Search results for: Sanjay Sarkar
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 217

Search results for: Sanjay Sarkar

97 Telephonic Communication in Palliative Care for Better Management of Terminal Cancer Patients in Rural India: An NGO Based Approach

Authors: Aditya Manna, L. K. Khanra, S. K. Sarkar

Abstract:

Aim: Due to financial incapability and the absence of manpower-poor families often fail to carry their advanced cancer patients to the nodal centers. This pilot study will explore whether communication by mobile phone can lessen this burden. Method: Initially a plan was generated regarding management of an advanced cancer patient in a nodal center at District Head Quarter. Subsequently every two week a trained social worker attached to the nodal center will follow up and give necessary advice and emotional support to the patients and their families through their registered mobile phone number. Patient’s family were also encouraged to communicate with the team by phone in case of fresh complain and urgency in between. Results: Since initiation in January 2013, 193 cancer patients were contacted by mobile phone every two weeks to enquire about their difficulties. In 76% of the situation trained social workers could give necessary advice by phone regarding management of their physical symptoms. Moreover, patient’s family was really overwhelmed by the emotional support offered by the team over the phone. Only 24% of cancer patients have to attend the nodal center for expert advice from Palliative Care specialists. Conclusion: This novel approach helped: (a) In providing regular physical and emotional support to the patients and their families. (b) In significantly reducing the financial and manpower problems of carrying patients to the nodal units. (c) In improving the quality of life of patients by continuous guidance. More and more team members can take help of this new strategy for better communication and uninterrupted care.

Keywords: palliative care, terminal care, home based palliative care, rural india

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96 Toxicological Standardization of Heavy Metals and Microbial Contamination Haematinic Herbal Formulations Marketed in India

Authors: A. V. Chandewar, Sanjay Bais

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Backgound: In India, drugs of herbal origin have been used in traditional systems of medicines such as Unani and Ayurveda since ancient times. WHO limit for Escherichia coli is 101/gm cfu, for Staphylococus aureus 105/gm cfu, and for Pseudomonas aeruginosa 103/gm cfu and for Salmonella species nil cfu. WHO mentions maximum permissible limits in raw materials only for arsenic, cadmium, and lead, which amount to 1.0, 0.3, and 10 ppm, respectively. Aim: The main purpose of the investigation was to document evidence for the users, and practitioners of marketed haematinic herbal formulations. In the present study haematinic herbal formulations marketed in Yavatmal India were determined for the presence of microbial and heavy metal content. Method: The investigations were performed by using specific medias and atomic absorption spectrometry. Result: The present work indicates the presence of heavy metal contents in herbal formulations selected for study. It was found that arsenic content in formulations was below the permissible limit in all formulations. The cadmium and lead content in six formulations were above the permissible limits. Such formulations are injurious to health of patient if consumed regularly. The specific medias were used to determining the presence of Escherichia coli 4 samples, Staphylococcus aureus 3 samples, and P. aeruginosa 4 samples. The data indicated suggest that there is requirement of in process improvement to provide better quality for consumer health in order to be competitive in international markets. Summary/Conclusion: The presence of microbial and heavy metal content above WHO limits indicates that the GMP was not followed during manufacturing of herbal formulations marketed in India.

Keywords: toxicological standardization, heavy metals, microbial contamination, haematinic herbal formulations

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95 Oxidosqualene Cyclase: A Novel Inhibitor

Authors: Devadrita Dey Sarkar

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Oxidosqualene cyclase is a membrane bound enzyme in which helps in the formation of steroid scaffold in higher organisms. In a highly selective cyclization reaction oxidosqualene cyclase forms LANOSTEROL with seven chiral centres starting from the linear substrate 2,3-oxidosqualene. In humans OSC in cholesterol biosynthesis it represents a target for the discovery of novel anticholesteraemic drugs that could complement the widely used statins. The enzyme oxidosqualene: lanosterol cyclase (OSC) represents a novel target for the treatment of hypercholesterolemia. OSC catalyzes the cyclization of the linear 2,3-monoepoxysqualene to lanosterol, the initial four-ringed sterol intermediate in the cholesterol biosynthetic pathway. OSC also catalyzes the formation of 24(S), 25-epoxycholesterol, a ligand activator of the liver X receptor. Inhibition of OSC reduces cholesterol biosynthesis and selectively enhances 24(S),25-epoxycholesterol synthesis. Through this dual mechanism, OSC inhibition decreases plasma levels of low-density lipoprotein (LDL)-cholesterol and prevents cholesterol deposition within macrophages. The recent crystallization of OSC identifies the mechanism of action for this complex enzyme, setting the stage for the design of OSC inhibitors with improved pharmacological properties for cholesterol lowering and treatment of atherosclerosis. While studying and designing the inhibitor of oxidosqulene cyclase, I worked on the pdb id of 1w6k which was the most worked on pdb id and I used several methods, techniques and softwares to identify and validate the top most molecules which could be acting as an inhibitor for oxidosqualene cyclase. Thus, by partial blockage of this enzyme, both an inhibition of lanosterol and subsequently cholesterol formation as well as a concomitant effect on HMG-CoA reductase can be achieved. Both effects complement each other and lead to an effective control of cholesterol biosynthesis. It is therefore concluded that 2,3-oxidosqualene cyclase plays a crucial role in the regulation of intracellular cholesterol homeostasis. 2,3-Oxidosqualene cyclase inhibitors offer an attractive approach for novel lipid-lowering agents.

