Search results for: Prakash Chandra Senapati

Authors: S. Jalaja, A. M. Vijaya Prakash

Abstract:

Recursive combination of an algorithm based on Karatsuba multiplication is exploited to design a generalized transpose and parallel Finite Impulse Response (FIR) Filter. Mid-range Karatsuba multiplication and Carry Save adder based on Karatsuba multiplication reduce time complexity for higher order multiplication implemented up to n-bit. As a result, we design modified N-tap Transpose and Parallel Symmetric FIR Filter Structure using Karatsuba algorithm. The mathematical formulation of the FFA Filter is derived. The proposed architecture involves significantly less area delay product (APD) then the existing block implementation. By adopting retiming technique, hardware cost is reduced further. The filter architecture is designed by using 90 nm technology library and is implemented by using cadence EDA Tool. The synthesized result shows better performance for different word length and block size. The design achieves switching activity reduction and low power consumption by applying with and without retiming for different combination of the circuit. The proposed structure achieves more than a half of the power reduction by adopting with and without retiming techniques compared to the earlier design structure. As a proof of the concept for block size 16 and filter length 64 for CKA method, it achieves a 51% as well as 70% less power by applying retiming technique, and for CSA method it achieves a 57% as well as 77% less power by applying retiming technique compared to the previously proposed design.

Keywords: carry save adder Karatsuba multiplication, mid range Karatsuba multiplication, modified FFA and transposed filter, retiming

Procedia PDF Downloads 204

Authors: Suruchi Shukla, Shantanu Prakash, Amita Jain

Abstract:

Introduction: Arboviral diseases are one of the most common causes of viral hemorrhagic fever (VHF). Of which, Dengue and Chikungunya pose a significant health problem in India. Arbovirus has a tendency to cross the territories and emerge in the new region. Considering the above issues, in the current study active surveillance was conducted among viral hemorrhagic fever (VHF) cases reported from Uttar Pradesh (UP), India. We studied the arboviral etiology of VHF; mainly Dengue, Chikungunya, and ZIKA. Methods: Clinical samples of 465 suspected VHF cases referred to tertiary care referral center of UP, India were enrolled in the study during a period from 15th May 2016 to 9th March 2018. Serum specimens were collected and analyzed for the presence of Dengue, Chikungunya, and ZIKA either by serology and/or by molecular assays. Results: Of all tested, 165 (35.4%) cases were positive for either Dengue or Chikungunya. Dengue (21.2%) was found to be the most prevalent, followed by Chikungunya, (6.6%). None of the cases tested positive for ZIKA virus. Serum samples of 35 (7.5%) cases were positive for both Dengue and Chikungunya. DEN-2 serotype was the most predominant serotype. Phylogenetic and sequence analysis of DEN-2 strains showed 100% clustering with the Cosmopolitan genotype strain. Bleeding from several sites, jaundice, abdominal pain, arthralgia, haemoconcentration, and thrombocytopenia were significantly higher in dengue hemorrhagic cases. However, the rash was significantly more common in Chikungunya patients. Most of the Dengue and Chikungunya positive cases (Age group 6-40 years) were seen in post monsoon season (September to November). Conclusion: Only one-third of total VHF cases are positive for either Dengue/Chikungunya or both. This necessitates the screening of other etiologies capable of causing hemorrhagic manifestations.

Keywords: viral hemorrhagic fever, dengue, chikungunya, zika, India

Procedia PDF Downloads 117

Authors: Amita Jain, Shantanu Prakash, Suruchi Shukla

Abstract:

Introduction: Acute encephalitis syndrome (AES) is a complex multi etiology syndrome posing a great public health problem in the northern part of India. Japanese encephalitis (JE) virus is an established etiology of AES in this region. Recently, Scrub typhus (ST) is being recognized as an emerging aetiology of AES in JE endemic belt. This study was conducted to establish the direct evidence of Central nervous system invasion by Orientia tsutsugamushi leading to AES. Methodology: A total of 849 cases with clinical diagnosis of AES were enrolled from six districts (Deoria and its adjoining area) of the traditional north Indian Japanese encephalitis (JE) belt. Serum and Cerebrospinal fluid samples were collected and tested for major agent causing acute encephalitis. AES cases either positive for anti-ST IgM antibodies or negative for all tested etiologies were investigated for ST-DNA by real-time PCR. Results: Of these 505 cases, 250 patients were laboratory confirmed for O. tsutsugamushi infection either by anti-ST IgM antibodies positivity (n=206) on serum sample or by ST-DNA detection by real-time PCR assay on CSF sample (n=2) or by both (n=42).Total 29 isolate could be sequenced for 56KDa gene. Conclusion: All the strains were found to cluster with Gilliam strains. The majority of the isolates showed a 97–99% sequence similarity with Thailand and Cambodian strains. Gilliam strain of O.tsusugamushi is an emerging as one of the major aetiologies leading to AES in northern part of India.

