Search results for: Latha Subbiah

Authors: Latha Subbiah, Dhanalakshmi Samiappan

Abstract:

In this paper, we propose denoising Common Carotid Artery (CCA) B mode ultrasound images by a decomposition approach to curvelet thresholding and automatic segmentation of the intima media thickness and adventitia boundary. By decomposition, the local geometry of the image, its direction of gradients are well preserved. The components are combined into a single vector valued function, thus removes noise patches. Double threshold is applied to inherently remove speckle noise in the image. The denoised image is segmented by active contour without specifying seed points. Combined with level set theory, they provide sub regions with continuous boundaries. The deformable contours match to the shapes and motion of objects in the images. A curve or a surface under constraints is developed from the image with the goal that it is pulled into the necessary features of the image. Region based and boundary based information are integrated to achieve the contour. The method treats the multiplicative speckle noise in objective and subjective quality measurements and thus leads to better-segmented results. The proposed denoising method gives better performance metrics compared with other state of art denoising algorithms.

Keywords: curvelet, decomposition, levelset, ultrasound

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Authors: Uwonkunda Jeanne, J. Godwin Prem Singh, Anjaneyalu Subbiah

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HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole.

Keywords: People living with HIV, social dysfunction, stigma, and Social support.

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Authors: S. Sushma, S. Balasubramanian, K. C. Latha

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The mammographic image of breast cancer compressed and synthesized to get co-efficient values which will be converted (5x5) matrix to get ROI image where we get the highest value of effected region and with the same ideology the technique has been extended to differentiate between Calcification and normal cell image using mean value derived from 5x5 matrix values

Keywords: texture analysis, mammographic image, partitioned gray scale co-oocurance matrix, co-efficient

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Authors: S. Sushma, S. Balasubramanian, K. C. Latha, R. Sridhar

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Structural texture measures are used to address the aspect of breast cancer risk assessment in screening mammograms. The current study investigates whether texture properties characterized by local Fractal Dimension (FD) and lacunarity contribute to assess breast cancer risk. Fractal Dimension represents the complexity while the lacunarity characterize the gap of a fractal dimension. In this paper, we present our result confirming that the lacunarity value resulted in algorithm using mammogram images states that level of lacunarity will be low when the Fractal Dimension value will be high.

Keywords: breast cancer, fractal dimension, image analysis, lacunarity, mammogram

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Authors: Shubha T., Latha H. K. E., Yogananth Karuppiah

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Accessing and sharing automobiles will become much simpler thanks to the wide range of automotive use cases made possible by digital keys. This study aims to provide digital keys to car owners and drivers so they can lock or unlock their automobiles and start the engine using a smartphone or other Bluetooth low energy-enabled mobile device. Private automobile owners can digitally lend their car keys to family members or friends without having to physically meet them, possibly for a certain period of time. Owners of company automobile fleets can electronically distribute car keys to staff members, possibly granting access for a given day or length of time. Customers no longer need to physically pick up car keys at a rental desk because automobile owners can digitally transfer keys with them.

Keywords: NFC, BLE, CCC, digital key, OEM

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Authors: Jessica Bain, Greg Thoma, Marty Matlock, Jeyam Subbiah, Ebenezer Kwofie

