Search results for: Vivek Jain
113 Supply Chain Network Design for Perishable Products in Developing Countries
Authors: Abhishek Jain, Kavish Kejriwal, V. Balaji Rao, Abhigna Chavda
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Increasing environmental and social concerns are forcing companies to take a fresh view of the impact of supply chain operations on environment and society when designing a supply chain. A challenging task in today’s food industry is the distribution of high-quality food items throughout the food supply chain. Improper storage and unwanted transportation are the major hurdles in food supply chain and can be tackled by making dynamic storage facility location decisions with the distribution network. Since food supply chain in India is one of the biggest supply chains in the world, the companies should also consider environmental impact caused by the supply chain. This project proposes a multi-objective optimization model by integrating sustainability in decision-making, on distribution in a food supply chain network (SCN). A Multi-Objective Mixed-Integer Linear Programming (MOMILP) model between overall cost and environmental impact caused by the SCN is formulated for the problem. The goal of MOMILP is to determine the pareto solutions for overall cost and environmental impact caused by the supply chain. This is solved by using GAMS with CPLEX as third party solver. The outcomes of the project are pareto solutions for overall cost and environmental impact, facilities to be operated and the amount to be transferred to each warehouse during the time horizon.Keywords: multi-objective mixed linear programming, food supply chain network, GAMS, multi-product, multi-period, environment
Procedia PDF Downloads 321112 Comparative Analysis of the Psychosocial Impact of Skin Diseases in India
Authors: Priyanka Jain, Sushila Pareek
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Skin disease is often considered to be ‘only cosmetic’ by many medical professionals and lay-people alike but unlike most internal illnesses, skin disease is often immediately visible to others and therefore people suffering from dermatological conditions may suffer serious social and emotional consequences. The purpose of this research was to compare patients suffering from acne, alopecia areata (AA) and melanosis on perceived stress, social appearance anxiety and coping. The study included 120 patients (acne = 40 AA = 40 melanosis = 40) ages ranged from 15 to 25 years. Perceived Stress Scale (PSS), Social Appearance Anxiety Scale (SAAS), and The Brief COPE were administered to the patients. Analytical evaluation was done by Kruskal Wallis and ANOVA-tests. The results of the present study clearly revealed that perceived stress and social appearance anxiety were highest in patients with AA followed by acne patients and found least in patients with melanosis. With regard to coping, self-distraction as a coping technique was found highest in patients suffering from AA followed by acne and then melanosis. Denial was highest in acne patients followed by AA and experienced least by patients with melanosis. Behavioural disengagement was almost equal in patients with melanosis and acne and a little less in patients suffering from AA Acceptance was highest in patients with melanosis, followed by AA and least in acne patients. Self-blame was found highest in patients with acne, followed by AA patients further followed by patients suffering from melanosis. This study is an attempt to stimulate professionals working in the field of dermatology and mental health to explore their supportive communication and increase awareness regarding the difficulties that patients with skin disease can face.Keywords: coping, dermatology, perceived stress, psychosocial impact, social appearance anxiety
Procedia PDF Downloads 474111 Industry 4.0 Platforms as 'Cluster' ecosystems for small and medium enterprises (SMEs)
Authors: Vivek Anand, Rainer Naegele
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Industry 4.0 is a global mega-trend revolutionizing the world of advanced manufacturing, but also bringing up challenges for SMEs. In response, many regional, as well as digital Industry 4.0 Platforms, have been set up to boost the competencies of established enterprises as well as SMEs. The concept of 'Clusters' is a policy tool that aims to be a starting point to establish sustainable and self-supporting structures in industries of a region by identifying competencies and supporting cluster actors with services that match their growth needs. This paper is motivated by the idea that Clusters have the potential to enable firms, particularly SMEs, to accelerate the innovation process and transition to digital technologies. In this research, the efficacy of Industry 4.0 platforms as Cluster ecosystems is evaluated, especially for SMEs. Focusing on the Baden Wurttemberg region in Germany, an action research method is employed to study how SMEs leverage other actors on Industry 4.0 Platforms to further their Industry 4.0 journeys. The aim is to evaluate how such Industry 4.0 platforms stimulate innovation, cooperation and competitiveness. Additionally, the barriers to these platforms fulfilling their promise to serve as capacity building cluster ecosystems for SMEs in a region will also be identified. The findings will be helpful for academicians and policymakers alike, who can leverage a ‘cluster policy’ to enable Industry 4.0 ecosystems in their regions. Furthermore, relevant management and policy implications stem from the analysis. This will also be of interest to the various players in a cluster ecosystem - like SMEs and service providers - who benefit from the cooperation and competition. The paper will improve the understanding of how a dialogue orientation, a bottom-up approach and active integration of all involved cluster actors enhance the potential of Industry 4.0 Platforms. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position Industry 4.0 Platforms at the forefront of the industrial renaissance. Motivated by this argument and based on the results of the qualitative research, a roadmap will be proposed to position Industry 4.0 Platforms as effective clusters ecosystems to support Industry 4.0 adoption in a region.Keywords: cluster policy, digital transformation, industry 4.0, innovation clusters, innovation policy, SMEs and startups
Procedia PDF Downloads 224110 A Study of Faculty Development Programs in India to Assist Pedagogy and Curriculum Development
Authors: Chhavi Rana, Sanjay K Jain