Keywords: acute encephalitis syndrome, O. tsutsugamushi, Gilliam strain, North India, cerebrospinal fluid

Procedia PDF Downloads 222

Authors: Ankit Sharma, Mudit Sachan, Anurag Prakash

Abstract:

Rapid growth in data acquisition technologies through drones, have led to advances and interests in collecting high-resolution images of geological fields. Being advantageous in capturing high volume of data in short flights, a number of challenges have to overcome for efficient analysis of this data, especially while data acquisition, image interpretation and processing. We introduce a method that allows effective mapping of geological fields using photogrammetric data of surfaces, drainage area, water bodies etc, which will be captured by airborne vehicles like UAVs, we are not taking satellite images because of problems in adequate resolution, time when it is captured may be 1 yr back, availability problem, difficult to capture exact image, then night vision etc. This method includes advanced automated image interpretation technology and human data interaction to model structures and. First Geological structures will be detected from the primary photographic dataset and the equivalent three dimensional structures would then be identified by digital elevation model. We can calculate dip and its direction by using the above information. The structural map will be generated by adopting a specified methodology starting from choosing the appropriate camera, camera’s mounting system, UAVs design ( based on the area and application), Challenge in air borne systems like Errors in image orientation, payload problem, mosaicing and geo referencing and registering of different images to applying DEM. The paper shows the potential of using our method for accurate and efficient modeling of geological structures, capture particularly from remote, of inaccessible and hazardous sites.

Keywords: digital elevation model, mapping, photogrammetric data analysis, geological structures

Procedia PDF Downloads 660

Authors: Prakash Singh

Abstract:

Many schools throughout the world are facing constant pressure to cope with the violence and drug abuse of learners who show little or no respect for acceptable and desirable social norms. These delinquent learners tend to harbour feelings of being beyond reproach because they strongly believe that it is well within their rights to engage in violent and destructive behaviour. Knives, guns, and other weapons appear to be more readily used by them on the school premises than before. It is known that learners smoke, drink alcohol, and use drugs during school hours, hence, their ability to concentrate, work, and learn, is affected. They become violent and display disruptive behaviour in their classrooms as well as on the school premises, and this atrocious behaviour makes it possible for drug dealers and gangsters to gain access onto the school premises. The primary purpose of this exploratory quantitative study was therefore to establish how tobephobia (TBP), caused by school violence and drug abuse, affects teaching and learning in schools. The findings of this study affirmed that poor discipline resulted in producing poor quality education. Most of the teachers in this study agreed that educating learners who consumed alcohol and other drugs on the school premises resulted in them suffering from TBP. These learners are frequently abusive and disrespectful, and resort to violence to seek attention. As a result, teachers feel extremely demotivated and suffer from high levels of anxiety and stress. The word TBP will surely be regarded as a blessing by many teachers throughout the world because finally, there is a word that will make people sit up and listen to their problems that cause real fear and anxiety in schools.

Keywords: aims and objectives of quality education, debilitating effects of tobephobia, fear of failure associated with education, learners' violent behaviour and drug abuse

Procedia PDF Downloads 252

Authors: Prakash Singh, Thembinkosi Twalo

Abstract:

The sustainability of the Buffalo City Metropolitan Municipality (BCMM), in South Africa, is being threatened by the reported cases of poor administration, weak management of resources, inappropriate job performance, and inappropriate job behaviour of some of the workers. Since the structural-functionalists assume that formal education is a solution to societal challenges, it therefore means that the BCMM should not be experiencing this threat since many of its workers have various levels of formal education. Consequently, this study using the mixed method research approach, set out to investigate the paradoxical co-existence of inappropriate job behaviour and performance with formal education at the BCMM. Considering the impact of human factors in the labour process, this study draws attention to the divergent objectives of skill and skill bearer, with the application of knowledge subject to the knowledge bearer’s motives, will, attitudes, ethics and values. Consequently, inappropriate job behaviour and performance practices could be due to numerous factors such as lack of the necessary capabilities or refusal to apply what has been learnt due to racial or other prejudices. The role of the human factor in the labour process is a serious omission in human capital theory, which regards schooling as the only factor contributing to the ability to do a job. For this reason this study’s theoretical framework is an amalgamation of the four theories - human capital, social capital, cultural capital, and reputation capital – in an effort to obtain a broader view of the factors that shape job behaviour and performance. Since it has been established that human nature plays a crucial role in how workers undertake their responsibilities, it is important that this be taken into consideration in the BCMM’s monitoring and evaluation of the workers’ job performance practices. Hence, this exploratory study brings to the fore, the effects of poor job performance practices on the job satisfaction of workers.

Keywords: human capital, poor job performance practices, service delivery, workers’ job satisfaction

Procedia PDF Downloads 265

Authors: Shivani Singla, Om Prakash Pandey, Gopi Sharma

Abstract:

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

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

Procedia PDF Downloads 98

Authors: Deepthinath Reghunathan, Satheesha Nayak, Sudarshan S., Prasad Alathady Maloor, Prakash Shetty

Abstract:

Lumbar plexus is formed by the union of ventral rami of T12, L1, L2, L3 spinal nerves and the larger upper division of L4 lumbar spinal nerves. Variations in the normal anatomy of the lumbar and sacral plexus might be seen in some cases and are reported in the literature, but finding such an unusual case comprising of multiple variations which is normally not expected in a clinical setup, proves to be a vital piece of information for clinicians and medical practitioners. During the dissection of the abdomen and pelvis of an approximately 70 year old cadaver, we observed the following variations in the formation of the lumbar and sacral nerves. 1. The genitofemoral nerve bifurcated at a higher level; genital branch of genitofemoral nerve gave branches to the anterior abdominal wall muscles, 2. A communicating branch was given from the lateral cutaneous nerve of thigh to the medial cutaneous nerve of thigh, 3. A muscular branch was given from femoral nerve to psoas major, 4. There was absence of contribution of L4 spinal nerve in the formation of the lumbosacral trunk and 5. Lumbosacral trunk gave communicating branches to the femoral and obturator nerves. Most of the variations found were rare and finding all the above said variations in a single cadaver is even rare. Documentation of such rare cases with multiple variations in the formation of nerves from the lumbar plexus provides vital information on such occurrences. This information would in turn improve the knowledge of clinicians and surgeons dealing with this region. Emphasizing such knowledge of this region would prevent accidental damage to the structures with a variant anatomy.

