Search results for: Bikram Puri
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 32

Search results for: Bikram Puri

32 Recognition and Enforcement of Foreign Arbitral Awards in Nepal

Authors: Biraj Puri, Bikram Puri

Abstract:

Arbitration is one of the prompt and efficient methods of alternative dispute resolution, especially of a commercial nature, by a neutral arbitrator outside the formal court structure. Due to the globalization of trade, privatization, and global investment, recognition and enforcement of foreign arbitral awards attract prime concern. Arbitral awards are generally based on arguments and evidence presented by disputing parties. The foreign investor wants to secure the investment by appropriate legal measures and an amicable way of dispute settlement if it arises. Now, arbitration as a mechanism of commercial dispute settlement has gained international recognition. It can take place in any State, in any language and with arbitrators of any nationality. There are various international institutions to conduct arbitral proceedings and render awards. Once an arbitral award is delivered, it can be enforced as a court judgment. However, it is really challenging to execute foreign arbitral awards in Nepal. Any party willing to execute an award made in a foreign country in Nepal should submit an application to the High Court along with essential documents prescribed by domestic law (The Arbitration Act 1999). Arbitrarily and public policy are also the requirements regarding the recognition and enforcement of foreign arbitral awards in Nepal. Nepal is a signatory State to the New York Convention on Recognition and Enforcement of Foreign Arbitral Awards, 1958. It is crucial to acknowledge that Nepal has liberalized its economy as well as opened the door for a liberal and market-oriented economy through the Constitution of Nepal, 2015. Nepal is trying to expand business from local to global level. Commercial trade is expanding day by day. So in this context, acceptance of arbitration as an alternative means to solve commercial disputes is a matter of prime importance. India ratified the New York Convention, and also being a neighborhood country of Nepal, in practice, does not enforce arbitral awards provided by Nepal in the name of reservation. India has published a gazette notice in which it lists the countries in which the award will be recognized in India, but it does not include Nepal. As the largest trade partner of Nepal, India should rethink this in order to make trade smooth.

Keywords: commercial arbitration, foreign arbitral awards, recognition and enforcement of foreign arbitral awards, requirements

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31 Graduate School of Biotechnology and Bioengineering/ YuanZe University

Authors: Sankhanil Das, Arunava Dasgupta, Keya Mitra

Abstract:

This paper investigates the relationship between natural ecological systems and modern urban morphology. Over years, ecological conditions represented by natural resources such as natural landforms, systems of water, urban geography and land covers have been a significant driving factor of how settlements have formed, expanded and functioned. These have played a pivotal role in formation of the community character and the cultural identity of the urban spaces, and have steered cultural behavior within these settings. Such cultural behaviors have been instrumental in transforming mere spaces to places with meaning and symbolism. The natural process of city formation is principally founded upon the idea of balance and harmony, mostly in a subconscious manner. Reimaging such processes of natural evolution, this paper systematically builds a development model that generates a balance between environment and development, with specific focus on the Urban-Rural fringe areas in the Temple Town of Puri, in Eastern India. Puri represents a unique cross section of ecological landscape, cultural practices and religious symbolism with a very rich history and a vibrant heritage. While the city centre gets more and more crowded by tourists and pilgrims to accommodate related businesses, the original residents of Puri relocate to move towards the urban peripheral areas for better living conditions, gradually converting agricultural lands into non agricultural uses. This rapid spread into the rural hinterland is devoid of any connection with the rich cultural identity of Puri. These past four decades of ‘development’ has been at the cost of 810 Hectares of ecological Lake systems in the region. Invaluable ecological resources at urban rural edges are often viewed as hindrances to development and conceptualized as taking away from the image of the city. This paper attempts to understand the language of development over years on existing natural resources through topo-analysis and proposes a sustainable approach of development using different planning tools, with ecological resources as the pivotal factor of development.

Keywords: livability, sustainable development, urbanization, urban-rural edge

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30 Study and Analysis of the Factors Affecting Road Safety Using Decision Tree Algorithms

Authors: Naina Mahajan, Bikram Pal Kaur

Abstract:

The purpose of traffic accident analysis is to find the possible causes of an accident. Road accidents cannot be totally prevented but by suitable traffic engineering and management the accident rate can be reduced to a certain extent. This paper discusses the classification techniques C4.5 and ID3 using the WEKA Data mining tool. These techniques use on the NH (National highway) dataset. With the C4.5 and ID3 technique it gives best results and high accuracy with less computation time and error rate.

Keywords: C4.5, ID3, NH(National highway), WEKA data mining tool

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29 Sustainability: Effect of Earthquake in Micro Hydro Sector, a Case Study of Micro Hydro Projects in Northern Part of Kavre District, Nepal

Authors: Ram Bikram Thapa, Ganesh Lama

Abstract:

The Micro Hydro is one of the successful technology in Rural Nepal. Kavre is one of the pioneer district of sustainability of Micro Hydro Projects. A total of 30 Micro Hydro projects have been constructed with producing 700 KW of energy in northern side of the Kavre district. This study shows that 67% of projects have been affected by devastating earthquake in April and May, 2015. Out of them 23% are completely damaged. Most of the structures are failure like Penstock 71%, forebay 21%, powerhouse 7% have been completely damaged and 91% Canal & 44% Intake structures have been partially damaged by the earthquake. This paper empathizes that the engineering design is the vital component for sustainability of Micro Hydro Projects. This paper recommended that technicians should be considered the safety factor of earthquake and provision of disaster recovery fund during design of Micro Hydro Projects.