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The environmental impact and particulate matter emissions (PM) associated with the production and packaging of 1 kg of almonds were evaluated using life cycle assessment (LCA). The assessment began at the point of ready to harvest with a system boundary was a cradle-to-gate assessment of almond packaging in California. The assessment included three scenarios of off-ground harvesting of almonds. The three general off-ground harvesting scenarios with variations include the harvested almonds solar dried on a paper tarp in the orchard, the harvested almonds solar dried on the floor in a separate lot, and the harvested almonds dried mechanically. The life cycle inventory (LCI) data for almond production were based on previously published literature and data provided by Almond Board of California (ABC). The ReCiPe 2016 method was used to calculate the midpoint impacts. Using consequential LCA model, the global warming potential (GWP) for the three harvesting scenarios are 2.90, 2.86, and 3.09 kg CO2 eq/ kg of packaged almond for scenarios 1, 2a, and 3a, respectively. The global warming potential for conventional harvesting method was 2.89 kg CO2 eq/ kg of packaged almond. The particulate matter emissions for each scenario per hectare for each off-ground harvesting scenario is 77.14, 9.56, 66.86, and 8.75 for conventional harvesting and scenarios 1, 2, and 3, respectively. The most significant contributions to the overall emissions were from almond production. The farm gate almond production had a global warming potential of 2.12 kg CO2 eq/ kg of packaged almond, approximately 73% of the overall emissions. Based on comparisons between the GWP and PM emissions, scenario 2a was the best tradeoff between GHG and PM production.

Keywords: life cycle assessment, low moisture foods, sustainability, LCA

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Authors: Murali Munisamy, Gauthaman Karunakaran, Mubarak Al-Gahtany, Vivekanandhan Subbiah, M. Manjari Tripati

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Background: Sodium valproate is a widely prescribed broad-spectrum anti-epileptic drug. It shows high inter-individual variability in pharmacokinetics and pharmacodynamics and has a narrow therapeutic range. We evaluated the effects of polymorphic uridine diphosphate glucuronosyltransferase (UGT1A9) metabolizing enzyme on the pharmacokinetics of sodium valproate in the patients with epilepsy who showed toxicity to therapy. Methods: Genotype analysis of the patients was made with polymerase chain–restriction fragment length polymorphism (RFLP) with sequencing. Plasma drug concentrations were measured with reversed phase high-performance liquid chromatography (HPLC) and concentration–time data were analyzed by using a non-compartmental approach. Results: The results of this study suggested a significant genotypic as well as allelic association with valproic acid toxicity for UGT1A9 polymorphic enzymes. The elimination half-life (t 1/2=40.2 h) of valproic acid was longer and the clearance rate (CL=937 ml/h) was lower in the poor metabolizers group of UGT1A9 polymorphism who showed toxicity than in the intermediate metabolizers group (t1/2=35.5 h, CL=1042 ml/h) or the extensive metabolizers group (t1/2=26. h, CL=1,302 ml/h). Conclusion: Our findings suggest that the UGT1A9 genetic polymorphism plays a significant role in the steady state concentration of sodium valproate, and it thereby has an impact on the toxicity of the sodium valproate used in the patients with epilepsy.

Keywords: UGT1A9, sodium valporate, pharmacogenetics, polymorphism

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Authors: Vishant Gahlaut, A Mercy Latha, Sanjay Kumar Ghosh

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Multi-stage depressed collectors (MDC) are used as an efficiency enhancement technique in traveling wave tubes the high-energy electron beam, after its interaction with the RF signal, gets velocity sorted and collected at various depressed electrodes of the MDC. The ultimate goal is to identify an optimum thermal management scheme (cooling mechanism) that could extract the heat efficiently from the electrodes. Careful thermal analysis, incorporating the cooling mechanism is required to ensure that the maximum temperature does not exceed the safe limits. A simple analytical model for quick prediction of the thermal has been developed. The model has been developed for the worst-case un-modulated DC condition, where all the thermal power is dissipated in the last electrode (typically, fourth electrode in the case of the four-stage depressed collector). It considers the thermal contact resistances at various braze joints accounting for the practical non-uniformities. Analytical results obtained from the model have been validated with simulated and experimental results.