Keywords: femoral nerve, genitofemoral nerve, lumbar plexus, lumbosacral trunk

Procedia PDF Downloads 255

Authors: K. Swapna, Sk. Mahamuda, Ch, Annapurna, A. Srinivasa Rao, G. Vijaya Prakash

Abstract:

Samarium ions doped Alkali Fluoro Tungsten Tellurite (AFTT) Glasses have been prepared by using the melt quenching technique and characterized through various spectroscopic techniques such as optical absorption, excitation, emission and decay spectral studies. From the measured absorption spectra of Sm3+ ions in AFTT glasses, the optical band gap and Urbach energies have been evaluated. The spectroscopic parameters such as oscillator strengths (f), Judd-Ofelt (J-O) intensity parameters (Ωλ), spontaneous emission probability (AR), branching ratios (βR) and radiative lifetimes (τR) of various excited levels have been determined from the absorption spectrum by using J-O analysis. A strong luminescence in the reddish-orange spectral region has been observed for all the Sm3+ ions doped AFTT glasses. It consisting four emission transitions occurring from the 4G5/2metastable state to the lower lying states 6H5/2, 6H7/2, 6H9/2 and 6H11/2 upon exciting the sample with a 478 nm line of an argon ion laser. The stimulated emission cross-sections (σe) and branching ratios (βmeas) were estimated from the emission spectra for all emission transitions. Correlation of the radiative lifetime with the experimental lifetime measured from the day curves allows us to measure the quantum efficiency of the prepared glasses. In order to know the colour emission of the prepared glasses under near UV excitation, the emission intensities were analyzed using CIE 1931 colour chromaticity diagram. The aforementioned spectral studies carried out on Sm3+ ions doped AFTT glasses allowed us to conclude that, these glasses are best suited for orange-red visible lasers.

Keywords: fluoro tungsten tellurite glasses, judd-ofelt intensity parameters, lifetime, stimulated emission cross-section

Procedia PDF Downloads 254

Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

Abstract:

Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

Procedia PDF Downloads 222

Authors: Fatemeh Babaeian, Nemai Chandra Karmakar

Abstract:

Chipless RFID system is a wireless system for tracking and identification which use passive tags for encoding data. The advantage of using chipless RFID tag is having a planar tag which is printable on different low-cost materials like paper and plastic. The printed tag can be attached to different items in the labelling level. Since the price of chipless RFID tag can be as low as a fraction of a cent, this technology has the potential to compete with the conventional optical barcode labels. However, due to the passive structure of the tag, data processing of the reflection signal is a crucial challenge. The captured reflected signal from a tag attached to an item consists of different components which are the reflection from the reader antenna, the reflection from the item, the tag structural mode RCS component and the antenna mode RCS of the tag. All these components are summed up in both time and frequency domains. The effect of reflection from the item and the structural mode RCS component can distort/saturate the frequency domain signal and cause difficulties in extracting the desired component which is the antenna mode RCS. Therefore, it is required to study the reflection of the tag in both time and frequency domains to have a better understanding of the nature of the captured chipless RFID signal. The other benefits of this study can be to find an optimised encoding technique in tag design level and to find the best processing algorithm the chipless RFID signal in decoding level. In this paper, the reflection from a typical backscattered chipless RFID tag with six resonances is analysed, and different components of the signal are separated in both time and frequency domains. Moreover, the time domain signal corresponding to each resonator of the tag is studied. The data for this processing was captured from simulation in CST Microwave Studio 2017. The outcome of this study is understanding different components of a measured signal in a chipless RFID system and a discovering a research gap which is a need to find an optimum detection algorithm for tag ID extraction.

Keywords: antenna mode RCS, chipless RFID tag, resonance, structural mode RCS

Procedia PDF Downloads 161

Authors: Prakash Singh

Abstract:

Employees who are satisfied at their place of work rate their leaders’ intrapersonal competencies as being high. They also believe that a leader’s intrapersonal competencies influence their sense of job satisfaction. Employees who indicate that they are unhappy at their place of work rate their leaders’ intrapersonal competencies as being low. They also believe that a leader’s intrapersonal intelligence influence their feeling of job satisfaction. The leader’s appropriate intrapersonal competencies are crucial to the creation of a motivated and satisfied employee team. In this study, the quantitative research method was used to determine the employees’ perceptions of their leaders’ intrapersonal competencies and their influence on their job satisfaction; the six competencies being self-awareness, self-confidence, self-expression, self-control, adaptability, and optimism. All the competencies of leaders identified in this quantitative study can therefore be described as intervening variables that influence an employee’s sense of job satisfaction. The number of responses that indicate that each of the intrapersonal competencies of a leader that will have an influence on an employee’s sense of job satisfaction, ranges from 93% (a leader’s sense of self-awareness) to 99% (a leader’s ability to be adaptable). As the responses are significantly similar, it can be stated that the respondents indicate that all the intrapersonal competencies of a leader can influence an employee’s sense of job satisfaction. The findings of this study strongly suggest that in order to be satisfied at work, employees prefer to be led by leaders who are confident in their leadership roles; who send out clear, unambiguous messages; who maintain self-control; who are adaptable and flexible;, who face the future with optimism and who support the establishment of a collegial working environment. Evidently, the findings corroborate the hypothesis that employees believe that the intrapersonal competencies of leaders have a positive influence on the employees’ sense of job satisfaction. This study’s findings, therefore, confirm that the key to the leaders’ self-knowledge is access to their own feelings and the ability to discriminate among them and draw upon them to guide behaviour in their organisations. This exploratory study makes a contribution to the emerging research being accomplished on leaders’ intrapersonal intelligence with more research still needing to be attempted to determine to what extent these competencies of leaders can reshape the organizational climate and culture.

