Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN-0001November30General SciencesVALORIZATION OF A CAMEROONIAN SPECIES: MOABI (BAILLONELLA TOXISPERMA Pierre) INTO ACTIVATED CARBONS English0110 Richard MponEnglish Joseph Ketcha MbadcamEnglishMorvan Clotaire Nko o AbuibotoEnglishJerome AvomEnglishPlacide Desire Belibi BelibiEnglishActivated carbons have been prepared from the chips of Moabi by chemical activation. We first carried out the chemical characterization (chemical composition, functional groups) of the chips of Moabi.The chemical characterization gave us extends of cellulose (40.5%) and lignin (29.6%) while an average pore volume is equal to 52.1% and its degree of crystallinity founded is 52%.We also characterize the sample with the scanning electron microscopy. Secondly, the optimizations of conditions for preparation have been done. The parameters investigated concerned temperature (600 and 700°C), heating rate(1 and 3°C), the residence time ( 2 and 5 hours) for the carbonization process while, the concentration of NaOH (20%, 40% and 60%), the time of the impregnation (2 and 6hours) and the impregnation ratio of biomass/reagent(NaOH)(1/20 and 1/15) for the activation process. The calculation of the iodine numbers conducted to choose the best conditions of preparation of our activated carbons. The optimum conditions retained were: 700°C, 1°C/min and 2 hours for carbonization process and 20%, 2 hours and 1/15 for activation process, which gave us the iodine number of 629 ± 13mg/g. This Iodine number obtained is compared to those of commercial activated carbons EnglishOptimization, activated carbon, moabi, chemical activation, iodine number.INTRODUCTION Since the 19th century, charcoal has been replaced by news energies sources (petroleum, nuclear energy)1. Nuclear disasters and depletion of petroleum resources have giving a lot of interest to the use of charcoal. During the last two decades, industrials and researchers turned back to agricultural and forestry wastes to prepare charcoal which can constitute an alternative solution to those problems cited above. This waste has the advantage to be environmental friendly, renewable, abundant and available in a lot of form and quantity. Among the charcoals, special attention is paid to the activated carbon because they are highly porous, carbon adsorbents, hydrophobic and non polar. Activated carbon is highly demand in the industry for its reductive, adsorbent and dehydrated properties. The activated carbon can be obtained by chemical or physical activation of biomass material. The chemical activation of plant material in order to obtain activated carbon has been the subject of many studies1-5. The advantage of chemical activation is to operate at low carbonization temperatures and obtain large specific surface areas. Nowadays, activated carbons are widely used in the extraction of chemical species in the aqueous or in the gas phase due to their excellent adsorption capacity due to their large specific surface area and porosity development. Thus, activated carbons have a privileged place in the purification of water, fading sugars, recovery of volatile solvents, dyes fixing and gas treatment6-10.  In the present work, we report the preparation of activated carbons from the chips of Moabi using NaOH as activating agent. The objective of the study is twofold. Firstly, it is to optimize the factors influencing the carbonization and activation with NaOH solution. On the other hand, we want to valorize the residues of Moabi which is abundant but less used locally. The purpose of this study is to obtain activated carbons from heavy wood, as performing as those already marketed. MATERIALS AND METHODS Sampling and characterisation The chips of moabi used in this study were collected from a Small and Medium Enterprise (ETS BOIS EQUATORIAL) in Yaoundé (Cameroon). The chips of Moabi still wet were oven dried at 110°C and store in the polyethylene bag. One part of them were converted into sawdust with diameter less than or equal to 0.40 mm using a mill blade RETSCH SM100. We characterized the sawdust chemically by CTFT (Centre Technique Forestier Tropical) protocols and standard French T12011 and the physical properties including the density following IAWA (International Association of Wood Anatomists) Code. The density is given by formula:    where m1,  m2, m3(g) represent respectively the mass of the tank filled with water, the mass of a sample of dry material and the mass of flask containing water and the sample. Humidity ratio was also determined according to standard French T12011. Average pore volume (C) has been determined by the formula:   Where  ρ0: specific density of dry wood (g/cm3) and γs: specific weight of the timber without pores (1.5 g/cm3). Infra-Red spectrum were recorded with an Infra-Red Fourier Transform Spectroscopy in Diffuse Reflection mode on KBr pellets made of 15 % clay in oven-dried KBr using a Bruker, IFS 55 spectrometer. The spectrum, recorded from 4000 cm-1 to 600 cm-1 with a resolution of 4 cm-1, was obtained by accumulating 200 scans. The XRD analysis was done on a Bruker AXS model D8 Advance diffractometer, with Cu-Kα radiation, under 40 kV and 30 mA operating conditions, to identify the constituent phases of the whole bulk samples. The data were recorded between 2° and 45° for whole-bulk samples using a step scan 0.02° and a step time of 2.0 s .The powder mounts were prepared through gentle hand mortar grinding (~1g of bulk wood) until the particle size was decreased below Ø< 250µm, and placed afterwards on sample holder, with gentle pressure so as to limit any orientation. The XRD analysis can be used to determine the degree of crystallinity with the formula:   Where I002 is the maximal intensity of diffraction pick of (002) plan and Iam the intensity of the sample amorphous phase. The morphological characterisation of the sample was also done by the scanning electron microscope (SEM) using Philips apparatus. Optimization of parameters of preparation Carbonization process The factors studied were: the carbonization temperature, the heating rate and the residence time. As part of our work where the production of charcoal is to promote, the slow pyrolysis technique is the most interesting. We define two levels for each factor studied (Tableau IV) The study of the thermal parameters of screening is performed on four samples of our raw material. We establish the following test matrix (Table V) Preparation procedure of charcoals Charcoals were prepared according to the following experimental protocol: The chips were dried for 24 hours in an oven at 110°C. The oven dried chips were then carbonized in a closed reactor (in the absence of oxygen) placed in a furnace with the require heating rate, to the known carbonization temperature, until the precise residence time. After cooling, the charcoals obtained were first ground and sieved to obtain an 80µm fraction (diameter ≤ 80 µm). This fraction was oven dried for 24 hours at 110 ° C and stored in sealed containers placed in a desiccator until they were ready to be studied. Charcoals obtained were characterized by measuring their iodine number. The experimental setup used is an ISUNI mark electric furnace with automatic regulation, having the temperature programmer relied to the furnace by a type K thermocouple and having a quartz reactor. This adsorption can be used to control the efficiency of the charcoal in the water treatment1.The adsorption of iodine from the aqueous phase is a useful tool for product control in the manufacture of activated carbon. The sample studied is characterized in terms of iodine number (mg/g) using iodine solution of 0,200±0,001 N. A volume of 20 ml of iodine solution was treated by 0,2000±0,0001g of activated carbon. After equilibrium, the waste iodine of the filtration was titrated by 0,1N of sodium thiosulfate. The formula11 as follows is used:                                                          (IV) Where mca(g): mass of activated carbon and Vn (ml): volume of sodium thiosulfate at equilibrium. Iodine and sodium thiosulfate used in this study are manufactured by Riedel-de-Haën. Optimization of the impregnation parameters The effect of the activating agent on the efficiency of the activated carbon obtained was studied through these factors: the concentration of the activating agent, the time of the impregnation and the ratio biomass/ impregnation solution. The activating agent used is NaOH. We define these levels for each factor studied (Table VI) The methodology of the experimental design provides the maximum information with the minimum experiments. This methodology carries out the complete study of the influence of all factors on the given process and its optimization12. We establish the following test matrix using the methodology cited above (Table VII). Preparation procedure of activated carbons Activated carbons were prepared according to the following experimental protocol: The chips were oven dried for 24 hours at 110°C. These chips were then treated for a limited time of the impregnation, in a NaOH aqueous solution of known concentration, in the precise Impregnation ratio of biomass/reagent. After the impregnation, the chips are drained in the open air for at least 12 hours before being carbonized in a closed reactor (in the absence of oxygen) placed in an electric furnace described above. Carbonization was carried out at the optimum thermal parameters determined above. After cooling, the charcoals obtained were washed with 5 % hydrochloric acid and distilled water, and finally dried. These charcoals were first ground and sieved to obtain a 80µm fraction (diameter ≤ 80 µm). This fraction was oven dried for 24 hours at 110°C and stored in sealed containers placed in a desiccator until they were ready to be studied. Activated carbons obtained were characterized by measuring their iodine number (mg/g) according to the protocol described above. RESULTS Characterisation of the raw material The chemical composition and the physical properties of the raw material are shown in tables I and II. Each value is the mean of three replications ± Standard Dispersion (SD) due to the variability of the biomass properties. Table III presents the infrared bands characteristic of wood species (Moabi). Its degree of crystallinity is 52% where the maximal intensity of diffraction pick situated at reticular plan indexed I002 around 2q002 = 22.5°C and the intensity at Iam at 2q002 =18°C. FTIR spectrum and X-ray diffractogram of Moabi are presented in figures I and II. Scanning electron microscopy (SEM) of Moabi is also presented in figure III Preparation of charcoals and activated carbons The parameters used for the preparation of the charcoals and the activated carbons are summarized in tables V and VII. The iodine number of a commercial activated carbon indexed F100 prepared by CHEMV society from bitu Coal with 0.8 -1.0 mm of granulometry and 900m2/g of BET surface area is found at 838 ± 13 mg/g. DISCUSSION Analysis of raw material (chips of Moabi) Carbonization of the raw material depends on the nature and the properties of biomass and can influence the adsorbent properties of the charcoals obtained. It depends on the degradation temperature of the components of the raw material. Thermal degradation of plants is the result of separated degradation20 of hemicelluloses within 200 and 260°C, cellulose within 240 and 350°C, lignin within 280 and 500°C. Then, carbonization temperature must be greater than this temperature range. This is why physicochemical characterization of the raw material is used to predict parameters in the pyrolysis process. Moreover, it is shown that the amount of charcoal is proportional to the fraction of lignin present in the biomass17. Moabi chemical composition displayed characteristics of tropical wood namely Lignin, cellulose, hemicelluloses, extractable and ash contents (Table I). Similar observations have been reported in the literature18 where chemical composition of Moabi have been studied by the laboratory of CTFT with cellulose (40.8–46.1 %), lignin (30.3–27.7 %), pentosans (15.7–14.0 %).There are some differences with the values of extractable and ash content, respectly 7.35 % and 0.33 %. The balance of the chemical composition shows that the rate of extractable of our species is high due to the fact that chemical composition of wood changes with species, age, part of plant and growing environment. The value of our density found in the present study shows that Moabi is a heavy wood which is in agreement with the literature16 while its X-ray Diffractogram revealed the semi-crystallynity nature of Moabi. The scanning electron microscopy (SEM) is used to characterise morphologically our sample before and after the activation process in order to show the effect of the chemical activation on the porosity. Effect of carbonization parameters Effects of temperature, heating rate and residence time on the carbonization was evaluated through the iodine number test. Increasing temperature from 600 to 700°C showed an increase iodine number from 127 to 152 mg/g when the residence time at the final temperature is 2 hours and the heating rate is 3°C/min.  This increasing temperature could been explained by the fact that at 600°C, the pores are not completely liberated by volatile components as observed by PORQUET2 in the preparation of activated carbons magnetisable from Oak . Minimum activation temperature exists for chosen heating rate and residence time. A further increase, in the residence time from 2 to 5 hours, when the carbonization temperature is 700°C and the heating rate 1°C/min illustrated a gradual decrease in iodine number from 159 to 108 mg/g. A longer residence time affected negatively the porosity of the charcoal. About 2 hours, the micropores are already completely liberated by volatile components. Similarly, increasing heating rate from 1 to 3°C/min showed a decrease in iodine number from 159 to 152 mg/g attributed by the fact that the rapid energy input does not homogeneously release micropores. Effect of the activating agent Effect of activating agent on the activation was investigated with its concentration, the time of impregnation and the ratio biomass/impregnation solution. Increasing concentration of the activating agent from 20 to 60 % resulted in a decrease in iodine number from 629 to 362 mg/g or from 559 to 438 respectively with the ratio biomass/impregnation solution of 1g/15ml or 1g/20ml when the time of impregnation is 2 hours. This increasing caused blockage of the pores leading to a dramatic decrease in accessible area. Additionally, increasing concentration would intensify a vigorous activation reaction, which leads to transition of micropores–mesopores into macropores lowering the charcoal yield as confirm by FOO19 in Microwave-assisted preparation and adsorption performance of activated carbon from biodiesel industry solid reside. The same phenomenon is ascribed when the biomass/impregnation solution goes from 1g/15ml to 1g/20ml with a decrease of iodine number. When the time of impregnation is 6 hours, increasing concentration of the activating agent from 20% to 60% indicated an increase in iodine number from 398 to 476 mg/g or from 360 to 502 mg/g respectively with the ratio biomass/impregnation solution of 1g/15ml or 1g/20ml. The values obtained are lower than those found at 2 hours of impregnation. This phenomenon can be explained by the fact that at 2 hours, transition of micropores-mesopores into macropores is completely achieved, and then iodine number decreases gradually at 6 hours. But, small increasing of iodine number at 6 hours of impregnation with concentration of activating agent can be explained by creation of new micropores available to iodine from ultramicropores. The iodine number of a commercial activated carbon indexed F100 prepared by CHEMV society from bitu Coal is found at 838 ± 13 mg/g. The best iodine number of the activated carbon obtained is 629± 13 mg/g. Then, better results can be obtained if the carbonization process was carried out by loading dried chips of Moabi into a tubular furnace19 and heating to a carbonization temperature of 700 °C under purified N2 flow (150 cm3/min), with heating rate and residence time respectively at 1°C/min  and 2 hours. CONCLUSION This work highlighted the feasibility of chips of Moabi as a promising precursor for the manufacture of activated carbon by chemical activation. Firstly, we have done the physicochemical and morphological characterisation of the raw material. Then, the methodology of the experimental research was used to optimize parameters (carbonization temperature, heating rate, residence time, concentration of the activating agent, time of impregnation, impregnation ratio) influencing the preparation of activated carbon.  Test on iodine number are carried out to examine the effectiveness of activated carbon obtained. The values of iodine number of the activated carbon obtained are compared favorably to those of commercial activated carbons. The study of the parameters influencing the preparation of activated carbon through the methodology of the experimental research allowed determining the optimums conditions of chemical activation of the chips of Moabi with NaOH solution. The optimum parameters of the carbonization found in this study are as follows: 700°C of carbonization temperature, 1°C/min of heating rate and 2 hours of residence time. The optimum parameters of activating agent (NaOH) are as follows: 20% of concentration, 2 hours of time of impregnation and 1g/15ml of ratio biomass/impregnation. Future studies should examine the characterisation of the activated carbon obtained into a determination of its BET surface area and pore size distribution. ACKNOWLEDGEMENT Authors thank Dr NDIKONTAR Maurice KOR of the Macromolecular Chemistry Laboratory of the University of Yaoundé I for the helpful discussions and Jacques MACHE for the results of X-ray diffraction and Infrared spectrum carried out in R.U. geology of Liege in Belgium. Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript.  Englishhttp://ijcrr.com/abstract.php?article_id=1369http://ijcrr.com/article_html.php?did=1369 Avom, J., Contribution à la valorisation de l’Ayous (Triplochiton scleroxylon), de l’Akom (Terminalia superba) et des rafles de régimes de palmes : Carbonisation-Activation – Propriétés adsorbantes : Application au traitement de l’eau, Thèse de Doctorat d’Etat, 2004, Université de Yaoundé I, Yaoundé, Cameroun. Porquet, C., Preparation of activated carbons magnetisable, Ph.D. thesis, Specialty Industrial Process Engineering, 1999, University of Technology of Compiegne (France). Sido-Pabyam M., Gueye M., Blin J. and Some E., Biomass residue valorization into activated charcoal - Efficiency tests on bacteria and pesticides, Sud Sciences & Technologies, 2009, 17, p. 65-73 Mukana W. M. and Kifuani M. K., Preparation of activated carbon from sugarcane, sawdust wood Ntola and Lifaki treated in solutions of phosphoric acid or caustic soda, Rev.Cong.Sc. Nucl., 2000, 16.1, 93 - 102.. Anwar E., Reactivity and thermal degradation kinetics of wood argan - Application to the preparation of activated carbon by chemical activation with phosphoric acid, PhD Thesis, University Mohammed V-Agdal (Morocco). Houas A., Bakir I., Ksibi, M. and Elaloui, E. Etude de l’élimination de bleu de méthylène dans l’eau par le charbon actif commercial CECA40, J. Chim. Phys., 1999, 96, p. 479-486. Avom J., Ketcha Mbadcam J., Noubactep C and Germain P., Adsorption of methylene blue from an aqueous solution on to activated carbons from an aqueous solution, Carbon, 1997, 35, 3, 365 – 369. Sahel M. and Ferrandon-D. O., Dynamic adsorption on activated carbon in the liquid phase: comparison and simplification of different models, Journal of Water Science, 1993, vol. 6, n° 1, p. 63-80. Ketcha M. J., Manga N. H.,, Tcheka C., Ntieche R. A., Djoyo H. S. and Kouotou D.,  Batch Equilibrium Adsorption of Cyanides from Aqueous Solution onto Copper- and Nickel-Impregnated Powder Activated Carbon and Clay, Journal of Environmental Protection Science, 2009, Vol. 3, pp. 53 – 57. Lee W.H. and Reucroft P.J., Vapor adsorption on coal and wood-based chemically activated carbons (II) adsorption of organic vapors, Carbon, 1999, 37, 1, 15-20. Gueye M., Blin J., Brunschwig C Etude de la synthèse des charbons actifs à partir des biomasses locales par activation chimique avec H3PO4, Comptes Rendus des Journées Scientifiques du 2iE, 2011, 6. Goupy J., The method of experimental design: optimizing the choice of testing and interpretation of results, Ed Dumod, Paris, 1996. Letelier M., Chemical, physical and mechanical characterization of elders pious, Graduation Project Engineer 3rd year, 2011-2012, University of Lorraine, France. Safou-Tchiama R., Physico-chemical characterization, supramolecular stability and chemical reactivity of some tropical species, Ph.D.Thesis,2005,Universityof Bordeaux I, France Kuo M.L., Mc Clelland F.F., Luo S., Chien P.L., Walker R.D., Hse C.Y., Application of infrared photoacoustic spectroscopy for wood samples, Wood and Fiber Science, 1988,  20, N°1, 132-145. Louppe D., Oteng-Amoako A.A. and Brink M., (editors), Plant Resources of Tropical Africa 7(1). Timbers 1, 2008, PROTA Foundation, Wageningen, Pays-Bas. p.107. Cosgrove D.J., Expansive growth of plant cell walls, Plant Physiol. Biochem., 38: 109 – 124. A.T.I.B.T., Revue Bois et Forêts des Tropiques, 1976, 169, p43 Foo K.Y. and Hameed, B.H., Microwave-assisted preparation and adsorption performance of activated carbon from biodiesel industry solid reside: influence of operational parameters. Bioresour. Technol., 2012, 103, 398–404. 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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN-0001November30General SciencesIN VITRO EVALUATION OF AFLATOXIN M1 CONTROL POTENTIAL OF SIX ESSENTIAL OILS IN BENIN English1119Philippe SessouEnglish Fidele TchoboEnglish Pascal AgbangnanEnglish Elvis AdjalianEnglish Paulin AzokpotaEnglish Issaka YoussaoEnglishSouaibou FarougouEnglishAflatoxin M1 (AFM1) is hepatocarcinogen frequently found in cheese. Its presence in this foodstuff constitutes a serious threat for consumers. The present study had evaluated aflatoxin M1 control potential of six essential oils against synthetic aflatoxin M1. It had consisted to blend Aflatoxin M1 diluted in acetonitrile (1μg/mL) with essential oil to achieve final concentrations of 2%, 4%, 6%, 8% and 10% of oil and to follow the disintegration of this AFM1 in the meantime of 30 minutes, 1, 2, 3, 4, 5 and 24 hours on silica gel with or without thin layer chromatography assay (TLC). The results obtained revealed that at the concentrations tested, no fluorescence was observed for the mixtures of Aflatoxin M1 with C. zeylanicum, P. racemosa and Syzygium aromaticum essential oils on silica gel without chromatography assay contrary to results obtained for the same mixtures after chromatography assay. The mixture of Cymbopogon citratus showed fluorescence with or without TLC assay. Pure extracts of Ocimum gratissimum and Zingiber officinale showed a green fluorescence. In sum, all the essential oils tested didn’t possess capacity to destroy AFM1 at concentrations investigated. Although, these extracts cannot be used for controlling aflatoxin M1, their potentiality for inhibiting mycotoxins production by moulds can be considered. EnglishAflatoxin M1, antiaflatoxin assay, essential oils, TLC assayINTRODUCTION Benin is underdeveloped country which produces milk with an output of 94 million liters in 2009 (FAO, 2010). Milk produced in Benin, instead of domestic consumption, is processed to many dairy products among which traditional cheese wagashi is the most consumed largely by rural than citizens populations due to its content in good source of many nutrients such as proteins and calcium (Dossou et al., 2006; Keke et al., 2008). However, Benin country has favourable warm and humid climate, socio-economic (ignorance of the toxin and poor infrastructure to manage mycotoxins prevention strategies) and compelling environmental (drought) factors that enhance the growth of aflatoxigenic fungi and subsequently aflatoxins production inside wagashi (Okeke et al., 2012; Sessou et al., 2012a, b). Aflatoxins are toxic fungal metabolites produced by Aspergillus species, mainly by Aspergillus flavus and Aspergillus parasiticus, but also by Aspergillus nomius, Aspergillus pseudotamarii, Aspergillus ochraceus (IARC, 2012; Siddappa et al., 2012). Aflatoxins consist of a group of approximately 20 related metabolites, among which aflatoxins B1, B2, G1 and G2 are often found in foods. Aflatoxin B1 (AFB1) is metabolized by the animals consuming these contaminated feeds to AFM1 mainly by the hepatic microsomal mixed-function oxidase system (Siddappa et al., 2012). Aflatoxin M1 (AFM1) was classified by the International Agency for Research on Cancer (IARC) as a group 1 human carcinogen (IARC, 2012, Okeke et al., 2012). Thus, its potential risk to human health makes its presence in milk products such as cheese wagashi undesirable. AFM1 is unaffected by pasteurization and ultra-high-temperature (UHT) treatment (Tekinsen and Eken, 2008). Alternative methods for its control are needed to be performed. The control or disintegration of AFM1 by natural agents as essential oils, safe for human (Burt, 2004) in order to reduce or eliminate this toxic metabolite in wagashi eventually contaminated is necessary for minimizing public health hazards. The objective of this work was to evaluate aflatoxin M1 control potential of six essential oils extracted in Benin. MATERIAL AND METHODS Material was constituted of six essential oils extracted by hydrodistillation from Cinnamomum zeylanicum, Cymbopogon citratus, Ocimum gratissimum, Pimenta racemosa, Syzygium aromaticum and Zingiber officinale previously analyzed by GC/MS and GC/FID (table 1) and  Aflatoxin M1 ( 10 µg/mL in acetonitrile, Lot: LB 96767; 46319-U, quantity: 1 mL, Exp: Nov/2015; USA) purchased at SUPELCO  Analytical  society based at Unity State of America and diluted in acetonitrile to have final concentration of 1µg/mL which is used for the assay. The method used in this study was based on that described by Adjou et al. (2012a, b, c and 2013). It had consisted to mix Aflatoxin M1 diluted in acetonitrile (1µg/mL) with essential oil to achieve final concentrations of 2%, 4%, 6%, 8% and 10% of oil and to follow the inhibition or disintegration of this metabolite (AFM1) in the meantime of 30 minutes, 1, 2, 3, 4, 5 and 24 hours on silica gel without or after thin layer chromatography assay (TLC). Five microliter of mixture (Aflatoxin + essential oil) or pure extract of essential was spotted and air dried on TLC plates (TLC Silica gel 60 F254, Merck, Germany) and observed under long wave (365 nm) UV and then developed in the solvents system comprising TEF (Toluene/ethylacetate/Formic acid, 5:4:1 v/v/v) and CAP (Chloroform/acetone/2-propanol, 85:15:20, v/v/v), air dried and observed under long wave (365 nm) UV. RESULTS AND DISCUSSION The present study had investigated the potentiality of six essential to destroy Aflatoxin M1 in perspective for their use to control mycotoxins produced eventually inside traditional cheese wagashi. The results obtained from this work are prsented in figures 1 to 5 and showed that these extracts studied didn’t possess capacity to decontaminate food contaminated by aflatoxin M1. In fact, results obtained from this study revealed that at the concentrations tested, no fluorescence was observed for the mixtures of Aflatoxin M1 with Cinnamomum zeylanicum, Pimenta racemosa and Syzygium aromaticum essential oils on silica gel without chromatography assay contrary to results obtained for the same mixtures after chromatography assay. Indeed, these extracts had masked the fluorescence of Aflatoxin M1 when mixed together and spotted on TLC plate and observed under UV light 365 nm without tthin layer chromatography assay (figure1). Based on theory of Adjou et al. (2012 a, b, c and 2013), we can conclude that our three extracts C. zeylanicum, P. racemosa and S. aromaticum possessed antiaflatoxin M1 potential. But this conclusion will be wrong when we consider the elution of these mixtures which showed the fluorescence at the same bright with the standard AFM1 spotted (figure 2 to 5). The masking of fluorescence of Aflatoxin M1 when mixed with extracts of C. zeylanicum, P. racemosa and S. aromaticum could be explained by a reaction of components of these oils with the fluorescence pole of Aflatoxin M1 which is not inevitably sinonymous of the destroying of the toxic metabolite. These extracts may possess capacity to inhibit production of mycotoxins produced by toxinogenic moulds.  The mixture of Cymbopogon citratus showed fluorescence either with or without TLC assay. This last pure oil (C. citratus) with no fluorescence when spotted on TLC plate had not capacity to mask the aflatoxin M1 fluorescence when mixed together with the toxic metabolite. Pure extracts of Ocimum gratissimum and Zingiber officinale spotted alone showed a green fluorescence on silica gel without TLC assay and didn’t allow appreciating their activity at this step (figure 1). The present study had shown that the works of Adjou et al. (2012a,b,c and 2013) concerning the appreciation of aflatoxigenic inhibition potential of extracts based on their ability to inhibit fluorescence of aflotoxins presents insufficiencies. In fact, these authors have wrongly exploited the method of Nguyen (2007) and Atanda et al. (2011) whose works were made not for evaluating the aflatoxin production inhibition by extracts but for the capacity of strains of Aspergillus to produce aflatoxins revealed by fluorescence of these metabolites under UV light. Our work showed that the inhibition of fluorescence of the metabolite is not inevitably synonymous of capacity of extract to inhibit the metabolite production of toxinogenic fungus which normally grows. Also, the appearance of fluorescence after observing the mixture of essential oil plus the metabolite in culture medium is not synonymous of incapacity of extract to possess antiaflatoxin inhibition potential. Indeed, our study showed that the pure extracts of O. gratissimum and Z. officinale spotted alone showed green fluorescence. As recommendation, before conclude that the extracts possess antiaflatoxin inhibition potential based on inhibition of fluorescence, the previous authors (Adjou et al) must complete their work by proceeding to the detection and the quantification of the aflatoxins in the whole culture medium composed of extract, toxinogenic fungus which had its metabolite fluorescence inhibited or not. As alternative methods to detected capacity of mycotoxins production inhibition by essential oils, that described by Singh et al. (2010), Prakash et al. (2012a, b, c) and Shukla et al. (2012) are scientifically efficient and appropriate. In sum, this study showed that essential oils of C. zeylanicum, C. citratus, O. gratissimum, P. racemosa, S. aromaticum and Z. officinale didn’t possess potential to destroy aflatoxin M1 when presented inside food. Also, it showed that the appreciation of inhibitory aflatoxin production potential of essential oils based on their ability to inhibit fluorescence of metabolites produced by toxinogenic moulds presents more insufficiencies.   