Search results for: Muthu Ramachandran
33 Factors Affecting the Adoption of Cloud Business Intelligence among Healthcare Sector: A Case Study of Saudi Arabia
Authors: Raed Alsufyani, Hissam Tawfik, Victor Chang, Muthu Ramachandran
Abstract:This study investigates the factors that influence the decision by players in the healthcare sector to embrace Cloud Business Intelligence Technology with a focus on healthcare organizations in Saudi Arabia. To bring this matter into perspective, this study primarily considers the Technology-Organization-Environment (TOE) framework and the Human Organization-Technology (HOT) fit model. A survey was hypothetically designed based on literature review and was carried out online. Quantitative data obtained was processed from descriptive and one-way frequency statistics to inferential and regression analysis. Data were analysed to establish factors that influence the decision to adopt Cloud Business intelligence technology in the healthcare sector. The implication of the identified factors was measured, and all assumptions were tested. 66.70% of participants in healthcare organization backed the intention to adopt cloud business intelligence system. 99.4% of these participants considered security concerns and privacy risk have been the most significant factors in the adoption of cloud Business Intelligence (CBI) system. Through regression analysis hypothesis testing point that usefulness, service quality, relative advantage, IT infrastructure preparedness, organization structure; vendor support, perceived technical competence, government support, and top management support positively and significantly influence the adoption of (CBI) system. The paper presents quantitative phase that is a part of an on-going project. The project will be based on the consequences learned from this study.
Keywords: cloud computing, business intelligence, HOT-fit model, TOE, healthcare and innovation adoptionProcedia PDF Downloads 94
32 Comparative in vitro Anticancer Activity of Two Siddha Formulations: Neeradi Muthu Vallathymezugu and Thamira Kattu Chendooram
Authors: Vasudha Devi, Arul Amuthan, K. Narayanan, Praveen KS, Venkata Rao J
Abstract:Background: Siddha Medicine is one of the Indian traditional medical systems, in which the cancer disease is mentioned as 'putrunoi' which literally means the disease of growth like termite mound. There are number of formulations available for the treatment of cancer disease. Neeradi muthu vallathymezugu (NMV) and thamira kattu chendooram (TKC) are two drugs commonly prescribed by Siddha physicians. These drugs have been clinically reported to be safe and effective when given orally. Though these formulations are in practice for centuries, no efforts have been made to standardize them and explore their anti-cancer potential systematically. Objective: To compare the cytotoxic activity of NMV and TKC with doxorubicin using cancer cell lines. Materials and methods: For this study, ethanol extract of NMV was taken, whereas TKC was used as such. In vitro cytotoxic activity was evaluated by sulphorhodamine (SRB) assay against human hepatic cancer cells (HepG2), human breast cancer cells (MCF-7) and human cervical cancer cells [KeLa]. Doxorubicin was used as the standard. The SRB assay is based on the ability of cellular proteins to bind with sulphorhodamine-B. The number of live cells in drug treated cell lines directly affects the color formation in the assay, which is estimated calorimetrically by measuring the absorbance at 540 nm to calculate the cytotoxicity (inhibitory concentration - IC50 value) of the drug. Results: The IC50values of NMV, TKC and doxorubicin against HepG2 were 3.08 µg/ml, 20.21 µg/ml and 1.21µg/ml respectively. In MCF-7, it was 11.75 µg/ml, 17.67 µg/ml and 2.8µg/ml. In HeLa, the values were 24.76 µg/ml, 73.35 µg/ml and 1.12µg/ml. Conclusions: The study proves the possible anti-cancer potential of these two formulations. Compared to TKC, NMV showed good cytotoxic effect even at low dose. Human hepatic cancer cells responded well even at very low dose, when compared to other cancer cells. Though, cytotoxic potential of these compounds was found to be less compared to doxorubicin, the isolated lead compound may have the potential to be used as an anticancer drug clinically.
Keywords: Neeradi muthu vallathymezugu (Hydnocarpus laurifolia), thamira kattu chendooram, cytotoxicity, in-vitro, Siddha MedicineProcedia PDF Downloads 375
31 A Conceptual Model of the Factors Affecting Saudi Citizens' Use of Social Media to Communicate with the Government
Authors: Reemiah Alotaibi, Muthu Ramachandran, Ah-Lian Kor, Amin Hosseinian-Far
Abstract:In the past decade, developers of Web 2.0 technologies have shown increasing interest in the topic of e-government. There has been a rapid growth in social media technology because of its significant role in backing up some essential social needs. Its importance and power is derived from its capacity to support two-way communication. Governments are curious to get engaged in these websites, hoping to benefit from the new forms of communication and interaction offered by such technology. Greater participation by the public can be viewed as a chief indicator of effective government communication. Yet, the level of public participation in government 2.0 is not quite satisfactory. In general, it is still at the early stage in most developing countries, including Saudi Arabia. Although it is a fact that Saudi people are among the most active in using social media, the number of people who use social media to communicate with the public institutions is not high. Furthermore, most of the governmental organisations are not using social media tools to communicate with the public. They use these platforms to disseminate information. Our study focuses on the factors affecting citizens’ adoption of social media in Saudi Arabia. Our research question is: what are the factors affecting Saudi citizens’ use of social media to communicate with the government? To answer this research question, the research aims to validate the UTAUT model for examining social media tools from the citizen perspective. An amendment will be proposed to fit the adoption of social media platforms as a communication channel in government by using a developed conceptual model which integrates constructs from the UTAUT model and others external variables based on the literature review. The set of potential factors that affect these citizens' decisions to adopt social media to communicate with their government has been identified as perceived encouragement, trust and cultural influence. The connection between the above-mentioned constructs from the basis for the research hypothesis will be examined in the light of a quantitative methodology. Data collection will be performed through a survey targeting a number of Saudi citizens who are social media users. The data collected from the primary survey will later be analysed by using statistical methods. The outcomes of this research project are argued to have potential contributions to the fields of social media and e-Government adoption, both on the theoretical and practical levels. It is believed that this research project is the first of its type that attempts to identify the factors that affect citizens’ adoption of social media to communicate with the government. The importance of identifying these factors stems from the potential use of them to enhance the government’s implementation of social media and help in making more accurate decisions and strategies based on comprehending the most important factors that affect citizens’ decisions.
