Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18

Search results for: Geeta Kasana

18 Error Analysis of Wavelet-Based Image Steganograhy Scheme

Authors: Geeta Kasana, Kulbir Singh, Satvinder Singh

Abstract:

In this paper, a steganographic scheme for digital images using Integer Wavelet Transform (IWT) is proposed. The cover image is decomposed into wavelet sub bands using IWT. Each of the subband is divided into blocks of equal size and secret data is embedded into the largest and smallest pixel values of each block of the subband. Visual quality of stego images is acceptable as PSNR between cover image and stego is above 40 dB, imperceptibility is maintained. Experimental results show better tradeoff between capacity and visual perceptivity compared to the existing algorithms. Maximum possible error analysis is evaluated for each of the wavelet subbands of an image.

Keywords: DWT, IWT, MSE, PSNR

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17 Blind Data Hiding Technique Using Interpolation of Subsampled Images

Authors: Singara Singh Kasana, Pankaj Garg

Abstract:

In this paper, a blind data hiding technique based on interpolation of sub sampled versions of a cover image is proposed. Sub sampled image is taken as a reference image and an interpolated image is generated from this reference image. Then difference between original cover image and interpolated image is used to embed secret data. Comparisons with the existing interpolation based techniques show that proposed technique provides higher embedding capacity and better visual quality marked images. Moreover, the performance of the proposed technique is more stable for different images.

Keywords: interpolation, image subsampling, PSNR, SIM

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16 Backstepping Design and Fractional Differential Equation of Chaotic System

Authors: Ayub Khan, Net Ram Garg, Geeta Jain

Abstract:

In this paper, backstepping method is proposed to synchronize two fractional-order systems. The simulation results show that this method can effectively synchronize two chaotic systems.

Keywords: backstepping method, fractional order, synchronization, chaotic system

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15 In situ Biodegradation of Endosulfan, Imidacloprid, and Carbendazim Using Indigenous Bacterial Cultures of Agriculture Fields of Uttarakhand, India

Authors: Geeta Negi, Pankaj, Anjana Srivastava, Anita Sharma

Abstract:

In the present study, the presence of endosulfan, imidacloprid, carbendazim, in the soil /vegetables/cereals and water samples was observed in agriculture fields of Uttarakhand. In view of biodegradation of these pesticides, nine bacterial isolates were recovered from the soil samples of the fields which tolerated endosulfan, imidacloprid, carbendazim from 100 to 200 µg/ml. Three bacterial consortia used for in vitro bioremediation experiments were three bacterial isolates for carbendazim, imidacloprid and endosulfan, respectively. Maximum degradation (87 and 83%) of α and β endosulfan respectively was observed in soil slurry by consortium. Degradation of Imidacloprid and carbendazim under similar conditions was 88.4 and 77.5% respectively. FT-IR analysis of biodegraded samples of pesticides in liquid media showed stretching of various bonds. GC-MS of biodegraded endosulfan sample in soil slurry showed the presence of non-toxic intermediates. A pot trial with Bacterial treatments lowered down the uptake of pesticides in onion plants.

Keywords: biodegradation, carbendazim, consortium, endosulfan

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14 Mathematical Modeling and Analysis of Forced Vibrations in Micro-Scale Microstretch Thermoelastic Simply Supported Beam

Authors: Geeta Partap, Nitika Chugh

Abstract:

The present paper deals with the flexural vibrations of homogeneous, isotropic, generalized micropolar microstretch thermoelastic thin Euler-Bernoulli beam resonators, due to Exponential time varying load. Both the axial ends of the beam are assumed to be at simply supported conditions. The governing equations have been solved analytically by using Laplace transforms technique twice with respect to time and space variables respectively. The inversion of Laplace transform in time domain has been performed by using the calculus of residues to obtain deflection.The analytical results have been numerically analyzed with the help of MATLAB software for magnesium like material. The graphical representations and interpretations have been discussed for Deflection of beam under Simply Supported boundary condition and for distinct considered values of time and space as well. The obtained results are easy to implement for engineering analysis and designs of resonators (sensors), modulators, actuators.

