Search results for: Aman Abhishek

Authors: Abhishek Mukherjee, Juan C. Cajas, Jenny Suckale, Guillaume Houzeaux, Oriol Lehmkuhl, Simone Marras

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The investigation of tsunami flow characteristics and the quantification of tsunami energy reduction through the coastal vegetation is important to understand the protective benefits of nature-based mitigation parks. In the present study, a three-dimensional non-hydrostatic incompressible Computational Fluid Dynamics model with a two-way coupling enabled fluid-structure interaction approach (FSI) is used. After validating the numerical model against experimental data, tsunami flow characteristics have been investigated by varying vegetation density, modulus of elasticity, the gap between stems, and arrangement or distribution of vegetation patches. Streamwise depth average velocity profiles, turbulent kinetic energy, energy flux reflection, and dissipation extracted by the numerical study will be presented in this study. These diagnostics are essential to assess the importance of different parameters to design the proper coastal defense systems. When a tsunami wave reaches the shore, it transforms into undular bores, which induce scour around offshore structures and sediment transport. The bed shear stress, instantaneous turbulent kinetic energy, and the vorticity near-bed will be presented to estimate the importance of vegetation to prevent tsunami-induced scour and sediment transport.

Keywords: coastal defense, energy flux, fluid-structure interaction, natural hazards, sediment transport, tsunami mitigation

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Authors: Brajesh Tiwari, Yuvraj Dangi, Abhishek Jain, Ashok Jain

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The purpose of the investigation was to evaluate the potential of sphingosomes as nanoscale drug delivery units for site-specific delivery of anti-cancer agents. Doxorubicin Hydrochloride (DOX) was selected as a model anti-cancer agent. Sphingosomes were prepared and loaded with DOX and optimized for size and drug loading. The formulations were characterized by Malvern zeta-seizer and Transmission Electron Microscopy (TEM) studies. Sphingosomal formulations were further evaluated for in-vitro drug release study under various pH profiles. The in-vitro drug release study showed an initial rapid release of the drug followed by a slow controlled release. In vivo studies of optimized formulations and free drug were performed on albino rats for comparison of drug plasma concentration. The in- vivo study revealed that the prepared system enabled DOX to have had enhanced circulation time, longer half-life and lower elimination rate kinetics as compared to free drug. Further, it can be interpreted that the formulation would selectively enter highly porous mass of tumor cells and at the same time spare normal tissues. To summarize, the use of sphingosomes as carriers of anti-cancer drugs may prove to be a fascinating approach that would selectively localize in the tumor mass, increasing the therapeutic margin of safety while reducing the side effects associated with anti-cancer agents.

Keywords: sphingosomes, anti-cancer, doxorubicin, formulation

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Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

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Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

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Authors: Zainab Bibi, Afsheen Aman, Shah Ali Ul Qader

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Endo-β-1,4-xylanases [EC 3.2.1.8] are one of the major groups of enzymes that are involved in degradation process of xylan and have several applications in food, textile and paper processing industries. Due to broad utility of endo-β-1,4-xylanase, researchers are focusing to increase the productivity of this hydrolase from various microbial species. Harsh industrial condition, faster reaction rate and efficient hydrolysis of xylan with low risk of contamination are critical requirements of industry that can be fulfilled by synthesizing the enzyme with efficient properties. In the current study, a newly isolated thermophile Geobacillus stearothermophilus KIBGE-IB29 was used in order to attain the maximum production of endo-1,4-β-xylanase. Bacterial culture was isolated from soil, collected around the blast furnace site of a steel processing mill, Karachi. Optimization of various nutritional and physical factors resulted the maximum synthesis of endo-1,4-β-xylanase from a thermophile. High production yield was achieved at 60°C and pH-6.0 after 24 hours of incubation period. Various nitrogen sources viz. peptone, yeast extract and meat extract improved the enzyme synthesis with 0.5%, 0.2% and 0.1% optimum concentrations. Dipotassium hydrogen phosphate (0.25%), potassium dihydrogen phosphate (0.05%), ammonium sulfate (0.05%) and calcium chloride (0.01%) were noticed as valuable salts to improve the production of enzyme. The thermophilic nature of isolate, with its broad pH stability profile and reduced fermentation time indicates its importance for effective xylan saccharification and for large scale production of endo-1,4-β-xylanase.

Keywords: geobacillus, optimization, production, xylanase

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Authors: Abhishek Saha, Serene Tay, Gerard Pijcke

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The availability of high-resolution topography and rainfall information in urban areas has made it necessary to revise modeling approaches used for simulating flood risk assessments. Lidar derived elevation models that have 1m or lower resolutions are becoming widely accessible. The classical approaches of 1D-2D flow models where channel flow is simulated and coupled with a coarse resolution 2D overland flow models may not fully utilize the information provided by high-resolution data. In this context, a study was undertaken to compare three different modeling approaches to simulate flooding in an urban area. The first model used is the base model used is Sobek, which uses 1D model formulation together with hydrologic boundary conditions and couples with an overland flow model in 2D. The second model uses a full 2D model for the entire area with shallow water equations at the resolution of the digital elevation model (DEM). These models are compared against another shallow water equation solver in 2D, which uses a subgrid method for grid refinement. These models are simulated for different horizontal resolutions of DEM varying between 1m to 5m. The results show a significant difference in inundation extents and water levels for different DEMs. They are also sensitive to the different numerical models with the same physical parameters, such as friction. The study shows the importance of having reliable field observations of inundation extents and levels before a choice of model and data can be made for spatial flood risk assessments.