Keywords: social media, adoption, citizen, UTAUT modelProcedia PDF Downloads 354
30 Investigation of Biocorrosion in Brass by Arthrobacter sulfureus in Neutral Medium
Authors: Ramachandran Manivannan, B. Sakthi Swaroop, Selvam Noyel Victoria
Abstract:Microbial corrosion of brass gauze by the aerobic film forming bacteria Arthrobacter sulfurous in neutral media was investigated using gravimetric studies. Maximum weight loss of 166.98 mg was observed for a period of 28 days of exposure to the bacterial medium as against the weight loss of 13.69 mg for control. The optical density studies for the bacterial culture was found to show attainment of stationary phase in 48 h. Scanning electron microscopy analysis of the samples shows the presence of pitting corrosion. The energy dispersive X-ray analysis of the samples showed increased oxygen and phosphorus content in the sample due to bacterial activity.
Keywords: Arthrobacter sulfureus, biocorrosion, brass, neutral mediumProcedia PDF Downloads 105
29 Investigation of the Corrosion Inhibition Mechanism of Tagetes erecta Extract for Mild Steel in Nitric Acid: Gravimetric Studies
Authors: Selvam Noyel Victoria, Kavita Yadav, Manivannan Ramachandran
Abstract:The extract of Tagetes erecta (marigold flower) was used as a green corrosion inhibitor for mild steel (MS) in nitric acid medium. The weight loss measurements were performed to understand the inhibition mechanism. The effect of temperature on the behaviour of mild steel corrosion without and with inhibitor was studied. The temperature studies revealed that the activation energy increased from 12 kJ/mol to 28.8 kJ/mol with the addition of 500 ppm inhibitor concentration. The thermodynamic analysis and the adsorption isotherm studies revealed that the molecules of inhibitor show physical adsorption on the surface of mild steel. Based on weight loss measurements, adsorption of the inhibitor on the surface of mild steel follows Langmuir isotherm.
Keywords: Tagetes erecta, corrosion, adsorption, inhibitorProcedia PDF Downloads 180
28 Theoretical Study on the Nonlinear Optical Responses of Peptide Bonds Created between Alanine and Some Unnatural Amino Acids
Authors: S. N. Derrar, M. Sekkal-Rahal
Abstract:The Nonlinear optics (NLO) technique is widely used in the field of biological imaging. In fact, grafting biological entities with a high NLO response on tissues and cells enhances the NLO responses of these latter, and ameliorates, consequently, their biological imaging quality. In this optics, we carried out a theoretical study, in the aim of analyzing the peptide bonds created between alanine amino acid and both unnatural amino acids: L-Dopa and Azatryptophan, respectively. Ramachandran plots have been performed for these systems, and their structural parameters have been analyzed. The NLO responses of these peptides have been reported by calculating the first hyperpolarizability values of all the minima found on the plots. The use of such unnatural amino acids as endogenous probing molecules has been investigated through this study. The Density Functional Theory (DFT) has been used for structural properties, while the Second-order Møller-Plesset Perturbation Theory (MP2) has been employed for the NLO calculations.
Keywords: biological imaging, hyperpolarizability, nonlinear optics, probing moleculeProcedia PDF Downloads 316
27 Experimental Set-Up for Investigation of Fault Diagnosis of a Centrifugal Pump
Authors: Maamar Ali Saud Al Tobi, Geraint Bevan, K. P. Ramachandran, Peter Wallace, David Harrison
Abstract:Centrifugal pumps are complex machines which can experience different types of fault. Condition monitoring can be used in centrifugal pump fault detection through vibration analysis for mechanical and hydraulic forces. Vibration analysis methods have the potential to be combined with artificial intelligence systems where an automatic diagnostic method can be approached. An automatic fault diagnosis approach could be a good option to minimize human error and to provide a precise machine fault classification. This work aims to introduce an approach to centrifugal pump fault diagnosis based on artificial intelligence and genetic algorithm systems. An overview of the future works, research methodology and proposed experimental setup is presented and discussed. The expected results and outcomes based on the experimental work are illustrated.
Keywords: centrifugal pump setup, vibration analysis, artificial intelligence, genetic algorithmProcedia PDF Downloads 358
26 Rapid Detection of MBL Genes by SYBR Green Based Real-Time PCR
Authors: Taru Singh, Shukla Das, V. G. Ramachandran
Abstract:Objectives: To develop SYBR green based real-time PCR assay to detect carbapenemases (NDM, IMP) genes in E. coli. Methods: A total of 40 E. coli from stool samples were tested. Six were previously characterized as resistant to carbapenems and documented by PCR. The remaining 34 isolates previously tested susceptible to carbapenems and were negative for these genes. Bacterial RNA was extracted using manual method. The real-time PCR was performed using the Light Cycler III 480 instrument (Roche) and specific primers for each carbapenemase target were used. Results: Each one of the two carbapenemase gene tested presented a different melting curve after PCR amplification. The melting temperature (Tm) analysis of the amplicons identified was as follows: blaIMP type (Tm 82.18°C), blaNDM-1 (Tm 78.8°C). No amplification was detected among the negative samples. The results showed 100% concordance with the genotypes previously identified. Conclusions: The new assay was able to detect the presence of two different carbapenemase gene type by real-time PCR.
