Search results for: Lokesh K.
Commenced in January 2007
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Edition: International
Paper Count: 15

Search results for: Lokesh K.

15 Alternative Seed System for Enhanced Availability of Quality Seeds and Seed/Varietal Replacement Rate - An Experience

Authors: Basave Gowda, Lokesh K., Prasanth S. M., Bellad S. B., Radha J., Lokesh G. Y., Patil S. B., Vijayakumar D. K., Ganigar B. S., Rakesh C. Mathad

Abstract:

Quality seed plays an important role in enhancing the crop productivity. It was reported and confirmed by large scale verification research trials that by use of quality seeds alone, the crop yield can be enhanced by 15 to 20 per cent. At present, the quality seed production and distribution through organised sectors comprising both public and private seed sector was only 20-25% of the requirement and the remaining quantity is met through unorganised sector which include the farmer to farmers saved seeds. With an objective of developing an alternative seed system, the University of Agricultural Sciences, Raichur in Karnataka state has implemented Seed Village Programme in more than 100 villages covering around 5000 farmers every year since 2009-10 and in the selected seed villages, a group of 50-150 farmers were supplied the foundation seeds of new varieties to an extent of 0.4 ha at 50 % subsidy. And two to three training programmes were conducted in the targeted villages for quality seed production and the seed produced in the target group was processed locally in the university seed processing units and arranged for distribution in the local villages by the seed growers themselves. By this new innovative and modified seed system, the university can able to replace old varieties of pigeon pea and green gram by producing 1482, 2978, 2729, 2560, and 4581 tonnes of seeds of new varieties on large scale under farmers and scientists participatory seed village programmes respectively during 2009-10, 2010-11, 2011-12, 2012-13 and 2013-14. From this new alternate model of seed system, there should be large scale promotion of regional seed system involving farmers, NGO and voluntary organisation for quick and effective replacement of old, low yielding, disease susceptible varieties with new high yielding, disease resistant for enhanced food production and food security.

Keywords: seed system, seed village, seed replacement, varietal replacement

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14 Study of Intermolecular Interactions in Binary Mixtures of 1-Butyl-3-Methyl Imidazolium Bis (Trifluoro Methyl Sulfonyl) Imide and 1-Ethyl-3-Methyl Imidazolium Ethyl Sulphate at Different Temperature from 293.18 to 342.15 K

Authors: V. Lokesh, M. Manjunathan, S. Sairam, K. Saithsh Kumar, R. Anantharaj

Abstract:

The densities of pure and its binary mixtures of 1-Butyl-3-methyl imidazolium bis (trifluoro methyl sulfonyl) imide and 1–Ethyl-3-methyl imidazolium ethyl sulphate at different temperature, over the entire composition range were measured at 293.15, 298.15, 303.15, 308.15, 313.15, 318.15, 323.15, 328.15, 33.15, 338.15, 343.15 K. In this study, the liquid-liquid extraction procedure was used. From this experimental data, the excess molar volumes, apparent molar volume, partial molar volumes and the excess partial molar volumes have been calculated for over the whole composition range. Hence, the effect of temperature and composition on all derived thermodynamic properties of this binary mixture will be discussed in terms of intermolecular interactions.

Keywords: ionic liquid, interaction energy, effect of temperature, effect of composition

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13 Genetic Algorithm Based Node Fault Detection and Recovery in Distributed Sensor Networks

Authors: N. Nalini, Lokesh B. Bhajantri

Abstract:

In Distributed Sensor Networks, the sensor nodes are prone to failure due to energy depletion and some other reasons. In this regard, fault tolerance of network is essential in distributed sensor environment. Energy efficiency, network or topology control and fault-tolerance are the most important issues in the development of next-generation Distributed Sensor Networks (DSNs). This paper proposes a node fault detection and recovery using Genetic Algorithm (GA) in DSN when some of the sensor nodes are faulty. The main objective of this work is to provide fault tolerance mechanism which is energy efficient and responsive to network using GA, which is used to detect the faulty nodes in the network based on the energy depletion of node and link failure between nodes. The proposed fault detection model is used to detect faults at node level and network level faults (link failure and packet error). Finally, the performance parameters for the proposed scheme are evaluated.