Keywords: flooding, DEM, shallow water equations, subgrid

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Authors: Abhishek Singh, Rajlakshmi Barman, Tanmay Shah

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Coagulation is considered to be one of the predominant water treatment processes which improve the cost effectiveness of wastewater. The sole purpose of this experiment on thermal coagulation is to increase the efficiency and the rate of reaction. The process uses renewable sources of energy which comprises of improved and minimized time method in order to eradicate the water scarcity of the regions which are on the brink of depletion. This paper includes the various effects of temperature on the standard coagulation treatment of wastewater and their effect on water quality. In addition, the coagulation is done with the mix of bottom/fly-ash that will act as an adsorbent and removes most of the minor and macro particles by means of adsorption which not only helps to reduce the environmental burden of fly ash but also enhance economic benefit. Also, the method of sand filtration is amalgamated in the process. The sand filter is an environmentally-friendly wastewater treatment method, which is relatively simple and inexpensive. The existing parameters were satisfied with the experimental results obtained in this study and were found satisfactory. The initial turbidity of the wastewater is 162 NTU. The initial temperature of the wastewater is 27 C. The temperature variation of the entire process is 50 C-80 C. The concentration of alum in wastewater is 60mg/L-320mg/L. The turbidity range is 8.31-28.1 NTU after treatment. pH variation is 7.73-8.29. The effective time taken is 10 minutes for thermal mixing and sedimentation. The results indicate that the presence of thermal energy affects the coagulation treatment process. The influence of thermal energy on turbidity is assessed along with renewable energy sources and increase of the rate of reaction of the treatment process.

Keywords: adsorbent, sand filter, temperature, thermal coagulation

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Authors: Hari Singh, Abhishek Kamboj, Sudhir Kumar

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This investigation proposes a grey-based Taguchi method to solve the multi-response problems. The grey-based Taguchi method is based on the Taguchi’s design of experimental method, and adopts Grey Relational Analysis (GRA) to transfer multi-response problems into single-response problems. In this investigation, an attempt has been made to optimize the drilling process parameters considering weighted output response characteristics using grey relational analysis. The output response characteristics considered are surface roughness, burr height and hole diameter error under the experimental conditions of cutting speed, feed rate, step angle, and cutting environment. The drilling experiments were conducted using L27 orthogonal array. A combination of orthogonal array, design of experiments and grey relational analysis was used to ascertain best possible drilling process parameters that give minimum surface roughness, burr height and hole diameter error. The results reveal that combination of Taguchi design of experiment and grey relational analysis improves surface quality of drilled hole.

Keywords: metal matrix composite, drilling, optimization, step drill, surface roughness, burr height, hole diameter error

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Authors: Manoj Sarda, Abhishek Agarwal, Juhi Kaushik, Vatsal Sanjay, Arup Kumar Das

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Railways in India remain primary mode of transport having one of the largest networks in the world and catering to billions of transits yearly. Catastrophic economic damage and loss to life is encountered over the past few decades due to fire to locomotives. Study of fire dynamics and fire propagation plays an important role in evacuation planning and reducing losses. Simulation based study of propagation of fire and soot inside an air conditioned coach of Indian locomotive is done in this paper. Finite difference based solver, Fire Dynamic Simulator (FDS) version 6 has been used for analysis. A single air conditioned 3 tier coupe closed to ambient surroundings by glass windows having occupancy for 8 people is the basic unit of the domain. A system of three such coupes combined is taken to be fundamental unit for the entire study to resemble effect to an entire coach. Analysis of flame and soot contours and concentrations is done corresponding to variations in heat release rate per unit volume (HRRPUA) of fire source, variations in conditioned air velocity being circulated inside coupes by vents and an alternate fire initiation and propagation mechanism via ducts. Quantitative results of fractional area in top and front view of the three coupes under fire and smoke are obtained using MATLAB (IMT). Present simulations and its findings will be useful for organizations like Commission of Railway Safety and others in designing and implementing safety and evacuation measures.

Keywords: air conditioned coaches, fire propagation, flame contour, soot flow, train fire

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Authors: Karish Thavabalan, Alistair Ovenell, Aman Sutaria, Annabelle Parkhouse, Numan Baydemir, Theodore Lally

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Background: Open discussions surrounding menopause are often associated with stigma, with many women feeling uncomfortable to engage in them with friends, colleagues, and healthcare professionals. Though the barriers regarding safe discussions of symptom management experienced by menopausal women are well documented, existing research offers little insight into whether these were shared by pre-menopausal women. This study aimed to explore the barriers regarding safe discussions about menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. Methods: This qualitative study was conducted over a 2-month period (March 2022 - April 2022) under the auspices of Imperial College Business School, London, UK. Snowball sampling was used to recruit both menopausal (age 45-70) and pre-menopausal participants (age <45), and sampling continued until data saturation was achieved. 16 semi-structured online interviews were conducted, and transcripts were thematically analyzed following Braun and Clarke’s six-step methodology. Results: A total of 7 higher themes regarding safe discussion of menopausal symptom management were identified by both pre-menopausal and menopausal women, including: “ineffective coping mechanisms”, “perceived onus to self-endure”, “lack of workplace support”, “poor knowledge of management approaches”, “poor healthcare infrastructure”, “poor support from friends and family”, “lack of knowledge and interest from a young age”. Conclusion: Identifying the barriers regarding safe discussion helped to highlight which areas require most significant intervention. Alongside tackling the barriers, menopausal women face, ultimately, there is a pertinent need to and address the lack of insight into menopause from a younger age and to encourage earlier discussions so as to not propagate the cycle of stigma.

