Search results for: Piyush Hajela
Commenced in January 2007
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Edition: International
Paper Count: 17

Search results for: Piyush Hajela

17 Evaluation of Planned and Organically Transformed Public Spaces in Urban Indian Market Places: A Case of Bhopal City, India

Authors: Piyush Hajela

Abstract:

Public spaces within Indian markets are vibrant, colorful and contain dimensions that make them attractive and therefore act as popular gathering spaces. Most of these public spaces emerge as squares, plazas of varied shapes and sizes spread at different locations within the market. These public spaces grow organically and are discovered by the people themselves as they respond positively to the collective human senses. On the other hand, there are the planned and designed public spaces as well that are less active. This research evaluates both the planned and the organically transformed public spaces in Indian markets from an Urban Design point of view. The purpose of such research is to provide a basis for design solutions to ensure the success of designed public spaces. The evaluation is done for identified Attributes, namely Comfort, Protection, Familiarity, Activities, Form, Legibility, Engagement, Safety, Accessibility, Environment and Transformations by which a Public Space attains its recognition. The evaluation is based on a rating done for forty-four parameters falling under eleven attributes of public space. An opinion survey of professionals is conducted for their priorities of attributes while designing Public spaces. A comparison is made to rank these attributes between Planned and Organically transformed Public spaces and, opinion of the professionals. After dues analysis, the research suggests the learning from the organically transformed Public spaces for ensuring the success of designed public spaces. The suggestions may be in the form of Design decisions or administrative regulations, or both for achieving the desirables.

Keywords: assessment, attributes, engagement, interaction

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16 Dimensions of Public Spaces in Indian Market Places Feelings through Human Senses

Authors: Piyush Hajela

Abstract:

Public spaces in Indian market places are vibrant, colorful and carry latent dimensions that make them attractive and popular gathering spaces. These markets satisfy the household needs of the people and also their social, cultural and traditional aspirations. Going to a market place for shopping in India is a great source of entertainment for the people. They would love to spend as much time as possible and stay for longer durations than otherwise required. It is this desire of the people that generates public spaces. Much of these public spaces emerge as squares, plazas, corners of varied shapes and sizes at different locations, and yet provide a conducive environment. Such public spaces grow organically and are discovered by the people themselves. Indian markets serve people of different culture, religion, caste, age, gender which keeps them alive all the year round. Indian is a diverse country and this diversity is reflected clearly in the market places. They hold the people together and promote harmony across cultures. Free access to these market places makes them magnets for social interaction. Public spaces are spread across a city and more or less have established their existence and prominence in a social set up. While few of them are created, others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The paper aims at identifying these freely accessible public spaces and the dimensions within it that make these public spaces hold the people for significant duration of time. The dimensions present shall be judged through collective response of human senses in form of safety, comfort and so on through the expressions of the participants. The aim therefore would be to trace the freely accessible public spaces emerged in Indian markets and evaluate them for human response and behavior. The hierarchy of market places in the city of Bhopal is well established as, city center level, sub city-center level, community level, local and convenient level market places. While many city-centers are still referred to as the old or traditional or the core area of the city, the others are part of the planned city. These different levels of market places are studied for emerged public spaces. These emerged public spaces are then documented in detail for unveiling the dimensions they offer through, photographs, visual observations, questionnaires and response of the participants of these public spaces.

Keywords: human comfort, enclosure, safety, social interaction

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15 Dimensions of Public Spaces: Feelings through Human Senses

Authors: Piyush Hajela

Abstract:

