Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 23

Search results for: D. Garg

23 Performance Analysis of Software Reliability Models using Matrix Method

Authors: RajPal Garg, Kapil Sharma, Rajive Kumar, R. K. Garg

Abstract:

This paper presents a computational methodology based on matrix operations for a computer based solution to the problem of performance analysis of software reliability models (SRMs). A set of seven comparison criteria have been formulated to rank various non-homogenous Poisson process software reliability models proposed during the past 30 years to estimate software reliability measures such as the number of remaining faults, software failure rate, and software reliability. Selection of optimal SRM for use in a particular case has been an area of interest for researchers in the field of software reliability. Tools and techniques for software reliability model selection found in the literature cannot be used with high level of confidence as they use a limited number of model selection criteria. A real data set of middle size software project from published papers has been used for demonstration of matrix method. The result of this study will be a ranking of SRMs based on the Permanent value of the criteria matrix formed for each model based on the comparison criteria. The software reliability model with highest value of the Permanent is ranked at number – 1 and so on.

Keywords: Matrix method, Model ranking, Model selection, Model selection criteria, Software reliability models.

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22 Backstepping Design and Fractional Derivative Equation of Chaotic System

Authors: Ayub Khan, Net Ram Garg, Geeta Jain

Abstract:

In this paper, Backstepping method is proposed to synchronize two fractional-order systems. The simulation results show that this method can effectively synchronize two chaotic systems.

Keywords: Backstepping method, Fractional order, Synchronization.

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21 Supplier Selection Criteria and Methods in Supply Chains: A Review

Authors: Om Pal, Amit Kumar Gupta, R. K. Garg

Abstract:

An effective supplier selection process is very important to the success of any manufacturing organization. The main objective of supplier selection process is to reduce purchase risk, maximize overall value to the purchaser, and develop closeness and long-term relationships between buyers and suppliers in today’s competitive industrial scenario. The literature on supplier selection criteria and methods is full of various analytical and heuristic approaches. Some researchers have developed hybrid models by combining more than one type of selection methods. It is felt that supplier selection criteria and method is still a critical issue for the manufacturing industries therefore in the present paper the literature has been thoroughly reviewed and critically analyzed to address the issue.

Keywords: Supplier selection, AHP, ANP, TOPSIS, Mathematical Programming

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20 Is Management Science doing Enough to Improve Healthcare?

Authors: Lalit Garg, Sally McClean, Maria Barton

Abstract:

Healthcare issues continue to pose huge problems and incur massive costs. As a result there are many challenging problems still unresolved. In this paper, we will carry out an extensive scientific survey of different areas of management and planning in an attempt to identify where there has already been a substantial contribution from management science methods to healthcare problems and where there is a clear potential for more work to be done. The focus will be on the read-across to the healthcare domain from such approaches applied generally to management and planning and how the methods can be used to improvement patient care. We conclude that, since the healthcare domain significantly differs from traditional areas of management and planning, in some cases there is a need to modify the approaches so as to incorporate the complexities of healthcare, and fully exploit the potential for improvement.

Keywords: Management science, management and planning, transforming services, healthcare.

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19 A Hybrid Machine Learning System for Stock Market Forecasting

Authors: Rohit Choudhry, Kumkum Garg

Abstract:

In this paper, we propose a hybrid machine learning system based on Genetic Algorithm (GA) and Support Vector Machines (SVM) for stock market prediction. A variety of indicators from the technical analysis field of study are used as input features. We also make use of the correlation between stock prices of different companies to forecast the price of a stock, making use of technical indicators of highly correlated stocks, not only the stock to be predicted. The genetic algorithm is used to select the set of most informative input features from among all the technical indicators. The results show that the hybrid GA-SVM system outperforms the stand alone SVM system.

Keywords: Genetic Algorithms, Support Vector Machines, Stock Market Forecasting.

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18 An Enhanced Cryptanalytic Attack on Knapsack Cipher using Genetic Algorithm

Authors: Poonam Garg, Aditya Shastri, D.C. Agarwal

Abstract:

With the exponential growth of networked system and application such as eCommerce, the demand for effective internet security is increasing. Cryptology is the science and study of systems for secret communication. It consists of two complementary fields of study: cryptography and cryptanalysis. The application of genetic algorithms in the cryptanalysis of knapsack ciphers is suggested by Spillman [7]. In order to improve the efficiency of genetic algorithm attack on knapsack cipher, the previously published attack was enhanced and re-implemented with variation of initial assumptions and results are compared with Spillman results. The experimental result of research indicates that the efficiency of genetic algorithm attack on knapsack cipher can be improved with variation of initial assumption.

