Search results for: D. M. Reddy Prasad
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 339

Search results for: D. M. Reddy Prasad

99 A Study on Pattern of Acute Poisoning in Patients Admitted to Emergency Wards in a Tertiary Care Hospital

Authors: Sathvika Reddy, Devi Revathi

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Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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98 Analysis of Compressive and Tensile Response of Pumpkin Flesh, Peel and Unpeeled Tissues Using Experimental and FEA

Authors: Maryam Shirmohammadi, Prasad K. D. V. Yarlagadda, YuanTong Gu

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The mechanical damage on the agricultural crop during and after harvesting can create high volume of damage on tissue. Uniaxial compression and tensile loading were performed on flesh and peel samples of pumpkin. To investigate the structural changes on the tissue, Scanning Electron Microscopy (SEM) was used to capture the cellular structure change before and after loading on tissue for tensile, compression and indentation tests. To obtain required mechanical properties of tissue for the finite element analysis (FEA) model, laser measurement sensors were used to record the lateral displacement of tissue under the compression loading. Uniaxial force versus deformation data were recorded using Universal Testing Machine for both tensile and compression tests. The experimental Results were employed to develop a material model with failure criteria. The results obtained by the simulation were compared with those obtained by experiments. Note that although modelling food materials’ behaviour is not a new concept however, majority of previous studies focused on elastic behaviour and damages under linear limit, this study, however, has developed FEA models for tensile and compressive loading of pumpkin flesh and peel samples using, as the first study, both elastic and elasto-plastic material types. In addition, pumpkin peel and flesh tissues were considered as two different materials with different properties under mechanical loadings. The tensile and compression loadings were used to develop the material model for a composite structure for FEA model of mechanical peeling of pumpkin as a tough skinned vegetable.

Keywords: compressive and tensile response, finite element analysis, poisson’s ratio, elastic modulus, elastic and plastic response, rupture and bio-yielding

Procedia PDF Downloads 302
97 Achieving Appropriate Use of Antibiotics through Pharmacists’ Intervention at Practice Point: An Indian Study Report

Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta

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Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.

Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling

Procedia PDF Downloads 150
96 Effect of Fiber Inclusion on the Geotechnical Parameters of Clayey Soil Subjected to Freeze-Thaw Cycles

Authors: Arun Prasad, P. B. Ramudu, Deep Shikha, Deep Jyoti Singh

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A number of studies have been conducted recently to investigate the influence of randomly oriented fibers on some engineering properties of cohesive soils.Freezing and thawing of soil affects the strength, durability and permeability of soil adversely. Experiments were carried out in order to investigate the effect of inclusion of randomly distributed polypropylene fibers on the strength, hydraulic conductivity and durability of local soil (CL) subjected to freeze–thaw cycles. For evaluating the change in strength of soil, a series of unconfined compression tests as well as tri-axial tests were carried out on reinforced and unreinforced soil samples. All the samples were subjected to seven cycles of freezing and thawing. Freezing was carried out at a temperature of - 15 to -18 °C; and thawing was carried out by keeping the samples at room temperature. The reinforcement of soil samples was done by mixing with polypropylene fibers, 12 mm long and with an aspect ratio of 240. The content of fibers was varied from 0.25 to 1% by dry weight of soil. The maximum strength of soil was found in samples having a fiber content of 0.75% for all the samples that were prepared at optimum moisture content (OMC), and if the OMC was increased (+2% OMC) or decreased (-2% OMC), the maximum strength observed at 0.5% fiber inclusion. The effect of fiber inclusion and freeze–thaw on the hydraulic conductivity was studied increased from around 25 times to 300 times that of the unreinforced soil, without subjected to any freeze-thaw cycles. For studying the increased durability of soil, mass loss after each freeze-thaw cycle was calculated and it was found that samples reinforced with polypropylene fibers show 50-60% less loss in weight than that of the unreinforced soil.

Keywords: fiber reinforcement, freezingand thawing, hydraulic conductivity, unconfined compressive strength

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95 Genetic Assessment of The Managed Gharial Population In The Girwa River, India

Authors: Surya Prasad Sharma, Suyash Katdare, Syed Ainul Hussain

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Human-induced factors contributed to the population decline of crocodylians in India which became evident by the mid-20th century when authorities forewarned the extinction risk for the crocodile and proposed regulation in the crocodile trade. The proposed action led to the enactment of national and international wildlife regulations to prohibit the trade-in of crocodile skins and parts. Subsequently, conservation translocation programs were initiated to restore the species in the wild through a 'head-start' approach. In India, the crocodile conservation program, which began in the early 1970s, has been one of India's longest-running conservation initiatives. The gharial (Gavialis gangeticus) population has benefitted, and the gharial number increased rapidly owing to these efforts. The immediate risk of extinction was averted as the gharial has recovered due to decades-long cumulative conservation efforts, the consideration of the genetic for monitoring the recovery of the recovered populations is still lacking. Hence, we assessed the genetic diversity of the Girwa gharial population in India using six polymorphic nuclear microsatellites loci and mitochondrial control region. The number of alleles per loci ranged between 2 to 5, and the allelic richness (Ar) was 2.67 ± 0.49, and the observed (Ho) and expected (He) heterozygosities were 0.42 ± 0.08 and 0.42 ± 0.09, respectively. The M-ratio yielded a value of (0.41 ± 0.16) lower than critical M, suggesting a genetic bottleneck in the Girwa population. We observed more mitochondrial control region haplotypes in the Girwa population than previously reported in the largest gharial population in the Chambal River. Overall, our study indicates that genetic diversity remains low despite the recovery in the Girwa population. Hence, we recommend a range-wide genetic assessment of gharial populations using high-throughput techniques to identify the source population and plan future translocation programs.