Keywords: resistance, b-lactamases, E. coli, real-time PCRProcedia PDF Downloads 348
25 Trastuzumab Decorated Bioadhesive Nanoparticles for Targeted Breast Cancer Therapy
Authors: Kasi Viswanadh Matte, Abhisheh Kumar Mehata, M.S. Muthu
Abstract:Brest cancer, up-regulated with human epidermal growth factor receptor type-2 (HER-2) led to the concept of developing HER-2 targeted anticancer therapeutics. Docetaxel-loaded D-α-tocopherol polyethylene glycol succinate 1000 conjugated chitosan (TPGS-g-chitosan) nanoparticles were prepared with or without Trastuzumab decoration. The particle size and entrapment efficiency of conventional, non-targeted and targeted nanoparticles were found to be in the range of 126-186 nm and 74-78% respectively. In-vitro, MDA-MB-231 cells showed that docetaxel-loaded non-targeted and HER-2 receptor targeted TPGS-g-chitosan nanoparticles have enhanced the cellular uptake and cytotoxicity with a promising bioadhesion property, in comparison to conventional nanoparticles. The IC50 values of non-targeted and targeted nanoparticles from cytotoxic assay were found to be 43 and 223 folds higher than DocelTM. The in-vivo pharmacokinetic study showed 2.33, and 2.82-fold enhancement in relative bioavailability of docetaxel for non-targeted and HER-2 receptor targeted nanoparticles, respectively than DocelTM, and after i.v administration, non-targeted and targeted nanoparticle achieved 3.48 and 5.94 times prolonged half-life in comparison to DocelTM. The area under the curve (AUC), relative bioavailability (FR) and mean residence time (MRT) were found to be higher for non-targeted and targeted nanoparticles compared to DocelTM. Further, histopathology results of non-targeted and targeted nanoparticles showed less toxicity on vital organs such as lungs, liver, and kidney compared to DocelTM.
Keywords: breast cancer, HER-2 receptor, targeted nanomedicine, chitosan, TPGSProcedia PDF Downloads 184
24 Predicting Potential Protein Therapeutic Candidates from the Gut Microbiome
Authors: Prasanna Ramachandran, Kareem Graham, Helena Kiefel, Sunit Jain, Todd DeSantis
Abstract:Microbes that reside inside the mammalian GI tract, commonly referred to as the gut microbiome, have been shown to have therapeutic effects in animal models of disease. We hypothesize that specific proteins produced by these microbes are responsible for this activity and may be used directly as therapeutics. To speed up the discovery of these key proteins from the big-data metagenomics, we have applied machine learning techniques. Using amino acid sequences of known epitopes and their corresponding binding partners, protein interaction descriptors (PID) were calculated, making a positive interaction set. A negative interaction dataset was calculated using sequences of proteins known not to interact with these same binding partners. Using Random Forest and positive and negative PID, a machine learning model was trained and used to predict interacting versus non-interacting proteins. Furthermore, the continuous variable, cosine similarity in the interaction descriptors was used to rank bacterial therapeutic candidates. Laboratory binding assays were conducted to test the candidates for their potential as therapeutics. Results from binding assays reveal the accuracy of the machine learning prediction and are subsequently used to further improve the model.
Keywords: protein-interactions, machine-learning, metagenomics, microbiomeProcedia PDF Downloads 303
23 Revealing the Structural and Dynamic Properties of Betaine Aldehyde Dehydrogenase 2 from Rice (Oryza sativa): Simulation Studies
Authors: Apisaraporn Baicharoen, Prapasiri Pongprayoon
Abstract:Betaine aldehyde dehydrogenase 2 (BADH2) is an enzyme that inhibits the accumulation of 2-acetyl-1-pyrroline (2AP), a potent flavor compound in rice fragrance. BADH2 contains three domains (NAD-binding, substrate-binding, and oligomerization domains). It catalyzes the oxidation of amino aldehydes. The lack of BADH2 results in the formation of 2AP and consequently an increase in rice fragrance. To date, inadequate data on BADH2 structure and function are available. An insight into the nature of BADH2 can serve as one of key starting points for the production of high quality fragrant rice. In this study, we therefore constructed the homology model of BADH2 and employed 500-ns Molecular Dynamics simulations (MD) to primarily understand the structural and dynamic properties of BADH2. Initially, Ramachandran plot confirms the good quality of modeled protein structure. Principle Component Analysis (PCA) was also calculated to capture the protein dynamics. Among 3 domains, the results show that NAD binding site is found to be more flexible. Moreover, interactions from key amino acids (N162, E260, C294, and Y419) that are crucial for function are investigated.
Keywords: betaine aldehyde dehydrogenase 2, fragrant rice, homology modeling, molecular dynamics simulationsProcedia PDF Downloads 154
22 Pareto Analysis of Critical Success Factors of Lean Production System
Authors: S. Bharath Sankar, Muthu Mathirajan
Abstract:In an attempt to assist the implementation of the Lean Production System (LPS) in Indian Small and Medium-sized Enterprises (SMEs), this research study aims to analyse and identify the reported critical success factors (CSFs) to compute the occurrence frequency of each of the reported CSF, and to identify the vital-few and useful-many CSFs using Pareto Analysis. Accordingly, this study is based on a comprehensive literature review of factors or enablers that influence the implementation of LPS. For this, four major publications: Emerald insights, Taylor and Francis, Springer link, and science direct sources, are explored during the period: 1990-2021. Subsequently, the Pareto Analysis, a quality tool, is used to identify the vital-few and useful-many CSFs w.r.t. implementation of LPS in Indian SMEs. By analysing 78 relevant empirical studies on LPS, 32 unique CSFs are identified. Applying Pareto Analysis considering 32 unique CSFs along with the 78 publications, there are 16 factors form under vital-few CSFs (accounts for 80.3% of occurrences), and the remaining 16 factors fall under useful-many CSFs. Particularly, the analysis of the Pareto results indicated that factors: Top management commitment, training and education, organizational cultural changes, and involvement of all employees are found to be the most significant factors addressed by the researcher in their studies for effective implementation of LPS. Further, this study will guide the researchers in selecting a set of CSFs for their empirical studies on the implementation of LPS. Overall this study provides a solution to the challenges normally faced by any SMEs in operationalizing the large number of CSFs reported by the various studies w.r.t. CSFs of LPS.