Keywords: Genetic Algorithm, Knapsack cipher, Key search.

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17 Audio Watermarking Using Spectral Modifications

Authors: Jyotsna Singh, Parul Garg, Alok Nath De

Abstract:

In this paper, we present a non-blind technique of adding the watermark to the Fourier spectral components of audio signal in a way such that the modified amplitude does not exceed the maximum amplitude spread (MAS). This MAS is due to individual Discrete fourier transform (DFT) coefficients in that particular frame, which is derived from the Energy Spreading function given by Schroeder. Using this technique one can store double the information within a given frame length i.e. overriding the watermark on the host of equal length with least perceptual distortion. The watermark is uniformly floating on the DFT components of original signal. This helps in detecting any intentional manipulations done on the watermarked audio. Also, the scheme is found robust to various signal processing attacks like presence of multiple watermarks, Additive white gaussian noise (AWGN) and mp3 compression.

Keywords: Discrete Fourier Transform, Spreading Function, Watermark, Pseudo Noise Sequence, Spectral Masking Effect

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16 Chitosan Functionalized [email protected] Core-Shell Nanomaterials for Targeted Drug Delivery

Authors: S. S. Pati, L. Herojit Singh, A. C. Oliveira, V. K. Garg

Abstract:

Chitosan functionalized Fe3O4-Au core shell nanoparticles have been prepared using a two-step wet chemical approach using NaBH4 as reducing agent for formation of Au in ethylene glycol. X-ray diffraction studies shows individual phases of Fe3O4 and Au in the as prepared samples with crystallite size of 5.9 and 11.4 nm respectively. The functionalization of the core-shell nanostructure with Chitosan has been confirmed using Fourier transform infrared spectroscopy along with signatures of octahedral and tetrahedral sites of Fe3O4 below 600cm-1. Mössbauer spectroscopy shows decrease in particle-particle interaction in presence of Au shell (72% sextet) than pure oleic coated Fe3O4 nanoparticles (88% sextet) at room temperature. At 80K, oleic acid coated Fe3O4 shows only sextets whereas the Chitosan functionalized Fe3O4 and Chitosan functionalized [email protected] core shell show presence of 5 and 11% doublet, respectively.

Keywords: Magnetic nanoparticles, [email protected] core shell, iron oxide, Au nanoparticles.

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15 Vision Based Hand Gesture Recognition

Authors: Pragati Garg, Naveen Aggarwal, Sanjeev Sofat

Abstract:

With the development of ubiquitous computing, current user interaction approaches with keyboard, mouse and pen are not sufficient. Due to the limitation of these devices the useable command set is also limited. Direct use of hands as an input device is an attractive method for providing natural Human Computer Interaction which has evolved from text-based interfaces through 2D graphical-based interfaces, multimedia-supported interfaces, to fully fledged multi-participant Virtual Environment (VE) systems. Imagine the human-computer interaction of the future: A 3Dapplication where you can move and rotate objects simply by moving and rotating your hand - all without touching any input device. In this paper a review of vision based hand gesture recognition is presented. The existing approaches are categorized into 3D model based approaches and appearance based approaches, highlighting their advantages and shortcomings and identifying the open issues.

Keywords: Computer Vision, Hand Gesture, Hand Posture, Human Computer Interface.

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14 An Evaluation of Barriers to Implement Reverse Logistics: A Case Study of Indian Fastener Industry

Authors: D. Garg, S. Luthra, A. Haleem

Abstract:

Reverse logistics (RL) is supposed to be a systematic procedure that helps in improving the environmental hazards and maintain business sustainability for industries. Industries in Indian are now opting for adoption of RL techniques in business. But, RL practices are not popular in Indian industries because of many barriers for its successful implementation. Therefore, need arises to identify and evaluate the barriers to implement RL practices by taking an Indian industries perspective. Literature review approach and case study approach have been adapted to identify relevant barriers to implement RL practices. Further, Fuzzy Decision Making Trial and Evaluation Laboratory methodology has been brought into use for evaluating causal relationships among the barriers to implement RL practices. Seven barriers out of ten barriers have been categorized into the cause group and remaining into effect group. This research will help Indian industries to manage these barriers towards effective implementing RL practices.