Keywords: microstretch, deflection, exponential load, Laplace transforms, residue theorem, simply supported

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13 Productivity and Profitability of Field Pea as Influenced by Different Levels of Fertility and Bio-Fertilizers under Irrigated Condition

Authors: Akhilesh Mishra, Geeta Rai, Arvind Srivastava, Nalini Tiwari

Abstract:

A field experiment was conducted during two consecutive Rabi seasons of 2007 and 2008 to study the economics of different bio-fertilizer’s inoculations in fieldpea (cv. Jai) at Chandra Shekhar Azad University of Agriculture and Technology, Kanpur (India). Results indicated that the seed inoculation with Rhizobium + PSB + PGPR improved all the growth; yield attributes and yields of field pea. Fresh and dry weight plant-1, nodules number and dry weight plant-1 were found significantly maximum. Number of grains pod-1, number and weight of pods plant-1 at maturity attributed significantly in increasing the grain yield as well as net return. On pooled basis, maximum net income (Rs.22169 ha-1) was obtained with the use of Rhizobium + PSB + PGPR which was improved by a margin of Rs.1502 (6.77%), 2972 (13.40%), 2672 (12.05%), 5212 (23.51%), 6176 (27.85%), 4666 (21.04%) and 8842/ha (39.88%) over the inoculation of PSB + PGPR, Rhizobium + PGPR, Rhizobium + PSB, PGPR, PSB, Rhizobium and control, respectively. Thus, it can be recommended that to earn the maximum net profit from dwarf field pea, seed should be inoculated with Rhizobium + PSB + PGPR.

Keywords: rhizobium, phosphorus solubilizing bacteria, plant growth promoting rhizobacteria, field pea

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12 Efficacy of Bio-Control Agents against Colletotrichum falcatum Causing Red Rot Disease of Sugarcane

Authors: Geeta Sharma, Suma Chandra

Abstract:

Sugarcane is one of the major commercial crop playing roles in agriculture and industrial economy of India. Globally sugarcane is affected by approximately 240 diseases caused by various plant pathogenic organisms. Among them, red rot disease caused by the fungus Colletotrichum falcatum, is one of the most important diseases. In the present investigation, one fungal bioagent of Trichoderma harzianum, Pant Bioagent 1 and one bacterial bioagent Pseudomonas fluorescence, Pant Bioagent 2 (PBAT 1 and PBAT 2, respectively) were tested by dual culture method against the pathogen under laboratory conditions. The effectiveness of biocontrol agents was observed against four isolates of C. falcatum. In the case of PBAT1 maximum percent inhibition of pathogen was recorded in isolated Cf 0238 (61.05%), followed by Cf 09 (60.62%) whereas, minimum percent inhibition was recorded in Cf 3220 (48.55%) and in case of PBAT2 maximum mycelial growth inhibition percent was recorded in Cf 767 (50.50%) followed by Cf 088230(48.83%), whereas minimum percent inhibition was recorded in Cf 08 (40.16%) followed by Cf 0238 (41.83%). The present study showed that these biocontrol agents have the potential of controlling the pathogen and can further be used for the management of red rot disease in field.

Keywords: biocontrol agents, Colletotrichum falcatum, isolates, sugarcane

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11 Optimization of Pressure in Deep Drawing Process

Authors: Ajay Kumar Choubey, Geeta Agnihotri, C. Sasikumar, Rashmi Dwivedi

Abstract:

Deep-drawing operations are performed widely in industrial applications. It is very important for efficiency to achieve parts with no or minimum defects. Deep drawn parts are used in high performance, high strength and high reliability applications where tension, stress, load and human safety are critical considerations. Wrinkling is a kind of defect caused by stresses in the flange part of the blank during metal forming operations. To avoid wrinkling appropriate blank-holder pressure/force or drawbead can be applied. Now-a-day computer simulation plays a vital role in the field of manufacturing process. So computer simulation of manufacturing has much advantage over previous conventional process i.e. mass production, good quality of product, fast working etc. In this study, a two dimensional elasto-plastic Finite Element (F.E.) model for Mild Steel material blank has been developed to study the behavior of the flange wrinkling and deep drawing parameters under different Blank-Holder Pressure (B.H.P.). For this, commercially available Finite Element software ANSYS 14 has been used in this study. Simulation results are critically studied and salient conclusions have been drawn.