Keywords: multi-stage depressed collector, TWTs, thermal contact resistance, thermal management

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Authors: D. Latha, V. Sunitha, Samson Mathew

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In India, most of the pavement is laid by bituminous road and the consumption of binder is high for pavement construction and also modified binders are used to satisfy any specific pavement requirement. Since the binders are visco-elastic material which is having the mechanical properties of binder transition from visco-elastic solid to visco-elastic fluid. In this paper, two different protocols were used to measure the viscosity property of binder using a Brookfield Viscometer and there is a need to find the appropriate mixing and compaction temperatures of various types of binders which can result in complete aggregate coating and adequate field density of HMA mixtures. The aim of this work is to find the transition temperature from Non-Newtonian behavior to Newtonian behavior of the binder by adopting a steady shear protocol and the shear rate ramp protocol. The transition from non-Newtonian to Newtonian can occur through an increase of temperature and shear of the material. The test has been conducted for unmodified binder VG 30. The transition temperature was found in the unmodified binder VG is 120oC. So the application of both modified binder and unmodified binder in the pavement construction needs to be studied properly by considering temperature and traffic loading factors of the respective project site.

Keywords: unmodified and modified binders, Brookfield viscometer, transition temperature, steady shear and shear rate protocol

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Authors: Ashokkumar Subbiah

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This study investigates the impact of factors that influenced the success of construction planning for a major construction project in Qatar. An approach of participant observation is adopted which is informed by the principles of ethnography: one that reports the participants’ view of their world rather than imposing an artificial theoretical framework upon it. As participant observant, key factors were observed and identified that had an impact on the management and execution of the construction planning. It is found that a ‘shadow culture’ exists between the project participants which, it is argued, is only observable from the perspective of an embedded participant observer. The shadow culture acts to enable the management of the planning process, and its efficacy relates to the ‘quality’ of human inter-relationships amongst immediate stakeholders. Whilst this study uses the concept of shadow culture, it is treated as both a methodological stance and one of the findings of this research in the context of the major construction project in Qatar. The concept of shadow culture is not imposed upon the findings, but instead is used as a research tool: respondents report their own worldview and this is reported from the view of a participant observant in a manner that is understandable and useful to those who are not part of the construction project. The findings of this study identify similar factors influencing the planning process of the Qatar project, but the shadow culture predominantly influences these factors towards the failure of planning process. The research concludes by questioning the assumption that construction planning is a mechanistic process that has to be conducted solely by the planning team. Instead, it is a highly social phenomenon in which the seemingly mechanistic process is made workable by the quality of relationships that exist in the project. Drawing on this the final section provides a series of recommendations that may be helpful in enhancing the efficacy of project planning; these include better training/education at the pre-construction phase; recognition of the importance of shadow processes at management levels, and better appreciation of the impact of contract type and chosen procurement route.

Keywords: construction planning, participant observation, project participants, shadow culture

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Authors: Dipti Yadav, Latha Rangan, Pinakeswar Mahanta

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Recent fuel-development strategies to reduce oil dependency, mitigate greenhouse gas emissions, and utilize domestic resources have generated interest in the search for alternative sources of fuel supplies. Bioenergy production from lignocellulosic biomass has a great potential. Cellulose, hemicellulose and Lignin are main constituent of woods or agrowaste. In all the industries there are always left over or waste products mainly lignin, due to the heterogeneous nature of wood and pulp fibers and the heterogeneity that exists between individual fibers, no method is currently available for the quantitative isolation of native or residual lignin without the risk of structural changes during the isolation. The potential benefits from finding alternative uses of lignin are extensive, and with a double effect. Lignin can be used to replace fossil-based raw materials in a wide range of products, from plastics to individual chemical products, activated carbon, motor fuels and carbon fibers. Furthermore, if there is a market for lignin for such value-added products, the mills will also have an additional economic incentive to take measures for higher energy efficiency. In this study residual lignin were isolated from areca nut shells by acid hydrolysis and were analyzed and characterized by Fourier Transform Infrared (FTIR), LCMS and complexity of its structure investigated by NMR.