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All sides of every education debate agree that quality learning happens when knowledgeable, caring teachers use sound pedagogy. Many deliberations of pedagogy make the fault of considering it as principally being about teaching. There has been lot of research about how to build a positive climate for learning, improve student curiosity, and enhance classroom association. However, these things can only be facilitated when teachers are equipped with better teaching techniques that use sound and accurate pedagogy. Pedagogy is the science and art of education. Its aims range from the full development of the human being to skills acquisition. In India, a project named Mission 10 x has been started by an esteemed IT Corporation Wipro as a faculty development programme (FDP) that particularly focus on elements that facilitated teachers in developing curriculum and new pedagogies that can lead to improvement in student engagement. This paper presents a study of these FDPs and examines (1) the parameters that help teachers in building new pedagogies (2) the extent to which appropriate usage of pedagogy is improved after the conduct of Mission 10 x FDPs, and (3) whether institutions differ in terms of their ability to convert usage of improved pedagogy into academic performance via these FDPs. The sample consisted of 2,236 students at 6 four-year engineering colleges and universities that completed several FDPs during 2012-2014. Many measures of usage of better pedagogy were linked positively with such FDPs, although some of the relationships were weak in strength. The results suggest that the usage of pedagogy were more benefited after conducting these FDPs and application of novel approaches in conducting classes.Keywords: student engagement, critical thinking; achievement, student learning, pedagogy
Procedia PDF Downloads 421109 Impact of Grassroot Democracy on Rural Development of Villages in the State of Haryana
Authors: Minakshi Jain, Sachin Yadav
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Gram Panchayat is the smallest unit of Democracy in India. Grassroots Democracy has been further strengthened by implementation of the 73rd Constitutional Amendment act (CAA) in 1992. To analyse the impact of grassroots democracy the three villages are selected, which have the representation of each section of the society. The selected villages belongs to the same block and district of Haryana state. Villages are selected to access the marginalized group such as women and other backward class. These groups are isolated and do not participate in the grassroots level development process. The caste continue to be a relevant factor in determining the rural leadership. The earlier models of Panchayati Raj failed to benefit the marginalized groups of the society. The 73rd CAA, advocates a uniform three tier system of Panchayat at District level (Zilla Panchayat), Taluka/Block level (Block Panchayat), and village level (Gram Panchayat). The socio-economic profile of representatives in each village is important factor in rural development. The study will highlight the socio-economic profile of elected members at gram Panchayat level, Block Level and District level. The analysis reveals that there is a need to educate and develop the capacity and capability of the elected representative. Training must be imparted to all of them to enable them to function as per provision in the act. The paper will analyse the impact of act on rural development than propose some measures to further strengthen the Panchayati Raj Institution (PRI’s) at grassroots level.Keywords: democracy, rural development, marginalized people, function
Procedia PDF Downloads 327108 Polyvinylidene Fluoride-Polyaniline Films for Improved Dielectric Properties
Authors: Anjana Jain, S. Jayanth Kumar
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Polyvinylidene fluoride (PVDF) is a well-known material for remarkable mechanical properties, resistance to chemicals and superior ferroelectric performances. This endows PVDF the potential for application in supercapacitor devices. The dielectric properties of PVDF, however, are not very high. To improve the dielectric properties of Polyvinylidene fluoride (PVDF), Piezoelectric polymer nanocomposites are prepared without affecting the other useful properties of PVDF. Polyaniline (PANI) was chosen as a filler material to prepare the nanocomposites. PVDF-PANI nanocomposite films were prepared using solvent cast method with different volume fractions of PANI varying from 0.04% to 0.048% of PANI content. The films are characterized for structural, mechanical, and surface morphological properties using X-ray diffraction, differential scanning calorimeter, Raman spectra, Infrared spectra, tensile testing, and scanning electron microscopy. The X-ray diffraction analysis shows that, prepared films were in β-phase. The DSC scans indicated that the degree of crystallinity in PVDF-PANI is improved. Raman and Infrared spectrum further confirm the presence of β-phase of PVDF-PANI film. Tensile properties of PVDF-PANI films were in good agreement with those reported in literature. The surface feature shows that PANI is uniformly distributed in PVDF and also results in disappearance of spherulites. The influence of volume fraction of PANI in PVDF on dielectric properties was analyzed. The results showed that the dielectric permittivity of PVDF-PANI (120) was much higher than that of PVDF (12). The sensitivity of these films was studied on application of a pressure and a constant output voltage was obtained.Keywords: dielectric Properties, PANI, PVDF, smart materials
Procedia PDF Downloads 440107 Study of 'Rolled in Scale' and 'Rolled in Scum' in Automotive Grade Cold-Rolled Annealed Steel Sheet
Authors: Soumendu Monia, Vaibhav Jain, Hrishikesh Jugade, Manashi Adhikary, Goutam Mukhopadhyay
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'Rolled in scale' (RIS) and 'Rolled in Scum' (RISc) are two superficial surface defects on cold rolled and annealed steel sheets which affect the aesthetics of surface and thereby that of the end-product. Both the defects are believed to be originating from distinctly different sources having different mechanisms of formation. However, due to their similar physical appearance, RIS and RISc are generally confused with each other and hence attaining the exact root cause for elimination of the defect becomes difficult. RIS appears irregular in shape, sometimes scattered, and always oriented in rolling direction. RISc is generally oval shaped, having identifiable pointed edges and mostly oriented in rolling direction. Visually, RIS appears to be greyish in colour whereas RISc is whitish in colour. Both the defects have quite random occurrence and do not leave any imprints on the reverse-side of the sheet. In the current study, an attempt has been made to differentiate these two similar looking surface defects using various metallographic and characterization techniques. Systematic experiments have been carried out to identify possible mechanisms of formation of these defects. Detailed characterization revealed basic differences between RIS and RISc with respect to their surface morphology. To summarize, RIS was observed as a residue of an otherwise under-pickled scale patch on surface, after it has been subjected to cold rolling and annealing in a batch/continuous furnace. Whereas RISc was found to be a localized rubbing of the surface, at the time of cold rolling itself, resulting in a rough surface texture.Keywords: annealing, rolled in scale, rolled in scum, skin panel