Keywords: ANSYS, deep drawing, BHP, finite element simulation, wrinkling

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10 Quantitative Assessment of Different Formulations of Antimalarials in Sentinel Sites of India

Authors: Taruna Katyal Arora, Geeta Kumari, Hari Shankar, Neelima Mishra

Abstract:

Substandard and counterfeit antimalarials is a major problem in malaria endemic areas. The availability of counterfeit/ substandard medicines is not only decreasing the efficacy in patients, but it is also one of the contributing factors for developing antimalarial drug resistance. Owing to this, a pilot study was conducted to survey quality of drugs collected from different malaria endemic areas of India. Artesunate+Sulphadoxine-Pyrimethamine (AS+SP), Artemether-Lumefantrine (AL), Chloroquine (CQ) tablets were randomly picked from public health facilities in selected states of India. The quality of antimalarial drugs from these areas was assessed by using Global Pharma Health Fund Minilab test kit. This includes physical/visual inspection and disintegration test. Thin-layer chromatography (TLC) was carried out for semi-quantitative assessment of active pharmaceutical ingredients. A total of 45 brands, out of which 21 were for CQ, 14 for AL and 10 for AS+SP were tested from Uttar Pradesh (U.P.), Mizoram, Meghalaya and Gujrat states. One out of 45 samples showed variable disintegration and retension factor. The variable disintegration and retention factor which would have been due to substandard quality or other factors including storage. However, HPLC analysis confirms standard active pharmaceutical ingredient, but may be due to humid temperature and moisture in storage may account for the observed result.

Keywords: antimalarial medicines, counterfeit, substandard, TLC

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9 Laboratory Scale Experimental Studies on CO₂ Based Underground Coal Gasification in Context of Clean Coal Technology

Authors: Geeta Kumari, Prabu Vairakannu

Abstract:

Coal is the largest fossil fuel. In India, around 37 % of coal resources found at a depth of more than 300 meters. In India, more than 70% of electricity production depends on coal. Coal on combustion produces greenhouse and pollutant gases such as CO₂, SOₓ, NOₓ, and H₂S etc. Underground coal gasification (UCG) technology is an efficient and an economic in-situ clean coal technology, which converts these unmineable coals into valuable calorific gases. The UCG syngas (mainly H₂, CO, CH₄ and some lighter hydrocarbons) which can utilized for the production of electricity and manufacturing of various useful chemical feedstock. It is an inherent clean coal technology as it avoids ash disposal, mining, transportation and storage problems. Gasification of underground coal using steam as a gasifying medium is not an easy process because sending superheated steam to deep underground coal leads to major transportation difficulties and cost effective. Therefore, for reducing this problem, we have used CO₂ as a gasifying medium, which is a major greenhouse gas. This paper focus laboratory scale underground coal gasification experiment on a coal block by using CO₂ as a gasifying medium. In the present experiment, first, we inject oxygen for combustion for 1 hour and when the temperature of the zones reached to more than 1000 ºC, and then we started supplying of CO₂ as a gasifying medium. The gasification experiment was performed at an atmospheric pressure of CO₂, and it was found that the amount of CO produced due to Boudouard reaction (C+CO₂  2CO) is around 35%. The experiment conducted to almost 5 hours. The maximum gas composition observed, 35% CO, 22 % H₂, and 11% CH4 with LHV 248.1 kJ/mol at CO₂/O₂ ratio 0.4 by volume.