Keywords: emotional intelligence, employees’ job satisfaction, leaders’ intrapersonal competencies, leaders’ self-knowledge

Procedia PDF Downloads 235

Authors: Vaibhav Budhiraja, Chandra Mouli Pandey

Abstract:

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

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

Procedia PDF Downloads 119

Authors: Chenxi Liao, Mizuho Akimoto, Mariya Bivolarova, Sekhar Chandra, Xiaojun Fan, Li Lan, Jelle Laverge, Pawel Wargocki

Abstract:

The bedroom environment plays an important role in maintaining good sleep quality, which is vital for humans health and next-day performance. A survey of the sleep-disturbed bedroom environmental factors and the occupants’ bedroom windows (BW) or bedroom door (BD) opening behaviors was launched in the capital region of Denmark in 2020 by an online questionnaire. People were asked if they were disturbed by too warm temperature, too cool temperature, noise, or stuffy air during sleep. Also, they reported their BW or the BD opening behaviors in the morning, afternoon, evening, and during sleep. A total of 512 responses were received. Too warm temperature was reported the most among the four sleep-disturbed factors, following too cool temperature, noise, and stuffy air. Whether or not opening BW or the BD was commonly used to improve or change the bedroom environment. The respondents who were disturbed by too warm temperature during sleep opened BW for a longer time in the morning compared to those who were never disturbed by it (OR, 1.28; 95% CI, 1.01-1.62). Those who were disturbed by too cool temperatures tended to open BW less frequently in the morning (OR, 1.24; 95% CI, 0.97-1.57). They preferred keeping BW open in the whole day if they realized stuffy air disturbing their sleep, although only a few of them still opened BW during sleep. Those who were disturbed by too cool temperature (OR, 0.76; 95% CI, 0.63-0.92) and noise (OR, 0.80; 95% CI, 0.66-0.96) were more likely to sleep with the BD open in a lesser frequency. Opening BW, increasing ventilation rates, could relieve disturbing by stuffy air during sleep, but induced other sleep-disturbed factors such as too cool in winter and noise. Also, opening BW only when people were not sleep was not sufficient to exempt disturbing by stuffy air during sleep. Using mechanical ventilation in bedrooms is necessary to ensure good air quality and meanwhile to avoid thermal discomfort and noise during sleep. Future studies are required to figure out the required flow rate of fresh air of mechanical ventilation during sleep.

Keywords: bedroom environmental, survey, occupants behaviors, windows, door

Procedia PDF Downloads 171

Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

Abstract:

Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

Procedia PDF Downloads 291

Authors: Lakmali Anthony, Bushra Oathman, Anshini Jain, Raaj Chandra

Abstract:

Introduction: Abscesses are traditionally treated by incision and drainage with the packing of the residual abscess cavity until healing. This method requires regular visits from community nurses for continuous wound packing upon discharge from the hospital and causes considerable patient discomfort. Whether abscess cavity packing offers any advantage over non-packing has not yet been adequately studied to the best of our knowledge. This study aims to determine if there are differences in clinical outcomes of time to healing, fistula formation and recurrence of abscess between abscess cavity packing vs. non-packing groups. Methods: This study was a single-center, single-blind, randomized controlled trial where patients were randomized into packing and non-packing arms. All patients over 18 years presenting to Eastern Health with an abscess requiring incision and drainage in the theatre were invited to participate. Those with underlying conditions that cause recurrent abscesses were excluded. Data were collected from December 2018 to April 2020. Results: There were 63 patients who had abscesses treated with incision and drainage that were enrolled in the study, 52 of which were suitable for analysis. Demographic characteristics were similar in both groups. The packing group had a significantly longer time to heal compared to the non-packing group. Rates of fistula formation and recurrence of abscess were low and there were no statistically significant differences between groups. The packing group had more patients with delayed healing (defined as >60 days) and required more follow-up visits compared to the non-packing group. Conclusion: This pilot study indicates that abscesses can not only be managed safely with incision and drainage alone without the need for continuous abscess cavity packing but also that non-packing may offer clinical benefits to patients with earlier healing of abscesses compared to continuous cavity packing.