Procedia PDF Downloads 191106 Stability-Indicating High-Performance Thin-Layer Chromatography Method for Estimation of Naftopidil
Authors: P. S. Jain, K. D. Bobade, S. J. Surana
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A simple, selective, precise and Stability-indicating High-performance thin-layer chromatographic method for analysis of Naftopidil both in a bulk and in pharmaceutical formulation has been developed and validated. The method employed, HPTLC aluminium plates precoated with silica gel as the stationary phase. The solvent system consisted of hexane: ethyl acetate: glacial acetic acid (4:4:2 v/v). The system was found to give compact spot for Naftopidil (Rf value of 0.43±0.02). Densitometric analysis of Naftopidil was carried out in the absorbance mode at 253 nm. The linear regression analysis data for the calibration plots showed good linear relationship with r2=0.999±0.0001 with respect to peak area in the concentration range 200-1200 ng per spot. The method was validated for precision, recovery and robustness. The limits of detection and quantification were 20.35 and 61.68 ng per spot, respectively. Naftopidil was subjected to acid and alkali hydrolysis, oxidation and thermal degradation. The drug undergoes degradation under acidic, basic, oxidation and thermal conditions. This indicates that the drug is susceptible to acid, base, oxidation and thermal conditions. The degraded product was well resolved from the pure drug with significantly different Rf value. Statistical analysis proves that the method is repeatable, selective and accurate for the estimation of investigated drug. The proposed developed HPTLC method can be applied for identification and quantitative determination of Naftopidil in bulk drug and pharmaceutical formulation.Keywords: naftopidil, HPTLC, validation, stability, degradation
Procedia PDF Downloads 400105 In silico Designing and Insight into Antimalarial Potential of Chalcone-Quinolinylpyrazole Hybrids by Preclinical Study in Mice
Authors: Deepika Saini, Sandeep Jain, Ajay Kumar
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The quinoline scaffold is one of the most widely studied in the discovery of derivatives with various heterocyclic moieties due to its potential antimalarial activities. In the present study, a chalcone series of quinoline derivatives clubbed with pyrazole were synthesized to evaluate their antimalarial property by in vitro schizont maturation inhibition assay against both chloroquine sensitive, 3D7 and chloroquine resistant, RKL9 strain of Plasmodium falciparum. Further, top five compounds were studied for in vivo preclinical study for antimalarial potential against P. berghei in Swiss albino mice. To understand the mechanism of synthesized analogues, they were screened computationally by molecular docking techniques. Compounds were docked into the active site of a protein receptor, Plasmodium falciparum Cysteine Protease Falcipain-2. The compounds were successfully synthesized, and structural confirmation was performed by FTIR, 1H-NMR, mass spectrometry and elemental analysis. In vitro study suggested that the compounds 5b, 5g, 5l, 5s and 5u possessed best antimalarial activity and further tested for in vivo screening. Compound 5u (CH₃ on both rings) with EC₅₀ 0.313 & 0.801 µg/ml against CQ-S & CQ-R strains of P. falciparum respectively and 78.01% suppression of parasitemia. The molecular docking studies of the compounds helped in understanding the mechanism of action against falcipain-2. The present study reveals the binding signatures of the synthesized ligands within the active site of the protein, and it explains the results from in vitro study in their EC₅₀ values and percentage parasitemia.Keywords: antimalarial activity, chalcone, docking, quinoline
Procedia PDF Downloads 409104 Interior Noise Reduction of Construction Equipment Vehicle
Authors: Pradeep Jawale, Sharad Supare, Sachin Kumar Jain, Nagesh Walke
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One can witness the constant development and redevelopment of cities throughout the world. Construction equipment vehicles (CEVs) are commonly used on the construction site. However, noise pollution from construction sites due to the use of CEV has become a major problem for many cities. The construction equipment employed, which includes excavators and bulldozers, is one of the main causes of these elevated noise levels. The construction workers possibly will face a potential risk to their auditory health and well-being due to the noise levels they are exposed to. Different countries have imposed exterior and operator noise limits for construction equipment vehicles, enabling them to control noise pollution from CEVs. In this study, the operator ear level noise of the identified vehicle is higher than the benchmark vehicle by 8 dB(A). It was a tough time for the NVH engineer to beat the interior noise level of the benchmark vehicle. Initially, the noise source identification technique was used to identify the dominant sources for increasing the interior noise of the test vehicle. It was observed that the transfer of structure-borne and air-borne noise to the cabin was the major issue with the vehicle. It was foremost required to address the issue without compromising the overall performance of the vehicle. Surprisingly, the steering pump and radiator fan were identified as the major dominant sources than typical conventional sources like powertrain, intake, and exhaust. Individual sources of noise were analyzed in detail, and optimizations were made to minimize the noise at the source. As a result, the significant noise reduction achieved inside the vehicle and the overall in-cab noise level for the vehicle became a new benchmark in the market.Keywords: interior noise, noise reduction, CEV, noise source identification
Procedia PDF Downloads 46103 Role of Mismatch Repair Protein Expression in Colorectal Cancer: A Study from North India
Authors: Alka Yadav, Mayank Jain, Rajan Saxena, Niraj Kumari, Narendra Krishnani, Ashok Kumar
