Search results for: Manju Pandey

Authors: Ashok Pandey, Rajan Adhikari

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Introduction: Menstruation is part of the female reproductive cycle that starts when girls become sexually mature at the time of puberty. It is a phenomenon unique to the females. During a menstrual period, a woman bleeds from her uterus via the vagina. For decades, in many countries, academic school ‘type,’ private or public, as a predictor of or factor in future academic success has been researched and debated. MATERIAL AND METHODS: The comparative study was carried out with adolescent girls studying in both public and private schools of Kathmandu valley. A total of 100 girls participated in the survey, and out of them 21 participated in the FGD and 5 in the in- depth interview. Quantitative data from the survey was analyzed using SPSS 16.0 software. Informed verbal consent with the respective head of school and the respondents were taken before data collection. Results:The age of the respondents ranges from 11 to 18 years, with mean age of menarche being 12.37 years in both school adolescent girls. 70 percent of the public school adolescent girls and 72 percent of the private school adolescent girls are feeling upset and tension during menarche. There is a statistically significant difference on take rest during the period and good hygienic practice during menstruation of public/private school, at α=0. 05 level of significance. There is a statistically significant difference on overall score of practice during menstruation between public and private adolescent girls. Conclusion: Private schools children are more knowledgeable and maintain hygiene as compere to public school even though, it can be said that among the adolescent school girls both in public and private school, menstrual knowledge and perceptions are poor and practices often not optimal for proper hygiene. Often ignored issues of privacy affect the hygienic practices and daily lives.

Keywords: Comparison, Menstruation, Private school, Public School

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Authors: Smriti Gour, Neelam Pandey

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The objective of this study was to describe and analyse the mutual relationship between the coping mechanisms used by the families of a child with Autism Spectrum Disorder (ASD) and family dynamics and the effect sibling interactions have on the dynamics and coping mechanisms in an urban setup. In-depth interviews were conducted for 25 families, with 4 members each in the Delhi NCR area in India. The families who were interviewed had a younger child who had received a diagnosis of ASD between the ages of 5-12. The in-depth questionnaires contained open-ended questions and the interviews were conducted separately for the mother, father and the typically developing sibling. The key findings of the study suggested that lack of communication was a common factor in most families (n=19) leading to other difficulties like stress and relationship dysfunction. It also fostered a fallacious perception of the relationship dynamics in the family in most of the interviewed families and changed depending on the family member being interviewed. In families where the typically developing elder sibling had a good relationship with the autistic child, the family dynamics were found to be more stable, and the overall family well-being was better maintained. The coping mechanisms employed by the families were also more positive and tended to work better if the typically developing sibling maintained a positive and interactive relationship with the parents and the autistic child. The type of coping mechanisms had a major impact on the relationship between the parents and in dictating the dynamics of the family of the child with ASD. Spirituality, professional help, family support and household help emerged to be the most effective coping mechanisms for the families, with spirituality emerging to be the most positive and effective coping mechanism in the families interviewed.

Keywords: autism spectrum disorder, coping mechanism, family dynamics, parental relationships, siblings

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Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Surabhi Pandey, Pavuluri Srinivasa Rao

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Extrusion processing is a high-temperature short time (HTST) treatment which can improve protein quality and digestibility together with retaining active nutrients. In-vitro protein digestibility of plant protein-based foods is generally enhanced by extrusion. The current study aimed to investigate the effect of extrusion cooking on in-vitro protein digestibility (IVPD) and conformational modification of protein in green banana flour extrudates. Green banana flour was extruded through a co-rotating twin-screw extruder varying the moisture content, barrel temperature, screw speed in the range of 10-20 %, 60-80 °C, 200-300 rpm, respectively, at constant feed rate. Response surface methodology was used to optimise the result for IVPD. Fourier-transform infrared spectroscopy (FTIR) analysis provided a convenient and powerful means to monitor interactions and changes in functional and conformational properties of extrudates. Results showed that protein digestibility was highest in extrudate produced at 80°C, 250 rpm and 15% feed moisture. FTIR analysis was done for the optimised sample having highest IVPD. FTIR analysis showed that there were no changes in primary structure of protein while the secondary protein structure changed. In order to explain this behaviour, infrared spectroscopy analysis was carried out, mainly in the amide I and II regions. Moreover, curve fitting analysis showed the conformational changes produced in the flour due to protein denaturation. The quantitative analysis of the changes in the amide I and II regions provided information about the modifications produced in banana flour extrudates.