CONCLUSION The work has assessed the potential of six essential oils to control aflatoxin M1 in perspective to their use to destroy this toxic metabolite inside cheese wagashi contaminated. Results obtained showed that these extracts had not potential to disintegrate AFM1 at concentrations investigated. However, these extract especially C. zeylanicum, P. racemosa and S. aromaticum can be considered as promising extract for mycotoxins production inhibition. ACKNOWLEDGMENTS The authors are grateful to University Council of Development (CUD) for its financial support. They are also thankful to Professor Dominique SOHOUNHLOUE for his scientific contributions. Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Englishhttp://ijcrr.com/abstract.php?article_id=1370http://ijcrr.com/article_html.php?did=13701. Adjou ES, Dahouenon - Ahoussi E, Degnon RG, Soumanou MM,  Sohounhloue DCK, 2012a. Bioefficacy of essential oil of Lantana Camara from Benin against the growth of fungi and aflatoxin production. Journal of Resent Advances in Agriculture 1(4): 112 - 121. 2. Adjou ES, Kouton S, Dahouenon - Ahoussi E,  Degnon GR,  Soumanou MM,  Sohounhloue DCK,  2012b. Investigations on bioactivity of essential oil of Ageratum conyzoides L., from benin against the growth of fungi and aflatoxin production. International Journal of Pharmaceutical Sciences Review and Research, 13(1):  143 - 148. 3. Adjou ES, Kouton S, Dahouenon - Ahoussi E, Sohounhloue DCK,  Soumanou MM, 2012c. Antifungal activity of Ocimum canum Essential oil against Toxinogenic Fungi isolated from Peanut Seeds in post-harvest in Benin. International Research Journal of Biological Science, 1(7): 20 - 26 4. Adjou ES, Kouton S, Dahouenon - Ahoussi E, Soumanou MM, Sohounhloue DCK,  2013. Effect of essential oil from fresh leaves of Ocimum gratissimum L. on mycoflora during storage of peanuts in Benin. 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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25General SciencesBIOENRICHMENT OF LIVE FEED DAPHNIA MAGNA FOR THE SURVIVAL AND GROWTH OF FRESHWATER FISH CATLA CATLA English2031S. MunirasuEnglish V. RamasubramanianEnglish V.UthayakumarEnglish S.MuthukumarEnglishDaphnia is the potential live feed available in small ponds and lakes. The present study is to evaluate the effect of the Daphnia magna enriched with different micro algae such as Spirulina platensis, Chlorella vulgaris and Spirogyra maximus on growth, survival and biochemical changes of freshwater fish Catla catla. The experimental fishes were fed with Spirulina enriched Daphnia (E1), Chlorella enriched Daphnia (E2), Spirogyra enriched Daphnia (E3), and unenriched Daphnia (E4) as a control and triplicates were maintained for each treatments. After 60 days, the growth rate, survival and Biochemical Compositions such as Protein, Lipids, carbohydrate, amino acids and fatty acids levels were measured. The highest survival rate was recorded as 99.17 % which corresponds to the highest growth rate of fish. Significant differences were observed (P < 0.05) in weight gain, Specific growth rate (SGR), Food conversion ratio (FCR) and Survival (%) (E1) between experimental and control groups. The fishes were fed with diet E1 (S.platensis) was highly significant (P< 0.05) with mean length (1.5 ?0.18 to 4.38 ?0.13) and mean weight (0. 0.210 ?0.01to 2.75 ?0.30) increase in weight gain 273.65% when compared to control (E4) fed fishes. The growth was estimated based on increase in biomass (1.91 + .007) and specific growth rate (3.12 ± 0.06). The Protein, Lipid and Carbohydrates were high in S.platensis enriched D.magna fed fishes. Hence we conclude that S.platensis enriched D.magna is a better food for the larval rearing of Commercial fish C. catla. EnglishSpirulina platensis, Chlorella vulgaris, Spirogyra maxima, Daphnia magna, Catla catla, Nutritional values. INTRODUCTION Live feeds are one of the major inputs in aquaculture. The success of fish farming depends on the adequate quality of nutritionally balanced feeds (Olsen et al., 1993); Most of the larviculture sector dependent on artemia is the primary food for larval nutrition (Mason 1974; Arthur 1976; Schmidt-Moser and Westphal 1980). The nutritional quality of live feeds can be improved by enriching them with exogenous source of nutrients. For freshwater fish larvae which have a very small mouth and swallow their prey in one bite the size of the nauplii is particularly critical. Cyclops and Daphnia are excellent food source, which could provide quality first feed for fish and crustaceans and the nutritional value on grown and adult D.magna is superior (Sorgeloos, 1980; Leger et al., 1986). The advantages of algae as a food is enormous as algal feeds are easy to culture and it is an excellent feed for the growth of zooplanktons (Bogdan and Gilbert, 1987).  Algae are alternative plant feedstuffs that are increasingly being used in aqua feeds because of their nutritional quality, low cost and availability (Mustafa and Nakagawa, 1995). The lower limit of the light intensity for the light type was about 1500 lux and the higher limit for the dim light type was about 1000 lux, although both limit intensities shifted to some extent depending on the freshwater macro algae biochemical investigations show Spirogyra to be rich in nutritive value (Venkataraman, Nigam and Ramanatham, 1980). Freshwater fish larvae, which is unable to synthesize essential amino acid DHA and EPA from the shorter PUFA, has precursor Linolenic acid (18:3n-3) which are required for larval growth and survival as well as contributing to egg and sperm quality when induced in brood stock. Algae are the main sources of highly unsaturated fatty acids (HUFA) for zooplankton (Witt et al., 1984; Kanazawa et al., 1985; Koven et al., 1992; Sargent et al., 1997). Enrichment or boosting of the aquatic feeds into the organisms has been incorporated in to the larval rearing protocols for many fish species (Sorgeloos et al., 1991). The best materials for enriching Daphnia are different micro algae and these are used because of its easy culturing and excellent food for fishes (Hassina Momotaj et al., 1986). Daphnia which is incapable of synthesizing highly polyunsaturated fatty acid and essential amino acids, it needs to be enriched by micro algal enrichment which contain high level of amino acid in particular, has high biological value during larval development. Catla catla is the fastest growing species (Ravi and Devaraj 1991). The aim of the present investigation is to evaluate the effect of D.manga enriched with different algae feeds phytoplankton’s (S. platensis, C. vulgaris and S.maxima) on survival and growth of C.catla. MATERIALS AND METHODS  The fresh water C. catla fries were collected from Bhavani sagar Government Fish Development Corporation, Erode district, Tamilnadu. They were transported safely and brought to the laboratory in well-oxygenated plastic bags. They were stocked in large cement tank (6’ × 4’ × 3’) and acclimatized to the laboratory condition for 2 weeks before the commencement of experiments. During acclimatization, C. catla were fed with live unenriched D.magna. Water was routinely changed every day in order to maintain a healthy environment for the fishes apart from providing artificial aeration. This ensures sufficient oxygen supply for the fishes and an environment devoid of accumulated metabolic wastes. Experimental Setup The fresh water fish’s C. catla with initial length of 1.2±0.5 cm and initial weights 0.13±0.08g were used. The experimental period was restricted to 60 days. Each experimental trough contained 40L of water capacity. The experimental groups were fed with different algae, Fishes were fed with Spirulina platensis, enriched Daphnia - (E1), Fishes were fed with Chlorella vulgaris enriched Daphnia - (E2), Fishes were fed with Spirogyra maximus enriched Daphnia - (E3), Control fishes were fed with unenriched Daphnia – (E4). Before initializing the experiment, the initial length and weight of the animals were measured; similarly at the end of this experiment (on 60th day) the final length and weight were measured. Similar experimental setup was maintained for several times to study various parameters.  Phytoplankton culture  In the present study important algae such as S. platensis, C. vulgaris and S.maxima were cultured to enrich the Zooplankton (D.magna). Collection of phytoplankton The experimental micro algae, S. platensis and C. vulgaris pure culture were obtained from Antenna Green Trust, Antheneri village, Kadachanenthal, Madurai, Tamilnadu. The Spirogyra cultures were collected from IRTC, Palakkad, Kerala. The pure cultures were transferred in oxygen filled polyethylene covers for proper aeration. Culture of Spirulina platensis The pure Spirulina cultures were poured into the 24 L plastic tubs and were placed in sun light. Several physico-chemical parameters were maintained in culture medium for the proper culture of Spirulina, such as pH, temperature and dissolved solids. The parameters were checked at every two days interval. Proper aeration was provided through aerators for proper mixing of chemicals and proper growth of Spirulina. Culture of Chlorella vulgaris The fresh water green C.vulgaris were cultured in Aquarium tanks. The salt ingredients were dissolved in Ground water. After that, cow dung was mixed with water and filtered with the nylon cloth. The filtrate was put in the culture and mixed well during the culture period.  The pH was maintained at 8 and no aeration was provided. The pure C.vulgaris culture were poured into the 24 L plastic tubs and placed in sun light. The culture medium was stirred twice daily for proper distribution of chemicals and good aeration such as pH, temperature, and dissolved solids. to prevent sedimentation and a homogenous exposure of algal cells to light; reduce the nutrient and temperature gradient along depth of culture. Culture of Spirogyra maxima The samples were collected just below the water surface in 500 ml plastic containers with screw caps. The Spirogyra was collected and washed thoroughly to remove the adhering dirt. pH of the medium was adjusted to 6.5. Soil-water medium with its variations was excellent for long-term preservation and normal morphology of the above culture. Calculation of Growth rate in Phytoplankton After the 20 days S. platensis, C. vulgaris and S.maxima can be viewed as a thin layer on the surface of the medium. At this stage the Spirulina cell count may be calculated by the following equation, Where, Nt = final density of phytoplankton,   No = Initial density of phytoplankton  t = time interval between the initial and final density estimated In = Individual animals, r = Growth rate. Procedures were repeated in several tubs and required quantities of phytoplankton were cultivated. Harvesting of phytoplankton Productivities rarely exceed 30-200 gm per day and cell densities of 2g/ L. The Spirulina and Chlorella were harvested by filtration through meshes having size about 10µm. After harvesting, the algal biomass was dehydrated by sun during. The harvested Spirulina and Chlorella powders were stored in clean, and air tight containers. During weight measurements of algae powders were calculated in gram per liter by during the biomass in an oven at 105?C for two hours. This Spirulina powder was used to enrich the Daphnia. Harvesting and drying The cultured Spirogyra were filtered with the help of net of mesh size 30µm and washed thoroughly with the clean water and dried in a hot oven at 60?C. After drying Spirogyra were powdered into fine particles, properly weighed and then stored in clean containers for further use. Zooplankton culture The live feed of present investigation D.magna collected from Muthanna Lake, P.N.Pudur, Coimbatore, Tamil Nadu, and India. During collection period the dip net was swept through the surface water near the shore. Collected mixed zooplanktons were stored in a container. The sample was diluted (5 times) by adding water. Using the plankton net Daphnia were isolated from other zooplanktons. Transferred to a cement tank which was prefilled with soil (5 cm depth), poultry manure (0.4 kg/ton), lime powder (1 kg) and water of 15cm height for further culture. The density of Daphnia were calculated as follows Where Nt = Final density of the Daphnia, No = Initial density of Daphnia. t = time interval between the initial and final density estimation. In =Individual animals. Enrichment D.magna was enriched with S. platensis, C. vulgaris and S.maxima to feed the commercially important fish C.catla, cultured in laboratory. The 48 hours adult nauplii of Daphnia were fed with each type of food at same concentration 0.5 mg/ml/d. The powdered feeds are taken at 0.5 mg concentration, mixed with distilled water and stirred for 2-3 minutes vigorously. D.magna (50/ml) was introduced into 500ml culture flasks containing freshwater and mild aeration was provided. After 6 hours of enrichment D.magna (adult nauplii) were fed to experimental fishes (C. catla) twice a day. Daily observations were done.  After 60days, the final length, weight and percentage of survival were determined. Nutritional analysis Protein, lipid and carbohydrates were determined by the following methods. The basic procedures followed were for protein (Lowry et al., 1951), lipids (Folch et al., 1957) and carbohydrates (Roe 1987). Amino acids analysis Total Amino acid composition was determined using a High Performance Thin Layer Liquid Chromatography (Hess and Sherma, 2004). Fatty acid analysis Fatty Acid Analysis was done using Gas Chromatography described by Nichols et al.., 1995. Growth analysis The growth parameters were calculated by using the following formulae according to (Felix and Sudharsan 2004; Venkat et al. 2004). Statistical analysis Statistical analysis was performed using analysis of variance (One-way ANOVA) and Student’s t-test, to determine differences between experimental levels. Levels of significance are expressed as (P < 0.05). All analyses were performed using the Statistical Analysis System (SAS computer software, North Carolina, USA) program. RESULTS Physico-chemical parameters of rearing water Mean physico-chemical parameters like water temperature (ºC), dissolved oxygen       (mg l-1), pH, ammonia–nitrogen(mg1-1), residual chloride (mg1-1) and Fluoride (mg1-1), were recorded in ranges from (27.03±0.45 to 27.27±0.4 ºC), (5.4±0.4 to 5.7±0.6 mg 1-1), (7.9±0.22 to 8.3±0.8), (0.7 ± 0.02 to 1.0 ± 0.6 mg 1-1), (0.2 ± 0.82 to 0.8  ± 2.91 mg 1-1) and (1.0 ± 1.74-1.8 ± 0.72 mg1-1) respectively (Table 1). Biochemical analysis of experimental diets and tissues Chemical compositions of the experimental tissues were reported in (Table 2). Variation in the values of crude protein content of feed was (34.46±0.89 to 43.26±1.47 %), crude lipid content (15.03±1.08 to19.27±2.18) crude carbohydrate content (30.3±0.31 to 39.7±7.07), Ash Content (15.07±1.83 to 16.83±0.62) and Moisture content (68.93±1.82 to 73.82±0.68) recorded respectively. Tissue crude lipid content was recorded within the range of (3.27–3.6%). Growth parameters The growth parameters recorded in this experiment were presented in (Table 3). The S.platensis performed the best in all the growth-related parameters. The fish fed with diet E1 (S.platensis) showed a high significant (P< 0.05) mean length (1.5 ±0.18 to 4.38 ±0.13) and mean weight (0. 0.210 ±0.01to 2.73±0.30) and increase in weight gain 273.65% over control. The highest survival rates were recorded as 99.17 % which also corresponds to the highest growth rate of fish. Values are means of three replicates per treatment Values containing same superscript in a row do not vary significantly (P < 0.05) Values are means of three replicates per treatment Values containing same superscript in a row do not vary significantly (P< 0.05) Amino acid analysis using HPTLC The Protein and amino acid estimation of the different algae enriched D.magna fed fishes was carried out by using HPTLC.17 amino acids were found to be present in the fresh fed with a total of 12.57mg/g tissue (Table 4). The concentration of amino acids in the fishes fed with S.platensis enriched D.magna were of Arginin  2.55, Histidine 9.72, Isoleucine  4.69, Leucine  5.59, Lysine 4.56, Tryptophan 1.89, Threonine ,3.79, Valine 1.00, Cysteine 1.83, Methionine  2.20, Tyrosine 2.3, Phenylalanin 4.01, Glutamic acid 14.20, Glycine  2.00, Alanin  2.53, Proline  3.30 and Serine  4.03 and total amino acids were 70.19 % respectively. Fatty Acid Profile: Fatty acids Profile of C.catla fed with different phytoplankton enriched D.magna (Expressed in mole %) were tabulated in Table.5. In the S.platensis enriched D.magna the total saturated fatty acid content was (SFA) 46.95%, total MUFA was 23.49%, and total PUFA and HUFA was 42.04 %. The C.vulgaris enriched D.magna had total SFA  46.84%, total MUFA as 14.6%, total PUFA and HUFA as 41.5%. In the S.maxima enriched D.magna, the total SFA content was 43.82 %, total MUFA was 17.56%, total PUFA and HUFA was 39.35% and unenriched Daphnia had the total SFA as 45.87 %, total MUFA as 16.15%, total PUFA and HUFA as 36.74% respectively. DISCUSSION In the present study, variations in nutritional composition among planktons were observed.  The studies indicated that the sufficient densities of S.platensis are important for the normal growth and development of larval C.catla during the early development (Lu, J. and Takeuchi, T. 2004). The S.platensis contains high protein compared to C.vulgaris and S.maxima (Table 3). The biochemical composition of S.platensis revealed that they have high amount of protein between 55-70% depending on the source (Phang et al, 2000). S.platensis is rich in high quality protein, vitamins, minerals and many biologically active substances (Becker, 1994). S.platensis can be used in the diets of domestic animals (Vekataraman 1972). Despite on the high nutritive value of algae, little information has been published on their use as a protein source for fishes (Appler, 1985; Nakagawa et al., 1987; Cho and Kaushik, 1990). The present study recommends that algae enriched D.magna and copepod (M.aspericornis) can be exclusively used as an important alternate or supplementary feed for commercial seed production of C.catla. Larvae of nearly all marine and of many freshwater fish species require live feed organisms as first food  for many fish species live food still gives better results in terms of growth and survival than artificial diets (Dabrowski, 1984). After 60days of experiment the biochemical composition of fish enriched with S. platensis enriched Daphnia was found to contain maximum level of protein. These results indicated that S. platensis is best food for enrichment of D.magna suitable for the growth and survival of commercial fish C.catla (Nandeesh et al., 1993). There is great difference found between the feeds enriched fed fish and control. Protein is the most important and expensive component of the aquaculture diets. Protein is required in the diet to provide indispensable amino acids and nitrogen for synthesis of dispensable amino acids (Balazs and Ross., 1976; Colvin and Brand, 1977).  They supply the major portion of energy required by living cells. If a large percentage of the metabolic energy requirements of the animal can be met from the carbohydrate, it have the potential for delivering a low cost source of energy that could spare protein for growth (Cedric Simon, 2009). Lipids are substances found in both plants and animals (Harrison, 1990).  Lipids fall into two basic categories (glycerol-based and nonglycerol-based). The lipids are important sources of metabolic energy adenosine triphosphate (ATP) and are the most energy-rich of all classes of nutrients. (Teshima 1972; Pillay and Nair, 1973; Galois, 1984). Among the 17 Protein in body tissues, 10 amino acids are essential and  must be supplied through the  diet since animals including fish cannot synthesis them (Watanabe, 1993; Coloso and Cruz, 1980; Kanazawa and Tsshima, 1981). A large proportion of the amino acid consumed by animals is catabolized for energy. Amino acids play important and versatile roles in fish nutrition and metabolism. (Peng Li et al., 2008). Since high protein diets are needed for good growth of most aquatic animals (NRC, 1993), estimation of minimum requirements of essential amino acids (EAA) is indispensable to formulate cost effective diets. The quantitative EAA requirements of fish and crustaceans are often determined by feeding experiments with diets containing graded levels of the particular amino acid to be examined (Wilson, and Halver, 1986; Tang and Hwang, 1966 and Cobb et al., 1975). Both the absolute amounts of individual fatty acids and their relative proportion are important in the nutrition of fish larvae (Sargent et al., 1997). In particular, the DHA/EPA ratio may affect larval growth and survival, possibly because high amounts of EPA in relation to DHA may create an imbalance in the structural composition of the phospholipids that are essential components of biological membranes (Rainuzzo et al., 1994). In the present study, DHA/EPA ratios ranged from 4.7:1 for A. sinjiensis to 2.2:1 for P. crassirostris. All three species therefore met or exceeded the recommended DHA/EPA ratio of about 2:1 formarine finfish larval feeds (Sargent et al., 1997). The improvements in larval growth, survival and rates of normal are generally attributed to levels of DHA, EPA and or arachidonic acid (ARA) in the diet (Castell et al., 1994; Reitan et al., 1994).   CONCLUSION The present investigation on nutritional evaluation of different algal diets for the survival and growth of C.catla showed best results especially with reference to biochemical compositions. We have used 3 important algae for the enrichment of live feed, D.magna and obtained detailed results. 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Kangsen Mai . Jesse Trushenski . Guoyao Wu. 2008.  New developments in fish amino acid nutrition  jurnal of  review article  Aquaculture 309-46 Phang, S.M., Miah, M.S., Chu, W.L. & Hashim, M. 2000. Spirulina culture in digested sago starch factory waste water. J. Appl. Phycol., 12: 395–400. Pillay, K.K., Nair, N.B., 1973. Observations on the biochemical changes in the gonads and other organs of Uca annulipes, Portunus pelagicus, and Metapenaeus affinis Decapoda: Crustacea during the reproductive cycle. Mar. Biol. 18, 167–198. Rainuzzo, J. R., Reita, K. I., Olsen, Y., 1994. Lipid Composition in turbot larvae fed live feed cultured by emulsions of different lipid classes. Comp. Biochem. Physiol. 107A, 699-710. Ravi J. & Devaraj K.V. 1991.  Quantitative essential amino acid requirements for growth of catla, Catla catla (Hamilton). Aquaculture 96, 281-291.. Reitan, K. I., Rainuzzo, J. R., Olsen, Y., 1994. Influence of lipid composition of live feed on growth, survival and pigmentation of turbot larvae. Aquaculture Int 2., 33-48. Roe. J.H., (1955). The determination of blood sugar and spinal fluid with anthrone reagent. J. Biol. Chem., 212 :335-343. Sargent, J. R., Mc Evoy, L. A., Bell, J. G., 1997. Requirements presentation and sources of polyunsaturated fattyacids in marine fish larval feeds. Aquaculture. 155, 117-127. Sargent, J. R., R.J. Henderson and D.R. Tocher, 1989. The lipids. In J. Halver (ed.), Fish Nutrition, 2nd edn., Academic Press: 153–217. Sargent, J.R., McEvoy, L.A., Bell, J.G., 1997. Requirements, presentation and sources of polyunsaturated fatty acids in marine fish larval feeds. Aquaculture 155, 117–127. Schmidt-Moser, R., and . Westphal. D, 1980. Relationships of gobies (Gobiidae, Pisces) and their prey in the brackfish foerde schlei (Baltic coast of Western Germany). 15th European Symposium on Marine Biology, Kiel 471-478. Sorgeloos, P., 1980. The use of the brine shrimp Artemia in aquaculture.  In: G. Persoone, P. Sorgeloos, O.  Roels and E. Jaspers (Editors), The Brine Shrimp, Artemia, Vol.3, Ecology, Culturing, Use in Aquaculture. Universa Press, Wetteren, Belgium, pp.25-46.             Tang, Y., and Hwang, T.L., 1966. Evaluation of the relative suitability of various groups of Techniques 13: 601–603. Venkat HK., Sahu NP., Jain KK, 2004.  Effect of feeding Lactobacillus-based probiotics on the gut microflora, growth and survival of postlarva of Macrobrachium rosenbergii(de Man). Aquac Res 35:501–507 Venkataraman L.V., Nigam BP, and Ramanathan PK, 1980. Rural oriented fresh water cultivation and production of algae in India. In:Shelf G and Soeder CJ (Eds), Algae Biomass, Elsevier, Amsterdam, pp 81-95. Venkataraman, S., 1972. Algal Biofertilizers for Rice Cultivation. Today & Tomorrow, New Delhi, 75. Watanabe, T., 1993.  Importance of docosa hexaenic acid in marine larval fish.  J. World Aquac, Soc.24(2) :152-161. 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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareCOMMUNICATIONS BETWEEN MUSCULOCUTANEOUS NERVE AND MEDIAN NERVE - A STUDY English3240Akhilandeswari BalasubramanianEnglish Shubha RajannaEnglishstudy was done to note the communications between the Musculocutaneous nerve and Median nerve. Of the 50 arms studied, 17 had variations. Communications from the Musculocutaneous nerve to the Median nerve were seen in 76.47% of the variant arms. Of these, 53.8% were in the upper 1/3 of the arm, 38.46% in the middle 1/3 and 7.69% in the distal 1/3 of the arm. A communicating branch from the Median nerve to the Musculocutaneous nerve was found only in 5.88% of the variant arms. In 11.76% of the variant arms, the whole lateral cord joined the medial root to form the Median nerve. The Musculocutaneous nerve then arose from the Median nerve. When the communications were classified according to the classification by earlier authors [Venieratos D, Anagnostopoulou S 1998, Choi. D 2002] the percentage of the communicating branches agreed with those of the earlier studies. The results of this study show that the intercommunications between Musculocutaneous nerve and Median nerve are frequent. These variations are frequent and have to be studied in detail by every surgeon so as to prevent any iatrogenic damage during surgery. These intercommunications can result in neuropathies with atypical presentation. Incorrect diagnosis and unnecessary surgeries (e.g, carpal tunnel release) can be avoided if the surgeon keeps in mind these variations and the clinical presentation of these variant nerves in case of an injury. EnglishCommunications, Musculocutaneous nerve, Median nerve, Variations.INTRODUCTION Musculocutaneous nerve of the arm innervates the flexor muscles of the arm and then continues as the lateral cutaneous nerve of the forearm. Anatomic variations of the peripheral nervous system often form the basis of unexpected clinical signs and symptoms.  Normal and anomalous position of the arteries and veins may be determined pre-operatively by angiographic studies, but in case of nerves it is not possible to detect such an anomaly1.Good knowledge of variations of the musculocutaneous nerve and its possible communications with median nerve is valuable in the traumatology of the shoulder joint, exploratory procedures and in repair operations. Hence this study will be of considerable value and of service in diagnosis and treatment in the neurosurgical department. MATERIALS AND METHODS The musculocutaneous nerve was studied in 50 embalmed human cadaver upperlimbs. The sample included 29 male and 21 female upperlimbs obtained from the Anatomy departments of Medical colleges in Bangalore,India. Upperlimb dissection was done by following the guidelines of Cunninghams manual2. The musculocutaneous nerve entering the deep surface of coracobrachialis was identified and followed upwards to its origin from the brachial plexus. Intercommunications between musculocutaneous nerve and median nerve were looked for and noted down.                                              RESULTS The percentage of variations seen in male was 34.48% and that of female 33.33%. The right arm (40% ) recorded more percentage of variations than that of left arm (28%). Most of the variations noted were of intercommunications between MCN and MN. Communications between MCN and any other nerve except median nerve was not found in this study.  Communication between musculocutaneous nerve and median nerve Communication between musculocutaneous nerve and median nerve was noted in 16/50 arms studied (32%). The intercommunications were classified into 5 types according to Le Minor3 . DISCUSSION The results obtained  were compared with similar data from previous studies. Communication between musculocutaneous nerve and median nerve Variations involving communication between the musculocutaneous and median nerves were the commonest recorded in earlier studies4. The most frequent was the communicating branch that arose from the MCN and ran distally to join the MN 5. The communications between the MCN and MN was considered as a remnant from the phylogenetic point of view6. Existence of such connections were seen in some monkeys and some apes. In man, this could represent the primitive MN supply of the anterior arm muscles7. The following table compares the percentage of intercommunications seen in the present study with that of earlier studies. Table-1 The percentage of intercommunications seen in the present study is more when compared to that of earlier studies. This may be due to some authors considering cases of MCN arising from MN as absence of MCN whereas in the present study, it was included under intercommunication between the two nerves. Figure-1 Percentage of variations in male/female and right/left arms. Percentage of variations in male/female and right /left arms seen in the present study is compared with an earlier study7 and tabulated below. Table-2 When compared to that of the earlier study, the present study shows a higher percentage of variations in the female and in the right arms. This difference may be attributed to a difference in the sample size and a difference in the race of the population studied. Communicating branch from the MCN to the MN Figure-2 In the present study, the communicating branch originated in the upper 1/3 of the arm  in 53.8% of cases. The communicating branch arising in the upper 1/3 of the arm, before the MCN  pierced the CB muscle is also regarded as the II lateral root of MN. Figure-3 The communicating branch arose from the MCN in the middle 1/3 of the arm in  38.46% (5/13) and  in the distal 1/3 of the arm in 7.69% cases (1/13).     