Keywords: distributed sensor networks, genetic algorithm, fault detection and recovery, information technology

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12 Laboratory Studies to Assess the Effect of Recron Fiber on Soil Subgrade Characteristics

Authors: Lokesh Gupta, Rakesh Kumar

Abstract:

Stabilization of weak subgrade soil is mainly aimed for the improvement of soil strength and its durability. Highway engineers are concerned to get the soil material or system that will hold under the design use conditions and for the designed life of the engineering project. The present study envisages the effect of Recron fibres mixed in different proportion (up to 1% by weight of dry soil) on Atterberg limits, Compaction of the soil, California bearing ratio (CBR) values and unconfined compressive strength (UCS) of the soil. The present study deals with the influence of varying in length (20 mm, 30mm, 40mm and 50mm) and percentage (0.25 %, 0.50 %, 0.75 % and 1.0 %) of fibre added to the soil samples. The aim of study is to determine the reinforcing effect of randomly distributed fibres on the Compaction characteristics, penetration resistance and unconfined compressive strength of soils. The addition of fibres leads to an increase in the optimum moisture content and decrease in maximum dry density. With the addition of the fibres, the increases in CBR and UCS values are observed. The test result shows higher CBR and unconfined compressive strength value for the soil reinforced with 0.5% Recron fibre, once keeping aspect ratio as 160.

Keywords: soil, recron fiber, unconfined compressive strength (UCS), California bearing ratio (CBR)

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11 Reliability Indices Evaluation of SEIG Rotor Core Magnetization with Minimum Capacitive Excitation for WECs

Authors: Lokesh Varshney, R. K. Saket

Abstract:

This paper presents reliability indices evaluation of the rotor core magnetization of the induction motor operated as a self-excited induction generator by using probability distribution approach and Monte Carlo simulation. Parallel capacitors with calculated minimum capacitive value across the terminals of the induction motor operating as a SEIG with unregulated shaft speed have been connected during the experimental study. A three phase, 4 poles, 50Hz, 5.5 hp, 12.3A, 230V induction motor coupled with DC Shunt Motor was tested in the electrical machine laboratory with variable reactive loads. Based on this experimental study, it is possible to choose a reliable induction machine operating as a SEIG for unregulated renewable energy application in remote area or where grid is not available. Failure density function, cumulative failure distribution function, survivor function, hazard model, probability of success and probability of failure for reliability evaluation of the three phase induction motor operating as a SEIG have been presented graphically in this paper.

Keywords: residual magnetism, magnetization curve, induction motor, self excited induction generator, probability distribution, Monte Carlo simulation

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10 Antihypertensive Activity of Alcoholic Extract of Citrus Paradise Juice in One Clip One Kidney Hypertension Model in Rats

Authors: Lokesh Bhatt, Jayesh Rathod

Abstract:

Hypertension is one of the most prevalent cardiovascular disorder. It is responsible for several other cardiovascular disorders. Although many drugs are available for the treatment of hypertension, still a large population has uncontrolled blood pressure. Thus there is an unmet need for new therapeutic approaches for the same. Fruit juice of Citrus paradise contains several flavonoids with vasodilatory activity. We hypothesized that alcoholic extract of Citrus paradise, which contains flavonoids, might attenuate hypertension. The objective of the present study was to evaluate the antihypertensive activity of alcoholic extract of Citrus paradise fruit juice in rats. Hypertension was induced using one clip one kidney model in rats. The renal artery was occluded for 4 h after removal of one kidney. Once stabilized, the ganglionic blockade was performed followed by removal of the arterial clip from the kidney. Removal of clip resulted in an increase in blood pressure which is due to release of renin from the kidney. Alcoholic extract of Citrus paradise fruit juice was then administered at 50 mg/kg and 100 mg/kg dose by intravenous injection. Blood pressure was monitored continuously. Alcoholic extract of Citrus paradise fruit juice reduced hypertension in dose-dependent manner. Antihypertensive activity was found to be associated with vasodilation. The results of the present study showed antihypertensive potential of alcoholic extract of Citrus paradise fruit juice.

