it is necessary to explore its physical mechanism in depth by more earthquakes cases.

Keywords: surface latent heat temperature, satellite data, earthquake, magnetic storm

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Authors: Krishna Pal Singh, Shailendra Kumar Gupta, Olaf Wolkenhauer

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Background: Our study aimed to identify common genes and potential targets across the four diseases, which include rheumatoid arthritis, melanoma metastasis, ulcerative colitis, and Crohn’s disease. We used a network and systems biology approach to identify the hub gene, which can act as a potential target for all four disease conditions. The regulatory network was extracted from the PPI using the MCODE module present in Cytoscape. Our objective was to investigate the significance of hub genes in these diseases using gene ontology and KEGG pathway enrichment analysis. Methods: Our methodology involved collecting disease gene-related information from DisGeNET databases and performing protein-protein interaction (PPI) network and core genes screening. We then conducted gene ontology and KEGG pathway enrichment analysis. Results: We found that IL6 plays a critical role in all disease conditions and in different pathways that can be associated with the development of all four diseases. Conclusions: The theoretical importance of our research is that we employed various systems and structural biology techniques to identify a crucial protein that could serve as a promising target for treating multiple diseases. Our data collection and analysis procedures involved rigorous scrutiny, ensuring high-quality results. Our conclusion is that IL6 plays a significant role in all four diseases, and it can act as a potential target for treating them. Our findings may have important implications for the development of novel therapeutic interventions for these diseases.

Keywords: melanoma metastasis, rheumatoid arthritis, inflammatory bowel diseases, integrated bioinformatics analysis

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Authors: Dipendra Kumar Yadav, Rajani Ghimire, Saroj Yadav

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Background: The concern about adolescent on reproductive health has grown due to unprecedented increasing rates of early pregnancies and sexually transmitted Infections and they do not have adequate awareness and knowledge about it. Access to these services as well as information about them is, therefore, crucial for adolescents to utilize and benefit from sexual and reproductive health services. The objective of the study was to assess the reproductive health knowledge, attitude and health services utilization among adolescents in rural and urban areas of Kaski district. Materials and Methods: A community-based descriptive cross-sectional study was conducted among adolescents (10-19 years of age) in rural and urban areas of Kaski district, Nepal. The period of data collection was October to November, 2014. Altogether 419 participants were taken for the study. Results: The mean age of the respondents was 15.86 and standard deviation was ±2.305. More than half (58.7 %) of the respondents were females and 41.3 % were males. Out of 419, majority (78.8%) of the respondents were known about family planning, among them only 70 % of respondents were aware about family planning methods. Fifty-one percentages of the respondents were aware about the sexually transmitted diseases. Before giving a birth there is need to consult with partner with this fact 68.7 % of the respondents were agree, 23.6 % of them were neutral and very few (7.6%) of them were disagree. Nearly twenty six percentage of the respondents were faced the reproductive health problems within one month. Out of 107 respondents, 57.9 % did not utilize reproductive health services because of different reasons. Conclusions: The overall level of knowledge towards reproductive health among adolescents was found low. However, levels of attitude towards different reproductive health components were found favorable. Only 42.1% of the respondents were utilized reproductive health services among those who was faced the reproductive health problems within one month which was low coverage of reproductive health services utilization.

Keywords: reproductive health knowledge, reproductive health attitudes, adolescent, service utilization

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Authors: Rakesh Kumar Meena, Tanushree Chatterjee