The significance of public spaces is on a rise in Indian cities as a strong interaction space across cultures and community. It is a pertinent gathering space for people across age and gender, where the face keeps changing with time. A public space is directly related to the social dimension, people, comfort, safety, and security, that, it proposes to provide, as inherent qualities. The presence of these and other dimensions of space, together with related equitable environments, impart certain quality to a public space. The higher the optimum contents of these dimensions, the better the quality of public space. Public is represented by PEOPLE through society and community, and space is created by dimensions. Society contains children, women and the elderly, community is composed of social, and religious groups. These behave differently in a different setting and call for varied quality of spaces, created and generated. Public spaces are spread across a city and have more or less established their existence and prominence in a social set up. While few of them are created others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The emergence of public space dates back to the times when people started forming communities, display cultures and traditions publicly, gathered for religious observations and celebrations, and address the society. Traditional cities and societies in India were feudal and orthodox in their nature and yet had public spaces. When the gathering of people at one point in a city became more frequent the point became more accessible and occupied. Baras (large courts, Chowks (public squares) and Maidans (large grounds) became well-known gathering spaces in the towns and cities. As the population grew such points grew in number, each becoming a public space in itself and with a different and definite social character. The author aims at studying the various dimensions of public spaces with which a public space has power to hold people for a significant period of time. The human senses here are note referred to as taste, sight, hearing, touch or smell, but how human senses collectively respond to when stationed in a given public space. The collectives may reflect in dimensions like comfort, safety, environment, freedom etc. Various levels of similar other responses would be studied through interviews, observations and other scientific methods for both qualitative and quantitative analysis.

Keywords: society, interaction, people, accessibility, comfort, enclosure

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14 Diagnosis of Diabetes Using Computer Methods: Soft Computing Methods for Diabetes Detection Using Iris

Authors: Piyush Samant, Ravinder Agarwal

Abstract:

Complementary and Alternative Medicine (CAM) techniques are quite popular and effective for chronic diseases. Iridology is more than 150 years old CAM technique which analyzes the patterns, tissue weakness, color, shape, structure, etc. for disease diagnosis. The objective of this paper is to validate the use of iridology for the diagnosis of the diabetes. The suggested model was applied in a systemic disease with ocular effects. 200 subject data of 100 each diabetic and non-diabetic were evaluated. Complete procedure was kept very simple and free from the involvement of any iridologist. From the normalized iris, the region of interest was cropped. All 63 features were extracted using statistical, texture analysis, and two-dimensional discrete wavelet transformation. A comparison of accuracies of six different classifiers has been presented. The result shows 89.66% accuracy by the random forest classifier.

Keywords: complementary and alternative medicine, classification, iridology, iris, feature extraction, disease prediction

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13 Fast and Accurate Model to Detect Ictal Waveforms in Electroencephalogram Signals

Authors: Piyush Swami, Bijaya Ketan Panigrahi, Sneh Anand, Manvir Bhatia, Tapan Gandhi

Abstract:

Visual inspection of electroencephalogram (EEG) signals to detect epileptic signals is very challenging and time-consuming task even for any expert neurophysiologist. This problem is most challenging in under-developed and developing countries due to shortage of skilled neurophysiologists. In the past, notable research efforts have gone in trying to automate the seizure detection process. However, due to high false alarm detections and complexity of the models developed so far, have vastly delimited their practical implementation. In this paper, we present a novel scheme for epileptic seizure detection using empirical mode decomposition technique. The intrinsic mode functions obtained were then used to calculate the standard deviations. This was followed by probability density based classifier to discriminate between non-ictal and ictal patterns in EEG signals. The model presented here demonstrated very high classification rates ( > 97%) without compromising the statistical performance. The computation timings for each testing phase were also very low ( < 0.029 s) which makes this model ideal for practical applications.

Keywords: electroencephalogram (EEG), epilepsy, ictal patterns, empirical mode decomposition

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12 Design and Validation of Different Steering Geometries for an All-Terrain Vehicle

Authors: Prabhsharan Singh, Rahul Sindhu, Piyush Sikka

Abstract:

The steering system is an integral part and medium through which the driver communicates with the vehicle and terrain, hence the most suitable steering geometry as per requirements must be chosen. The function of the chosen steering geometry of an All-Terrain Vehicle (ATV) is to provide the desired understeer gradient, minimum tire slippage, expected weight transfer during turning as these are requirements for a good steering geometry of a BAJA ATV. This research paper focuses on choosing the best suitable steering geometry for BAJA ATV tracks by reasoning the working principle and using fundamental trigonometric functions for obtaining these geometries on the same vehicle itself, namely Ackermann, Anti- Ackermann, Parallel Ackermann. Full vehicle analysis was carried out on Adams Car Analysis software, and graphical results were obtained for various parameters. Steering geometries were achieved by using a single versatile knuckle for frontward and rearward tie-rod placement and were practically tested with the help of data acquisition systems set up on the ATV. Each was having certain characteristics, setup, and parameters were observed for the BAJA ATV, and correlations were created between analytical and practical values.