Keywords: anticholesteraemic, crystallization, statins, homeostasis

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94 Numerical Simulations of Fire in Typical Air Conditioned Railway Coach

Authors: Manoj Sarda, Abhishek Agarwal, Juhi Kaushik, Vatsal Sanjay, Arup Kumar Das

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Railways in India remain primary mode of transport having one of the largest networks in the world and catering to billions of transits yearly. Catastrophic economic damage and loss to life is encountered over the past few decades due to fire to locomotives. Study of fire dynamics and fire propagation plays an important role in evacuation planning and reducing losses. Simulation based study of propagation of fire and soot inside an air conditioned coach of Indian locomotive is done in this paper. Finite difference based solver, Fire Dynamic Simulator (FDS) version 6 has been used for analysis. A single air conditioned 3 tier coupe closed to ambient surroundings by glass windows having occupancy for 8 people is the basic unit of the domain. A system of three such coupes combined is taken to be fundamental unit for the entire study to resemble effect to an entire coach. Analysis of flame and soot contours and concentrations is done corresponding to variations in heat release rate per unit volume (HRRPUA) of fire source, variations in conditioned air velocity being circulated inside coupes by vents and an alternate fire initiation and propagation mechanism via ducts. Quantitative results of fractional area in top and front view of the three coupes under fire and smoke are obtained using MATLAB (IMT). Present simulations and its findings will be useful for organizations like Commission of Railway Safety and others in designing and implementing safety and evacuation measures.

Keywords: air conditioned coaches, fire propagation, flame contour, soot flow, train fire

Procedia PDF Downloads 255
93 Effect of Austenitizing Temperature, Soaking Time and Grain Size on Charpy Impact Toughness of Quenched and Tempered Steel

Authors: S. Gupta, R. Sarkar, S. Pathak, D. H. Kela, A. Pramanick, P. Talukdar

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Low alloy quenched and tempered steels are typically used in cast railway components such as knuckles, yokes, and couplers. Since these components experience extensive impact loading during their service life, adequate impact toughness of these grades need to be ensured to avoid catastrophic failure of parts in service. Because of the general availability of Charpy V Test equipment, Charpy test is the most common and economical means to evaluate the impact toughness of materials and is generally used in quality control applications. With this backdrop, an experiment was designed to evaluate the effect of austenitizing temperature, soaking time and resultant grain size on the Charpy impact toughness and the related fracture mechanisms in a quenched and tempered low alloy steel, with the aim of optimizing the heat treatment parameters (i.e. austenitizing temperature and soaking time) with respect to impact toughness. In the first phase, samples were austenitized at different temperatures viz. 760, 800, 840, 880, 920 and 960°C, followed by quenching and tempering at 600°C for 4 hours. In the next phase, samples were subjected to different soaking times (0, 2, 4 and 6 hours) at a fixed austenitizing temperature (980°C), followed by quenching and tempering at 600°C for 4 hours. The samples corresponding to different test conditions were then subjected to instrumented Charpy tests at -40°C and energy absorbed were recorded. Subsequently, microstructure and fracture surface of samples corresponding to different test conditions were observed under scanning electron microscope, and the corresponding grain sizes were measured. In the final stage, austenitizing temperature, soaking time and measured grain sizes were correlated with impact toughness and the fracture morphology and mechanism.

Keywords: heat treatment, grain size, microstructure, retained austenite and impact toughness

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92 Effects of Spent Dyebath Recycling on Pollution and Cost of Production in a Cotton Textile Industry

Authors: Dinesh Kumar Sharma, Sanjay Sharma

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Textile manufacturing industry uses a substantial amount of chemicals not only in the production processes but also in manufacturing the raw materials. Dyes are the most significant raw material which provides colour to the fabric and yarn. Dyes are produced by using a large amount of chemicals both organic and inorganic in nature. Dyes are further classified as Reactive or Vat Dyes which are mostly used in cotton textiles. In the process of application of dyes to the cotton fiber, yarn or fabric, several auxiliary chemicals are also used in the solution called dyebath to improve the absorption of dyes. There is a very little absorption of dyes and auxiliary chemicals and a residual amount of all these substances is released as the spent dye bath effluent. Because of the wide variety of chemicals used in cotton textile dyes, there is always a risk of harmful effects which may not be apparent immediately but may have an irreversible impact in the long term. Colour imparted by the dyes to the water also has an adverse effect on its public acceptability and the potability. This study has been conducted with an objective to assess the feasibility of reuse of the spent dye bath. Studies have been conducted in two independent industries manufacturing dyed cotton yarn and dyed cotton fabric respectively. These have been referred as Unit-I and Unit-II. The studies included assessment of reduction in pollution levels and the economic benefits of such reuse. The study conclusively establishes that the reuse of spent dyebath results in prevention of pollution, reduction in pollution loads and cost of effluent treatment & production. This pollution prevention technique presents a good preposition for pollution prevention in cotton textile industry.

Keywords: dyes, dyebath, reuse, toxic, pollution, costs

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91 Strain-Driven Bidirectional Spin Orientation Control in Epitaxial High Entropy Oxide Films

Authors: Zhibo Zhao, Horst Hahn, Robert Kruk, Abhisheck Sarkar

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High entropy oxides (HEOs), based on the incorporation of multiple-principal cations into the crystal lattice, offer the possibility to explore previously inaccessible oxide compositions and unconventional properties. Here it is demonstrated that despite the chemical complexity of HEOs external stimuli, such as epitaxial strain, can selectively stabilize certain magneto-electronic states. Epitaxial (Co₀.₂Cr₀.₂Fe₀.₂Mn₀.₂Ni₀.₂)₃O₄-HEO thin films are grown in three different strain states: tensile, compressive, and relaxed. A unique coexistence of rocksalt and spinel-HEO phases, which are fully coherent with no detectable chemical segregation, is revealed by transmission electron microscopy. This dual-phase coexistence appears as a universal phenomenon in (Co₀.₂Cr₀.₂Fe₀.₂Mn₀.₂Ni₀.₂)₃O₄ epitaxial films. Prominent changes in the magnetic anisotropy and domain structure highlight the strain-induced bidirectional control of magnetic properties in HEOs. When the films are relaxed, their magnetization behavior is isotropic, similar to that of bulk materials. However, under tensile strain, the hardness of the out-of-plane (OOP) axis increases significantly. On the other hand, compressive straining results in an easy OOP magnetization and a maze-like magnetic domain structure, indicating perpendicular magnetic anisotropy. Generally, this study emphasizes the adaptability of the high entropy design strategy, which, when combined with coherent strain engineering, opens additional prospects for fine-tuning properties in oxides.