Communicating branch from MN to MCN A communicating branch from the MN to MCN was reported to be uncommon .  In the present study, a communicating branch from the MN to MCN was seen only in 5.88% (1/17) of the variant arms.  This type of intercommunication can be due to the nerve fibres from the C5 and C6 ventral rami hitch hiking along the MN and rejoining the MCN in the lower 1/2 of the arm. This may be the effect of “neurobiotaxis” occurring during fetal development 13. Fusion of MCN and MN  In some cases, the whole Lateral cord along with the fibres destined for MCN joined the medial root of MN to from the trunk of the MN  and the muscular branches which were usually given off from the MCN arose from the MN individually or as a common trunk. This was considered by some authors as absence of MCN14, 15 while others considered it as fusion of MCN & MN7. Here the common trunk which arose from the fused MN trunk was considered as MCN arising from the MN. This was seen in 11.76% i.e, 2/17 of the variant arms.  The MCN may join the MN in the lower 1/3 of arm to form an ansa 8% 4. Apart from these cases, in 1 case, the whole MCN joined the MN in the distal 1/3 of the arm after giving branches to all the 3 muscles. Two or more communications between MCN and MN Presence of many communicating branches was also called as plexiform pattern 7. In the present study, in one of the cases where the MCN arose from the MN, a communicating branch arose from the MN and joined the MCN. This was the only case where two communications between the MCN and the MN was found. Classification of communications between MCN and MN The communications that were discussed above were classified according to different authors and compared with earlier studies. Le Minor’s classification Figure-4 The variations of the musculocutaneous and median nerve were classified into five types by Le Minor3. The following table compares the communicating branches classified according to Le Minor’s classification in the present study with an earlier study. Table-3 The percentage of intercommunications in the present study coincides with that seen in the earlier study. Venieratos and Anagnostopoulou’s classification The communications were classified into 3 types according to the site of occurance of the communication with respect to the CB muscle5. Figure-5 The percentage of communicating branches between MCN and MN in the present study is classified and compared with the earlier studies in the following table . Table-4 On comparison, the % of the intercommunications in the present coincided with that of  earlier studies 5, 7 . Choi.D’s classification    This unified classification  included their own results and those of the others and consisted of 3 patterns7. Figure-6 The results of this study were classified according to Choi.D’s  and compared to that of earlier studies in the table given below. Table-5 The results in the present study coincided with that of Choi.D. After considering the 3 types of classification given above, it is concluded that the classification by Choi.D is complete, and as it included all the possible types of communications.  Clinical implications of the various communications In case of communication between the MCN and MN, some fibres of MN usually run in the MCN leaving it to join the proper trunk later. In such cases, a combined lesion of MCN and part of the MN would occur in injury to the MCN. Lesions of the connecting nerve may impose difficulty in diagnosis. Injury to the MCN, proximal to the anastomotic branch between MCN and MN may lead to unexpected presentation of weakness of forearm flexors and thenar muscles. Knowledge of various communications is important in the evaluation of unexplained sensory loss after trauma or surgical intervention in a particular area13. Anterior surgical approach to the shoulder joint may be complicated by the presence of communicating branches. In case of presence of a II lateral root of MN, after a trauma to the arm, signs of MN injury could be observed in a patient with an intact MN, if the fibres coursing in the MCN are damaged. Result of exploratory intervention of the arm for peripheral nerve repair in a patient with these variations can be successful, only if the surgeon is aware of such variations of peripheral nerves and specifically looks for their presence. During flap dissections, unexpected nerve damages could be caused especially by surgeons who are inexperienced in variations. Any injury to the MCN in a patient with this kind of variation presents as double nerve injury which makes the diagnosis problematic. Although anterior approach for internal fixation of humeral fracture seems to be safer than the posterior approach because of high risk of radial nerve damage in the latter, neurovascular variations should be kept in mind to prevent iatrogenic damage to these structures during their retraction for exposure of the fracture line16. CONCLUSION  The results of the study discussed, clearly show that the Musculocutaneous nerve shows frequent variations. Most of the variations are intercommunications between Musculocutaneous nerve and Median nerve. Communications between the MCN and MN were recorded in 32% of the cases. The variant arms were more of the right side but no gender difference was seen.  When the communications are classified according to the classification by earlier authors (Choi.D et al 2002, Venieratos.D, Anagnostopoulou.S 1998), the percentage of the communicating branches agree with those of the earlier studies.  The presence of variations thus appears to be an almost normal entity of Musculocutaneous nerve. These variations are frequent and have to be studied in detail by every surgeon so as to prevent any iatrogenic damage during surgery. These intercommunications can result in neuropathies with atypical presentation. Incorrect diagnosis and unnecessary surgeries (e.g, carpal tunnel release) can be avoided if the surgeon keeps in mind these variations and the clinical presentation of these variant nerves in case of an injury. Abbreviations Used MN-Median nerve MCN-Musculocutaneous nerve CB-Coracobrachialis                                             ACKNOWLEDGEMENTS Authors acknowledge the great help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Englishhttp://ijcrr.com/abstract.php?article_id=1372http://ijcrr.com/article_html.php?did=1372 Das,S. Paul,S. Anomalous branching pattern of the lateral cord of brachial plexus. Int.J.Morphol 2005; 23(4):289-292. Romanes .G.J, The arm. Cunningham’s manual of Practical Anatomy Volume 1:upper limbs and lower limbs, 15th Edition. Oxford University Press, Oxford ,1986:67-68 Gumusburun E, Adiguzel E. A variation of the brachial plexus characterized by the absence of the MCN; a case report. Surg Radiol Anat 2000; 22: 63-65. Bergman R.A, Thompson S.A, Afifi A.K, Saadeh F.A.Compendium of Human Anatomic Variation. Munich: Urban and Schwarzenberg; 1988. Venieratos D, Anagnostopoulou S. Classification of communications between the musculocutaneous and median nerves. Clin Anat 1998;11:327-331. Chauhan.R and Roy.T.S. Communication between the median and musculocutaneous nerves a case report. J.Anat.Soc.India 2002; 52(1): 72-75. Choi D, Rodriguez- Niedenfuhr.M, Vazquez.T, Parkin.I, Sanudo.J.R. Patterns of connections between the musculocutaneous and median nerves in the axilla and arm. Clin Anat 2002; 15:11-17. Kerr A.T. The brachial plexus of nerves in man, the variations in its formation and branches. Am J Anat 1918;23:285-395. Yang Z, Pho R.W.H, Kour A, Pereira B.P. The musculocutaneous nerve and its branches to the biceps and brachialis muscles. J Hand Surg 1995; 20A: 671-675. Chiarapattanakom P, Leechavengvong S, Witoon chart K, Verpairoj kit C, Thurasethakul P. Anatomy and internal topography of the musculocutaneous nerve: the nerves to the biceps and brachialis muscle. J Hand Surg 1998; 23A: 250-255. Aktan.Z.A. A cadaveric study of the anatomic variations of the brachial plexus nerves in the axillar region and arm. Turk J Med Sci 2001; 31:147-150. Fazan V.P.S, Amadeu A.S, Caleffi A.L, Filho O.A.R. Brachial plexus variations in its formation and main branches. Acta Cir. Bras  2003; Vol.18 Suppl.5 SaoPaulo. Saeed.M, Rufai,A.A. Median and musculocutaneous nerves : variant formation and distribution. Clin.Anat 2003; 16(5): 453-457. Sud .M, Sharma .A.  Absence of musculocutaneous nerve and the innervation of coracobrachialis, biceps brachii and brachialis  from the median nerve. J.Anat .Soc .India 2000; 49(2):176-177. Rao P.V.V.P, Chaudhary S.C. Absence of musculocutaneous nerve: two case reports. Clin Anat 2001; 14: 31-35. Ibrahim.C.H, Adnan.E., Cem.D.C. Variations between median and musculocutaneous nerves Internet.J.Surg 2005; 6(1).

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareDRUG RESISTANCE IN CANCER CHEMOTHERAPY- AN OVERVIEW English4146Ambili Remesh EnglishDrug resistance is one of the primary obstacles in cancer chemotherapy. The causes of drug resistances are varied. The primary resistance attributed to genomic instability while alteration in membrane permeability of drug and inability to reach the target sites, drug inactivation by enzymes, mutation and altered expression of target proteins there by affecting drug target interactions are some of the mechanism of acquired drug resistance. In addition to genetic changes there are epigenetic changes or non mutational mechanisms which occur quickly in response to environmental changes. Normal tissues never develop resistance to chemotherapy, because they possess intact genetic machinery. Drug resistance in addition to reducing clinical effectiveness, result in early termination of treatment, reduced relapse free interval and survival. There are various methods for overcoming these major disadvantages of cancer chemotherapy. Combination chemotherapy with clear understanding of the biochemical, molecular and pharmacokinetic mechanisms of interaction between the individual drugs in a given combination is one method.Optimal cancer drug scheduling is also a strategy for controlling resistance to therapy. Control avenues of drug administration and dose intensification provide better outcome. Despite various measures to overcome drug resistance, the problem especially multidrug resistance is still casting its shadow in successful chemotherapy. A better understanding of mechanism of drug resistance, its genetic and epigenetic links will open up new avenues in circumventing this fundamental problem and prolong the life expectancy of the patient. This article gives an overview of drug resistance encountered in cancer chemotherapy. EnglishCancer, Chemotherapy, Cell cycle, Drug resistanceINTRODUCTION The term chemotherapy coined by Paul Ehrlich (‘magic bullet’) referred to the use of chemical compounds in the treatment of diseases, without injuring the host cells1. Nowadays this term broadly refers to anti-neoplastic drugs in the management of neoplastic diseases. Advances in chemotherapy have provided important proof of the principle that anti cancer drugs can cure cancer, and subsequently have been integrated into treatment programmes with surgery and radiation therapy2.  Chemotherapy  currently has various roles like   in  induction treatment for advanced diseases, as an adjunct to local forms of treatment, and as neoadjuvant therapy for localised disease3.The term induction therapy implies the use of chemotherapy as the primary treatment for patients who present with advanced cancer for which no alternate treatment exists. Adjuvant chemotherapy denotes the use of systemic treatment after the primary treatment has been controlled by an alternative modality such as radiotherapy and surgery. Neo adjuvant chemotherapy refers to the use of chemotherapy as the initial treatment for patients who present with localised cancer4. Chemotherapy targets proliferating cells but exerts little selectivity on the proliferating normal tissues5.The primary obstacles to the clinical efficacy of chemotherapy have been the toxicity to the normal tissues of the body and the development of cellular resistance to these chemotherapeutic agents. Drug resistances occur in most tumours treated with chemotherapy. Normal tissues never develop resistance to chemotherapy, because they possess intact genetic machinery 6. Sensitive cancer cells later develop resistance because of drug-induced mutations in their DNA7. In the last decade, molecular techniques for analysis of the DNA of normal and neoplastic cells identified some of the critical mechanisms through which chemotherapy induces cell death8. A new level of understanding of the molecular path ways through which chemotherapy works has opened up avenues for novel therapeutic approaches. Such   strategies not only enhance the chemo sensitivity of malignant cells to treatment, but also reduce toxicities and prevent the emergence of drug resistance. MECHANISM OF DRUG RESISTANCE One of the frequent problems encountered in cancer chemotherapy is drug resistance. Only tumour cells that are sensitive to the action of drugs are killed9.  There are several types of drug resistances which are broadly divided into primary or inherent and acquired. Various mechanisms are attributed to drug resistance. Alteration in membranes permeability causing inability to enter the target cells, increased drug   efflux, inactivation by enzymes  affect  the concentration of drug within the cancer cells10. Drug target interaction is prevented by mutation or altered expression of the target protein.  Defects in apoptosis, senescence, repair mechanisms affect signalling pathways of drug target receptors11. Alterations in complex pathways   associated with growth factors, ion and nutrient transports and utilization, hormone responsiveness, oncogene and protein kinase signalling pathways, chromosome structure and gene expressions are   involved in drug resistance 12, 13. The efflux mechanisms especially by efflux pumps like P-glycoprotein and the multidrug-resistance protein which belongs to Adenosine Triphosphate – Binding Cassette family are particularly important in multidrug resistance13.  There are various studies confirming the importance of genetic changes for acquired resistance during cancer chemotherapy 13. Mutational changes can be single step or multistep. In addition to genetic changes there are epigenetic changes or non mutational mechanisms which occur quickly in response to environmental changes 14. Tumour growth rate along with phase and cell cycle specificity are other major factors that determine the sensitivity of cancer cells to chemotherapy15. The growth of a neoplasm depends on several interrelated factors like normal cell cycle time, growth fraction, total number of cells in the population and the intrinsic cell death rate16. Cells progress through a cell cycle comprising four phases: G1, S, and G2, M. At the end of the G2M phase, cells divide and new cells begin their cycle in G1. Cells remain in the quiescent phase G0 (quiescence) in the absence of external changes, otherwise they may return to the proliferative cycle (at the first step of S phase)17.There are certain check points in between cell cycle phase transition, the most important of which occur at the G1=S and G2=M transitions17. There are exchanges of cells between phases G0 and G1 all the time till restriction point occur at G1.  Then the proliferation of cells continues until actual division. This can be prematurely   interrupted by anticancer drugs17.Many anticancer drugs cause direct damage to DNA, which triggers cellular checkpoints18.The resistant cells survive and multiply and result in re growth of cancer cells not sensitive to the administered drug 19, 20. Figure 1 depicts the cell cycle 16, 19.  The cytotoxic effects of cancer drugs follow log cell kill kinetics. According to the log-cell-kill hypothesis constant fraction of tumour cells are eliminated21. i.e Cell kill is proportional regardless of tumour burden. The viability and character of remaining tumour cells can be analysed by histological examination of residual tumour cells22.The experimental data in human solid cancers  follows Gompertzian kinetics ie, the growth fraction of tumour is not constant but decreases exponentially with time 22 . The location of tumour is in its particular growth curve determines the response to chemotherapy in drug sensitive tumour23.Figure 2 depicts log cell kill hypothesis16, 21, 22. DISCUISSION a.Clinical significance of drug resistance The efficacy of a treatment regime is determined by the complete response rate21and the relapse-free survival from the time treatment is discontinued. The relapse-free survival is the major end point in adjuvant programmes. If a patient is having good response to chemotherapy, further treatment need to be continued while a poor response points out the need to consider an alternative method of treatment24. Drug resistance in addition to reducing clinical effectiveness, result in early termination of treatment and reduced relapse free interval and survival. b. Measures for overcoming drug resistance There are various methods for overcoming these major disadvantages of cancer chemotherapy. Combination chemotherapy using conventional cytotoxic agents attain several important objectives not achieved with single agents25.It provides maximal cell killing with tolerable side effects and in addition can slow or prevent the development of resistance26. Principle of selection of drugs in an effective drug combination follows the following principle; like only drugs known to be partially effective against a given tumour when used alone should be selected; drug selection should be based on the spectrum of toxicities without any overlap in toxicities21.  There should be a clear understanding of the biochemical, molecular and pharmacokinetic mechanisms of interaction between the individual drugs in a given combination to allow for maximal effect16,27. Drug discovery efforts are now directed toward restoring apoptosis in tumour cells, as this process or their absences have profound influence on tumour cell sensitivity to drugs 28. In high grade tumours although more aggressive, drugs are generally more effective in combination and may be synergistic through biochemical interactions29. New regimens are designed based on useful interactions 30. When the drugs share common mechanism of resistance or have overlapping toxicities combinations are considered irrational31. Tumour cells in population in patients with visible disease exceed 1gm or 109 cells and   each cycle of therapy kills less than 99% of cells. So treatments are repeated with multiple cycles to effectively kill the entire tumour cells32. Optimal cancer drug scheduling is a way of controlling resistance to therapy. Control avenues of drug administration and dose intensification provide better outcome16. CONCLUSION Despite various strategies to overcome drug resistance, the problem especially multidrug resistance is still casting its shadow in successful treatment of cancer therapy.  A better understanding of mechanism of drug resistance, its genetic and epigenetic links will open up new vistas in   circumventing   this  problem and prolong the life expectancy of the patient. ACKNOWLEDGEMENT Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The author is  also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Englishhttp://ijcrr.com/abstract.php?article_id=1373http://ijcrr.com/article_html.php?did=1373 H. P. Rang, M. M. Dale and J. M. Ritter, 2012.Anticancer drugs, Text book of Pharmacology, ( 7th Eds ) Elsevier,pp: 673-88. Paul Calabresi and Bruce A chabner, 2001. Chemotherapy of Neoplastic diseases, Introduction: The pharmacological basis of therapeutics, (10th Eds), Goodman and Gilman. pp: 1381 – 88. Devita VT, Hellman S and Rosenberg SA, 2008.Cancer: Principles and Practise of Oncology, (8th Edn), Lippincott Williams and Wilkins. DeVita V T. 1988. On the value of response criteria in therapeutic research. Le Bulletin du cancer, colloque INSERM-John Libbey series. Proceedings of the 21 International congress on Neo-Adjuvant Chemotherapy: 75, pp: 863. Airley, R, 2009. Anticancer drugs. 1st Edn., Wiley-Blackwell, Chichester. Weinberg RA, 1996. How Cancer Arises. Scientific American; 275: 42-48 Nielsen LL, Maneval DC, 1998. P53 tumor suppressor gene therapy for cancer. Cancer Gene Ther, 5: 52-63. Mimeault M, Hauke R, Batra  S.K , 2008.Recent advances on the molecular mechanism involved in the drug resistance of cancer cells and novel targeting therapies. Clin. Pharmacol Ther, 83:673-691. Kruh GD, 2003.Introduction to resistance to anticancer agents. Oncogene, 22: 7262–7264.    CrossRef  Hsing-Pang Lu, Chuck C.K Chao, 2012. Cancer cells Acquire Resistance to Anticancer Drugs; An Update. Biomed J, 35 (6): 464-72 Zornig M, Hueber A. O, Baum W, Evan G,2001.Apoptosis regulators and their role in tumorogenesis. Biochim. Biophys Acta, 1551:F1-F37 Talapatra S, Thompson C.B,2001 .Growth factor implications for cancer treatment. J. Pharmacol.Exp.Ther, 298:873-878 Gottesman M.M, Fojo T, Bates S.E, 2002. Multi drug resistance in cancer: role of ATP dependant transporters. Nat. Rev. cancer, 2:48-56 Glasspool RM, Teodoridis JM, Brown R., 2006.Epi genetics as a mechanism of  driving polygenic clinical drug resistance. Br. J Cancer, 94: 1087-92 Rolland T Skeel., 1995. Handbook of Cancer Therapy. (5thEds), Lippincott Williams and Wilkins, pp: 630-2. Edward Chu, Alan C. Sartorelli, 2009.Cancer chemotherapy. Basic and Clinical pharmacology Bertram G. Katzung, Susan B.Masters, Anthony J. Trevor, (11th Eds). Mc Graw Hill., pp:935-61 Simon JA etal., 2000.   Differential toxicities of anticancer agents among DNA repair and checkpoint mutants of Saccharomyces cerevisiae. Cancer Res, 60(2) 15 : 328-33  Fojo, T.  , Bates, S., 2003. Oncogene22, pp: 7512-7523. CrossRef  George M. Brenner, Craig W. Stevens, 2010. Antineoplastic drugs. Text book of Pharmacology, ( 3rd Eds) Saunders Elsevier, pp: 493-511. Smith JK, Mamoon NM, Duhe RJ., 2004. Oncol Res , 14(4-5):175-225. DeVita V.T. and Schein P.S., 1973. The use of drugs in combination for treatment of cancer. Rational and results. N Engl J Med,  288:998-1006 A. K. Laird, 1969. Dynamics of growth in tumors and in normal organisms. Monograph 30, National Cancer Institute, Washington, D.C. pp: 29-50. Chabner BA, Longo DL, 2006.Cancer chemotherapy and Biotherapy: Principles and Practice,4th Edn, Lippincott Williams and Wilkins Muggia FM. 1985. Primary chemotherapy: concepts and issues. In: Primary Chemotherapy in Cancer Medicine. New York: Alan R. Liss, pp:377-383. Robert Souhami, Jeffrey Tobias, 1995. Cancer and its management. pp: 547-549. George M. Brenner, Craig W. Stevens, 2010. Antineoplastic drugs, Text book of Pharmacology, (3rd Eds) Saunders Elsevier, pp: 493-511. Chu E, Devita VT Jr, 2009. Cancer chemotherapy drug manual. 9th Edn, Jones and Bartlett. Schmitt CA, Lowe SW., 1999. Apoptosis and therapy. J Pathol; 187:127­37. Kufe DW, Pollock RE, Weichselbaum RR, et al., 2003. Cancer Medicine. 6th Edn, Hamilton, BC Decker. Weinberg RA, 2006. Biology of cancer, Taylor and Francis. Redmond KM et al, 2008. Resistance mechanisms to cancer chemotherapy. Front Biosci, 13:5138 Goldie JH, 2001.Drug Resistance. The Chemotherapy Source Book (3rd Eds )  Michael C., Perry, Lippincott Williams and Wilkins Publishers

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareSERUM URIC ACID AS A MARKER FOR MICROALBUMIN- URIA IN PREHYPERTENSION GROUP English4752Anjaneya Prasad V.English Vasu Babu N.English Pradeep Babu K.V.EnglishBackground: Development of target organ damages like chronic kidney disease and coronary artery disease in hypertension is more common and more rapid. Identifying sub clinical target organ damage in prehypertensive phase is essential to prevent complications. Objective: Prehypertension is an elevation of systolic blood pressure of 120 - 139 mmHg and diastolic blood pressure of 80 – 89mmHg. The purpose of this case – control study was to corelate serum uric acid levels in Prehypertensive patients to the presence or absence of microalbuminuria. Method: This study was done at the Department of Internal Medicine, DR. PSIMS and RF foundation, Chinaoutpally, A.P.India between Jan 2011 to Dec 2012. 1000 patients (500 cases, 500 controls) above 18 years of age were included in the study. The microalbuminuric reference range was 30 – 300mg/day. The reference values for serum Uric acid levels in males: 3.4 – 7.0mg/dl and females were 2.4 – 5.4mg/dl. Results: In our study, the microalbuminuria was present in 17.4% of prehypertensive cases and 3.4% of controls (p=0.0001), with mean value of microalbuminuria in cases was 30.91 + 16.54 and in controls was 7.191 + 6.039 (p = 0.0001). The mean serum uric acid levels in Prehypertensive group was 5.107 + 2.286 and in controls was 2.614 + 1.58 (p EnglishPrehypertension, Microalbuminuria, Serum uric acidINTRODUCTION The association between elevated serum uric acid level and cardiovascular disease risk was established by several large epidemiological studies.1 The causal role of uric acid in Cardiovascular risk was direct or indirect influence studied by different investigators.2 Elevated serum uric acid levels are associated with cardiovascular disease, particularly in hypertensive individuals due to endothelial dysfunction by reduced nitric oxide levels, decreasing neuronal nitric oxide synthase in the kidney, and activation of the renin-angiotensin system 3. Later studies, the development of  renal microvascular changes,  in which the thickened  afferent arterioles and  renal microvasculature hyalinosis , independently of hypertension and is likely to direct effects of  high serum uric acid levels, which in turn stimulates  and proliferation of vascular smooth muscle 4.  The presence of direct or indirect effects of uric acid on microvasculature producing endothelial dysfunction, which in turn triggers hypertension cascade 5,6. By presence of this association of uric acid and hypertension, the risk of cardiovascular complications occurs rapid and severe. The diagnosis of hypertension in earlier phase i.e. Prehypertension, by JNC 7 definition: elevation of systolic blood pressure of 120 - 139 mmHg and diastolic blood pressure of 80 – 89mmHg 7, is useful to avoid subclinical cardiovascular risk and complications. Risk of progression to hypertension and risk of development of strokes are minimized by early detection of pro inflammatory markers and induction of early treatment schedules. Microalbuminuria, by definition, excretion of albumin with urine in small amounts i.e. 30 – 300mg/day 8  influenced by wide range of confounding factors like increased body mass index, increased blood pressure (systolic, diastolic), blood  glucose, C- reactive protein, altered lipid levels, hyperinsulinemia, smoking,Salt sensitivity and elderly individuals 9. Studies showed the significance microalbuminuria leads to pathogenesis of cardiovascular disease, by means  of  development of atherosclerotic vascular disease by systemic pathophysiological processes like activation of inflammatory mediators, Increased transcapillary escape rate of albumin and Vascular endothelial dysfunction 10. Microalbuminuria is a well known marker of subclinical cardiovascular and renal disease as well as vascular endothelial dysfunction, in patients with diabetes, hypertension and general population. The effect of hyperuricemia on microalbuminuria in Prehypertensive phase can indirectly reflect its importance as a prognostic marker for long term complications of cardiovascular system even before the diagnosis of hypertension is made. The relationship between uric acid and microalbuminuria in Prehypertensive patients without other cardiovascular risk factors may help to clarify the role of uric acid in cardiovascular disease. On this background, our study aims at comparing the occurrence of hyperuricemia in patients with Prehypertensive group with and without microalbuminuria, thus, reflecting presence or absence of any additive effect of hyperuricemia in Prehypertensive phase in causing major vascular complications. MATERIAL AND METHODS A prospective study was undertaken in the Department of General Medicine with the investigatory aid of Department of Biochemistry in Dr.PSIMSandRF, Chinoutpally, Gannavaram, Krishna (Dt.), Andhra Pradesh. 