Keywords: micro hydro, earthquake, structural failure, sustainability

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28 Processing and Characterization of (Pb0.55Ca0.45) (Fe0.5Nb0.5)O3 and (Pb0.45Ca0.55) (Fe0.5Nb0.5) O3 Dielectric Ceramics

Authors: Shalini Bahel, Maalti Puri, Sukhleen Bindra Narang

Abstract:

Ceramic samples of (Pb0.55Ca0.45) (Fe0.5Nb0.5)O3 and (Pb0.45Ca0.55)(Fe0.5Nb0.5)O3 were synthesized by columbite precursor method and characterized for structural and dielectric properties. Both the synthesized samples have perovskite structure with tetragonal symmetry. The variations in relative permittivity and loss tangent were measured as a function of frequency at room temperature. Both the relative permittivity and loss tangent decreased with increase in frequency. A reasonably high value of relative permittivity of 63.46, loss tangent of 0.0067 at 15 MHz and temperature coefficient of relative permittivity of -82 ppm/˚C was obtained for (Pb0.45Ca0.55) (Fe0.5Nb0.5) O3.

Keywords: loss tangent, perovskite, relative permittivity, X-ray diffraction

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27 Fuzzy Multi-Component DEA with Shared and Undesirable Fuzzy Resources

Authors: Jolly Puri, Shiv Prasad Yadav

Abstract:

Multi-component data envelopment analysis (MC-DEA) is a popular technique for measuring aggregate performance of the decision making units (DMUs) along with their components. However, the conventional MC-DEA is limited to crisp input and output data which may not always be available in exact form. In real life problems, data may be imprecise or fuzzy. Therefore, in this paper, we propose (i) a fuzzy MC-DEA (FMC-DEA) model in which shared and undesirable fuzzy resources are incorporated, (ii) the proposed FMC-DEA model is transformed into a pair of crisp models using cut approach, (iii) fuzzy aggregate performance of a DMU and fuzzy efficiencies of components are defined to be fuzzy numbers, and (iv) a numerical example is illustrated to validate the proposed approach.

Keywords: multi-component DEA, fuzzy multi-component DEA, fuzzy resources, decision making units (DMUs)

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26 Ecological and Economical Indicators of Successful Community Based Forest Management: A Case of Lowland Community Forestry in Nepal

Authors: Bikram Jung Kunwar, Pralhad Kunwor

Abstract:

The Community-Based Forest Management (CBFM) approach is often glorified as the best forest management alternatives in the developing countries. However, how the approach has been understood by the local user households, who implement it is remained unanswered for many planners, policy makers, and sometimes researcher as well. The study attempts to assess the understanding of ecology and economics of CBFM in Nepal, where community forest program has been implemented since the 1970s. In order to understand the impacts of the program, eight criteria and sixteen indicators for ecological conservation and similarly same number of criteria and indicators for socio-economic impacts of the program were designed and compared between before and after the program implementation. The community forestry program has positive effects in forest ecology conservation and at the same time rural livelihood improvement of local people. The study revealed that collective understanding of forest ecology and economics leads the CBFM approach towards the sustainability of the program in a win-win situation. The recommendations of the study are expected to be useful to natural resource managers, planners, and policy makers.

Keywords: community, forest management, ecology, economics, Nepal

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25 Improving Overall Equipment Effectiveness of CNC-VMC by Implementing Kobetsu Kaizen

Authors: Nakul Agrawal, Y. M. Puri

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TPM methodology is a proven approach to increase Overall Equipment Effectiveness (OEE) of machine. OEE is an established method to monitor and improve the effectiveness of manufacturing process. OEE is a product of equipment availability, performance efficiency and quality performance of manufacturing operations. The paper presents a project work for improving OEE of CNC-VMC in a manufacturing industry with the help of TPM tools Kaizen and Autonomous Maintenance. The aim of paper is to enhance OEE by minimizing the breakdown and re-work, increase availability, performance and quality. The calculated OEE of bottle necking machines for 4 months is lower of 53.3%. Root Cause Analysis RCA tools like fishbone diagram, Pareto chart are used for determining the reasons behind low OEE. While Tool like Why-Why analysis is use for determining the basis reasons for low OEE. Tools like Kaizen and Autonomous Maintenance are effectively implemented on CNC-VMC which eliminate the causes of breakdown and prevent from reoccurring. The result obtains from approach shows that OEE of CNC-VMC improved from 53.3% to 73.7% which saves an average sum of Rs.3, 19,000.

Keywords: OEE, TPM, Kaizen, CNC-VMC, why-why analysis, RCA

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24 Geometry of the Bandaging Procedure and Its Application while Wrapping Bandages for Treatment of Leg Ulcers

Authors: Monica Puri Sikka, Subrato Ghosh Arunangshu Mukhopadhyay

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Appropriate compression bandaging is important for compression therapeutic medical diseases. The high compression approach employed for treating venous leg ulcers should be used correctly so that sufficient (but not excessive) pressure is applied. Bandages used to treat venous disease by compression should achieve and sustain effective levels and gradients of pressure and minimise the risk of pressure trauma. To maintain graduated compression on the limb the bandage needs to be applied at same tension for each layer from ankle to the knee. In this paper the geometry for various bandaging procedures is used to wrap each layer of bandage by marking the relaxed length of the bandage. The relaxed length is calculated depending on the stretch, average circumference of the limb on which it is to be applied and the bandaging technique to be used. This paper aims at developing a scientific approach while applying the bandage to reduce the inter operator variability in applying same tension on each successive layer of bandage.

Keywords: bandaging, compression, inter operator variability, graduated, relaxed length, stretch

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23 Synthesis, Biological Evaluation and Molecular Modeling Studies on Chiral Chloroquine Analogues as Antimalarial Agents

Authors: Srinivasarao Kondaparla, Utsab Debnath, Awakash Soni, Vasantha Rao Dola, Manish Sinha, Kumkum Kumkum Srivastava, Sunil K. Puri, Seturam B. Katti

Abstract:

In a focused exploration, we have designed synthesized and biologically evaluated chiral conjugated new chloroquine (CQ) analogs with substituted piperazines as antimalarial agents. In vitro as well as in vivo studies revealed that compound 7c showed potent activity [for in vitro IC₅₀= 56.98nM (3D7), 97.76nM (K1); for in vivo (up to at the dose of 12.5 mg/kg); SI = 3510] as a new lead of antimalarial agent. Other compounds 6b, 6d, 7d, 7h, 8c, 8d, 9a, and 9c are also showing moderate activity against CQ-sensitive (3D7) strain and superior activity against resistant (K1) strain of P. falciparum. Furthermore, we have carried out docking and 3D-QSAR studies of all in-house data sets (168 molecules) of chiral CQ analogs to explain the structure activity relationships (SAR). Our new findings specified the significance of H-bond interaction with the side chain of heme for biological activity. In addition, the 3D-QSAR study against 3D7 strain indicated the favorable and unfavorable sites of CQ analogs for incorporating steric, hydrophobic and electropositive groups to improve the antimalarial activity.