Keywords: lean production system, small and medium-sized enterprises, literature review, critical success factor, Pareto analysisProcedia PDF Downloads 7
21 Biotransformation of Glycerine Pitch as Renewable Carbon Resource into P(3HB-co-4HB) Biopolymer
Authors: Amirul Al-Ashraf Abdullah, Hema Ramachandran, Iszatty Ismail
Abstract:Oleochemical industry in Malaysia has been diversifying significantly due to the abundant supply of both palm and kernel oils as raw materials as well as the high demand for downstream products such as fatty acids, fatty alcohols and glycerine. However, environmental awareness is growing rapidly in Malaysia because oleochemical industry is one of the palm-oil based industries that possess risk to the environment. Glycerine pitch is one of the scheduled wastes generated from the fatty acid plants in Malaysia and its discharge may cause a serious environmental problem. Therefore, it is imperative to find alternative applications for this waste glycerine. Consequently, the aim of this research is to explore the application of glycerine pitch as direct fermentation substrate in the biosynthesis of poly(3-hydroxybutyrate-co-4-hydroxybutyrate) [P(3HB-co-4HB)] copolymer, aiming to contribute toward the sustainable production of biopolymer in the world. Utilization of glycerine pitch (10 g/l) together with 1,4-butanediol (5 g/l) had resulted in the achievement of 40 mol% 4HB monomer with the highest PHA concentration of 2.91 g/l. Synthesis of yellow pigment which exhibited antimicrobial properties occurred simultaneously with the production of P(3HB-co-4HB) through the use of glycerine pitch as renewable carbon resource. Utilization of glycerine pitch in the biosynthesis of P(3HB-co-4HB) will not only contribute to reducing society’s dependence on non-renewable resources but also will promote the development of cost efficiency microbial fermentation towards biosustainability and green technology.
Keywords: biopolymer, glycerine pitch, natural pigment, P(3HB-co-4HB)Procedia PDF Downloads 381
20 A Comparison of South East Asian Face Emotion Classification based on Optimized Ellipse Data Using Clustering Technique
Authors: M. Karthigayan, M. Rizon, Sazali Yaacob, R. Nagarajan, M. Muthukumaran, Thinaharan Ramachandran, Sargunam Thirugnanam
Abstract:In this paper, using a set of irregular and regular ellipse fitting equations using Genetic algorithm (GA) are applied to the lip and eye features to classify the human emotions. Two South East Asian (SEA) faces are considered in this work for the emotion classification. There are six emotions and one neutral are considered as the output. Each subject shows unique characteristic of the lip and eye features for various emotions. GA is adopted to optimize irregular ellipse characteristics of the lip and eye features in each emotion. That is, the top portion of lip configuration is a part of one ellipse and the bottom of different ellipse. Two ellipse based fitness equations are proposed for the lip configuration and relevant parameters that define the emotions are listed. The GA method has achieved reasonably successful classification of emotion. In some emotions classification, optimized data values of one emotion are messed or overlapped to other emotion ranges. In order to overcome the overlapping problem between the emotion optimized values and at the same time to improve the classification, a fuzzy clustering method (FCM) of approach has been implemented to offer better classification. The GA-FCM approach offers a reasonably good classification within the ranges of clusters and it had been proven by applying to two SEA subjects and have improved the classification rate.
Keywords: ellipse fitness function, genetic algorithm, emotion recognition, fuzzy clusteringProcedia PDF Downloads 493
19 Off-Policy Q-learning Technique for Intrusion Response in Network Security
Authors: Zheni S. Stefanova, Kandethody M. Ramachandran
Abstract:With the increasing dependency on our computer devices, we face the necessity of adequate, efficient and effective mechanisms, for protecting our network. There are two main problems that Intrusion Detection Systems (IDS) attempt to solve. 1) To detect the attack, by analyzing the incoming traffic and inspect the network (intrusion detection). 2) To produce a prompt response when the attack occurs (intrusion prevention). It is critical creating an Intrusion detection model that will detect a breach in the system on time and also challenging making it provide an automatic and with an acceptable delay response at every single stage of the monitoring process. We cannot afford to adopt security measures with a high exploiting computational power, and we are not able to accept a mechanism that will react with a delay. In this paper, we will propose an intrusion response mechanism that is based on artificial intelligence, and more precisely, reinforcement learning techniques (RLT). The RLT will help us to create a decision agent, who will control the process of interacting with the undetermined environment. The goal is to find an optimal policy, which will represent the intrusion response, therefore, to solve the Reinforcement learning problem, using a Q-learning approach. Our agent will produce an optimal immediate response, in the process of evaluating the network traffic.This Q-learning approach will establish the balance between exploration and exploitation and provide a unique, self-learning and strategic artificial intelligence response mechanism for IDS.