Keywords: Barriers, decision making trial and evaluation laboratory, fuzzy set theory, Indian industries, reverse logistics.

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13 Peeling Behavior of Thin Elastic Films Bonded to Rigid Substrate of Random Surface Topology

Authors: Ravinu Garg, Naresh V. Datla

Abstract:

We study the fracture mechanics of peeling of thin films perfectly bonded to a rigid substrate of any random surface topology using an analytical formulation. A generalized theoretical model has been developed to determine the peel strength of thin elastic films. It is demonstrated that an improvement in the peel strength can be achieved by modifying the surface characteristics of the rigid substrate. Characterization study has been performed to analyze the effect of different parameters on effective peel force from the rigid surface. Different surface profiles such as circular and sinusoidal has been considered to demonstrate the bonding characteristics of film-substrate interface. Condition for the instability in the debonding of the film is analyzed, where the localized self-debonding arises depending upon the film and surface characteristics. This study is towards improved adhesion strength of thin films to rigid substrate using different textured surfaces.

Keywords: Debonding, fracture mechanics, surface topology, thin film adhesion.

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12 A Generalized Approach for State Analysis and Parameter Estimation of Bilinear Systems using Haar Connection Coefficients

Authors: Monika Garg, Lillie Dewan

Abstract:

Three novel and significant contributions are made in this paper Firstly, non-recursive formulation of Haar connection coefficients, pioneered by the present authors is presented, which can be computed very efficiently and avoid stack and memory overflows. Secondly, the generalized approach for state analysis of singular bilinear time-invariant (TI) and time-varying (TV) systems is presented; vis-˜a-vis diversified and complex works reported by different authors. Thirdly, a generalized approach for parameter estimation of bilinear TI and TV systems is also proposed. The unified framework of the proposed method is very significant in that the digital hardware once-designed can be used to perform the complex tasks of state analysis and parameter estimation of different types of bilinear systems single-handedly. The simplicity, effectiveness and generalized nature of the proposed method is established by applying it to different types of bilinear systems for the two tasks.

Keywords: Bilinear Systems, Haar Wavelet, Haar ConnectionCoefficients, Parameter Estimation, Singular Bilinear Systems, StateAnalysis.

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11 Ranking of Performance Measures of GSCM towards Sustainability: Using Analytic Hierarchy Process

Authors: Dixit Garg, S. Luthra, A. Haleem

Abstract:

During recent years, the natural environment has become a challenging topic that business organizations must consider due to the economic and ecological impacts and increasing awareness of environment protection among society. Organizations are trying to achieve the goals of improvement in environment, low cost, high quality, flexibility and more customer satisfaction. Performance measurement frameworks are very useful to monitor the performance of any organization. The basic goal of this paper is to identify performance measures and ranking of these performance measures of GSCM performance measurement towards sustainability framework. Five perspectives (Environment, Economic, Social, Operational and Cost performances) and nineteen performance measures of GSCM performance towards sustainability have been have been identified from extensive literature review. Analytical Hierarchy Process (AHP) technique has been utilized for ranking of these performance perspectives and measures. All pair comparisons in AHP have been made on the basis on the experts’ opinions (selected from academia and industry). Ranking of these performance perspectives and measures will help to understand the importance of environmental, economic, social, operational performances and cost performances in the supply chain.

Keywords: Analytical Hierarchy Process (AHP), Green Supply Chain Management, Performance Measures (PM), Sustainability.