Keywords: piperazines, CQ-sensitive strain-3D7, in-vitro and in-vivo assay, docking, 3D-QSAR

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22 Anxiety and Depression in Chronic Headache Patients: Major Concern for Community Mental Health

Authors: Neeti Sharma, Harshika Pareek, Prerna Puri, Manika Mohan

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The present study is aimed at studying the significant relationship between anxiety and depression in chronic headache patients. Chronic Headache patients coming to the Neurology Unit-1 Outpatient Department of the Sawai Mansingh Hospital (SMS) Jaipur, Rajasthan, were included in this study. The sample consisted of 100 patients (N=100). Initially patients were examined by a physician and then they were assessed for Anxiety and Depression using the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale for Depression. The relevant information was recorded on a Performa designed for this purpose comprising of socio-demographic variables like age, gender and triggering factors. The correlation-coefficient indicated a significant positive relationship between the anxiety and depression in chronic headache patients. These findings implicate high prevalence of anxiety and depression in the general population, and also indicate an association between headache and psychological disorders. Many evidences support the anxiety-headache-depression syndrome as a distinct disorder, and the association of co-morbid psychiatric illness with headache intractability. This study highlights the importance of prospective research for studying the developmental course and consequences of headache syndromes. Also, various psychotherapies should be applied to the headache patients so as to treat them, at the onset level of anxiety and depression, with the help of medication.

Keywords: anxiety, chronic headaches, depression, HAM-A, HAM

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21 Comparing Skill, Employment, and Productivity of Industrial City Case Study: Bekasi Industrial Area and Special Economic Zone Sei Mangkei

Authors: Auliya Adzillatin Uzhma, M. Adrian Rizky, Puri Diah Santyarini

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Bekasi Industrial Area in Kab. Bekasi and SEZ (Special Economic Zone) Sei Mangkei in Kab. Simalungun are two areas whose have the same main economic activity that are manufacturing industrial. Manufacturing industry in Bekasi Industrial Area contributes more than 70% of Kab. Bekasi’s GDP, while manufacturing industry in SEZ Sei Mangkei contributes less than 20% of Kab. Simalungun’s GDP. The dependent variable in the research is labor productivity, while the independent variable is the amount of labor, the level of labor education, the length of work and salary. This research used linear regression method to find the model for represent actual condition of productivity in two industrial area, then the equalization using dummy variable on labor education level variable. The initial hypothesis (Ho) in this research is that labor productivity in Bekasi Industrial Area will be higher than the productivity of labor in SEZ Sei Mangkei. The variable that supporting the accepted hypothesis are more labor, higher education, longer work and higher salary in Bekasi Industrial Area.

Keywords: labor, industrial city, linear regression, productivity

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20 Bioremediation of Sea Food Waste in Solid State Fermentation along with Production of Bioactive Agents

Authors: Rahul Warmoota, Aditya Bhardwaj, Steffy Angural, Monika Rana, Sunena Jassal, Neena Puri, Naveen Gupta

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Seafood processing generates large volumes of waste products such as skin, heads, tails, shells, scales, backbones, etc. Pollution due to conventional methods of seafood waste disposal causes negative implications on the environment, aquatic life, and human health. Moreover, these waste products can be used for the production of high-value products which are still untapped due to inappropriate management. Paenibacillus sp. AD is known to act on chitinolytic and proteinaceous waste and was explored for its potential to degrade various types of seafood waste in solid-state fermentation. Effective degradation of seafood waste generated from a variety of sources such as fish scales, crab shells, prawn shells, and a mixture of such wastes was observed. 30 to 40 percent degradation in terms of decrease in the mass was achieved. Along with the degradation, chitinolytic and proteolytic enzymes were produced, which can have various biotechnological applications. Apart from this, value-added products such as chitin oligosaccharides and peptides of various degrees of polymerization were also produced, which can be used for various therapeutic purposes. Results indicated that Paenibacillus sp. AD can be used for the development of a process for the infield degradation of seafood waste.

Keywords: chitin, chitin-oligosaccharides, chitinase, protease, biodegradation, crab shells, prawn shells, fish scales

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19 Role of Community Based Forest Management to Address Climate Change Problem: A Case of Nepalese Community Forestry

Authors: Bikram Jung Kunwar

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Forests have central roles in climate change. The conservation of forests sequestrates the carbon from the atmosphere and also regulates the carbon cycle. However, knowingly and unknowingly the world’s forests were deforested and degraded annually at the rate of 0.18% and emitted the carbon to the atmosphere. The IPCC reports claimed that the deforestation and forest degradation accounts 1/5th of total carbon emission, which is second position after fossil fuels. Since 1.6 billion people depend on varying degree on forests for their daily livelihood, not all deforestation are undesirable. Therefore, to conserve the forests and find the livelihood opportunities for forest surrounding people is prerequisites to address the climate change problems especially in developing countries, and also a growing concern to the forestry sector researchers, planners and policy makers. The study examines the role of community based forest management in carbon mitigation and adaptation taking the examples of Nepal’s community forestry program. In the program, the government hands over a part of national forests to the local communities with sole forest management authorities. However, the government itself retained the ownership rights of forestland. Local communities organized through a local institution called Community Forest User Group (CFUG) managed the forests. They also formed an operational plan with technical prescriptions and a constitution with forest management rules and regulations. The implementation results showed that the CFUGs are not only found effective to organize the local people and construct a local institution to forest conservation and management activities, but also they are able to collect a community fund from the sale of forest products and carried out various community development activities. These development activities have decisive roles to improve the livelihood of forest surrounding people and eventually to address the climate change problems.