Keywords: high entropy oxides, thin film, strain tuning, perpendicular magnetic anistropy

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90 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population

Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal

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Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

Keywords: urology, endourology, prostate, bladder outlet obstruction, laser

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89 Development of a CFD Model for PCM Based Energy Storage in a Vertical Triplex Tube Heat Exchanger

Authors: Pratibha Biswal, Suyash Morchhale, Anshuman Singh Yadav, Shubham Sanjay Chobe

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Energy demands are increasing whereas energy sources, especially non-renewable sources are limited. Due to the intermittent nature of renewable energy sources, it has become the need of the hour to find new ways to store energy. Out of various energy storage methods, latent heat thermal storage devices are becoming popular due to their high energy density per unit mass and volume at nearly constant temperature. This work presents a computational fluid dynamics (CFD) model using ANSYS FLUENT 19.0 for energy storage characteristics of a phase change material (PCM) filled in a vertical triplex tube thermal energy storage system. A vertical triplex tube heat exchanger, just like its name consists of three concentric tubes (pipe sections) for parting the device into three fluid domains. The PCM is filled in the middle domain with heat transfer fluids flowing in the outer and innermost domains. To enhance the heat transfer inside the PCM, eight fins have been incorporated between the internal and external tubes. These fins run radially outwards from the outer-wall of innermost tube to the inner-wall of the middle tube dividing the middle domain (between innermost and middle tube) into eight sections. These eight sections are then filled with a PCM. The validation is carried with earlier work and a grid independence test is also presented. Further studies on freezing and melting process were carried out. The results are presented in terms of pictorial representation of isotherms and liquid fraction

Keywords: heat exchanger, thermal energy storage, phase change material, CFD, latent heat

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88 Multidimensional Inequality and Deprivation Among Tribal Communities of Andhra Pradesh, India

Authors: Sanjay Sinha, Mohd Umair Khan

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The level of income inequality in India has been worrisome as the World Inequality Report termed it as a “poor and unequal country, with an affluent elite”. As important as income is to understand inequality and deprivation, it is just one dimension. But the historical roots and current realities of inequality and deprivation in India lies in many of the non-income dimensions such as housing, nutrition, education, agency, sense of inclusion etc. which are often ignored, especially in solution-oriented research. The level of inequality and deprivation among the tribal is one such case. There is a corpus of literature establishing that the tribal communities in India are disadvantageous on various grounds. Given their rural geography, issues of access and quality of basic facilities such as education and healthcare are often unaddressed. COVID-19 has further exacerbated this challenge and climate change will make it even more worrying. With this background, a succinct measurement tool at the village level is necessary to design short to medium-term actions with reference to risk mitigation for tribal communities. This research paper examines the level of inequality and deprivation among the tribal communities in the rural areas of Andhra Pradesh state of India using a Multidimensional Inequality and Deprivation Index based on the Alkire-Foster methodology. The methodology is theoretically grounded in the capability approach propounded by Amartya Sen, emphasizing on achieving the “beings and doings” (functionings) an individual reason to value. In the index, the authors have five domains, including Livelihood, Food Security, Education, Health and Housing and these domains are divided into sixteen indicators. This assessment is followed by domain-wise short-term and long-term solutions.

Keywords: Andhra Pradesh, Alkire-Foster methodology, deprivation, inequality, multidimensionality, poverty, tribal

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87 Sustainability in Retaining Wall Construction with Geosynthetics

Authors: Sateesh Kumar Pisini, Swetha Priya Darshini, Sanjay Kumar Shukla

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This paper seeks to present a research study on sustainability in construction of retaining wall using geosynthetics. Sustainable construction is a way for the building and infrastructure industry to move towards achieving sustainable development, taking into account environmental, socioeconomic and cultural issues. Geotechnical engineering, being very resource intensive, warrants an environmental sustainability study, but a quantitative framework for assessing the sustainability of geotechnical practices, particularly at the planning and design stages, does not exist. In geotechnical projects, major economic issues to be addressed are in the design and construction of stable slopes and retaining structures within space constraints. In this paper, quantitative indicators for assessing the environmental sustainability of retaining wall with geosynthetics are compared with conventional concrete retaining wall through life cycle assessment (LCA). Geosynthetics can make a real difference in sustainable construction techniques and contribute to development in developing countries in particular. Their imaginative application can result in considerable cost savings over the use of conventional designs and materials. The acceptance of geosynthetics in reinforced retaining wall construction has been triggered by a number of factors, including aesthetics, reliability, simple construction techniques, good seismic performance, and the ability to tolerate large deformations without structural distress. Reinforced retaining wall with geosynthetics is the best cost-effective and eco-friendly solution as compared with traditional concrete retaining wall construction. This paper presents an analysis of the theme of sustainability applied to the design and construction of traditional concrete retaining wall and presenting a cost-effective and environmental solution using geosynthetics.