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10 Use of Agricultural Waste for the Removal of Nickel Ions from Aqueous Solutions: Equilibrium and Kinetics Studies

Authors: Manjeet Bansal, Diwan Singh, V.K.Garg, Pawan Rose

Abstract:

The potential of economically cheaper cellulose containing natural materials like rice husk was assessed for nickel adsorption from aqueous solutions. The effects of pH, contact time, sorbent dose, initial metal ion concentration and temperature on the uptake of nickel were studied in batch process. The removal of nickel was dependent on the physico-chemical characteristics of the adsorbent, adsorbate concentration and other studied process parameters. The sorption data has been correlated with Langmuir, Freundlich and Dubinin-Radush kevich (D-R) adsorption models. It was found that Freundlich and Langmuir isotherms fitted well to the data. Maximum nickel removal was observed at pH 6.0. The efficiency of rice husk for nickel removal was 51.8% for dilute solutions at 20 g L-1 adsorbent dose. FTIR, SEM and EDAX were recorded before and after adsorption to explore the number and position of the functional groups available for nickel binding on to the studied adsorbent and changes in surface morphology and elemental constitution of the adsorbent. Pseudo-second order model explains the nickel kinetics more effectively. Reusability of the adsorbent was examined by desorption in which HCl eluted 78.93% nickel. The results revealed that nickel is considerably adsorbed on rice husk and it could be and economic method for the removal of nickel from aqueous solutions.

Keywords: Adsorption, nickel, SEM, EDAX.

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9 Can Exams Be Shortened? Using a New Empirical Approach to Test in Finance Courses

Authors: Eric S. Lee, Connie Bygrave, Jordan Mahar, Naina Garg, Suzanne Cottreau

Abstract:

Marking exams is universally detested by lecturers. Final exams in many higher education courses often last 3.0 hrs. Do exams really need to be so long? Can we justifiably reduce the number of questions on them? Surprisingly few have researched these questions, arguably because of the complexity and difficulty of using traditional methods. To answer these questions empirically, we used a new approach based on three key elements: Use of an unusual variation of a true experimental design, equivalence hypothesis testing, and an expanded set of six psychometric criteria to be met by any shortened exam if it is to replace a current 3.0-hr exam (reliability, validity, justifiability, number of exam questions, correspondence, and equivalence). We compared student performance on each official 3.0-hr exam with that on five shortened exams having proportionately fewer questions (2.5, 2.0, 1.5, 1.0, and 0.5 hours) in a series of four experiments conducted in two classes in each of two finance courses (224 students in total). We found strong evidence that, in these courses, shortening of final exams to 2.0 hrs was warranted on all six psychometric criteria. Shortening these exams by one hour should result in a substantial one-third reduction in lecturer time and effort spent marking, lower student stress, and more time for students to prepare for other exams. Our approach provides a relatively simple, easy-to-use methodology that lecturers can use to examine the effect of shortening their own exams.

Keywords: Exam length, psychometric criteria, synthetic experimental designs, test length.

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8 Development and in vitro Characterization of Self-nanoemulsifying Drug Delivery Systems of Valsartan

Authors: P. S. Rajinikanth, Yeoh Suyu, Sanjay Garg

Abstract:

The present study is aim to prepare and evaluate the selfnanoemulsifying drug delivery (SNEDDS) system of a poorly water soluble drug valsartan in order to achieve a better dissolution rate which would further help in enhancing oral bioavailability. The present research work describes a SNEDDS of valsartan using labrafil M 1944 CS, Tween 80 and Transcutol HP. The pseudoternary phase diagrams with presence and absence of drug were plotted to check for the emulsification range and also to evaluate the effect of valsartan on the emulsification behavior of the phases. The mixtures consisting of oil (labrafil M 1944 CS) with surfactant (tween 80), co-surfactant (Transcutol HP) were found to be optimum formulations. Prepared formulations were evaluated for its particle size distribution, nanoemulsifying properties, robustness to dilution, self emulsication time, turbidity measurement, drug content and invitro dissolution. The optimized formulations are further evaluated for heating cooling cycle, centrifugation studies, freeze thaw cycling, particle size distribution and zeta potential were carried out to confirm the stability of the formed SNEDDS formulations. The prepared formulation revealed t a significant improvement in terms of the drug solubility as compared with marketed tablet and pure drug.

Keywords: Self Emulsifying Drug Delivery System, Valsartan, Bioavailability, poorly soluble drug.