Keywords: menopause, stigma, safe discussions, symptom management

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Authors: Karish Thavabalan, Aman Sutaria, Alistair Ovenell, Annabelle Parkhouse, Numan Baydemir, Theodore Lally

Abstract:

Background: Open discussions surrounding menopause are often associated with stigma, with many women feeling uncomfortable engaging in them with friends, colleagues, and healthcare professionals. Though the barriers regarding safe discussions of symptom management experienced by menopausal women are well documented, existing research offers little insight into whether these were shared by pre-menopausal women. This study aimed to explore the barriers regarding safe discussions about menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. Methods: This qualitative study was conducted over a 2-month period (March 2022 - April 2022) under the auspices of Imperial College Business School, London, UK. Snowball sampling was used to recruit both menopausal (age 45-70) and pre-menopausal participants (age <45) and sampling continued until data saturation was achieved. Sixteen semi-structured online interviews were conducted, and transcripts were thematically analyzed following Braun and Clarke’s six-step methodology. Results: A total of 7 higher themes regarding safe discussion of menopausal symptom management were identified by both pre-menopausal and menopausal women, including: “ineffective coping mechanisms,” “perceived onus to self-endure,” “lack of workplace support,” “poor knowledge of management approaches,” “poor healthcare infrastructure,” “poor support from friends and family,” “lack of knowledge and interest from a young age.” Conclusion: Identifying the barriers regarding safe discussion helped to highlight which areas require the most significant intervention. Alongside tackling the barriers, menopausal women face, ultimately, there is a pertinent need to address the lack of insight into menopause from a younger age and to encourage earlier discussions so as to not propagate the cycle of stigma.

Keywords: menopause, safe discussion, symptom management, stigma

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Authors: Aman Ullah Khan, Muhammad Younus, Aqil Ijaz, Muti-Ur-Rehman Khan, Sayyed Aun Muhammad, Asif Idrees, Sanan Raza, Amar Nasir

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Dengue fever and malaria are important vector-borne diseases of public health significance affecting millions of people around the globe. Dengue fever is caused by Dengue virus while malaria is caused by plasmodium protozoan. Generally, the consequences of Malaria are less severe compared to dengue fever. This study was designed to differentiate dengue fever and malaria on the basis of clinical and laboratory findings and to compare the changes in both diseases having different causative agents transmitted by the common vector. A total of 200 patients of dengue viral infection (120 males, 80 females) were included in this prospective descriptive study. The blood samples of the individuals were first screened for malaria by blood smear examination and then the negative samples were tested by anti-dengue IgM strip. The strip positive cases were further screened by IgM capture ELISA and their complete blood count including hemoglobin estimation (Hb), total and differential leukocyte counts (TLC and DLC), erythrocyte sedimentation rate (ESR) and platelet counts were performed. On the basis of the severity of signs and symptoms, dengue virus infected patients were subdivided into dengue fever (DF) and dengue hemorrhagic fever (DHF) comprising 70 and 100 confirmed patients, respectively. On the other hand, 30 patients were found infected with Malaria while overall 120 patients showed thrombocytopenia. The patients of DHF were found to have more leucopenia, raised hemoglobin level and thrombocytopenia < 50,000/µl compared to the patients belonging to DF and malaria. On the basis of the outcomes of the study, it was concluded that patients affected by DF were at a lower risk of undergoing haematological disturbance than suffering from DHF. While, the patients infected by Malaria were found to have no significant change in their blood components.

Keywords: dengue fever, blood, serum, malaria, ELISA

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Authors: Akhtar Aman, Abida Raza, Shumaila Bashir, Javaid Irfan, Andreas G. Schätzlein, Ijeoma F Uchegbeu

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Development of efficient delivery system for hydrophobic drugs remains a major concern in chemotherapy. The objective of the current study was to develop polymeric drug-delivery system for etoposide from amphiphilic derivatives of glycol chitosan, capable to improve the pharmacokinetics and to reduce the adverse effects of etoposide due to various organic solvents used in commercial formulations for solubilisation of etoposide. As a promising carrier, amphiphilic derivatives of glycol chitosan were synthesized by chemical grafting of palmitic acid N-hydroxy succinimide and quaternisation to glycol chitosan backbone. To this end a 7.9 kDa glycol chitosan was modified by palmitoylation and quaternisation into 13 kDa. Nano sized micelles prepared from this amphiphilic polymer had the capability to encapsulate up to 3 mg/ml etoposide. The pharmacokinetic results indicated that GCPQ based etoposide formulation transformed the biodistribution pattern. AUC 0.5-24 hr showed statistically significant difference in ETP-GCPQ vs. commercial preparation in liver (25 vs 70, p<0.001), spleen (27 vs. 36, P<0.05), lungs (42 vs. 136, p<0.001), kidneys (25 vs. 30, p<0.05) and brain (19 vs. 9,p<0.001). Using the hydrophobic fluorescent dye Nile red, we showed that micelles efficiently delivered their payload to MCF7 and A2780 cancer cells in-vitro and to A431 xenograft tumor in-vivo, suggesting these systems could deliver hydrophobic anti- cancer drugs such as etoposide to tumors. The pharmacokinetic results indicated that the GCPQ micelles transformed the biodistribution pattern and increased etoposide concentration in the brain significantly compared to free drug after intravenous administration. GCPQ based formulations not only reduced side effects associated with current available formulations but also increased their transport through the biological barriers, thus making it a good delivery system.