Keywords: sustainability, retaining wall, geosynthetics, life cycle assessment

Procedia PDF Downloads 2020
86 Bayesian System and Copula for Event Detection and Summarization of Soccer Videos

Authors: Dhanuja S. Patil, Sanjay B. Waykar

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Event detection is a standout amongst the most key parts for distinctive sorts of area applications of video data framework. Recently, it has picked up an extensive interest of experts and in scholastics from different zones. While detecting video event has been the subject of broad study efforts recently, impressively less existing methodology has considered multi-model data and issues related efficiency. Start of soccer matches different doubtful circumstances rise that can't be effectively judged by the referee committee. A framework that checks objectively image arrangements would prevent not right interpretations because of some errors, or high velocity of the events. Bayesian networks give a structure for dealing with this vulnerability using an essential graphical structure likewise the probability analytics. We propose an efficient structure for analysing and summarization of soccer videos utilizing object-based features. The proposed work utilizes the t-cherry junction tree, an exceptionally recent advancement in probabilistic graphical models, to create a compact representation and great approximation intractable model for client’s relationships in an interpersonal organization. There are various advantages in this approach firstly; the t-cherry gives best approximation by means of junction trees class. Secondly, to construct a t-cherry junction tree can be to a great extent parallelized; and at last inference can be performed utilizing distributed computation. Examination results demonstrates the effectiveness, adequacy, and the strength of the proposed work which is shown over a far reaching information set, comprising more soccer feature, caught at better places.

Keywords: summarization, detection, Bayesian network, t-cherry tree

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85 Cold Formed Steel Sections: Analysis, Design and Applications

Authors: A. Saha Chaudhuri, D. Sarkar

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In steel construction, there are two families of structural members. One is hot rolled steel and another is cold formed steel. Cold formed steel section includes steel sheet, strip, plate or flat bar. Cold formed steel section is manufactured in roll forming machine by press brake or bending operation. Cold formed steel (CFS), also known as Light Gauge Steel (LGS). As cold formed steel is a sustainable material, it is widely used in green building. Cold formed steel can be recycled and reused with no degradation in structural properties. Cold formed steel structures can earn credits for green building ratings such as LEED and similar programs. Cold formed steel construction satisfies international demand for better, more efficient and affordable buildings. Cold formed steel sections are used in building, car body, railway coach, various types of equipment, storage rack, grain bin, highway product, transmission tower, transmission pole, drainage facility, bridge construction etc. Various shapes of cold formed steel sections are available, such as C section, Z section, I section, T section, angle section, hat section, box section, square hollow section (SHS), rectangular hollow section (RHS), circular hollow section (CHS) etc. In building construction cold formed steel is used as eave strut, purlin, girt, stud, header, floor joist, brace, diaphragm and covering for roof, wall and floor. Cold formed steel has high strength to weight ratio and high stiffness. Cold formed steel is non shrinking and non creeping at ambient temperature, it is termite proof and rot proof. CFS is durable, dimensionally stable and non combustible material. CFS is economical in transportation and handling. At present days cold formed steel becomes a competitive building material. In this paper all these applications related present research work are described and how the CFS can be used as blast resistant structural system that is examined.

Keywords: cold form steel sections, applications, present research review, blast resistant design

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84 An Analytical Study on the Politics of Defection in India

Authors: Diya Sarkar, Prafulla C. Mishra

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In a parliamentary system, party discipline is the impulse; when it falls short, the government usually falls. Conceivably, the platform of Indian politics suffers with innumerous practical disorders. The politics of defection is one such specie entailing gross miscarriage of fair conduct turning politics into a game of thrones (powers). This practice of political nomaditude can trace its seed in the womb of British House of Commons. Therein, if a legislator was found to cross the floor, the party considered him disloyal. In other words, the legislator lost his allegiance to his former party by joining another party. This very phenomenon, in practice has a two way traffic i.e. ruling party to the opposition party or vice versa. The democracies like USA, Australia and Canada were also aware of this fashion of swapping loyalties. There have been several instances of great politicians changing party allegiance, for example Winston Churchill, Ramsay McDonald, William Gladstone etc. Nevertheless, it is interesting to cite that irrespective of such practice of changing party allegiance, none of the democracies in the west ever desired or felt the need to legislatively ban defections. But, exceptionally India can be traced to have passed anti-defection laws. The politics of defection had been a unique popular phenomenon on the floor of Indian Parliamentary system gradually gulping the democratic essence and synchronization of the Federation. This study is both analytical and doctrinal, which tries to examine whether representative democracy has lost its essence due to political nomadism. The present study also analyzes the classical as well as contemporary pulse of floor crossing amidst dynastic politics in a representative democracy. It will briefly discuss the panorama of defections under the Indian federal structure in the light of the anti-defection law and an attempt has been made to add valuable suggestions to streamline remedy for the still prevalent political defections.

Keywords: constitutional law, defection, democracy, polarization, political anti-trust

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83 Antibacterial Activity of Calendula officinalis Extract Loaded Chitosan Nanoparticles