Keywords: citrus paradise, alcoholic extract, one clip one kidney model, vasodilation

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9 Improving Search Engine Performance by Removing Indexes to Malicious URLs

Authors: Durga Toshniwal, Lokesh Agrawal

Abstract:

As the web continues to play an increasing role in information exchange, and conducting daily activities, computer users have become the target of miscreants which infects hosts with malware or adware for financial gains. Unfortunately, even a single visit to compromised web site enables the attacker to detect vulnerabilities in the user’s applications and force the downloading of multitude of malware binaries. We provide an approach to effectively scan the so-called drive-by downloads on the Internet. Drive-by downloads are result of URLs that attempt to exploit their visitors and cause malware to be installed and run automatically. To scan the web for malicious pages, the first step is to use a crawler to collect URLs that live on the Internet, and then to apply fast prefiltering techniques to reduce the amount of pages that are needed to be examined by precise, but slower, analysis tools (such as honey clients or antivirus programs). Although the technique is effective, it requires a substantial amount of resources. A main reason is that the crawler encounters many pages on the web that are legitimate and needs to be filtered. In this paper, to characterize the nature of this rising threat, we present implementation of a web crawler on Python, an approach to search the web more efficiently for pages that are likely to be malicious, filtering benign pages and passing remaining pages to antivirus program for detection of malwares. Our approaches starts from an initial seed of known, malicious web pages. Using these seeds, our system generates search engines queries to identify other malicious pages that are similar to the ones in the initial seed. By doing so, it leverages the crawling infrastructure of search engines to retrieve URLs that are much more likely to be malicious than a random page on the web. The results shows that this guided approach is able to identify malicious web pages more efficiently when compared to random crawling-based approaches.

Keywords: web crawler, malwares, seeds, drive-by-downloads, security

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8 Molecular Genetic Purity Test Using SSR Markers in Pigeon Pea

Authors: Rakesh C. Mathad, G. Y. Lokesh, Basavegowda

Abstract:

In agriculture using quality seeds of improved varieties is very important to ensure higher productivity thereby food security and sustainability. To ensure good productivity, seeds should have characters as described by the breeder. To know whether the characters as described by the breeder are expressing in a variety such as genuineness or genetic purity, field grow out test (GOT) is done. In pigeon pea which is long durational crop, conducting a GOT may take very long time and expensive also. Since in pigeon pea flower character is a most distinguishing character from the contaminants, conducting a field grow out test require 120-130 days or till flower emergence, which may increase cost of storage and seed production. This will also delay the distribution of seed inventory to the pigeon pea growing areas. In this view during 2014-15 with financial support of Govt. of Karnataka, India, a project to develop a molecular genetic test for newly developed variety of pigeon pea cv.TS3R was commissioned at Seed Unit, UAS, Raichur. A molecular test was developed with the help SSR markers to identify pure variety from possible off types in newly released pigeon pea variety TS3R. In the investigation, 44 primer pairs were screened to identify the specific marker associated with this variety. Pigeon pea cv. TS3R could be clearly identified by using the primer CCM 293 based on the banding pattern resolved on gel electrophoresis and PCR reactions. However some of the markers like AHSSR 46, CCM 82 and CCM 57 can be used to test other popular varieties in the region like Asha, GRG-811 and Maruti respectively. Further to develop this in to a lab test, the seed sample size was standardized to 200 seeds and a grow out matrix was developed. This matrix was used to sample 12 days old leaves to extract DNA. The lab test results were validated with actual field GOT test results and found variations within the acceptable limit of 1%. This molecular method can now be employed to test the genetic purity in pigeon pea cv TS3R which reduces the time and can be a cheaper alternative method for field GOT.

Keywords: genuineness, grow-out matrix, molecular genetic purity, SSR markers

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7 Application of Building Information Modelling In Analysing IGBC® Ratings (Sustainability Analyses)

Authors: Lokesh Harshe

Abstract:

The building construction sector is using 36% of global energy consumption with 39% of CO₂ emission. Professionals in the Built Environment Sector have long been aware of the industry’s contribution towards CO₂ emissions and are now moving towards more sustainable practices. As a result of this, many organizations have introduced rating systems to address the issue of global warming in the construction sector by ranking construction projects based on sustainability parameters. The pre-construction phase of any building project is the most essential time to make decisions for addressing the sustainability aspects. Traditionally, it is very difficult to collect data from different stakeholders and bring it together to form a decision based on factual data to perform sustainability analyses in the pre-construction phase. Building Information Modelling (BIM) is the solution where one single model is the result of the collaborative approach of BIM processes where all the information is shared, extracted, communicated, and stored on a single platform that everyone can access and make decisions based on real-time data. The focus of this research is on the Indian Green Rating System IGBC® with the objective of understanding IGBC® requirements and developing a framework to create the relationship between the rating processes and BIM. A Hypothetical (Architectural) model of a hostel building is developed using AutoCAD 2019 & Revit Arch. 2019, where the framework is applied to generate results on sustainability analysis using Green Building Studio (GBS) and Revit Add-ins. The results of any sustainability analysis are generated within a fraction of a minute, which is very quick in comparison with traditional sustainability analysis. This may save a considerable amount of time as well as cost. The future scope is to integrate Architectural, Structural, and MEP Models to perform accurate sustainability analyses with inputs from industry professionals working on real-life Green BIM projects.

Keywords: sustainability analyses, BIM, green rating systems, IGBC®, LEED

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6 Association of Clostridium difficile Infection and Bone Cancer

Authors: Daniela Prado, Lexi Frankel, Amalia Ardeljan, Lokesh Manjani, Matthew Cardeiro, Omar Rashid

Abstract:

Background: Clostridium difficile (C. diff) is a gram-positive bacterium that is known to cause life-threatening diarrhea and severe inflammation of the colon. It originates as an alteration of the gut microbiome and can be transmitted through spores. Recent studies have shown a high association between the development of C. diff in cancer patients due to extensive hospitalization. However, research is lacking regarding C. diff’s association in the causation or prevention of cancer. The objective of this study was to therefore assess the correlation between Clostridium difficile infection (CDI) and the incidence of bone cancer. Methods: This retrospective analysis used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with C. diff using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale, for the purpose of academic research. Standard statistical methods were used. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 78863 patients in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bone cancer was 659 patients (0.835%) in the C. diff group compared to 1941 patients (2.461%) in the control group. The difference was statistically significant by a P-value < 2.2x10^-16 with an odds ratio (OR)= 0.33 (0.31-0.37) with a 95% confidence interval (CI). Treatment for CDI was analyzed for both C. diff infected and noninfected populations. 91 out of 16,676 (0.55%) patients with a prior C. diff infection and treated with antibiotics were compared to the control group were 275 out of 16,676 (1.65%) patients with no history of CDI and received antibiotic treatment. Results remained statistically significant by P-value <2.2x10-16 with an OR= 0.42 (0.37, 0.48). and a 95% CI. Conclusion: The study shows a statistically significant correlation between C. diff and a reduced incidence of bone cancer. Further evaluation is recommended to assess the potential of C. difficile in reducing bone cancer incidence.

Keywords: bone cancer, colitis, clostridium difficile, microbiome

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5 A Molecular Dynamic Simulation Study to Explore Role of Chain Length in Predicting Useful Characteristic Properties of Commodity and Engineering Polymers

Authors: Lokesh Soni, Sushanta Kumar Sethi, Gaurav Manik

Abstract:

This work attempts to use molecular simulations to create equilibrated structures of a range of commercially used polymers. Generated equilibrated structures for polyvinyl acetate (isotactic), polyvinyl alcohol (atactic), polystyrene, polyethylene, polyamide 66, poly dimethyl siloxane, poly carbonate, poly ethylene oxide, poly amide 12, natural rubber, poly urethane, and polycarbonate (bisphenol-A) and poly ethylene terephthalate are employed to estimate the correct chain length that will correctly predict the chain parameters and properties. Further, the equilibrated structures are used to predict some properties like density, solubility parameter, cohesive energy density, surface energy, and Flory-Huggins interaction parameter. The simulated densities for polyvinyl acetate, polyvinyl alcohol, polystyrene, polypropylene, and polycarbonate are 1.15 g/cm3, 1.125 g/cm3, 1.02 g/cm3, 0.84 g/cm3 and 1.223 g/cm3 respectively are found to be in good agreement with the available literature estimates. However, the critical repeating units or the degree of polymerization after which the solubility parameter showed saturation were 15, 20, 25, 10 and 20 respectively. This also indicates that such properties that dictate the miscibility of two or more polymers in their blends are strongly dependent on the chosen polymer or its characteristic properties. An attempt has been made to correlate such properties with polymer properties like Kuhn length, free volume and the energy term which plays a vital role in predicting the mentioned properties. These results help us to screen and propose a useful library which may be used by the research groups in estimating the polymer properties using the molecular simulations of chains with the predicted critical lengths. The library shall help to obviate the need for researchers to spend efforts in finding the critical chain length needed for simulating the mentioned polymer properties.