Keywords: cyber security, intrusion prevention, optimal policy, Q-learningProcedia PDF Downloads 166
18 Improving Indoor Air Quality by Increasing Bio-Based Negative Air Ion Release
Authors: Shuye Jiang, Ali Ma, Srinivasan Ramachandran
Abstract:Indoor air quality could be improved through traditional air purifiers. However, they may not be environmental products. Here, a bio-based method was employed to improve indoor air quality by increasing negative air ion (NAI) release from ornamental plants. A total of 60 plant species has been screened by evaluating their ability to release NAIs, from which four candidates were selected to further study. All of them are from the Dracaena or fabids clade. These four candidates were then subjected to survey their ability to reduce the concentration of particulate matter with diameter of 2.5 or 10 microns (PM2.5 and PM10) in the growth chamber. High concentrations of PM2.5 and PM10 were artificially generated by burning a stick of incense for 2 minutes in the closed growth chamber (80cm length × 80cm width × 80cm height), in which the PM2.5 and PM10 concentration were generally around 500 µg/m3 and 1500 µg/m3, respectively. Both PM2.5 and PM10 were naturally reduced to 410 and 670, respectively after two hours in case that no plants were placed inside the chamber. Interestingly, these two sizes of particulars were reduced to 170 µg/m3 and 210 µg/m3, respectively after two hours when plants were placed to the chamber. It took 4 hours for the plants to reduce particular concentration to acceptable level at less than 55 µg/m3 for both PM2.5 and PM10, respectively. However, the PM2.5 and PM10 concentration were still above 200 µg/m3 and 300 µg/m3, respectively after 4 hours in the growth chamber without any plants. These results suggest the contribution of plants to the particulate deposition. However, all of these data are preliminary and the results may be updated by further studies. In addition, the roles of plants in absorbing indoor formaldehyde have also been explored and their absorbing ability is being improved by optimizing their growth conditions and treating with various exogenous agents. Thus, our preliminary studies provide an alternative strategy to improve indoor air quality.
Keywords: bio-based method, indoor air, negative air ion, particulate matterProcedia PDF Downloads 100
17 Sustainable Development in India: Towards a New Paradigm
Authors: Raghav Srivastava, Namrata Ramachandran
Abstract:Strong sustainability has been, by consensus, imagined as comprising economic and extra-economic variables and cannot be viewed merely in terms of a trade-off between the economic needs of today and the potential left for tomorrow. Specifically, the cultural as well the ecological impacts of development projects on the affected communities should be evaluated, in addition to the economic. In developing and densely populated economies such as India, energy intensive development is seen as a sine qua non – a necessary trade off with ecological conservation. Although social impact assessment has been included as an inalienable part of the Environmental Impact Assessment required to be conducted under Indian law, it seems that the same is unable to meet the ends it seeks to achieve. The dissociation between those bearing the costs of development, and those reaping its benefits, lies at the heart of this failure. This paper attempts to study the various cost–benefit relationships for these minority stakeholders using the proposed Nyamjang Chhu hydroelectric power plant in Tawang District of Arunachal Pradesh (in North-east India) as the chief object of study, and discusses whether the current model of sustainable development is truly sustainable, given the level of social dissociation and disintegration that occurs between affected communities and their environment. The economic allure of hydroelectric projects in the hilly regions of India very rarely results in a proper assessment of their ecological and social externalities. Examining the various issues that have been agitated in the course of litigation over the Nyamjang Chhu hydroelectric project, the authors argue that there is a pressing need to re-evaluate the current Indian model of sustainable development going forward.
Keywords: hydroelectric power, socio-cultural dissociation, sustainable development, trade offsProcedia PDF Downloads 229
16 Development of Pre-Mitigation Measures and Its Impact on Life-Cycle Cost of Facilities: Indian Scenario
Authors: Mahima Shrivastava, Soumya Kar, B. Swetha Malika, Lalu Saheb, M. Muthu Kumar, P. V. Ponambala Moorthi
Abstract:Natural hazards and manmade destruction causes both economic and societal losses. Generalized pre-mitigation strategies introduced and adopted for prevention of disaster all over the world are capable of augmenting the resiliency and optimizing the life-cycle cost of facilities. In countries like India where varied topographical feature exists requires location specific mitigation measures and strategies to be followed for better enhancement by event-driven and code-driven approaches. Present state of vindication measures followed and adopted, lags dominance in accomplishing the required development. In addition, serious concern and debate over climate change plays a vital role in enhancing the need and requirement for the development of time bound adaptive mitigation measures. For the development of long-term sustainable policies incorporation of future climatic variation is inevitable. This will further assist in assessing the impact brought about by the climate change on life-cycle cost of facilities. This paper develops more definite region specific and time bound pre-mitigation measures, by reviewing the present state of mitigation measures in India and all over the world for improving life-cycle cost of facilities. For the development of region specific adoptive measures, Indian regions were divided based on multiple-calamity prone regions and geo-referencing tools were used to incorporate the effect of climate changes on life-cycle cost assessment. This study puts forward significant effort in establishing sustainable policies and helps decision makers in planning for pre-mitigation measures for different regions. It will further contribute towards evaluating the life cycle cost of facilities by adopting the developed measures.
Keywords: climate change, geo-referencing tools, life-cycle cost, multiple-calamity prone regions, pre-mitigation strategies, sustainable policiesProcedia PDF Downloads 279
15 Polymerization of Epsilon-Caprolactone Using Lipase Enzyme for Medical Applications
Authors: Sukanya Devi Ramachandran, Vaishnavi Muralidharan, Kavya Chandrasekaran
Abstract:Polycaprolactone is polymer belonging to the polyester family that has noticeable characteristics of biodegradability and biocompatibility which is essential for medical applications. Polycaprolactone is produced by the ring opening polymerization of the monomer epsilon-Caprolactone (ε-CL) which is a closed ester, comprising of seven-membered ring. This process is normally catalysed by metallic components such as stannous octoate. It is difficult to remove the catalysts after the reaction, and they are also toxic to the human body. An alternate route of using enzymes as catalysts is being employed to reduce the toxicity. Lipase enzyme is a subclass of esterase that can easily attack the ester bonds of ε-CL. This research paper throws light on the extraction of lipase from germinating sunflower seeds and the activity of the biocatalyst in the polymerization of ε-CL. Germinating Sunflower seeds were crushed with fine sand in phosphate buffer of pH 6.5 into a fine paste which was centrifuged at 5000rpm for 10 minutes. The clear solution of the enzyme was tested for activity at various pH ranging from 5 to 7 and temperature ranging from 40oC to 70oC. The enzyme was active at pH6.0 and at 600C temperature. Polymerization of ε-CL was done using toluene as solvent with the catalysis of lipase enzyme, after which chloroform was added to terminate the reaction and was washed in cold methanol to obtain the polymer. The polymerization was done by varying the time from 72 hours to 6 days and tested for the molecular weight and the conversion of the monomer. The molecular weight obtained at 6 days is comparably higher. This method will be very effective, economical and eco-friendly to produce as the enzyme used can be regenerated as such at the end of the reaction and can be reused. The obtained polymers can be used for drug delivery and other medical applications.