Keywords: climate change, community forestry, local institution, Nepal

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18 Insight into the Electrocatalytic Activities of Nitrogen-Doped Graphyne and Graphdiyne Families: A First-Principles Study

Authors: Bikram K. Das, Kalyan K. Chattopadhyay

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The advent of 2-D materials in the last decade has induced a fresh spur of growth in fuel cell technology as these materials have some highly promising traits that can be exploited to felicitate Oxygen Reduction Reaction (ORR) in an efficient way. Among the various 2-D carbon materials, graphyne (Gy) and graphdiyne (Gdy)1 with their intrinsic non-uniform charge distribution holds promises in this purpose and it is expected2 that substitutional Nitrogen (N) doping could further enhance their efficiency. In this regard, dispersive force corrected density functional theory is used to map the oxygen reduction reaction (ORR) kinetics of five different kinds of N doped graphyne and graphdiyne systems (namely αGy, βGy, γGy, RGy and 6,6,12Gy and Gdy) in alkaline medium. The best doping site for each of the Gy/ Gdy system is determined comparing the formation energies of the possible doping configurations. Similarly, the best di-oxygen (O₂) adsorption sites for the doped systems are identified by comparing the adsorption energies. O₂ adsorption on all N doped Gy/ Gdy systems is found to be energetically favorable. ORR on a catalyst surface may occur either via the Eley-Rideal (ER) or the Langmuir–Hinschelwood (LH) pathway. Systematic studies performed on the considered systems reveal that all of them favor the ER pathway. Further, depending on the nature of di-oxygen adsorption ORR can follow either associative or dissociative mechanism; the possibility of occurrence of both the mechanisms is tested thoroughly for each N doped Gy/ Gdy. For the ORR process, all the Gy/Gdy systems are observed to prefer the efficient four-electron pathway but the expected monotonically exothermic reaction pathway is found only for N doped 6,6,12Gy and RGy following the associative pathway and for N doped βGy, γGy and Gdy following the dissociative pathway. Further computation performed for these systems reveals that for N doped 6,6,12Gy, RGy, βGy, γGy and Gdy the overpotentials are 1.08 V, 0.94 V, 1.17 V, 1.21 V and 1.04 V respectively depicting N doped RGy is the most promising material, to carry out ORR in alkaline medium, among the considered ones. The stability of the ORR intermediate states with the variation of pH and electrode potentials is further explored with Pourbiax diagrams and the activities of these systems in the alkaline medium are compared with the prior reported B/N doped identical systems for ORR in an acidic medium in terms of a common descriptor.

Keywords: graphdiyne, graphyne, nitrogen-doped, ORR

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17 Tofu Flour as a Protein Sources

Authors: Dicky Eka Putra, S. P. Nadia Chairunissa, Lidia Paramita, Roza Hartati, Ice Yolanda Puri

Abstract:

Background: Soy bean and the products such as tofu, tempeh and soy milk are famous in the community. Moreover, another product is tofu flour which is not familiar in Indonesia yet and it is well known as Okara. There are massive differences of energy, protein and carbohydrate between them which is know as good for protein sources as well. Unfortunately, it is seldom used as food variety. Basically, it can be benefit in order to create many products for example cakes, snacks and some desserts. Aim: the study was in order to promote the benefit of tofu flour as school feeding of elementary school and baby porridge and also to compare the nutrient. Method: Soy pulp was filtered and steamed approximately 30 minutes. Then, it was put at a plate under sunrise or barked on the oven for 10 hours at 800C. When it have dried and milling and tofu flour is ready to be used. Result: Tofu flour could be used as substitute of flour and rice flour when people want to cook some foods. In addition, some references said that soy bean is good for a specific remedy for the proper functioning of the heart, liver, kidneys, stomach, and bowels, constipation, as a stimulant for the lungs, for eradication of poison from the system, improving the complexion by cleaning the skin of impurities, and stimulating the growth and appearance of the hair. Discussion: Comparing between soy bean, tofu and tofu flour which has difference amount of nutrients. For example energy 382 kcal, 79 kcal and 393 kcal respectively and also protein 30.2 kcal, 7.8 kcal, and 17.4 kcal. In addition, carbohydrate of soy pulp was high than soy bean and tofu (30.1 kcal). Finally, local should replace flour, rice and gelatin rice flour with tofu flour.

Keywords: tofu flour, protein, soy bean, school feeding

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16 Erythrophagocytic Role of Mast Cells in vitro and in vivo during Oxidative Stress

Authors: Priyanka Sharma, Niti Puri

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Anemia develops when blood lacks enough healthy erythrocytes. Past studies indicated that anemia, inflammatory process, and oxidative stress are interconnected. Erythrocytes are continuously exposed to reactive oxygen species (ROS) during circulation, due to normal aerobic cellular metabolism and also pathology of inflammatory diseases. Systemic mastocytosis and genetic depletion of mast cells have been shown to affect anaemia. In the present study, we attempted to reveal whether mast cells have a direct role in clearance or erythrophagocytosis of normal or oxidatively damaged erythrocytes. Murine erythrocytes were treated with tert-butyl hydroperoxidase (t-BHP), an agent that induces oxidative damage and mimics in vivo oxidative stress. Normal and oxidatively damaged erythrocytes were labeled with carboxyfluorescein succinimidyl ester (CFSE) to track erythrophagocytosis. We show, for the first time, direct erythrophagocytosis of oxidatively damaged erythrocytes in vitro by RBL-2H3 mast cells as well as in vivo by murine peritoneal mast cells. Also, activated mast cells, as may be present in inflammatory conditions, showed a significant increase in the uptake of oxidatively damaged erythrocytes than resting mast cells. This suggests the involvement of mast cells in erythrocyte clearance during oxidative stress or inflammatory disorders. Partial inhibition of phagocytosis by various inhibitors indicated that this process may be controlled by several pathways. Hence, our study provides important evidence for involvement of mast cells in severe anemia due to inflammation and oxidative stress and might be helpful to circumvent the adverse anemic disorders.