Keywords: conservation translocation, recovery, crocodile, bottleneck

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94 Measurement of Radon Exhalation Rate, Natural Radioactivity, and Radiation Hazard Assessment in Soil Samples from the Surrounding Area of Kasimpur Thermal Power Plant Kasimpur (U. P.), India

Authors: Anil Sharma, Ajay Kumar Mahur, R. G. Sonkawade, A. C. Sharma, R. Prasad

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In coal fired thermal power stations, large amount of fly ash is produced after burning of coal. Fly ash is spread and distributed in the surrounding area by air and may be deposited on the soil of the region surrounding the power plant. Coal contains increased levels of these radionuclides and fly ash may increase the radioactivity in the soil around the power plant. Radon atoms entering into the pore space from the mineral grain are transported by diffusion and advection through this space until they in turn decay or are released into the atmosphere. In the present study, Soil samples were collected from the region around a Kasimpur Thermal Power Plant, Kasimpur, Aligarh (U.P.). Radon activity, radon surface exhalation and mass exhalation rates were measured using “sealed can technique” using LR 115-type II nuclear track detectors. Radon activities vary from 92.9 to 556.8 Bq m-3 with mean value of 279.8 Bq m-3. Surface exhalation rates (EX) in these samples are found to vary from 33.4 to 200.2 mBq m-2 h-1 with an average value of 100.5 mBq m-2 h-1 whereas, Mass exhalation rates (EM) vary from 1.2 to 7.7 mBq kg-1 h-1 with an average value of 3.8 mBq kg-1 h-1. Activity concentrations of radionuclides were measured in these samples by using a low level NaI (Tl) based gamma ray spectrometer. Activity concentrations of 226Ra 232Th and 40K vary from 12 to 49 Bq kg-1, 24 to 49 Bq kg-1 and 135 to 546 Bq kg-1 with overall mean values of 30.3 Bq kg-1, 38.5 Bq kg-1 and 317.8 Bq kg-1, respectively. Radium equivalent activity has been found to vary from 80.0 to 143.7 Bq kg-1 with an average value of 109.7 Bq kg-1. Absorbed dose rate varies from 36.1 to 66.4 nGy h-1 with an average value of 50.4 nGy h-1 and corresponding outdoor annual effective dose varies from 0.044 to 0.081 mSv with an average value of 0.061 mSv. Values of external and internal hazard index Hex, Hin in this study vary from 0.21 to 0.38 and 0.27 to 0.50 with an average value of 0.29 and 0.37, Respectively. The results will be discussed in light of various factors.

Keywords: natural radioactivity, radium equivalent activity, absorbed dose rate, gamma ray spectroscopy

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93 Genetic Association and Functional Significance of Matrix Metalloproteinase-14 Promoter Variants rs1004030 and rs1003349 in Gallbladder Cancer Pathogenesis

Authors: J. Vinay , Kusumbati Besra, Niharika Pattnaik, Shivaram Prasad Singh, Manjusha Dixit

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Gallbladder cancer (GBC) is rare but highly malignant cancer; its prevalence is more in certain geographical regions and ethnic groups, which include the Northern and Eastern states of India. Previous studies in India have reported genetic predisposition as one of the risk factors in GBC pathogenesis. Although the matrix metalloproteinase-14 (MMP14) is a well-known modulator of the tumor microenvironment and tumorigenesis and TCGA data also suggests its upregulation yet, its role in the genetic predisposition for GBC is completely unknown. We elucidated the role of MMP14 promoter variants as genetic risk factors and their implications in expression modulation. We screened MMP14 promoter variants association with GBC using Sanger’s sequencing in approximately 300 GBC and 300 control subjects and 26 GBC tissue samples of Indian ethnicity. The immunohistochemistry was used to check the MMP14 protein expression in GBC tissue samples. The role of promoter variants on expression levels was elucidated using a luciferase reporter assay. The variants rs1004030 (p-value = 0.0001) and rs1003349 (p-value = 0.0008) were significantly associated with gallbladder cancer. The luciferase assay in two different cell lines, HEK-293 (p = 0.0006) and TGBC1TKB (p = 0.0036) showed a significant increase in relative luciferase activity in the presence of risk alleles for both the single nucleotide polymorphisms (SNPs). Similarly, genotype-phenotype correlation in patients samples confirmed that the presence of risk alleles at rs1004030 and rs1003349 increased MMP14 expression. Overall, this study unravels the genetic association of MMP14 promoter variants with gallbladder cancer, which may contribute to pathogenesis by increasing its expression.

Keywords: gallbladder cancer, matrix metalloproteinase-14, single nucleotide polymorphism, case control study, genetic association study

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92 Computational Fluid Dynamics Modeling of Physical Mass Transfer of CO₂ by N₂O Analogy Using One Fluid Formulation in OpenFOAM

Authors: Phanindra Prasad Thummala, Umran Tezcan Un, Ahmet Ozan Celik

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Removal of CO₂ by MEA (monoethanolamine) in structured packing columns depends highly on the gas-liquid interfacial area and film thickness (liquid load). CFD (computational fluid dynamics) is used to find the interfacial area, film thickness and their impact on mass transfer in gas-liquid flow effectively in any column geometry. In general modeling approaches used in CFD derive mass transfer parameters from standard correlations based on penetration or surface renewal theories. In order to avoid the effect of assumptions involved in deriving the correlations and model the mass transfer based solely on fluid properties, state of art approaches like one fluid formulation is useful. In this work, the one fluid formulation was implemented and evaluated for modeling the physical mass transfer of CO₂ by N₂O analogy in OpenFOAM CFD software. N₂O analogy avoids the effect of chemical reactions on absorption and allows studying the amount of CO₂ physical mass transfer possible in a given geometry. The computational domain in the current study was a flat plate with gas and liquid flowing in the countercurrent direction. The effect of operating parameters such as flow rate, the concentration of MEA and angle of inclination on the physical mass transfer is studied in detail. Liquid side mass transfer coefficients obtained by simulations are compared to the correlations available in the literature and it was found that the one fluid formulation was effectively capturing the effects of interface surface instabilities on mass transfer coefficient with higher accuracy. The high mesh refinement near the interface region was found as a limiting reason for utilizing this approach on large-scale simulations. Overall, the one fluid formulation is found more promising for CFD studies involving the CO₂ mass transfer.