Keywords: all-terrain vehicle, Ackermann, Adams car, Baja Sae, steering geometry, steering system, tire slip, traction, understeer gradient

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11 SVM-RBN Model with Attentive Feature Culling Method for Early Detection of Fruit Plant Diseases

Authors: Piyush Sharma, Devi Prasad Sharma, Sulabh Bansal

Abstract:

Diseases are fairly common in fruits and vegetables because of the changing climatic and environmental circumstances. Crop diseases, which are frequently difficult to control, interfere with the growth and output of the crops. Accurate disease detection and timely disease control measures are required to guarantee high production standards and good quality. In India, apples are a common crop that may be afflicted by a variety of diseases on the fruit, stem, and leaves. It is fungi, bacteria, and viruses that trigger the early symptoms of leaf diseases. In order to assist farmers and take the appropriate action, it is important to develop an automated system that can be used to detect the type of illnesses. Machine learning-based image processing can be used to: this research suggested a system that can automatically identify diseases in apple fruit and apple plants. Hence, this research utilizes the hybrid SVM-RBN model. As a consequence, the model may produce results that are more effective in terms of accuracy, precision, recall, and F1 Score, with respective values of 96%, 99%, 94%, and 93%.

Keywords: fruit plant disease, crop disease, machine learning, image processing, SVM-RBN

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10 Experimental Study on Modified Double Slope Solar Still and Modified Basin Type Double Slope Multiwick Solar Still

Authors: Piyush Pal, Rahul Dev

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Water is essential for life and fresh water is a finite resource that is becoming scarce day by day even though it is recycled by hydrological cycle. The fresh water reserves are being polluted due to expanding irrigation, industries, urban population and its development. Contaminated water leads to several health problems. With the increasing demand of fresh water, solar distillation is an alternate solution which uses solar energy to evaporate water and then to condense it, thereby collecting distilled water within or outside the same system to use it as potable water. The structure that houses the process is known as a 'solar still'. In this paper, ‘Modified double slope solar still (MDSSS)’ & 'Modified double slope basin type multiwick solar still (MDSBMSS)' have been designed to convert saline, brackish water into drinking water. In this work two different modified solar stills are fabricated to study the performance of these solar stills. For modification of solar stills, Fibre Reinforced Plastic (FRP) and Acrylic sheets are used. The experiments in MDSBMSS and MDSSS was carried on 10 September 2015 & 5 November 2015 respectively. Performances of the stills were investigated. The amount of distillate has been found 3624 Ml/day in MDSBMSS on 10 September 2015 and 2400 Ml/day in MDSSS on 5 November 2015.

Keywords: contaminated water, conventional solar still, modified solar still, wick

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9 Biogenic Synthesis of ZnO Nanoparticles Using Annona muricata Plant Leaf Extract and Its Anti-Cancer Efficacy

Authors: Siva Chander Chabattula, Piyush Kumar Gupta, Debashis Chakraborty, Rama Shanker Verma

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Green nanoparticles have gotten a lot of attention because of their potential applications in tissue regeneration, bioimaging, wound healing, and cancer therapy. The physical and chemical methods to synthesize metal oxide nanoparticles have an environmental impact, necessitating the development of an environmentally friendly green strategy for nanoparticle synthesis. In this study, we used Annona muricata plant leaf extract to synthesize Zinc Oxide nanoparticles (Am-ZnO NPs), which were evaluated using UV/Visible spectroscopy, FTIR spectroscopy, X-Ray Diffraction, DLS, and Zeta potential. Nanoparticles had an optical absorbance of 355 nm and a net negative surface charge of ~ - 2.59 mV. Transmission Electron Microscope characterizes the Shape and size of the nanoparticles. The obtained Am-ZnO NPs are biocompatible and hemocompatible in nature. These nanoparticles caused an anti-cancer therapeutic effect in MIA PaCa2 and MOLT4 cancer cells by inducing oxidative stress, and a change in mitochondrial membrane potential leads to programmed cell death. Further, we observed a reduction in the size of lung cancer spheroids (act as tumor micro-environment) with doxorubicin as a positive control.