Keywords: mast cells, anemia, erythrophagocytosis, oxidatively damaged erythrocytes

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15 Folding Pathway and Thermodynamic Stability of Monomeric GroEL

Authors: Sarita Puri, Tapan K. Chaudhuri

Abstract:

Chaperonin GroEL is a tetradecameric Escherichia coli protein having identical subunits of 57 kDa. The elucidation of thermodynamic parameters related to stability for the native GroEL is not feasible as it undergoes irreversible unfolding because of its large size (800kDa) and multimeric nature. Nevertheless, it is important to determine the thermodynamic stability parameters for the highly stable GroEL protein as it helps in folding and holding of many substrate proteins during many cellular stresses. Properly folded monomers work as building-block for the formation of native tetradecameric GroEL. Spontaneous refolding behavior of monomeric GroEL makes it suitable for protein-denaturant interactions and thermodynamic stability based studies. The urea mediated unfolding is a three state process which means there is the formation of one intermediate state along with native and unfolded states. The heat mediated denaturation is a two-state process. The unfolding process is reversible as observed by the spontaneous refolding of denatured protein in both urea and head mediated refolding processes. Analysis of folding/unfolding data provides a measure of various thermodynamic stability parameters for the monomeric GroEL. The proposed mechanism of unfolding of monomeric GroEL is a three state process which involves formation of one stable intermediate having folded apical domain and unfolded equatorial, intermediate domains. Research in progress is to demonstrate the importance of specific residues in stability and oligomerization of GroEL protein. Several mutant versions of GroEL are under investigation to resolve the above mentioned issue.

Keywords: equilibrium unfolding, monomeric GroEl, spontaneous refolding, thermodynamic stability

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14 Forest Products Pricing System in Community Forestry Program: An Analysis of Its Impacts on Forest Resources Management and Livelihood Improvement of Local People

Authors: Mohan Bikram Thapa

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Despite the successful implementation of community forestry program, a number of pros and cons have been raised on Terai community forestry in the case of lowland locally called Terai region of Nepal, which climatically belongs to tropical humid and possessed high-quality forests in terms of ecology and economy. The study aims to investigate the local pricing strategy of forest products and its impacts on equitable forest benefits sharing, the collection of community fund and carrying out livelihood improvement activities. The study was carried out on six community forests revealed that local people have substantially benefited from the community forests. However, being the region is heterogeneous by socio-economic conditions and forest resources have higher economic potential, the decision of low pricing strategy made by the local people have created inequality problems while sharing the forest benefits, and poorly contributed to community fund collection and consequently carrying out limited activities of livelihood improvement. The paper argued that the decision of low pricing strategy of forest products is counterproductive to promote the equitable benefit-sharing in the areas of heterogeneous socio-economic conditions with high-value forests. The low pricing strategy has been increasing accessibility of better off households at a higher rate than poor, as such households always have the higher affording capacity. It is also defective to increase the community fund and carry out activities of livelihood improvement effectively. The study concluded that unilateral decentralized forest policy and decision-making autonomy to the local people seems questionable unless their decision-making capacities are enriched sufficiently. Therefore, it is recommended that empowerments of decision-making capacity of local people and their respective institutions together with policy and program formulation are prerequisite for efficient and equitable community forest management and its long-term sustainability.

Keywords: benefit sharing, community forest, livelihood, pricing mechanism, Nepal

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13 Flexural Behavior of Eco-Friendly Prefabricated Low Cost Bamboo Reinforced Wall Panels

Authors: Vishal Puri, Pradipta Chakrabortty, Swapan Majumdar

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Precast concrete construction is the most commonly used technique for a rapid construction. This technique is very frequently used in the developed countries. Different guidelines required to utilize the potential of prefabricated construction are still not available in the developing countries. This causes over dependence on in-situ construction procedure which further affects the quality, scheduling, and duration of construction. Also with the ever increasing costs of building materials and their negative impact on the environment it has become imperative to look out for alternate construction materials which are cheap and sustainable. Bamboo and fly ash are alternate construction materials having great potential in the construction industry. Thus there is a great need to develop prefabricated components by utilizing the potential of these materials. Bamboo reinforced beams, bamboo reinforced columns and bamboo arches as researched previously have shown great prospects for prefabricated construction industry. But, many other prefabricated components still need to be studied and widely tested before their utilization in the prefabricated construction industry. In the present study, authors have showcased prefabricated bamboo reinforced wall panel for the prefabricated construction industry. It presents a detailed methodology for the development of such prefabricated panels. It also presents the flexural behavior of such panels as tested under flexural loads following ASTM guidelines. It was observed that these wall panels are much flexible and do not show brittle failure as observed in traditional brick walls. It was observed that prefabricated walls are about 42% cheaper as compared to conventional brick walls. It was also observed that prefabricated walls are considerably lighter in weight and are environment friendly. It was thus concluded that this type of wall panels are an excellent alternative for partition brick walls.

Keywords: bamboo, prefabricated walls, reinforced structure, sustainable infrastructure

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12 Estimation of Source Parameters and Moment Tensor Solution through Waveform Modeling of 2013 Kishtwar Earthquake

Authors: Shveta Puri, Shiv Jyoti Pandey, G. M. Bhat, Neha Raina

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TheJammu and Kashmir region of the Northwest Himalaya had witnessed many devastating earthquakes in the recent past and has remained unexplored for any kind of seismic investigations except scanty records of the earthquakes that occurred in this region in the past. In this study, we have used local seismic data of year 2013 that was recorded by the network of Broadband Seismographs in J&K. During this period, our seismic stations recorded about 207 earthquakes including two moderate events of Mw 5.7 on 1st May, 2013 and Mw 5.1 of 2nd August, 2013.We analyzed the events of Mw 3-4.6 and the main events only (for minimizing the error) for source parameters, b value and sense of movement through waveform modeling for understanding seismotectonic and seismic hazard of the region. It has been observed that most of the events are bounded between 32.9° N – 33.3° N latitude and 75.4° E – 76.1° E longitudes, Moment Magnitude (Mw) ranges from Mw 3 to 5.7, Source radius (r), from 0.21 to 3.5 km, stress drop, from 1.90 bars to 71.1 bars and Corner frequency, from 0.39 – 6.06 Hz. The b-value for this region was found to be 0.83±0 from these events which are lower than the normal value (b=1), indicating the area is under high stress. The travel time inversion and waveform inversion method suggest focal depth up to 10 km probably above the detachment depth of the Himalayan region. Moment tensor solution of the (Mw 5.1, 02:32:47 UTC) main event of 2ndAugust suggested that the source fault is striking at 295° with dip of 33° and rake value of 85°. It was found that these events form intense clustering of small to moderate events within a narrow zone between Panjal Thrust and Kishtwar Window. Moment tensor solution of the main events and their aftershocks indicating thrust type of movement is occurring in this region.