Keywords: Areca nut, Lignin, wood, bioenergy

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Authors: P.J. Jiji, B.V. Murlimanju, Latha V. Prabhu, Mangala M. Pai

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Background: The lunate bone dislocation can lead to the compression of the median nerve and subsequent carpal tunnel syndrome. The dislocation can interrupt the vasculature and would cause avascular necrosis. The objective of the present study was to study the morphology and number of the nutrient foramina in the cadaveric dried lunate bones of the Indian population. Methods: The present study included 28 lunate bones (13 right sided and 15 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the lunate bones. The foramen ranged between 2 and 10. The foramina were more in number over the dorsal surface (average number 3.3) in comparison to the palmar surface (average number 2.4). Conclusion: We believe that the present study has provided important data about the nutrient foramina of the lunate bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the lunatomalacia and Kienbock’s disease.

Keywords: avascular necrosis, foramen, lunate, nutrient

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Authors: Nadia Adnan, Muhammad Mohsin Raza, Latha Ravindran

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Based on the principles above, the study presents an economic model of food waste for consumers, intermediaries, and producers. We discriminate between purchasing and selling, purchases versus customers consumption, and gross output versus sales for each intermediary. To compensate for waste at each level of the supply chain, agents must charge higher sales prices. The research model can produce more accurate predictions about how actions (public regulations or private efforts) to reduce food waste impact markets, including indirect (cascading) effects. With a formal model, researchers demonstrate the uniqueness of these interaction effects and simulate an empirical model calibrated to market characteristics and waste rates in Saudi Arabia. Researchers demonstrate that the effects of waste reduction differ per commodity, depending on supply and demand elasticities, degree of openness to international commerce, and the beginning rates of food loss and waste at each level of the value chain. Because of the consequential effects related to the supply chain, initiatives to minimize food waste will be strengthened in some circumstances and partially countered in others.

Keywords: food loss, food waste, supply chain management, Saudi Arabia, food supply

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Authors: B. V. Murlimanju, P. J. Jiji, Latha V. Prabhu, Mangala M. Pai

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Background: The scaphoid is the most commonly fractured bone of the wrist. The fracture may disrupt the vessels and end up as the avascular necrosis of the bone. The objective of the present study was to investigate the morphology and number of the nutrient foramina in the cadaveric dried scaphoid bones of the Indian population. Methods: The present study included 46 scaphoid bones (26 right sided and 20 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular surfaces. The foramina were observed only over the palmar and dorsal surfaces of the scaphoid bones. The foramina were observed both proximal and distal to the mid waist of the scaphoid bone. The foramen ranged between 9 and 54 in each scaphoid bone. The foramina over the palmar surface ranged between, 2-24 in number. The foramina over the dorsal surface ranged between, 7-36 in number. The foramina proximal to the waist ranged between 2 and 24 in number and distal to the waist ranged between 3 and 39. Conclusion: We believe that the present study has provided additional data about the nutrient foramina of the scaphoid bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The morphological knowledge of the vasculature, their foramina of entry and their number is required to understand the concepts in the avascular necrosis of the proximal scaphoid and non-union of the fracture at the waist of the scaphoid.

Keywords: avascular necrosis, nutrient, scaphoid, vascular

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Authors: Latha V. Prabhu, B.V. Murlimanju, P.J. Jiji, Mangala M. Pai

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Background: The capitate is the largest among the carpal bones. There exists no literature about the vascular foramina of the capitate bone. The objective of the present study was to investigate the morphology and number of the nutrient foramina in the cadaveric dried capitate bones of the Indian population. Methods: The present study included 59 capitate bones (25 right sided and 34 left sided) which were obtained from the gross anatomy laboratory of our institution. The bones were macroscopically observed for the nutrient foramina and the data was collected with respect to their number. The tabulation of the data and analysis were done. Results: All of our specimens (100%) exhibited the nutrient foramina over the non-articular and articular surfaces. The foramina were observed at the medial, lateral, palmar and dorsal surfaces of the capitate bones. The foramina were ranged from 6 to 23 in each capitate bone. In the medial surface, the foramina ranged from 1 to 6, lateral surface from 0 to 7, the foramina ranged between 0 and 5 in the palmar surface. However most of the foramina were located at the dorsal surface which ranged from 3 to 11. Conclusion: We believe that the present study has provided additional data about the nutrient foramina of the capitate bones. The data is enlightening to the orthopedic surgeon and would help in the hand surgeries. The knowledge about the foramina is also important to the radiologists to prevent the misinterpretation of the findings in the x ray and computed tomogram scan films. The foramina may mimick like erosions and ossicles. The morphological knowledge of the vasculature, their foramina of entry and number is required to understand the concepts in the avascular necrosis of the capitate.