Keywords: lipase, monomer, polycaprolactone, polymerizationProcedia PDF Downloads 235
14 Drivers and Barriers to the Acceptability of a Human Milk Bank Among Malaysians: A Cross Sectional Study
Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid
Abstract:WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.
Keywords: acceptability, attitude, human milk bank, knowledgeProcedia PDF Downloads 32
13 Transcriptome Analysis Reveals Role of Long Non-Coding RNA NEAT1 in Dengue Patients
Authors: Abhaydeep Pandey, Shweta Shukla, Saptamita Goswami, Bhaswati Bandyopadhyay, Vishnampettai Ramachandran, Sudhanshu Vrati, Arup Banerjee
Abstract: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, transcriptomeProcedia PDF Downloads 253
12 Pathogenic Effects of IgG and IgM Apoptotic Cell-Reactive Monoclonal Auto-Antibodies on Innate and Adaptive Immunity in Lupus
Authors: Monika Malik, Pooja Arora, Ruchi Sachdeva, Vishnampettai G. Ramachandran, Rahul Pal
Abstract:Apoptotic debris is believed to be the antigenic trigger in lupus. Whether such debris and autoantibodies induced in lupus-prone mice which specifically recognize its constituents can mediate differential effects on innate and humoral responses in such mice was assessed. The influence of apoptotic blebs and apoptotic cell-reactive monoclonal antibodies on phenotypic markers expressed on bone marrow-derived dendritic cells (BMDCs) and secreted cytokines were evaluated. Sera from lupus-prone and healthy mice immunized with the antibodies were analyzed for anti-self reactivity. Apoptotic blebs, as well as somatically-mutated IgG and non-mutated IgM apoptotic-cell reactive monoclonal antibodies, induced the preferential maturation of BMDCs derived from lupus-prone mice relative to BMDCs derived from healthy mice; antibody specificity and cell genotype both influenced the secretion of inflammatory cytokines. Immunization of lupus-prone mice with IgM and IgG antibodies led to hypergammaglobulinemia; elicited antibodies were self-reactive, and exhibited enhanced recognition of lupus-associated autoantigens (dsDNA, Ro60, RNP68, and Sm) in comparison with adjuvant-induced sera. While ‘natural’ IgM antibodies are believed to contribute to immune homeostasis, this study reveals that apoptotic cell-reactive IgM antibodies can promote inflammation and drive anti-self responses in lupus. Only in lupus-prone mice did immunization with IgG auto-antibodies enhance the kinetics of humoral anti-self responses, resulting in advanced-onset glomerulosclerosis. This study reveals that preferential innate and humoral recognition of the products of cell death in an autoimmune milieu influences the indices associated with lupus pathology.
Keywords: antigen spreading, apoptotic cell-reactive pathogenic IgG, and IgM autoantibodies, glomerulosclerosis, lupusProcedia PDF Downloads 109
11 A Versatile Standing Cum Sitting Device for Rehabilitation and Standing Aid for Paraplegic Patients
Authors: Sasibhushan Yengala, Nelson Muthu, Subramani Kanagaraj
Abstract:The abstract reports on the design related to a modular and affordable standing cum sitting device to meet the requirements of paraplegic patients of the different physiques. Paraplegic patients need the assistance of an external arrangement to the lower limbs and trunk to help patients adopt the correct posture while standing abreast gravity. This support can be from a tilt table or a standing frame which the patient can use to stay in a vertical posture. Standing frames are devices fitting to support a person in a weight-bearing posture. Commonly, these devices support and lift the end-user in shifting from a sitting position to a standing position. The merits of standing for a paraplegic patient with a spinal injury are numerous. Even when there is limited control on muscles that ordinarily support the user using the standing frame in a vertical position, the standing stance improves the blood pressure, increases bone density, improves resilience and scope of motion, and improves the user's feelings of well-being by letting the patient stand. One limitation with standing frames is that these devices are typically function definitely; cannot be used for different purposes. Therefore, users are often compelled to purchase more than one of these devices, each being purposefully built for definite activities. Another concern frequent in standing frames is manoeuvrability; it is crucial to provide a convenient adjustment scope for all users. Thus, there is a need to provide a standing frame with multiple uses that can be economical for a larger population. There is also a need to equip added readjustment means in a standing frame to lessen the shear and to accommodate a broad range of users. The proposed Versatile Standing cum Sitting Device (VSD) is designed to change from standing to a comfortable sitting position using a series of mechanisms. First, a locking mechanism is provided to lock the VSD in a standing stance. Second, a dampening mechanism is provided to make sure that the VSD shifts from a standing to a sitting position gradually when the lock mechanism gets disengaged. An adjustment option is offered for the height of the headrest via the use of lock knobs. This device can be used in clinics for rehabilitation purposes irrespective of patient's anthropometric data due to its modular adjustments. It can facilitate the patient's daily life routine while in therapy and giving the patient the comfort to sit when tired. The device also provides the availability of rehabilitation to a common person.