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7 Optimization of Wire EDM Parameters for Fabrication of Micro Channels

Authors: Gurinder Singh Brar, Sarbjeet Singh, Harry Garg

Abstract:

Wire Electric Discharge Machining (WEDM) is thermal machining process capable of machining very hard electrically conductive material irrespective of their hardness. WEDM is being widely used to machine micro scale parts with the high dimensional accuracy and surface finish. The objective of this paper is to optimize the process parameters of wire EDM to fabricate the micro channels and to calculate the surface finish and material removal rate of micro channels fabricated using wire EDM. The material used is aluminum 6061 alloy. The experiments were performed using CNC wire cut electric discharge machine. The effect of various parameters of WEDM like pulse on time (TON) with the levels (100, 150, 200), pulse off time (TOFF) with the levels (25, 35, 45) and current (IP) with the levels (105, 110, 115) were investigated to study the effect on output parameter i.e. Surface Roughness and Material Removal Rate (MRR). Each experiment was conducted under different conditions of pulse on time, pulse off time and peak current. For material removal rate, TON and Ip were the most significant process parameter. MRR increases with the increase in TON and Ip and decreases with the increase in TOFF. For surface roughness, TON and Ip have the maximum effect and TOFF was found out to be less effective.

Keywords: Micro Channels, Wire Electric Discharge Machining (WEDM), Metal Removal Rate (MRR), Surface Finish.

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6 Influence of Valve Lift Timing on Producer Gas Combustion and Its Modeling Using Two-Stage Wiebe Function

Authors: M. Sreedhar Babu, Vishal Garg, S. B. Akella, Shibu Clement, N. K. S Rajan

Abstract:

Producer gas is a biomass derived gaseous fuel which is extensively used in internal combustion engines for power generation application. Unlike the conventional hydrocarbon fuels (Gasoline and Natural gas), the combustion properties of producer gas fuel are much different. Therefore, setting of optimal spark time for efficient engine operation is required. Owing to the fluctuating tendency of producer gas composition during gasification process, the heat release patterns (dictating the power output and emissions) obtained are quite different from conventional fuels. It was found that, valve lift timing is yet another factor which influences the burn rate of producer gas fuel, and thus, the heat release rate of the engine. Therefore, the present study was motivated to estimate the influence of valve lift timing analytically (Wiebe model) on the burn rate of producer gas through curve fitting against experimentally obtained mass fraction burn curves of several producer gas compositions. Furthermore, Wiebe models are widely used in zero-dimensional codes for engine parametric studies and are quite popular. This study also addresses the influence of hydrogen and methane concentration of producer gas on combustion trends, which are known to cause dynamics in engine combustion.

Keywords: Combustion Duration, crank angle, mass fraction burnt, producer gas, wiebe combustion model, wide open throttle.

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5 Seismic Retrofitting of RC Buildings with Soft Storey and Floating Columns

Authors: Vinay Agrawal, Suyash Garg, Ravindra Nagar, Vinay Chandwani

Abstract:

Open ground storey with floating columns is a typical feature in the modern multistory constructions in urban India. Such features are very much undesirable in buildings built in seismically active areas. The present study proposes a feasible solution to mitigate the effects caused due to non-uniformity of stiffness and discontinuity in load path and to simultaneously hold the functional use of the open storey particularly under the floating column, through a combination of various lateral strengthening systems. An investigation is performed on an example building with nine different analytical models to bring out the importance of recognising the presence of open ground storey and floating columns. Two separate analyses on various models of the building namely, the equivalent static analysis and the response spectrum analysis as per IS: 1893-2002 were performed. Various measures such as incorporation of Chevron bracings and shear walls, strengthening the columns in the open ground storey, and their different combinations were examined. The analysis shows that, in comparison to two short ones separated by interconnecting beams, the structural walls are most effective when placed at the periphery of the buildings and used as one long structural wall. Further, it can be shown that the force transfer from floating columns becomes less horizontal when the Chevron Bracings are placed just below them, thereby reducing the shear forces in the beams on which the floating column rests.

Keywords: Equivalent static analysis, floating column, open ground storey, response spectrum analysis, shear wall, stiffness irregularity.