Keywords: glycol chitosan, Nile red, micelles, etoposide, A431 xenografts

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Authors: Teja Sai Puligadda

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Satellite images in detail can serve an important role in the geographic study. Quantitative and qualitative information provided by the satellite and remote sensing images minimizes the complexity of work and time. Data/images are captured at regular intervals by satellite remote sensing systems, and the amount of data collected is often enormous, and it expands rapidly as technology develops. Interpreting remote sensing images, geographic data mining, and researching distinct vegetation types such as agricultural and forests are all part of satellite image categorization. One of the biggest challenge data scientists faces while classifying satellite images is finding the best suitable classification algorithms based on the available that could able to classify images with utmost accuracy. In order to categorize satellite images, which is difficult due to the sheer volume of data, many academics are turning to deep learning machine algorithms. As, the CNN algorithm gives high accuracy in image recognition problems and automatically detects the important features without any human supervision and the ANN algorithm stores information on the entire network (Abhishek Gupta., 2020), these two deep learning algorithms have been used for satellite image classification. This project focuses on remote sensing through Deep Neural Networks i.e., ANN and CNN with Deep Sat (SAT-4) Airborne dataset for classifying images. Thus, in this project of classifying satellite images, the algorithms ANN and CNN are implemented, evaluated & compared and the performance is analyzed through evaluation metrics such as Accuracy and Loss. Additionally, the Neural Network algorithm which gives the lowest bias and lowest variance in solving multi-class satellite image classification is analyzed.

Keywords: artificial neural network, convolutional neural network, remote sensing, accuracy, loss

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Authors: Sunita Kumari, Abhishek Thakur

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Focusing on female migrant domestic workers from Jharkhand, this study looks at their life before and after migration in Mumbai city. Girls coming from the marginalised communities migrate through different means and organizations like placement agencies, religious institutions such as church, with the help of group of friends or relatives and so forth. Most of them due to low educational attainment get into the unorganized sector jobs such as domestic work. In this backdrop, the paper tries to understand the socio-economic condition of tribal migrant women engaged as the domestic workers in the M ward of Mumbai city. The paper tries to investigate the early life of migrant women domestic workers, explores the reasons behind their migration and also examines the changes in their status after their engagement as domestic workers. The paper argues that though the economic and political reasons are quite explicit but the role of social institutions is also significant in the process of migration of women domestic workers. The study was qualitative in nature where fifteen in depth interviews were conducted and to develop a profound understanding one Focus Group Discussion was carried out at M ward of Mumbai Municipal Corporation (Chembur East). To substantiate the findings, the secondary data was taken from the available resources. The findings of the study shows that situation in the family, lack of education, non availability of better economic opportunities and other factors forced them to migrate. The factors such as income in form of cash rather than in kind, attraction towards the Mumbai city and so on was also the reason behind migration. Finally, this study gives the ample opportunity to look at the lives of the women who are the part of the unorganised sector of our country. It further unbolts exploration in terms of social security legislation at the national level.

Keywords: paid domestic work, women, migration, Mumbai city

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Authors: Iahtasham Khan, Vania Lucia De Assis Santana, Marcilia Maria Alves De Souza, Mabel Hanna Vance Harrop, Fernando Leandro Dos Santos, Cecília Maria Souza Leão E. Silva, Pedro Paulo Silveira, Marcelo Brasil, Marcus Vinícius, Hélio Cordeiro Manso Filho, Muhammad Younus, Aman Ullah Khan

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Glanders ranks high on clinical lists in some regions of Brazil as a cause of respiratory and lymphatic disease in equids. Glanders is caused by Burkolderia mallei (B. mallei) Gram-negative bacterium. B. mallei was first biological agent used in World War I in 20th century. The complement fixation test (CFT) is a serodiagnostic tool prescribed by the World Organization for Animal Health (OIE)for the diagnosis of glanders in the international trade of equids. The aim of the present study was to monitor the serological responses in equines naturally infected with B. mallei using the CFT. A total of 574 equids were tested with CFT, 30 days apart in a total of 12 samplings. One hundred thirty-four sera tested negative in all samplings; 192 sera tested positive in one sampling and 125 sera tested positive in two or more samplings. Remaining 123 samples showed uncertain results. Thus, CFT results can vary over a period of time. These variations could be the consequence of the effects of the natural immune response in each animal. The findings of the present study demonstrate difficulties regarding the simultaneous implementation of CFT and test and slaughter policies to eradicate glanders. Another constraint to control this disease is the presence of carrier/transitory CFT-negative animals, which are a potential source of disease in glanders-free areas. Serodiagnostic tests of higher sensitivity and specificity like immunobloat should be implemented to achieve success in the eradication of glanders.

Keywords: glanders, equids, horses, immunological, mules

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Authors: Rashida Rahmat Zohra, Afsheen Aman, Shah Ali Ul Qader

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Commercially important biopolymer, dextran, is enzymatically degraded into lower molecular weight fractions of vast industrial potential. Various organisms are associated with dextranase production, among which fungal, yeast and bacterial origins are used for commercial production. Dextranases are used to remove contaminating dextran in sugar processing industry and also used in oral care products for efficient removal of dental plaque. Among the hydrolytic products of dextran, isomaltooligosaccharides have prebiotic effect in humans and reduces the cariogenic effect of sucrose in oral cavity. Dextran derivatives produced by hydrolysis of high molecular polymer are also conjugated with other chemical and metallic compounds for usage in pharmaceutical, fine chemical industry, cosmetics, and food industry. Owing to the vast application of dextran and dextranases, current study focused on purification and analysis of kinetic parameters of dextranase from a newly isolated strain of Bacillus licheniformis KIBGE-IB25. Dextranase was purified up to 35.75 folds with specific activity of 1405 U/mg and molecular weight of 158 kDa. Analysis of kinetic parameters revealed that dextranase performs optimum cleavage of low molecular weight dextran (5000 Da, 0.5%) at 35ºC in 15 min at pH 4.5 with a Km and Vmax of 0.3738 mg/ml and 182.0 µmol/min, respectively. Thermal stability profiling of dextranase showed that it retained 80% activity up to 6 hours at 30-35ºC and remains 90% active at pH 4.5. In short, the dextranase reported here performs rapid cleavage of substrate at mild operational conditions which makes it an ideal candidate for dextran removal in sugar processing industry and for commercial production of low molecular weight oligosaccharides.