Keywords: b-value, moment tensor, seismotectonics, source parameters

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11 Intervening into the World of a Cyber-Bully

Authors: Aanshika Puri, Sakshi Mehrotra

Abstract:

Technology has always been a double edged sword. The constant rut of updating oneself to a better and newer version is the new norm. ‘Being Online’ is the latest addition to one’s everyday routine. Availability of various social online platforms being served on a platter topped with easy and cheap access to the internet makes it simple and doable for people of all social backgrounds. Interestingly, in India, a recent development is the line of demarcation between people from varied backgrounds, doing the vanishing act. One finds everybody on at least one, if not more, social platforms in a desire to stay connected. For instance, this ranges from sending a ‘WhatsApp’ message to a vegetable vendor for ordering your daily needs to vendors and small entrepreneurs. Even a rickshaw puller now has access to a mobile phone, an internet connection and apps/ platforms to stay connected. Recent observations show the extent to which everyone is hooked on to their mobile phones/ tabs/ laptops/ etc. Young mothers use them to distract their children and keep them busy while they finish the task at hand. Exposure to this part of the technology at such a tender age requires responsible and careful handling. Talking of adolescents, their self- image depends on their online social image to a large extent. There is a desire to be liked and accepted by the peer group at all times. Cyber-bullying is a by-product of the 24/7 availability of these resources. There is enough research-based evidence to prove the psychosocial and emotional impact on the development and well-being of the victim. The present paper attempts to understand the dynamics of cyber bullying vis-à-vis the developmental and mental health issues faced by the bully.

Keywords: Developmental Psychology, Empathy & Resilience Based Interventions, Mental Well-Being of Cyber Bully, Positive Psychology

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10 Honey Intoxication: A Unique Cause of Sudden Cardiac Collapse

Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar

Abstract:

Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.

Keywords: rhobdodendron, honey, grayanotoxin, bradycardia

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9 Determination of Crustal Structure and Moho Depth within the Jammu and Kashmir Region, Northwest Himalaya through Receiver Function

Authors: Shiv Jyoti Pandey, Shveta Puri, G. M. Bhat, Neha Raina

Abstract:

The Jammu and Kashmir (J&K) region of Northwest Himalaya has a long history of earthquake activity which falls within Seismic Zones IV and V. To know the crustal structure beneath this region, we utilized teleseismic receiver function method. This paper presents the results of the analyses of the teleseismic earthquake waves recorded by 10 seismic observatories installed in the vicinity of major thrusts and faults. The teleseismic waves at epicentral distance between 30o and 90o with moment magnitudes greater than or equal to 5.5 that contains large amount of information about the crust and upper mantle structure directly beneath a receiver has been used. The receiver function (RF) technique has been widely applied to investigate crustal structures using P-to-S converted (Ps) phases from velocity discontinuities. The arrival time of the Ps, PpPs and PpSs+ PsPs converted and reverberated phases from the Moho can be combined to constrain the mean crustal thickness and Vp/Vs ratio. Over 500 receiver functions from 10 broadband stations located in the Jammu & Kashmir region of Northwest Himalaya were analyzed. With the help of H-K stacking method, we determined the crustal thickness (H) and average crustal Vp/Vs ratio (K) in this region. We also used Neighbourhood algorithm technique to verify our results. The receiver function results for these stations show that the crustal thickness under Jammu & Kashmir ranges from 45.0 to 53.6 km with an average value of 50.01 km. The Vp/Vs ratio varies from 1.63 to 1.99 with an average value of 1.784 which corresponds to an average Poisson’s ratio of 0.266 with a range from 0.198 to 0.331. High Poisson’s ratios under some stations may be related to partial melting in the crust near the uppermost mantle. The crustal structure model developed from this study can be used to refine the velocity model used in the precise epicenter location in the region, thereby increasing the knowledge to understand current seismicity in the region.

Keywords: H-K stacking, Poisson’s ratios, receiver function, teleseismic

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8 Hydrological Analysis for Urban Water Management

Authors: Ranjit Kumar Sahu, Ramakar Jha

Abstract:

Urban Water Management is the practice of managing freshwater, waste water, and storm water as components of a basin-wide management plan. It builds on existing water supply and sanitation considerations within an urban settlement by incorporating urban water management within the scope of the entire river basin. The pervasive problems generated by urban development have prompted, in the present work, to study the spatial extent of urbanization in Golden Triangle of Odisha connecting the cities Bhubaneswar (20.2700° N, 85.8400° E), Puri (19.8106° N, 85.8314° E) and Konark (19.9000° N, 86.1200° E)., and patterns of periodic changes in urban development (systematic/random) in order to develop future plans for (i) urbanization promotion areas, and (ii) urbanization control areas. Remote Sensing, using USGS (U.S. Geological Survey) Landsat8 maps, supervised classification of the Urban Sprawl has been done for during 1980 - 2014, specifically after 2000. This Work presents the following: (i) Time series analysis of Hydrological data (ground water and rainfall), (ii) Application of SWMM (Storm Water Management Model) and other soft computing techniques for Urban Water Management, and (iii) Uncertainty analysis of model parameters (Urban Sprawl and correlation analysis). The outcome of the study shows drastic growth results in urbanization and depletion of ground water levels in the area that has been discussed briefly. Other relative outcomes like declining trend of rainfall and rise of sand mining in local vicinity has been also discussed. Research on this kind of work will (i) improve water supply and consumption efficiency (ii) Upgrade drinking water quality and waste water treatment (iii) Increase economic efficiency of services to sustain operations and investments for water, waste water, and storm water management, and (iv) engage communities to reflect their needs and knowledge for water management.