Keywords: abscess packing, subcutaneous, perianal, pilonidal

Procedia PDF Downloads 45

Authors: Naveen Kumar B. T., Anuj Tyagi, Niraj Kumar Singh, Visanu Boonyawiwat, Shanthanagouda A. H., Orawan Boodde, Shankar K. M., Prakash Patil, Shubhkaramjeet Kaur

Abstract:

Since 2009, Acute Hepatopancreatic Necrosis Disease (AHPND) outbreaks have increased rapidly, and these have led to the major economic losses to the global shrimp industry. In comparison to other treatments, passive immunity and monoclonal antibody (MAb) based farmer level kit have proved their importance in controlling and treating the diseases in the shrimp industry. In the present study, MAbs were produced against the recombinant PirB protein Vibrio parahaemolyticus strain causing AHPND. Briefly, Balb/C mice were immunized with rPirB at 15 days interval, and antibody titer was determined by ELISA. Spleen cells from mice showing high antibody titer were fused with SP2O myeloma cells for hybridoma production. Among 130 hybridomas, four showed high antibody titer and positive reactivity in an immunoblot assay. In Western blot assay, three out of four MAbs (4C4, 2C2 and 4G3) showed reactivity to rPirB protein. However, in the natural host, only Mab clone 4G3 show strong reactivity (with a strain of V. parahemolyticus causing EMS/AHPND). These clones also showed reactivity with less than 20 kDa proteins in AHPND free V. parahaemolyticus (Thailand stain). Further, on from MAb 4G3 clone, four panels of single cell MAbs clones (G3F5, G3B8, G3H2, and G3D6) were produced of which three showed strong positive reactivity to rPirB protein in the Western blot. These MAbs have potential for controlling and prevention of the AHPND through passive immunity and development of filed level rapid diagnostic kits.

Keywords: shrimp, economic loss, AHPND, MAb

Procedia PDF Downloads 224

Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

Abstract:

Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

Procedia PDF Downloads 428

Authors: Vidhi Chandra, Arshpreet Singh Grewal

Abstract:

A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

Procedia PDF Downloads 77

Authors: Aschalew Cherie Workneh, K. S. Hari Prasad, Chandra Shekhar Prasad Ojha

Abstract:

Due to the increase in water scarcity, the crop water stress index (CWSI) is receiving significant attention these days, especially in arid and semiarid regions, for quantifying water stress and effective irrigation scheduling. Nowadays, machine learning techniques such as neural networks are being widely used to determine CWSI. In the present study, the performance of two artificial neural networks, namely, Self-Organizing Maps (SOM) and Feed Forward-Back Propagation Artificial Neural Networks (FF-BP-ANN), are compared while determining the CWSI of rice crop. Irrigation field experiments with varying degrees of irrigation were conducted at the irrigation field laboratory of the Indian Institute of Technology, Roorkee, during the growing season of the rice crop. The CWSI of rice was computed empirically by measuring key meteorological variables (relative humidity, air temperature, wind speed, and canopy temperature) and crop parameters (crop height and root depth). The empirically computed CWSI was compared with SOM and FF-BP-ANN predicted CWSI. The upper and lower CWSI baselines are computed using multiple regression analysis. The regression analysis showed that the lower CWSI baseline for rice is a function of crop height (h), air vapor pressure deficit (AVPD), and wind speed (u), whereas the upper CWSI baseline is a function of crop height (h) and wind speed (u). The performance of SOM and FF-BP-ANN were compared by computing Nash-Sutcliffe efficiency (NSE), index of agreement (d), root mean squared error (RMSE), and coefficient of correlation (R²). It is found that FF-BP-ANN performs better than SOM while predicting the CWSI of rice crops.

Keywords: artificial neural networks; crop water stress index; canopy temperature, prediction capability

Procedia PDF Downloads 81

Authors: Dibyakanta Seth, Hari Niwas Mishra, Sankar Chandra Deka

Abstract:

Microencapsulation is an established method of protecting bacteria from the adverse conditions. An improved extrusion spraying technique was used to encapsulate mixed bacteria culture of S. thermophilus and L. bulgaricus using sodium alginate as the coating material. The effect of nozzle air pressure (200, 300, 400 and 500 kPa), sodium alginate concentration (1%, 1.5%, 2%, 2.5% and 3% w/v), different concentration of calcium chloride (0.1, 0.2, 1 M) and initial cell loads (10⁷, 10⁸, 10⁹ cfu/ml) on the viability of encapsulated bacteria were investigated. With the increase in air pressure the size of microcapsules decreased, however the effect was non-significant. There was no significant difference (p > 0.05) in the viability of encapsulated cells when the concentration of calcium chloride was increased. Increased level of sodium alginate significantly increased the survival ratio of encapsulated bacteria (P < 0.01). Encapsulation with 3% alginate was treated as optimum since a higher concentration of alginate increased the gel strength of the solution and thus was difficult to spray. Under optimal conditions 3% alginate, 10⁹ cfu/ml cell load, 20 min hardening time in 0.1 M CaCl2 and 400 kPa nozzle air pressure, the viability of bacteria cells was maximum compared to the free cells. The microcapsules made at the optimal condition when mixed with yoghurt and subjected to spray drying at 148°C, the survival ratio was 2.48×10⁻¹ for S. thermophilus and 7.26×10⁻¹ for L. bulgaricus. In contrast, the survival ratio of free cells of S. thermophilus and L. bulgaricus were 2.36×10⁻³ and 8.27×10⁻³, respectively. This study showed a decline in viable cells count of about 0.5 log over a period of 7 weeks while there was a decline of about 1 log in cultures which were incorporated as free cells in yoghurt. Microencapsulation provided better protection at higher acidity compared to free cells. This study demonstrated that microencapsulation of yoghurt culture in sodium alginate is an effective technique of protection against extreme drying conditions.