Keywords: Bacillus licheniformis, dextranase, gel permeation chromatograpy, enzyme purification, enzyme kinetics

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Authors: Sidra Pervez, Afsheen Aman, Shah Ali Ul Qader

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The importance of attaining an optimum performance of an enzyme is often a question of devising an effective method for its immobilization. Cross-linked enzyme aggregate (CLEAs) is a new approach for immobilization of enzymes using carrier free strategy. This method is exquisitely simple (involving precipitation of the enzyme from aqueous buffer followed by cross-linking of the resulting physical aggregates of enzyme molecules) and amenable to rapid optimization. Among many industrial enzymes, amyloglucosidase is an important amylolytic enzyme that hydrolyzes alpha (1→4) and alpha (1→6) glycosidic bonds in starch molecule and produce glucose as a sole end product. Glucose liberated by amyloglucosidase can be used for the production of ethanol and glucose syrups. Besides this amyloglucosidase can be widely used in various food and pharmaceuticals industries. For production of amyloglucosidase on commercial scale, filamentous fungi of genera Aspergillus are mostly used because they secrete large amount of enzymes extracellularly. The current investigation was based on isolation and identification of filamentous fungi from genus Aspergillus for the production of amyloglucosidase in submerged fermentation and optimization of cultivation parameters for starch saccharification. Natural isolates were identified as Aspergillus niger KIBGE-IB36, Aspergillus fumigatus KIBGE-IB33, Aspergillus flavus KIBGE-IB34 and Aspergillus terreus KIBGE-IB35 on taxonomical basis and 18S rDNA analysis and their sequence were submitted to GenBank. Among them, Aspergillus fumigatus KIBGE-IB33 was selected on the basis of maximum enzyme production. After optimization of fermentation conditions enzyme was immobilized on CLEA. Different parameters were optimized for maximum immobilization of amyloglucosidase. Data of enzyme stability (thermal and Storage) and reusability suggested the applicability of immobilized amyloglucosidase for continuous saccharification of starch in industrial processes.

Keywords: aspergillus, immobilization, industrial processes, starch saccharification

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Authors: Abhishek Kumar Gupta

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Atomistic Molecular Dynamics (MD) Simulations have been performed to study the effect of monovalent salt i.e. NaCl concentration (Cs) and chain degree of neutralization (f) on the structure and dynamics of anionic poly(methacrylic acid) (PMA) in dilute aqueous solutions. In the present study, the attention is to unveil the conformational structure, hydrogen-bonding, local polyion-counterion structure, h-bond dynamics, chain dynamics and thermodynamic enthalpy of solvation of a-PMA in dilute aqueous solutions as a function of salt concentration, Cs and f. The results have revealed that at low salt concentration, the conformational radius of gyration (Rg) increases and then decreases reaching a maximum in agreement with the reported light scattering experimental results. The Rg at f = 1 shows a continual decrease and acquire a plateau value at higher salt concentration in agreement with results obtained by light scattering experiments. The radial distribution functions between PMA, salt and water atoms has been computed with respect to atom and centre-of-mass to understand the intermolecular structure in detail. The results pertaining to PMA chain conformations and hydrogen bond autocorrelation function showcasing the h-bond dynamics will be presented. The results pertaining to chain dynamics will be presented. The results pertaining to counterion condensation on the PMA chain shows greater condensation of Na+ ions on to the carboxylate ions with increase in salt concentration. Moreover, the solvation enthalpy of the system as a function of salt concentration will be presented.

Keywords: conformations, molecular dynamics simulations, NaCl concentration, radial distribution functions

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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Authors: Valeria Aman

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The presented study examines the impact of international mobility on knowledge production among mobile scientists and within the sending and receiving research groups. Scientists are relevant to the dynamics of knowledge production because scientific knowledge is mainly characterized by embeddedness and tacitness. International mobility enables the dissemination of scientific knowledge to other places and encourages new combinations of knowledge. It can also increase the interdisciplinarity of research by forming synergetic combinations of knowledge. Particularly innovative ideas can have their roots in related research domains and are sometimes transferred only through the physical mobility of scientists. Diversity among scientists with respect to their knowledge base can act as an engine for the creation of knowledge. It is therefore relevant to study how knowledge acquired through international mobility affects the knowledge production process. In certain research domains, international mobility may be essential to contextualize knowledge and to gain access to knowledge located at distant places. The knowledge production process contingent on the type of international mobility and the epistemic culture of a research field is examined. The production of scientific knowledge is a multi-faceted process, the output of which is mainly published in scholarly journals. Therefore, the study builds upon publication and citation data covered in Elsevier’s Scopus database for the period of 1996 to 2015. To analyse these data, bibliometric and social network analysis techniques are used. A basic analysis of scientific output using publication data, citation data and data on co-authored publications is combined with a content map analysis. Abstracts of publications indicate whether a research stay abroad makes an original contribution methodologically, theoretically or empirically. Moreover, co-citations are analysed to map linkages among scientists and emerging research domains. Finally, acknowledgements are studied that can function as channels of formal and informal communication between the actors involved in the process of knowledge production. The results provide better understanding of how the international mobility of scientists contributes to the production of knowledge, by contrasting the knowledge production dynamics of internationally mobile scientists with those being nationally mobile or immobile. Findings also allow indicating whether international mobility accelerates the production of knowledge and the emergence of new research fields.