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Purpose: To study the mismatch repair (MMR) protein expression and its clinicopathological correlation in colorectal cancer patients in North India. Methods: A prospective study was conducted on histologically proven 52 (38 males and 14 females) patients with adenocarcinoma of colorectum. MMR protein loss was determined by using immunohistochemistry for MLH1, MSH2, PMS2 and MSH6. Results: 52 patients (38 males and 14 females) underwent resection for colorectal cancer with the median age of 52 years (16-81 years). 35% of the patients (n=18) were younger than 50 years of the age. 3 patients had associated history of malignancy in the family. 29 (56%) patients had right colon cancer, 9 (17%) left colon cancer and 14 (27%) rectal cancer. 2 patients each had synchronous and metachronous cancer. Histology revealed well-differentiated tumour in 16, moderately differentiated in 10 and poorly differentiated tumour in 26 patients. MMR protein loss was seen in 15 (29%) patients. Seven (46%) of these patients were less than 50 years of age. Combined loss of MSH2 and MSH6 was seen most commonly and it was found in 6 patients. 12 (80%) patients with MMR protein loss had tumour located proximal to the splenic flexure compared to 3 (20%) located distal to the splenic flexure. There was no difference in MMR protein loss based on patients' age, gender, degree of tumour differentiation, stage of the disease and tumour histological characteristics. Conclusions: This study revealed that there was less than 30% MMR protein loss in colorectal cancer patients. The loss was most commonly seen in right sided colon cancer than left. A larger study is further required to validate these findings.Keywords: colorectal cancer, mismatch repair protein, immunohitochemistry, clinicopathological correlation
Procedia PDF Downloads 233102 Ameliorative Effect of Martynia annua Linn. on Collagen-Induced Arthritis via Modulating Cytokines and Oxidative Stress in Mice
Authors: Alok Pal Jain, Santram Lodhi
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Martynia annua Linn. (Martyniaccae) is traditionally used in inflammation and applied locally to tuberculosis glands of camel’s neck. The leaves used topically to bites of venomous insects and wounds of domestic animals. Chemical examination of Martynia annua leaves revealed the presence of glycosides, tannins, proteins, phenols and flavonoids. The present study was aimed to evaluate the anti-arthritic activity of methanolic extract of Martynia annua leaves. Methanolic extract of Martynia annua leaves was tested by using in vivo collagen-induced arthritis mouse model to investigate the anti-rheumatoid arthritis activity. In addition, antioxidant effect of methanolic extract was determined by the estimation of antioxidants level in joint tissues. The severity of arthritis was assessed by arthritis score and edema. Levels of cytokines TNF-α and IL-6, in the joint tissue homogenate were measured using ELISA. A high dose (250 mg/kg) of methanolic extract was significantly reduced the degree of inflammation in mice as compared with reference drug. Antioxidants level and malondialdehyde (MDA) in joint tissue homogenate found significantly (p < 0.05) higher. Methanolic extract at dose of 250 mg/kg modulated the cytokines production and suppressed the oxidative stress in the mice with collagen-induced arthritis. This study suggested that Martynia annua might be alternative herbal medicine for the management of rheumatoid arthritis.Keywords: Martynia annua, collagen, rheumatoid arthritis, antioxidants
Procedia PDF Downloads 297101 The Influence of Imposter Phenomenon on the Experiences of Intimacy in Non-Binary Young Adults
Authors: Muskan Jain, Baiju Gopal
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Objectives: Intimacy in interpersonal relationships is integral to psychological health and everyday wellbeing; the focus is on intimacy, which can be described as feelings of closeness, connection, and belonging within relationships, which is influenced by an individual's gender identity as well as life experiences. The study aims to explore the experiences of intimacy of the non-binary gender; this marginalized community has increased risks of developing the imposter phenomenon. The study explores the influence of IP on the development and sustenance of intimacy in relationships. Methods: The present study accumulates detailed narratives from 10 non-binary young adults ages 18 to 25 in metropolitan cities of India. Thematic analysis was used for the data analysis. Results: Seven major themes have emerged revolving around internalized criticism and self-depreciating behavior, which causes distance between partners. The four themes that result in the internalization of criticism are lack of social stability, invalidation by social units, adverse life experiences, and estrangement due to gender identity. Three themes that encapsulate major difficulties in relationships are limited self-disclosure, inhibition of physical needs, and fear of taking space. The findings have been critically compared and contrasted with the existing body of literature in the domain, which sets the agenda for further inquiry. Conclusion: It is important for future studies to capture the experiences of non-binary genders in India to provide better therapeutic support in order to assist them in forming meaningful and authentic relationships, thus increasing overall wellbeing.Keywords: imposter phenomenon, intimacy, internalized criticism, marginalized community
Procedia PDF Downloads 59100 Effect of Diet and Life Style Modification to Control the Plasma Glucose Level in the 60 Patients of Gestational Diabetes Mellitus
Authors: Vivek Saxena, Shreshtha Saxena
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Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance first recognized during pregnancy. Uncontrolled or untreated GDM is associated with various adverse outcomes to the maternal and fetal health. Overt diabetes mellitus may also develop in such patients. It is universally accepted fact that first and foremost management to treat GDM is dietary control and lifestyle modification even before starting any oral hypoglycemic agent (OHA) or insulin. So, proper dietary management and little changes in the patient’s lifestyle are very effective for reducing her plasma glucose level. Objectives: Proper counselling of the patients and flexibility in their lifestyle and diet can effectively control the plasma glucose level in GDM patients. Methods: Total 60 GDM patients of age > 18 years were taken. We had three counselling sessions with the patient and other members of the family like husband, parents, and in-laws at different intervals, discussed their lifestyle and diet pattern, helped them to eliminate the factors those had an adverse effect on plasma glucose level and promoted them to acquire a healthy lifestyle. We have counselled the patient and her family member separately and then together also. They have explained how increased plasma glucose level can be effectively controlled with the little modification in their diet and routine activities. They were also taught to remain stress-free during their rest of antenatal period. We have excluded the patients from our study who were diabetic before pregnancy and patients with other comorbid illnesses like hypothyroidism and valvular heart disease. Results and conclusions: Results were very rewarding as patients could acquire a lifestyle of their choice. They were happy because extra pill burden was not there. All the 60 patients were normoglycemic in remaining antenatal period, 48 patients were delivered normally and 12 patients underwent cesarean section due to various reasons.Regular counselling of the patients regarding their disease and little alterations in diet and lifestyle controlled the plasma glucose level much effectively. The things were more easier and effective when we included other family members during our counselling session because they play a major role in patient’s day to day activity and influence her life.Keywords: dietary management, gestational diabetes mellitus, impaired glucose tolerance, oral hypoglycemic agent, pregnancy