Keywords: underground coal gasification, clean coal technology, calorific value, syngas

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8 Efficacy of Eutectic Mixture of Local Anaesthetics and Diclofenac Spray in Attenuating Intravenous Cannulation Pain- Paeallel Randomized Trial

Authors: Anju Rani, Geeta, Sudha Rani, Choudhary, Puhal

Abstract:

Method- A total of 300 patients were studied, with 100 patients in each group. Patients aged 16-60 years, ASA grade I and II undergoing elective general surgical, urology and orthopedic procedures were included in the study. The patients were randomly allocated to any of the three groups by Using Sealed envelopes. 1. Group A: EMLA (eutectic mixture of 2.5% lidocaine with 2.5% prilocaine) - Patients receiving eutectic Lidocaine/ Prilocaine cream (2gm/10cm2) of Prilox cream), for 60- 70 min under occlusive dressing. 2. Group B - Patients receiving topical diclofenac 4 % spray gel for 60- 70 min, covering an absorption area of 50 cm2 3. Group C: control – Direct cannulation was done without any intervention. Results - Group B showed significantly least number of patients complaining pain on IV cannulation in comparison to group A and group C. The Mean VAS scores were found to be maximum in GROUP C: control-8.76 ± 4.14, then in GROUP A: EMLA- 2.54 ± 4.21.and least in GROUP B: Diclofenac 4% spray-1.13 ± 3.05. Erythema, induration and edema were significantly reported to be higher for the control group. Also group A patients reported adverse skin reactions more than patients in group B. Conclusion - It can be concluded that diclofenac spray 4 % and EMLA cream are effective in reducing the incidence and severity of venous cannulation pain as compared to the control group. However, a higher incidence of skin blanching, erythema, and oedema associated with EMLA cream and a lower incidence of these adverse effects favours the use of diclofenac spray 4%. They are promising agents for the treatment of venous cannulation pain.

Keywords: diclofenac spray, EMLA, intravenous, pain

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7 Sustainable and Efficient Recovery of Polyhydroxyalkanoate Polymer from Cupriavidus necator Using Environment Friendly Solvents

Authors: Geeta Gahlawat, Sanjeev Kumar Soni

Abstract:

An imprudent use of environmentally hazardous petrochemical-based plastics and limited availability of fossil fuels have provoked research interests towards production of biodegradable plastics - polyhydroxyalkanoate (PHAs). However, the industrial application of PHAs based products is primarily restricted by their high cost of recovery and extraction protocols. Moreover, solvents used for the extraction and purification are toxic and volatile which causes adverse environmental hazards. Development of efficient downstream recovery strategies along with utilization of non-toxic solvents will accelerate their commercialization. In this study, various extraction strategies were designed for sustainable and cost-effective recovery of PHAs from Cupriavidus necator using non-toxic environment friendly solvents viz. 1,2-propylene carbonate, ethyl acetate, isoamyl alcohol, butyl acetate. The effect of incubation time i.e. 10, 30 and 50 min and temperature i.e. 60, 80, 100, 120°C was tested to identify the most suitable solvent. PHAs extraction using a recyclable solvent, 1,2 propylene carbonate, showed the highest recovery yield (90%) and purity (93%) at 120°C and 30 min incubation. Ethyl acetate showed the better capacity to recover PHAs from cells than butyl acetate. Extraction with ethyl acetate exhibited high recovery yield and purity of 96% and 92%, respectively at 100°C. Effect of non-toxic surfactant such as linear alkylbenzene sulfonic acid (LAS) was also studied at 40, 60 and 80°C, and detergent pH range of 3.0, 5.0, 7.0 and 9.0 for the extraction of PHAs from the cells. LAS gave highest yield of 86% and purity of 88% at temperature 80°C and 5.0 pH.