Keywords: bibliometrics, diversity, interdisciplinarity, international mobility, knowledge production

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Authors: Abhishek Pandey

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Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis and rheumatoid arthritis. Acetaminophen is used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression and top spray granulation technique. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimized formulation, nine different formulations were generated among them batch F7, F8, F9 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of dissolution study. Furtherly, directly compressible granules of both drugs were prepared by using top spray granulation technique in fluidized bed processor equipment and compressed .In order to obtain best product process optimization was carried out by performing four trials in which various parameters like inlet air temperature, spray rate, peristaltic pump rpm, % LOD, properties of granules, blending time and hardness were optimized. Batch T3 coined as optimized batch on the basis physical & chemical evaluation. Finally formulations prepared by both techniques were compared.

Keywords: direct compression, top spray granulation, process optimization, blending time

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Authors: Abhishek Soti, Aditya Sharma, Akhilendra Bhushan Gupta

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Fouled reverse osmosis membranes are primarily characterized by Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectrometer (EDS) for a detailed investigation of foulants; however, this has severe limitations on several accounts. Apart from inaccuracy in spectral properties and inevitable interferences and interactions between sample and instrument, misidentification of elements due to overlapping peaks is a significant drawback of EDS. This paper discusses this limitation by analyzing fouled polyamide RO membranes derived from community RO plants of Rajasthan treating brackish water via a combination of results obtained from EDS and Raman spectroscopy and cross corroborating with ICP-MS analysis of water samples prepared by dissolving the deposited salts. The anomalous behavior of different morphic forms of CaCO₃ in aqueous suspensions tends to introduce false reporting of the presence of certain heavy metals and rare earth metals in the scales of the fouled RO membranes used for treating brackish groundwater when analyzed using the commonly adopted techniques like SEM-EDS or Raman spectrometry. Peaks of CaCO₃ reflected in EDS spectra of the membrane were found to be misinterpreted as Scandium due to the automatic assignment of elements by the software. Similarly, the morphic forms merged with the dominant peak of CaCO₃ might be reflected as a single peak of Molybdenum in the Raman spectrum. A subsequent ICP-MS analysis of the deposited salts showed that both Sc and Mo were below detectable levels. It is always essential to cross-confirm the results through a destructive analysis method to avoid such interferences. It is further recommended to study different morphic forms of CaCO₃ scales, as they exhibit anomalous properties like reverse solubility with temperature and hence altered precipitation tendencies, for an accurate description of the composition of scales, which is vital for the smooth functioning of RO systems.

Keywords: reverse osmosis, foulant analysis, groundwater, EDS, artifacts

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Authors: Salima Kerai, Muhammad Islam, Uzma Khan, Nargis Asad, Junaid Razzak, Omrana Pasha

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Background: Pre-hospital care providers are exposed to various kinds of stressors. Their daily exposure to diverse critical and traumatic incidents can lead to stress reactions like Post-Traumatic Stress Disorder (PTSD). Consequences of PTSD in terms of work loss can be catastrophic because of its compound effect on families, which affect them economically, socially and emotionally. Therefore, it is critical to assess the association between PTSD and Work performance in Emergency Medical Service (EMS) if exist any. Methods: This prospective observational study was carried out at AMAN EMS in Karachi, Pakistan. EMS personnel were screened for potential PTSD using impact of event scale-revised (IES-R). Work performance was assessed on basis of five variables; number of late arrivals to work, number of days absent, number of days sick, adherence to protocol and patient satisfaction survey over the period of 3 months. In order to model outcomes like number of late arrivals to work, days absent and days late; negative binomial regression was used whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Results: Out of 536 EMS personnel, 525 were found to be eligible, of them 518 consented. However data on 507 were included because 7 left the job during study period. The mean score of PTSD was found to be 24.0 ± 12.2. However, weak and insignificant association was found between PTSD and work performance measures: number of late arrivals (RRadj 0.99; 95% CI 0.98-1.00), days absent (RRadj 0.98; 95% CI 0.96-0.99), days sick (Rradj 0.99; 95% CI 0.98 to 1.00), adherence to protocol (ORadj 1.01: 95% CI 0.99 to 1.04) and patient satisfaction (0.001% score; 95% CI -0.03% to 0.03%). Conclusion: No association was found between PTSD and Work performance in the selected EMS population in Karachi Pakistan. Further studies are needed to explore the phenomenon of resiliency in these populations. Moreover, qualitative work is required to explore perceptions and feelings like willingness to go to work, readiness to carry out job responsibilities.

Keywords: trauma, emergency medical service, stress, pakistan

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Authors: A. Aman, S. M. Tang, F. H. Alharrassy