500 diagnosed Prehypertensive cases, who attended to our hospital and 500 age, sex matched controls, were included in our study group. All patients survive till the end of the study period of two years duration i.e., Jan 2011 to Dec 2012. Diagnosis of Prehypertensive cases was done as per the JNC 7 guidelines. Microalbuminuria in both cases and controls were estimated. Serum Uric acid and Lipid profile were also estimated in both cases and controls. The study was approved by the Ethics committee of our college. After fulfilling the inclusion and exclusion criteria, prior consent was obtained from the subjects. Inclusion criteria Patients with Systolic blood pressure: 120 – 139mmHg, Diastolic blood pressure : 80 – 89mmHg Age 18 or older Exclusion criteria Patients with diabetes, heart failure, acute febrile illness, renal, hepatic, malignant disorders, chronic illnesses, asymptomatic infections and smokers. Sample collection and analysis Both heparinised and plain blood samples were collected from each case and control. For analysis of FBS, lipid profile - serum was used and for HBA1c – whole blood was used. Serum glucose estimation was done by Trindler’s Glucose Oxidase – Peroxidase (GOD – POD) method (commercial kit – ERBA – MANNHEIM), cholesterol estimation was done by Cholesterol Oxidase – Peroxidase (CHOD – POD) method (commercial kit – ERBA – MANNHEIM), Triglycerides estimation was done by Glycerol peroxidase (GPO) method (commercial kit – ERBA – MANNHEIM), HDL cholesterol estimation was done by apolipoprotein (APO)  precipitation or Phospho Tungstic Acid (PTA) method (ERBA – MANNHEIM), and HBA1c estimation was done by Ion exchange resin method (commercial kit – Randox Rx series). All these estimations were performed by Randox Daytona Autoanalyzer. VLDL-c or LDL-c levels of all cases and controls were calculated by using Friedwald’s formula. Estimation of serum uric acid was done by ERBA Chem 7 (Trans Asia) Semi Automatic analyzer and Autopak kits from Bayer Diagnostics India Ltd. Urine samples from 24 – hour collected specimens were taken from each case and control and microalbumin estimation was done in those samples by Latex turbidimetry method (commercial kit-Euro diagnostic systems) on Randox Daytona Autoanalyzer. RESULTS The microalbuminuria was present in 17.4% of prehypertensive cases and 3.4% of controls (p=0.0001), which showed microalbuminuria is more frequent in prehypertensive cases than controls. Among in males, 68 (22.2%) in cases and 13(4.24%) in controls showed microalbuminuria that was statistically significant (p=0.0001). Among in females, 19 (9.79%) in cases and 4 (2.06%) in controls showed microalbuminuria that was statistically significant (p=0.0026). The mean microalbuminuria in cases was 30.91 + 16.54 and in controls was 7.191 + 6.039 (p = 0.0001) which showed microalbuminuria is more frequent in Prehypertensive group, among in males mean microalbuminuria in cases was 32.55 + 11.96 and in controls was 7.459 + 6.382 (p = 0.0001), among in females mean microalbuminuria in cases was 28.31 + 7.77 and in controls was 6.769 + 5.445 (p < 0.05) were showed  statistically significant mean microalbuminuria levels in males and females in cases than controls. The mean serum uric acid levels in Prehypertensive group was 5.107 + 2.286 and in controls was 2.614 + 1.58 (p Englishhttp://ijcrr.com/abstract.php?article_id=1374http://ijcrr.com/article_html.php?did=1374 Lee JE, Kim YG, Choi YH et al. Serum uric acid is associated with microalbuminuria in prehypertension. Hypertension 2006; 47: 962–967. Johnson RJ, Kivlighn SD, Kim YG, Suga S, Fogo AB. Reappraisal of the pathogenesis and consequences of hyperuricemia in hypertension, cardiovascular disease, and renal disease. Am J Kidney Dis. 1999;33:225–234 Mazzali M, Hughes J, Kim YG, et al. Elevated uric acid increases blood pressure in the Rat by a novel crystal-independent mechanism. Hypertension 2001; 38:1101–1106. Mazzali M, Kanellis J, Han L, et al. Hyperuricemia induces a primary renal arteriolopathy   in rats by a blood pressure-independent mechanism. Am J Physiol Renal Physiol 2002;   282:F991–F997. Erdogan D, Gullu H, Caliskan M, et al. Relationship of serum uric acid to measures of endothelial function and atherosclerosis in healthy adults. Int J Clin Pract 2005; 59:1276–1282. Zoccali C, Maio R, Mallamaci F, Sesti G, Perticone F. Uric acid and endothelial dysfunction in essential hypertension. J Am Soc Nephrol 2006; 17:1466–1471. The Seventh Report of the Joint National Committee on hypertension Bennett PH, Haffner S, Kasiske BL et al. Screening and management of microalbuminuria in patients with diabetes mellitus: recommen- dations to the Scientic  Advisory Board of the National Kidney Foun- dation from an ad hoc committee of the Council on Diabetes Mellitus of the National Kidney Foundation. Am J Kidney Dis 1995; 25: 107-12. Syamala S, Li J, Shankar A. Association between serum uric acid and prehypertension among US adults. J Hypertens. 2007;25(8):1583- Yong Loo Lin School of Medicine, National University of Singapore,           Singapore Microalbuminuria: marker of vascular dysfunction, risk factor for cardiovascular disease Vascular Medicine 2002; 7: 35±43 Meena CL,Harsha R,Meena VK,Anju B, Rajani N,Meena LP et al, Association of serum    uric acid and microalbuminuria in prehypertension:Across sectional study.  National journal of physiology, pharmacy and pharmacology 201; 3(1):87-91. Francesca Viazzi, Giovanna Leoncini, Elena Ratto, Valeria Falqui,Angelica Parodi, Novella Conti, Lorenzo E. Derchi, Cinzia Tomolillo,Giacomo Deferrari, and Roberto  Pontremoli. Mild Hyperuricemia and Subclinical Renal Damage in Untreated Primary Hypertension. AJH 2007; 20:1276–1282. Viazzi F, Parodi D, Leoncini G, Parodi A, Falqui V, Ratto E, Vettoretti S, Bezante GP, Del Sette M, Deferrari G, Pontremoli R. Serum uric acid and target organ damage in primary hypertension. Hypertension. 2005;45:991–996. Mattei P, Arzilli F, Giovannetti R, Penno G, Arrighi P, Taddei S, Salvetti A. Microalbuminuria and renal haemodynamics in essential hypertension. Eur J Clin Invest. 1997;27:755–760.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareFACTORS ASSOCIATED WITH NON-COMPLIANCE OF DIRECTLY OBSERVED TREATMENT-SHORT COURSE FOR TUBERCULOSIS IN A RURAL AND A TRIBAL VILLAGE OF ANDHRA PRADESH-A COMPARATIVE STUDY English5362Maseer KhanEnglish Manohar MogiliEnglishBackground: TB is the number one killer infectious disease in developing countries. In 1990 World Health Organization (WHO) report on the Global Burden of Disease ranked TB as the seventh most morbidity-causing disease in the world and expected it to continue in the same position up to 20201.DOTS as the most systematic and cost-effective approach to revitalize the TB control programme in India has been formulated.Non adherence is found to be the major problem in DOTS therapy. Objectives:1)To study the socio-demographic factors of the study population. 2) To compare reasons for non-adherence/non compliance to DOTS in Tribal TB unit (TU) of Dhammapeta and TB unit (TU) of Nandigama (rural TB unit). Study design: The present study is an observational, prospective and community based study. Study population: All newly diagnosed sputum smear positive TB cases under DOTS- Strategy were selected The study population consisted of 174 in rural area and 107 in tribal area. Study period: The study was conducted from 01.04.2006 to 31.04.2007 (including follow-up). Results: In the age group of 15-49 years, the treatment interruption was more in the tribal area (70.73%) when compared to rural area (64.96%). In rural areas the most common factors for non adherence is adverse effects (40.24%), lack of personal interest (31.70%) followed by work load (30.48%).In tribal area the most common factors for non adherence is adverse effects (37.60%), work load (25.64%) followed by lack of personal interest (24.78%). Conclusion: the present RNTCP should develop Information, Education, and Communication package for the target group of patients. EnglishDOTS, non-adherence, defaultersINTRODUCTION TB is the number one killer infectious disease in developing countries. In 1990 World Health Organization (WHO) report on the Global Burden of Disease ranked TB as the seventh most morbidity-causing disease in the world and expected it to continue in the same position up to 20201. WHO estimated that 1.86 billion people were infected with tuberculosis each year? 8.74 million Develop tuberculosis and nearly 2 million die. This means that someone somewhere contracts TB every four seconds and one of them dies every 10 seconds 2, 3. India accounts for nearly one-third of the global burden of tuberculosis and two-thirds of the total cases in South-East Asia. Nearly 40 percent of the Indian population is infected with the TB bacillus. In1993, WHO declared TB as a global emergency. Every year, 1.8 million new cases of TB occur in the country, of which about 0.8 million are highly infectious New Smear-Positive pulmonary TB cases.4 The disease is most prevalent in the age group 20 to 50 years. About 415,000 deaths occur each year, more than 1,000 every day, or two every three minutes 4. Despite the National TB Control Programme (NTP) being in existence since 1962, no appreciable change in the epidemiological situation of TB in the country has been observed. To rectify lacunae, the Government of India, decided to give a new thrust to TB control activities by revitalizing the NTP, with assistance from international agencies. In1993 the Revised National TB Control Programme (RNTCP) thus formulated and adopted the internationally recommended directly Observed Treatment Short-course (DOTS)-Strategy, as the most systematic and cost-effective approach to revitalize the TB control programme in India10. Implementation of RNTCP in Andhra Pradesh: Andhra Pradesh is the fifth largest state in India with a population of over 80.43 million. About 4,47,523 TB suspects examined,  total of 1,07,051 TB patients registered on RNTCP DOTS treatment and 44,867 NSP patients registered on RNTCP DOTS for four quarters of 2006.5  The RNTCP was initially pilot tested in Hyderabad and Medak districts during 1995-96.The Programme extended to six more districts namely Ananthapur Chitoor, Mahabubnagar, Rangareddy, Srikakulam Vijianagaram in 2000 -2001. Cuddapha, Guntur, Nellore, Prakasam joined RNTCP fold in 2002, and Adilabad, Badrachalam, East.Godavari, Khammam, Kurnool, Krishna, Nalgonda, Nizambad, Visakhapatnam, Waragal and West.Godavari districts implemented RNTCP in the year 2003. Karimnagar was the last district to implement RNTCP in the state in 2004.2   The analysis of the RNTCP data over a one-year period from 3rd quarter 2002 to 3rd quarter 2003, shows that the performance in terms of case detection and cure rates in a sample of predominantly tribal districts in the tribal-dominant states of India, was similar to the rest of India.7 Tribal TB unit (TU) of Dhammapeta was the first TB unit (TU) of Andhra Pradesh which achieved 98% of new sputum positive cure rate for the year 2005.8   Where as in rural TB unit (TU) of Nandigama of Krishna district treatment outcome of new sputum positive cases for the year 2005 showing cure rate 85.6%.9  Due to this difference in the new sputum positive cure rate, it was decided to compare the reasons and the factors which showed the tribal unit (98%) to be more effective than the rural TB unit (85.6%). Objectives: To study the socio-demographic factors of the study population. To compare reasons for non-adherence/non compliance to DOTS in Tribal TB unit (TU) of Dhammapeta and TB unit (TU) of Nandigama (rural TB unit) Non compliance to self administered multi drug tuberculosis treatment  regimens is common and is the most important cause of failure of initial therapy and relapse. Non-compliance may  also result in acquired drug resistance, requiring more prolonged and expensive therapy that is less likely to be successful  than treatment of drug susceptible tuberculosis.12 MATERIALS AND METHODS Study design:  The present study is an observational, prospective and community based study Study population:   Inclusion criteria: All newly diagnosed sputum smear positive TB cases under DOTS- strategy for the period between 01.04.2006 to 30.09.2006 (i.e. 2nd and 3rd quarter of R.N.T.C.P calendar) were selected because of theire highest priority due to their role in infection spread and in whom treatment outcome is evaluated most correctly by following smear conversion Study setting: Tribal TB unit (TU) of Dhammapeta of Khammam district and rural TB unit (TU) of Nandigama of Krishna District of Andhra Pradesh was selected. Sample size and selection: All newly diagnosed sputum smear positive TB cases under DOTS- Strategy were selected as study subjects for the period between 01.04.2006 to 30.09.2006 (i.e. 2nd and 3rd quarter of R.N.T.C.P calendar). The study population consisted of 174 in rural area and 107 in tribal area. Study period: The study was conducted from 01.04.2006 to 31.04.2007 (including follow-up). RESULTS  In the present study among rural area out of 174 subjects, 138 were males and 36 were females, whereas in tribal area out of 107 subjects 73 were males and 34 females. Majority of the study subject belong to 15-49 years age group in both rural (65.53%) and tribal area (68.22%). 52.29% and 71.96% of the study subjects in the Rural and tribal area were found to be illiterates. Most of them were agricultural labourers. Housing standards were poor in the study population in rural area, 80.45% of cases are residing in katcha houses where as it was more in tribal (93.45%) area. 90% of study population were living below poverty line. 72% of rural subjects and 82% of the study population were living in Overcrowded houses. Among study population, 7.49% patients were traveling >2KM for their treatment in tribal area, which is more, when compared to rural area. In the present study, out of 174 subjects, 44.82% were cured, 25.88% were Treatment completed, 9.19% died, and 5.17% were failure and 14.94% were defaulters after treatment in the rural area. Out of 107 subjects, 39.25% were cured, 22.44% were Treatment completed, 6.54 % died, and 4.67% were failure and 27.10% were defaulter after treatment in tribal area. Treatment outcome was found to be better in rural areas (44.82%) when    compared to tribal area (39.25%).Defaulters rate was more in tribal area (27.10%) when compared to rural area (14.94%) Similarly in a study done N. Pandit et al 11 it was noticed that, Majority of study population (85%) was in age group of 15 - 55 years, which is the productive age and 50% of patients were labourers.81% of patients were from socio-economic class IV and V, lower socio economic class.  Gopi PG, et al12noticed that, 39% were aged 45 years or more and it was noticed that, 71% of the cases were males, 39% of the TB cases were illiterate.35% were unemployed in their study. They also noticed that among TB cases 41% were smokers and 31% were alcoholics. In rural area: *Among 16 deaths, 9cases were Defaulters, ** among 9 failure cases, 5 were Defaulters.                                                                                                              In tribal area: # Among 7 deaths, 6 cases were Defaulters,     # # All 5 failure cases were defaulters. During the treatment period, the total interruption was more in tribal area (76.62%) when compared to rural area (67.33%). Among this, interruption was more in rural area (33.31%) when compared to tribal area (19.61%) in intensive phase but in continuous phase treatment interruption was more in tribal area (53.26%) when compared to rural area (31.60%). Among the total treatment interrupted cases, defaulters were more in tribal area (37.37%) when compared to rural area (22.98%).   Reasons for treatment interruption included both patient and program factors. In rural areas the most common factors for non-adherence is adverse effects (40.24%), lack of personal interest (31.70%) followed by work load (30.48%).In tribal area the most common factors for non adherence is adverse effects (37.60%), work load (25.64%) followed by lack of personal interest (24.78%).Migration and false beliefs were other reasons for non-adherence which were comparatively more in tribal area.                                                  In the age group of 15-49 years, the treatment interruption was more in the tribal area (70.73%) when compared to rural area(64.96%). This is the productive age group who are usually the bread earners for their families, so once they become asymptomatic they tend to resume their regular activities and thereby neglect the treatment. The treatment interruption was more among rural males (82.05%) when to tribal males (74.39%) whereas treatment interruption was more in tribal females (25.61%) when compared to rural females. The treatment interruption among agricultural laborers was more in tribal area (65.85%) when compared to rural area (47.87%).The treatment interruption among cultivators was more in tribal area (7.32%) when compared to rural area (0.86%).  Among the patients who chew tobacco, the treatment interruption was more in tribal area(17.07%) when compared to rural area(7.69%). the treatment interruption was more in tribal area(73.17%) when compared to rural area (66.67%) among alcoholic patients. Defaulters were more in productive age group when compared to other age group. In the tribal area 42% of male patients were defaulters when compared with female patients (24%).75% of Defaulters in tribal area were found to be illiterates In rural area: * Among 40 defaulters, 9 cases were died and 5 cases were failure at 6th month follow-up. In tribal area: *Among 40 defaulters, 6 cases were died and 5 cases were failure at 6th month follow-up. # Multiple responses DISCUSSION In the present study males were more in both the areas indicating that prevalence of TB is more in males in India. Around 2/3rd of the study population belong to the productive age group 15-49yrs. Most of the study subjects were agricultural labourers and are the bread winners for the families Chronic diseases like Tuberculosis warrant treatment for long periods for which patients have to lose their wages hampering the economic status of the family. Along with these, the cases were living in overcrowded katcha houses and in joint families leaving their family members at risk of contracting the infection. Treatment outcome was found to be better in rural areas when compared to tribal area and also the defaulters rate was more in tribal area. Both in rural and tribal areas maximum TB deaths were defaulters of treatment. Treatment outcomes was found to be better in rural areas (44.82%) when    compared to tribal area (39.25%).Defaulters rate was found to be more in tribal area (27.10%) when compared to rural area (14.94%.All failure cases in tribal area and 5 out of 9 failure cases in rural area were defaulters. This shows  that the reason for treatment failure is defaulters. So it is understood that along with treatment health education should also be provided to the patients. Among 16 TB deaths in rural 9 were found to be defaulters and in rural area out of 7TB deaths 6 were defaulters. The reason for a significant proportion of the patients not adhered to treatment could be due to lack of knowledge about the importance of treatment under supervision. It was also found that all the defaulters were illiterates. In a study done in Pakistan10 it was found that around 71% of the Non-adherent patients were illiterates. This directly correlates literacy levels to the Non-adherence of treatment. Regular adherence to treatment was only 23% and 32% in tribal and rural areas respectively. The most common factors for non-adherence is fear of adverse effects (around40%) followed by lack of personal interest followed by work load. Migration and false beliefs were other reasons for non-adherence which were comparatively more in tribal area. It is therefore clear that to achieve the target of RNTCP, proper counseling of patients regarding various aspects of the disease is a must to ensure compliance. Treatment interruption was more in the age group of 15-49 years. This is the productive age group who are usually the bread earners for their families, so once they become asymptomatic they tend to resume their regular activities and thereby neglect the treatment. The treatment interruption among agricultural labourers was more in tribal area (65.85%) when compared to rural area (47.87%). Approximately 70% of the non-adherent patients were found to be alcoholics indicating alcoholism as one of the factor of non-adherence to treatment. Defaulters were more in productive age group when compared to other age group. In the tribal area 42% of male patients were defaulters when compared with female patients (24%).75% of Defaulters in tribal area were found to be illiterates. In conclusion, the present RNTCP should develop Information, Education, Communication package for the target group of patients. CONCLUSIONS Majority of the study subjects were males and belong to productive age group and are found to be illiterates belonging to low socioeconomic strata. Being male and belonging to productive age group will not only affect health of the patient but also affect the family`s economic status. Lower cure rates and high defaulters are found to be more in tribal area when compared to rural area. So, locally available traditional healers, school teachers and tribal literate youth may be utilized for IEC regarding completion of treatment as per the DOTS strategy. Treatment outcome was found to be better in rural areas when    compared to tribal area .Defaulters rate was more in tribal area when compared to rural area. With this it can be concluded that lack of communication and accessibility is the major problem in the treatment of tuberculosis. Majority of the people who died with Tuberculosis were defaulters in both the study areas. This shows that constant motivation of the patient is required for the treatment. Reasons for treatment interruption included both patient and program factors. In rural areas the most common factors for non-adherence is adverse effects ,lack of personal interest   followed by work load .In tribal area the most common factors for non- adherence is adverse effects, work load  followed by lack of personal interest.  Migration and false beliefs were other reasons for non-adherence which were comparatively more in tribal area. ACKNOWLEDGEMENT Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Englishhttp://ijcrr.com/abstract.php?article_id=1375http://ijcrr.com/article_html.php?did=1375 Murray, Christopher J.L., Lopez, Alan D.: The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020: summary WHO Geneva, Switzerland, 1996; W 74 96GL-1/1996. Tuberculosis programme review- India, 1992: World Health Organization, Geneva. 1992; National Tuberculosis Institute, Summaries of NTI studies, 1997, 101. Annual status report 2006, TB control: A.P scenario performance andProgress, page No.12http://tbcindia.nic.in/pdfs/RNTCP%20Annual%20Report%202006%20-%20AP.pdf L.S. Chauhan,S.P Agrwal et al.: Revised National Tuberculosis Control Programme, Tuberculosis Control in India. http://www.tbcindia.nic.in/pdfs/Tuberculosis%20Control%20in%20India-Final.pdf R.N.T.C.P. Andhra Pradesh annual status report 2006, message of Joint Director (TB) and State TB Officer (AP) TRIBAL ACTION PLAN (Proposed for the World Bank assisted RNTCP II Project )  Central TB Division, Directorate General of Health Services Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi – 110011,  Dated: 10 May 2005 R.N.T.C.P. Andhra Pradesh annual status report 2006, treatment out come-2005 (GEO, APBC 02) page No.41. R.N.T.C.P. Andhra Pradesh annual status report 2006, treatment out come-2005 (GEO, APKN 06) page No.42. Khatri G.R, Frieden T.R. The status and prospectus of tuberculosis control in India. Int J Tuberc Lung Dis 2000; 4: 193-200 Ibrahim Khan. Assessing adherence and its determinants among TB patients. Chapter4.http://www.bieson.ub.unibielefeld.de/volltexte/2003/332/pdf/06kapitel4.pdf Pandit N, Chaudhary SK. A study of treatment compliance  in directly observed therapy for tuberculosis. Ind  J Community Medicine. 2006;31:241.  Gopi PG, Vasantha M, Muniyandi M, Chandrasekaran V, Balasubramanian R, Narayanan PR. Risk factors for non-adherence to directly observed treatment (DOT) in a rural tuberculosis unit, South India. Indian J  Tuberc. 2007 Apr; 54(2):66-70, PMID: 17575677.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareFLOW CYTOMETRY DIAGNOSIS OF (CD4+/CD8+) T CELL LYMPHOBLASTIC LEUKEMIA ASSOCIATED WITH NORMAL KARYOTYPE - CASE REPORT English6368Trajkova SanjaEnglish Cevreska LidijaEnglish Ivanovski MartinEnglish Dukovski DuskoEnglish Simjanovska-Popova MarijaEnglish Panovska-Stavridis IrinaEnglishAdult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell neoplasm caused by human T-cell lymphotropic virus type I (HTLV-I). The neoplastic cells are highly pleomorphic and are usually CD4+ and CD8- phenotypically, but some rare cases have unusual immmunophenotype presented by co-expression of CD4/CD8 double positive cells. We present a rare case of a patient with T cell lymphoblastic leukemia associated with double-positive (CD4+/CD8+) blast cells. The diagnose was accessed with multiparameter immunophenotyping by flow cytometry analyses of bone marrow, and for the first time in our country, we confirmed isolated relapse of double-positive (CD4+/CD8+) T cell lymphoblastic leukemia in CNS. EnglishT cell lymphoblastic leukemia, flow cytometry, cerebrospinal fluidINTRODUCTION Adult T-cell leukemia/lymphoma (ATLL) is T-cell neoplasm that is linked to infection by the human T-cell lymphotropic virus 1 (HTLV-1).    ATLL is an aggressive type of leukemia/lymphoma which is diagnose with multiparameter immunophenotype analyses by flow cytometry. The neoplastic cells are highly pleomorphic and are usually CD4+ and CD8- phenotypically, but some rare cases have unusual immmunophenotype presented by co-expression of CD4/CD8 double positive cells. Here we report a rear case of CD4/CD8 double positive ATLL with normal karyotype. For the first time in our county we confirmed isolated relapse of CD4/CD8 double positive ATLL in CNS by flow cytometry analyses of cerebrospinal fluid. CASE REPORT A 20-year old male presented in August 2010, with one week history of weakness, myalgia, lethargy, malaise, high temperature, hemorrhagic syndrome associated with purpura, melena, bleeding from nose, severe headache, vomiting, and pain under left rib. Physical examination disclosed palpable lymphadenopaty in all peripheral regions with dimension of 1sm, palpable spleen of 3sm. Routine laboratory test revealed a white blood cell count 174x10 9/L, hemoglobulin 118gr/L, platelet 10x109/L. Other laboratory tests including liver functional tests, urine analyses, serum protein electrophoresis, blood urea, and creatinine were within normal limits. Examination of peripheral blood smear revealed presence of 90% blast cells. Immmunophenotype study was performed by 4-color-2-laser  flow cytometry FACS CantoII (BD-Biosciensies, San Jose, CA, USA) using the standard protocol and panel of monoclonal antibodies (MoAb) according to European Group for the Immunological Classification of Leukemia (EGIL), and clinical groups of the European Leukemia Net. (table1.) Reading the data was using the FACS DIVA TM software. Using the CD45 gating strategy we found blast cell population of 93,3%:  T –cell population CD2, CD7 ,CD5,CD3,  CD4, CD8(93%), CD10(59,4%), CD19(84,6%), cytoplasmic  Terminal deoxynucleotidyl transferase (TdT)(89%).We confirmed the diagnose of acute lymphoblastic leukemia with expression of T and B cell markers( figure 1). The patient underwent  Hyper CVAD regiment (Cyclophosphamide,Doxorubicin, Vincristine, Dexamethasone , Methotrexate and Cytarabine) course A and B, 3 cycles in total until April 2011 when complete response was achieved. Hematological response was maintained by Methotrexate and Purinethol until September 2011. In George Papanicolau Hospital in Thessalonica, Greece minimal residual disease analysis was done from a sample of bone marrow. The minimal residual disease analysis was positive and revealed CD34+CD10+CD200+CD38+BCL2+TdT+ of 0, 2%. Cytogenetic study from bone marrow showed normal male karyotype 46 x, y. Few days after returning from Greece patient presented with meningeal syndrome symptoms: visual disturbances, severe headache, and nausea. Routine laboratory test revealed a white blood cell count 3,9x10 9/L, hemoglobulin 148gr/L, platelet 133x109/L, with normal peripheral blood smear. Lumbar puncture (LP) was performed with 293 elements counted in Fuchs- Rosenthal chamber at 400x magnification, with 94% lymphocyte counted. In blood serum and cerebrospinal fluid (CSF) IgM antibodies of West Nile virus was detected by ELISA. The treatment was symptomatic but under suspecion of CNS relapse of ATLL, intrathecal therapy started with Methotrexate, Dexamethasone, Cytarabine. In December 2011 control test of blood serum and CSF were negative of West Nile virus. In February 2012 the patient was admitted to the clinic with severe pain in lumbar spine, enlargement of peripheral lymph nodes, high temperature. Routine laboratory test revealed a white blood cell count 53,9x10 9/L, hemoglobin 157gr/L, platelet 123x109/L. Examination of peripheral blood smear revealed presence of 90% blast cells. Immunophenotype analyses of the blast cells in bone marrow simples showed a CD45/CD2/CD7/CD5/CD3 positive with double positive of CD4/CD8, cytoplasmatic   TdT and CD3 were positive and ATLL was confirmed (figure 2). The patient was given a chemotherapy regimen FLAG-Ida (Fludarabine, Cytarabine, Idarubicyn) along with 20Gy radiotherapy of CNS. In Mart 2012 patient underwent allogeneus stem cell transplantation with Busulfan-Cyclophasphamide-Melphalan regimen and peripheral stem cells of HLA-DNA identical sister donor. After two month of allo - transplant patient was admitted to the clinic under suspection of leukemia involvement of CNS because of presence meningeal syndrome symptoms. Lumbar puncture was performed with 2775 elements in CSF detected in Fuchs- Rosenthal chamber at 400 x magnifications, with 98% lymphocyte and lymphoblast counted. A cytological finding of CSF was V classification group with conformation of lymphoblast cells in CSF. Several lumbar punctures were repeated with elevation of elements to 7000 in 1ml of CSF. For the first time in our country, in our immunohematology unit immunophenotype analyses of CSF was performed. Up to 1 ml extra CSF was obtained during routine LP. Immediately after withdrawal,   CSF was put in sterile tube with 1ml plasma. CSF cells were concentrated by centrifugation (8 minutes 450g) and re-suspended in 0,5ml phosphate – buffered saline (PBS). Next the samples ware incubated for 10 minutes at room temperature in the dark with 5microliters of each of the following (Moab): CD3 conjugated with allophycocyanin (APC), CD4fluorescein isothiocyanate (FITC) and CD8 phyoerytrin (PE).We applied only  this three moAb knowing the immunophenotype of the patient, because we had  insufficient material in volume and cells in 1ml of CSF. After incubation, cells were washed and subsequently re-suspended in PBS. Immediately after staining list mode data  were acquired on a by 4-color-2-laser  flow cytometry FACS CantoII (BD-Biosciensies, San Jose, CA, USA).Using BD DIVA TM  software analysis were performed. The immunophenotype definition of leukocytes and major T subsets are shown on table 2, figure 3. Salvage regimen which included high doses of Cyterabine and Methotrexate was started with intrathecal administration of Cyterabine, Methotrexate, and Dexamethasone. The patient underwent second allo-transplant from his HLA-DNA identical sister with administration of absolute number of CD34 of 1,428x10 6/L (determined with flow cytometry analysis according to ISHAGE recommendation). Second pulse of CNS radiotherapy was applied followed by several intrathecal applications of Cyterabine, Methotrexate, and Dexamethasone. However the disease recurred again with infiltration of medulla spinalis, being complicated with quadriparesis, vital centre dysfunction. Overall the patient survived 24 month from the time of the diagnosis and 5 month after first allo-transplant. DISCUSSION We have reported a rare case with ATLL with expansion of a CD4+CD8+ double positive cell population in a young patient with normal karyotype. For several years in our country   flow cytometry is tool which is part of standard diagnostic algorithm of acute leukemia. For the first time we confirmed the usefulness of flow cytometry in imunophenotype analysis of CSF in young patient with CNS involvement of the disease. Babusikova O (1) in her study explores the same problem like us. Immunophenotypic profiles of specimen from different sites (CSF, BM, and PB) of the same patient have been performed and no phenotypic changes were found. So we use well know immunophenotype profile from BM analysis, and we applied positive Moab like CD3, CD4, and CD8 which were positive in BM analysis. The results from our study are the same like those from Babusikova O (1), that positive CSF immunology is a useful indicator of malignancy and reflects leptomeningeal involvement; also the technique is reliable and quick. In the past flow cytometry has been considered to have limitation for the study of CSF samples, mainly related to the low cell count observed in this type of sample. Few authors have reported about this limitation, but Subirá D ET all. (2) proposed a flow cytometric approach that has been applied in our study. Our results have shown that flow cytometry could be reliable for the identification of total T cells, major CD4subsets. Moreover CD8+ T lymphocytes were identified as well. Graof TM et all. (3) helped us with their protocol of addition of serum-containing medium immediately after CSF sampling, and to prevent cell loss. On the clinical side of the study double positive CD4/CD8 is associated with very aggressive course. Kim et all (4) reported an extremely aggressive course with poor survival in a patient with double positive CD4/CD8ATLL with skin manifestation. Kamihira S et all (5) reported a poorer prognosis with a medium survival of 7, 8 months as compared to patient with typical CD4-CD8-phenotype. Ciminale V et all(6) et Raza et all(7)have reported a rare cases of double positive CD4/CD8 ATLL  with hypercalciemia and short overall survival. There are several clinical subtypes of ATLL, associated with mature CD4+CD8- T- cell phenotype. However same rare cases of immunophenotype characterized by co-expression of CD4+CD8+ T- cells have been reported (8). Our patient had initial flow cytometry analyses on a sample of BM with expression of T and B cell markers, but when relapse occurred the analyses from BM reveal expression only of T cell markers. Initial event was on early hematopoietic progenitor, but when relapse occurred only T cell markers express on blastic cells with double positive CD4/CD8, which presented leukemic clone with characteristics of cortical ATLL.  