Keywords: polyhydroxyalkanoates, Cupriavidus necator, extraction, recovery yield

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6 Repeated Batch Cultivation: A Novel Empty and Fill Strategy for the Enhanced Production of a Biodegradable Polymer, Polyhydroxy Alkanoate by Alcaligenes latus

Authors: Geeta Gahlawat, Ashok Kumar Srivastava

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In the present study, a simple drain and fill protocol strategy of repeated batch was adopted for enhancement in polyhydroxyalkanoates (PHAs) production using alcaligenes latus DSM 1124. Repeated batch strategy helped in increasing the longevity of otherwise decaying culture in the bioreactor by supplementing fresh substrates during each cycle of repeated-batch. The main advantages of repeated batch are its ease of operation, enhancement of culture stability towards contamination, minimization of pre-culture effects and maintenance of organism at high growth rates. The cultivation of A. latus was carried out in 7 L bioreactor containing 4 L optimized nutrient medium and a comparison with the batch mode fermentation was done to evaluate the performance of repeated batch in terms of PHAs accumulation and productivity. The statistically optimized medium recipe consisted of: 25 g/L Sucrose, 2.8 g/L (NH4)2SO4, 3.25 g/L KH2PO4, 3.25 g/L Na2HPO4, 0.2 g/L MgSO4, 1.5 mL/L trace element solution. In this strategy, 20% (v/v) of the culture broth was removed from the reactor and supplemented with an equal volume of fresh medium when sucrose concentration inside the reactor decreased below 8 g/L. The fermenter was operated for three repeated batch cycles and fresh nutrient feeding was done at 27 h, 48 h, and 60 h. Repeated batch operation resulted in a total biomass of 27.89 g/L and PHAs concentration 20.55 g/L at the end of 69 h which was a marked improvement as compared to batch cultivation (8.71 g/L biomass and 6.24 g/L PHAs). This strategy demonstrated 3.3 fold and 1.8 fold increase in PHAs concentration and volumetric productivity, respectively as compared to batch cultivation. Repeated batch cultivation strategy had also the benefit of avoiding non-productive time period required for cleaning, refilling and sterilization of bioreactor, thereby increasing the overall volumetric productivity and making the entire process cost-effective too.

Keywords: alcaligenes, biodegradation, polyhydroxyalkanoates, repeated batch

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5 Ethnomedicinal Plants Used for Gastrointestinal Ailments by the People of Tribal District Kinnaur (Himachal Pradesh) India

Authors: Geeta, Richa, M. L. Sharma

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Himachal Pradesh, a hilly State of India located in the Western Himalayas, with varied altitudinal gradients and climatic conditions, is a repository of plant diversity and the traditional knowledge associated with plants. The State is inhabited by various tribal communities who usually depend upon local plants for curing various ailments. Utilization of plant resources in their day-to-day life has been an age old practice of the people inhabiting this State. The present study pertains to the tribal district Kinnaur of Himachal Pradesh, located between 77°45’ and 79°00’35” east longitudes and between 31°05’50” and 32°05’15” north altitudes. Being a remote area with only very basic medical facilities, local people mostly use traditional herbal medicines for primary healthcare needs. Traditional healers called “Amji” are usually very secretive in revealing their medicinal knowledge to novice and pass on their knowledge to next generation orally. As a result, no written records of healing herbs are available. The aim of present study was to collect and consolidate the ethno-medicinal knowledge of local people of the district about the use of plants for treating gastrointestinal ailments. The ethnobotanical information was collected from the local practitioners, herbal healers and elderly people having rich knowledge about the medicinal herbs through semi-structured questionnaire and key informant discussions. A total 46 plant species belonging to 40 genera and 24 families have been identified which are used as cure for gastrointestinal ailments. Among the parts used for gastointestinal ailments, aerial parts (14%) were followed by the whole plant (13%), root (8%), leaves (6%), flower (5%), fruit and seed (3%) and tuber (1%). These plant species could be prioritized for conservation and subject to further studies related to phytochemical screening for their authenticity. Most of the medicinal plants of the region are collected from the wild and are often harvested for trade. Sustainable harvesting and domestication of the highly traded species from the study area is needed.