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Omanisation was established to increase job opportunities for national employment in Sultanate of Oman. With half of the population below 25 years of age, the sultanate is striving to diversify the economy fast enough to meet the burgeoning number of jobseekers annually. On the other hand, training personnel to be competent oil and gas operators and technicians is a difficult task in a complex reservoir structures in Oman using highly advanced and sophisticated extracting processes. Coupled towards Omanisation which encourages nationals into the oil and gas sector so as to create sustainable employment for the local population, the challenge to churn out competent manpower became a daunting task. Immersive technologies provided the impetus to create a new digital media sector which provided job opportunities as well as the learning contents to enhance the competency-based training for the oil and gas sector in the Sultanate. This lead to a win-win-win collaboration amongst the government represented by the Information Technology Authority (ITA), private sector specialised company (represented by ASM Technologies), jobseekers and oil and gas organisations. This is also one of the first private-public partnership model in the Information Communication Technology (ICT) sector in Oman. A pilot phase was conducted for 8 months to develop four virtual applications for training in equipment and process engineering; oil rig familiarisation, Health Safety Environment (HSE) application, turbine application and the mechanical vapour compressor (MVC) water recycling plant in order to enhance the competency level of the trainees. The immersive applications were installed in operational settings which enabled new employees to practice and understand various processes and procedures regarding enhanced oil recovery. Existing employees used the application to review the working principles in order to carry out troubleshooting scenarios. Concurrently, these applications were also developed by local Omani resources within the country. This created job opportunities for job-seekers as well the establishment of a digital media sector. The purpose of this paper is to discuss how immersive technologies can enhance operational competencies, create job and establish a digital media sector in the Sultanate of Oman.

Keywords: immersive, virtual reality, operations training, Omanisation

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Authors: Abhishek N. Srivastava, Rahul Singh, Sumedha Chakma

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The rapid urbanization in the developing countries is generating an enormous amount of waste leading to the creation of unregulated landfill sites at various places at its disposal. The liquid waste, known as leachate, produced from these landfills sites is severely affecting the surrounding water quality. The water quality in the proximity areas of the landfill is found affected by various physico-chemical parameters of leachate such as pH, alkalinity, total hardness, conductivity, chloride, total dissolved solids (TDS), total suspended solids (TSS), sulphate, nitrate, phosphate, fluoride, sodium and potassium, biological parameters such as biochemical oxygen demand (BOD), chemical oxygen demand (COD), Faecal coliform, and heavy metals such as cadmium (Cd), lead (Pb), iron (Fe), mercury (Hg), arsenic (As), cobalt (Co), manganese (Mn), zinc (Zn), copper (Cu), chromium (Cr), nickel (Ni). However, all these parameters are distributive in leachate that produced according to the nature of waste being dumped at various landfill sites, therefore, it becomes very difficult to predict the main responsible parameter of leachate for water quality contamination. The present study is endeavour the comparative analysis of the physical, chemical and biological parameters of various landfills in India viz. Okhla landfill, Ghazipur landfill, Bhalswa ladfill in NCR Delhi, Deonar landfill in Mumbai, Dhapa landfill in Kolkata and Kodungayaiyur landfill, Perungudi landfill in Chennai. The statistical analysis of the parameters was carried out using the Statistical Packages for the Social Sciences (SPSS) and LandSim 2.5 model to simulate the long term effect of various parameters on different time scale. Further, the uncertainties characterization of various input parameters has also been analysed using fuzzy alpha cut (FAC) technique to check the sensitivity of various water quality parameters at the proximity of numerous landfill sites. Finally, the study would help to suggest the best method for the prevention of pollution migration from the landfill sites on priority basis.

Keywords: landfill leachate, water quality, LandSim, fuzzy alpha cut

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Authors: Niyti, Aman Deep, Rajesh Kharab, Sahila Chopra, Raj. K. Gupta

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Relatively long-lived transactinide elements (i.e., elements with atomic number Z≥104) up to Z = 108 have been produced in nuclear reactions between low Z projectiles (C to Al) and actinide targets. Cross sections have been observed to decrease steeply with increasing Z. Recently, production cross sections of several picobarns have been reported for comparatively neutron-rich nuclides of 112 through 118 produced via hot fusion reactions with 48Ca and actinide targets. Some of those heavy nuclides are reported to have lifetimes on the order of seconds or longer. The relatively high cross sections in these hot fusion reactions are not fully understood and this has renewed interest in systematic studies of heavy-ion reactions with actinide targets. The main aim of this work is to understand the dynamics hot fusion reactions 18O+ 248Cm and 22Ne+244Pu (carried out at RIKEN and TASCA respectively) using the collective clusterization technique, carried out by undertaking the decay of the compound nucleus 266Rf∗ into 4n, 5n and 6n neutron evaporation channels. Here we extend our earlier study of the excitation functions (EFs) of 266Rf∗, formed in fusion reaction 18O+248Cm, based on Dynamical Cluster-decay Model (DCM) using the pocket formula for nuclear proximity potential, to the use of other nuclear interaction potentials derived from Skyrme energy density formalism (SEDF) based on semiclassical extended Thomas Fermi (ETF) approach and also study entrance channel effects by considering the synthesis of 266Rf* in 22Ne+244Pu reaction. The Skyrme forces used are the old force SIII, and new forces GSkI and KDE0(v1). Here, the EFs for the production of 260Rf, 261Rf and 262Rf isotope via 6n, 5n and 4n decay channel from the 266Rf∗ compound nucleus are studied at Elab = 88.2 to 125 MeV, including quadrupole deformations β2i and ‘hot-optimum’ orientations θi. The calculations are made within the DCM where the neck-length ∆R is the only parameter representing the relative separation distance between two fragments and/or clusters Ai which assimilates the neck formation effects.