Keywords: avascular necrosis, capitate, morphology, nutrient foramen

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Authors: Latha Nataraj, Todd Henry, Micheal Wallock, Asha Hall, Christine Hatter, Babak Anasori, Yury Gogotsi

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Multifunctional composites with enhanced strength and toughness for superior damage tolerance are essential for advanced aerospace and military applications. Detection of structural changes prior to visible damage may be achieved by incorporating fillers with tunable properties such as two-dimensional (2D) nanomaterials with high aspect ratios and more surface-active sites. While 2D graphene with large surface areas, good mechanical properties, and high electrical conductivity seems ideal as a filler, the single-atomic thickness can lead to bending and rolling during processing, requiring post-processing to bond to polymer matrices. Lately, an emerging family of 2D transition metal carbides and nitrides, MXenes, has attracted much attention since their discovery in 2011. Metallic electronic conductivity and good mechanical properties, even with increased polymer content, coupled with hydrophilicity make MXenes a good candidate as a filler material in polymer composites and exceptional as multifunctional damage indicators in composites. Here, we systematically study MXene-based (Ti₃C₂) coated on glass fibers for fiber reinforced polymer composite for self-sensing using microscopy and micromechanical testing. Further testing is in progress through the investigation of local variations in optical, acoustic, and thermal properties within the damage sites in response to strain caused by mechanical loading.

Keywords: damage sensing, fiber composites, MXene, self-sensing

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Authors: M. Latha, Achintya K. Dolui, P. Vijayaraj

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Vegetable oils mainly triacylglycerol (TAG) are an essential nutrient in the human diet as well as one of the major global commodity. There is a pressing need to enhance the yield of oil production to meet the world’s growing demand. Oil content is controlled by the balance between synthesis and breakdown in the cells. Several studies have established to increase the oil content by the overexpression of oil biosynthetic enzymes. Interestingly the significant oil accumulation was observed with impaired TAG hydrolysis. Unfortunately, the structural, as well as the biochemical properties of the lipase enzymes, is widely unknown, and so far, no candidate gene was identified in seeds except sugar-dependent1 (SDP1). Evidence has shown that SDP1directly responsible for initiation of oil breakdown in the seeds during germination. The present study is the identification of seed-specific acyl-hydrolases by activity based proteome profiling (ABPP) using Arabidopsis thaliana as a model system. The ABPP reveals that around 8 to 10 proteins having the serine hydrolase domain and are expressed during germination of Arabidopsis seed. The N-term sequencing, as well as LC-MS/MS analysis, was performed for the differentially expressed protein during germination. The coding region of the identified proteins was cloned, and lipases activity was assessed with purified recombinant protein. The enzyme assay was performed against various lipid substrates, and we have observed the acylhydrolase activity towards lysophosphatidylcholine and monoacylglycerol. Further, the functional characteristic of the identified protein will reveal the physiological significance the enzyme in oil accumulation.