Keywords: Amji, gastrointestinal, Kinnaur, medicinal plants, traditional knowledge

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4 Task-Based Teaching for Developing Communication Skills in Second Language Learners

Authors: Geeta Goyal

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Teaching-learning of English as a second language is a challenge for the learner as well as the teacher. Whereas a student may find it hard and get demotivated while communicating in a language other than mother tongue, a teacher, too, finds it difficult to integrate necessary teaching material in lesson plans to maximize the outcome. Studies reveal that task-based teaching can be useful in diverse contexts in a second language classroom as it helps in creating opportunities for language exposure as per learners' interest and capability levels, which boosts their confidence and learning efficiency. The present study has analysed the impact of various activities carried out in a heterogenous group of second language learners at tertiary level in a semi-urban area in Haryana state of India. Language tasks were specifically planned with a focus on engaging groups of twenty-five students for a period of three weeks. These included language games such as spell-well, cross-naught besides other communicative and interactive tasks like mock-interviews, role plays, sharing experiences, storytelling, simulations, scene-enact, video-clipping, etc. Tools in form of handouts and cue cards were also used as per requirement. This experiment was conducted for ten groups of students taking bachelor’s courses in different streams of humanities, commerce, and sciences. Participants were continuously supervised, monitored, and guided by the respective teacher. Feedback was collected from the students through classroom observations, interviews, and questionnaires. Students' responses revealed that they felt comfortable and got plenty of opportunities to communicate freely without being afraid of making mistakes. It was observed that even slow/timid/shy learners got involved by getting an experience of English language usage in friendly environment. Moreover, it helped the teacher in establishing a trusting relationship with students and encouraged them to do the same with their classmates. The analysis of the data revealed that majority of students demonstrated improvement in their interest and enthusiasm in the class. The study revealed that task-based teaching was an effective method to improve the teaching-learning process under the given conditions.

Keywords: communication skills, English, second language, task-based teaching

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3 Kinetic Studies on CO₂ Gasification of Low and High Ash Indian Coals in Context of Underground Coal Gasification

Authors: Geeta Kumari, Prabu Vairakannu

Abstract:

Underground coal gasification (UCG) technology is an efficient and an economic in-situ clean coal technology, which converts unmineable coals into calorific valuable gases. This technology avoids ash disposal, coal mining, and storage problems. CO₂ gas can be a potential gasifying medium for UCG. CO₂ is a greenhouse gas and, the liberation of this gas to the atmosphere from thermal power plant industries leads to global warming. Hence, the capture and reutilization of CO₂ gas are crucial for clean energy production. However, the reactivity of high ash Indian coals with CO₂ needs to be assessed. In the present study, two varieties of Indian coals (low ash and high ash) are used for thermogravimetric analyses (TGA). Two low ash north east Indian coals (LAC) and a typical high ash Indian coal (HAC) are procured from the coal mines of India. Low ash coal with 9% ash (LAC-1) and 4% ash (LAC-2) and high ash coal (HAC) with 42% ash are used for the study. TGA studies are carried out to evaluate the activation energy for pyrolysis and gasification of coal under N₂ and CO₂ atmosphere. Coats and Redfern method is used to estimate the activation energy of coal under different temperature regimes. Volumetric model is assumed for the estimation of the activation energy. The activation energy estimated under different temperature range. The inherent properties of coals play a major role in their reactivity. The results show that the activation energy decreases with the decrease in the inherent percentage of coal ash due to the ash layer hindrance. A reverse trend was observed with volatile matter. High volatile matter of coal leads to the estimation of low activation energy. It was observed that the activation energy under CO₂ atmosphere at 400-600°C is less as compared to N₂ inert atmosphere. At this temperature range, it is estimated that 15-23% reduction in the activation energy under CO₂ atmosphere. This shows the reactivity of CO₂ gas with higher hydrocarbons of the coal volatile matters. The reactivity of CO₂ with the volatile matter of coal might occur through dry reforming reaction in which CO₂ reacts with higher hydrocarbon, aromatics of the tar content. The observed trend of Ea in the temperature range of 150-200˚C and 400-600˚C is HAC > LAC-1 >LAC-2 in both N₂ and CO₂ atmosphere. At the temperature range of 850-1000˚C, higher activation energy is estimated when compared to those values in the temperature range of 400-600°C. Above 800°C, char gasification through Boudouard reaction progressed under CO₂ atmosphere. It was observed that 8-20 kJ/mol of activation energy is increased during char gasification above 800°C compared to volatile matter pyrolysis between the temperature ranges of 400-600°C. The overall activation energy of the coals in the temperature range of 30-1000˚C is higher in N₂ atmosphere than CO₂ atmosphere. It can be concluded that higher hydrocarbons such as tar effectively undergoes cracking and reforming reactions in presence of CO₂. Thus, CO₂ gas is beneficial for the production of high calorific value syngas using high ash Indian coals.