Keywords: extrusion, microencapsulation, spray drying, sweetened yoghurt

Procedia PDF Downloads 226

Authors: Subhro Sarkar, Umesh Mishra

Abstract:

Agartala Municipal Council (AMC) is the municipal body which regulates and governs the Agartala city. MSW management may be proclaimed as a tool which rests on the principles of public health, economy, engineering and other aesthetic or environmental factors by dealing with the controlled generation, collection, transport, processing and disposal of MSW. Around 220-250 MT of solid waste per day is collected by AMC out of which 12-14 MT is plastic and is disposed of in Devendra Chandra Nagar dumping ground (33 acres), nearly 12-15 km from the city. A survey was performed to list down the prevailing operations conducted by the AMC which includes road sweeping, garbage lifting, carcass removal, biomedical waste collection, dumping, and incineration. Different types of vehicles are engaged to carry out these operations. Door to door collection of garbage is done from the houses with the help of 220 tricycles issued by 53 NGOs. The location of the dustbin containers were earmarked which consisted of 4.5 cum, 0.6 cum containers and 0.1 cum containers, placed at various locations within the city. The total household waste was categorized as organic, recyclable and other wastes. It was found that East Pratapgarh ward produced 99.3% organic waste out of the total MSW generated in that ward which is maximum among all the wards. A comparison of the waste generation versus the family size has been made. A questionnaire for the survey of MSW from household and market place was prepared. The average waste generated (in kg) per person per day was found out for each of the wards. It has been noted that East Jogendranagar ward had a maximum per person per day waste generation of 0.493 kg/day.In view of the studies made, it has been found that AMC has failed to implement MSWM in an effective way because of the unavailability of suitable facilities for treatment and disposal of the large amount of MSW. It has also been noted that AMC is not following the standard procedures of handling MSW. Transportation system has also been found less effective leading to waste of time, money and manpower.

Keywords: MSW, waste generation, solid waste disposal, management

Procedia PDF Downloads 284

Authors: R. Adwaith, J. Gopinath, Vasantha Kohila B., R. Chandru, Arul Prakash R.

Abstract:

The turbofan engine is a type of air breathing engine that is widely used in aircraft propulsion produces thrust mainly from the mass-flow of air bypassing the engine core. The present research has developed an effective method numerically by increasing the thrust generated from the bypass air. This thrust increase is brought about by heating the walls of the bypass valve from the combustion chamber using convective heat transfer method. It is achieved computationally by the use external heat to enhance the velocity of bypass air of turbofan engines. The bypass valves are either heated externally using multicell tube resistor which convert electricity generated by dynamos into heat or heat is transferred from the combustion chamber. This increases the temperature of the flow in the valves and thereby increase the velocity of the flow that enters the nozzle of the engine. As a result, mass-flow of air passing the core engine for producing more thrust can be significantly reduced thereby saving considerable amount of Jet fuel. Numerical analysis has been carried out on a scaled down version of a typical turbofan bypass valve, where the valve wall temperature has been increased to 700 Kelvin. It is observed from the analysis that, the exit velocity contributing to thrust has significantly increased by 10 % due to the heating of by-pass valve. The degree of optimum increase in the temperature, and the corresponding effect in the increase of jet velocity is calculated to determine the operating temperature range for efficient increase in velocity. The technique used in the research increases the thrust by using heated by-pass air without extracting much work from the fuel and thus improve the efficiency of existing turbofan engines. Dimensional analysis has been carried to prove the accuracy of the results obtained numerically.

Keywords: turbofan engine, bypass valve, multi-cell tube, convective heat transfer, thrust

Procedia PDF Downloads 332

Authors: Prarabdh Tiwari, M. Vidya Sagar, K. Bhima Raju, Joy Choudhury, Subash Chandra, E. Nagaiah, Shakeel Ahmed

Abstract:

Passive seismic, a wavefield interferometric imaging, low cost and rapid tool for subsurface investigation is used for various geotechnical purposes such as hydrocarbon exploration, seismic microzonation, etc. With the recent advancement, its application has also been extended to groundwater exploration by means of finding the bedrock depth. Council of Scientific & Industrial Research (CSIR)-National Geophysical Research Institute (NGRI) has experimented passive seismic studies along with electrical resistivity tomography for groundwater in hard rock (Choutuppal, Hyderabad). Passive Seismic with Electrical Resistivity (ERT) can give more clear 2-D subsurface image for Groundwater Exploration in Hard Rock area. Passive seismic data were collected using a Tromino, a three-component broadband seismometer, to measure background ambient noise and processed using GRILLA software. The passive seismic results are found corroborating with ERT (Electrical Resistivity Tomography) results. For data acquisition purpose, Tromino was kept over 30 locations consist recording of 20 minutes at each station. These location shows strong resonance frequency peak, suggesting good impedance contrast between different subsurface layers (ex. Mica rich Laminated layer, Weathered layer, granite, etc.) This paper presents signature of passive seismic for hard rock terrain. It has been found that passive seismic has potential application for formation characterization and can be used as an alternative tool for delineating litho-stratification in an urban condition where electrical and electromagnetic tools cannot be applied due to high cultural noise. In addition to its general application in combination with electrical and electromagnetic methods can improve the interpreted subsurface model.