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Okra (Abelmoschus esculentas L. Moench) or lady’s finger is an important vegetable crop belonging to the Malvaceae family. Unfortunately, production and productivity of Okra are majorly affected by Yellow Vein mosaic virus (YVMV). The AO: 189 (resistant parent) X AO: 191(susceptible parent) used for the development of mapping population. The mapping population has 143 individuals (F₂:F₃). Population was characterized by physiological and pathological observations. Screening of 360 DNA markers was performed to survey for parental polymorphism between the contrasting parents’, i.e., AO: 189 and AO: 191. Out of 360; 84 polymorphic markers were used for genotyping of the mapping population. Total markers were distributed into four linkage groups (LG1, LG2, LG3, and LG4). LG3 covered the longest span (106.8cM) with maximum number of markers (27) while LG1 represented the smallest linkage group in terms of length (71.2cM). QTL identification using the composite interval mapping approach detected two prominent QTLs, QTL1 and QTL2 for resistance against YVMV disease. These QTLs were placed between the marker intervals of NBS-LRR72-Path02 and NBS-LRR06- NBS-LRR65 on linkage group 02 and linkage group 04 respectively. The LOD values of QTL1 and QTL2 were 5.7 and 6.8 which accounted for 19% and 27% of the total phenotypic variation, respectively. The findings of this study provide two linked markers which can be used as efficient diagnostic tools to distinguish between YVMV resistant and susceptible Okra cultivars/genotypes. Lines identified as highly resistant against YVMV infection can be used as donor lines for this trait. This will be instrumental in accelerating the trait improvement program in Okra and will substantially reduce the yield losses due to this viral disease.

Keywords: Okra, yellow vein mosaic virus, resistant, linkage map, QTLs

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Authors: Garima Joshi, Pratap Sharan, V. Sreenivas, Nand Kumar, Kameshwar Prasad, Ashima N. Wadhawan

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Schizophrenia is a debilitating disorder and is marked by cognitive impairment, which deleteriously impacts the social and professional functioning along with the quality of life of the patients and the caregivers. Often the cognitive symptoms are in their prodromal state and worsen as the illness progresses; they have proven to have a good predictive value for the prognosis of the illness. It has been shown that intensive cognitive rehabilitation (CR) leads to improvements in the healthy as well as cognitively-impaired subjects. As the majority of population in India falls in the lower to middle socio-economic status and have low education levels, using the existing packages, a majority of which are developed in the West, for cognitive rehabilitation becomes difficult. The use of technology is also restricted due to the high costs involved and the limited availability and familiarity with computers and other devices, which pose as an impedance for continued therapy. Cognitive rehabilitation in India uses a plethora of retraining methods for the patients with schizophrenia targeting the functions of attention, information processing, executive functions, learning and memory, and comprehension along with Social Cognition. Psychologists often have to follow an integrative therapy approach involving social skills training, family therapy and psychoeducation in order to maintain the gains from the cognitive rehabilitation in the long run. This paper reviews the methodologies and cognitive retaining programs used in India. It attempts to elucidate the evolution and development of methodologies used, from traditional paper-pencil based retraining to more sophisticated neuroscience-informed techniques in cognitive rehabilitation of deficits in schizophrenia as home-based or supervised and guided programs for cognitive rehabilitation.

Keywords: schizophrenia, cognitive rehabilitation, neuropsychological interventions, integrated approached to rehabilitation

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Authors: Sushila Jaiswal, Awadhesh Kumar Jaiswal

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Background: Primary melanocytic tumors of the central nervous system (CNS) are uncommon lesions and arise from the melanocytes located within the leptomeninges. Aim and objective: The aim of the study was to evaluate the clinical details, histomorphology of the primary melanocytic tumor of CNS. Method: The study was performed by the retrospective review of the case records of the primary melanocytic tumors of CNS diagnosed in our department. The formalin-fixed, paraffin embedded tissue blocks and tissue sections were retrieved and reviewed. Results: Seven cases (6 males, 1 female; age range- 16-40 years; mean age- 27 years) of primary melanocytic tumors of CNS were retrieved over last seven years. The tumor was intracranial (n=5; frontal – 1 case, parietal – 1 case, cerebello-pontine angle- 1 case, occipital -1 case, foramen magnum-1 case) and intra spinal (n=2; cervical – 2 cases). All patients presented with the neurological deficits related to the location of the tumor. Four cases were malignant melanoma; two were melanocytoma of intermediate grade and remaining one was melanocytoma. On histopathology, melanocytoma and melanoma both displayed sheets of well-differentiated melanocytes having round to oval nuclei with finely dispersed chromatin, occasional single eosinophilic nucleoli and a moderate amount of cytoplasm with abundant granular melanin pigment. The absence of mitosis and macronucleoli was noticed in melanocytoma while melanoma showed frequent mitosis and macronucleoli. On immunohistochemistry, both showed diffuse strong HMB45 and S-100 immunopositivity. Conclusion: Primary melanocytic tumors of CNS are rare and predominantly seen in males. It is important to differentiate melanoma from melanocytoma as prognosis of later is good.