Keywords: extrusion, FTIR, protein conformation, raw banana flour, SDS-PAGE method

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Authors: Shivani Singla, Om Prakash Pandey, Gopi Sharma

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Metallic nanoparticle doped glasses has lead to rapid development in the field of optics. Large third order non-linearity, ultrafast time response, and a wide range of resonant absorption frequencies make these metallic nanoparticles more important in comparison to their bulk material. All these properties are highly dependent upon the size, shape, and surrounding environment of the nanoparticles. In a quest to find a suitable material for optical applications, several efforts have been devoted to improve the properties of such glasses in the past. In the present study, bismuth borate glass doped with different size gold nanoparticles (AuNPs) has been prepared using the conventional melt-quench technique. Synthesized glasses are characterized by X-ray diffraction (XRD) and Fourier Transformation Infrared spectroscopy (FTIR) to observe the structural modification in the glassy matrix with the variation in the size of the AuNPs. Glasses remain purely amorphous in nature even after the addition of AuNPs, whereas FTIR proposes that the main structure contains BO₃ and BO₄ units. Field emission scanning electron microscopy (FESEM) confirms the existence and variation in the size of AuNPs. Differential thermal analysis (DTA) depicts that prepared glasses are thermally stable and are highly suitable for the fabrication of optical fibers. The nonlinear optical parameters (nonlinear absorption coefficient and nonlinear refractive index) are calculated out by using the Z-scan technique with a Ti: sapphire laser at 800 nm. It has been concluded that the size of the nanoparticles highly influences the structural thermal and optical properties system.

Keywords: bismuth borate glass, different size, gold nanoparticles, nonlinearity

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Authors: Kunal Mankodi, Sudhir Pandey

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This study aims to assess the factors that play a role in setting up and running a social enterprise driven towards sustainability at the intersection of energy, environment, and poverty alleviation. According to the theory of sustainability-oriented innovation (SOI), conventional organisations adapt their processes to focus on sustainability-oriented innovations. On the other hand, social enterprises that are purpose-driven are also influenced by the context of innovation, which need due attention. This paper presents an account of innovation at Oorja - an Indian social enterprise operating with a farming-as-a-service business model. It aims to illustrate the contexts in which the innovative solutions were developed to work at an intersection between agriculture and clean energy, thereby allowing small farmers access to efficient solutions in the agriculture cycle. Primary data was collected through in-depth interviews, and secondary data was collected from company sources. The study finds that in the case of a social enterprise, the definition of innovation assumes a wider scope by going beyond the introduction of a new product/service. The context of innovation for social enterprise is affected by organisational factors such as organisation’s philosophical mindset, behaviour towards innovation, organisation’s capabilities, regulatory environment, and customer receptiveness. Additionally, the study also finds that the context of innovation for a social enterprise is affected by its organizational structure. A majority of these organizational factors are, in turn, affected by individual (Founder’s) factors such as the founder’s formative years, education, direct exposure to relevant issues, complementary skills of co-founders, and a common calling.

Keywords: context of innovation, social enterprise, sustainability oriented innovations, emerging markets, agriculture

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Authors: Rajat Jain, Himanshu Pandey, Somesh Mehta, Pravin P. Patil

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Formula SAE cars are the student designed and fabricated formula prototype cars, designed according to SAE INTERNATIONAL design rules which compete in the various national and international events. This paper shows a FEM based comparative study of free vibration analysis of different mode shapes of a formula prototype car chassis frame. Tubing sections of different diameters as per the design rules are designed in such a manner that the desired strength can be achieved. Natural frequency of first five mode was determined using finite element analysis method. SOLIDWORKS is used for designing the frame structure and SOLIDWORKS SIMULATION and ANSYS WORKBENCH 16.2 are used for the modal analysis. Mode shape results of ANSYS and SOLIDWORKS were compared. Fixed –fixed boundary conditions are used for fixing the A-arm wishbones. The simulation results were compared for the validation of the study. First five modes were compared and results were found within the permissible limits. The AISI4130 (CROMOLY- chromium molybdenum steel) material is used and the chassis frame is discretized with fine quality QUAD mesh followed by Fixed-fixed boundary conditions. The natural frequency of the chassis frame is 53.92-125.5 Hz as per the results of ANSYS which is found within the permissible limits. The study is concluded with the light weight and compact chassis frame without compensation with strength. This design allows to fabricate an extremely safe driver ergonomics, compact, dynamically stable, simple and light weight tubular chassis frame with higher strength.

Keywords: FEM, modal analysis, formula SAE cars, chassis frame, Ansys

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Authors: Govind Ji Pandey

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The divergent opinions in the society are important for its development but with reasonable restrictions. The world recently witnessed one of the most violent protests by a group against the editor and publisher of the magazine ‘Charlie Hebdo’ for publishing cartoon of their religious leader. The supporter of freedom of speech and expression around the world were in shock and termed it the strongest attack against the free speech. People all around the world condemned the killing of the journalists but many soft voices from several corners were also coming for reasonable restrictions on the freedom of speech and expression. Of late, Indian society has witnessed many protests and supports of films with controversial content. It is the beauty of the Indian democracy which gives an opportunity to all for discussion and debate on any issue that challenges established social norms. However, many organizations as well as individuals misuse it for their personal benefits. There have been many film directors who faced protest from several quarters for their controversial themes. This research aims at analyzing the controversial contents published in print media and shown in films. To understand the nature and frequency of such media reports, content analysis technique is used. The research also highlights the perception of the public regarding the controversies. For getting the popular opinion on the coverage of controversial content in cinema and print media, five hundred people from Lucknow, UP, India were randomly selected. The findings of this research are important to understand the response of media and society towards the controversial content presented in cinema and print media. The research highlights that how a handful of people curb free speech in a democratic country like India.