Keywords: passive seismic, resonant frequency, Tromino, GRILLA

Procedia PDF Downloads 158

Authors: Hemanth K. Balaga, Prakash Nanthagopalan

Abstract:

Every year a huge amount of paper gets discarded of which only a minute fraction is being recycled and the rest gets dumped as landfills. Paper fibres can be recycled only a limited number of times before they become too short or weak to make high quality recycled paper. This eventually adds to the already big figures of waste paper that is being generated and not recycled. It would be advantageous if this prodigious amount of waste can be utilized as a low-cost sustainable construction material and make it as a value added product. The generic term for the material under investigation is paper-concrete. This is a fibrous mix made of Portland cement, water and pulped paper and/or other aggregates. The advantages of this material include light weight, good heat and sound insulation capability and resistance to flame. The disadvantages include low strength compared to conventional concrete and its hydrophilic nature. The properties vary with the variation of cement and paper content in the mix. In the present study, Portland Pozzolona Cement and news print paper were used for the preparation of paper concrete cubes. Initially, investigations were performed to determine the minimum soaking period required for the softening of the paper fibres. Further different methodologies were explored for proper blending of the pulp with cement paste. The properties of paper concrete vary with the variation of cement to paper to water ratio. The study mainly addresses the parameters of strength and weight loss of the concrete cubes with age and the time that is required for the dry paper fibres to become soft enough in water to bond with the cement. The variation of compressive strength with cement content, water content, and time was studied. The water loss of the cubes with time and the minimum time required for the softening of paper fibres were investigated .Results indicate that the material loses 25-50 percent of the initial weight at the end of 28 days, and a maximum 28 day compressive strength (cubes) of 5.4 Mpa was obtained.

Keywords: soaking time, difference water, minimum water content, maximum water content

Procedia PDF Downloads 229

Authors: Shashank Kumar, Mansi Chandra, Ujjawal Singh, Parth Gupta, Rishi Ram, Arnab Sarkar

Abstract:

Milk is one of the basic and primary sources of food and energy as we start consuming milk from birth. Hence, milk quality and purity and checking the concentration of its constituents become necessary steps. Considering the importance of the purity of milk for human health, the following study has been carried out to simultaneously detect and quantify the different adulterants like urea and starch in milk with the help of a paper-based microfluidic device integrated with a smartphone. The detection of the concentration of urea and starch is based on the principle of colorimetry. In contrast, the fluid flow in the device is based on the capillary action of porous media. The microfluidic channel proposed in the study is equipped with a specialized detection zone, and it employs a colorimetric indicator undergoing a visible color change when the milk gets in touch or reacts with a set of reagents which confirms the presence of different adulterants in the milk. In our proposed work, we have used iodine to detect the percentage of starch in the milk, whereas, in the case of urea, we have used the p-DMAB. A direct correlation has been found between the color change intensity and the concentration of adulterants. A calibration curve was constructed to find color intensity and subsequent starch and urea concentration. The device has low-cost production and easy disposability, which make it highly suitable for widespread adoption, especially in resource-constrained settings. Moreover, a smartphone application has been developed to detect, capture, and analyze the change in color intensity due to the presence of adulterants in the milk. The low-cost nature of the smartphone-integrated paper-based sensor, coupled with its integration with smartphones, makes it an attractive solution for widespread use. They are affordable, simple to use, and do not require specialized training, making them ideal tools for regulatory bodies and concerned consumers.

Keywords: paper based microfluidic device, milk adulteration, urea detection, starch detection, smartphone application

Procedia PDF Downloads 27

Authors: Arvan Prakash Ankitha, Madasamy Arockiasamy

Abstract:

The increasing demand for adopting pile foundations in bridgeshas pointed towardsthe need to constantly improve the existing analytical techniques for better understanding of the behavior of such foundation systems. This study presents a simplistic approach using the energy-based method to assess the displacement responses of piles subjected to general loading conditions: Axial Load, Lateral Load, and a Bending Moment. The governing differential equations and the boundary conditions for a bridge pile embedded in multi-layered soil strata subjected to the general loading conditions are obtained using the Hamilton’s principle employing variational principles and minimization of energies. The soil non-linearity has been incorporated through simple constitutive relationships that account for degradation of soil moduli with increasing strain values.A simple power law based on published literature is used where the soil is assumed to be nonlinear-elastic and perfectly plastic. A Tresca yield surface is assumed to develop the soil stiffness variation with different strain levels that defines the non-linearity of the soil strata. This numerical technique has been applied to a pile foundation in a two - layered soil strata for a pier supporting the bridge and solved using the software MATLAB R2019a. The analysis yields the bridge pile displacements at any depth along the length of the pile. The results of the analysis are in good agreement with the published field data and the three-dimensional finite element analysis results performed using the software ANSYS 2019R3. The methodology can be extended to study the response of the multi-strata soil supporting group piles underneath the bridge piers.