Authors: Sanjay Singh, Swati Jaiswal, Prashant Mishra

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Nanoparticle based formulations of drug delivery systems have shown their potential in improving the performance of existing drugs and have opened avenues for new therapies. Calendula extract is a low cost, wide spectrum bioactive material that has been used for a long term therapy of various infections. Aim: The aim of this study was to develop Calendula officinalis extract based nanoformulations and to study the antibacterial activity of either Calendula extract loaded chitosan nanoparticles or Calendula extract coated silver nanoparticles for increased bioavailability and their long term effect. Methods: Chitosan nanoparticles were prepared by the process of ionotropic gelation, based on interaction between the negative groups of tri polyphosphate (TPP) and positively charged amino groups of chitosan. The size of the Calendula extract-loaded chitosan particles was determined using dynamic light scattering and scanning electron microscopy. Antibacterial activities of these formulations were determined based on minimum inhibitory concentration and time kill studies. In addition, silver nanoparticles were also synthesized in the presence of Calendula extract and characterized by UV visible spectrum, DLS and XRD. Experiments were conducted on 96-plates against two Gram-positive bacteria; Staphylococcus aureus and Bacillus subtilis two Gram-negative bacteria; Escherichia coli and Pseudomonas aeruginosa. Results: Results demonstrated time dependent antibacterial activity against different microbes studied. Both Calendula extract and Calendula extract loaded chitosan nanoparticles have shown good antimicrobial activity against both Gram positive and Gram negative bacteria. Conclusion: Calendula extract loaded chitosan nanoparticles and calendula extract coated silver nanoparticles are potential antibacterial for their long term antibacterial effects.

Keywords: antibacterial, Calendula extract, chitosan nanoparticles, silver nanoparticles

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82 GIS Based Spatial Modeling for Selecting New Hospital Sites Using APH, Entropy-MAUT and CRITIC-MAUT: A Study in Rural West Bengal, India

Authors: Alokananda Ghosh, Shraban Sarkar

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The study aims to identify suitable sites for new hospitals with critical obstetric care facilities in Birbhum, one of the vulnerable and underserved districts of Eastern India, considering six main and 14 sub-criteria, using GIS-based Analytic Hierarchy Process (AHP) and Multi-Attribute Utility Theory (MAUT) approach. The criteria were identified through field surveys and previous literature. After collecting expert decisions, a pairwise comparison matrix was prepared using the Saaty scale to calculate the weights through AHP. On the contrary, objective weighting methods, i.e., Entropy and Criteria Importance through Interaction Correlation (CRITIC), were used to perform the MAUT. Finally, suitability maps were prepared by weighted sum analysis. Sensitivity analyses of AHP were performed to explore the effect of dominant criteria. Results from AHP reveal that ‘maternal death in transit’ followed by ‘accessibility and connectivity’, ‘maternal health care service (MHCS) coverage gap’ were three important criteria with comparatively higher weighted values. Whereas ‘accessibility and connectivity’ and ‘maternal death in transit’ were observed to have more imprint in entropy and CRITIC, respectively. While comparing the predictive suitable classes of these three models with the layer of existing hospitals, except Entropy-MAUT, the other two are pointing towards the left-over underserved areas of existing facilities. Only 43%-67% of existing hospitals were in the moderate to lower suitable class. Therefore, the results of the predictive models might bring valuable input in future planning.

Keywords: hospital site suitability, analytic hierarchy process, multi-attribute utility theory, entropy, criteria importance through interaction correlation, multi-criteria decision analysis

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81 Studies on the Existing Status of MSW Management in Agartala City and Recommendation for Improvement

Authors: Subhro Sarkar, Umesh Mishra

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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

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80 Association of Brain-Derived Neurotrophic Factor (BDNF) Gene with Obesity and Metabolic Traits in Malaysian Adults

Authors: Yamunah Devi Apalasamy, Sanjay Rampal, Tin Tin Su, Foong Ming Moy, Hazreen Abdul Majid, Awang Bulgiba, Zahurin Mohamed

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Obesity is a growing global health issue. Obesity results from a combination of environmental and genetics factors. Brain-derived neurotrophic factor (BDNF), a gene encodes the BDNF protein and the BDNF gene have been linked to regulation of body weight and appetite. Genome-wide association studies have identified the BDNF variants to be related to obesity among Caucasians, East Asians, and Filipinos. However, the role of BDNF in other ethnic groups remains inconclusive. This case control study aims to investigate the associations of BDNF gene polymorphisms with obesity and metabolic parameters in Malaysian Malays. BDNF rs4074134, BDNF rs10501087 and BDNF rs6265 were genotyped using Sequenom MassARRAY. Anthropometric, body fat, fasting lipids and glucose levels were measured. A total of 663 subjects (194 obese and 469 non-obese) were included in this study. There were no significant associations association between BDNF SNPs and obesity. The allelic and genotype frequencies of the BDNF SNPs were similar in the obese and non-obese groups. After adjustment for age and sex, the BDNF variants were not associated with obesity, body fat, fasting lipids and glucose levels. Haplotypes at the BDNF gene region, were not significantly associated with obesity. The BDNF rs4074134 was in strong LD with BDNF rs10501087 (D'=0.98) and BDNF rs6265 (D'=0.87). The BDNF rs10501087 was also in strong LD with BDNF rs6265 (D'=0.91). Our findings suggest that the BDNF variants and the haplotypes of BDNF gene were not associated with obesity and metabolic traits in this study population. Further research is needed to explore other BDNF variants with a larger sample size with gene-environment interactions in multi ethnic Malaysian population.

Keywords: genomics of obesity, SNP, BMI, haplotypes

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79 p210 BCR-ABL1 CML with CMML Clones: A Rare Presentation