Keywords: cinema, censor board, free speech, liberty, social-religious beliefs

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Authors: Vaibhav Budhiraja, Chandra Mouli Pandey

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The ultrasonic synthesis of nanostructured conducting copolymer is an effective technique to synthesize polymer with desired chemical properties. This tailored nanostructure, shows tremendous improvement in sensitivity and stability to detect a variety of analytes. The present work reports ultrasonically synthesized nanostructured conducting poly(o-phenylenediamine)-co-poly(1-naphthylamine) (POPD-co-PNA). The synthesized material has been characterized using Fourier transform infrared spectroscopy (FTIR), ultraviolet-visible spectroscopy, transmission electron microscopy, X-ray diffraction and cyclic voltammetry. FTIR spectroscopy confirmed random copolymerization, while UV-visible studies reveal the variation in polaronic states upon copolymerization. High crystallinity was achieved via ultrasonic synthesis which was confirmed by X-ray diffraction, and the controlled morphology of the nanostructures was confirmed by transmission electron microscopy analysis. Cyclic voltammetry shows that POPD-co-PNA has rather high electrochemical activity. This behavior was explained on the basis of variable orientations adopted by the conducting polymer chains. The synthesized material was electrophoretically deposited at onto indium tin oxide coated glass substrate which is used as cathode and parallel platinum plate as the counter electrode. The fabricated bioelectrode was further used for detection of glucose by crosslinking of glucose oxidase in the PODP-co-PNA film. The bioelectrode shows a surface-controlled electrode reaction with the electron transfer coefficient (α) of 0.72, charge transfer rate constant (ks) of 21.77 s⁻¹ and diffusion coefficient 7.354 × 10⁻¹⁵ cm²s⁻¹.

Keywords: conducting, electrophoretic, glucose, poly (o-phenylenediamine), poly (1-naphthylamine), ultrasonic

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Suvidha Gupta, R. A. Pandey, Sanjay Pawar

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The effluents from various food processing industries are found with high BOD, COD, suspended solids, nitrate, and phosphate. Mixotrophic growth of microalgae using food processing industrial wastewater as an organic carbon source has emerged as more effective and energy intensive means for the nutrient removal and COD reduction. The present study details the treatment of non-sterilized unfiltered food processing industrial wastewater by microalgae for nutrient removal as well as to determine the tolerance to COD by taking different dilutions of wastewater. In addition, the effect of different inoculum percentages of microalgae on removal efficiency of the nutrients for given dilution has been studied. To see the effect of dilution and COD tolerance, the wastewater having initial COD 5000 mg/L (±5), nitrate 28 mg/L (±10), and phosphate 24 mg/L (±10) was diluted to get COD of 3000 mg/L and 1000 mg/L. The experiments were carried out in 1L conical flask by intermittent aeration with different inoculum percentage i.e. 10%, 20%, and 30% of Chlorella sp. isolated from nearby area of NEERI, Nagpur. The experiments were conducted for 6 days by providing 12:12 light- dark period and determined various parameters such as COD, TOC, NO3-- N, PO4-- P, and total solids on daily basis. Results revealed that, for 10% and 20% inoculum, over 90% COD and TOC reduction was obtained with wastewater containing COD of 3000 mg/L whereas over 80% COD and TOC reduction was obtained with wastewater containing COD of 1000 mg/L. Moreover, microalgae was found to tolerate wastewater containing COD 5000 mg/L and obtained over 60% and 80% reduction in COD and TOC respectively. The obtained results were found similar with 10% and 20% inoculum in all COD dilutions whereas for 30% inoculum over 60% COD and 70% TOC reduction was obtained. In case of nutrient removal, over 70% nitrate removal and 45% phosphate removal was obtained with 20% inoculum in all dilutions. The obtained results indicated that Microalgae assisted nutrient removal gives maximum COD and TOC reduction with 3000 mg/L COD and 20% inoculum. Hence, microalgae assisted wastewater treatment is not only effective for removal of nutrients but also can tolerate high COD up to 5000 mg/L and solid content.

Keywords: Chlorella sp., chemical oxygen demand, food processing industrial wastewater, mixotrophic growth

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Authors: Vaibhav Pandey, K. Chattopadhyay, N. C. Santhi Srinivas, Vakil Singh

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Aluminium alloy 7075 consist of different intermetallic precipitate particles MgZn2, CuAl2, which result in heterogeneity of micro structure and influence the corrosion properties of the alloy. Artificial ageing was found to enhance the strength properties, but highly susceptible to stress-corrosion cracking. Various conventional surface modification techniques are developed for improving corrosion properties of aluminum alloys. This led to development of novel surface mechanical attrition treatment (SMAT) technique the so called ultrasonic shot peening which gives nano-grain structure at surface. In the present investigation the influence of surface mechanical attrition treatment on corrosion behavior of aluminum alloy 7075 was studied in 3.5wt% NaCl solution. Two different size of 1 mm and 3 mm steel balls are used as peening media and SMAT was carried out for different time intervals 5, 15 and 30 minutes. Surface nano-grains/nano-crystallization was observed after SMAT. The formation of nano-grain structure was observed for larger size balls with time of treatment and consequent increase in micro strain. As-SMATed sample with 1 mm balls exhibits better corrosion resistance as compared to that of un-SMATed sample. The enhancement in corrosion resistance may be due to formation of surface nano-grain structure which reduced the electron release rate. In contrast the samples treated with 3 mm balls showed very poor corrosion resistance. A decrease in corrosion resistance was observed with increase in the time of peening. The decrease in corrosion resistance in the shotpeened samples with larger diameter balls may due to increase in microstrain and defect density.