Procedia PDF Downloads 16199 Effect of Atrial Flutter on Alcoholic Cardiomyopathy
Authors: Ibrahim Ahmed, Richard Amoateng, Akhil Jain, Mohamed Ahmed
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Alcoholic cardiomyopathy (ACM) is a type of acquired cardiomyopathy caused by chronic alcohol consumption. Frequently ACM is associated with arrhythmias such as atrial flutter. Our aim was to characterize the patient demographics and investigate the effect of atrial flutter (AF) on ACM. This was a retrospective cohort study using the Nationwide Inpatient Sample database to identify admissions in adults with principal and secondary diagnoses of alcoholic cardiomyopathy and atrial flutter from 2019. Multivariate linear and logistic regression models were adjusted for age, gender, race, household income, insurance status, Elixhauser comorbidity score, hospital location, bed size, and teaching status. The primary outcome was all-cause mortality, and secondary outcomes were the length of stay (LOS) and total charge in USD. There was a total of 21,855 admissions with alcoholic cardiomyopathy, of which 1,635 had atrial flutter (AF-ACM). Compared to Non-AF-ACM cohort, AF-ACM cohort had fewer females (4.89% vs 14.54%, p<0.001), were older (58.66 vs 56.13 years, p<0.001), fewer Native Americans (0.61% vs2.67%, p<0.01), had fewer smaller (19.27% vs 22.45%, p<0.01) & medium-sized hospitals (23.24% vs28.98%, p<0.01), but more large-sized hospitals (57.49% vs 48.57%, p<0.01), more Medicare (40.37% vs 34.08%, p<0.05) and fewer Medicaid insured (23.55% vs 33.70%, p=<0.001), fewer hypertension (10.7% vs 15.01%, p<0.05), and more obesity (24.77% vs 16.35%, p<0.001). Compared to Non-AF-ACM cohort, there was no difference in AF-ACM cohort mortality rate (6.13% vs 4.20%, p=0.0998), unadjusted mortality OR 1.49 (95% CI 0.92-2.40, p=0.102), adjusted mortality OR 1.36 (95% CI 0.83-2.24, p=0.221), but there was a difference in LOS 1.23 days (95% CI 0.34-2.13, p<0.01), total charge $28,860.30 (95% CI 11,883.96-45,836.60, p<0.01). In patients admitted with ACM, the presence of AF was not associated with a higher all-cause mortality rate or odds of all-cause mortality; however, it was associated with 1.23 days increase in LOS and a $28,860.30 increase in total hospitalization charge. Native Americans, older age and obesity were risk factors for the presence of AF in ACM.Keywords: alcoholic cardiomyopathy, atrial flutter, cardiomyopathy, arrhythmia
Procedia PDF Downloads 11298 Surveillance of Hepatitis C Virus Genotype Circulating in North India
Authors: Shantanu Prakash, Suruchi Shukla, Amita Jain
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Introduction: The hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. Injection drug use and individuals receiving blood and blood products are the primary modes of HCV transmission. Our study aims to establish the prevalent genotypes/ subtypes of HCV circulating in Uttar Pradesh, North India, as reported from a tertiary care hospital. Methods: It is a retrospective observational analysis of consecutive 404 HCV RNA positive cases referred to our hospital during September 2014 to April 2017. The study was approved by an institutional ethics committee. Written informed consent was taken from each participant. Clinical and demographic details of these patients were recorded using predesigned questionnaires. All the laboratory testing was carried on stored serum sample of enrolled cases. Genotyping of all 404 strains was done by Sanger’s sequencing of the core region. The phylogenetic analysis of 179 HCV strains with high -quality sequencing data was performed. Results: The distribution of prevalent genotypes/ subtypes as noted in the present study was; Genotype (GT)1a [n-101(25%)], GT1b [n-12(2.9%)], GT1c [1(0.25%)], GT3a [275(68.07%)], GT3b [9(2.2%)], GT3g [2(0.49%)], GT3i [3(0.74%)], and GT4a [1(0.24%)]. HCV genotypes GT2, GT5 and GT6 were not detected from our region. Sequence analysis showed high genotypic variability in HCV GT3. Phylogenetic analysis showed that HCV GT3 and GT1 circulating in our region were related to Indian strains reported earlier. Conclusions: HCV genotypes 3a and 1a are commonest circulating genotypes in Uttar Pradesh (UP), India.Keywords: Hepatitis C virus, genetic variation, bioinformatics, genotype, HCV
Procedia PDF Downloads 16097 Using Machine Learning to Build a Real-Time COVID-19 Mask Safety Monitor
Authors: Yash Jain
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The US Center for Disease Control has recommended wearing masks to slow the spread of the virus. The research uses a video feed from a camera to conduct real-time classifications of whether or not a human is correctly wearing a mask, incorrectly wearing a mask, or not wearing a mask at all. Utilizing two distinct datasets from the open-source website Kaggle, a mask detection network had been trained. The first dataset that was used to train the model was titled 'Face Mask Detection' on Kaggle, where the dataset was retrieved from and the second dataset was titled 'Face Mask Dataset, which provided the data in a (YOLO Format)' so that the TinyYoloV3 model could be trained. Based on the data from Kaggle, two machine learning models were implemented and trained: a Tiny YoloV3 Real-time model and a two-stage neural network classifier. The two-stage neural network classifier had a first step of identifying distinct faces within the image, and the second step was a classifier to detect the state of the mask on the face and whether it was worn correctly, incorrectly, or no mask at all. The TinyYoloV3 was used for the live feed as well as for a comparison standpoint against the previous two-stage classifier and was trained using the darknet neural network framework. The two-stage classifier attained a mean average precision (MAP) of 80%, while the model trained using TinyYoloV3 real-time detection had a mean average precision (MAP) of 59%. Overall, both models were able to correctly classify stages/scenarios of no mask, mask, and incorrectly worn masks.Keywords: datasets, classifier, mask-detection, real-time, TinyYoloV3, two-stage neural network classifier
Procedia PDF Downloads 16396 Developing Environmental Engineering Alternatives for Deep Desulphurization of Transportation Fuels
Authors: Nalinee B. Suryawanshi, Vinay M. Bhandari, Laxmi Gayatri Sorokhaibam, Vivek V. Ranade