Keywords: one fluid formulation, CO₂ absorption, liquid mass transfer coefficient, OpenFOAM, N₂O analogy

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91 Transient Response of Elastic Structures Subjected to a Fluid Medium

Authors: Helnaz Soltani, J. N. Reddy

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Presence of fluid medium interacting with a structure can lead to failure of the structure. Since developing efficient computational model for fluid-structure interaction (FSI) problems has broader impact to realistic problems encountered in aerospace industry, ship industry, oil and gas industry, and so on, one can find an increasing need to find a method in order to investigate the effect of fluid domain on structural response. A coupled finite element formulation of problems involving FSI issue is an accurate method to predict the response of structures in contact with a fluid medium. This study proposes a finite element approach in order to study the transient response of the structures interacting with a fluid medium. Since beam and plate are considered to be the fundamental elements of almost any structure, the developed method is applied to beams and plates benchmark problems in order to demonstrate its efficiency. The formulation is a combination of the various structure theories and the solid-fluid interface boundary condition, which is used to represent the interaction between the solid and fluid regimes. Here, three different beam theories as well as three different plate theories are considered to model the solid medium, and the Navier-Stokes equation is used as the theoretical equation governed the fluid domain. For each theory, a coupled set of equations is derived where the element matrices of both regimes are calculated by Gaussian quadrature integration. The main feature of the proposed methodology is to model the fluid domain as an added mass; the external distributed force due to the presence of the fluid. We validate the accuracy of such formulation by means of some numerical examples. Since the formulation presented in this study covers several theories in literature, the applicability of our proposed approach is independent of any structure geometry. The effect of varying parameters such as structure thickness ratio, fluid density and immersion depth, are studied using numerical simulations. The results indicate that maximum vertical deflection of the structure is affected considerably in the presence of a fluid medium.

Keywords: beam and plate, finite element analysis, fluid-structure interaction, transient response

Procedia PDF Downloads 536
90 Robotic Mini Gastric Bypass Surgery

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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89 Computational Fluid Dynamics Based Analysis of Heat Exchanging Performance of Rotary Thermal Wheels

Authors: H. M. D. Prabhashana Herath, M. D. Anuradha Wickramasinghe, A. M. C. Kalpani Polgolla, R. A. C. Prasad Ranasinghe, M. Anusha Wijewardane

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The demand for thermal comfort in buildings in hot and humid climates increases progressively. In general, buildings in hot and humid climates spend more than 60% of the total energy cost for the functionality of the air conditioning (AC) system. Hence, it is required to install energy efficient AC systems or integrate energy recovery systems for both new and/or existing AC systems whenever possible, to reduce the energy consumption by the AC system. Integrate a Rotary Thermal Wheel as the energy recovery device of an existing AC system has shown very promising with attractive payback periods of less than 5 years. A rotary thermal wheel can be located in the Air Handling Unit (AHU) of a central AC system to recover the energy available in the return air stream. During this study, a sensitivity analysis was performed using a CFD (Computational Fluid Dynamics) software to determine the optimum design parameters (i.e., rotary speed and parameters of the matrix profile) of a rotary thermal wheel for hot and humid climates. The simulations were performed for a sinusoidal matrix geometry. Variation of sinusoidal matrix parameters, i.e., span length and height, were also analyzed to understand the heat exchanging performance and the induced pressure drop due to the air flow. The results show that the heat exchanging performance increases when increasing the wheel rpm. However, the performance increment rate decreases when increasing the rpm. As a result, it is more advisable to operate the wheel at 10-20 rpm. For the geometry, it was found that the sinusoidal geometries with lesser spans and higher heights have higher heat exchanging capabilities. Considering the sinusoidal profiles analyzed during the study, the geometry with 4mm height and 3mm width shows better performance than the other combinations.

Keywords: air conditioning, computational fluid dynamics, CFD, energy recovery, heat exchangers

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88 Critical Appraisal, Smart City Initiative: China vs. India

Authors: Suneet Jagdev, Siddharth Singhal, Dhrubajyoti Bordoloi, Peesari Vamshidhar Reddy

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There is no universally accepted definition of what constitutes a Smart City. It means different things to different people. The definition varies from place to place depending on the level of development and the willingness of people to change and reform. It tries to improve the quality of resource management and service provisions for the people living in the cities. Smart city is an urban development vision to integrate multiple information and communication technology (ICT) solutions in a secure fashion to manage the assets of a city. But most of these projects are misinterpreted as being technology projects only. Due to urbanization, a lot of informal as well government funded settlements have come up during the last few decades, thus increasing the consumption of the limited resources available. The people of each city have their own definition of Smart City. In the imagination of any city dweller in India is the picture of a Smart City which contains a wish list of infrastructure and services that describe his or her level of aspiration. The research involved a comparative study of the Smart City models in India and in China. Behavioral changes experienced by the people living in the pilot/first ever smart cities have been identified and compared. This paper discussed what is the target of the quality of life for the people in India and in China and how well could that be realized with the facilities being included in these Smart City projects. Logical and comparative analyses of important data have been done, collected from government sources, government papers and research papers by various experts on the topic. Existing cities with historically grown infrastructure and administration systems will require a more moderate step-by-step approach to modernization. The models were compared using many different motivators and the data is collected from past journals, interacting with the people involved, videos and past submissions. In conclusion, we have identified how these projects could be combined with the ongoing small scale initiatives by the local people/ small group of individuals and what might be the outcome if these existing practices were implemented on a bigger scale.