Another interest feature is cytogenic study which showed normal karyotype associated with aggressive disease. In literature abnormal karyotype is found in 35-36% of patients with ATLL. Itoyama T et all(9) reveled cytogenetic findings in 50 cases of ATLL where  multiple breaks( at least 6), abnormalities of chromosome 1p,1p22, 1q,1q10-21, 2q, 3q, 3q10-12, 3q21, 14p, 14q32 and partial loss of chromosome  2q,9p,14p, 14q, 17q  correlated with shorter survival. Several authors have suggested that14q32 translocation is the most common abnormalities of T cell malignancy (10). FUTURE ASPECTS AND CONCLUSION We presented a case of a young male with normal karyotype with double positive CD4/CD8 ATLL. Based on this study we recommend immunophenotype analyses of CSF to be routine diagnostic tool. The method will improve the diagnostic accuracy of classical cytological studies in acute leukemia (T, B ALL) and acute myeloid leukemia especially M5, extra nodal Non Hodgkin Lymphoma etc. This diagnostic tool will perform risk stratification of patient with adequate therapeutically approach. ACKNOWLEDGEMENT Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript.      Englishhttp://ijcrr.com/abstract.php?article_id=1376http://ijcrr.com/article_html.php?did=1376 BabusikovaO, ZeleznikovaT. The value of multiparameter flow cytometry of cerebrospinal fluid involved by leukemia/lymphoma cells. Neoplasia.2004;51(5):345-51. Subirá D, CastananS, AceitunoE, et al. Flow Cytometric Analysis of Cerebrospinal Fluid Samples and Its Usefulness in Routine Clinical Practice. AmJ Clin Pathol.2002;117:952-958. Graaf MT, Broek PDM, Kraen J et all. Addition of serum – containing medium to cerebrospinal fluid prevents cellular loss over time.J Neurol.2011;258:1507-1512 Kim YJ, Hwang ES, Kim IH, et al. CD4/CD8 double-positive, acute type of adult T-cell leukemia/lymphoma with extensive cutaneous involvement. Int J Dermatol. 2006; 45:1193–1195. Kamihira S, Sohda H, Atogami S, et al. Phenotypic diversity and prognosis of adult T-cell leukemia. Leuk Res. 1992; 16:435–441. Ciminale V, Hatziyanni M, Felber BK, et al. Unusual CD4+CD8+ phenotype in a Greek patient diagnosed with adult T-cell leukemia positive for human T-cell leukemia virus type I (HTLV-I) Leuk Res. 2000;24:353–358. RazaS,  NaikS, Venkat P. Dual-Positive (CD4+/CD8+) Acute Adult T-Cell Leukemia/Lymphoma Associated with Complex Karyotype and Refractory Hypercalcemia: Case Report and Literature Review. Case Rep Oncol. 2010 Sep-Dec; 3(3): 489–494. Yamada Y, Nagata Y, Kamihira S, et al. IL-2-dependent ATL cell lines with phenotypes differing from the original leukemia cells. Leuk Res. 1991; 15: 619–625. Itoyama T, Chaganti RS, Yamada Y, et al. Cytogenetic analysis and clinical significance in adult T-cell leukemia/lymphoma: a study of 50 cases from the human T-cell leukemia virus type-1 endemic area, Nagasaki. Blood. 2001; 97: 3612–3620. Tsukasaki K, Krebs J, Nagai K, et al. Comparative genomic hybridization analysis in adult T-cell leukemia/lymphoma: correlation with clinical course. Blood. 2001; 97: 3875–3881.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareEVALUATION OF GENERIC AND BRANDED DRUG UTILIZATION PATTERN IN A TRIBAL DISTRICT TEACHING HOSPITAL OF SOUTH INDIA English6973Mohammed Shakeel Mohammed BashirEnglish Kishor A BansodEnglish Ajay KhadeEnglishBackground: Generic drugs are relatively cheap and equally effective as branded drugs. Government of Andhra Pradesh is promoting the use of generic drugs in all the districts and planning to open generic outlets in each district. We conducted the study to assess the status of use of generic drugs in a rural cum tribal district of Andhra Pradesh India. Materials and Methods: Case records of 200 patients analyzed retrospectively for use of generic and branded drugs. Equal cases were selected randomly from medicine, surgery, and gynecology and paediatrics departments. Result: A total of 952 drugs were used. 37.86% were prescribed by generic name. In general medicine, general surgery, obstetric and genecology and paediatrics 39.39%, 25.5%, 46.65% and 39.91% over all generic drugs and 52.70%, 28.86, 37.71% and 25.5% generic antimicrobials were used respectively. Ranitidine, Metoclopramide, Pheniramine, Frusemide, Dicyclomine, Nifidepine, Cefixime and Ceftriaxone were 100% prescribed by all the departments with brand names. All the departments prescribed Ampicillin as generic drug only. Conclusion: Quality controlled generic drugs are equally effective as branded drugs. We suggest that generic drugs are substitution for branded drugs which reduces over all treatment cost. EnglishBranded drugs, generic drugs, irrational medicationINTRODUCTION In this century, increasing cost of drug therapy is a major problem for health care providers and patients in both developed and developing countries 1. Governments, insurance companies and health care providers are doing lot of efforts to control increased cost but health expenditures are not only increasing in developing countries but also in developed world every year. Apart from many reasons, ageing of the population, growing expectations regarding health by the society as well as the continuous improvement in health care facilities are the important reasons behind it in developed countries 2 while in developing nations there are different reasons. Generic drugs are relatively cheap and equally effective as branded drugs. Because these drugs are launched after expiration of patent of the original innovative drug and companies producing such types of drugs after presenting data which indicates that their launched generic has 80%–125% bioavailability of the original drug. In most of the situations and for the many patients, variations in this range are probably having very less clinical consequences 3. Thus generic pharmaceutical industry has the strong ability as a major force for shaping the economics of medication use. It is because generic drugs have huge potential to play an important role in containing costs of the drugs in disease management, although we cannot exactly and always easily measure the amount which we can save through the use of generic medications 4. Use of generic drugs has increased dramatically during last few decades and it is widely accepted practice in health care system 5. The economic impacts of generic drug use are much more on both the direction; in favor of consumers and against the RandD companies. In India, pharmaceutical production is grossly diverse in nature. Lot of pharmaceuticals companies are manufacturing number of generic drugs 6. These drugs are cheap and easily available in India. Government of Andhra Pradesh is promoting use of generic drugs in all the districts and planning to open generic outlets in each district. Prescription pattern can be evaluated retrospectively from clinical records of the institute or health care facility 7. Usually the main aim of such type of studies is to facilitate rational use of drugs in populations 8. It is one type of medical audit which review prescription status and, if needed prescription pattern can be modified for cost effective and rational use of medicine 9. Such type of studies also assesses the status of use of generic and branded drugs. In this background we planned the study to assess the actual status of use of generic drugs in this region so that suitable suggestion can be given. MATERIALS AND METHODS In this retrospective study case record of 200 patients belonging to general medicine, general surgery, obstetrics and gynecology and paediatrics department of Rajiv Gandhi Institute of Medical Science (RIMS) Adilabad were included. From each department case record of 50 hospitalized patients was randomly selected form medical record section of the institute. All the out patients record was excluded from the study. Case sheets were examined and findings related to use of generic and branded drugs recorded and analyzed using Microsoft Office Excel 2007. Necessary permission was obtained from the institutional authorities for the study. RESULT A total of 952 drugs were used by all the departments for the management of 200 different types of hospitalized patients. Out of 952 drugs 37.86% were prescribed by generic names while rest of the drugs by brand names. Maximum number of generic drugs were prescribed by obstetric and genecology (46.65%). Paediatrics and general medicine department used almost equal number of generic drugs; 39.91% and 39.39% respectively. General surgery department prescribed mainly branded drugs (74.50%) table-1.     Branded drugs were used most commonly in antimicrobial category in which all the departments used more than 50% branded antimicrobials except general medicine department in which they used 47.3% branded antimicrobials. Paediatric department used 74.5% branded drugs in antimicrobial category and general surgery department used 71.14% branded antimicrobials while obstetrics and gynecology department used 62.29% branded drugs (Table-2).  Ranitidine, Metoclopramide, Pheniramine, Frusemide, Dicyclomine, Nifidepine, Cefixime and Ceftriaxone were 100% prescribed by all the departments with brand names only. Ampicillin was the only drug which was prescribed by all the departments as generic drug only. DISCUSSION Uses of generic drugs become common in United States in the decade of 1970s. But in those days many of those generic drugs caused bioavailability problems 10. So it is well debated since many years that whether the generic drugs are equal to branded drugs or whether these drugs are of good quality and have fully investigated. There are also some questions that the bioequivalence studies can give the sufficient guarantee of efficacy and safety of generic drugs 11. Generic drugs which are launched only after bioequivalence studies should be sufficient guarantee for clinicians to routinely substitute generic drugs for branded drugs. But narrow therapeutic drugs should be substituted cautiously since the safety and efficacy issue exist with these drugs. FDA firmly believes that generic drug should always be prescribed with the full expectation that the recipient will receive the same clinical benefit as can be with innovator drug 17. In our study we observed use of almost 38% generic drugs by the four major departments of the institute. It is much higher in comparison to the observations of Irshaid et al 12 who observed use of 15% generic drugs in Saudi Arabia. But Guyon AB et al 13 in Bangladesh at primary health care centre level observed much higher number (78%) of use of generic drugs and Massele AY et al 14 in Dar es Salaam, Tanzania also found prescription of very high number of generic drugs in all health care facilities which were almost 80% of all prescriptions. In India, Ravi Shankar P et al 15 in South region found 67.4% of the drugs were prescribed by brand name which is higher in comparison to our findings. But generic drug utilization pattern was much less (7.4%) in Pune region of India as observed by Anuja et al 16. Bapna et al 17 also observed use of less number of generic drugs in comparison to branded drugs at primary health care level in southern India. Above observations indicates that there is no uniform report regarding use of generic drugs as different patterns of generic drug utilizations are observed in different countries and even the different regions of India. There might be many reasons for such type of pattern. It may be health insurance related matter like in western world where insurance providers insist for generic substitution leading to high number of generic drug utilization. In some countries clinicians prescribe less generic drugs due to their belief of under quality of generic drugs. In some region pharmaceutical inducements to clinicians promote more utilization of branded drugs. Some governments promote generic drugs vigorously. Thus there are lots of factors which affect prescription pattern of generic drugs. Use of Ampicillin only in generic form in our study indicates that generic drugs are qualitatively equal to branded drugs since it is most common antimicrobial agent which is used in most of the government institutions due to its cheap cost for the management of various conditions. As far as use of mostly branded cephalosporin in our region is concerned, it increases treatment cost which will not be helpful for the region since the district is tribal in nature with majority of population living in rural cum tribal areas 18.  CONCLUSION Quality controlled generic drugs are equal in term of safety and efficacy. We suggest that generic drugs can be used since these drugs are cost effective which will have greater positive socioeconomic impact in this tribal region. Costly 3rd generation cephalosporins can be switched over with cheap generics or alternative antimicrobials to reduce health care costs. ACKNOWLEDGMENT We are thankful to Mr. M. Salimuddin record section incharge (Junior Assistant), RIMS Adilabad for his invaluable help during data collection. Authors also acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Table- 1: Use of Generic and Branded Drugs Englishhttp://ijcrr.com/abstract.php?article_id=1377http://ijcrr.com/article_html.php?did=1377 Al Shimemeri A, Al Ghadeer H, Memish Z. Antibiotic utilization pattern in a general medical ward of a tertiary medical center in Saudi Arabia. Avicenna Journal of Medicine 2011; 1(1): 8-11. Ess SM, Schneeweiss S, Szucs TD: European healthcare policies for controlling drug expenditure. Pharmacoeconomics 2003; 21(2): 89-103. Pierre Blier. Brand versus generic medications: the money, the patient and the research. J Psychiatry Neurosci 2003; 28(3): 167–168. Kirking DM, Ascione FJ, Gaither CA, Welage LS. Economics and structure of the generic pharmaceutical industry. J Am Pharm Assoc (Wash). 2001; 41(4): 578-84. Ascione FJ, Kirking DM, Gaither CA, Welage LS. Historical overview of generic medication policy. J Am Pharm Assoc (Wash) 2001; 41(4): 567-77. Mohanty BK, Aswini M, Hasamnis AA, Patil SS, Murty KSN, Jena SK. Prescription Pattern in Rajahmundry. India Journal of Clinical and Diagnostic Research 2010; (4): 2047-2051. Hogerzeil HV. Promoting rational prescribing: An international perspective. Br J Clin Pharmacol 1995;39:1-6. Khan FA, Sheikh N, Salman MT. Patterns of prescription of antimicrobial agents in the department of otorhinolaryngology in a tertiary care teaching hospital. Int Res J Pharm Pharmacol August 2011; 1(5): 79-85. Available from: http://www.interesjournals.org/IRJPP {accessed on October 18, 2011}. Marr JJ, Moffet HL, Kunin CM. Guidelines for improving the use of antimicrobial agents in hospitals: A statement by the Infectious Diseases Society of America. J Infect Dis 1988; 157: 869-76.  Al-Jazairi AS, Bhareth S, Eqtefan IS, Al-Suwayeh SA. Brand and generic medications: are they interchangeable? Ann Saudi Med 2008; 28(1): 33-41. Tschabitscher D, Platzer P, Baumgärtel C, Müllner M. Generic drugs: quality, efficacy, safety and interchangeability. Wien Klin Wochenschr 2008; 120(3-4): 63-9. Irshaid YM, Al Homrany M, Hamdi AA, Adjepon- Yamoah KK, Mahfouz AA. Compliance with good practice in prescription writing at outpatient clinics in Saudi Arabia. Eastern Mediterranean Health Journal 2005; 11(5/6): 922-28. Guyon AB, Barman A, Ahmed JU, Ahmed AU, Alam MS. A baseline survey at the primary health care level in Bangladesh. Bull World Health Organ 1994; 72: 265- 71. Massele AY, Mwaluko GM. A study of prescribing patterns at different health care facilities in Dar es Salaam, Tanzania. East Afr Med J 1994; 71: 314-6. Ravi Shankar P, Partha P, Nagesh S. Prescribing patterns in medical outpatients. Int J Clin Pract 2002; 56: 549-51. Pandey AA, Thakre SB, Bhatkule PR. Prescription Analysis of Pediatric Outpatient Practice in Nagpur City. Indian J Community Med. 2010; 35(1): 70-73. Bapna JS, Tekur U, Gitanjali B, Shashindran CH, Pradhan SC, Thulasimani M, et al. Drug utilization at primary health care level in southern India. Eur J Clin Pharmacol 1992; 43: 413-5. National informatics centre Adilabad, Official website of Adilabad collectorate.mht, {accessed on June 28, 2012}. Available from: http://www.adilabad.ap.gov.in

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareSEXUAL DIMORPHISM OF BICONDYLAR WIDTH OF FEMORA IN SOUTH INDIAN POPULATION English7478Shanta ChandrasekaranEnglish R. SudhaEnglishObjectives: Aim of the study was to assess the values of bicondylar width of femora and to evaluate the sexual dimorphism. Methods: This analytical study was done in the department of anatomy from Vinayaka Missions Kirupananda Variyar Medical College, Annapoorana Medical College and Vinayaka Missions Homeopathy Medical College, Salem. All the dry adult femora of both sexes available in the above mentioned colleges were included and those which were damaged or having any pathological deformity were excluded from the study. Sex determination of all the femora were initially done by using distinct anatomical features. Maximum width between medial and lateral condyles of the femur was measured by using the vernier caliper and considered as bicondylar width. The mean values of the bicondylar width of both the sex were compared and demarking point was identified. The percentages, range, mean, standard deviation and p value were calculated using SPSS 15 (Statistical Package of Social Services) Results: The mean values of bicondylar width of male femora was 7.60 CM SD 0.38CM and female femora was 6.74 CM SD 0.34 CM. Male had higher value and it was statically significant (P< 0.001) Conclusion: Bicondylar width of femora in males was greater than bicondylar width of femora in females. EnglishBicondylar width, Sexual dimorphism, FemurINTRODUCTION Sexual dimorphism in bony parts of long bone is gaining more attention in forensic osteology and in anthropology. Sexual dimorphism relies heavily on the advanced and updated tech­niques to get better information to medico-legal system. Determining the sex using visual method alone needs more experience of the observer and inter rater variation cannot be avoided. Recent advances in this field made a shift from visual analysis to anthro­pometric measurements which is more objective and the possibility of the inter rater variability could be minimized. Sex determination of person is easy when the entire skeleton is available, especially pelvis and the skull helps in determining the sex differentiation. (1)  But it is difficult task for the forensic experts to determine the sex using the parts of long bones alone without skull or pelvis. Hence it is essential to undergo multiple researches on small parts of long bones to determine the sex. The role of bicondylar width of femora in sexual dimorphism is studied by many researchers in different populations. (2–7) The standards of morphological and morphometric attributes varies from one population to other population. It is a general rule that standards should be used with reference to population from which they are drawn; hence this study was aimed at measuring the maximal bicondylar width of the femora of both the sexes to determine the standards for sex determination in South Indian population. MATERIALS AND METHODS This analytical study was done in the department of anatomy from Vinayaka Missions Kirupananda Variyar Medical College, Annapoorana Medical College and Vinayaka Missions Homeopathy Medical College, Salem. All the dry adult femora of both sexes available in the above mentioned colleges were included and those which were damaged or having any pathological deformity were excluded from the study. Sex determination of all the femora were initially done by using distinct anatomical features. Using vernier caliper the maximum width between the most projected points of medial and lateral condyles of the femur in coronal plane was measured in centimetres (Fig 1). STATISTICAL ANALYSIS Data collected was tabulated. The mean values of the bicondylar width of both the sex were compared and demarking point was identified.   The percentages, range, mean, standard deviation and p values were calculated using SPSS 15 (Statistical Package of Social Services). The resultant p value was less than 0.05 making it statistically significant. RESULTS Totally one hundred and ninety six femora were studied. Of which 133 were male femora and 66 were female femora. The mean of bicondylar width of over all femora(n=196) was 7.32 CM SD 0.54 CM  with a range from 5.80 CM to 8.70 CM .The mean bicondylar width of male femora(n=133) was 7.60 CM SD 0.38CM with a range from 6.60CM  to 8.70 CM. The mean bicondylar width of the female femora was 6.74 CM SD 0.34CM with a range from 5.80CM  to 7.40 CM. Male femora showed higher bicondylar width than bicondylar width of female femora and it was statistically highly significant (pEnglishhttp://ijcrr.com/abstract.php?article_id=1378http://ijcrr.com/article_html.php?did=1378 Krogman, W. M. and Iscan, M. Y. Human Skeleton in Forensic Medicine. 2nd Edition, Charles C. Thomas, Springfield, 1986. Dittrick J. and Suchey J. M., Sex determination of prehistoric central California skeleton remains using discriminant analysis of the femur and humerus, American Journal of Physical Anthropology 1986; 70: 3-9. King C.A., Iscan M. Y. and Loth S.R., Metric and comparative analysis of sexual dimorphism in the Thai Femur. Journal of Forensic Science 1998; 43(5): 954–958. Iscan M.Y. and Miller-Shaivitz P., Determination of sex from the femur in blacks and whites. Coll. Antropol. 1984; 8(2):169–75. as cited by King C.A. et al, 1998 Steyn M. and Iscan M. Y., Sex determination from the femur and tibia in South African whites, Forensic Science International 1997; 90: 111-119. Iscan M.Y. and Shihai D., Sexual Dimorphism in the Chinese Femur. Forensic Science International June 1995; 74(1-2): 79-87. Singh S. P. and Singh S., The sexing of adult femora: Demarking points for Varanasi zone, Journal of the Indian Academy of Forensic Sciences 1972 B; 11:1- 6. Purkait R. and Chandra H., Sexual Dimorphism in Femora: An Indian Study. Forensic Science Communications 2002 July; 4(3): 1-6. Trancho G. J., Robledo, B., Lopez-Bueis I., and Sanchez S.A. Sexual determination of femur using discriminant function analysis of a Spanish population of known sex and age, Journal of Forensic Sciences 1997; 42:181-185. Pandya A. M,  Singel T.C,  Patel M.P,  Dangar K.P. Sexual Dimorphism of Bicondylar width of Femora. NJIRM 2011; Vol. 2(4): 68-71 UmapathySembian, Muhil. M, Srimathi.T, Muthukumar.T, Nalinakumari.S.D. A Study of Sexual Dimorphism in Femora of Rural Population of South Tamilnadu, India. Journal of Clinical and Diagnostic Research. 2012 April, Vol-6(2): 163-165. Pal G.P., Reliability of criteria used for sexing of hip bone. Journal of Anatomical Society of India. 2004; 53 (2): 58-60.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcarePREVALENCE AND DETERMINANTS OF DISABILITIES IN RURAL ELDERLY IN CHITTOOR DISTRICT, ANDHRA PRADESH English7983Swarnalatha N.EnglishSimilar to developed countries, aging was increased in India. Because of epidemiology and demographic transition phase, chronic diseases and disabilities were increasing. Socio-economic factors and chronic diseases were the major reasons for geriatric disability. There is a dearth of community based studies from India for geriatric disabilities and its associated risk factors; the present study was undertaken with the following objectives. Study objectives: To determine the prevalence of disability and its association with the age, gender and other selected variables in a rural geriatric population. Study design: cross-sectional, observational community based study. Study Period: April 2009 to September 2009. Study Setting: Villages covered under Rural Health Centre, which is a rural field practice area, attached Community Medicine department, S.V. Medical College, Tirupati. Study Subjects: 400 individuals aged 60 years and above of both sexes equally were interviewed by house-to-house visits. Study Method: Study subjects were selected by random sampling technique. Study was conducted by house-to-house visits. Clinical examination, observation and interview were conducted with a pre-designed and pre-tested proforma. Sample Size: 400. Study analysis: The data are analysed statistically using SPSS software 17 version. Results: The prevalence of disability was 70%. Most prevalent disability was vision (63.5%). The disability prevalence was high among 80 years and above elderly and it was increasing with age. The prevalence of disability was high among males (69.5%) than females (70.5%). In present study 46.5% elderly having one disability. Age, literacy, marital status and cognitive impairment were having statistical significant association with the disability. EnglishGeriatric population, disability, rural area.INTRODUCTION India is the 2 nd largest country in the world in terms of geriatric population. The proportion of elderly persons in Indian population is increasing as a result of many contributing factors i.e., a significant decline in birth rate, increase in life expectancy due to advancement in medical treatment and technology, prevention and eradication of many infectious diseases and improved nutrition, hygiene and sanitation. Though there is increased life expectancy, the health conditions of the people in their late stage have been observed to be worsening. Illness and injuries along with degeneration of body organs result in hospitalization or decreased activity, which may subsequently lead to disability or dependency. Disability is found to be major health concern among the elder people as it seriously affects the economic, social and psychological aspect of life. There are discussions about vulnerable groups like women, schedule castes and tribes etc. Elderly is another important group which need attention because of their increasing number. The incidence of disabilities is higher in developing countries than in the industrialized countries. Disabled individuals in the community face many social problems. They are perceived only in the light of their infirmities. There are a number of studies that look at the health conditions of elderly in developing countries. Though disability is the commonest problem, there are very few community based studies that look into the elderly disability pattern in India. Interestingly, most of the studies focus on the disability patterns of the younger population. However, there is very little information about gender differentials in disability among the elderly in developing countries, like India. Little is known about association of disabilities among elderly with gender, marital status, living arrangements etc. No similar study had been conducted in the past among geriatric population in Chandragiri, a rural area of Chittoor district. Considering this background, the present study was initiated in rural area of Chittoor district with the following objectives 1) To assess the prevalence of disability among 60 and above age group. 2) To find out the association of disability with age, gender and other selected variables in a rural elderly population. MATERIAL AND METHODS A community based cross sectional study was conducted from April2009 to September 2009 in rural field practice area of Rural Health Centre, Chandragiri, Chittoor district which is a field practice area of Sri Venkateswara Medical College, Tirupati. To draw a simple random sample with 10% of non respondents, approximately 400 subjects (aged 60 years and above) of both sex was included in the study. Data were collected from the study population by house to house visits using a pre designed, pre tested proforma after taking a verbal consent. Predictor variables included were socio demographic variables such as age, gender, literacy status, occupation, marital status, type of family, living status, socio economic status, status in the family, economic dependency, addiction, cognitive impairment and depression. Outcome variable was disability. Socio economic status was classified according to Aggarwal classification . Folstein’s Mini Mental Status Examination (MMSE) questionnaire was used to assess the cognitive status and Yesavage’s Geriatric Depression Scale (GDS) – Shorter version was used to detect depression status of the study subjects. Data was analysed using SPSS 17 version and the results were recorded as frequencies, percentages. The tables were used for comprehensive viewing of the results. The chi square test was used whenever necessary. Value < 0.05 was taken as criteria for significance for all purposes. Binary logistic regression analysis with significance was also done. RESULTS In current study prevalence of disability was 70.0% (Table1). The prevalence of various types of disabilities was found to increase with age and the differences were statistically significant. Most prevalent disability was vision (63.5%) followed by hearing (25.3%), loco motor disabilities (7.4%) and speech (5.8%). Prevalence of various types of disabilities was found to be more or less similar in both males and females and it was not statistically significant (Table 2). 