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Deep desulphurization of transportation fuels is a major environmental concern all over the world and recently prescribed norms for the sulphur content require below 10 ppm sulphur concentrations in fuels such as diesel and gasoline. The existing technologies largely based on catalytic processes such as hydrodesulphurization, oxidation require newer catalysts and demand high cost of deep desulphurization whereas adsorption based processes have limitations due to lower capacity of sulphur removal. The present work is an attempt to provide alternatives for the existing methodologies using a newer non-catalytic process based on hydrodynamic cavitation. The developed process requires appropriate combining of organic and aqueous phases under ambient conditions and passing through a cavitating device such as orifice, venturi or vortex diode. The implosion of vapour cavities formed in the cavitating device generates (in-situ) oxidizing species which react with the sulphur moiety resulting in the removal of sulphur from the organic phase. In this work, orifice was used as a cavitating device and deep desulphurization was demonstrated for removal of thiophene as a model sulphur compound from synthetic fuel of n-octane, toluene and n-octanol. The effect of concentration of sulphur (up to 300 ppm), nature of organic phase and effect of pressure drop (0.5 to 10 bar) was discussed. A very high removal of sulphur content of more than 90% was demonstrated. The process is easy to operate, essentially works at ambient conditions and the ratio of aqueous to organic phase can be easily adjusted to maximise sulphur removal. Experimental studies were also carried out using commercial diesel as a solvent and the results substantiate similar high sulphur removal. A comparison of the two cavitating devices- one with a linear flow and one using vortex flow for effecting pressure drop and cavitation indicates similar trends in terms of sulphur removal behaviour. The developed process is expected to provide an attractive environmental engineering alternative for deep desulphurization of transportation fuels.Keywords: cavitation, petroleum, separation, sulphur removal
Procedia PDF Downloads 38195 Assessment of Delirium, It's Possible Risk Factors and Outcome in Patient Admitted in Medical Intensive Care Unit
Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda
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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.Keywords: delirium, risk factors, outcome, intervention
Procedia PDF Downloads 16394 Performance Evaluation of Filtration System for Groundwater Recharging Well in the Presence of Medium Sand-Mixed Storm Water
Authors: Krishna Kumar Singh, Praveen Jain
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The collection of storm water runoff and forcing it into the groundwater is the need of the hour to sustain the ground water table. However, the runoff entraps various types of sediments and other floating objects whose removal are essential to avoid pollution of ground water and blocking of pores of aquifer. However, it requires regular cleaning and maintenance due to the problem of clogging. To evaluate the performance of filter system consisting of coarse sand (CS), gravel (G) and pebble (P) layers, a laboratory experiment was conducted in a rectangular column. The effect of variable thickness of CS, G and P layers of the filtration unit of the recharge shaft on the recharge rate and the sediment concentration of effluent water were evaluated. Medium sand (MS) of three particle sizes, viz. 0.150–0.300 mm (T1), 0.300–0.425 mm (T2) and 0.425–0.600 mm of thickness 25 cm, 30 cm, and 35 cm respectively in the top layer of the filter system and having seven influent sediment concentrations of 250–3,000 mg/l were used for the experimental study. The performance was evaluated in terms of recharge rates and clogging time. The results indicated that 100 % suspended solids were entrapped in the upper 10 cm layer of MS, the recharge rates declined sharply for influent concentrations of more than 1,000 mg/l. All treatments with a higher thickness of MS media indicated recharge rate slightly more than that of all treatment with a lower thickness of MS media respectively. The performance of storm water infiltration systems was highly dependent on the formation of a clogging layer at the filter. An empirical relationship has been derived between recharge rates, inflow sediment load, size of MS and thickness of MS with using MLR.Keywords: groundwater, medium sand-mixed storm water filter, inflow sediment load
Procedia PDF Downloads 39293 Long Term Follow-Up, Clinical Outcomes and Quality of Life after Total Arterial Revascularisation versus Conventional Coronary Surgery: A Retrospective Study
Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun
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Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.Keywords: CABG; MACCEs; quality of life; total arterial revascularisation
Procedia PDF Downloads 21892 Optimizing Campaign Effectiveness: Identifying Target Customers via Recommender Engine
Authors: Nikita Katyal, Shubham Jain
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In today’s competitive business environment, the success of campaigns relies not only on their creation but also on effectively reaching the right customers. Campaigns often feature products that customers may not have considered or are unaware of, including popular items. This research aims to enhance retailer sales by leveraging an efficient recommender system that reminds targeted customers to purchase their preferred products and suggests additional items they hadn’t initially considered during a campaign. Our focus is on utilizing the recommender system to identify potential customers for a curated set of products selected by the marketing team for a specific campaign. Communicating with all customers can be time-consuming and costly, and irrelevant messages may harm customer loyalty. Therefore, the primary objective is to strategically select the right customers for a campaign, increasing sales and reducing communication costs. This paper provides valuable insights into connecting with the right customer segments to optimize revenue generation for businesses. The analysis shows that high-value customers (those generating the highest revenue) contributed to increases in average basket size, while win-back customers (with low engagement) and about to churn customers (those at risk of attrition) improved the effectiveness of marketing contacts by increasing engagement and reducing churn. Targeted communication, focused on revenue, also enhanced the quality of the relationship between the customer and the firm, helping to lower churn rates by engaging customers with suitable campaigns. This research provides empirical evidence supporting the theoretical benefits of targeting the right customers for a campaign.Keywords: recommendation, ALS, marketing campaigns, target customers, churn
Procedia PDF Downloads 1591 Spectroscopic Relation between Open Cluster and Globular Cluster
Authors: Robin Singh, Mayank Nautiyal, Priyank Jain, Vatasta Koul, Vaibhav Sharma