Keywords: Biomaterials, nanoparticle, anticancer activity, ZnO nanoparticles

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8 Speed Breaker/Pothole Detection Using Hidden Markov Models: A Deep Learning Approach

Authors: Surajit Chakrabarty, Piyush Chauhan, Subhasis Panda, Sujoy Bhattacharya

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A large proportion of roads in India are not well maintained as per the laid down public safety guidelines leading to loss of direction control and fatal accidents. We propose a technique to detect speed breakers and potholes using mobile sensor data captured from multiple vehicles and provide a profile of the road. This would, in turn, help in monitoring roads and revolutionize digital maps. Incorporating randomness in the model formulation for detection of speed breakers and potholes is crucial due to substantial heterogeneity observed in data obtained using a mobile application from multiple vehicles driven by different drivers. This is accomplished with Hidden Markov Models, whose hidden state sequence is found for each time step given the observables sequence, and are then fed as input to LSTM network with peephole connections. A precision score of 0.96 and 0.63 is obtained for classifying bumps and potholes, respectively, a significant improvement from the machine learning based models. Further visualization of bumps/potholes is done by converting time series to images using Markov Transition Fields where a significant demarcation among bump/potholes is observed.

Keywords: deep learning, hidden Markov model, pothole, speed breaker

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7 Exaptive Urbanism: Evolutionary Biology and the Regeneration of Mumbai’s Dhobighat

Authors: Piyush Bajpai, Sneha Pandey

Abstract:

Mumbai’s Dhobighat, 150 year old largest open laundry in the world, is the true live-work place and only source of income for some of Mumbai’s highest density ‘urban poor’ residents. The regeneration of Dhobighat, due to its ultra prime location and complex socio-political culture has been a complex issue. This once flourishing urban industrial core has been degrading for the past several decades mainly due to the decline of the open laundry business, the site’s over burdened infrastructure and conflicting socio-political and economic forces. The phenomena of ‘exaptation’ or ‘co-option’ has been observed by evolutionary biologists as a process responsible for producing highly tenacious and resilient offsprings within a species. The reddish egret uses its wings to cast shadow in shallow waters to attract small fish and hunt them. An unrelated feature used opportunistically to produce a very favorable result. How can this idea of co-option be applied to resolve the complex issue of Dhobighat’s regeneration? Our paper proposes a new methodology/approach for the regeneration of Dhobighat through the lens of evolutionary biology. Forces and systems (social, political, economic, cultural and ecological) that seem conflicting or unrelated by nature are opportunistically transformed into symbiotic and complimentary relationships that produce an inclusive, resilient and holistic solution for the regeneration of Dhobighat.

Keywords: urban regeneration, exaptation, resilience, Dhobighat, Mumbai

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6 In vitro P-Glycoprotein Modulation: Combinatorial Approach Using Natural Products

Authors: Jagdish S. Patel, Piyush Chudasama

Abstract:

Context: Over-expression of P-glycoprotein (P-gp) plays critical role in absorption of many drug candidates which results into lower bioavailability of the drug. P-glycoprotein also over expresses in many pathological conditions like diabetes, affecting the drug therapy. Modulation of P-gp expression using inhibitors can help in designing novel formulation enhancing the bioavailability of the drug in question. Objectives: The main focus of the study was to develop advanced glycation end products (AGEs) induced P-gp over expression in Caco-2 cells. Curcumin, piperine and epigallocatechin gallate were used to evaluate their P-gp inhibitory action using combinatorial approach. Materials and methods: Methylglyoxal (MG) induced P-gp over expression was checked in Caco-2 cells using real time PCR. P-gp inhibitory effects of the phytochemicals were measured after induction with MG alone and in combination of any two compounds. Cytotoxicity of each of the phytochemical was evaluated using MTT assay. Results: Induction with MG (100mM) significantly induced the over expression of P-glycoprotein in Caco-2 cells after 24 hr. Curcumin, piperine and epigallocatechin gallate alone significantly reduced the level of P-gp within 6 hr of treatment period monitored by real time PCR. The combination of any two phytochemical also down regulated the expression of P-gp in cells. Combinations of Curcumin and epigallocatechin gallate have shown significant down regulation when compared with other two combinations. Conclusions: Combinatorial approach for down regulating the expression of P-gp, in pathological conditions like diabetes, has demonstrated promising approach for therapeutic purpose.