Keywords: lipase, lipids, vegetable oil, triacylglycerol

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Authors: Mangala M. Pai, B. V. Murlimanju, Latha V. Prabhu, P. J. Jiji , Vandana Blossom

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Background:To study the morphological parameters of the axis vertebra in anatomical specimens. Methods: The present study was designed to obtain the morphometric data of axis vertebra. The superior and inferior articular facets of the axis were macroscopically observed for their shapes and the different parameters were measured using the digital Vernier caliper. It included 20 dried axis bones, which were obtained from the anatomy laboratory. Results: The morphometric data obtained in the present study are represented in the tables. The side wise comparison of the length and width of the articular facets of the axis vertebra were done. The present study observed that, there is no statistically significant difference observed among the parameters of right and left side articular facets (p>0.05). The superior and inferior articular facets were observed to have variable shapes. The frequencies of different shapes of superior and inferior articular facets are represented in figures. All the shapes of the inferior and superior articular facets were symmetrical over the right and left sides. Among the superior articular facets, the constrictions were absent in 13 cases (65%), 2 (10%) exhibited a single constriction, 3 (15%) had 2 constrictions and 2 (10%) were having 3 constrictions. The constrictions were absent in 11 (55%) of the inferior articular facets, 3 (15%) of them had 1 constriction, 3 (15%) were having 2 constrictions, 2 (10%) exhibited 3 constrictions and 1 (5%) of them had 4 constrictions. The constrictions of the inferior and superior articular facets were symmetrical over the right and left sides. Conclusion: We believe that the present study has provided additional information on the morphometric data of the axis vertebra. The data are important to the neurosurgeons, orthopedic surgeons and radiologists. The preoperative assessment of the axis vertebra may prevent dangerous complications like spinal cord and nerve root compression during the surgical intervention.

Keywords: axis, articular facet, morphology, morphometry

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Authors: Latha Krishnan, Andrew Cobley

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Epoxy resin is most widely used as matrices for composites of aerospace, automotive and electronic applications due to its outstanding mechanical properties. These properties are chiefly predetermined by the chemical structure of the prepolymer and type of hardener but can also be varied by the processing conditions such as prepolymer and hardener mixing, degassing and curing conditions. In this research, the effect of degassing on the curing behaviour and the void occurrence is experimentally evaluated for epoxy /anhydride resin system. The epoxy prepolymer was mixed with an anhydride hardener and accelerator in an appropriate quantity. In order to investigate the effect of degassing on the curing behaviour and void content of the resin, the uncured resin samples were prepared using three different methods: 1) no degassing 2) degassing on prepolymer and 3) degassing on mixed solution of prepolymer and hardener with an accelerator. The uncured resins were tested in differential scanning calorimeter (DSC) to observe the changes in curing behaviour of the above three resin samples by analysing factors such as gel temperature, peak cure temperature and heat of reaction/heat flow in curing. Additionally, the completely cured samples were tested in DSC to identify the changes in the glass transition temperature (Tg) between the three samples. In order to evaluate the effect of degassing on the void content and morphology changes in the cured epoxy resin, the fractured surfaces of cured epoxy resin were examined under the scanning electron microscope (SEM). Also, the changes in the mechanical properties of the cured resin were studied by three-point bending test. It was found that degassing at different stages of resin mixing had significant effects on properties such as glass transition temperature, the void content and void size of the epoxy/anhydride resin system. For example, degassing (vacuum applied on the mixed resin) has shown higher glass transition temperature (Tg) with lower void content.

Keywords: anhydride epoxy, curing behaviour, degassing, void occurrence

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Authors: Latha Krishnan, Andrew Cobley

Abstract:

Epoxy resin is most widely used as matrices for composites of aerospace, automotive and electronic applications due to its outstanding mechanical properties. These properties are chiefly predetermined by the chemical structure of the prepolymer and type of hardener but can also be varied by the processing conditions such as prepolymer and hardener mixing, degassing and curing conditions. In this research, the effect of degassing on the curing behaviour and the void occurrence is experimentally evaluated for epoxy /anhydride resin system. The epoxy prepolymer was mixed with an anhydride hardener and accelerator in an appropriate quantity. In order to investigate the effect of degassing on the curing behaviour and void content of the resin, the uncured resin samples were prepared using three different methods: 1) no degassing 2) degassing on prepolymer and 3) degassing on mixed solution of prepolymer and hardener with an accelerator. The uncured resins were tested in differential scanning calorimeter (DSC) to observe the changes in curing behaviour of the above three resin samples by analysing factors such as gel temperature, peak cure temperature and heat of reaction/heat flow in curing. Additionally, the completely cured samples were tested in DSC to identify the changes in the glass transition temperature (Tg) between the three samples. In order to evaluate the effect of degassing on the void content and morphology changes in the cured epoxy resin, the fractured surfaces of cured epoxy resin were examined under the scanning electron microscope (SEM). In addition, the amount of void, void geometry and void fraction were also investigated using an optical microscope and image J software (image analysis software). It was found that degassing at different stages of resin mixing had significant effects on properties such as glass transition temperature, the void content and void size of the epoxy/anhydride resin system. For example, degassing (vacuum applied on the mixed resin) has shown higher glass transition temperature (Tg) with lower void content.

Keywords: anhydride epoxy, curing behaviour, degassing, void occurrence

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Authors: Aishvarya Gupta, Keerthana Anand, Sasirekha Rengaraj, Latha Chathurvedula

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Introduction: Advances in assisted reproductive technology and increase in the proportion of infertile couples have both contributed to the steep increase in the incidence of twin pregnancies in past decades. Maternal and perinatal complications are higher in twins than in singleton pregnancies. Studies comparing the maternal and perinatal outcomes of ART twin pregnancies versus spontaneously conceived twin pregnancies report heterogeneous results making it unclear whether the complications are due to twin gestation per se or because of assisted reproductive techniques. The present study aims to compare both maternal and perinatal outcomes in twin pregnancies which are spontaneously conceived and after assisted conception methods, so that targeted steps can be undertaken in order to improve maternal and perinatal outcome of twins. Objectives: To study perinatal and maternal outcome in twin pregnancies conceived spontaneously as well as with assisted methods and compare the outcomes between the two groups. Setting: Women delivering at JIPMER (tertiary care institute), Pondicherry. Population: 380 women with twin pregnancies who delivered in JIPMER between June 2015 and March 2017 were included in the study. Methods: The study population was divided into two cohorts – one conceived by spontaneous conception and other by assisted reproductive methods. Association of various maternal and perinatal outcomes with the method of conception was assessed using chi square test or Student's t test as appropriate. Multiple logistic regression analysis was done to assess the independent association of assisted conception with maternal outcomes after adjusting for age, parity and BMI. Multiple logistic regression analysis was done to assess the independent association of assisted conception with perinatal outcomes after adjusting for age, parity, BMI, chorionicity, gestational age at delivery and presence of hypertension or gestational diabetes in the mother. A p value of < 0.05 was considered as significant. Result: There was increased proportion of women with GDM (21% v/s 4.29%) and premature rupture of membranes (35% v/s 22.85%) in the assisted conception group and more anemic women in the spontaneous group (71.27% v/s 55.1%). However assisted conception per se increased the incidence of GDM among twin gestations (OR 3.39, 95% CI 1.34 – 8.61) and did not influence any of the other maternal outcomes. Among the perinatal outcomes, assisted conception per se increased the risk of having very preterm (<32 weeks) neonates (OR 3.013, 95% CI 1.432 – 6.337). The mean birth weight did not significantly differ between the two groups (p = 0.429). Though there were higher proportion of babies admitted to NICU in the assisted conception group (48.48% v/s 36.43%), assisted conception per se did not increase the risk of admission to NICU (OR 1.23, 95% CI 0.76 – 1.98). There was no significant difference in perinatal mortality rates between the two groups (p = 0.829). Conclusion: Assisted conception per se increases the risk of developing GDM in women with twin gestation and increases the risk of delivering very preterm babies. Hence measures should be taken to ensure appropriate screening methods for GDM and suitable neonatal care in such pregnancies.

Keywords: assisted conception, maternal outcomes, perinatal outcomes, twin gestation

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