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The curiosity to investigate the space and its mysteries was dependably the main impetus of human interest, as the particle of livings exists from the "debut de l'Univers" (beginning of the Universe) typified with its few other living things. The sharp drive to uncover the secrets of stars and their unusual deportment was dependably an ignitor of stars investigation. As humankind lives in civilizations and states, stars likewise live in provinces named ‘clusters’. Clusters are separates into 2 composes i.e. open clusters and globular clusters. An open cluster is a gathering of thousand stars that were moulded from a comparable goliath sub-nuclear cloud and for the most part; contain Propulsion I (extremely metal-rich) and Propulsion II (mild metal-rich), where globular clusters are around gathering of more than thirty thousand stars that circles a galactic focus and basically contain Propulsion III (to a great degree metal-poor) stars. Futurology of this paper lies in the spectroscopic investigation of globular clusters like M92 and NGC419 and open clusters like M34 and IC2391 in different color bands by using software like VIREO virtual observatory, Aladin, CMUNIWIN, and MS-Excel. Assessing the outcome Hertzsprung-Russel (HR) diagram with exemplary cosmological models like Einstein model, De Sitter and Planck survey demonstrate for a superior age estimation of respective clusters. Colour-Magnitude Diagram of these clusters was obtained by photometric analysis in g and r bands which further transformed into BV bands which will unravel the idea of stars exhibit in the individual clusters.Keywords: color magnitude diagram, globular clusters, open clusters, Einstein model
Procedia PDF Downloads 22690 Clinical, Demographic and Molecular Characterization of Dengue, Chikungunya and Zika Viruses Causing Hemorrhagic Fever in North India
Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain
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Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India
Procedia PDF Downloads 15689 Orientia Tsutsugamushi an Emerging Etiology of Acute Encephalitis Syndrome in Northern Part of India
Authors: Amita Jain, Shantanu Prakash, Suruchi Shukla
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Introduction: Acute encephalitis syndrome (AES) is a complex multi etiology syndrome posing a great public health problem in the northern part of India. Japanese encephalitis (JE) virus is an established etiology of AES in this region. Recently, Scrub typhus (ST) is being recognized as an emerging aetiology of AES in JE endemic belt. This study was conducted to establish the direct evidence of Central nervous system invasion by Orientia tsutsugamushi leading to AES. Methodology: A total of 849 cases with clinical diagnosis of AES were enrolled from six districts (Deoria and its adjoining area) of the traditional north Indian Japanese encephalitis (JE) belt. Serum and Cerebrospinal fluid samples were collected and tested for major agent causing acute encephalitis. AES cases either positive for anti-ST IgM antibodies or negative for all tested etiologies were investigated for ST-DNA by real-time PCR. Results: Of these 505 cases, 250 patients were laboratory confirmed for O. tsutsugamushi infection either by anti-ST IgM antibodies positivity (n=206) on serum sample or by ST-DNA detection by real-time PCR assay on CSF sample (n=2) or by both (n=42).Total 29 isolate could be sequenced for 56KDa gene. Conclusion: All the strains were found to cluster with Gilliam strains. The majority of the isolates showed a 97–99% sequence similarity with Thailand and Cambodian strains. Gilliam strain of O.tsusugamushi is an emerging as one of the major aetiologies leading to AES in northern part of India.Keywords: acute encephalitis syndrome, O. tsutsugamushi, Gilliam strain, North India, cerebrospinal fluid
Procedia PDF Downloads 25288 Thermal Analysis of Adsorption Refrigeration System Using Silicagel–Methanol Pair
Authors: Palash Soni, Vivek Kumar Gaba, Shubhankar Bhowmick, Bidyut Mazumdar
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Refrigeration technology is a fast developing field at the present era since it has very wide application in both domestic and industrial areas. It started from the usage of simple ice coolers to store food stuffs to the present sophisticated cold storages along with other air conditioning system. A variety of techniques are used to bring down the temperature below the ambient. Adsorption refrigeration technology is a novel, advanced and promising technique developed in the past few decades. It gained attention due to its attractive property of exploiting unlimited natural sources like solar energy, geothermal energy or even waste heat recovery from plants or from the exhaust of locomotives to fulfill its energy need. This will reduce the exploitation of non-renewable resources and hence reduce pollution too. This work is aimed to develop a model for a solar adsorption refrigeration system and to simulate the same for different operating conditions. In this system, the mechanical compressor is replaced by a thermal compressor. The thermal compressor uses renewable energy such as solar energy and geothermal energy which makes it useful for those areas where electricity is not available. Refrigerants normally in use like chlorofluorocarbon/perfluorocarbon have harmful effects like ozone depletion and greenhouse warming. It is another advantage of adsorption systems that it can replace these refrigerants with less harmful natural refrigerants like water, methanol, ammonia, etc. Thus the double benefit of reduction in energy consumption and pollution can be achieved. A thermodynamic model was developed for the proposed adsorber, and a universal MATLAB code was used to simulate the model. Simulations were carried out for a different operating condition for the silicagel-methanol working pair. Various graphs are plotted between regeneration temperature, adsorption capacities, the coefficient of performance, desorption rate, specific cooling power, adsorption/desorption times and mass. The results proved that adsorption system could be installed successfully for refrigeration purpose as it has saving in terms of power and reduction in carbon emission even though the efficiency is comparatively less as compared to conventional systems. The model was tested for its compliance in a cold storage refrigeration with a cooling load of 12 TR.Keywords: adsorption, refrigeration, renewable energy, silicagel-methanol
Procedia PDF Downloads 20687 Elasticity Model for Easing Peak Hour Demand for Metrorail Transport System
Authors: P. K. Sarkar, Amit Kumar Jain