Keywords: paraplegic, rehabilitation, spinal cord injury, standing frameProcedia PDF Downloads 140
10 Designed Purine Molecules and in-silico Evaluation of Aurora Kinase Inhibition in Breast Cancer
Authors: Pooja Kumari, Anandkumar Tengli
Abstract:Aurora kinase enzyme, a protein on overexpression, leads to metastasis and is extremely important for women’s health in terms of prevention or treatment. While creating a targeted technique, the aim of the work is to design purine molecules that inhibit in aurora kinase enzyme and helps to suppress breast cancer. Purine molecules attached to an amino acid in DNA block protein synthesis or halt the replication and metastasis caused by the aurora kinase enzyme. Various protein related to the overexpression of aurora protein was docked with purine molecule using Biovia Drug Discovery, the perpetual software. Various parameters like X-ray crystallographic structure, presence of ligand, Ramachandran plot, resolution, etc., were taken into consideration for selecting the target protein. A higher negative binding scored molecule has been taken for simulation studies. According to the available research and computational analyses, purine compounds may be powerful enough to demonstrate a greater affinity for the aurora target. Despite being clinically effective now, purines were originally meant to fight breast cancer by inhibiting the aurora kinase enzyme. In in-silico studies, it is observed that purine compounds have a moderate to high potency compared to other molecules, and our research into the literature revealed that purine molecules have a lower risk of side effects. The research involves the design, synthesis, and identification of active purine molecules against breast cancer. Purines are structurally similar to the normal metabolites of adenine and guanine; hence interfere/compete with protein synthesis and suppress the abnormal proliferation of cells/tissues. As a result, purine target metastasis cells and stop the growth of kinase; purine derivatives bind with DNA and aurora protein which may stop the growth of protein or inhibits replication and stop metastasis of overexpressed aurora kinase enzyme.
Keywords: aurora kinases, in silico studies, medicinal chemistry, combination therapies, chronic cancer, clinical translationProcedia PDF Downloads 13
9 Transcriptome Analysis for Insights into Disease Progression in Dengue Patients
Authors: Abhaydeep Pandey, Shweta Shukla, Saptamita Goswami, Bhaswati Bandyopadhyay, Vishnampettai Ramachandran, Sudhanshu Vrati, Arup Banerjee
Abstract: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)Procedia PDF Downloads 251
8 Functional Characterization of Rv1019, a Putative TetR Family Transcriptional Regulator of Mycobacterium Tuberculosis H37Rv
Authors: Akhil Raj Pushparajan, Ranjit Ramachandran, Jijimole Gopi Reji, Ajay Kumar Ramakrishnan
Abstract:Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is one of the leading causes of death by an infectious disease. In spite of the availability of effective drugs and a vaccine, TB is a major health concern and was declared a global emergency by the World Health Organization (WHO). The success of intracellular pathogens like Mtb depends on its ability to overcome the challenging environment in the host. Gene regulation controlled by transcriptional regulators (TRs) plays a crucial role for the bacteria to adapt to the host environment. In vitro studies on gene regulatory mechanisms during dormancy and reactivation have provided insights into the adaptations employed by Mtb to survive in the host. Here we present our efforts to functionally characterize Rv1019, a putative TR of Mtb H37Rv which was found to be present at significantly varying levels during dormancy and reactivation in vitro. The expression of this protein in the dormancy-reactivation model was validated by qRT-PCR and western blot. By DNA- protein interaction studies and reporter assays we found that under normal laboratory conditions of growth this protein behaves as an auto-repressor and tetracycline was found to abrogate this repression by interfering with its ability to bind DNA. Further, by cDNA analysis, we found that this TR is co-transcribed with its downstream genes Rv1020 (mfd) and Rv1021 (mazG) which are involved in DNA damage response in Mtb. Constitutive expression of this regulator in the surrogate host M. smegmatis showed downregulation of the orthologues of downstream genes suggested that Rv1019 could negatively regulate these genes. Our finds also show that M. smegmatis expressing Rv1019 is sensitive to DNA damage suggests the role of this protein in regulating DNA damage response induced by oxidative stress. Because of its role in regulating DNA damage response which may help in the persistence of Mtb, Rv1019 could be used as a prospective target for therapeutic intervention to fight TB.
Keywords: auto-repressor, DNA repair, mycobacterium smegmatis, mycobacterium tuberculosis, tuberculosisProcedia PDF Downloads 72
7 A Xenon Mass Gauging through Heat Transfer Modeling for Electric Propulsion Thrusters
Authors: A. Soria-Salinas, M.-P. Zorzano, J. Martín-Torres, J. Sánchez-García-Casarrubios, J.-L. Pérez-Díaz, A. Vakkada-Ramachandran
Abstract:The current state-of-the-art methods of mass gauging of Electric Propulsion (EP) propellants in microgravity conditions rely on external measurements that are taken at the surface of the tank. The tanks are operated under a constant thermal duty cycle to store the propellant within a pre-defined temperature and pressure range. We demonstrate using computational fluid dynamics (CFD) simulations that the heat-transfer within the pressurized propellant generates temperature and density anisotropies. This challenges the standard mass gauging methods that rely on the use of time changing skin-temperatures and pressures. We observe that the domes of the tanks are prone to be overheated, and that a long time after the heaters of the thermal cycle are switched off, the system reaches a quasi-equilibrium state with a more uniform density. We propose a new gauging method, which we call the Improved PVT method, based on universal physics and thermodynamics principles, existing TRL-9 technology and telemetry data. This method only uses as inputs the temperature and pressure readings of sensors externally attached to the tank. These sensors can operate during the nominal thermal duty cycle. The improved PVT method shows little sensitivity to the pressure sensor drifts which are critical towards the end-of-life of the missions, as well as little sensitivity to systematic temperature errors. The retrieval method has been validated experimentally with CO2 in gas and fluid state in a chamber that operates up to 82 bar within a nominal thermal cycle of 38 °C to 42 °C. The mass gauging error is shown to be lower than 1% the mass at the beginning of life, assuming an initial tank load at 100 bar. In particular, for a pressure of about 70 bar, just below the critical pressure of CO2, the error of the mass gauging in gas phase goes down to 0.1% and for 77 bar, just above the critical point, the error of the mass gauging of the liquid phase is 0.6% of initial tank load. This gauging method improves by a factor of 8 the accuracy of the standard PVT retrievals using look-up tables with tabulated data from the National Institute of Standards and Technology.