Authors: Mona Vijayaran, Gurleen Oberoi, Sanjay Mishra

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Introduction: p190 BCR‐ABL1 in CML is often associated with monocytosis. In the case described here, monocytosis is associated with coexisting p210 BCR‐ABL and CMML clones. Mutation analysis using next‐generation sequence (NGS) in our case showed TET2 and SRSF2 mutations. Aims & Objectives: A 75-year male was evaluated for monocytosis and thrombocytopenia. CBC showed Hb-11.8g/dl, TLC-12,060/cmm, Monocytes-35%, Platelets-39,000/cmm. Materials & Methods: Bone marrow examination showed a hypercellular marrow with myeloid series showing sequential maturation up to neutrophils with 30% monocytes. Immunophenotyping by flow cytometry from bone marrow had 3% blasts. Making chronic myelomonocytic leukemia as the likely diagnosis. NGS for myeloid mutation panel had TET2 (48.9%) and SRSF2 (32.5%) mutations. This report further supported the diagnosis of CMML. To fulfil the WHO diagnostic criteria for CMML, a BCR ABL1 by RQ-PCR was sent. The report came positive for p210 (B3A2, B2A2) Major Transcript (M-BCR) % IS of 38.418. Result: The patient was counselled regarding the unique presentation of the presence of 2 clones- P210 CML and CMML. After discussion with an international faculty with vast experience in CMML. It was decided to start this elderly gentleman on Imatinib 200mg and not on azacytidine, as ASXL1 was not present; hence, his chances of progressing to AML would be less and on the other end, if CML is left untreated then chances of progression to blast phase would always be a possibility. After 3 months on Imatinib his platelet count improved to 80,000 to 90,000/cmm, but his monocytosis persists. His 3rd month BCR-ABL1 IS% is 0.004%. Conclusion: After searching the literature, there were no case reports of a coexisting CML p210 with CMML. This case might be the first case report. p190 BCR ABL1 is often associated with monocytosis. There are few case reports of p210 BCR ABL1 positivity in patients with monocytosis but none with coexisting CMML. This case highlights the need for extensively evaluating patients with monocytosis with next-generation sequencing for myeloid mutation panel and BCR-ABL1 by RT-PCR to correctly diagnose and treat them.

Keywords: CMML, NGS, p190 CML, Imatinib

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78 Phytobeds with Fimbristylis dichotoma and Ammannia baccifera for Treatment of Real Textile Effluent: An in situ Treatment, Anatomical Studies and Toxicity Evaluation

Authors: Suhas Kadam, Vishal Chandanshive, Niraj Rane, Sanjay Govindwar

Abstract:

Fimbristylis dichotoma, Ammannia baccifera, and their co-plantation consortium FA were found to degrade methyl orange, simulated dye mixture, and real textile effluent. Wild plants of Fimbristylis dichotoma and Ammannia baccifera with equal biomass showed 91 and 89% decolorization of methyl orange within 60 h at a concentration of 50 ppm, while 95% dye removal was achieved by consortium FA within 48 h. Floating phyto-beds with co-plantation (Fimbristylis dichotoma and Ammannia baccifera) for the treatment of real textile effluent in a constructed wetland was observed to be more efficient and achieved 79, 72, 77, 66 and 56% reductions in ADMI color value, chemical oxygen demand, biological oxygen demand, total dissolve solid and total suspended solid of textile effluent, respectively. High performance thin layer chromatography, gas chromatography-mass spectroscopy, Fourier transform infrared spectroscopy, Ultra violet-Visible spectroscopy and enzymatic assays confirmed the phytotransformation of parent dye in the new metabolites. T-RFLP analysis of rhizospheric bacteria of Fimbristylis dichotoma, Ammannia baccifera, and consortium FA revealed the presence of 88, 98 and 223 genera which could have been involved in dye removal. Toxicity evaluation of products formed after phytotransformation of methyl orange by consortium FA on bivalves Lamellidens marginalis revealed less damage in the gills architecture when analyzed histologically. Toxicity measurement by Random Amplification of Polymorphic DNA (RAPD) technique revealed normal banding pattern in treated methyl orange sample suggesting less toxic nature of phytotransformed dye products.

Keywords: constructed wetland, phyto-bed, textile effluent, phytoremediation

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77 A Feasibility Study of Waste (d) Potential: Synergistic Effect Evaluation by Co-digesting Organic Wastes and Kinetics of Biogas Production

Authors: Kunwar Paritosh, Sanjay Mathur, Monika Yadav, Paras Gandhi, Subodh Kumar, Nidhi Pareek, Vivekanand Vivekanand

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A significant fraction of energy is wasted every year managing the biodegradable organic waste inadequately as development and sustainability are the inherent enemies. The management of these waste is indispensable to boost its optimum utilization by converting it to renewable energy resource (here biogas) through anaerobic digestion and to mitigate greenhouse gas emission. Food and yard wastes may prove to be appropriate and potential feedstocks for anaerobic co-digestion for biogas production. The present study has been performed to explore the synergistic effect of co-digesting food waste and yard trimmings from MNIT campus for enhanced biogas production in different ratios in batch tests (37±10C, 90 rpm, 45 days). The results were overwhelming and showed that blending two different organic waste in proper ratio improved the biogas generation considerably, with the highest biogas yield (2044±24 mLg-1VS) that was achieved at 75:25 of food waste to yard waste ratio on volatile solids (VS) basis. The yield was 1.7 and 2.2 folds higher than the mono-digestion of food or yard waste (1172±34, 1016±36mLg-1VS) respectively. The increase in biogas production may be credited to optimum C/N ratio resulting in higher yield. Also Adding TiO2 nanoparticles showed virtually no effect on biogas production as sometimes nanoparticles enhance biogas production. ICP-MS, FTIR analysis was carried out to gain an insight of feedstocks. Modified Gompertz and logistics models were applied for the kinetic study of biogas production where modified Gompertz model showed goodness-of-fit (R2=0.9978) with the experimental results.