Keywords: Storm Water Management Model (SWMM), uncertainty analysis, urban sprawl, land use change

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7 Clostridium thermocellum DBT-IOC-C19, A Potential CBP Isolate for Ethanol Production

Authors: Nisha Singh, Munish Puri, Collin Barrow, Deepak Tuli, Anshu S. Mathur

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The biological conversion of lignocellulosic biomass to ethanol is a promising strategy to solve the present global crisis of exhausting fossil fuels. The existing bioethanol production technologies have cost constraints due to the involvement of mandate pretreatment and extensive enzyme production steps. A unique process configuration known as consolidated bioprocessing (CBP) is believed to be a potential cost-effective process due to its efficient integration of enzyme production, saccharification, and fermentation into one step. Due to several favorable reasons like single step conversion, no need of adding exogenous enzymes and facilitated product recovery, CBP has gained the attention of researchers worldwide. However, there are several technical and economic barriers which need to be overcome for making consolidated bioprocessing a commercially viable process. Finding a natural candidate CBP organism is critically important and thermophilic anaerobes are preferred microorganisms. The thermophilic anaerobes that can represent CBP mainly belong to genus Clostridium, Caldicellulosiruptor, Thermoanaerobacter, Thermoanaero bacterium, and Geobacillus etc. Amongst them, Clostridium thermocellum has received increased attention as a high utility CBP candidate due to its highest growth rate on crystalline cellulose, the presence of highly efficient cellulosome system and ability to produce ethanol directly from cellulose. Recently with the availability of genetic and molecular tools aiding the metabolic engineering of Clostridium thermocellum have further facilitated the viability of commercial CBP process. With this view, we have specifically screened cellulolytic and xylanolytic thermophilic anaerobic ethanol producing bacteria, from unexplored hot spring/s in India. One of the isolates is a potential CBP organism identified as a new strain of Clostridium thermocellum. This strain has shown superior avicel and xylan degradation under unoptimized conditions compared to reported wild type strains of Clostridium thermocellum and produced more than 50 mM ethanol in 72 hours from 1 % avicel at 60°C. Besides, this strain shows good ethanol tolerance and growth on both hexose and pentose sugars. Hence, with further optimization this new strain could be developed as a potential CBP microbe.

Keywords: Clostridium thermocellum, consolidated bioprocessing, ethanol, thermophilic anaerobes

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6 Molecular Characterization of Arginine Sensing Response in Unravelling Host-Pathogen Interactions in Leishmania

Authors: Evanka Madan, Madhu Puri, Dan Zilberstein, Rohini Muthuswami, Rentala Madhubala

Abstract:

The extensive interaction between the host and pathogen metabolic networks decidedly shapes the outcome of infection. Utilization of arginine by the host and pathogen is critical for determining the outcome of pathogenic infection. Infections with L. donovani, an intracellular parasite, will lead to an extensive competition of arginine between the host and the parasite donovani infection. One of the major amino acid (AA) sensing signaling pathways in mammalian cells are the mammalian target of rapamycin complex I (mTORC1) pathway. mTORC1, as a sensor of nutrient, controls numerous metabolic pathways. Arginine is critical for mTORC1 activation. SLC38A9 is the arginine sensor for the mTORC1, being activated during arginine sufficiency. L. donovani transport arginine via a high-affinity transporter (LdAAP3) that is rapidly up-regulated by arginine deficiency response (ADR) in intracellular amastigotes. This study, to author’s best knowledge, investigates the interaction between two arginine sensing systems that act in the same compartment, the lysosome. One is important for macrophage defense, and the other is essential for pathogen virulence. We hypothesize that the latter modulates lysosome arginine to prevent host defense response. The work presented here identifies an upstream regulatory role of LdAAP3 in regulating the expression of SLC38A9-mTORC1 pathway, and consequently, their function in L. donovani infected THP-1 cells cultured in 0.1 mM and 1.5 mM arginine. It was found that in physiological levels of arginine (0.1 mM), infecting THP-1 with Leishmania leads to increased levels of SLC38A9 and mTORC1 via an increase in the expression of RagA. However, the reversal was observed with LdAAP3 mutants, reflecting the positive regulatory role of LdAAP3 on the host SLC38A9. At the molecular level, upon infection, mTORC1 and RagA were found to be activated at the surface of phagolysosomes which was found to form a complex with phagolysosomal localized SLC38A9. To reveal the relevance of SLC38A9 under physiological levels of arginine, endogenous SLC38A9 was depleted and a substantial reduction in the expression of host mTORC1, its downstream active substrate, p-P70S6K1 and parasite LdAAP3, was observed, thereby showing that silencing SLC38A9 suppresses ADR. In brief, to author’s best knowledge, these results reveal an upstream regulatory role of LdAAP3 in manipulating SLC38A9 arginine sensing in host macrophages. Our study indicates that intra-macrophage survival of L. donovani depends on the availability and transport of extracellular arginine. An understanding of the sensing pathway of both parasite and host will open a new perspective on the molecular mechanism of host-parasite interaction and consequently, as a treatment for Leishmaniasis.