Keywords: melanocytoma, melanoma, brain tumor, melanin

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Authors: Janaki Rama Raju Patchamatla, Emani Pavan Kumar

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The idea of increasing the existing train speeds and introduction of the high-speed trains in India as a part of Vision-2020 is really challenging from both economic viability and technical feasibility. More than economic viability, technical feasibility has to be thoroughly checked for safe operation and execution. Trains moving at high speeds need a well-established firm and safe track thoroughly tested against vibration effects. With increased speeds of trains, the track structure and layered soil-structure interaction have to be critically assessed for vibration and displacements. Physical establishment of track, testing and experimentation is a costly and time taking process. Software-based modelling and simulation give relatively reliable, cost-effective means of testing effects of critical parameters like sleeper design and density, properties of track and sub-grade, etc. The present paper reports the applicability of infinite elements in reducing the unrealistic stress-wave reflections from so-called soil-structure interface. The influence of the infinite elements is quantified in terms of the displacement time histories of adjoining soil and the deformation pattern in general. In addition, the railhead response histories at various locations show that the numerical model is realistic without any aberrations at the boundaries. The numerical model is quite promising in its ability to simulate the critical parameters of track design.

Keywords: high speed railway track, finite element method, Infinite elements, vibration analysis, soil-structure interface

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Authors: Sreeja Shaw, Prosenjit Samanta, Asish Kumar Mukhopadhyay

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Cholera is still a global public health burden and is caused by Vibrio cholerae O1 and O139 serogroups. Evidence from recent outbreaks in Haiti and Yemen suggested that circulating V. cholerae O1 El Tor variant strains are continuously changing to cause more ruinous outbreaks worldwide, and most of them have emerged from the Indian subcontinents. Therefore, we studied the changing virulence characteristics along with the antibiotic resistance profile of V. cholerae O1strains isolated from seasonal outbreaks in three cholera endemic regions during 2018, Gujarat and Maharashtra in Western India (87 strains), and to compare those features with the isolates of West Bengal in Eastern India (48 strains) collected during the same period. All the strains from Western India were of Ogawa serotype, polymyxin B-sensitive, hemolytic, and contained a large fragment deletion in VSP-II genomic region similar with Yemen outbreak strains and carried more virulent Haitian genetic alleles of major virulence associated genes ctxB, tcpA, and rtxA. Conversely, 14.6% (7/48) of the strains from Eastern India were belong to the Inaba serotype, polymyxin B-resistant, non-hemolytic, harbored intact VSP-II region, classical ctxB, Haitian tcpA, and El Tor rtxA alleles. Interestingly, resistance to tetracycline and chloramphenicol was seen in isolates from both regions, which are not very common among V. cholerae O1 isolates in India. Therefore, this study indicated West Bengal as a diverse region where two different types of El Tor variant hypervirulent strains are co-existed, probably competing for their better environmental survival, which may result in severe irrepressible disease outcome in the future.

Keywords: cholera, vibrio cholerae, polymyxin B, Non-hemolytic, ctxB, tcpA, rtxA, VSP-II

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Authors: Shreya Ghosh, Akansha Garg, Chayanika Kala, Ashwani Kumar Thakur

Abstract:

Background: Granuloma formation is one of the characteristic features of tuberculosis. Besides, chronic inflammation underlying tuberculosis is often indicated by an increase in the concentration of serum amyloid A (SAA) protein. The connection between tuberculosis and SAA-driven secondary amyloidosis is well documented. However, SAA-derived amyloid deposition start sites are not well understood in tuberculosis and other chronic inflammatory conditions. It was hypothesized that granuloma could be a potential site for an amyloid deposition because both SAA protein and proteases that cleave SAA into aggregation-prone fragments are reported to be present in the granuloma. Here the authors have shown the presence of SAA-derived amyloid deposits in the granuloma of tuberculosis patients. Methodology: Over a period of two years, tuberculosis patients were screened, and biopsies were collected from the affected organs of the patients. The gold standard, Congo red dye staining, was used to identify amyloid deposits in the tissue sections of tuberculosis patients containing granulomatous structure. Results: 11 out of 150 FFPE biopsy specimens of tuberculosis patients showed eosinophilic hyaline-rich deposits surrounding granuloma. Upon Congo red staining, these deposits exhibited characteristic apple-green birefringence under polarized light, confirming amyloid deposits. Further, upon immunohistochemical staining with anti-SAA, the amyloid enriched areas showed positive immunoreactivity. Conclusion: In this pilot study, we have shown that granuloma can be a potential site for serum amyloid A-derived amyloid formation in tuberculosis patients. Moreover, the presence of amyloid gave significant cues that granuloma might be a probable amyloid deposition start in tuberculosis patients. This study will set a stage to expand the clinical and fundamental research in the understanding of amyloid formation in granuloma underlying tuberculosis and chronic inflammatory conditions.

Keywords: amyloid, granuloma, periphery, serum amyloid A, tuberculosis

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Authors: S. B. Rathna Kumar, Pranjali A Ujwane, Panchanan Mohanty

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The present study aimed to develop a battery for assessing speech recognition performance by adults in Marathi. A total of four word lists were developed by considering word frequency, word familiarity, words in common use, and phonemic balance. Each word list consists of 25 words (15 monosyllabic words in CVC structure and 10 monosyllabic words in CVCV structure). Equivalence analysis and performance-intensity function testing was carried using the four word lists on a total of 150 native speakers of Marathi belonging to different regions of Maharashtra (Vidarbha, Marathwada, Khandesh and Northern Maharashtra, Pune, and Konkan). The subjects were further equally divided into five groups based on above mentioned regions. It was found that there was no significant difference (p > 0.05) in the speech recognition performance between groups for each word list and between word lists for each group. Hence, the four word lists developed were equally difficult for all the groups and can be used interchangeably. The performance-intensity (PI) function curve showed semi-linear function, and the groups’ mean slope of the linear portions of the curve indicated an average linear slope of 4.64%, 4.73%, 4.68%, and 4.85% increase in word recognition score per dB for list 1, list 2, list 3 and list 4 respectively. Although, there is no data available on speech recognition tests for adults in Marathi, most of the findings of the study are in line with the findings of research reports on other languages. The four word lists, thus developed, were found to have sufficient reliability and validity in assessing speech recognition performance by adults in Marathi.

Keywords: speech recognition performance, phonemic balance, equivalence analysis, performance-intensity function testing, reliability, validity

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Authors: Naveen Kumar Challa, Pavan Verıkıcherla, Madhubalan, Ashısh Sharma

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Aim: Aim of the study was to find whether any difference exists in pupil mydriasis measured with Orbscan in non-diabetic and type 2 diabetic patients at various intervals after installation of Tropicamide 0.8% and Phenylephrine 5%. Methods: the Observational study conducted at a tertiary care eye hospital during September 2014 to March 2015. 240 eyes from 120 patients (40 non-diabetic, 80 diabetic) were dilated with Tropicamide 0.8% and Phenylephrine 5%. One drop of a drug was installed twice. The second drop is installed at 20 minutes after installation of the first drop. In two groups’ pupil diameter was measured before installation of drops and also at 15, 30, 45 and 60 minutes after installation of the first drop using both Orbscan. Result: Mean age of the non-diabetic group is 48.67 ± 7.93 years; Diabetic group is 59.97 ± 8.77 years. Mean duration of Diabetes was 7.01 ± 5.05 years. Mean pupil diameter measured with Orbscan before installation of the drops and also at 15, 30, 45 and 60 minutes after installation of first drop in non-diabetic group was 4.18 ± 0.64mm, 6.15 ± 0.41mm, 7.76 ±0.34, 9.59 ± 0.30, and 9.97 ± 0.10 mm respectively and for the diabetic group it was 4.00 ± 0.56 mm, 5.53 ± 0.52 mm, 7.018 ± 0.58mm, 8.25±0.51mm and 9.18 ± 0.46mm respectively. The mean difference between the mean pupil diameters of the non-diabetic and diabetic group shows a significant difference (P< 0.01) at all intervals except before dilatation. There is a significant negative correlation (r = 0.78 – 0.92) between the duration of diabetes and pupil dilatation at all intervals after installation of the drops. There is also significant difference (P< 0.005) in the mean values of pupil diameter between non retinopathy diabetic subjects and diabetic retinopathy subjects at all intervals after installation of drops. Conclusion: People attending eye clinic, whose pupil mydriasis values falls below the normal may be referred for diabetic evaluation. If normative data is established for the pupil size in Indian population using Orbscan then the values fall under normative data could be a predictor for diabetes. This would in turn help ophthalmologist to detect the diabetes at an early stage and prevent the complications resulting from the diabetes.