Keywords: p-glycoprotein, curcumin, piperine, epigallocatechin gallate, p-gp inhibition

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5 General Architecture for Automation of Machine Learning Practices

Authors: U. Borasi, Amit Kr. Jain, Rakesh, Piyush Jain

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Data collection, data preparation, model training, model evaluation, and deployment are all processes in a typical machine learning workflow. Training data needs to be gathered and organised. This often entails collecting a sizable dataset and cleaning it to remove or correct any inaccurate or missing information. Preparing the data for use in the machine learning model requires pre-processing it after it has been acquired. This often entails actions like scaling or normalising the data, handling outliers, selecting appropriate features, reducing dimensionality, etc. This pre-processed data is then used to train a model on some machine learning algorithm. After the model has been trained, it needs to be assessed by determining metrics like accuracy, precision, and recall, utilising a test dataset. Every time a new model is built, both data pre-processing and model training—two crucial processes in the Machine learning (ML) workflow—must be carried out. Thus, there are various Machine Learning algorithms that can be employed for every single approach to data pre-processing, generating a large set of combinations to choose from. Example: for every method to handle missing values (dropping records, replacing with mean, etc.), for every scaling technique, and for every combination of features selected, a different algorithm can be used. As a result, in order to get the optimum outcomes, these tasks are frequently repeated in different combinations. This paper suggests a simple architecture for organizing this largely produced “combination set of pre-processing steps and algorithms” into an automated workflow which simplifies the task of carrying out all possibilities.

Keywords: machine learning, automation, AUTOML, architecture, operator pool, configuration, scheduler

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4 Fast Robust Switching Control Scheme for PWR-Type Nuclear Power Plants

Authors: Piyush V. Surjagade, Jiamei Deng, Paul Doney, S. R. Shimjith, A. John Arul

Abstract:

In sophisticated and complex systems such as nuclear power plants, maintaining the system's stability in the presence of uncertainties and disturbances and obtaining a fast dynamic response are the most challenging problems. Thus, to ensure the satisfactory and safe operation of nuclear power plants, this work proposes a new fast, robust optimal switching control strategy for pressurized water reactor-type nuclear power plants. The proposed control strategy guarantees a substantial degree of robustness, fast dynamic response over the entire operational envelope, and optimal performance during the nominal operation of the plant. To improve the robustness, obtain a fast dynamic response, and make the system optimal, a bank of controllers is designed. Various controllers, like a baseline proportional-integral-derivative controller, an optimal linear quadratic Gaussian controller, and a robust adaptive L1 controller, are designed to perform distinct tasks in a specific situation. At any instant of time, the most suitable controller from the bank of controllers is selected using the switching logic unit that designates the controller by monitoring the health of the nuclear power plant or transients. The proposed switching control strategy optimizes the overall performance and increases operational safety and efficiency. Simulation studies have been performed considering various uncertainties and disturbances that demonstrate the applicability and effectiveness of the proposed switching control strategy over some conventional control techniques.

Keywords: switching control, robust control, optimal control, nuclear power control

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3 Cedrela Toona Roxb.: An Exploratory Study Describing Its Antidiabetic Property

Authors: Kinjal H. Shah, Piyush M. Patel

Abstract:

Diabetes mellitus is considered to be a serious endocrine syndrome. Synthetic hypoglycemic agents can produce serious side effects including hematological effects, coma, and disturbances of the liver and kidney. In addition, they are not suitable for use during pregnancy. In recent years, there have been relatively few reports of short-term side effects or toxicity due to sulphonylureas. Published figures and frequency of side effects in large series of patient range from about 1 to 5%, with symptoms severe enough to lead to the withdrawal of the drug in less than 1 to 2%. Adverse effects, in general, have been of the following type: allergic skin reactions, gastrointestinal disturbances, blood dyscrasias, hepatic dysfunction, and hypoglycemia. The associated disadvantages with insulin and oral hypoglycemic agents have led to stimulation in the research for locating natural resources showing antidiabetic activity and to explore the possibilities of using traditional medicines with proper chemical and pharmacological profiles. Literature survey reveals that the inhabitants of Abbottabad district of Pakistan use the dried leaf powder along with table salt and water orally for treating diabetes, skin allergy, wounds and as a blood purifier, where they pronounced the plant locally as ‘Nem.' The detailed phytochemical investigation of the Cedrela toona Roxb. leaves for antidiabetic activity has not been documented. Hence, there is a need for phytochemical investigation of the leaves for antidiabetic activity. The collection of fresh leaves and authentification followed by successive extraction, phytochemical screening, and testing of antidiabetic activity. The blood glucose level was reduced maximum in ethanol extract at 5th and 7th h after treatment. Blood glucose was depressed by 8.2% and 10.06% in alloxan – induced diabetic rats after treatment which was comparable to the standard drug, Glibenclamide. This may be due to the activation of the existing pancreatic cells in diabetic rats by the ethanolic extract.

Keywords: antidiabetic, Cedrela toona Roxb., phytochemical screening, blood glucose

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2 Modeling and Design of a Solar Thermal Open Volumetric Air Receiver

Authors: Piyush Sharma, Laltu Chandra, P. S. Ghoshdastidar, Rajiv Shekhar

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Metals processing operations such as melting and heat treatment of metals are energy-intensive, requiring temperatures greater than 500oC. The desired temperature in these industrial furnaces is attained by circulating electrically-heated air. In most of these furnaces, electricity produced from captive coal-based thermal power plants is used. Solar thermal energy could be a viable heat source in these furnaces. A retrofitted solar convective furnace (SCF) concept, which uses solar thermal generated hot air, has been proposed. Critical to the success of a SCF is the design of an open volumetric air receiver (OVAR), which can heat air in excess of 800oC. The OVAR is placed on top of a tower and receives concentrated solar radiation from a heliostat field. Absorbers, mixer assembly, and the return air flow chamber (RAFC) are the major components of an OVAR. The absorber is a porous structure that transfers heat from concentrated solar radiation to ambient air, referred to as primary air. The mixer ensures uniform air temperature at the receiver exit. Flow of the relatively cooler return air in the RAFC ensures that the absorbers do not fail by overheating. In an earlier publication, the detailed design basis, fabrication, and characterization of a 2 kWth open volumetric air receiver (OVAR) based laboratory solar air tower simulator was presented. Development of an experimentally-validated, CFD based mathematical model which can ultimately be used for the design and scale-up of an OVAR has been the major objective of this investigation. In contrast to the published literature, where flow and heat transfer have been modeled primarily in a single absorber module, the present study has modeled the entire receiver assembly, including the RAFC. Flow and heat transfer calculations have been carried out in ANSYS using the LTNE model. The complex return air flow pattern in the RAFC requires complicated meshes and is computational and time intensive. Hence a simple, realistic 1-D mathematical model, which circumvents the need for carrying out detailed flow and heat transfer calculations, has also been proposed. Several important results have emerged from this investigation. Circumferential electrical heating of absorbers can mimic frontal heating by concentrated solar radiation reasonably well in testing and characterizing the performance of an OVAR. Circumferential heating, therefore, obviates the need for expensive high solar concentration simulators. Predictions suggest that the ratio of power on aperture (POA) and mass flow rate of air (MFR) is a normalizing parameter for characterizing the thermal performance of an OVAR. Increasing POA/MFR increases the maximum temperature of air, but decreases the thermal efficiency of an OVAR. Predictions of the 1-D mathematical are within 5% of ANSYS predictions and computation time is reduced from ~ 5 hours to a few seconds.

Keywords: absorbers, mixer assembly, open volumetric air receiver, return air flow chamber, solar thermal energy

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1 Septic Pulmonary Emboli as a Complication of Peripheral Venous Cannula Insertion

Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

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