Keywords: behavior change, mission monitoring, pilot smart cities, social capital

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87 Factors Associated with Contraceptive Use and Nonuse, among Currently Married Young (15-24 Years) Women in Nepal

Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

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Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

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86 Physical Planning Trajectories for Disaster Mitigation and Preparedness in Costal and Seismic Regions: Capital Region of Andhra Pradesh, Vijayawada in India

Authors: Timma Reddy, Srikonda Ramesh

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India has been traditionally vulnerable to natural disasters such as Floods, droughts, cyclones, earthquakes and landslides. It has become a recurrent phenomenon as observed in last five decades. The survey indicates that about 60% of the landmass is prone to earthquakes of various intensities; over 40 million hectares is prone to floods; about 8% of the total area is prone to cyclones and 68% of the area is susceptible to drought. Climate change is likely to be perceived through experience of extreme weather events. There is growing societal concern about climate change, given the potential impacts of associated natural hazards such as cyclones, flooding, earthquakes, landslides etc, hence it is essential and crucial to strengthening our settlements to respond to such calamities. So, the research paper focus is to analyze the effective planning strategy/mechanism to integrate disaster mitigation measures in coastal regions in general and Capital Region of Andhra Pradesh in particular. The basic hypothesis is to govern the appropriate special planning considerations would facilitate to have organized way of protective life and properties from natural disasters. And further to integrate the infrastructure planning with conscious direction would provide an effective mitigations measures. It has been planned and analyzed to Vijayawada city with conscious land use planning with reference to space syntax trajectory in accordance to required social infrastructure such as health facilities, institution areas and recreational and other open spaces. It has been identified that the geographically ideal location with reference to the population densities based on GIS tools the properness strategies can be effectively integrated to protect the life and to save the properties by means of reducing the damage/impact of natural disasters in general earth quake/cyclones or floods in particularly.

Keywords: modular, trajectories, social infrastructure, evidence based syntax, drills and equipments, GIS, geographical micro zoning, high resolution satellite image

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85 U Slot Loaded Wearable Textile Antenna

Authors: Varsha Kheradiya, Ganga Prasad Pandey

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The use of wearable antennas is rising because wireless devices become small. The wearable antenna is part of clothes used in communication applications, including energy harvesting, medical application, navigation, and tracking. In current years, Antennas embroidered on clothes, conducting antennas based on fabric, polymer embedded antennas, and inkjet-printed antennas are all attractive ways. Also shows the analysis required for wearable antennas, such as wearable antennae interacting with the human body. The primary requirements for the antenna are small size, low profile minimizing radiation absorption by the human body, high efficiency, structural integrity to survive worst situations, and good gain. Therefore, research in energy harvesting, biomedicine, and military application design is increasingly favoring flexible wearable antennas. Textile materials that are effectively used for designing and developing wearable antennas for body area networks. The wireless body area network is primarily concerned with creating effective antenna systems. The antenna should reduce their size, be lightweight, and be adaptable when integrated into clothes. When antennas integrate into clothes, it provides a convenient alternative to those fabricated using rigid substrates. This paper presents a study of U slot loaded wearable textile antenna. U slot patch antenna design is illustrated for wideband from 1GHz to 6 GHz using textile material jeans as substrate and pure copper polyester taffeta fabric as conducting material. This antenna design exhibits dual band results for WLAN at 2.4 GHz and 3.6 GHz frequencies. Also, study U slot position horizontal and vertical shifting. Shifting the horizontal positive X-axis position of the U slot produces the third band at 5.8 GHz.

Keywords: microstrip patch antenna, textile material, U slot wearable antenna, wireless body area network

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84 Tribal Food Security Assessment and Its Measurement Index: A Study of Tribes and Particularly Vulnerable Tribal Groups in Jharkhand, India

Authors: Ambika Prasad Gupta, Harshit Sosan Lakra

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Food security is an important issue that has been widely discussed in literature. However, there is a lack of research on the specific food security challenges faced by tribal communities. Tribal food security refers to the ability of indigenous or tribal communities to consistently access and afford an adequate and nutritious supply of food. These communities often have unique cultural, social, and economic contexts that can impact their food security. The study aims to assess the food security status of all thirty-two major tribes, including Particularly Vulnerable Tribal Groups (PVTG) people living in various blocks of Jharkhand State. The methodology of this study focuses on measuring the food security index of indigenous people by developing and redefining a new Tribal Food Security Index (TFSI) as per the indigenous community-level indicators identified by the Global Food Security Index and other indicators relevant to food security. Affordability, availability, quality and safety, and natural resources were the dimensions used to calculate the overall Tribal Food Security Index. A survey was conducted for primary data collection of tribes and PVTGs at the household level in various districts of Jharkhand with a considerable tribal population. The result shows that due to the transition from rural to urban areas, there is a considerable change in TFSI and a decrease in forest dependency of tribal communities. Socioeconomic factors like occupation and household size had a significant correlation with TFSI. Tribal households living in forests have a higher food security index than tribal households residing in urban transition areas. The study also shows that alternative methodology adopted to measure specific community-level food security creates high significant impact than using commonly used indices.

Keywords: indigenous people, tribal food security, particularly vulnerable tribal groups, Jharkhand

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83 Cellulose Enhancement in Wood Used in Pulp Production by Overexpression of Korrigan and Sucrose Synthase Genes

Authors: Anil Kumar, Diwakar Aggarwal, M. Sudhakara Reddy

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The wood of Eucalyptus, Populus and bamboos are some important species used as raw material for the manufacture of pulp. However, higher levels of lignin pose a problem during Kraft pulping and yield of pulp is also lower. In order to increase the yield of pulp per unit wood and reduce the use of chemicals during kraft pulping it is important to reduce the lignin content and/or increase cellulose content in wood. Cellulose biosynthesis in wood takes place by the coordinated action of many enzymes. The two important enzymes are KORRIGAN and SUCROSE SYNTHASE. KORRIGAN (Endo-1,4--glucanase) is implicated in the process of editing growing cellulose chains and improvement of the crystallinity of produced cellulose, whereas SUCROSE SYNTHASE is involved in providing substrate (UDP-glucose) for growing cellulose chains. The present study was aimed at the cloning, characterization and overexpression of these genes in Eucalyptus and Populus. An efficient shoot organogenesis protocol from leaf explants taken from micro shoots of the species has been developed. Agrobacterium mediated genetic transformation using Agrobacterium tumefaciens strain EHA105 and LBA4404 harboring binary vector pBI121 was achieved. Both the genes were cloned from cDNA library of Populus deltoides. These were subsequently characterized using various bioinformatics tools. The cloned genes were then inserted into pBI121 under the CaMV35S promotors replacing GUS gene. The constructs were then mobilized into above strains of Agrobacterium and used for the transformation work. Subsequently, genetic transformation of these clones with target genes following already developed protocol is in progress. Four transgenic lines of Eucalyptus tereticornis overexpressing Korrigan gene under the strong constitutive promoters CaMV35S have been developed, which are being further evaluated. Work on development of more transgenic lines overexpressing these genes in Populus and Eucalyptus is also in progress. This presentation will focus on important developments in this direction.