46.5% elderly having 1 disability while 23.5% were having more than 1 disability. Proportion of subjects having more than one disability was increasing with age and it was statistically significant (Table 3). The prevalence of having one or more than one disability was found to be high in females (70.5%) compared to males (69.5%). However, the difference was not statistically significant (Table 4). Association of different socio demographic characteristics, economic dependency, status in the family, cognitive impairment and depression with disability was analyzed by binary logistic regression (Table 5). Among these variables age, literacy, marital status and cognitive impairment were significantly associated with disability. DISCUSSION The prevalence of disability in current study was 70%. Joshi et al found that 87.5% elderly had minimal to severe disabilities . Mangalore study showed the disability prevalence as 65.8% . Venkata Rao et al and Krishnamachari Srinivasan studies revealed the disabilities prevalence as 74.12% and 58% respectively 6, 7 . In North Indian study the prevalence of various impairments was 48% . The present showed variation in prevalence of disability among geriatric population in comparison to other studies. This may be due to methodological reasons. The prevalence of disability was increasing with age and it was statistically significant. Many studies related to disability among elderly have confirmed that increasing age tend to be associated with increased risk of disability 5, 6, 8, 9 . The prevalence of disability was high among males (69.5%) than females (70.5%) and it was not statistically significant. In current study 63.5% elderly having vision disability which was a major disability. Venkata Rao et al and Grover et al studies revealed vision disability as 56% and 69% respectively 6, 10 . In present study, cataract was observed to be responsible for visual disability. The prevalence of visual impairment in the present study was found high among males than females. The reason was probably due to tendency of early health seeking behaviour in men as compared to women. In present study hearing impairment was 25.3%. Various studies in India showed prevalence of hearing impairment ranging from 22% to 43.3% 10, 11 . Even higher prevalence of hearing impairment (46%) was reported by Vijaya Kumar 12 Earlier population studies from India have reported that impairment in hearing and visual functions as important causes of disablement in the elderly 13 . Similar findings were observed in current study. In present study loco motor disability was 7.4%. Goswami et al study reported loco motor disability as 11% in the elderly, without much difference in any gender . Speech disability in present study was 5.8% and Venkata Rao et al study revealed speech disability as 4% In present study 46.5% elderly having one disability while 23.5% were having more than one disability. Venkata Rao et al and Goswami et al studies revealed that 74.12% and 48.0% of the aged population were having at least one disability repectively 6, 8 . In present study the proportion of persons having one or more than one disabilities increased with the age. Present study found that age, literacy status, marital status, cognitive impairment was significantly associated with disability (binary logistic regression analysis). Similar association was also reported in different studies 14, 15 . Similar to current study, Italy showed that cognitive impairment is a more powerful predictor of impaired functional activities than disease burden 16 CONCLUSION Disability is an important health problem among elderly in rural area of India. There is need to provide appropriate awareness, comprehensive and accessible services, so as to enable the elders to realize their full potential and lead a comfortable, healthy and happy life. The mobile health clinics equipped with these facilities may be a solution. ACKNOWLEDGMENTS I thank all the study participants and their families for their cooperation during the study period. Author acknowledges the great help received from the scholars whose article cited and included in references of this manuscript. The author is also grateful to authors/editors/publishers of all those articles, journals from where the literature for this article has been reviewed and discussed. Author is grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Englishhttp://ijcrr.com/abstract.php?article_id=1379http://ijcrr.com/article_html.php?did=13791. Aggarwal OP, Bhasin SK, Sharma AK, Chabra P, Aggarwal K, Rajoura OP. A socioeconomic status of a family: Preliminary study. Indian Journal of Community Medicine 2005; 30(4): 111 14. 2. Folstein MF, Folstein SE and Mc Hugh PR. “Mini Mental State”. A Practical method for grading the cognitive status of patients for the clinicians. Journal of psychiatric Research 1975;12:189 98. 3. Yesavage JA. Geriatric depression scale (Short version). Psychopharmacology Bulletin 1998;24:709 11. 4. Joshi K, Kumar R, Avasthi A. Morbidity profile and its relationship with disability and psychological distress among elderly people in Northern India. International Journal of Epidemiology 2003;32:978 87. 5. Ganesh KS, Yadav A, Sajjan BS and Kotian MS. Epidemiology of disability among geriatric population in the semi urban area of Mangalore city, Karnataka. Indian Journal of Gerontology 2008;22(1):35 42. 6. Venkatarao T, Ezhil R, Jabbar S, Ramakrishnan R. Prevalence of disability and handicaps in geriatric population in rural South India. Indian Journal of Public Health 2005;49(1):11 7. 7. Krishnamachari Srinivasan, Mario Vaz and Tinku Thomas. Prevalence of health related disability among community dwelling urban elderly from middle socioeconomic strata in Bengaluru, India. Indian J Med Res 2010;131:515 21. 8. Goswami A, Reddaiah VP, Kapoor SK et al. Prevalence and determinants of disability in the rural elderly population in Northern India. Indian Journal of Physical Medicine and Rehabilitation 2005; 16:39 44. 9. Dhar HL. Emerging Geriatric Challenge. JAPI 2005;53:867 71. 10. Grover V, Aggarwal OP, Tiwari RS, Markandey N. Prevalence of health problems among the elderly in rural areas of Delhi. Indian J Preventive Social Medicine 2000; 31:47 51. 11. Dr. Chandra Paul Singh. Socio economic status and health conditions of landless rural aged in Haryana. Help Age India Research and development Journal 2005; 11:7 15. 12. Vijaya Kumar S. Rural elderly health status and available health services. Help Age India Research and development Journal 1996; 2:16 22. 13. Venkoba Rao A. The health care of the rural aged – kallandiri experience. Indian Journal of Social Psychometry 1997; 298. 14. Fuller Thomson E and Minkler M. Functional limitations among older American Indians and Alaska natives. Findings from the census 2000 Supplementary survey. American Journal of Public Health 2005;95:1945 48. 15. Hayward MD and Heron M. Racial inequality in active life among adult Americans. Demography 1999; 36:77 91. 16. Scalan JM, Binkin N, Michieletto F, Lessig M, Zuhur E, Borson S. Cognitive impairment, chronic disease burden and functional disability: a population study of older Italians. Am.J geriatr psychiatry 2007; 15:716 4.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareEFFICACY OF DEEP CERVICAL FLEXOR STRENGTH TRAINING VERSUS CONVENTIONAL TREATMENT IN CERVICOGENIC HEADACHE English8490Rabiul IslamEnglish Nishat QuddusEnglish Mohammad MirajEnglish Shahnawaz AnwerEnglishObjective: To evaluate the effectiveness of Pressure-biofeedback as an add-on therapy with conventional exercise on deep cervical strength, pain, and headache disability index in patient with cervicogenic headache. Design: Pretest-posttest experimental group design. Methods: Thirty patients (17 men, 13 women) with cervicogenic headache participated in the study completed the trial. Subjects were randomly placed into two groups receiving the pressure biofeedback training (n=15) and a control group (n=15). The pressure biofeedback group received biofeedback stabilizer (PBU) guided DCF strength training along with conventional treatment program for 3 days a week for 3 week, whereas the control group received an exercise program only. Pain intensity was assessed with a visual analogue scale (VAS) and the headache score of the patients were measured by the Headache Disability Index (HDI) respectively. Results: On between group comparisons, pressure biofeedback group has shown significant improvement in pain intensity and headache disability score as compared to control group at the end of trial (pEnglishPressure-biofeedback stabilizer, Deep Cervical Flexors exercise, Cervicogenic Headache, Neck painINTRODUCTION Headache is a common and often incapacitating condition affecting a large number of individuals. It has been estimated that a headache in some form will be experienced by at least 90% of the population at some stage of their lives.1 Headache’s arising from musculoskeletal disorders of the cervical spine termed cervicogenic headache (CGH).2 Neck pain and cervical muscle tenderness are common and prominent symptoms of primary headache disorders.3 Less commonly, head pain may actually arise from bony structures or soft tissues of the neck, a condition known as CGH.4 Headaches will strike 2/3 of the population at any one given time, 15-20% are vascular and remaining 80-85% are placed under a multitude of diagnostic categories, and may be related to depression, fatigue and structures in cervical spine.5 With a point prevalence of 16% in the general population, headache is one of the most common human ailments. The recent clinical investigations of many studies have shown that the cervical spine to be responsible for the majority of headaches in general population.5 Recently Bogduk has demonstrated experimentally that disorders of the cervical spine can cause headache.6 The computer aided evaluation of the functional roentgenograms of the cervical spine in ventral and dorsal flexion studied in 15 cervicogenic headache patients and 18 controls showed a statistically signifacant hypomobility (pEnglishhttp://ijcrr.com/abstract.php?article_id=1380http://ijcrr.com/article_html.php?did=13801. K Niere, P Robinson. Determination of manipulative physiotherapy treatment outcome in headache patients. Manual therapy 1997; 2(4):199-205. 2. Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: Diagnostic criteria. Headache 1998;38:442-445. 3. Blau JN, MacGregor EA. Migraine and the neck. Headache 1994;34:88-90. 4. Sjaasted O, Saunte C, Hovdahl H, Breivik H, Gronback E. “Cervicogenic” headache. A hypothesis. Cephalalgia 1983;3:249-256. 5. Nilsson N. The Prevalence of Cervicogenic Headache in a Random Population Sample of 20-59 Year Olds: Spine 1995;20(17):1884- 1888 6. Gwendolen A. Jull. Grieve’s modern manual therapy. The vertebral column. 2nd edition. Cervical headache: A review 1994;333-347. 7. Darryl D Curl. Classification of headache: A new look. “Chiropractic approach to head pain” (Chap. 9) Williams and Wilkins, 1994: 182-189. 8. Beeton K. Jull G. Effectiveness of manipulative physiotherapy in the management of cervicogenic headache: a single case study. Physiotherapy 1994;80:417-423 . 9. Shannon M. Peterson. Articular and muscular impairments in cervicogenic headache: Acase report. Journal of orthopedic and sports physical therapy 2003;33:21-30. 10. Fernandez Cesar, Calos Juan. Performance of the craniocervical flexion test, forward head posture, and headache clinical parameters in patients with chronic tension-type headache: A pilot study. JOSPT 2007; 37(2):33-39. 11. Bovfim G., Berg Rakel, Dale L. Cervicogenic headache: anesthetic blockades of cervical nerve (C2-C5) and facet joints (C2/C3). Pain 1992;49:315-320. 12. Gwendolen Jull, Patricia Trott, Helen Potter et al. A Randomized Controlled Trial of exercise and Manipulative Therapy for Cervicogenic Headache: Spine 2002;27:1835- 1843. 13. Jull G, Barrett C, Magee R et al. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia 1999;19(3):179- 175. 14. Benson TB, Copp EB. The effects of therapeutic forms of heat and ice on the pain threshold of the normal shoulder. Rheumatol Rehabil 1978;13:100-104. 15. Lehman JF, DeLateur BJ. Therapeutic heat. In therapeutic heat and cold. Baltimore: Williums and Wilkins.p404-562; 1982. 16. H Duane Saunders. Use of spinal traction in the treatment of neck and back conditions. Clinical orthopaedics and related research 1983; 179:32-38. 17. Geert JMG van der Heijden, Anna JHM Beurskens et al. The efficacy of traction for back and neck pain: A systematic, blinded review of randomized clinical trial methds. Physical therapy 1995;75(2):93-104. 18. Mary J. Murphy. Effects of cervical traction on muscle activity. JOSPT 1991;13(5):220- 225.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareANALYSIS OF NUTRIENT FORAMEN OF TIBIA-SOUTH INDIAN POPULATION STUDY English9198K.UdhayaEnglish K.V.Sarala DeviEnglish J.SridharEnglishObjectives: The aim of the present study was to analyse the morphology and morphometry of nutrient foramen of tibia, knowledge of which becomes precise during bone surgeries for orthopaedic surgeons. Methods: The study included 135 tibia (70 right and 65 left) irrespective of age and sex. Number, direction, location were studied by direct observation. Size was analysed by using 24 size hypodermic needle. Position of nutrient foramen of tibia was studied by calculating foramen index. For this length and distance of the tibia were measured by using osteometric board. Results: In our present study, out of 135 tibia (70 right and 65 left) studied,130 showed single foramen in the upper third of tibia and 5 tibia in addition to single foramen showed another foramen in the middle third. On both sides, we commonly observed that majority of nutrient foramen was positioned lateral to vertical line, on the right being (74.28%), and on left side (72.30%). Similarly the most common size of nutrient foramen observed were primary or dominant type on both the sides, right as (87.14%) and left as (89.23%). The direction of nutrient foramen were also found to be similar on both sides, majority directed vertically downwards, on right (95.71%) and on left (96.92%). The mean length of tibia on right was 35.23 with SD 2.401 and on left it was observed as 35.91 with SD 2.110. The mean foramen index of tibia on right was 30.60 with SD 3.804, and on left 31.45 with SD 2.906. Conclusion: The present study provides a wide knowledge for orthopaedic surgeons about the morphology of nutrient foramen while performing microvascular bone surgeries to preserve microcirculation. EnglishForamen index, morphology, morphometry, nutrient artery.INTRODUCTION The nutrient artery is the main source of blood supply to any long bone and is very important not only during its embryonic growth period, but also during the early phase of ossification1 . During young age, long bones primarily receive about 80% of its blood supply from the nutrient arteries, and in their absence, the vascularisation occurs through the periosteal vessels2 . These nutrient arteries enter the long bones through the nutrient foramen. The nutrient foramen, in most of the cases is located away from the growing end3 derivation of the axiom saying that direction of foramina ‘seeks the elbow and flee from the knee’4 . The topography of nutrient foramina may differ in its growing and non-growing end, precise understanding of this becomes essential in certain surgical procedures to conserve the circulation5-7 . The preserved nutrient blood flow also becomes much important for the survival of the osteoblasts and osteocytes in cases of tumour resection, traumas and congenital pseudoarthrosis8 .Thorough knowledge about the blood supply of long bones is one of the important factor for success of new techniques in bone transplant and resection in orthopaedics9, 10. During transplant techniques, these statistical datas about the distribution of nutrient foramina guides the operating surgeons to select the osseous section levels and place the graft without damaging the nutrient arteries thus preserving the diaphyseal vascularisation and also the transplant consolidation11. Detailed study about the vascularisation of long bones and the nutrient foramina morphometry8, 12-17 were reported in different populations. But very few studies were reported on nutrient foramina of tibia in South Indian population. Hence an effort was made to study the morphometry of nutrient foramina of tibia in South Indian population. MATERIALS AND METHODS The study was done in the Department of Anatomy, Vinayaka Mission Kirupananda Variyar Medical College and Annapoorna Medical College, Salem. For this, we collected 135 tibia, (which includes70 right and 65 left) irrespective of age and sex. The bones with gross pathological deformity were excluded from our study. The number, direction, location were noticed by direct observation. Only those foramina’s with elevated margins and distinct groove proximal to them were accepted and foramina other than these were not considered. Double foramen if any, was also noticed. The direction of nutrient foramen facing vertically downwards or upwards was noticed. Position of nutrient foramen on the posterior surface of tibia in relation to borders was noticed. Size was analysed by using 24 size hypodermic needle. Foramina smaller than a size of 24 hypodermic needle were considered secondary foramina8, 14,17,18 and these were not used for analysing foramen index. Distribution of nutrient foramen of tibia was studied by calculating foramen index (FI). For this total length (TL) of the tibia and distance (D) between the nutrient foramina and the highest point of intercondylar eminence of tibia, both were measured using Brocas osteometric board. But for bones with double nutrient foramen, only the larger foramina (primary) were considered during the calculation of foramen index. By applying Hughes formula19 , FI was calculated as follows: : FI = D / L x 100 STATISTICAL METHODS The frequency, percentage, mean and standard deviation were calculated using SPSS 15 (Statistical Package of Social Services) RESULTS On the right side out of 70 tibia studied,73 nutrient foramina was noticed, which comprised of 67 bones with single foramen (95.71%) and three bones with two nutrient foramens (4.28%)(Table-5) (Figure-2). Among 70 right tibia, the most common position of nutrient foramen found was lateral to vertical line, being (74.28 %) and the most common type of nutrient foramen was primary which was observed as (87.14%) (Table-1).The direction of nutrient foramen was mostly directed vertically downwards (VD) on the right side (95.71%). The mean distance (D) of tibia was found to be 10.79 ± 1.565, and the mean length of tibia (TL) on right was 35.23 ± 2.401. The mean foramen index of tibia (FI) on right was 30.60 ± 3.804 (Table-2) On the left side out of 65 tibia studied,67 nutrient foramina was noticed, which comprised of 63 bones with single foramen (96.92%) and two bones with two nutrient foramens (3.07%)(Table5) (Figure-3). Among 65 left tibia, the most common position of nutrient foramen found was lateral to the vertical line, being (72.30 %) and the most common type of nutrient foramen was primary which was observed as (89.23%)(Table - 1).The direction of nutrient foramen was mostly directed vertically downwards (VD )(96.92%). The mean distance (D) of left tibia was found to be 11.30 ± 1.237, and mean length of tibia (TL) was 35.91 ± SD 2.110. The mean foramen index of tibia (FI) on left was 31.45 ± 2.906. (Table -2) (Figure -1) As a result, we considered that out of 135 tibia which includes 70 right (67 showing single foramen and 3 showing double foramen) and 65 left (63 showing single foramen and 2 showing double foramen), 130 showed single nutrient foramina and 5 showed double foramina (10 in number), the percentage of single nutrient foramina being 93% and percentage of double nutrient foramina being 7.14% (Table-5) DISCUSSION It is well known that one of the causes of delayed union or non-union of fracture is lack of arterial supply24. The morphological knowledge of nutrient foramina is significantly important for orthopaedic surgeons undertaking an open reduction of a fracture to avoid injuring the nutrient artery and thus lessening the chances of delayed or non-union of the fracture24. These nutrient arteries pass through the nutrient foramina, the position of nutrient foramina in mammalian bones are variable and may alter during the growth25 . In the present study we observed 93% of single nutrient foramen and 7.14% of double foramina which almost coincide with studies reported by Kirschner10 et al ( 93.5% a foramen and 6.5% two foramina) and Longia20 et al (95% a foramen and 5% two foramina) Similar studies with double nutrient foramina were also reported by authors5,8,12,21-23 The present study showed predominantly primary/dominant type of nutrient foramina 88.14% for 135 tibia,{ right (87.14%) and left side (89.23%) } which coincide with the study reported by Kizilkanat17 et al. The position of nutrient foramina in our present study was most commonly located on the posterior surface of tibia. Similar results were reported by authors5,8,12,17,20-23. As reported17, the position of the nutrient foramina was directly related to the requirements of a continuous blood supply to specific aspects of each bone. Out of 140 foramina majority of nutrient foramina were found in the upper third 107 foramina (76.42%){right 60 and left 47 foramina} and remaining 33 foramina (23.57%) in the middle third of tibia {right 13 and left 20}. No foramina were found in the distal third of tibia. Similar reports were stated by many authors5, 20-23, like majority of nutrient foramen were present in the proximal third of the tibia. Of the 140 foramina, 99 (70.71%) were lying lateral to the vertical line, 17 (12.14%) were lying on the vertical line, 12 (8.57%) were medial to vertical line, 7 (5%) were on the interosseous border (Table-6), 5 (3.57%) were miscellaneous - one on medial border (0.71%) and 4 close to interosseous border (2.85%). Our results were similar to the report of Myosekar5. In the present study, the mean length of right tibia were observed as 35.23 cm ± 2.401 (Range 30.4 – 41), the mean length of left tibia were 35.91 cm ± 2.110 (Range 30.8 – 40.5) (Table-2).Our results coincide with the study of Erika Collipal26. The mean distance of right tibia between the nutrient foramina and the apex of the intercondylar eminence was 10.79 cm ± 1.565, and the left tibia was found to be 11.30 cm ± 1.237. The findings of our investigation were similar to the reports of Erika Collipal26. The mean foramen index on the right side were 30.60 ± 3.804 and on left were found as 31.45 ± 2.906 the findings of which were close in comparison with the previous studies of Gumusburun22 et al. Though our present study coincided with the results of previous studies, it has some limitations too, because we were not considered with age and sex differences during our analysis. As we know that some foramina may get ossified in old age and moreover there might be variations in the gender, we should get a forensic help to identify the age and gender of the bone before analysis. This would suffice and will provide thorough information about variations in age and gender. Moreover many previous studies on tibia have not defined the values separately for the right and left side, which were provided in our results that may help for future implications. CONCLUSION Our present study will help for future implication of these data in a South Indian population group, not only with their morphology and morphometry but also to compare them with their sides for analysis. Our study will provide a thorough and precise knowledge about clinical importance of nutrient foramina of tibia for orthopaedic surgeons to proceed with a successful graft transfer and also to avoid damage to the nutrient vessels during surgical procedures. ACKNOWLEDGEMENTS The authors sincerely wish to thank the management, administrators and the Professor and Head of the department of Anatomy of Vinayaka Missions Kirupananda Variyar Medical College, Salem for their whole hearted support and permissions to utilize their resources and conduct this study. Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors/ editors/ publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript.   Englishhttp://ijcrr.com/abstract.php?article_id=1381http://ijcrr.com/article_html.php?did=13811. Lewis OJ. The blood supply of developing long bones with special reference to the metaphyses. J Bone Jt Surg 1956; 38: 928- 933. 2. Trueta J. Blood supply and the rate of healing of tibial fractures. Clin Orthop Rel Res 1953; 105: 11-26. 3. Mysorekar VR, Nandedkar AN. Diaphysial nutrient foramina in human phalanges. J Anat 1979; 128: 315-322. 4. Patake SM, Mysorekar VR. Diaphysial nutrient foramina in human metacarpals and metatarsals. J Anat 1977; 124: 299-304. 5. Mysorekar VR. Diaphysial nutrient foramina in human long bones. J Anat 1967; 101: 813- 822. 6. Taylor GI. Fibular transplantation. In: Sefarin D, Burke HJ, editors. Microsurgical composite tissue transplantation. St Louis: Mosby 1979; pp 418- 423. 7. McKee NH, Haw P, Vettese T. Anatomic study of the nutrient foramen in the shaft of the fibula. Clin Orthop Rel Res 1984; 184: 141-144. 8. Sendemir E, Cimen A. Nutrient foramina in the shafts of lower limb long bones: situation and number. Surg Radiol Anat 1991; 13: 105-8. 9. Guo F. Observations of the blood supply to the fibula. Arch Orthop Traumat Surg 1981; 98: 147-51. 10. Kirschner MH, Menck J, Hennerbichler A, Gaber O and Hofmann GO. Importance of arterial blood supply to the femur and tibia transplantation of vascularised femoral diaphyseal and knee joints. World J Surg 1998; 22: 845-52. 11. Wavreille G, Dos Remedios C, Chantelot C, Limousin M and Fontaine C. Anatomic bases of vascularised elbow joint harvesting to achieve vascularised allograft. Surg Radiol Anat 2006; 28: 498-510. 12. Nagel A. The clinical significance of the nutrient artery. Orthop Rev 1993; 22:557-61. 13. Ciszek B and Glinkowski W. Nutrient foramina in the diaphyses of long bones. Orthop Traumatol Rehabil 2000; 2: 97-9. 14. Lee JH, Ehara S, Tamakawa Y and Horiguchi M. Nutrient canal of the fibula. Skeletal Radiol 2000; 29:22-6. 15. Dyankova S. Vascular anatomy of the radius and ulna diaphyses in their reconstructive surgery. Acta Chir Plast 2004; 46:105-9. 16. Chen B, Pei GX, Jin D, Wei KH, Qin Y and Liu QS. Distribution and property of nerve fibers in human long bone tissue. Chin J Traumatol 2007; 10:3-9. 17. Kizilkanat E, Boyan N, Ozsahin ET, Soames R and Oguz O. Location, number and clinical significance of nutrient foramina in human long bones. Ann Anat 2007; 189:87-95. 18. Carroll SE. A study of the nutrient foramina of the humeral diaphysis. J. Bone Joint Surg Br 1963; 45-B: 176-81. 19. Hughes H. The factors determining the direction of the canal for the nutrient artery in the long bones of mammals and birds. Acta Anat (Basel) 1952; 15:261-280. 20. Longia GS, Ajmani ML, Saxena SK and Thomas R. J Study of diaphyseal nutrient foramina in human long bones. Acta anal. 1980; 107:399-406. 21. Forriol Campos F, Gomez Pellico L, Gianonatti Alias M, Fernandez Valencia R. A study of the nutrient foramina in human long bones. Surg Radiol Anat. 1987; 9:251- 255. 22. Gumusburun E, Adiguzel E, Erdil H, Ozkan Y, Gulec E. A study of the nutrient foramina in the shaft of the fibula. Okajimas Folia Anat. Jpn. 1996; 73 (2-3):125-128. 23. Collipal E, Vargas R, Parra X, Silva H, Sol M. Diaphyseal nutrient foramina in the femur, tibia and fibula bones. Int. J Morphol. 2007; 25 (2):305-308. 24. Joshi H, Doshi B, Malukar O. A study of the nutrient foramina of the humeral diaphysis. NJIRM. 2011; 2:14-17. 25. Henderson RG. The position of the nutrient foramen in the growing tibia and femur of the rat. J Anat 1978; 125:593-599. 26. Erika Collipal, Ramiro Vargas, Ximena Parra, Hector Silva and Mariano d