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The demand for Urban transportation is characterised by a large scale temporal and spatial variations which causes heavy congestion inside metro trains in peak hours near Centre Business District (CBD) of the city. The conventional approach to address peak hour congestion, metro trains has been to increase the supply by way of introduction of more trains, increasing the length of the trains, optimising the time table to increase the capacity of the system. However, there is a limitation of supply side measures determined by the design capacity of the systems beyond which any addition in the capacity requires huge capital investments. The demand side interventions are essentially required to actually spread the demand across the time and space. In this study, an attempt has been made to identify the potential Transport Demand Management tools applicable to Urban Rail Transportation systems with a special focus on differential pricing. A conceptual price elasticity model has been developed to analyse the effect of various combinations of peak and nonpeak hoursfares on demands. The elasticity values for peak hour, nonpeak hour and cross elasticity have been assumed from the relevant literature available in the field. The conceptual price elasticity model so developed is based on assumptions which need to be validated with actual values of elasticities for different segments of passengers. Once validated, the model can be used to determine the peak and nonpeak hour fares with an objective to increase overall ridership, revenue, demand levelling and optimal utilisation of assets.Keywords: urban transport, differential fares, congestion, transport demand management, elasticity
Procedia PDF Downloads 31086 Quantifying Temporal Variation of Volatile Organic Compounds and Their Ozone Forming Potential at Rural Atmosphere in Delhi
Authors: Amit Kumar, Bhupendra Pratap Singh, Manoj Singh, Monika Punia, Krishan Kumar, V. K. Jain
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Ambient concentrations of volatile organic compounds (VOCs) were investigated in order to find out temporal variations and their ozone forming potentials (OFP) at rural site in Delhi National Capital Region during summer 2013. Sampling was performed for continuous five days, to identify the differences in working days and weekend VOCs concentration levels. Sampling and analytical procedure for VOCs were done using National Institute for Occupational Safety and Health (NIOSH) standard method. On each sampling day, VOCs samples were collected for 3-hours in the morning, afternoon and evening. There has been observed a noticeable contrast in the concentration of VOCs levels between working days and weekend. However, most of the VOCs showed diurnal fluctuations with higher concentrations in the morning and evening as compared to afternoon which might be due to change in meteorology. The results showed that mean toluene/benzene and m-/p-xylene/benzene ratios were higher in the afternoon while it was lower during morning and evening. The relative contribution of the VOCs to ozone formation, total propylene equivalent concentrations and OFP were calculated. Toluene was the most contributing organic contaminant to ozone formation as well as ambient VOCs concentrations. Results obtained in current study demonstrate that ozone formation at rural site in Delhi is probably limited by the emissions of VOCs.Keywords: VOCs, rural, NIOSH, ozone forming potential, propylene equivalent concentration
Procedia PDF Downloads 53085 Comparison of Wake Oscillator Models to Predict Vortex-Induced Vibration of Tall Chimneys
Authors: Saba Rahman, Arvind K. Jain, S. D. Bharti, T. K. Datta
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The present study compares the semi-empirical wake-oscillator models that are used to predict vortex-induced vibration of structures. These models include those proposed by Facchinetti, Farshidian, and Dolatabadi, and Skop and Griffin. These models combine a wake oscillator model resembling the Van der Pol oscillator model and a single degree of freedom oscillation model. In order to use these models for estimating the top displacement of chimneys, the first mode vibration of the chimneys is only considered. The modal equation of the chimney constitutes the single degree of freedom model (SDOF). The equations of the wake oscillator model and the SDOF are simultaneously solved using an iterative procedure. The empirical parameters used in the wake-oscillator models are estimated using a newly developed approach, and response is compared with experimental data, which appeared comparable. For carrying out the iterative solution, the ode solver of MATLAB is used. To carry out the comparative study, a tall concrete chimney of height 210m has been chosen with the base diameter as 28m, top diameter as 20m, and thickness as 0.3m. The responses of the chimney are also determined using the linear model proposed by E. Simiu and the deterministic model given in Eurocode. It is observed from the comparative study that the responses predicted by the Facchinetti model and the model proposed by Skop and Griffin are nearly the same, while the model proposed by Fashidian and Dolatabadi predicts a higher response. The linear model without considering the aero-elastic phenomenon provides a less response as compared to the non-linear models. Further, for large damping, the prediction of the response by the Euro code is relatively well compared to those of non-linear models.Keywords: chimney, deterministic model, van der pol, vortex-induced vibration
Procedia PDF Downloads 22184 Comparative Study of Outcomes of Nonfixation of Mesh versus Fixation in Laparoscopic Total Extra Peritoneal (TEP) Repair of Inguinal Hernia: A Prospective Randomized Controlled Trial
Authors: Raman Sharma, S. K. Jain
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Aims and Objectives: Fixation of the mesh during laparoscopic total extraperitoneal (TEP) repair of inguinal hernia is thought to be necessary to prevent recurrence. However, mesh fixation may increase surgical complications and postoperative pain. Our objective was to compare the outcomes of nonfixation with fixation of polypropylene mesh by metal tacks during TEP repair of inguinal hernia. Methods: Forty patients aged 18 to72 years with inguinal hernia were included who underwent laparoscopic TEP repair of inguinal hernia with (n=20) or without (n=20) fixation of the mesh. The outcomes were operative duration, postoperative pain score, cost, in-hospital stay, time to return to normal activity, and complications. Results: Patients in whom the mesh was not fixed had shorter mean operating time (p < 0.05). We found no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications (P > 0.05). Moreover, a net cost savings was realized for each hernia repair performed without stapled mesh. Conclusions: TEP repair without mesh fixation resulted in the shorter operating time and lower operative cost with no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications. All this contribute to make TEP repair without mesh fixation a better choice for repair of uncomplicated inguinal hernia, especially in developing nations with scarce resources.Keywords: postoperative pain score, inguinal hernia, nonfixation of mesh, total extra peritoneal (TEP)
Procedia PDF Downloads 345