Keywords: pile foundations, deep foundations, multilayer soil strata, energy based method

Procedia PDF Downloads 105

Authors: Jai Prakash, Promod Kumar, Chantel Swart, J. H. Neethling, A. Janse van Vuuren, H. C. Swart

Abstract:

Ag nanoparticles (NPs) have been used as functional nanomaterials due to their optical and antibacterial properties. Similarly, TiO2 photocatalysts have also been used as suitable nanomaterials for killing cancer cells, viruses and bacteria. Here, we report on multifunctional plasmonic Ag-TiO2 nano-biocomposite synthesized by the sol-gel technique and their optical, surface enhanced Raman scattering (SERS) and antibacterial activities. The as-prepared composites of Ag–TiO2 with different silver content and TiO2 nanopowder were characterized by X-ray diffraction, scanning electron microscopy, high-resolution transmission electron microscopy, energy-dispersed X-ray analysis (EDX), UV-vis and Raman spectroscopy. The Ag NPs were found to be uniformly distributed and strongly attached to the TiO2 matrix. The novel optical response of the Ag-TiO2 nanocomposites is due to the strong electric field from the surface plasmon excitation of the Ag NPs. The Raman spectrum of Ag-TiO2 nanocomposite was found to be enhanced as compared to TiO2. The enhancement of the low frequency band is evident. This indicates the SERS effect of the TiO2 NPs in close vicinity of Ag NPs. In addition, nanocomposites showed enhancement in the SERS signals of methyl orange (MO) dye molecules with increasing Ag content. The localized electromagnetic field from the surface plasmon excitation of the Ag NPs was responsible for the SERS signals of the TiO2 NPs and MO molecules. The antimicrobial effect of the Ag–TiO2 nanocomposites with different silver content and TiO2 nanopowder were carried out against the bacterium Staphylococcus aureus. The Ag–TiO2 composites showed antibacterial activity towards S. aureus with increasing Ag content as compared to the TiO2 nanopowder. These results foresee promising applications of the functional plasmonic metal−semiconductor based nanobiocomposites for both chemical and biological samples.

Keywords: metal-Semiconductor, nano-Biocomposites, anti-microbial activity, surface enhanced Raman scattering

Procedia PDF Downloads 209

Authors: Waqas Ahmed Khan Afridi, Subhas Chandra Mukhopadhyay, Bandita Mainali

Abstract:

The research paper presents a unique approach to evapotranspiration (ET) prediction using a Support Vector Machine (SVM) learning algorithm. The study leverages real-time sensor node data to develop an accurate and adaptable prediction model, addressing the inherent challenges of traditional ET estimation methods. The integration of the SVM algorithm with real-time sensor node data offers great potential to improve spatial and temporal resolution in ET predictions. In the model development, key input features are measured and computed using mathematical equations such as Penman-Monteith (FAO56) and soil water balance (SWB), which include soil-environmental parameters such as; solar radiation (Rs), air temperature (T), atmospheric pressure (P), relative humidity (RH), wind speed (u2), rain (R), deep percolation (DP), soil temperature (ST), and change in soil moisture (∆SM). The one-year field data are split into combinations of three proportions i.e. train, test, and validation sets. While kernel functions with tuning hyperparameters have been used to train and improve the accuracy of the prediction model with multiple iterations. This paper also outlines the existing methods and the machine learning techniques to determine Evapotranspiration, data collection and preprocessing, model construction, and evaluation metrics, highlighting the significance of SVM in advancing the field of ET prediction. The results demonstrate the robustness and high predictability of the developed model on the basis of performance evaluation metrics (R2, RMSE, MAE). The effectiveness of the proposed model in capturing complex relationships within soil and environmental parameters provide insights into its potential applications for water resource management and hydrological ecosystem.

Keywords: evapotranspiration, FAO56, KNIME, machine learning, RStudio, SVM, sensors

Procedia PDF Downloads 33

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

Abstract:

Introduction: It is well known that patients with Head and Neck Cancer (HNC) are at increased risk of subsequent head and neck cancers due to various aetiologies. Aim: We sought to determine the factors contributing to an increased risk of subsequent HNC primaries, and also to evaluate whether Aboriginal patients are at increased risk. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. We collected patient data including smoking and alcohol consumption, tumour and treatment data, and data on subsequent HNC primaries. Results: A subsequent HNC primary was seen in 37 patients (11.6%) overall. There was no significant difference in the rate of second primary HNCs between Aboriginal patients (12.5%) and nonAboriginal patients (11.2%) (p=0.408). Subsequent HNCs, were strongly associated with smoking and alcohol consumption however, with 95% of patients with a second primary being ever-smokers, and 54% of patients with a second primary having a history of excessive alcohol consumption. In the 37 patients with multiple HNC primaries, there were a total of 57 HNCs, with 29 patients having two primaries, six patients having 3 HNC primaries, one patient with four, and one with six. 54 out of the 57 cancers were in ever smokers (94.7%). There were only two multiple HNC primaries in a never smoker, non-drinker, and these cases were of unknown etiology with HPV/p16 status unknown in both cases. In the whole study population, there were 32 HPV-positive HNCs, and 67 p16-positive HNCs, with only two 2 nd HNCs in a p16-positive case, giving a rate of 3% in the p16+ population, which is actually much lower than the rate of second primaries seen in the overall population (11.6%), and was highest in the p16-negative population (15.7%). This suggests that p16-positivity is not a strong risk factor for subsequent primaries, and in fact p16-negativity appeared to be associated with increased risk, however this data is limited by the large number of patients without documented p16 status (45.3% overall, 12% for oropharyngeal, and 59.6% for oral cavity primaries had unknown p16 status). Summary: Subsequent HNC primaries were strongly associated with smoking and alcohol excess. Second and later HNC primaries did not appear to occur at increased rates in Aboriginal patients compared with non-Aboriginal patients, and p16-positivity did not predict increased risk, however p16-negativity was associated with an increased risk of subsequent HNCs.

Keywords: head and neck cancer, multiple primaries, aboriginal, p16 status, smoking, alcohol

Procedia PDF Downloads 45