Keywords: Eucalyptus tereticornis, genetic transformation, Kraft pulping Populus deltoides

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82 Investigation on the Energy Impact of Spatial Geometry in a Residential Building Using Building Information Modeling Technology

Authors: Shashank. S. Bagane, H. N. Rajendra Prasad

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Building Information Modeling (BIM) has currently developed into a potent solution. The consistent development of BIM technology in the sphere of Architecture, Engineering, and Construction (AEC) industry has enhanced the effectiveness of construction and decision making. However, aggrandized global warming and energy crisis has impacted on building energy analysis. It is now becoming an important factor to be considered in the AEC industry. Amalgamating energy analysis in the planning and design phase of a structure has become a necessity. In the current construction industry, estimating energy usage and reducing its footprint is of high priority. The construction industry is giving more prominence to sustainability alongside energy efficiency. This demand is compelling the designers, planners, and engineers to inspect the sustainable performance throughout the building's life cycle. The current study primarily focuses on energy consumption, space arrangement, and spatial geometry of a residential building. Most commonly residential structures in India are constructed considering Vastu Shastra. Vastu designs are intended to integrate architecture with nature and utilizing geometric patterns, symmetry, and directional alignments. In the current study, a residential brick masonry structure is considered for BIM analysis, Architectural model of the structure will be created using Revit software, later the orientation and spatial arrangement will be finalized based on Vastu principles. Furthermore, the structure will be investigated for the impact of building orientation and spatial arrangements on energy using Green Building Studio software. Based on the BIM analysis of the structure, energy consumption of subsequent building orientations will be understood. A well-orientated building having good spatial arrangement can save a considerable amount of energy throughout its life cycle and reduces the need for heating and lighting which will prove to diminish energy usage and improve the energy efficiency of the residential building.

Keywords: building information modeling, energy impact, spatial geometry, vastu

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81 Investigations on Utilization of Chrome Sludge, Chemical Industry Waste, in Cement Manufacturing and Its Effect on Clinker Mineralogy

Authors: Suresh Vanguri, Suresh Palla, Prasad G., Ramaswamy V., Kalyani K. V., Chaturvedi S. K., Mohapatra B. N., Sunder Rao TBVN

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The utilization of industrial waste materials and by-products in the cement industry helps in the conservation of natural resources besides avoiding the problems arising due to waste dumping. The use of non-carbonated materials as raw mix components in clinker manufacturing is identified as one of the key areas to reduce Green House Gas (GHG) emissions. Chrome sludge is a waste material generated from the manufacturing process of sodium dichromate. This paper aims to present studies on the use of chrome sludge in clinker manufacturing, its impact on the development of clinker mineral phases and on the cement properties. Chrome sludge was found to contain substantial amounts of CaO, Fe2O3 and Al2O3 and therefore was used to replace some conventional sources of alumina and iron in the raw mix. Different mixes were prepared by varying the chrome sludge content from 0 to 5 % and the mixes were evaluated for burnability. Laboratory prepared clinker samples were evaluated for qualitative and quantitative mineralogy using X-ray Diffraction Studies (XRD). Optical microscopy was employed to study the distribution of clinker phases, their granulometry and mineralogy. Since chrome sludge also contains considerable amounts of chromium, studies were conducted on the leachability of heavy elements in the chrome sludge as well as in the resultant cement samples. Estimation of heavy elements, including chromium was carried out using ICP-OES. Further, the state of chromium valence, Cr (III) & Cr (VI), was studied using conventional chemical analysis methods coupled with UV-VIS spectroscopy. Assimilation of chromium in the clinker phases was investigated using SEM-EDXA studies. Bulk cement was prepared from the clinker to study the effect of chromium sludge on the cement properties such as setting time, soundness, strength development against the control cement. Studies indicated that chrome sludge can be successfully utilized and its content needs to be optimized based on raw material characteristics.

Keywords: chrome sludge, leaching, mineralogy, non-carbonate materials

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80 Evaluation of Properties of Alkali Activated Slag Concrete Blended with Polypropylene Shredding and Admixture

Authors: Jagannath Prasad Tegar, Zeeshan Ahmad

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The Ordinary Portland Cement (OPC) is a major constituent of concrete, which is being used extensively since last half century. The production of cement is impacting not only environment alone, but depleting natural materials. During the past 3 decades, the scholars have carried out studies and researches to explore the supplementary cementatious materials such as Ground granulated Blast furnace slag (GGBFS), silica fumes (SF), metakaolin or fly ash (FA). This has contributed towards improved cementatious materials which are being used in construction, but not the way it is supposed to be. The alkali activated slag concrete is another innovation which has constituents of cementatious materials like Ground Granuled Blast Furnace Slag (GGBFS), Fly Ash (FA), Silica Fumes (SF) or Metakaolin. Alkaline activators like Sodium Silicate (Na₂SiO₃) and Sodium Hydroxide (NaOH) is utilized. In view of evaluating properties of alkali activated slag concrete blended with polypropylene shredding and accelerator, research study is being carried out. This research study is proposed to evaluate the effect of polypropylene shredding and accelerating admixture on mechanical properties of alkali-activated slag concrete. The mechanical properties include the compressive strength, splitting tensile strength and workability. The outcomes of this research are matched with the hypothesis and it is found that 27% of cement can be replaced with the ground granulated blast furnace slag (GGBFS) and for split tensile strength 20% replacement is achieved. Overall it is found that 20% of cement can be replaced with ground granulated blast furnace slag. The tests conducted in the laboratory for evaluating properties such as compressive strength test, split tensile strength test, and slump cone test. On the aspect of cost, it is substantially benefitted.