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4 An Evaluation of Drivers in Implementing Sustainable Manufacturing in India: Using DEMATEL Approach

Authors: D. Garg, S. Luthra, A. Haleem

Abstract:

Due to growing concern about environmental and social consequences throughout the world, a need has been felt to incorporate sustainability concepts in conventional manufacturing. This paper is an attempt to identify and evaluate drivers in implementing sustainable manufacturing in Indian context. Nine possible drivers for successful implementation of sustainable manufacturing have been identified from extensive review. Further, Decision Making Trial and Evaluation Laboratory (DEMATEL) approach has been utilized to evaluate and categorize these identified drivers for implementing sustainable manufacturing in to the cause and effect groups. Five drivers (Societal Pressure and Public Concerns; Regulations and Government Policies; Top Management Involvement, Commitment and Support; Effective Strategies and Activities towards Socially Responsible Manufacturing and Market Trends) have been categorized into the cause group and four drivers (Holistic View in Manufacturing Systems; Supplier Participation; Building Sustainable culture in Organization; and Corporate Image and Benefits) have been categorized into the effect group. “Societal Pressure and Public Concerns” has been found the most critical driver and “Corporate Image and Benefits” as least critical or the most easily influenced driver to implementing sustainable manufacturing in Indian context. This paper may surely help practitioners in better understanding of these drivers and their priorities towards effective implementation of sustainable manufacturing.

Keywords: Drivers, Decision Making Trial and Evaluation Laboratory (DEMATEL), India, Sustainable Manufacturing (SM).

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3 Performance Analysis of Chrominance Red and Chrominance Blue in JPEG

Authors: Mamta Garg

Abstract:

While compressing text files is useful, compressing still image files is almost a necessity. A typical image takes up much more storage than a typical text message and without compression images would be extremely clumsy to store and distribute. The amount of information required to store pictures on modern computers is quite large in relation to the amount of bandwidth commonly available to transmit them over the Internet and applications. Image compression addresses the problem of reducing the amount of data required to represent a digital image. Performance of any image compression method can be evaluated by measuring the root-mean-square-error & peak signal to noise ratio. The method of image compression that will be analyzed in this paper is based on the lossy JPEG image compression technique, the most popular compression technique for color images. JPEG compression is able to greatly reduce file size with minimal image degradation by throwing away the least “important" information. In JPEG, both color components are downsampled simultaneously, but in this paper we will compare the results when the compression is done by downsampling the single chroma part. In this paper we will demonstrate more compression ratio is achieved when the chrominance blue is downsampled as compared to downsampling the chrominance red in JPEG compression. But the peak signal to noise ratio is more when the chrominance red is downsampled as compared to downsampling the chrominance blue in JPEG compression. In particular we will use the hats.jpg as a demonstration of JPEG compression using low pass filter and demonstrate that the image is compressed with barely any visual differences with both methods.

Keywords: JPEG, Discrete Cosine Transform, Quantization, Color Space Conversion, Image Compression, Peak Signal to Noise Ratio & Compression Ratio.

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2 Development and Evaluation of a Nutraceutical Herbal Summer Drink

Authors: Munish Garg, Vinni Ahuja

Abstract:

In the past few years, high consumption of soft drinks has attracted negative attention world-wide due to its possible adverse effects, leading the health conscious people to find alternative nutraceutical or herbal health drinks. In the present study, a nutraceutical soft drink was developed utilizing some easily available and well known traditional herbs having nutritional potential. The key ingredients were selected as bael, amla, lemon juice, ashwagandha and poppy seeds based on their household routine use in the summer with proven refreshing, cooling and energetic feeling since ages. After several trials made, the final composition of nutraceutical summer soft drink was selected as most suitable combination based on the taste, physicochemical, microbial and organoleptic point of view. The physicochemical analysis of the prepared drink found to contain optimum level of titratable acidity, total soluble solids and pH which were in accordance of the commercial recommendations. There were no bacterial colonies found in the product therefore found within limits. During the nine point’s hedonic scale sensory evaluation, the drink was strongly liked for colour, taste, flavour and texture. The formulation was found to contain flavonoids (80mg/100ml), phenolics (103mg/100ml), vitamin C (250mg/100ml) and has antioxidant potential (75.52%) apart from providing several other essential vitamins, minerals and healthy components. The developed nutraceutical drink provides an economical and feasible option for the consumers with very good taste combined with potential health benefits. The present drink is potentially capable to replace the synthetic soft drinks available in the market.

Keywords: Herbal drink, nutraceuticals, summer drink, antioxidant.

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1 Outcomes of Pregnancy in Women with TPO Positive Status after Appropriate Dose Adjustments of Thyroxin: A Prospective Cohort Study

Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

Abstract:

This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: Antinuclear antibody, Subclinical hypothyroidism, Thyroxin, TPO antibody.

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