Keywords: aluminum alloy 7075, corrosion, SMAT, ultrasonic shot peening, surface nano-grains

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Authors: Abhaydeep Pandey, Shweta Shukla, Saptamita Goswami, Bhaswati Bandyopadhyay, Vishnampettai Ramachandran, Sudhanshu Vrati, Arup Banerjee

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Background: Long non-coding RNAs (lncRNAs) are the important regulators of gene expression and play important role in viral replication and disease progression. The role of lncRNA genes in the pathogenesis of Dengue virus-mediated pathogenesis is currently unknown. Methods: To gain additional insights, we utilized an unbiased RNA sequencing followed by in silico analysis approach to identify the differentially expressed lncRNA and genes that are associated with dengue disease progression. Further, we focused our study on lncRNAs NEAT1 (Nuclear Paraspeckle Assembly Transcript 1) as it was found to be differentially expressed in PBMC of dengue infected patients. Results: The expression of lncRNAs NEAT1, as compared to dengue infection (DI), was significantly down-regulated as the patients developed the complication. Moreover, pairwise analysis on follow up patients confirmed that suppression of NEAT1 expression was associated with rapid fall in platelet count in dengue infected patients. Severe dengue patients (DS) (n=18; platelet count < 20K) when recovered from infection showing high NEAT1 expression as it observed in healthy donors. By co-expression network analysis and subsequent validation, we revealed that coding gene; IFI27 expression was significantly up-regulated in severe dengue cases and negatively correlated with NEAT1 expression. To discriminate DI from dengue severe, receiver operating characteristic (ROC) curve was calculated. It revealed sensitivity and specificity of 100% (95%CI: 85.69 – 97.22) and area under the curve (AUC) = 0.97 for NEAT1. Conclusions: Altogether, our first observations demonstrate that monitoring NEAT1and IFI27 expression in dengue patients could be useful in understanding dengue virus-induced disease progression and may be involved in pathophysiological processes.

Keywords: dengue, lncRNA, NEAT1, transcriptome

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Authors: Varsha Kheradiya, Ganga Prasad Pandey

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

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

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Authors: Abhishek Pandey

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Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis and rheumatoid arthritis. Acetaminophen is used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression and top spray granulation technique. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimized formulation, nine different formulations were generated among them batch F7, F8, F9 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of dissolution study. Furtherly, directly compressible granules of both drugs were prepared by using top spray granulation technique in fluidized bed processor equipment and compressed .In order to obtain best product process optimization was carried out by performing four trials in which various parameters like inlet air temperature, spray rate, peristaltic pump rpm, % LOD, properties of granules, blending time and hardness were optimized. Batch T3 coined as optimized batch on the basis physical & chemical evaluation. Finally formulations prepared by both techniques were compared.

Keywords: direct compression, top spray granulation, process optimization, blending time

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

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

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

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Authors: Sudha Summarwar, Sudesh Agarwal, Deepali Lall, Nalini Kataria, Jyotsana Pandey

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Assessment of antioxidant status is an effective tool to appraise the presence of oxidative stress. A combination of assays can be used to evaluate the antioxidant status like serum catalase (CAT), superoxide dismutase (SOD) and monoamine oxidase (MAO). In human medicine pregnancy is known to be associated with oxidative stress. Oxidative stress produces harmful effects to the developing foetus. Several metabolic changes occur in the maternal body to meet the demand of energy of developing foetus. Due to these changes susceptibility of maternal body increases to oxidative stress. There is paucity of research work on this aspect in nondescript goats. Therefore, the present study was intended to appraise the oxidative stress in pregnant and non-pregnant non-descript goat. Blood samples were collected for serum separation in otherwise healthy pregnant and non-pregnant nondescript goats. Mean values of serum CAT, SOD and MAO were found on a higher side (p≤0.05) with serum SOD values showing a rise of 2.5 times higher than the control healthy value. Correlations among all the three parameters were found to be highly significant (p≤0.01) especially greatest in youngest group of pregnant animals. Illustration of result enlightened the veracity of bumped up production of free radicals in pregnant animals. Technical savoir-faire of oxidative stress supervision is essential for upholding of health status of foetus. The upshot of present study undoubtedly implied the development of oxidative stress in pregnant goats on the basis of altered antioxidant status. These findings conclude that initially the oxidative stress due to pregnancy is critically combated by the intricate defensive mechanism of natural antioxidant system of the body. It appears that this imbalance between oxidant and antioxidant must be checked in time to prevent cellular damage by regularly appraising the antioxidant status through laboratory methods.