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareKAPAL BHATI PRANAYAMA MODIFIES VISUAL REACTION TIME English99103Neera GoelEnglish Varun MalhotraEnglish Usha DharEnglish ArchanaEnglish NiketaEnglishKapalbhatti is form of Pranayama, which means („breath of life?). This exercise helps to regulate and control breathing. It is useful in clearing of mind, weight loss, diabetes, it improves the quality of life in people with heart diseases and prostrate enlargement. This procedure uses excess inhaled air to flush the blood vessels in the heart and clear them of nascent block. It involves taking normal breaths, diaphragm and abdominal muscles are to be moved violently and the air is exhaled with that movement. This is done for 2 minutes and Reaction times are recorded before and after the procedure. During normal breathing, we just take shallow breaths, and we don?t fill our lungs to capacity. Shallow breath causes excessive weight. Kapalbhatti teaches us how to take deep breath which increases oxygen supply to body and removes waste products. Continuous inhalation of oxygen and expulsion of carbon dioxide converts the venous blood to oxygenated blood. The heart&#39;s function to pump blood to the lungs is sub-served by the breathing technique. The heart is given extraordinary rest. Hyperventilation washes out carbon dioxide which leads to central vasoconstriction that leads to a filling of emptiness in the head. This possibly explains, scientifically why kapalbhatti cleanses the head. This is the reason we ventured to see reaction times in our study. EnglishINTRODUCTION Patanjali, foremost exponent of Yoga, described pranayama as the gradual unforced cessation of breathing. Pranayama is derived from two Sanskrit words - prana (life) and yama (control). Pranayama or control of prana or life force yields heart beat, pulse and mind control. Kapalbhatti is a form of pranayama, whose root meaning comes from the words kapal (skull) and bhatti (shining). This breathing exercise involves expulsion of the air with violent movements of abdomen and diaphragm. It helps in clearing the mind, weight loss and improves quality of life in people with heart diseases and prostrate enlargement, as it uses excess inhaled air to flush out the blood vessels in heart and clear them from nascent block. This technique stimulates the kapal (forehead region) through rapid breathing movements and sensitizes the frontal region to the touch of air. The impact is on the Swadisthan and Ajna chakras corresponding to sacral and medullary plexus (23). Our study is designed to observe the effect to kapalbhatti pranayama on visual reaction time. MATERIAL AND METHODS The pranayama is performed before meals. Twenty normal male MBBS subjects at Santosh Medical College, Ghaziabad were seated in a comfortable sitting posture with spine straight, body relaxed. Kapalbhatti pranayama starts with a short inhalation followed by exhalation of air with violent movements of diaphragm and abdominal muscles. The procedure was done for two minutes. Visual reaction time is taken before and after the kapalbhatti pranayama. Reaction time test was taken online (24). It consists of a traffic light signal of red, yellow and green. The subject is instructed to click on a button to begin when ready, to wait for the stoplight to turn green, and click the button when it turns green quickly! The average of five responses in seconds is taken as a reading. RESULTS   Twenty subjects took the online reaction time. There visual reaction time decreased from 0.44 ± 0.12 to 0.37 ± 0.11 at pEnglishhttp://ijcrr.com/abstract.php?article_id=1382http://ijcrr.com/article_html.php?did=13821. Nagarthna R, Nagendra HR. Yoga for bronchial asthma –controlled study. British Medical Journal 1985; 291:977-1079. 2. Murthy KJR, Sahay BK, Madhavi S, Sitaramaraju P, Yogi R, Venkat Reddy M, Annapurna N, Ramesh M, Vijaylakshmi P, Eshwar Reddy EM: Effect of yoga on ventilatory functions in normal healthy volunteers. Lung India 1983; 1:189-192. 3. Murthy KJR, Sahay BK, Madhavi S, Sitaramaraju P, Yogi R, Venkat Reddy M, Annapurna N, Ramesh M, Vijaylakshmi P, Eshwar Reddy EM. Effect of Pranayama (Rechaka, Puraka, Kumbaka) on bronchial asthma-an open study. Lung India 1984; 2: 187-191. 4. Kumar A, Kumar GK, Kumar GD, Sahay BK, Murthy KJR. Immediate effects of Pranayama in airway obstruction. Lung India 1985; 3: 77-81. 5. Udupa KN, Singh RH, Settiwar RM. A comparative study on the effect of some individual yogic practices in normal person. Indian J Med Res 63:1055-1071. 6. Telles S, Nagarthna R, Nagendra HR. Breathing through a particular Nostril can alter Metabolism and Autonomic Activities. Indian J Physiol Pharmacol 1994; 38 (2): 133-137. 7. M.V. Bhole. A Comparative Study of Minute Ventilation in Deep and Pranayamic Breathing. Yoga Mimasa July 1977; October 1978 Vol 19:8-20. 8. Conceicao Santos-e-Fonseca MC, Manco Jove, Gallo Lourenco Jr, Bareira Amilton A, Foss Milton C. Cholinergic Bronchomotor tone and airway caliber in IDDM. Chest 1992; 101:1038. 9. Raju P.S., Anil Kumar K, Reddy SS, Madhavi S, Gnanakumar K, Bhaskaracharya C, Sahay BK, Murthy KJR. Effect of Yoga in exercise tolerance in normal healthy volunteers. Indian J Physiol Pharmac AprilJune 1986; 121-132. 10. Savita Singh, V Malhotra, KP Singh, SV Madhu, OP Tandon.Role of Yoga in Modifying Certain Cardiovascular Functions in Type 2 Diabetes Mellitus. JAPI Vol 52, March 2004; 203-206.  11. Varun Malhotra, Savita Singh, KP Singh, P Gupta, SB Sharma, SV Madhu, OP Tandon. Study of Yoga Asanas in Assessment of Pulmonary Function in NIDDM Patients. Indian J Physiol Pharmacology 2002; 46 (3): 313-320. 12. Patel C. Randomised control trial of Yoga and biofeedback in management of hypertension. The Lancet 1975; 19:93-95. 13. Wallace KW, Baron H. The physiology of meditation. Sc. Amer. 1972; 262: 84-90. 14. Anand BK, China GS. Investigation on yogis claiming to stop their heart beats. Ind J Med Res 1961; 49; 90-94. 15. Sri Sri Paramhansa Yogananda. Scientific Healing Affirmations. Theory and Practice of Concentration. Chapter 3. Healing Body, Mind, and Soul. 20-21. 16. Kavalyananda Swamy. Pranayama. Popular Prakashan. Bombay 1968:24-29. 17. Dang KK, Sahay BK, Singh MM. Yoga and meditation. The Association of Physicians of India. Medicine Update. APICON, New Delhi. Chapters 57 and 58, Part 1, 1999; 9:502-506, 507,512. 18. Goleman. Meditation as an intervention in stress activity. J Consult Clin Psychol 1976, 44:456-66. 19. Udupa KN, Singh RH, Settiwar RM. A comparative study on the effect of some individual yogic practices in normal persons. Indian J Med Res 1975; 63:1066-55. 20. Jain Suresh C, Uppal Alka, Bhatnagar SOD, Talukdar BA. Study of response pattern of Non-Insulin Dependent Diabetes to Yoga Therapy. Diabetic Research and Clinical Practice 1993; 69-74. 21. Sri Sri Paramhansa Yogananda, God Talks to Arjuna. The Bhagvad Gita. Royal Science of God Realization, Permanent Shelter in Spirit Through Yoga Meditation. Krishna?s Advise for Succesful practice of yoga, Chapter VI Verse II Volume II, 2000. 22. Lajpat Rai, Selvamurthy W, Sawhney RC. Meditation techniques and their scientific evaluation. Section 9.3. Meditationeffect on blood pressure and hypertension in Meditators and Physiological effects 179- 189. (Anubav Rai publications 1996). 23. R.L. Bijlani. Understanding Medical Physiology. Edition. Section 14 Yoga. Chapter 14.2 Physilogical Understanding of Yogic techniques. Page 892. 24. The Online Reaction Time Test http:/

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareIMPORTANCE OF COMPLIANCE IN CONTACT LENS WEAR -A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICES AMONG CONTACT LENS USERS FOR A HEALTHY VISION English104109Ch. Vijay KumarEnglish Yousef D.EnglishPurpose: To assess the knowledge related to contact lens wear and their care among the female students. Methods: A structured questionnaire covering aspects on wearers&#39; attitude, knowledge related to lens care, hygiene of hands and lens cases was introduced in which about 50 female contact lens wearers participated in this study. By doing multi-variate testing, the factors like demography, hygiene, behaviors and attitude to aftercare visits were analyzed among lens wearers and significant findings are reported. Conclusion: Poor hand hygiene, inadequate lens care and not remembering when to come back for aftercare visits are the common non-compliant behaviors in lens wearers where proper health education plays a major role in improving compliance. EnglishContact lens wear, Compliance, knowledge, demographics, health educationINTRODUCTION Contact lens have become more and more important as an optical correction resource especially among females in Saudi Arabia as they provide a convenient way of correcting refractive error and offer more advantages over spectacles in many regards. Since they are used for refractive correction, cosmetic reasons and therapeutically in eye diseases where an uneven cornea blurs vision such as keratoconus or corneal scarring 1, 2 they are getting more and more popular among the younger population (school, college and university students and young working adults) as they improve the aesthetics. The probable reasons for popularity of contact lens usage are the huge amounts of choices available not only in terms of lens type and materials alone but also the increased availability at large number of locations in the country at a much lower cost compared to the past 3 . Non compliance is a major issue in contact lens wearers and it is seen in various aspects of contact lens wear and care 4 . Side effects ranging from transient redness to severe keratitis 5 have been observed due to improper use. Studies have identified several risk factors associated with lens wear complications in an attempt to encourage successful lens wear and to minimize disease burden. Amongst the identifies risk factors, some are non-modifiable such as gender or age 6 and others are modifiable for instance poor hand cleaning and lens case hygiene 7 and therefore can be targeted in minimizing vision loss and maximizing successful lens wear. Recently, it was found that the purchase of contact lenses over the internet and higher socio- economic status to be associated with microbial keratitis 8 . Ocular health education especially knowledge in the correct and careful practice regarding contact lens wear can prevent complications resulting from the wearer&#39;s inappropriate behavior. One of the ways of investigating this is from the person&#39;s perception regarding his own knowledge of contact lens wear 9. Therefore the study of knowledge can contribute to the planning of educational and health campaigns aiming to reduce the complications of contact lens wear in our society. Webster?s Medical Dictionary defines „compliance? as „the process of complying with a regimen of treatment?. In the context of contact lens wear, this can be interpreted as a wearer correctly adhering to the instructions provided by the contact lens practitioner with respect to optimum lens wear and care. Noncompliance issues related to contact lenses have been around for as long as contact lenses have been available (Bowden et al, 1989). There are three primary areas of concern: contact lens wear schedule, lens care, and contact lens replacement schedule. Whilst many eye care practitioners are familiar with the notion that many contact lens wearers are non-compliant, there is very little up-to-date objective data available to support this belief. In this report we present independent research which describes the lens wear and care habits of female contact lens wearers in Saudi Arabia. The current study was conducted among the female college students with a primary objective to assess the knowledge and compliance of contact lens care and their practice related to contact lens use, cleaning and maintenance. MATERIALS AND METHODS A cross sectional descriptive study was conducted using a structured questionnaire among the females aged 17-30 years. The study got clearance from the University Research and Ethics Committee and was implemented among the female students. Any female who has ever worn contact lens for any period of time and for whatever reason was enrolled in this study. A total of 50 contact lens wearers were identified and a structured questionnaire was introduced to collect the information from March to May 2010 after getting the informed consent for the participation in this study. The questionnaire was in Arabic language and had 35 questions. The tool was validated by three Optometry experts working in the Department of Optometry before using in this present study. For analysis purpose the questionnaire was also back translated in English to ensure the same meaning is conveyed. The questionnaire was based on the knowledge and practices of contact lens wear, care and its possible complications. All the questions were prepared in Arabic language and the answers were also given in Arabic language by the participants who participated in the study. To get a better understanding of some questions and to capture appropriate information, a pilot study (pre- test) was conducted on 10 students a week prior of starting research work and after review few modifications were done in the questionnaire for the final research work. The questionnaire was designed in a very comprehensive manner which consisted of 35 questions related to general demographic data, socio economic status, contact lens hygiene and hand cleaning, compliance to eye care provider&#39;s instructions and behavioral aspects. The tool was objective type which was not time consuming as the participant has to tick her answer on the appropriate box (answers being &#39;Yes&#39;, &#39;NO&#39;and/ &#39;Sometimes&#39;). The data that was collected in the questionnaires was coded and it was analyzed using Epi_info software version 3.5.1 2008, (CDC Atlanta). RESULTS The answers collected from the questionnaires distributed among 50 female students who participated in the study were analyzed and presented as follows. Demographic characteristics: Out of total 50 female students who participated in the study the majority (62%) are under age group of 21-25 years followed by other ages. Most of the students are single (84%) and only 16% are married among them  Contact lens hygiene and hand cleaning: In this study out of 50 contact lens users, it was observed that majority 94% (47) are using soft lens and 6% (3) were hybrid lens users. Majority of the participants 62% (31) were using for cosmetic purposes while the remaining 38% (19) were using for refractive purpose. It was also observed that majority 52% (26) of them got the contact lens from cosmetic center followed by optical shop with 38% and only 10% got the lens prescribed from hospital. Compliance to Optometrist: It was also found that majority of the contact lens users 88% (44) were cleaning the lens case regularly. Out of 50 contact lens wearers, majority 82% (42) of them clean their hands before using contact lens but only 58% of them clean the hands before putting the contact lens in lens case and remaining either don?t clean at all (18%) or clean sometimes (24%) as shown in Figure 1. Other significant finding of the study is that majority 66% (33) immerse the lens in cleaning solution completely which is correct practice while 34% of them place the lens half immersed in the cleaning solution which is an incorrect practice and there is a need to raise awareness regarding the correct practice. It was also found that only 38% (19) of them visit the eye practitioner regularly as shown in Figure 2. There was also usage of expired contact lens by 10% (5) participants and 16% (8) of them use the expired contact lens sometimes. Among the lens wearers, it was found that 10% (5) of them had eye infections because of contact lens. The distribution of subjects as per their practice of cleaning contact lens is shown in Table 1. DISCUSSION There is no data available on the prevalence and pattern of contact lens use in the published literature from our country especially among females and there are no documented studies in this area done in Qassim province, even though large numbers of young adults are wearing contact lenses. However Lee et al (2000)10 from Singapore has been reported that the prevalence of contact lens use was 8% in their population aged between 15-50 years. The study of prevalence of contact lens usage among medical students done by I Tajunisah et al (2007)11 was much lower than a similar study reported by Vidotti et al (2006)12 from Brazil (27.4%). Most healthcare providers say that one third of patients will follow instructions exactly, one third will follow some instructions and one third will not follow instructions at all. A similar study done by MJ Collins and LG Carney found that only 26% of the patients were compliant 13. Factors which reduce the level of patient compliance include complexity, frequency, duration and cost of therapeutic regime. According to Claydon et al, the major areas of non-compliance in contact lens wear have been highlighted as the lack of hand and lens-case hygiene, the over wearing of contact lenses, the poor attendance of patients at aftercare appointments and the inadequate use of care and maintenance systems14. Education is one of the factors thought to influence compliance. The results indicate that the additional education had no significant effect on the compliance levels of the patients to whom it was applied. The population of contact lens wearers was generally very compliant and the contact lenses and care regimen were clinically successful. The results were found to be similar in many areas. Practitioners are encouraged to review the compliant behavior of their contact lens patients at every aftercare appointment and pay particular attention to the areas of frequent non-compliance highlighted. A study done by Hickson Curran SB et al15 among 787 contact lens wearers revealed that only 30 percent cleaned their lens case daily; and among these wearers, 53 percent cleaned their case with tap water. Also, 48 percent replaced their case annually or less often and 7 percent never cleaned or replaced their lens case. (Most eye care professionals recommend that lens cases should be cleaned daily with fresh contact lens solution and allowed to air dry, and lens cases should be discarded and replaced at least every 90 days.) In our study we found that majority of the contact lens users 88% (44) were cleaning the lens case regularly. In a similar study conducted by Mayers et al16, revealed 71 percent of contact lens wearers put their lenses directly into the lens case without rinsing and rubbing the lenses to clean them; 11 percent rinsed only, and only 7 percent performed the generally recommended “rinse-and-rub” cleaning technique. The study also found that 36 percent of contact lens wearers wait up to 12 months to replace their lens case, 20 percent report never cleaning their case, and 48 percent rinse their case with tap water. In our study we also found that some of the contact lens users were using tap water to clean the contact lenses. The results of these studies discussed above shows similarities with our current study which reveals that many contact lens wearers are putting themselves at risk for eye infections and other contact lens-related complications because of poor compliance with accepted contact lens care practices. The major areas highlighted by Nathan Efron17 of non-compliance in contact lens wear have been highlighted as the lack of hand and lens-case hygiene, the over wearing of contact lenses, the poor attendance of patients at aftercare appointments and the inadequate use of care and maintenance systems It was also observed in our study that majority 52% (26) of our subjects got the contact lens from cosmetic center followed by optical shop with 38% and only 8% got the lens prescribed from hospital. When eye care practitioners dispense the contact lenses, they educate patients on the proper wearing schedule, should not sleep in lenses that are not approved for overnight wear. This gives patients the opportunity to ask to be fit in a higher-Dk lens if overnight wear is an option. Eye care practitioners educate patients on the replacement schedule of their lenses when you give them their annual prescription. Give patients helpful tips on how to stay compliant. While some contact lens patients are noncompliant on purpose, most patients would be more compliant with their replacement schedule if they had reminders or a way of remembering when to replace their lenses. There is a place on an eye care practitioners written contact lens prescription for the recommended wearing time, replacement schedule, and contact lens solution. Recommendations: Education, improving communication, behavioral modifications are the main factors that helps improving the compliance level in any population. Although improving the compliance of contact lens wearers appears difficult, as primary eye care providers, we should strongly promote lens care compliance to minimize the risk of contamination of contact lenses and lens care accessories. It is relatively easy to blame patients for poor compliance but poor compliance can be avoided or atleast reduced by proper training at the initial fitting of contact lenses and reinforcement at the follow up visits. A contact lens (CL) can act as a vector for microorganisms to adhere to and transfer to the ocular surface. In the presence of reduced tissue resistance, these resident microorganisms or transient pathogens can invade and colonize the cornea or conjunctiva to produce inflammation or infection. CONCLUSION There is no way to anticipate and prevent all of the inadvisable actions that patients may take with contact lens wear and care, even with the best instructive efforts. Continually educating patients that contact lenses are medical devices and reviewing proper lens wearing and replacement schedules is the best way to avoid noncompliance.Contact lenses are seen as a commodity by many patients, not as medical devices. This attitude can lead to contact lens noncompliance and unwanted complications. Proper education from the beginning can help prevent patients from falling into bad habits. Because studies show that contact lens noncompliance is prevalent in patients who have worn contact lenses for several years, each patient encounter is an opportunity to review and reinforce proper wearing and replacement time and contact lens care. ACKNOWLEDGEMENTS Researcher is grateful to the Dean of College of Applied Health Sciences, Qassim University for providing the necessary resources and thanks all the participants who actively participated in the study. Authors acknowledge the great help received from the scholars whose articles cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Englishhttp://ijcrr.com/abstract.php?article_id=1383http://ijcrr.com/article_html.php?did=13831. Stein H A, Freeman M I, Stein R M, Maund L D. Contact Lenses Fundamentals and Clinical Use. Slack Incorporated 1997. 59- 74. 2. Mannis M J, Zadnik C, Coral- Ghanem C, Kara-Jose N. Contact Lenses in Ophthalmic Practice. Springer-Verlag New York, Inc 2004. 7-14. 3. Bowden T, Harknett A. What the patients wore and why…Contact Lensand Anterior Eye 2006; 29:5-15. 4. Claydon BE, Efron N, Non-complicance in contact lens wear. Ophthal Physiol Optics Dec 2007; 14: (4): 356-364. 5. Mah-Sadorra J H, Yavuz S G A, Najjar D, Laibson P R, Rapuano C J, Cohen E J. Trends in contact lens related corneal ulcers. Cornea. 2005; 24: 51-58. 6. Dart J K, Radford C F, Minassian D, Verma S, Stapleton F. Risk factors for microbial keratitis with contemporary contact lenses: a case- control study. Ophthalmology 2008; 115: 1647- 54, 54 e 1-3. 7. Stapleton F, Keay L, Edwards K, Naduvilath T, Dart J K, Brian G et al. The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology 2008; 115: 1655- 62. 8. Fogel J, Zidile C. Contact lenses purchased over the internet place individuals potentially at risk for harmful eye care practices. Optometry 2008; 79:23-35. 9. De Oliveira PR, Temporini- Nastari ER, Alves MR, Kara-Jose N. Self evaluation of contact lens wearing and care by college students and health care workers. Eye and Contact Lens 2003; 29: 164-67. 10. Lee YC, Lim CW, Saw SM. The prevalence and pattern of contact lens use in a Singapore community. CLAO J. 2000; 26: 21-25. 11. I Tajunisah, S C Reddy. Knowledge and Practice of contact lens wear and care among medical students of University of Malaya. Med J Malaysia Vol 63 No 3 Aug 2008. 12. Vidotti VG, Kamegasawa A. Profile of medical students from the Universidada Estadual Paulista- UNESP-Botucatu, who wear contact lenses, Arq Bras Oftalmol 2006;69: 197-201 (article in Portuguese). 13. MJ Collins and LG Carney, Compliance with care and maintenance procedures amongst contact lens wearers, Department of Optometry, Queensland Institute of Technology and University of Melbourne, Australia 1986;174-75 14. Claydon, Bridget E., Efron, Nathan, and Woods, Craig (1996) A prospective study of non-compliance in contact lens wear. Journal of the British Contact Lens Association, 19(4), pp. 133-140. 15. Hickson-Curran SB, Chalmers RL, Sencer S. "Making the case for daily disposable contact lenses: patient non-compliance with storage case hygiene and replacement." Johnson and Johnson Vision Care, Contact Lens Care and Compliance, Dec 2010. 16. Mayers M, Callan BS, Borazjani R et al. Compliance and contamination in contact lens wear. Alcon, Contact Lens Care and Compliance, Dec 2010 17. Claydon, Bridget E., Efron, Nathan, and Woods, Craig (1997) Non-compliance in contact lens wear. Ophthalmic and Physiological Optics, 17(2), p. 172.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareDEPRESSION AMONG GERIATRICS:PREVALENCE AND ASSOCIATED FACTORS English110112Sreejith S. NairEnglish S.G. HiremathEnglish RameshEnglish PoojaEnglish Sreekanth S. NairEnglishMethod: 182 participants aged over 60 from an urban area, Ashapur, Raichur were interviewed to assess their psychiatric morbidity and associated factors using geriatric depression scale. Objective: To establish prevalence of depression and associated factors in geriatrics in Ashapur urban area, Raichur Dist, Karnataka., India. Type of study: Cross sectional. Methodology: The cross sectional epidemiological study was conducted in urban slums of Ashapur, Raichur Dist. The study area has a population of 25486 with a geriatric population of 2536.A sample size of 182 was estimated using Random Sampling Technique. Study group: 182 Study area: Ashapur urban area, Raichur Dist, Karnataka. Study period: July17 to October 17 . Study tool: Pretested Questionnaire. Analysis: Descriptive statistics and other appropriate statistical studies will be used. Results: This study revealed that 32.4% of individuals were suffering from depression. We conclude that depression in elderly is associated with poor socio economic status, unemployment, disrupted marital status, illiteracy, and substance abuse. Conclusion: By the end of the study we concluded that prevalence of depression in geriatrics is significantly high. It is mainly associated with substance abuse, unemployment, disrupted mental status, illiteracy and poor economic status. Englishgeriatrics, associated factors, depression.INTRODUCTION Aging is a universal phenomenon. India is the second largest country in the world, with 72 million elderly persons above 60 years of age as of 2001.From 1990 to 2025, the elderly population in Asia will rise from 50 per cent of the world&#39;s elderly to 58 per cent, in Africa and Latin America from 5 to 7 percent, but in Europe the figure will drop from 19 to 12 per cent of the world&#39;s elderly. According to projections, the elderly in the age group 60 and above is expected to increase from 72 million in 2001 to 179 million in 2031, and further to 301million in 2051.The life span has increased in India from 32 years in 1947 to more than 62 years now. In India, the 60 plus population in 1951 was just 5.43% that had gone up to more than 7.7% in 2001. Of all the diseases the senior citizens meet, depression is the most hideous. Depression in elderly people often goes untreated because many people think that depression is a normal part of aging and a natural reaction to chronic illness, loss and social transition. It remains highly prevalent in the elderly population, and certain vulnerable populations of older adults are at special risk. Further, the morbidity of late-life depression on physical health, social support systems, and overall functioning is considerable, making depression a leading cause of disability in elderly adults and a risk factor for mortality and suicide as well. Depression is associated with morbidity as well as disability among the elderly. They constitute a major public health problem worldwide and their prevalence rates range between 10 and 55%. The long-term prognosis of geriatric depression is bleak with incomplete recovery and higher relapse rates. Along with the physiological and psychological changes associated with aging, changes in the associated risk factors also modify the prevalence and prognosis of geriatric depression. Medical co-morbidity and cognitive impairment have a complex bidirectional relationship with geriatric depression. Available Indian study employing the Geriatric Depression Scale (GDS), a screening tool, in a small sample of elderly has reported prevalence of up to 45.9% (Jain and Aras5 , in 2007). Another larger Indian study evaluating the Hindi version of the GDS studied only the depressive symptoms and not the depressive disorders, Ganguli2 ET al1999)...There is dearth of community studies from India investigating geriatric depression and its associated factors. This study aim to establish the prevalence and factors associated with geriatric depression in an urban study area in India. METHODOLOGY The cross sectional epidemiological study was conducted in urban slums of Ashapur, Raichur Dist. The study area has a population of 25486 with a geriatric population of 2536.A sample size of 182 was estimated using Random Sampling Technique .Individuals above 60 years of age not residing in the study area, residing in old age homes and critically ill were excluded. The questionnaire was based on semi structured Performa. Geriatric Depression scale was used for the assessment of depression. The data was collected by home visit, analyzed by computer of statistics Epi info 2000 and SPSS (version17). RESULTS This study revealed that 32.4% of individuals were suffering from depression. The median GDS score calculated was 5. Mean age was 68.07+/- 12.98. Depression in elderly is associated with poor socio economic status, unemployment, disrupted marital status, illiteracy, and substance abuse. (Table 1) DISCUSSION Our study showed no significant relationship between age and prevalence of depression similar to Hussaini1 . Illiteracy leads to unproductive life and cause greater difficulty in getting jobs, leading to depression, which was well depicted in our study similar to the study done earlier. Elderly suffering from acute/chronic illnesses showed higher prevalence of depression i.e. 61.5% similar to Hughes et al4 . Foley DJ 3 et al found depressed mood associated with insomnia same as shown in our study. Thus we can conclude that depression in elderly is associated with poor socio economic status, unemployment, disrupted marital status , illiteracy ,and substance abuse. CONCLUSION By the end of the study we concluded that prevalence of depression in geriatrics is significantly high. It’s mainly associated with substance abuse, unemployment, disrupted mental status, illiteracy and poor economic status. ACKNOWLEDGEMENT Authors acknowledge the great help received from the scholars whose articles cited and included in reference of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and IJCRR team of reviewers who have helped to bring quality to this manuscript. Englishhttp://ijcrr.com/abstract.php?article_id=1384http://ijcrr.com/article_html.php?did=13841. Hussaini Ph.D., Bagar A. Predictors of depression among the elderly: racial differences over time. American Orthopsychiatric Association 1997; G7 (1), 48-58. 2. Ganguli M, Dube S, Johnston JM, Pandav R, Chandra V, Dodge HH. Depressive Symptoms, Cognitive impairment and Functional impairment in a Rural Elderly Population in India: A Hindi version of the geriatric depression scale (GDSH).International journal of Geriatric psychiatry 1999; 14(10):807-820. 3. Foley DJ et al; Incidence and remission of insomnia among the elderly adults in a biracial Cohort. Epidemiology, demography and biometry program, national institute on ageing, Bethesda, MD 20892-9205, US Sleep (LJ.S) May 1, 1999; 22 p ,373- 8.ISSN:0161-8105. 4. Hughes RN, Dana C, Demaillie, Diane and Blazer, Dan G. Age makes a diff. in the effects of physical health and social support on the outcome of a major depressive episode. American journal of psychiatry.1993; 150(5); 728-733. 5. R.K. Jain, R.Y. Aras, Depression in geriatric population in urban slums of Mumbai. Indian Journal of Public Health.2007; AprilJune 51(2):112-3