Keywords: ordinary Portland cement, activated slag concrete, ground granule blast furnace slag, fly ash, silica fumes

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79 Overcoming Challenges of Teaching English as a Foreign Language in Technical Classrooms: A Case Study at TVTC College of Technology

Authors: Sreekanth Reddy Ballarapu

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The perception of the whole process of teaching and learning is undergoing a drastic and radical change. More and more student-centered, pragmatic, and flexible approaches are gradually replacing teacher-centered lecturing and structural-syllabus instruction. The issue of teaching English as a Foreign language is no exception in this regard. The traditional Present-Practice-Produce (P-P-P) method of teaching English is overtaken by Task-Based Teaching which is a subsidiary branch of Communicative Language Teaching. At this juncture this article strongly tries to convey that - Task-based learning, has an advantage over other traditional methods of teaching. All teachers of English must try to customize their texts into productive tasks, apply them, and evaluate the students as well as themselves. Task Based Learning is a double edged tool which can enhance the performance of both the teacher and the taught. The sample for this case study is a class of 35 students from Semester III - Network branch at TVTC College of Technology, Adhum - Kingdom of Saudi Arabia. The students are high school passed out and aged between 19-21years.For the present study the prescribed textbook Technical English 1 by David Bonamy was used and a number of language tasks were chalked out during the pre- task stage and the learners were made to participate voluntarily and actively. The Action Research methodology was adopted within the dual framework of Communicative Language Teaching and Task-Based Learning. The different tools such as questionnaires, feedback and interviews were used to collect data. This study provides information about various techniques of Communicative Language Teaching and Task Based Learning and focuses primarily on the advantages of using a Task Based Learning approach. This article presents in detail the objectives of the study, the planning and implementation of the action research, the challenges encountered during the execution of the plan, and the pedagogical outcome of this project. These research findings serve two purposes: first, it evaluates the effectiveness of Task Based Learning and, second, it empowers the teacher's professionalism in designing and implementing the tasks. In the end, the possibility of scope for further research is presented in brief.

Keywords: action research, communicative language teaching, task based learning, perception

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78 Physical Planning Strategies for Disaster Mitigation and Preparedness in Coastal Region of Andhra Pradesh, India

Authors: Thimma Reddy Pothireddy, Ramesh Srikonda

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India is prone to natural disasters such as Floods, droughts, cyclones, earthquakes and landslides frequently due to its geographical considerations. It has become a persistent phenomenon as observed in last ten decades. The recent survey indicates that about 60% of the landmass is prone to earthquakes of various intensities with reference to Richard scale, over 40 million hectares is prone to floods; about 8% of the total area is prone to cyclones and 68% of the area is vulnerable to drought. Climate change is likely to be perceived through the experience of extreme weather events. There is growing societal concern about climate change, given the potential impacts of associated natural hazards such as cyclones, flooding, earthquakes, landslides etc. The recent natural calamities such as Cyclone Hudhud had crossed the land at Northern cost of AP, Vishakapatanam on 12 Oct’2014 with a wind speed ranging between 175 – 200 kmph and the records show that the tidal waves were reached to the height of 14mts and above; and it alarms us to have critical focus on planning issues so as to find appropriate solutions. The existing condition is effective is in terms of institutional set up along with responsive management mechanism of disaster mitigation but considerations at settlement planning level to allow mitigation operations are not adequate. This paper deals to understand the response to climate change will possibly happen through adaptation to climate hazards and essential to work out an appropriate mechanism and disaster receptive settlement planning for responding to natural (and climate-related) calamities particularly to cyclones and floods. The statistics indicate that 40 million hectares flood prone (5% of area), and 1853 kmts of cyclone prone coastal length in India so it is essential and crucial to have appropriate physical planning considerations to improve preparedness and to operate mitigation measures effectively to minimize the loss and damage. Vijayawada capital region which is susceptible to cyclonic and floods has been studied with respect to trajectory analysis to work out risk vulnerability and to integrated disaster mitigation physical planning considerations.

Keywords: meta analysis, vulnerability index, physical planning, trajectories

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77 Sustainable Membranes Based on 2D Materials for H₂ Separation and Purification

Authors: Juan A. G. Carrio, Prasad Talluri, Sergio G. Echeverrigaray, Antonio H. Castro Neto

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Hydrogen as a fuel and environmentally pleasant energy carrier is part of this transition towards low-carbon systems. The extensive deployment of hydrogen production, purification and transport infrastructures still represents significant challenges. Independent of the production process, the hydrogen generally is mixed with light hydrocarbons and other undesirable gases that need to be removed to obtain H₂ with the required purity for end applications. In this context, membranes are one of the simplest, most attractive, sustainable, and performant technologies enabling hydrogen separation and purification. They demonstrate high separation efficiencies and low energy consumption levels in operation, which is a significant leap compared to current energy-intensive options technologies. The unique characteristics of 2D laminates have given rise to a diversity of research on their potential applications in separation systems. Specifically, it is already known in the scientific literature that graphene oxide-based membranes present the highest reported selectivity of H₂ over other gases. This work explores the potential of a new type of 2D materials-based membranes in separating H₂ from CO₂ and CH₄. We have developed nanostructured composites based on 2D materials that have been applied in the fabrication of membranes to maximise H₂ selectivity and permeability, for different gas mixtures, by adjusting the membranes' characteristics. Our proprietary technology does not depend on specific porous substrates, which allows its integration in diverse separation modules with different geometries and configurations, looking to address the technical performance required for industrial applications and economic viability. The tuning and precise control of the processing parameters allowed us to control the thicknesses of the membranes below 100 nanometres to provide high permeabilities. Our results for the selectivity of new nanostructured 2D materials-based membranes are in the range of the performance reported in the available literature around 2D materials (such as graphene oxide) applied to hydrogen purification, which validates their use as one of the most promising next-generation hydrogen separation and purification solutions.