Keywords: Kuhn length, Flory Huggins interaction parameter, cohesive energy density, free volume

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4 Incidence of Lymphoma and Gonorrhea Infection: A Retrospective Study

Authors: Diya Kohli, Amalia Ardeljan, Lexi Frankel, Jose Garcia, Lokesh Manjani, Omar Rashid

Abstract:

Gonorrhea is the second most common sexually transmitted disease (STDs) in the United States of America. Gonorrhea affects the urethra, rectum, or throat and the cervix in females. Lymphoma is a cancer of the immune network called the lymphatic system that includes the lymph nodes/glands, spleen, thymus gland, and bone marrow. Lymphoma can affect many organs in the body. When a lymphocyte develops a genetic mutation, it signals other cells into rapid proliferation that causes many mutated lymphocytes. Multiple studies have explored the incidence of cancer in people infected with STDs such as Gonorrhea. For instance, the studies conducted by Wang Y-C and Co., as well as Caini, S and Co. established a direct co-relationship between Gonorrhea infection and incidence of prostate cancer. We hypothesize that Gonorrhea infection also increases the incidence of Lymphoma in patients. This research study aimed to evaluate the correlation between Gonorrhea infection and the incidence of Lymphoma. The data for the research was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. This database was utilized to evaluate patients infected with Gonorrhea versus the ones who were not infected to establish a correlation with the prevalence of Lymphoma using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for academic research. Standard statistical methods were applied throughout. Between January 2010 and December 2019, the query was analyzed and resulted in 254 and 808 patients in both the infected and control group, respectively. The two groups were matched by Age Range and CCI score. The incidence of Lymphoma was 0.998% (254 patients out of 25455) in the Gonorrhea group (patients infected with Gonorrhea that was Lymphoma Positive) compared to 3.174% and 808 patients in the control group (Patients negative for Gonorrhea but with Lymphoma). This was statistically significant by a p-value < 2.210-16 with an OR= 0.431 (95% CI 0.381-0.487). The patients were then matched by antibiotic treatment to avoid treatment bias. The incidence of Lymphoma was 1.215% (82 patients out of 6,748) in the Gonorrhea group compared to 2.949% (199 patients out of 6748) in the control group. This was statistically significant by a p-value <5.410-10 with an OR= 0.468 (95% CI 0.367-0.596). The study shows a statistically significant correlation between Gonorrhea and a reduced incidence of Lymphoma. Further evaluation is recommended to assess the potential of Gonorrhea in reducing Lymphoma.

Keywords: gonorrhea, lymphoma, STDs, cancer, ICD

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3 Effect of Sodium Arsenite Exposure on Pharmacodynamic of Meloxicam in Male Wistar Rats

Authors: Prashantkumar Waghe, N. Prakash, N. D. Prasada, L. V. Lokesh, M. Vijay Kumar, Vinay Tikare

Abstract:

Arsenic is a naturally occurring metalloid with potent toxic effects. It is ubiquitous in the environment and released from both natural and anthropogenic sources. It has the potential to cause various health hazards in exposed populations. Arsenic exposure through drinking water is considered as one of the most serious global environmental threats including Southeast Asia. The aim of present study was to evaluate the modulatory role of subacute exposure to sodium (meta) arsenite on the antinociceptive, anti-inflammatory and antipyretic responses mediated by meloxicam in rats. Rats were exposed to arsenic as sodium arsenite through drinking water for 28 days. A single dose of meloxicam (2 mg/kg b. wt.) was administered by oral gavage on the 29th day. The exact time of meloxicam administration depended on the type of test. Rats were divided randomly into 5 groups (n=6). Group I served as normal control and received arsenic free drinking water, while rats in group II were maintained similar to Group I but received meloxicam on 29th day. Groups III, IV and V were pre-exposed to arsenic through drinking water at 0.5, 5.0 and 50 ppm, respectively, for 28 days and was administered meloxicam next day and; pain and inflammation carried out by using formalin-induced nociception and carrageenan-induced inflammatory model(s), respectively by using standard protocol. For assessment of antipyretic effects, one more additional group (Group VI) was taken and given LPS @ 1.8 mg/kg b. wt. for induction of pyrexia (LPS control). Higher dose of arsenic inhibited the meloxicam mediated antinociceptive, anti-inflammatory and antipyretic responses. Further, meloxicam inhibited the arsenic induced level of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 and COX2 mediated prostaglandin E2 in hind paw muscle. These results suggest a functional antagonism of meloxicam by arsenic. This may relate to arsenic mediated local release of tumor necrosis factor-α, inetrleukin-1β, interleukin -6 releases COX2 mediated prostaglandin E2. Based on the experimental study, it is concluded that sub-acute exposure to arsenic through drinking water aggravate pyrexia, inflammation and pain at environment relevant concentration and decrease the therapeutic efficacy of meloxicam at higher level of arsenite exposure. Thus, the observation made has clinical relevance in situations where animals are exposed to arsenite epidemic geographical locations.

Keywords: arsenic, analgesic activity, meloxicam, Wistar rats

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2 Efficient Synthesis of Highly Functionalized Biologically Important Spirocarbocyclic Oxindoles via Hauser Annulation

Authors: Kanduru Lokesh, Venkitasamy Kesavan

Abstract:

The unique structural features of spiro-oxindoles with diverse biological activities have made them privileged structures in new drug discovery. The key structural characteristic of these compounds is the spiro ring fused at the C-3 position of the oxindole core with varied heterocyclic motifs. Structural diversification of heterocyclic scaffolds to synthesize new chemical entities as pharmaceuticals and agrochemicals is one of the important goals of synthetic organic chemists. Nitrogen and oxygen containing heterocycles are by far the most widely occurring privileged structures in medicinal chemistry. The structural complexity and distinct three-dimensional arrangement of functional groups of these privileged structures are generally responsible for their specificity against biological targets. Structurally diverse compound libraries have proved to be valuable assets for drug discovery against challenging biological targets. Thus, identifying a new combination of substituents at C-3 position on oxindole moiety is of great importance in drug discovery to improve the efficiency and efficacy of the drugs. The development of suitable methodology for the synthesis of spiro-oxindole compounds has attracted much interest often in response to the significant biological activity displayed by the both natural and synthetic compounds. So creating structural diversity of oxindole scaffolds is need of the decade and formidable challenge. A general way to improve synthetic efficiency and also to access diversified molecules is through the annulation reactions. Annulation reactions allow the formation of complex compounds starting from simple substrates in a single transformation consisting of several steps in an ecologically and economically favorable way. These observations motivated us to develop the annulation reaction protocol to enable the synthesis of a new class of spiro-oxindole motifs which in turn would enable the enhancement of molecular diversity. As part of our enduring interest in the development of novel, efficient synthetic strategies to enable the synthesis of biologically important oxindole fused spirocarbocyclic systems, We have developed an efficient methodology for the construction of highly functionalized spirocarbocyclic oxindoles through [4+2] annulation of phthalides via Hauser annulation. functionalized spirocarbocyclic oxindoles was accomplished for the first time in the literature using Hauser annulation strategy. The reaction between methyleneindolinones and arylsulfonylphthalides catalyzed by cesium carbonate led to the access of new class of biologically important spiro[indoline-3,2'-naphthalene] derivatives in very good yields. The synthetic utility of the annulated product was further demonstrated by fluorination Using NFSI as a fluorinating agent to furnish corresponding fluorinated product.

Keywords: Hauser-Kraus annulation, spiro carbocyclic oxindoles, oxindole-ester, fluoridation

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1 The Effect of Post Spinal Hypotension on Cerebral Oxygenation Using Near-Infrared Spectroscopy and Neonatal Outcomes in Full Term Parturient Undergoing Lower Segment Caesarean Section: A Prospective Observational Study

Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

Abstract:

Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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