Keywords: anaerobic co-digestion, biogas, kinetics, nanoparticle, organic waste

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76 Formation of in-situ Ceramic Phase in N220 Nano Carbon Containing Low Carbon Mgo-C Refractory

Authors: Satyananda Behera, Ritwik Sarkar

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In iron and steel industries, MgO–C refractories are widely used in basic oxygen furnaces, electric arc furnaces and steel ladles due to their excellent corrosion resistance, thermal shock resistance, and other excellent hot properties. Conventionally magnesia carbon refractories contain about 8-20 wt% of carbon but the use of carbon is also associate with disadvantages like oxidation, low fracture strength, high heat loss and higher carbon pick up in steel. So, MgO-C refractory having low carbon content without compromising the beneficial properties is the challenge. Nano carbon, having finer particles, can mix and distribute within the entire matrix uniformly and can result in improved mechanical, thermo-mechanical, corrosion and other refractory properties. Previous experiences with the use of nano carbon in low carbon MgO-C refractory have indicated an optimum range of use of nano carbon around 1 wt%. This optimum nano carbon content was used in MgO-C compositions with flaky graphite followed by aluminum and silicon metal powder as an anti-oxidant. These low carbon MgO-C refractory compositions were prepared by conventional manufacturing techniques. At the same time 16 wt. % flaky graphite containing conventional MgO-C refractory was also prepared parallel under similar conditions. The developed products were characterized for various refractory related properties. Nano carbon containing compositions showed better mechanical, thermo-mechanical properties, and oxidation resistance compared to that of conventional composition. Improvement in the properties is associated with the formation of in-situ ceramic phase-like aluminum carbide, silicon carbide, and magnesium aluminum spinel. Higher surface area and higher reactivity of N220 nano carbon black resulted in greater formation in-situ ceramic phases, even at a much lower amount. Nano carbon containing compositions were found to have improved properties in MgO-C refractories compared to that of the conventional ones at much lower total carbon content.

Keywords: N220nano carbon black, refractory properties, conventionally manufacturing techniques, conventional magnesia carbon refractories

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75 Integrated Mass Rapid Transit System for Smart City Project in Western India

Authors: Debasis Sarkar, Jatan Talati

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This paper is an attempt to develop an Integrated Mass Rapid Transit System (MRTS) for a smart city project in Western India. Integrated transportation is one of the enablers of smart transportation for providing a seamless intercity as well as regional level transportation experience. The success of a smart city project at the city level for transportation is providing proper integration to different mass rapid transit modes by way of integrating information, physical, network of routes fares, etc. The methodology adopted for this study was primary data research through questionnaire survey. The respondents of the questionnaire survey have responded on the issues about their perceptions on the ways and means to improve public transport services in urban cities. The respondents were also required to identify the factors and attributes which might motivate more people to shift towards the public mode. Also, the respondents were questioned about the factors which they feel might restrain the integration of various modes of MRTS. Furthermore, this study also focuses on developing a utility equation for respondents with the help of multiple linear regression analysis and its probability to shift to public transport for certain factors listed in the questionnaire. It has been observed that for shifting to public transport, the most important factors that need to be considered were travel time saving and comfort rating. Also, an Integrated MRTS can be obtained by combining metro rail with BRTS, metro rail with monorail, monorail with BRTS and metro rail with Indian railways. Providing a common smart card to transport users for accessing all the different available modes would be a pragmatic solution towards integration of the available modes of MRTS.

Keywords: mass rapid transit systems, smart city, metro rail, bus rapid transit system, multiple linear regression, smart card, automated fare collection system

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74 Thermal Hydraulic Analysis of Sub-Channels of Pressurized Water Reactors with Hexagonal Array: A Numerical Approach

Authors: Md. Asif Ullah, M. A. R. Sarkar

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This paper illustrates 2-D and 3-D simulations of sub-channels of a Pressurized Water Reactor (PWR) having hexagonal array of fuel rods. At a steady state, the temperature of outer surface of the cladding of fuel rod is kept about 1200°C. The temperature of this isothermal surface is taken as boundary condition for simulation. Water with temperature of 290°C is given as a coolant inlet to the primary water circuit which is pressurized upto 157 bar. Turbulent flow of pressurized water is used for heat removal. In 2-D model, temperature, velocity, pressure and Nusselt number distributions are simulated in a vertical sectional plane through the sub-channels of a hexagonal fuel rod assembly. Temperature, Nusselt number and Y-component of convective heat flux along a line in this plane near the end of fuel rods are plotted for different Reynold’s number. A comparison between X-component and Y-component of convective heat flux in this vertical plane is analyzed. Hexagonal fuel rod assembly has three types of sub-channels according to geometrical shape whose boundary conditions are different too. In 3-D model, temperature, velocity, pressure, Nusselt number, total heat flux magnitude distributions for all the three sub-channels are studied for a suitable Reynold’s number. A horizontal sectional plane is taken from each of the three sub-channels to study temperature, velocity, pressure, Nusselt number and convective heat flux distribution in it. Greater values of temperature, Nusselt number and Y-component of convective heat flux are found for greater Reynold’s number. X-component of convective heat flux is found to be non-zero near the bottom of fuel rod and zero near the end of fuel rod. This indicates that the convective heat transfer occurs totally along the direction of flow near the outlet. As, length to radius ratio of sub-channels is very high, simulation for a short length of the sub-channels are done for graphical interface advantage. For the simulations, Turbulent Flow (K-Є ) module and Heat Transfer in Fluids (ht) module of COMSOL MULTIPHYSICS 5.0 are used.