Keywords: membranes, 2D materials, hydrogen purification, nanocomposites

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76 Non-Candida Albicans Candida: Virulence Factors and Species Identification in India

Authors: Satender Saraswat, Dharmendra Prasad Singh, Rajesh Kumar Verma, Swati Sarswat

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Background and Purpose: The predominant cause of candidiasis was Candida albicans which has shifted towards non-Candida albicans Candida (NCAC) (Candida species other than the C. albicans). NCAC, earlier considered non-pathogenic or minimally virulent, are now considered a primary cause of morbidity and mortality in immunocompromised. With the NCAC spp. gaining weightage in the clinical cases, this study was conducted to determine the prevalence of NCAC spp. in different clinical specimens and to assess a few of their virulence factors. Material and Methods: Routine samples for bacterial culture and sensitivity, showing colony characteristics like Candida on Blood Agar and microscopic features resembling Candida spp. were processed further. Candida isolates were tested for chlamydospore formation, biochemical tests including sugar fermentation and sugar assimilation tests, and growth at 42oC, colony colour on HiCrome™ Candida Differential Agar, HiCandida Identification Kit and VITEK-2 Compact. Virulence factors like adherence to buccal epithelial cells (ABEC), biofilm formation, hemolytic activity, and production of coagulase enzyme were also tested. Results: Mean age of the patients was 38.46 with a male-female ratio of 1.36:1. 137 Candida isolates were recovered. 45.3% isolates were isolated from urine, 19.7% from vaginal swabs and 13.9% from oropharyngeal swabs. 55 (40.1%) isolates of C. albicans and 82 (59.9%) of NCAC spp. were identified, with C. tropicalis (23.4%) in NCAC. C. albicans (3; 50%) was the commonest species in cases of candidemia. Haemolysin production (85.5%) and ABEC (78.2%) were the major virulence factors in C. albicans. C. tropicalis (59.4%) and C. dubliniensis (50%) showed maximum ABEC. Biofilm forming capacity was higher in C. tropicalis (78.1%) than C. albicans (67%). Conclusion: This study suggests varied prevalence and virulence based on geographical locations, even within a subcontinent. It clearly demarcates the emergence of NCAC and their predominance in different body fluids. Identification of Candida to species level should become a routine in all the laboratories.

Keywords: ABEC, NCAC, non-Candida albicans Candida, Vitek-2TM compact

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75 Regional Variation of Cancer Incidence in Nepal

Authors: Rudra Prasad Khanal

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Introduction: Non-communicable disease, such as cancer, has spread all over the world for some last decades. However, every nation has experienced a burden from the development of technology. In the context of Nepal, 10 to 15 thousand new cancer incidences are being registered in different hospitals for treatment. Since the date of starting nuclear medicine at Bir Hospital in 1998, cancer patients have been getting treatment regularly. According to the data of the population-based cancer registry, approximately 60% of the population having a middle-class income is being affected by cancer in Nepal. Methods and Materials: The study is aimed to find out the particular place where the population density of new cancer incidence is highest in Nepal and to inform the concerned regulatory body that is working on cancer screening and early detection for the proper treatment from the beginning. In order to identify the areas with the highest population density of new cancer incidence, all the data of cancer patients were collected from five different renowned hospitals and also from the population-based cancer registry center and then analyzed the data. The history of cancer patients was studied from 2003 to 2020, but here the data are analyzed from 2015 to 2020 only to find the latest trend in cancer incidence. Results: In the five major hospitals in Nepal, the total new cancer incidence was 61783 from 2015 to 2020. Out of those, 34617 were female, and 27176 were male. This research shows that female cancer patients were more every year. In the male, lung cancer patients more than cancer of other organs, but in females, the number of breast cancer patients was greatest. The age-adjusted mortality rate for males in Kathmandu valley was 36.3, and for females was 27.0 per 100,000 population. The cancer incidence and mortality rate were slightly lesser in other districts of Nepal. This rate increased with the increase in the age of people. Over 60 years, cancer incidence and mortality rates have been found to increase rapidly. Conclusion: This research supports conducting the program of cancer screening and early detection at Kathmandu valley with high priority and then Morang, Rukum, SSDM, etc., to control cancer.

Keywords: cancer incidence, research scholar, Tribhuvan University, Bhaktapur Cancer Hospital, Nepal

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74 Evaluation of Genetic Fidelity and Phytochemical Profiling of Micropropagated Plants of Cephalantheropsis obcordata: An Endangered Medicinal Orchid

Authors: Gargi Prasad, Ashiho A. Mao, Deepu Vijayan, S. Mandal

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The main objective of the present study was to optimize and develop an efficient protocol for in vitro propagation of a medicinally important orchid Cephalantheropsis obcordata (Lindl.) Ormerod along with genetic stability analysis of regenerated plants. This plant has been traditionally used in Chinese folk medicine and the decoction of whole plant is known to possess anticancer activity. Nodal segments used as explants were inoculated on Murashige and Skoog (MS) medium supplemented with various concentrations of isopentenyl adenine (2iP). The rooted plants were successfully acclimatized in the greenhouse with 100% survival rate. Inter-simple sequence repeats (ISSR) markers were used to assess the genetic fidelity of in vitro raised plants and the mother plant. It was revealed that monomorphic bands showing the absence of polymorphism in all in vitro raised plantlets analyzed, confirming the genetic uniformity among the regenerants. Phytochemical analysis was done to compare the antioxidant activities and HPLC fingerprinting assay of 80% aqueous ethanol extract of the leaves and stem of in vitro and in vivo grown C. obcordata. The extracts of the plants were examined for their antioxidant activities by using free radical 1, 1-diphenyl-2-picryl hydrazyl (DPPH) scavenging method, 2,2’-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging ability, reducing power capacity, estimation of total phenolic content, flavonoid content and flavonol content. A simplified method for the detection of ascorbic acid, phenolic acids and flavonoids content was also developed by using reversed phase high-performance liquid chromatography (HPLC). This is the first report on the micropropagation, genetic integrity study and quantitative phytochemical analysis of in vitro regenerated plants of C. obcordata.