Keywords: electric propulsion, mass gauging, propellant, PVT, xenonProcedia PDF Downloads 292
6 In Silico Screening, Identification and Validation of Cryptosporidium hominis Hypothetical Protein and Virtual Screening of Inhibitors as Therapeutics
Authors: Arpit Kumar Shrivastava, Subrat Kumar, Rajani Kanta Mohapatra, Priyadarshi Soumyaranjan Sahu
Abstract:Computational approaches to predict structure, function and other biological characteristics of proteins are becoming more common in comparison to the traditional methods in drug discovery. Cryptosporidiosis is a major zoonotic diarrheal disease particularly in children, which is caused primarily by Cryptosporidium hominis and Cryptosporidium parvum. Currently, there are no vaccines for cryptosporidiosis and recommended drugs are not effective. With the availability of complete genome sequence of C. hominis, new targets have been recognized for the development of effective and better drugs and/or vaccines. We identified a unique hypothetical epitopic protein in C. hominis genome through BLASTP analysis. A 3D model of the hypothetical protein was generated using I-Tasser server through threading methodology. The quality of the model was validated through Ramachandran plot by PROCHECK server. The functional annotation of the hypothetical protein through DALI server revealed structural similarity with human Transportin 3. Phylogenetic analysis for this hypothetical protein also showed C. hominis hypothetical protein (CUV04613) was the closely related to human transportin 3 protein. The 3D protein model is further subjected to virtual screening study with inhibitors from the Zinc Database by using Dock Blaster software. Docking study reported N-(3-chlorobenzyl) ethane-1,2-diamine as the best inhibitor in terms of docking score. Docking analysis elucidated that Leu 525, Ile 526, Glu 528, Glu 529 are critical residues for ligand–receptor interactions. The molecular dynamic simulation was done to access the reliability of the binding pose of inhibitor and protein complex using GROMACS software at 10ns time point. Trajectories were analyzed at each 2.5 ns time interval, among which, H-bond with LEU-525 and GLY- 530 are significantly present in MD trajectories. Furthermore, antigenic determinants of the protein were determined with the help of DNA Star software. Our study findings showed a great potential in order to provide insights in the development of new drug(s) or vaccine(s) for control as well as prevention of cryptosporidiosis among humans and animals.
Keywords: cryptosporidium hominis, hypothetical protein, molecular docking, molecular dynamics simulationProcedia PDF Downloads 301
5 Targeted Delivery of Docetaxel Drug Using Cetuximab Conjugated Vitamin E TPGS Micelles Increases the Anti-Tumor Efficacy and Inhibit Migration of MDA-MB-231 Triple Negative Breast Cancer
Authors: V. K. Rajaletchumy, S. L. Chia, M. I. Setyawati, M. S. Muthu, S. S. Feng, D. T. Leong
Abstract:Triple negative breast cancers (TNBC) can be classified as one of the most aggressive with a high rate of local recurrences and systematic metastases. TNBCs are insensitive to existing hormonal therapy or targeted therapies such as the use of monoclonal antibodies, due to the lack of oestrogen receptor (ER) and progesterone receptor (PR) and the absence of overexpression of human epidermal growth factor receptor 2 (HER2) compared with other types of breast cancers. The absence of targeted therapies for selective delivery of therapeutic agents into tumours, led to the search for druggable targets in TNBC. In this study, we developed a targeted micellar system of cetuximab-conjugated micelles of D-α-tocopheryl polyethylene glycol succinate (vitamin E TPGS) for targeted delivery of docetaxel as a model anticancer drug for the treatment of TNBCs. We examined the efficacy of our micellar system in xenograft models of triple negative breast cancers and explored the effect of the micelles on post-treatment tumours in order to elucidate the mechanism underlying the nanomedicine treatment in oncology. The targeting micelles were found preferentially accumulated in tumours immediately after the administration of the micelles compare to normal tissue. The fluorescence signal gradually increased up to 12 h at the tumour site and sustained for up to 24 h, reflecting the increases in targeted micelles (TPFC) micelles in MDA-MB-231/Luc cells. In comparison, for the non-targeting micelles (TPF), the fluorescence signal was evenly distributed all over the body of the mice. Only a slight increase in fluorescence at the chest area was observed after 24 h post-injection, reflecting the moderate uptake of micelles by the tumour. The successful delivery of docetaxel into tumour by the targeted micelles (TPDC) exhibited a greater degree of tumour growth inhibition than Taxotere® after 15 days of treatment. The ex vivo study has demonstrated that tumours treated with targeting micelles exhibit enhanced cell cycle arrest and attenuated proliferation compared with the control and with those treated non-targeting micelles. Furthermore, the ex vivo investigation revealed that both the targeting and non-targeting micellar formulations shows significant inhibition of cell migration with migration indices reduced by 0.098- and 0.28-fold, respectively, relative to the control. Overall, both the in vivo and ex vivo data increased the confidence that our micellar formulations effectively targeted and inhibited EGF-overexpressing MDA-MB-231 tumours.
Keywords: biodegradable polymers, cancer nanotechnology, drug targeting, molecular biomaterials, nanomedicineProcedia PDF Downloads 229
4 Recurrent Fevers with Weight Gain - Possible Rapid onset Obesity with Hypoventilation, Hypothalamic Dysfunction and Autonomic Dysregulation Syndrome
Authors: Lee Rui, Rajeev Ramachandran
Abstract:The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.
Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescentProcedia PDF Downloads 29