Keywords: antioxidant, oxidative stress, pregnancy, serum catalase

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Authors: Manish Pandey, Gurinderjit Kaur, Meenu Talwar, Sachin Chauhan, Jagbir Gill

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Health-care management systems are a unit of nice connection as a result of the supply a straightforward and fast management of all aspects relating to a patient, not essentially medical. What is more, there are unit additional and additional cases of pathologies during which diagnosing and treatment may be solely allotted by victimization medical imaging techniques. With associate ever-increasing prevalence, medical pictures area unit directly acquired in or regenerate into digital type, for his or her storage additionally as sequent retrieval and process. Data Mining is the process of extracting information from large data sets through using algorithms and Techniques drawn from the field of Statistics, Machine Learning and Data Base Management Systems. Forecasting may be a prediction of what's going to occur within the future, associated it's an unsure method. Owing to the uncertainty, the accuracy of a forecast is as vital because the outcome foretold by foretelling the freelance variables. A forecast management should be wont to establish if the accuracy of the forecast is within satisfactory limits. Fuzzy regression strategies have normally been wont to develop shopper preferences models that correlate the engineering characteristics with shopper preferences relating to a replacement product; the patron preference models offer a platform, wherever by product developers will decide the engineering characteristics so as to satisfy shopper preferences before developing the merchandise. Recent analysis shows that these fuzzy regression strategies area units normally will not to model client preferences. We tend to propose a Testing the strength of Exponential Regression Model over regression toward the mean Model.

Keywords: health-care management systems, fuzzy regression, data mining, forecasting, fuzzy membership function

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Authors: Rajeev Kumar, Angad Singh Kushwaha, Amritanshu Pandey, S. K. Srivastava

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Photonic crystals (PCs) have attracted much attention due to its electromagnetic properties and potential applications. In PCs, there is certain range of wavelength where electromagnetic waves are not allowed to pass are called photonic band gap (PBG). A localized defect mode will appear within PBG, due to change in the interference behavior of light, when we create a defect in the periodic structure. We can also create different types of defect structures by inserting or removing a layer from the periodic layered structure in two and three-dimensional PCs. We can design microcavity, waveguide, and perfect mirror by creating a point defect, line defect, and palanar defect in two and three- dimensional PC structure. One-dimensional and two-dimensional PCs with defects were reported theoretically and experimentally by Smith et al.. in conventional photonic band gap structure. In the present paper, we have presented the defect mode tunability in tilted non-graded photonic crystal (NGPC) and linearly graded photonic crystal (LGPC) using lead sulphide (PbS) and titanium dioxide (TiO2) in the infrared region. A birefringent defect layer is created in NGPC and LGPC using potassium titany phosphate (KTP). With the help of transfer matrix method, the transmission properties of proposed structure is investigated for transverse electric (TE) and transverse magnetic (TM) polarization. NGPC and LGPC without defect layer is also investigated. We have found that a photonic band gap (PBG) arises in the infrared region. An additional defect layer of KTP is created in NGPC and LGPC structure. We have seen that an additional transmission mode appers in PBG region. It is due to the addition of defect layer. We have also seen the effect, linear gradation in thickness, angle of incidence, tilt angle, and thickness of defect layer, on PBG and additional transmission mode. We have observed that the additional transmission mode and PBG can be tuned by changing the above parameters. The proposed structure may be used as channeled filter, optical switches, monochromator, and broadband optical reflector.

Keywords: defect modes, graded photonic crystal, photonic crystal, tilt angle

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Authors: Kashi Raj Pandey

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Transformative learning is a form of learning rooted in learners' life experiences and their inherent love for learning. It emphasizes the importance of incorporating students' everyday work through the use of learning diaries and reflective journals. It encourages learners to take a proactive role in their own improvement, fostering creativity and promoting informed discussions about the learning process. Reflecting on the personal experience with English language learning in a rural village in Nepal where rote memorization was the prevailing teaching method, this traditional approach hindered a deeper understanding of the language, prompting the author to recognize the need for more effective pedagogy. In this study, the author delved into the cultural contextualization of English language learning, taking into account learners' backgrounds. The study’s findings highlighted the importance of equity, inclusion, mutuality, and social justice in the classroom, emphasizing the significance of integrating students' lived experiences into the pedagogical approach. This, in turn, can encourage students to engage in profound and collaborative learning practices within the realm of English language education. Upon successfully implementing the research findings, including the eight key conditions of transformative learning, in multiple classrooms, the author collaborated with international educationists and government stakeholders in Nepal. The purpose was to disseminate the research findings, conduct teacher training workshops, and systematically enhance Nepali students’ English language learning. These methods have already demonstrated a significant improvement in student engagement within the same school where the author once learned English as a child. This study aims to explore teachers’ decision-making process regarding the transition from traditional teaching methods to interactive ones, which have gained national recognition within the ESL/EFL teaching community in Nepal. By sharing these experiences, it is expected that other teachers will also contemplate adopting transformative learning pedagogy in their own classrooms.