Keywords: sub-channels, Reynold’s number, Nusselt number, convective heat transfer

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73 Urea and Starch Detection on a Paper-Based Microfluidic Device Enabled on a Smartphone

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

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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

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72 Mixotropohic Growth of Chlorella sp. on Raw Food Processing Industrial Wastewater: Effect of COD Tolerance

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

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

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

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71 Experimental Investigations on Setting Behavior and Compreesive Strength of Flyash Based Geopolymer

Authors: Ishan Tank, Ashmita Rupal, Sanjay Kumar Sharma

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Concrete, a widely used building material, has cement as its main constituent. An excessive amount of emissions are released into the atmosphere during the manufacture of cement, which is detrimental to the environment. To minimize this problem, innovative materials like geopolymer mortar (GPM) seem to be a better alternative. By using fly ash-based geopolymer instead of standard cement mortar as a binding ingredient, this concept has been successfully applied to the building sector. The advancement of this technology significantly reduces greenhouse gas emissions and helps in source reduction, thereby minimizing pollution of the environment. In order to produce mortar and use this geopolymer mortar in the development of building materials, the current investigation is properly introducing this geopolymeric material, namely fly ash, as a binder in place of standard cement. In the domain of the building material industry, fly ash based geopolymer is a new and optimistic replacement for traditional binding materials because it is both environmentally sustainable and has good durability. The setting behaviour and strength characteristics of fly ash, when mixed with alkaline activator solution with varied concentration of sodium hydroxide solution, alkaline liquids mix ratio, and curing temperature, must be investigated, though, in order to determine its suitability and application in comparison with the traditional binding material, by activating the raw materials, which include various elements of silica and alumina, finer material known as geopolymer mortar is created. The concentration of the activator solution has an impact on the compressive strength of the geopolymer concrete formed. An experimental examination of compressive strength after 7, 14, and 28 days of fly ash-based geopolymer concrete is presented in this paper. Furthermore, the process of geopolymerization largely relies on the curing temperature. So, the setting time of Geopolymer mortar due to different curing temperatures has been studied and discussed in this paper.

Keywords: geopolymer mortar, setting time, flyash, compressive strength, binder material

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70 Improving Fluid Catalytic Cracking Unit Performance through Low Cost Debottlenecking

Authors: Saidulu Gadari, Manoj Kumar Yadav, V. K. Satheesh, Debasis Bhattacharyya, S. S. V. Ramakumar, Subhajit Sarkar

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Most Fluid Catalytic Cracking Units (FCCUs) are big profit makers and hence, always operated with several constraints. It is the primary source for production of gasoline, light olefins as petrochemical feedstocks, feedstock for alkylate & oxygenates, LPG, etc. in a refinery. Increasing unit capacity and improving product yields as well as qualities such as gasoline RON have dramatic impact on the refinery economics. FCCUs are often debottlenecked significantly beyond their original design capacities. Depending upon the unit configuration, operating conditions, and feedstock quality, the FCC unit can have a variety of bottlenecks. While some of these are aimed to increase the feed rate, improve the conversion, etc., the others are aimed to improve the reliability of the equipment or overall unit. Apart from investment cost, the other factors considered generally while evaluating the debottlenecking options are shutdown days, faster payback, risk on investment, etc. A low-cost solution such as replacement of feed injectors, air distributor, steam distributors, spent catalyst distributor, efficient cyclone system, etc. are the preferred way of upgrading FCCU. It also has lower lead time from idea inception to implementation. This paper discusses various bottlenecks generally encountered in FCCU and presents a case study on improvement of performance of one of the FCCUs in IndianOil through implementation of cost-effective technical solution including use of improved internals in Reactor-Regeneration (R-R) section. After implementation reduction in regenerator air, gas superficial velocity in regenerator and cyclone velocities by about 10% and improvement of CLO yield from 10 to 6 wt% have been achieved. By ensuring proper pressure balance and optimum immersion of cyclone dipleg in the standpipe, frequent formation of perforations in regenerator cyclones could be addressed which in turn improved the unit on-stream factor.

Keywords: FCC, low-cost, revamp, debottleneck, internals, distributors, cyclone, dipleg

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69 Caregiver’s Perception Regarding Diagnosis Disclosure to Children Living with Human Immunodeficiency Virus in Resource-Limited Settings: Observational Study from India

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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68 Reduced Lung Volume: A Possible Cause of Stuttering

Authors: Shantanu Arya, Sachin Sakhuja, Gunjan Mehta, Sanjay Munjal

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Stuttering may be defined as a speech disorder affecting the fluency domain of speech and characterized by covert features like word substitution, omittance and circumlocution and overt features like prolongation of sound, syllables and blocks etc. Many etiologies have been postulated to explain stuttering based on various experiments and research. Moreover, Breathlessness has also been reported by many individuals with stuttering for which breathing exercises are generally advised. However, no studies reporting objective evaluation of the pulmonary capacity and further objective assessment of the efficacy of breathing exercises have been conducted. Pulmonary Function Test which evaluates parameters like Forced Vital Capacity, Peak Expiratory Flow Rate, Forced expiratory flow Rate can be used to study the pulmonary behavior of individuals with stuttering. The study aimed: a) To identify speech motor & physiologic behaviours associated with stuttering by administering PFT. b) To recognize possible reasons for an association between speech motor behaviour & stuttering severity. In this regard, PFT tests were administered on individuals who reported signs and symptoms of stuttering and showed abnormal scores on Stuttering Severity Index. Parameters like Forced Vital Capacity, Forced Expiratory Volume, Peak Expiratory Flow Rate (L/min), Forced Expiratory Flow Rate (L/min) were evaluated and correlated with scores of Stuttering Severity Index. Results showed significant decrease in the parameters (lower than normal scores) in individuals with established stuttering. Strong correlation was also found between degree of stuttering and the degree of decrease in the pulmonary volumes. Thus, it is evident that fluent speech requires strong support of lung pressure and requisite volumes. Further research in demonstrating the efficacy of abdominal breathing exercises in this regard is needed.

Keywords: forced expiratory flow rate, forced expiratory volume, forced vital capacity, peak expiratory flow rate, stuttering

Procedia PDF Downloads 244