Keywords: arginine sensing, LdAAP3, L. donovani, mTORC1, SLC38A9, THP-1

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5 Nutritional Status of Children in a Rural Food Environment, Haryana: A Paradox for the Policy Action

Authors: Neha Gupta, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora

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The concurrent increasing prevalence of underweight and overweight/obesity among children with changing lifestyle and the rapid transitioning society has necessitated the need for a unifying/multi-level approach to understand the determinants of the problem. The present community-based cross-sectional research study was conducted to assess the associations between lifestyle behavior and food environment of the child at household, neighborhood, and school with the BMI of children (6-12 year old) (n=612) residing in three rural clusters of Palwal district, Haryana. The study used innovative and robust methods for assessing the lifestyle and various components of food environment in the study. The three rural clusters selected for the study were located at three different locations according to their access to highways in the SOMAARTH surveillance site. These clusters were significantly different from each other in terms of their socio-demographic and socio-economic profile, living conditions, environmental hygiene, health seeking behavior and retail density. Despite of being different, the quality of living conditions and environmental hygiene was poor across three clusters. The children had higher intakes of dietary energy and sugars; one-fifth share of the energy being derived from unhealthy foods, engagement in high levels of physical activity and significantly different food environment at home, neighborhood and school level. However, despite having a high energy intake, 22.5% of the recruited children were thin/severe thin, and 3% were overweight/obese as per their BMI-for-age categories. The analysis was done using multi-variate logistic regression at three-tier hierarchy including individual, household and community level. The factors significantly explained the variability in governing the risk of getting thin/severe thin among children in rural area (p-value: 0.0001; Adjusted R2: 0.156) included age (>10years) (OR: 2.1; 95% CI: 1.0-4.4), the interaction between minority category and poor SES of the household (OR: 4.4; 95% CI: 1.6-12.1), availability of sweets (OR: 0.9; 95% CI: 0.8-0.99) and cereals (OR: 0.9; 95% CI: 0.8-1.0) in the household and poor street condition (proxy indicator of the hygiene and cleanliness in the neighborhood) (OR: 0.3; 95% CI: 0.1-1.1). The homogeneity of other factors at neighborhood and school level food environment diluted the heterogeneity in the lifestyles and home environment of the recruited children and their households. However, it is evident that when various individual factors interplay at multiple levels amplifies the risk of undernutrition in a rural community. Conclusion: These rural areas in Haryana are undergoing developmental, economic and societal transition. In correspondence, no improvements in the nutritional status of children have happened. Easy access to the unhealthy foods has become a paradox.

Keywords: transition, food environment, lifestyle, undernutrition, overnutrition

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4 Lived Experiences and Perspectives of Adult Survivors of Incest-Related Childhood Sexual Abuse

Authors: Varsha Puri, Sharon Hudson, Ian Kim

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Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to the shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified, and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding of this population’s experiences, perspectives, and long-term struggles. To date, research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, much of the data is from 10-40 years prior. Methods. In June 2018, an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences, and outcomes data. Results: We obtained 1310 completed surveys. Demographics of all ages, racial backgrounds, financial backgrounds, and genders were obtained; the majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than one year in 84% of respondents, and 39% reported ten or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had ten or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were the highest reported sexual abusers at 60%, and mothers were reported at 17%. Only 16% reported that at least one of their perpetrators was prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time, they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), and employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), and improved laws protecting IRCSA survivors (63%). Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors have major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders. Pediatricians should recognize that perpetrators can be pediatric patients, women, and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.

Keywords: incest, childhood sexual abuse, incest-related childhood sexual abuse, incest survivor

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3 Implementation of a Web-Based Clinical Outcomes Monitoring and Reporting Platform across the Fortis Network

Authors: Narottam Puri, Bishnu Panigrahi, Narayan Pendse

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Background: Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from the patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving the quality of patient care. In 2012, International Consortium Of HealthCare Outcome Measurement (ICHOM) was founded which has defined global Standard Sets for measuring the outcome of various treatments. Method: Monitoring of Clinical Outcomes was identified as a pillar of Fortis’ core value of Patient Centricity. The project was started as an in-house developed Clinical Outcomes Reporting Portal by the Fortis Medical IT team. Standard sets of Outcome measurement developed by ICHOM were used. A pilot was run at Fortis Escorts Heart Institute from Aug’13 – Dec’13.Starting Jan’14, it was implemented across 11 hospitals of the group. The scope was hospital-wide and major clinical specialties: Cardiac Sciences, Orthopedics & Joint Replacement were covered. The internally developed portal had its limitations of report generation and also capturing of Patient related outcomes was restricted. A year later, the company provisioned for an ICHOM Certified Software product which could provide a platform for data capturing and reporting to ensure compliance with all ICHOM requirements. Post a year of the launch of the software; Fortis Healthcare has become the 1st Healthcare Provider in Asia to publish Clinical Outcomes data for the Coronary Artery Disease Standard Set comprising of Coronary Artery Bypass Graft and Percutaneous Coronary Interventions) in the public domain. (Jan 2016). Results: This project has helped in firmly establishing a culture of monitoring and reporting Clinical Outcomes across Fortis Hospitals. Given the diverse nature of the healthcare delivery model at Fortis Network, which comprises of hospitals of varying size and specialty-mix and practically covering the entire span of the country, standardization of data collection and reporting methodology is a huge achievement in itself. 95% case reporting was achieved with more than 90% data completion at the end of Phase 1 (March 2016). Post implementation the group now has one year of data from its own hospitals. This has helped identify the gaps and plan towards ways to bridge them and also establish internal benchmarks for continual improvement. Besides the value created for the group includes: 1. Entire Fortis community has been sensitized on the importance of Clinical Outcomes monitoring for patient centric care. Initial skepticism and cynicism has been countered by effective stakeholder engagement and automation of processes. 2. Measuring quality is the first step in improving quality. Data analysis has helped compare clinical results with best-in-class hospitals and identify improvement opportunities. 3. Clinical fraternity is extremely pleased to be part of this initiative and has taken ownership of the project. Conclusion: Fortis Healthcare is the pioneer in the monitoring of Clinical Outcomes. Implementation of ICHOM standards has helped Fortis Clinical Excellence Program in improving patient engagement and strengthening its commitment to its core value of Patient Centricity. Validation and certification of the Clinical Outcomes data by an ICHOM Certified Supplier adds confidence to its claim of being leaders in this space.

Keywords: clinical outcomes, healthcare delivery, patient centricity, ICHOM

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