Keywords: reflection, student engagement, pedagogy, transformative learning

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Authors: Abhaydeep Pandey, Shweta Shukla, Saptamita Goswami, Bhaswati Bandyopadhyay, Vishnampettai Ramachandran, Sudhanshu Vrati, Arup Banerjee

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Dengue virus infection is now considered as one of the most important mosquito-borne infection in human. The virus is known to promote vascular permeability, cerebral edema leading to Dengue hemorrhagic fever (DHF) or Dengue shock syndrome (DSS). Dengue infection has known to be endemic in India for over two centuries as a benign and self-limited disease. In the last couple of years, the disease symptoms have changed, manifesting severe secondary complication. So far, Delhi has experienced 12 outbreaks of dengue virus infection since 1997 with the last reported in 2014-15. Without specific antivirals, the case management of high-risk dengue patients entirely relies on supportive care, involving constant monitoring and timely fluid support to prevent hypovolemic shock. Nonetheless, the diverse clinical spectrum of dengue disease, as well as its initial similarity to other viral febrile illnesses, presents a challenge in the early identification of this high-risk group. WHO recommends the use of warning signs to identify high-risk patients, but warning signs generally appear during, or just one day before the development of severe illness, thus, providing only a narrow window for clinical intervention. The ability to predict which patient may develop DHF and DSS may improve the triage and treatment. With the recent discovery of high throughput RNA sequencing allows us to understand the disease progression at the genomic level. Here, we will collate the results of RNA-Sequencing data obtained recently from PBMC of different categories of dengue patients from India and will discuss the possible role of deregulated genes and long non-coding RNAs NEAT1 for development of disease progression.

Keywords: long non-coding RNA (lncRNA), dengue, peripheral blood mononuclear cell (PBMC), nuclear enriched abundant transcript 1 (NEAT1), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS)

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Authors: Pankaj Singh Rawat, Rajeew Kumar, Pradeep Ram, Priyanka Pandey

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Wheat is an important cereal crop for food security. Boosting the wheat production and productivity is the major challenge across the nation. Good quality of seed is required for maintaining optimum plant stand which ultimately increases grain yield. Ensuring a good germination is one of the key steps to ensure proper plant stand and moisture assurance during seed germination may help to speed up the germination. The tiny size of nanoparticles may help in entry of water into seed without disturbing their internal structure. Considering above, a laboratory experiment was conducted during 2012-13 at G.B. Pant University of Agriculture and Technology, Pantnagar, India. The completely randomized design was used for statistical analysis. The experiment was conducted in two phases. In the first phase, the appropriate concentration of nanoparticles for seed treatment was screened. In second phase seed soaking hours of nanoparticles for better seed germination were standardized. Wheat variety UP2526 was taken as test crop. Four nanoparticles (TiO₂, ZnO, nickel and chitosan) were taken for study. The crop germination studies were done in petri dishes and standard package and practices were used to raise the seedlings. The germination studies were done by following standard procedure. In first phase of the experiment, seeds were treated with 50 and 300 ppm of nanoparticles and control was also maintained for comparison. In the second phase of experiment, seeds were soaked for 4 hours, 6 hours and 8 hours with 50 ppm nanoparticles of TiO₂, ZnO, nickel and chitosan along with control treatment to identify the soaking time for better seed germination. Experiment revealed that the application of nanoparticles help to enhance seed germination. The study revealed that seed treatment with  nanoparticles at 50 ppm concentration increases root length, shoot length, seedling length, shoot dry weight, seedling dry weight, seedling vigour index I and seedling vigour index II as compared to seed soaking at 300 ppm concentration. This experiment showed that seed soaking up to 4 hr was better as compared to 6 and 8 hrs. Seed soaking with nanoparticles specially TiO₂, ZnO, and chitosan proved to enhance germination and seedling growth indices of wheat crop.

Keywords: nanoparticles, seed germination, seed soaking, wheat

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Authors: Maneesh Kumar, Roshan Kamal Topno, Manas Ranjan Dikhit, Vahab Ali, Ganesh Chandra Sahoo, Bhawana, Major Madhukar, Rishikesh Kumar, Krishna Pandey, Pradeep Das

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Chandipura vesiculovirus is an emerging (-) ssRNA viral entity belonging to the genus Vesiculovirus of the family Rhabdoviridae, associated with fatal encephalitis in tropical regions. The multi-functionally active viral RNA-dependent RNA polymerase (vRdRp) that has been incorporated with conserved amino acid residues in the pathogens, assigned to synthesize distinct viral polypeptides. The lack of proofreading ability of the vRdRp produces many mutated variants. Here, we have performed the evolutionary analysis of 20 viral protein sequences of vRdRp of different strains of Chandipura vesiculovirus along with other viral species from genus Vesiculovirus inferred in MEGA6.06, employing the Neighbour-Joining method. The p-distance algorithmic method has been used to calculate the optimum tree which showed the sum of branch length of about 1.436. The percentage of replicate trees in which the associated taxa are clustered together in the bootstrap test (1000 replicates), is shown next to the branches. No mutation was observed in the Indian strains of Chandipura vesiculovirus. In vRdRp, 1230(His) and 1231(Arg) are actively participated in catalysis and, are found conserved in different strains of Chandipura vesiculovirus. Both amino acid residues were also conserved in the other viral species from genus Vesiculovirus. Many isolates exhibited maximum number of mutations in catalytic regions in strains of Chandipura vesiculovirus at position 26(Ser→Ala), 47 (Ser→Ala), 90(Ser→Tyr), 172(Gly→Ile, Val), 172(Ser→Tyr), 387(Asn→Ser), 1301(Thr→Ala), 1330(Ala→Glu), 2015(Phe→Ser) and 2065(Thr→Val) which make them variants under different tropical conditions from where they evolved. The result clarifies the actual concept of RNA evolution using vRdRp to develop as an evolutionary marker. Although, a limited number of vRdRp protein sequence similarities for Chandipura vesiculovirus and other species. This might endow with possibilities to identify the virulence level during viral multiplication in a host.