Keywords: diabetes mellitus, pupil diameter, orbscan, tropicamide

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Authors: Vijay Kumar Kolagani, Yingcai Xiao

Abstract:

Adaptation of Natural User Interface (NUI) has been slow and limited. NUI devices like Microsoft’s Kinect and Ultraleap’s Leap Motion can only interact with a handful applications that were specifically designed and implemented for them. A NUI device just can’t be used to directly control millions of applications that are not designed to take NUI input. This is in the similar situation like the adaptation of color TVs. At the early days of color TV, the broadcasting format was in RGB, which was not viewable by blackand-white TVs. TV broadcasters were reluctant to produce color programs due to limited viewership. TV viewers were reluctant to buy color TVs because there were limited programs to watch. Color TV’s breakthrough moment came after the adaptation of NTSC standard which allowed color broadcasts to be compatible with the millions of existing black-and-white TVs. This research presents a framework to use NUI devices to control existing non-NUI applications without reprogramming them. The methodology is to create an adapter to convert input from NUI devices into input compatible with that generated by CLI (Command Line Input) and GUI (Graphical User Interface) devices. The CLI/GUI compatible input is then sent to the active application through the operating system just like any input from a CLI/GUI device to control the non-NUI program that the user is controlling. A sample adapter has been created to convert input from Kinect to keyboard strokes, so one can use the input from Kinect to control any applications that take keyboard input, such as Microsoft’s PowerPoint. When the users use the adapter to control their PowerPoint presentations, they can free themselves from standing behind a computer to use its keyboard and can roam around in front of the audience to use hand gestures to control the PowerPoint. It is hopeful such adapters can accelerate the adaptation of NUI devices.

Keywords: command line input, graphical user interface, human computer interaction, natural user interface, NUI adapter

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Authors: Sabuj Kanti Mazumder, Mazlan Abd Ghaffar, Simon Kumar Das

Abstract:

In this study, we analyzed the effects of water temperature and diet on the growth properties and gastric emptying period of juvenile Malabar blood snapper (Lutjanus malabaricus) over a 30day experimental period. Fish were collected from a local hatchery of Pulau Ketam, Selangor, Malaysia and immediately transferred to flow-through sea water system and subjected to four different temperatures (22, 26, 30, and 34 °C) and two diets (formulated pellet and shrimp). Body weight gain, food consumption, food conversion ratio, food consumption efficiency, specific growth rate, relative growth rate, daily growth rate, and gastric emptying period were significantly influenced by temperature and diet (P<0.05). The best food conversion ratio was with the shrimp group recorded at 30°C (1.33±0.08). The highest growth rate was observed in the shrimp group at 30°C (3.97±0.57% day-1), and the lowest was observed in the formulated pellet group at 22°C (1.63±0.29% day-1). No significant difference was observed between the groups subjected to temperatures of 26 and 30°C. Similarly, the lowest gastric emptying period was detected in the shrimp group at 30°C (16h), where the proportion of meal residues in the stomach decreased from 100% to less than 8% after 12h of starvation. A significantly longer gastric emptying period was observed in the formulated pellet group at 22°C (28h). Overall, the best results were observed on shrimp group subjected to a 30°C temperature. The data obtained from this study suggest that a shrimp diet fed on L. malabaricus at 30°C will optimize the commercial production of this commercially important fish species.