Keywords: clean coal technology, CO₂ gasification, activation energy, underground coal gasification

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2 A Look into Surgical Site Infections: Impact of Collective Interventions

Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

Abstract:

Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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1 Microbiological Profile of UTI along with Their Antibiotic Sensitivity Pattern with Special Reference to Nitrofurantoin

Authors: Rupinder Bakshi, Geeta Walia, Anita Gupta

Abstract:

Introduction: Urinary tract infections (UTI) are considered to be one of the most common bacterial infections with an estimated annual global incidence of 150 million. Antimicrobial drug resistance is one of the major threats due to widespread usage of uncontrolled antibiotics. Materials and Methods: A total number of 9149 urine samples were collected from R.H Patiala and processed in the Department of Microbiology G.M.C Patiala. Urine samples were inoculated on MacConkey’s and blood agar plates by using calibrated loop delivering 0.001 ml of sample and incubated at 37 °C for 24 hrs. The organisms were identified by colony characters, gram’s staining and biochemical reactions. Antimicrobial susceptibility of the isolates was determined against various antimicrobial agents (Hi – Media Mumbai India) by Kirby-Bauer disk diffusion method on Muller Hinton agar plates. Results: Maximum patients were in the age group of 21-30 yrs followed by 31-40 yrs. Males (34%) are less prone to urinary tract infections than females (66%). Out of 9149 urine sample, the culture was positive in 25% (2290) samples. Esch. coli was the most common isolate 60.3% (n = 1378) followed by Klebsiella pneumoniae 13.5% (n = 310), Proteus spp. 9% (n = 209), Staphylococcus aureus 7.6 % (n = 173), Pseudomonas aeruginosa 3.7% (n = 84), Citrobacter spp. 3.1 % (70), Staphylococcus saprophyticus 1.8 % (n = 142), Enterococcus faecalis 0.8%(n=19) and Acinetobacter spp. 0.2%(n=5). Gram negative isolates showed higher sensitivity towards, Piperacillin +Tazobactum (67%), Amikacin (80%), Nitrofurantoin (82%), Aztreonam (100%), Imipenem (100%) and Meropenam (100%) while gram positive showed good response towards Netilmicin (69%), Nitrofurantoin (79%), Linezolid (98%), Vancomycin (100%) and Teicoplanin (100%). 465 (23%) isolates were resistant to Penicillins, 1st generation and 2nd generation Cehalosporins which were further tested by double disk approximation test and combined disk method for ESBL production. Out of 465 isolates, 375 were ESBLs consisting of n 264 (70.6%) Esch.coli and 111 (29.4%) Klebsiella pneumoniae. Susceptibility of ESBL producers to Imipenem, Nitrofurantoin and Amikacin were found to be 100%, 76%, and 75% respectively. Conclusion: Uropathogens are increasingly showing resistance to many antibiotics making empiric management of outpatients UTIs challenging. Ampicillin, Cotrimoxazole, and Ciprofloxacin should not be used in empiric treatment. Nitrofurantoin could be used in lower urinary tract infection. Knowledge of uropathogens and their antimicrobial susceptibility pattern in a geographical region will help inappropriate and judicious antibiotic usage in a health care setup.

Keywords: Urinary Tract Infection, UTI, antibiotic susceptibility pattern, ESBL

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