Keywords: Chandipura, (-) ssRNA, viral RNA-dependent RNA polymerase, neighbour-joining method, p-distance algorithmic, evolutionary marker

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Authors: Saroj Pandey

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COVID-19, declared by the World Health Organization a pandemic (WHO,2020), has created an unprecedented crisis world over endangering the human survival itself. Corona induced lockdowns forced approximately 140 million students of 190 countries at various levels of education from preprimary to higher education to remain confined to their homes. In India, approximately 360 million students were affected by the forced shut down of schools due to the countrywide lockdown in March 2020 and resultant disruption of education. After the initial shock and anxiety the Indian polity and education system bounced back with a number of initiatives, and online education came as a major rescuer for the education system of the country. The distance and online mode of learning that was treated as the poor cousin of conventional mode and often criticized for its quality became the major crusader overnight changing the entire ecosystem of traditional teaching -leaning towards the virtual mode. Teachers who were averse to technology were forced to remodel their educational pedagogies and reorient themselves overnight to use various online platforms such as Zoom, Google meet, and other such platforms to reach the learners. This metamorphosis through ensured students was meaningfully engaged in their studies during the lockdown period but it has its own set of challenges. This paper deals with the government initiatives, and teachers' self-efforts to keep the channel of teaching learning on providing academic and socio emotional support to students during the most difficult period of their life as well as the digital divide between the rich and poor, rural and urban, and boys and girls in India and resultant challenges. It also provides an overview of few significant self-initiatives of teachers to reach their students during the crisis period, who did not have internet and smartphone facilities as well as the initiatives being taken at the government level to address the learning needs and mitigate the learning gaps of learners, bridge the digital divide, strategic planning and upskilling of teachers to overcome the effect of COVID-19 crisis.

Keywords: COVID-19, online education, initiatives, challenges

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Authors: Thapa M., J.P. Dutta, K.R. Pandey, R.R. Kattel

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Nepal is extremely vulnerable to the impact of climate change. To mitigate the climate change effects on agricultural production and productivity a range of adaptive strategies needs to be considered. The study was conducted to assess organic paddy production as a coping strategy to the adverse impact of climate change in Phulbari, VDC of Chitwan district. Altogether, 120 respondents (60 adopters of organic farming and 60 from non adopter) were selected using snowball technique of sampling. Pre- tested interview schedule, direct observation, focus group discussion, key informant interview as well as secondary data were used to collect the required information. Factors determining the adoption of organic farming were found to be age, year of schooling, training, frequency of extension contact, perception about climate change, economically active members and poor. A unit increase in these factors except poor would increase the probability of adoption by 4.1%, 7.5%, 7.8%, 43.1%, 41.8% and 7% respectively. However, for poor, it would decrease the probability of adoption of organic farming by 5.1%. Average organic matter content in the adopters' field was higher (2.7%) than the non-adopters' field (2.5%). The regression result showed that type of farmer, price and area under rice cultivation had positive and significant relationship with income; however dependency ratio had negative relationship. As the year of adoption of organic farming increases, the production of rice decline in the first two years then after goes on increasing but the cost of production goes on decreasing with the year of adoption. The respondents adapted to the changing climate through diversification of crops, use of resistance varieties and following good cropping pattern. Gradually growing consumers' awareness about health, preference towards quality food products are the strong points behind organic farming, whereas lacks of bio-fertilizers, lack of effective extension services, no price differentiation between organic and inorganic products were the weak points. There is need for more training and education to change the attitude of farmers and enhance their confidence about the role of organic farming to cope with climate change impact.

Keywords: Organic farming, climate change, sustainable development

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Authors: Shende Suraj Balu, A. B. Deoghare, K. M. Pandey

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The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.

Keywords: computed tomography (μCT), human middle ear (ME), harmonic response, pathologies, tympanic membrane (TM)

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Authors: Tridipa Biswas, Kamal Pandey

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A Digital Elevation Model (DEM) is a simple representation of a surface in 3 dimensional space with elevation as the third dimension along with X (horizontal coordinates) and Y (vertical coordinates) in rectangular coordinates. DEM has wide applications in various fields like disaster management, hydrology and watershed management, geomorphology, urban development, map creation and resource management etc. Cartosat-1 or IRS P5 (Indian Remote Sensing Satellite) is a state-of-the-art remote sensing satellite built by ISRO (May 5, 2005) which is mainly intended for cartographic applications.Cartosat-1 is equipped with two panchromatic cameras capable of simultaneous acquiring images of 2.5 meters spatial resolution. One camera is looking at +26 degrees forward while another looks at –5 degrees backward to acquire stereoscopic imagery with base to height ratio of 0.62. The time difference between acquiring of the stereopair images is approximately 52 seconds. The high resolution stereo data have great potential to produce high-quality DEM. The high-resolution Cartosat-1 stereo image data is expected to have significant impact in topographic mapping and watershed applications. The objective of the present study is to generate high-resolution DEM, quality evaluation in different elevation strata, generation of ortho-rectified image and associated accuracy assessment from CARTOSAT-1 data based Ground Control Points (GCPs) for Aglar watershed (Tehri-Garhwal and Dehradun district, Uttarakhand, India). The present study reveals that generated DEMs (10m and 30m) derived from the CARTOSAT-1 stereo pair is much better and accurate when compared with existing DEMs (ASTER and CARTO DEM) also for different terrain parameters like slope, aspect, drainage, watershed boundaries etc., which are derived from the generated DEMs, have better accuracy and results when compared with the other two (ASTER and CARTO) DEMs derived terrain parameters.