Keywords: Cephalantheropsis obcordata, genetic fidelity, ISSR markers, HPLC

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73 Camptothecin Promotes ROS-Mediated G2/M Phase Cell Cycle Arrest, Resulting from Autophagy-Mediated Cytoprotection

Authors: Rajapaksha Gedara Prasad Tharanga Jayasooriya, Matharage Gayani Dilshara, Yung Hyun Choi, Gi-Young Kim

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Camptothecin (CPT) is a quinolone alkaloid which inhibits DNA topoisomerase I that induces cytotoxicity in a variety of cancer cell lines. We previously showed that CPT effectively inhibited invasion of prostate cancer cells and also combined treatment with subtoxic doses of CPT and TNF-related apoptosis-inducing ligand (TRAIL) potentially enhanced apoptosis in a caspase-dependent manner in hepatoma cancer cells. Here, we found that treatment with CPT caused an irreversible cell cycle arrest in the G2/M phase. CPT-induced cell cycle arrest was associated with a decrease in protein levels of cell division cycle 25C (Cdc25C) and increased the level of cyclin B and p21. The CPT-induced decrease in Cdc25C was blocked in the presence of proteasome inhibitor MG132, thus reversed the cell cycle arrest. In addition to that treatment of CPT-increased phosphorylation of Cdc25C was the resulted of activation of checkpoint kinase 2 (Chk2), which was associated with phosphorylation of ataxia telangiectasia-mutated. Interestingly CPT induced G2/M phase of the cell cycle arrest is reactive oxygen species (ROS) dependent where ROS inhibitors NAC and GSH reversed the CPT-induced cell cycle arrest. These results further confirm by using transient knockdown of nuclear factor-erythroid 2-related factor 2 (Nrf2) since it regulates the production of ROS. Our data reveal that treatment of siNrf2 increased the ROS level as well as further increased the CPT induce G2/M phase cell cycle arrest. Our data also indicate CPT-enhanced cell cycle arrest through the extracellular signal-regulated kinase (ERK) and the c-Jun N-terminal kinase (JNK) pathway. Inhibitors of ERK and JNK more decreased the Cdc25C expression and protein expression of p21 and cyclin B. These findings indicate that Chk2-mediated phosphorylation of Cdc25C plays a major role in G2/M arrest by CPT.

Keywords: camptothecin, cell cycle, checkpoint kinase 2, nuclear factor-erythroid 2-related factor 2, reactive oxygen species

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72 Blood Ketones as a Point of Care Testing in Paediatric Emergencies

Authors: Geetha Jayapathy, Lakshmi Muthukrishnan, Manoj Kumar Reddy Pulim , Radhika Raman

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Introduction: Ketones are the end products of fatty acid metabolism and a source of energy for vital organs such as the brain, heart and skeletal muscles. Ketones are produced in excess when glucose is not available as a source of energy or it cannot be utilized as in diabetic ketoacidosis. Children admitted in the emergency department often have starvation ketosis which is not clinically manifested. Decision on admission of children to the emergency room with subtle signs can be difficult at times. Point of care blood ketone testing can be done at the bedside even in a primary level care setting to supplement and guide us in our management decisions. Hence this study was done to explore the utility of this simple bedside parameter as a supplement in assessing pediatric patients presenting to the emergency department. Objectives: To estimate blood ketones of children admitted in the emergency department. To analyze the significance of blood ketones in various disease conditions. Methods: Blood ketones using point of care testing instrument (ABOTTprecision Xceed Pro meters) was done in patients getting admitted in emergency room and in out-patients (through sample collection centre). Study population: Children aged 1 month to 18 years were included in the study. 250 cases (In-patients) and 250 controls (out-patients) were collected. Study design: Prospective observational study. Data on details of illness and physiological status were documented. Blood ketones were compared between the two groups and all in patients were categorized into various system groups and analysed. Results: Mean blood ketones were high in in-patients ranging from 0 to 7.2, with a mean of 1.28 compared to out-patients ranging from 0 to 1.9 with a mean of 0.35. This difference was statistically significant with a p value < 0.001. In-patients with shock (mean of 4.15) and diarrheal dehydration (mean of 1.85) had a significantly higher blood ketone values compared to patients with other system involvement. Conclusion: Blood ketones were significantly high (above the normal range) in pediatric patients who are sick requiring admission. Patients with various forms of shock had very high blood ketone values as found in diabetic ketoacidosis. Ketone values in diarrheal dehydration were moderately high correlating to the degree of dehydration.

Keywords: admission, blood ketones, paediatric emergencies, point of care testing

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71 Factors Associated with Commencement of Non-Invasive Ventilation

Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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70 Study of Three-Dimensional Computed Tomography of Frontoethmoidal Cells Using International Frontal Sinus Anatomy Classification

Authors: Prabesh Karki, Shyam Thapa Chettri, Bajarang Prasad Sah, Manoj Bhattarai, Sudeep Mishra

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Introduction: Frontal sinus is frequently described as the most difficult sinus to access surgically due to its proximity to the cribriform plate, orbit, and anterior ethmoid artery. Frontal sinus surgery requires a detailed understanding of the cellular structure and FSDP unique to each patient, making high-resolution CT scans an indispensable tool to assess the difficulty of planned sinus surgery. International Frontal Sinus Anatomy Classification (IFAC) was developed to provide a more precise nomenclature for cells in the frontal recess, classifying cells based on their anatomic origin. Objectives: To assess the proportion of frontal cell variants defined by IFAC, variation with respect to age and gender. Methods: 54 cases were enrolled after a detailed clinical history, thorough general and physical examinations, and CT a report ordered in a film. Assessment and tabulation of the presence of frontal cells according to the IFAC analyzed. The prevalence of each cell type was calculated, and data were entered in MS Excel and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics and frequencies were defined for categorical and numerical variables. Frequency, percentage, the mean and standard deviation were calculated. Result: Among 54 patients, 30 (55.6%) were male and 24 (44.4%) were female. The patient enrolled ranged from 18 to 78 years. Majority33.3% (n=18) were in age group of >50 years.According to IFAC, Agger nasi cells (92.6%) were most common, whereas supraorbital ethmoidal cells were least common 16 (29.6%). Prevalence of other frontoethmoidal cells was SAC- 57.4%, SAFC- 38.9%, SBC- 74.1%, SBFC- 33.3%, FSC- 38.9% of 54 cases. Conclusion: IFAC is an international consensus document that describes an anatomically precise nomenclature for classifying frontoethmoidal cells' anatomy. This study has defined the prevalence, symmetry and reliability of frontoethmoidal cells as established by the IFAC system as in other parts of the world.

Keywords: frontal sinus, frontoethmoidal cells, international frontal sinus anatomy classification

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