Keywords: entrance channel effects, fusion reactions, skyrme force, superheavy nucleus

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Authors: Sanjeev Prasher, T. Sai Vijay, Chandan Parsad, Abhishek Banerjee, Sahakari Nikhil Krishna, Subham Chatterjee

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With rapid rise in internet retailing, the industry is set for a major implosion. Due to the little difference among competitors, companies find it difficult to segment and target the right shoppers. The objective of the study is to segment Indian online shoppers on the basis of the factors – website characteristics and shopping values. Together, these cover extrinsic and intrinsic factors that affect shoppers as they visit web retailers. Data were collected using questionnaire from 319 Indian online shoppers, and factor analysis was used to confirm the factors influencing the shoppers in their selection of web portals. Thereafter, cluster analysis was applied, and different segments of shoppers were identified. The relationship between income groups and online shoppers’ segments was tracked using correspondence analysis. Significant findings from the study include that web entertainment and informativeness together contribute more than fifty percent of the total influence on the web shoppers. Contrary to general perception that shoppers seek utilitarian leverages, the present study highlights the preference for fun, excitement, and entertainment during browsing of the website. Four segments namely Information Seekers, Utility Seekers, Value Seekers and Core Shoppers were identified and profiled. Value seekers emerged to be the most dominant segment with two-fifth of the respondents falling for hedonic as well as utilitarian shopping values. With overlap among the segments, utilitarian shopping value garnered prominence with more than fifty-eight percent of the total respondents. Moreover, a strong relation has been established between the income levels and the segments of Indian online shoppers. Web shoppers show different motives from being utility seekers to information seekers, core shoppers and finally value seekers as income levels increase. Companies can strategically use this information for target marketing and align their web portals accordingly. This study can further be used to develop models revolving around satisfaction, trust and customer loyalty.

Keywords: online shopping, shopping values, effectiveness of information content, web informativeness, web entertainment, information seekers, utility seekers, value seekers, core shoppers

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Authors: Richa Shri, Varinder Singh, Kundan Singh Bora, Abhishek Bhanot, Rahul Kumar, Amit Kumar, Ravinder Kaur

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The term ‘neuroprotection’ means preserving/salvaging function and structure of neurons. Neuroprotection is an adjunctive treatment option for neurodegenerative disorders. Oxidative stress is considered a major culprit in neurodegenerative disorders; hence, management strategies include use of antioxidants. Our search for a neuroprotective agent began with Allium cepa L. or onions, (family Amaryllidaceae) - a potent antioxidant. We have investigated the neuroprotective potential of onions in experimental models of ischemic stroke, diabetic neuropathy, neuropathic pain, and dementia. In pre and post-ischemic stroke model, the methanol extract of outer scales of onion bulbs (MEOS) prevented memory loss and motor in-coordination; reduced oxidative stress and cerebral infarct size. This also prevented and ameliorated diabetic neuropathy in mice. The MEOS was fractionated to yield a flavonoid rich fraction (FRF) that successfully reversed ischemia-reperfusion induced neuronal damage, thereby demonstrating that the flavonoids are responsible for the activity. The FRF effectively ameliorated chronic constriction induced neuropathic pain in rats. The FRF was subjected to bioactivity-guided fractionated. It was seen that FRF is more effective as compared to the isolated components probably due to synergism among the constituents (i.e., quercetin and quercetin glucosides) in the FRF. The outer scales of onion bulbs have great potential for prevention as well as for treatment of neuronal disorders. Red onions, with higher amounts of flavonoids as compared to the white onions, produced more significant neuroprotection. Thus, the standardized FRF from the waste material of a commonly used vegetable, especially the red variety, may be developed as a valuable neuroprotective agent.

Keywords: Allium cepa, antioxidant activity, flavonoid rich fraction, neuroprotection

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Authors: Yohannes Kelifa, Gomathi Periasamy, Aman Karim

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Introduction: Diabetes mellitus has become a major public health and economical problem across the globe. Modern antidiabetic drugs have a number of limitations, and scientific investigation of traditional herbal remedies used for diabetes may provide novel leads for the development of new antidiabetic drugs that can be used as alternative or complementary to available antidiabetic allopathic medications. Though Myrica salicifolia Hochst. ex A. Rich. is used for the management of diabetes in Ethiopian traditional medicine, there was no previous scientific evidence about its antidiabetic effect to the authors’ knowledge. This study was undertaken to evaluate the antidiabetic activity the root extracts of Myrica salicifolia in streptozotocin (STZ)-induced diabetic mice. Methods: Experimental diabetes was induced by intraperitoneal administration of STZ (150 mg/kg) in male mice. Diabetic mice were treated with oral doses of M. salicifolia root extracts at 200, 400 and 600 mg/kg, and its fractions (chloroform, ethyl acetate, n-butanol and aqueous) at a dose of 400 mg/kg daily for 15 days. Fasting blood glucose level (BGL) was measured at 0, 5th,10th, and 15th day. The free radical scavenging activity of the crude extract was determined using in vitro by DPPH assay. The statistical significance was assessed by one-way ANOVA, followed by Tukey’s multiple comparison tests. Results were considered significant when p < 0.05. Results: Daily administration of the M. salicifolia 80% methanol root extracts (at three different doses (200, 400 and 600 mg/kg) significantly (p < 0.05, p < 0.01 and p < 0.001) reduced fasting BGL compared with diabetic control. The aqueous and butanol fractions at a dose of 400 mg/kg resulted in maximum reduction of fasting BGL by 42.39%, and 52.13%, respectively at the 15th day in STZ-induced diabetic mice. Free radical scavenging activity of the 80% methanol extract of M. salicifolia was comparable to ascorbic acid. The IC50 values of the crude extract and ascorbic acid (a reference compound) were found to be 4.54 μg/ml and 4.39 μg/ml, respectively. Conclusion: These findings demonstrated that the methanolic extracts of M. salicifolia root and its fractions (n-butanol and aqueous) exhibit a significant antihyperglycemic activity in STZ-induced diabetic mice. Furthermore, the result of the present study indicates that M. salicifolia root extract is a potential source of natural antioxidants.

Keywords: antidiabetic, diabetes mellitus, DPPH, mice, Myrica salicifolia, streptozotocin

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Authors: Abhishek Oswal

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Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

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