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareSTUDY OF THE AZYGOS SYSTEM OF VEINS IN HUMAN CADAVER English113117Kanchana latha G.English Raju SugavasiEnglishObjectives: To investigate the origin, course, relations, tributaries and terminations of azygos system of veins in human cadavers. Methods: A total number of 100 specimens (Foetuses: 10, Children: 8, Adults: 82) were selected for this study. Results: The azygos vein is formed by the union of ascending lumbar vein and subcostal veins in 88% of subjects and subcostal veins alone in 12% of subjects. The termination of azygos vein took place at the level of 4 th thoracic vertebra in 85%, 3rd thoracic vertebra in 8% and 5th thoracic vertebra in 7% of subjects. Conclusions: The anomalies of azygos vein, hemiazygos, and accessory azygos veins are very rare. The variations in the azygos system of veins are utmost importance for thoracic surgeons because vulnerability of damage during surgical procedure. EnglishAzygos vein, Foetus, variation, Superior vena cavaINTRODUCTION The name azygos derived from Greek, which means unpaired. The Azygos system is a main channel of drainage of the thoracic wall and also part of parities of abdomen. Azygos vein is formed by joining the right ascending lumbar and sub costal veins in posterior mediastinum (FIG: 01).After the formation it passes forward and to the right of the twelfth thoracic vertebra behind the right crus of diaphragm. At the level of the fourth thoracic vertebra, it arches forward above the right pulmonary hilum then it terminates into superior vena cava. The hemi azygos vein is formed by the left ascending lumbar and sub costal veins, and then it ascends upwards ends in azygos vein at the level of eighth thoracic vertebral level. The accessory hemi azygos vein is formed by veins from fourth or fifth to eighth left inter costal spaces, then it crosses the seventh thoracic vertebra to join the azygos vein [1] MATERIALS AND METHODS The materials selected for this present study were human cadavers and fetuses. A total number of 100 specimens (TABLE: 01) were obtained from the department of Anatomy, forensic medicine and Gynaecology& Obstetrics of Kurnool medical college, Kurnool, Andhra Pradesh, India. The selected cadavers were preserved by injecting with routine embalming fluid. Cadavers from department of forensic medicine were dissected immediately after the autopsy. Received fetuses were fixed by 10% formalin into the serous and cranial cavities and preserved in embalming tank fluid. The preserved fetuses and cadavers were taken and the thoracic and abdominal cavities are opened by a midline incision from the supra sternal notch to pubic symphysis. The thoracic and abdominal organs were removed by dissection then observed the commencement and termination of azygos vein into superior vena cava. All the posterior intercostal veins are cleaned to the site of their termination into the azygos vein.The communications of the hemiazygos, accessory azygos veins into azygos vein are identify and cleaned by reflecting the oesopagus and aorta. RESULTS In the present study we concluded the, mode of formation of azygos vein, its deviation and side shifting and its termination related to vertebral level. A total number of 100 specimens, the azygos vein (FIG: 01) formed by the union of ascending lumbar vein and subcostal veins in 88% of subjects, where as it is formed by subcostal veins alone in 12% of subjects (TABLE: 02). Out of 10 foetuses and 8 children the azygos vein was right anterolateral aspect of vertebral bodies. In all adult cadavers up to 45 years age group the azygos vein was located right side, but age group between 45 to 70 years the azygos vein was found to be crossing the midline towards the left side (FIG: 02). In the present study the level of termination of azygos vein into superior vena cava was varying considerably, in adults, fetuses and children. Out of 82 adult cadavers 7 were terminated at third and 75 were at fourth thoracic vertebra. Out of 10 foetuses one at third, two at fourth, and seven at the level of fifth thoracic vertebra. In all the 8 cadavers of children azygos vein terminated at the level of fourth thoracic vertebra (TABLE: 03). Hemiazygos vein is crossing the midline towards the right side at the level of eight thoracic vertebra in 70 % of subjects and at the ninth thoracic vertebra in 3 % of subjects. The formation, course and termination of accessory hemiazygos vein observed normal. DISCUSSION Kagami et al [2] studied azygos system of veins in a total number of 26 adult human bodies and 10 foetuses, in 22 out of 26 bodies the azygos vein crosses the midline of vertebral column from right to left, in 3 bodies azygos vein ascending in midline, and one body azygos vein ascending on the right side of vertebra column. ac mahon et al [3] observed the congenital absence of azygos vein, is a cause for aortic nipple enlargement. Lindsay et al [4] reported the abnormal hemiazygos vein. Seib et al [5] conducted a study on azygos system of veins in American whites and Negroes. Gladstone et al [6] conducted study on development of inferior vena cava, he observed the abnormalities in ascending lumbar and azygos vein. Chiiba et al [7] reported a rare case of persistence left azygos vein in a left lung. According to Celik et al [8] anatomical knowledge about the variations of azygos systems of veins are important in radiological diagnosis like CT and MRI techniques and also in the surgical treatment of aneurysms of thoracic aorta and posterior mediastinal tumours. According to Elzbieta Krakowiak Sarnowska et al [9] studies, out of 32 human fetuses the azygos vein situated 90.6% on right side, 9.4 % on median side and the azygos vein terminated at the level of T4 and hemiazygos vein at the level of T7. Kadir et al [10] observed the termination of azygos vein seen at T4, T5 and hemiazygos vein at T7 level. The variations of azygos, hemiazygos, and accessory hemiazygos veins are exisisted in associated with congenital anomalies of the heart, arteries, and veins, like doubling of superior and inferior vena cava. Cotter et al [11] demonstrated double superior vena cava in three human hearts. Mori et al [12] reported double superior vena cava in 2 cases out of 300 Japanese cadavers. Morton et al [13] reported pre aortic anastomotic channel between azygos and hemiazygos veins. CONCLUSION Azygos vein was formed by ascending lumbar vein and subcostal veins in 88% of subjects and only by subcostal veins alone in 12%.Termination of azygos vein seen at the T4 level in 85%, T3 level in 8% and T5 level in 7% of subjects. The present study concluded the deviation of azygos vein that was due to ageing basis. The hemiazygos vein crossing to right side at T7 level in 70%, T9 level in 3% of subjects. ACKNOWLEDGEMENTS Authors are greatful to Dr. B.T. Narayana Rao, HOD, Department of Anatomy, Kurnool Medical College, AP, India and also previous authors, publishers, editors of all of those articles, journals and books from where the literature of this article has been reviewed and discussed. Englishhttp://ijcrr.com/abstract.php?article_id=1385http://ijcrr.com/article_html.php?did=13851. Standring S. Gray’s Anatomy. The Anatomical basis of clinical practice. 39th ed. Edinburg. Elsevier Churchill Livingstone. 2005; (60):1026 1027. 2. Kagami H, Sakai H. The problems in the arrangements of the azygos vein leftward deviation of azygos vein. Okajimas folia Anat Jap.1990; 67 (2 3):11 4. 3. Mac mahon H. congenital absence of azygos vein: a cause for aortic nipple enlargement. AJR Am J. Roentgenol. 1987; 149 (2): 273 4. 4. Lindsay HC. An abnormal vena Hemiazygos. J Anat. 1925; (50): 438. 5. Seib GB. The azygos system of veins in American whites and American Negroes. AM .J. Phy Anthropol. 1934; 19 39. 6. Gladstone R J. Development of IVC in the light of receat research with spt reference to certain abnormalities and current descriptions of ascending lumbar and azygos veins. J Anat. 1929; (64): 60 93. 7. Chiiba S. An autopsy case of azygos lobe. Okajimas folia Anat.Jap.1990; (66): 313 37. 8. Celik HH, Sargon MF, Aldur MM and Cumbur M. An anomalous course of the interazygos vein. Surg Radiol Anat.196; 18: 61–62. 9. Elzbieta Krakowiak Sarnowska, Marcin Wisniewski, Michal Szpinda, Helena Krakowiak. Variability of the azygos vein system in human fetuses. Folia Morphol. 2003; (62) 4: 427–430. 10. Kadir S. Atlas of normal and variant angiographic anatomy. WB Saunders Company, Philadelphia. 1991; pp. 164–165. 11. MC Cotter RC. Demonstration of 3 human hearts showing double superior vena cava. J Mic. Med Soc. 1915; 14: 479 484. 12. Mori c. Two cases of double SVC Japan heart. J. 1990; (6): 881 8. 13. Morton WRM. Pre aortic drainage of azygos vein report of 2 cases. Anat Rec. 1948; 101 187.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25HealthcareMORPHOMETRICAL STUDY OF MENISCI OF HUMAN KNEE JOINT English118125Ashwini C. English Nanjaiah C.M. English G.S. SaraswathiEnglish N.M. Sham sundarEnglishIntroduction: The knee is the largest synovial joint in our body. Among the different ligaments of knee joint, menisci are a pair of fibro cartilaginous plates situated within the knee joint on the tibial condyles. Lubrication, proprioception, joint stabilization, load transmission are the major functions of the knee meniscus. Variations of form and in particular of thickness and width of menisci can determine the possibility and the kind of injury. Meniscal replacement is required in cases of severe loss of meniscal issue or degenerated. The correct size of the allograft is likely to be critical for successful healing and functionality. Objective: 1) To determine the thickness, width and circumference of the menisci of human knee joint 2) To measure the distance between anterior and posterior horn of the menisci of human knee joint. Material and Methods: 50 menisci of 25 knees of the formalin fixed adult human cadavers were dissected and studied in the department of anatomy, JSS Medical College, Mysore. The knee joints included 13 right and 12 left specimens. A slide caliper is used to measure the distance between anterior horn and posterior horn of the menisci and to measure the thickness and width in anterior 1/3rd, middle1/3rd and posterior 1/3rd of the menisci. Outer circumference and inner circumference is measured by non elastic cotton thread. Results: The peripheral length and inner border length of medial meniscus was more than that of the lateral meniscus. Posterior third of the medial and lateral menisci was the thickest part compared to anterior and middle thirds. The distance between the anterior and posterior horns of the medial meniscus was significantly more than the lateral meniscus. The individual analysis of each meniscus showed that the posterior third was the widest part than the anterior and middle thirds. EnglishKnee, Meniscus, Thickness, LengthINTRODUCTION The knee is the largest synovial joint in the body. It consists of femoro-patellar, medial and lateral tibio-femoral articulations which form a complex &#39;hinge&#39; variety type of joint. This arrangement offers a fulcrum for propulsion, and allows the limb to bear and transmit the body weight. Because of the wide range of its mobility it has more tendencies for instability, to counter this tendency, a complex ligament arrangement has evolved1 . Among the different ligaments of knee joint, menisci are a pair of fibro cartilaginous plates situated within the knee joint on the tibial condyles. Lubrication, proprioception, joint stabilization, load transmission are the major functions of the knee meniscus. Among many types of meniscal anomalies reported, discoid meniscus is the most common entity. Identification of discoid meniscus is clinically important because of its high prone to injury than the normal meniscus. Knowledge of the dimensions of the normal meniscus could help to differentiate between the discoid meniscus and a normal meniscus. This is important for planning surgical interventions in the knee joint. Variations of form and in particular of thickness and width of menisci can determine the possibility and the kind of injury2,3 . It is observed by Fairbank that the removal of the meniscus lead to degenerative changes in the knee joint in the long term4 . Nowadays the meniscus is repaired instead of removed, but this treatment is only feasible when the meniscus tissue is otherwise of good quality. Meniscal cartilage can be conserved by replacing or by re-growing the cartilage which must be accompanied by measurement techniques to determine meniscal size. So the correct size of the allograft is likely to be critical for successful healing and functionality. With this clinical perspective, the aim of our work is to determine the thickness of the menisci, width of the menisci, circumference of the menisci and to measure the distance between anterior and posterior horn of the menisci. OBJECTIVES 1) To determine the thickness, width and circumference of the menisci of human knee joint 2) To measure the distance between anterior and posterior horn of the menisci of human knee joint MATERIAL AND METHODS 50 menisci of 25 knees of the formalin fixed adult human cadavers were dissected and studied in the department of anatomy, JSS Medical College, Mysore. The knee joints included 13 right and 12 left specimens. All menisci that showed any structural change which prevents its morphometric analysis such as injuries or advanced degenerative changes were excluded. After the removal of skin and the muscles surrounding the knee joint, joint cavity is opened anteriorly by a vertical incision on joint capsule and by dividing the patellar and collateral ligaments horizontally. Menisci are exposed clearly by cutting the cruciate ligaments and then the tibial condyles with menisci are disconnected from the femur. The data were collected with the aid of sliding callipers, and were recorded manually. The collection followed the following protocol in both menisci (lateral and medial): the distances between the anterior and posterior horns were measured using the sliding calipers, which was placed between the apex of the anterior horn and the apex of the posterior horn. (Figure1) Then, the peripheral lengths of the menisci were measured with the non- elastic cotton thread. (Figure 2) For this, a piece of thread was placed across the outer edge of the meniscus from the apex of the anterior horn to the apex of posterior horn. The thread which placed along the periphery of the meniscus was held in place with metallic pins. The length of this thread from the most anterior part of the insertional area to the most posterior part was measured and was called “peripheral length”. In the same way, the inner free border length was measured by keeping the thread at the inner free edge. Next, the thread length was measured using sliding calipers. To measure the thickness of menisci, firstly we determined its length. Then the menisci were divided into 3 equal parts using the thread and the parts are called anterior1/3rd, middle1/3rd and posterior1/3 respectively. The thickness and width of the menisci was measured with the vernier caliper. The measurements of the thickness and width were done at the midpoint of the above mentioned 3 parts. Then thickness values were noted by measuring at midpoint between outer and inner circumference. RESULTS There were some statistically significant morphometrical differences between medial and lateral meniscus. The peripheral length of medial meniscus (90.12±8.0.mm) were not significantly more than (p>0.05) that of the lateral meniscus (83.28 ± 7.46mm) where as inner border length of medial meniscus (59.96±8.55mm) were significantly more than (p0.05) of medial menisci. A statistically significant difference was observed (p0. 05) (Table 1). In the lateral meniscus the posterior third part (9.36 ± 1.19mm) was the widest compared to the anterior third (8.08 ± 1.14mm) and the middle third parts (8.52 ± 2.12 mm). It was found that anterior third was more than that the posterior third and it was statistically significant (p0.05). With regard to the thickness of the outer circumference of the medial meniscus, Almeida et al. in their study observed that medial menisci was the thinnest at posterior third followed by anterior and middle thirds in contrast to Braz & Silva who observed the middle third was the thickest compared to other two points5 . (Table 3 &4) In our study we found that the posterior third (2.06 ± 9.3 mm) of the lateral meniscus was the thickest part (pEnglishhttp://ijcrr.com/abstract.php?article_id=1386http://ijcrr.com/article_html.php?did=13861. Standing S. Gray’s Anatomy, The Anatomical Basis of Clinical Practice, 39th edn, Elsevier Limited, London, 2006; 1476- 87. 2. Almeida S.K.S., Demoraes A.S.R, Tashiro T, Neves S.E., Toscano A.E, Deabreu R.RM. Morphometric study of menisci of the knee joint. Int.J.Morphol. 2004; 22(3): 181-4. 3. Murlimanju BV, Morphometric analysis of the menisci of the knee joint in South Indian human fetuses. Int. J. Morphol. 2010; 28(4): 1167-71. 4. Fairbank TJ. Knee joint changes after meniscectomy. J bone Joint Surg B.1948; 30: 664-70. 5. Braz PRP, Silva WG. Meniscus morphometric study in humans. J.morphol.Sci.2010; 27(2):62-6. 6. Rico, E. G. C, Ayala, C. E. A. Localizacion de las rupturas meniscales en nuestro medio. Rev. Mex. Ortop.Traumatol. 1997; 11:10-3, 7. Erbachi H, Gumusburun E, Bayram M, Karakurum G, Sirikei A. The normal menisci: in vivo measurements. Surg Radiol Anat 2004; 26: 28-32. 8. Messner K,Gao J. The menisci of the knee joint. Anatomical and functional characteristics and rationale for clinical treatment. J of Anat.1998; 193:161-178.

Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52410508EnglishN2013April25TechnologyENHANCED BIODEGRADATION OF HYDROCARBON SLUDGE USING CONSORTIUM OF MICROORGANISMS English126135Adeeyo Opeyemi A.English Ayoola Ayodeji A.English Efeovbokhan Vincent E.EnglishIn this work, the effects of consortium of Microorganisms, Pseudomonas purida, Pseudomonas aeuniguma, Pseudomonas florescence, and Bacillus megaterium, in degrading hydrocarbon sludge from refinery wastes, in Niger Delta area of Nigeria, have been studied. Focus is particularly on reduction of BOD, COD, TOC and ROC of the hydrocarbon sludge to comply with standard requirement for disposal. The organisms were maintained in nutrient agar plants and subculture on weekly basis throughout the period of investigation. Lab-assay method was used to carry out the experiment, i.e, Ex-Situ treatment. The sludge was inoculated with the consortium of Microorganisms and samples were taken for analysis at two week interval for a period of eight weeks. Result shows that, for the duration of investigation, there was 71.3% reduction of the initial BOD, 60.0% reduction of the initial COD, 78.4% reduction of the initial TOC and 78.1 % reduction of the initial ROC. It was noted that given enough time the consortium of Microorganisms has the potential to biodegrade the hydrocarbon sludge to an acceptable level of the Environmental Regulatory Body&#39;s standard. The sludge however requires more than eight weeks for the toxic level to be reduced to Regulatory Body&#39;s standard. It was also observed that the rate of biodegradation of the sludge by the Microorganisms declined with time. EnglishBiodegradation, Hydrocarbon sludge, Consortium, MicroorganismsINTRODUCTION The production and subsequent storage and transportation of petroleum and its refined products have resulted in generation of large volume of oil (hydrocarbon) sludge. Hydrocarbon sludge is the residue or waste material from the oil industries. The oil sludge contains crude oil, water and petroleum solid particles. It is a pitch of messy mix of oil mixture of low and high molecular weights, sand and some inorganic materials(1) . The hydrocarbon sludge enters the environment by way of leakage or spillage from petroleum pipes or tanks, sediments obtained from storage tanks or tankers which are disposed off and from drilling wastes generated in the exploration and production of crude petroleum. The improper management of this sludge results in enormous environmental pollution and degradation. There has been a lot of advancement in the use of microorganisms for the destruction of chemical pollutants. These various technologies rely on the biodegradative activities of microorganisms, and they focus on enhancing existent but slow biodegradation processes in nature or technologies that bring chemicals into contact with microorganisms in some type of reactor that allows for rapid transformation (2) (3) (4). Oil degrading microorganism are ubiquitous and they naturally biodegrade numerous contaminating petroleum hydrocarbon, thereby cleansing such environment of pollutants(5) (6) (7) . The hydrocarbon sludge contains high level of environmental pollutants. The surface waters, underground water and the water table are polluted by the sludge. When the sludge find its way to a body of water it results in improper penetration of light and competition for oxygen by aquatic life thus causing large massive fish kill (8). This sludge pollutant equally gradually destroys coral reefs, coastal ecosystem and vegetation when discharge directly unto them or through percolation or otherwise (9) (10) (11) . The practice of indiscriminate dumping of the sludge generated from the oil prospecting, production and transportation, without treatment, poses a great health hazard and doom to the neighboring ecosystem and ultimately to man. Although there are occurrences of oil spillages whereby hydrocarbon sludge is adventitiously added to the environment, unused hydrocarbon sludge that can be controlled is however also dumped into the environment without treatment. One importance of development of better technologies is because of huge money required for clean-up. This study therefore focuses on reduction of the level of the toxic constituents, i.e. its toxicity, to an acceptable level such that when the sludge is afterwards discharged unto the environment it is neither inimical to man nor the ecology. MATERIALS AND METHOD Sample collection: sludge sample was collected from disposal unit of Warri refinery, Nigeria, where sludge has been deposited for years. The sample was thereafter transferred to the laboratory for biodegradation process and analysis of its effluent sample. Microorganisms: The consortium of four microorganisms used for the biodegradation experiment was grown in the culture collection unit of the department of Biotechnology, Federal Institute of Industrial Research, Oshodi (FIIRO), Nigeria. The microorganisms are Psedomonas purida, Psedomonas aeuniguma, Psedomonas florescence and Bacillus megaterium. The organisms were maintained in nutrient agar plants and subculture on weekly basis throughout the period of investigation. The choice of these organisms was based on their ability at enhancing the process of degradation of effluents and sludge samples and thereby enhancing the process of biodegradation. METHODS The isolates were grown on minimal salt medium for increase in their biomass. 500ml of the sludge sample was asceptically introduced into 100mls of erlemeyer beaker. This was then autoclaved at 121 for 15 minutes. The autoclaved medium was then inoculated with the consortium of microorganism. The inoculated sample was left in the laboratory for a period of 8 weeks at room temperature (28 2 ) ? . At fortnight intervals, analysis of the sludge sample was carried out in order to monitor the level of degradation in the sample. Analysis was carried out to determine the Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), Total Organic Content (TOC) and Residual Organic Content (ROC) at two weeks interval The experimental procedures and methods used for the determination of these parameters are given below: Determination of the physiochemical properties of the sample Temperature: The temperature of the sludge sample was determined with the aid of mercury bulb thermometer. Determination: The was determined with the aid of a previously standardized meter (Unicam 0 945 model). The meter was calibrated using 4.0 and 7.0 buffers. Biochemical Oxygen Demand (BOD) determination Two BOD bottles were filled during each analysis with the sludge sample. The bottles were stoppered tightly. One of the bottles was placed in the incubator at 20oC . The dissolved oxygen ?D1 ? of the sample in the other bottle was determined as described: 2mls of manganese sulphate solution was added to the sample followed by 2mls alkaline iodine reagent below the surface of the liquid. The solution was then mixed carefully and the precipitate allowed to settle, leaving a clear supernatant above the manganese hydroxide floc and later shaken again. 2mls of concentrated sulphuric acid was added and allowed to run down the neck of the bottle. The bottle was then re-stopperred and mixed by gentle inversion until dissolution was complete. 100 mls of the sample was taken for the BOD bottle and titrated with 0.025N sodium thiosulphate solution to a pale straw yellow colour. I ml of starch solution was added and the titration continued to the appearance of the blue colour (12) . The dissolved oxygen in mg l referred to as ? 1 ? was then calculated as follows: After the incubation period of 5 days, the dissolved oxygen ? 2 ? of the incubated sample was determined in the same manner as above. The BOD of the sludge was then calculated as: BOD ?mg l? = 1 - 2 Chemical Oxygen Demand (COD) determination The chemical oxygen demand was determined as follows: 100mls of the sample was measured into a measuring cylinder. This was later mixed with 5ml of sulphuric acid (1:3). The mixture was then heated quickly to boiling point. 15.0cm3 of 0.01M potassium permanganate  solution was quickly added into the boiling mixture and left for ten minutes. Thereafter oxalic acid (0.01M) solution was added. Two drops of permanganate solution was used as the indicator and thereafter (0.01M) solution was used for the titration to a noticeable pink colour. COD was calculated as: Total Organic Content (TOC) determination This was done by weighing out 10g of the sludge sample into a known weight of beaker. Thereafter, the sample was subjected to an initial temperature of 70 in an oven. temperature was later steadily increased by 20oC at an interval of 10 minutes and the sample reweighed at each interval until a constant weight is achieved thereby signifying that all the volatile organic matter has escaped. TOC was thus calculated as: Residual Oil Content (ROC) determination The oil content in the sludge sample was evaluated by the extraction method as follows: 10g of the sludge was mixed with 50mls of nhexane and stirred thoroughly. The resulting solution was later added to 50mls of dichloromethane and stirred sufficiently. The solution was later filtered with glass wool placed in a funnel. The extraction was later repeated four times with decreasing volume of dichloromethane (40mls, 30mls and 20mls). The extracts were later pooled into a previously weighed beaker and thereafter placed in an electric oven at 70oC . This was followed by the adjustment of the oven temperature at 5 minutes interval up to 100oC . This continued until no more effervescence is noticed from the beaker. The beaker with its content was cooled at intervals in a dessicator to avoid absorption of water from the surrounding. The beaker and its contents are then reweighed. The difference in weight gives the approximate weight of the oil content in the sludge. The residual oil content was calculated as follows: RESULTS The physiochemical properties monitored are temperature and H P values at two weeks interval. DISCUSSION From the physiochemical factors during the process of degradation over a period of eight weeks, as shown in Table 1, it could be observed that the temperature for the activity of the bacteria isolates was at the mesophyllic range ?30 2 ? o ? C . Also, changes in the temperature of the sample during experiment reveals occurrence of the activities of the microorganisms. The H P on the other hand dropped from its initial level of 7.2 to 6.4 at the end of the degradation process. The gradual drop in the H P of the sludge medium was as a result of the activities of the bacteria isolates thereby resulting in degradation. Similar drop in H P was observed by earlier workers(13) (14) . The final BOD of the sludge sample, at various times during degradation is as shown in Figure 1. There was a great reduction in the BOD of the sludge sample from its initial value of 145.83 mg l to 41.87 mg l . This shows a reduction of 71.3% of the initial BOD of the hydrocarbon sludge. Figure 2 shows the variation of COD of sludge at various times during treatment. The COD reduced from its initial level of 158.0 mg l to 63.2 mg l at the end of the degradation process. This shows a reduction 60.0% of the initial COD in the sludge. The significance of the decrease will prevent the effects of pollution that would have resulted if the sludge sample had not been treated. The final level of BOD of 41.87 mg l and COD of 63.2 mg l are very close to the acceptable standard of 20 mg l and 30 mg l respectively as specified for effluent by Federal Environmental Protection Agency, FEPA, (15) . The Total Organic Content (TOC) of the sludge sample during degradation is plotted in Figure 3. There was a fall of the Total Organic Content (TOC) of the oil sludge from an initial value of 74% to 16% for the period of eight weeks for which the experiment was carried out. This shows that 78.38% of the Total Organic Content (TOC) of the sludge was removed by degradation within the eight weeks. This reduction of Total Organic Content (TOC) of the oil sludge might have been as a result of its utilization by the consortium of microorganisms for their growth and multiplication. The Residual Oil Content (ROC) of the hydrocarbon sludge during the experiment is plotted in Figure 4. The result revealed that the Residual Oil Content (ROC) dropped from an initial value of 62.0% to 13.6% within the eight weeks of the experiment. This shows a reduction of 78.07% of the Residual Oil Content (ROC) of the oil sludge. This reduction might have been as a result of the Utilization of the Residual Oil Content (ROC) by the microorganisms for growth and multiplication. The consortium of Microorganisms, Psedomonas purida, Psedomonas aeuniguma, Psedomonas florescence and Bacillus megaterium, used in this experiment, given enough time, would biodegrade typical hydrocarbon sludge from refinery waste to a level that can be safely disposed in the environment or to an environmental regulatory body’s standard. The time required for this consortium of Microorganism to biodegrade the sample hydrocarbon sludge to a regulatory body’s standard is however more than the eight weeks used in the experiment. There is a decline with time in the rate of biodegradation of the hydrocarbon sludge by the consortium of Microorganisms. ACKNOWLEDGEMENT Special thanks to Dr. Lawal of Biotechnology Department, Federal Institute of Industrial Research Oshodi, (FIIRO) for the assistance he rendered in carrying out the analysis in the institute. 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