Keywords: ASTER-DEM, CARTO-DEM, CARTOSAT-1, digital elevation model (DEM), ortho-rectified image, photogrammetry, RPC, stereo pair, terrain parameters

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Authors: Rajendra Kumar Pandey

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Forest genetic resources not only represent regional biodiversity but also have immense value as the wealth for securing livelihood of poor people. These are vulnerable to ecological due to depletion/deforestation and /or impact of climate change. These resources of various plant categories are vulnerable on the floor of natural tropical forests, and leading to the threat on the growth and development of future forests. More than 170 species, including NTFPs, are in critical condition for their survival in natural tropical forests of Central India. Forest degradation, commensurate with biodiversity loss, is now pervasive, disproportionately affecting the rural poor who directly depend on forests for their subsistence. Looking ahead the interaction between forest and water, soil, precipitation, climate change, etc. and its impact on biodiversity of tropical forests, it is inevitable to develop co-operation policies and programmes to address new emerging realities. Forests ecosystem also known as the 'wealth of poor' providing goods and ecosystem services on a sustainable basis, are now recognized as a stepping stone to move poor people beyond subsistence. Poverty alleviation is the prime objective of the Millennium Development Goals (MDGs). However, environmental sustainability including other MDGs, is essential to ensure successful elimination of poverty and well being of human society. Loss and degradation of ecosystem are the most serious threats to achieving development goals worldwide. Millennium Ecosystem Assessment (MEA, 2005) was an attempt to identify provisioning and regulating cultural and supporting ecosystem services to provide livelihood security of human beings. Climate change may have a substantial impact on ecological structure and function of forests, provisioning, regulations and management of resources which can affect sustainable flow of ecosystem services. To overcome these limitations, policy guidelines with respect to planning and consistent research strategy need to be framed for conservation and sustainable development of forest genetic resources.

Keywords: climate change, forest ecosystem services, sustainable forest management, biodiversity conservation

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Authors: Manju Bala Jassi

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The Covid 19 pandemic has badly mauled Dubai’s GDP heavily dependent on hospitality, tourism, entertainment, logistics, property and the retail sectors. In the context of the World Health protocols on social distancing for better maintenance of health and hygiene, the revival of the battered tourism and hospitality sectors has serious lessons for designers- interiors and public places. The tangible and intangible aesthetic elements and design –ambiance, materials, furnishings, colors, lighting and interior with architectural design issues of tourism and hospitality need a rethink to ensure a memorable tourist experience. Designers ought to experiment with sustainable places of tourism and design, develop, build and projects are aesthetic and leave as little negative impacts on the environment and public as possible. In short, they ought to conceive public spaces that makes use of little untouched materials and energy, and creates pollution and waste that are minimal. The spaces can employ healthier and more resource-efficient prototypes of construction, renovation, operation, maintenance, and demolition and thereby mitigate the environment impacts of the construction activities and it is sustainable These measures encompass the hospitality sector that includes hotels and restaurants which has taken the hardest fall from the pandemic. The paper sought to examine building energy efficiency and materials and design employed in public places, green buildings to achieve constructive sustainability and to establish the benefits of utilizing energy efficiency, green materials and sustainable design; to document diverse policy interventions, design and Spatial dimensions of tourism and hospitality sectors; to examine changes in the hospitality, aviation sector especially from a design perspective regarding infrastructure or operational constraints and additional risk-mitigation measures; to dilate on the nature of implications for interior designers and architects to design public places to facilitate sustainable tourism and hospitality while balancing convenient space and their operations' natural surroundings. The qualitative research approach was adopted for the study. The researcher collected and analyzed data in continuous iteration. Secondary data was collected from articles in journals, trade publications, government reports, newspaper/ magazine articles, policy documents etc. In depth interviews were conducted with diverse stakeholders. Preliminary data indicates that designers have started imagining public places of tourism and hospitality against the backdrop of the government push and WHO guidelines. For instance, with regard to health, safety, hygiene and sanitation, Emirates, the Dubai-based airline has augmented health measures at the Dubai International Airport and on board its aircraft. It has leveraged high tech/ Nano-tech, social distancing to encourage least human contact, flexible design layouts to limit the occupancy. The researcher organized the data into thematic categories and found that the Government of Dubai has initiated comprehensive measures in the hospitality, tourism and aviation sectors in compliance with the WHO guidelines.

Keywords: Covid 19, design, Dubai, hospitality, public spaces, tourism

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Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

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Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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