Keywords: aquaculture, diet, digestion rate, growth, Malabar blood snapper

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Authors: Siva Kumar Bathina, Sudheer Siddapureddy

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Fires accident becomes even worse when the hazardous equipment like reactors or radioactive waste packages are engulfed in fire. In this work, large-eddy numerical fire simulations are performed using fire dynamic simulator to predict the thermal behavior of such bodies engulfed in hydrocarbon pool fires. A radiatively dominated 0.3 m circular burner with n-heptane as the fuel is considered in this work. The fire numerical simulation results without anybody inside the fire are validated with the reported experimental data. The comparison is in good agreement for different flame properties like predicted mass burning rate, flame height, time-averaged center-line temperature, time-averaged center-line velocity, puffing frequency, the irradiance at the surroundings, and the radiative heat feedback to the pool surface. Cask of different sizes is simulated with SS304L material. The results are independent of the material of the cask simulated as the adiabatic surface temperature concept is employed in this study. It is observed that the mass burning rate increases with the blockage ratio (3% ≤ B ≤ 32%). However, the change in this increment is reduced at higher blockage ratios (B > 14%). This is because the radiative heat feedback to the fuel surface is not only from the flame but also from the cask volume. As B increases, the volume of the cask increases and thereby increases the radiative contribution to the fuel surface. The radiative heat feedback in the case of the cask engulfed in the fire is increased by 2.5% to 31% compared to the fire without cask.

Keywords: adiabatic surface temperature, fire accidents, fire dynamic simulator, radiative heat feedback

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Authors: Auwal Abubakar, Ahmed Ahidjo, Shazril Imran Shaukat, Noor Khairiah A. Karim, Gokula Kumar Appalanaido, Hafiz Mohd Zin

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Background: The use of optical surface imaging systems (OSISs) is increasingly becoming popular in radiotherapy practice, especially during breast cancer treatment. This study reviews the accuracy of the available commercial OSISs for breast radiotherapy. Method: A literature search was conducted and identified the available commercial OSISs from different manufacturers that are integrated into radiotherapy practice for setup verification during breast radiotherapy. Studies that evaluated the accuracy of the OSISs during breast radiotherapy using cone beam computed tomography (CBCT) as a reference were retrieved and analyzed. The physics and working principles of the systems from each manufacturer were discussed together with their respective strength and limitations. Results: A total of five (5) different commercially available OSISs from four (4) manufacturers were identified, each with a different working principle. Six (6) studies were found to evaluate the accuracy of the systems during breast radiotherapy in conjunction with CBCT as a goal standard. The studies revealed that the accuracy of the system in terms of mean difference ranges from 0.1 to 2.1 mm. The correlation between CBCT and OSIS ranges between 0.4 and 0.9. The limit of agreements obtained using bland Altman analysis in the studies was also within an acceptable range. Conclusion: The OSISs have an acceptable level of accuracy and could be used safely during breast radiotherapy. The systems are non-invasive, ionizing radiation-free, and provide real-time imaging of the target surface at no extra concomitant imaging dose. However, the system should only be used to complement rather than replace x-ray-based image guidance techniques such as CBCT.

Keywords: optical surface imaging system, Cone beam computed tomography (CBCT), surface guided radiotherapy, Breast radiotherapy

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Authors: Ajay Kumar Yadav, Masum Paudel, Ritesh Chaudhary

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Background: Understanding the diagnosis and the treatment plan is very important for the patient which reflects the effectiveness of the patient care as well as counseling. Large groups of patients do not understand their emergency care plan or their discharge instructions. With only a little more than 2/3ʳᵈ of the adult population is literate and poorly distributed health service institutions in Nepal, exploring the current status of patient understanding of their diagnosis and treatment would help identify interventions to improve patient compliance with the provided care and the treatment outcomes. Objectives: This study was conducted to identify and describe the areas of patients’ understanding and confusion regarding emergency care and discharge instructions at the Emergency ward of B. P. Koirala Institute of Health Sciences teaching hospital, Dharan, Nepal. Methods: A cross-sectional study was conducted among 426 patients discharged from the emergency unit of BPKIHS. Cases who are leaving against medical advice absconded cases and those patients who came just for vaccination are excluded from the study. Patients’ understanding of the treatment plan and diagnosis was measured. Results: There were 60% men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. Conclusions: There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Keywords: discharge instruction, emergency ward, health literacy, treatment plan

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