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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN-0001November30HealthcareQUANTIFICATION OF SUBGINGIVAL MICROFLORA IN A PERI IMPLANTITIS PATIENT USING REAL TIME POLYMERASE CHAIN REACTION TECHNIQUE - A PILOT STUDY
English0619PSG PrakashEnglish D.J. VictorEnglish S. VaishnaviEnglish Ponsekar A. AbrahamEnglishAim and Objective: Peri-implantitis is a chronic progressive marginal infection which is defined as an inflammatory reaction affecting the tissues surrounding osseointegrated dental implants resulting in loss of supporting bone. The microflora of patients with implants who are edentulous mainly consists of gram positive facultative cocci and non motile rods. Predominantly Streptococcus sanguis, Streptococcus mitis are found in a healthy, stable implant whereas motile rods, Spirochetes, Fusiforms and filaments are infrequently found. Microbiota around the failing implant in edentulous patients usually consists of gram negative anaerobic rods. In partially edentulous patients, peri implant microorganisms in a stable implant majorly consists of motile rods, Spirochetes and cocci. In a failing implant in partially edentulous patients high proportions of P.micros, P.intermedia, C.rectus and Fusobacterium species were observed (Alcoforado et al in 1994). The concept that the composition of subgingival microflora around implants in partially edentulous patients is said to be resultant of composition of flora around the teeth. Based on this principle we set out to identify the presence of putative periodontal pathogens on teeth in a predominantly edentulous arch with a metallic coping with periodontitis and a site in the same mouth with peri implantitis. Materials and Method: Subgingival plaque samples were collected from a partially edentulous patient using a paper point from the periimplantitis lesion with a probing depth of 8-9mm and
a tooth with deepest pocket with a probing depth of 6mm and we analyzed the five putative periodontal pathogens namely, P.gingivalis, P.intermedia, P.nigrecens, T.denticola and T.forcythia using Real Time Polymerised Chain Reaction (RTPCR) technique. Results: P.Gingivalis and P.Intermedia , P.Nigrecens had a 3 fold increase and T.Denticola had 1 fold increase when compared to the periodontitis ( teeth) site, and T.Forsythia was found in trace amounts at the periimplantitis site and was completely absent at the periodontitis( teeth) site.
EnglishImplants, Periimplantitis, Periimplant microflora, Ball abutments, Over denture.INTRODUCTION
From the past to present, the various treatment modalities in Dentistry for the replacement of missing teeth starting from Removable partial denture to Fixed partial denture, Dental Implants play a major role in the present scenario. Osseointegrated Titanium implants have become important alternative to conventional prosthesis for replacement of missing teeth1,2 . With increasing demand for dental implants,dental implant failure is also being reported more frequently3-8 . Hence the appropriate management of dental implants is always a quest to accomplish fruitful results. But, the Implant Dentistry often fails to impart us knowledge about the significance of regular assessment and the monitoring of the peri implant conditions. This often leads to peri implant infections and peri implant failures. Implant failures can be categorized as early and late. Early failures occur before osseointegration and prosthetic rehabilitation has taken place and late failures occurr afterwards9 . Late failures maybe sub classified into late-early and late-delayed depending on whether they occur during or after the first year of loading. Late-delayed failures are likely due to changes in the loading conditions in relation to quality or volume of bone and peri implantitis10. Aleast 10% of implant failures have been reported due to peri implantitis11 . The peri implant tissues of dental implants are colonized by a large variety of oral microbial complexes. The microflora that is present in the oral cavity before implant placement determines the composition of the newly establishing microflora around implants12 . Peri implant infections are peri implant mucositis which progresses onto peri implantitis, depending on the severity of the infection. Peri implant mucositis is defined as a reversible inflammatory reaction in the soft tissues surrounding an implant13 . Peri implantitis may be defined as the inflammatory process affecting the tissues around an osseointegrated implant in function, resulting in loss of supporting bone14. Apart from the microbial shift; local circumstances ( i.e. unsatisfactory oral hygiene, bone defects, deep pockets, overload ) as well as systemic conditions ( i.e. diabetes, smoking, genetic factors) may be important contributing factors as well15,16,17 On a clinically stable implant, S.sanguis and S.mitis are the most predominant organisms; while motile rods, spirochetes, fusiforms, and filaments are infrequently found18. When an implant failure occurs; a paradigm shift takes place in the microflora in which gram positive organisms basically become gram negative. Wherein the cocci becomes rods; immobile facultative anerobes become motile and strict anerobes19. According to Klinge et al in 2005, the medium of transfer of infection in oral cavity is saliva which proves that the transfer of periodontopathogenic bacteria from the natural teeth site to the vicinity of implants is saliva20 . In another study, Mombelli and associates21 isolated an increased proportion of gram negative anaerobic rods in edentulous and partially edentulous patients, especially P intermedia, Fusobacteria and Spirochetes. Quirynen and co workers22 in their study isolated the periodontal pathogens P.intermedia, P.nigrescens, A.actinomycetumcomitans and P.gingivalis of their samples of partially edentulous patients and none in edentulous patients. There is limited information in the literature regarding the incidence of peri implant disease and presence putative periodontal pathogens in a partially edentulous patient having a metal coping over three teeth in one quadrant with an implant in the adjacent quadrant supporting an overdenture against a complete denture in the opposite arch. Hence the present study aims to identify and quantify putative periodontal pathogens at peri implantitis site and to compare it with isolated teeth sites with metal copings and to discuss the differences that might be present.
MATERIALS AND METHODS
Patient Information
A 53 years old female , was referred from the department of Prosthodontics to the department of Periodontology and Oral Implantology, SRM Dental College, Bharathi salai, Ramapuram, Tamil Nadu, Chennai, India; for the management of a failed dental implant in the 44 region, that was placed 3 years back. In the lower arch, the patient was partially edentulous with three teeth bearing a metal coping with a ball interface and on the adjacent quadrant she had a single implant with a ball abutment, both supporting an overdenture. She was given a complete denture in the maxillary arch opposing the lower overdenture. The implant was placed in the year 2008 and the patient reported back to the department after 3 years with a complaint of pain in relation to the lower implant region for past two weeks. In the deparment of Peridontics it was diagnosed as a Late-delayed implant failure. On Clinical examination revealed a probing depth of 6-7mm all around the peri implantitis site except in the lingual region (fig 2). The remaining teeth in the opposite quadrant showed a probing depth of 4-5mm. On the otherhand, the radiographical examination revealed horizontal bone loss in relation to the remaining three teeth and there was a bone loss upto the cervical third of the implant body at the 44 region (fig 3). Probing pocket depth has been found to be the most important clinical parameter in relation to the peri implant microbiota23. With increasing pocket depth, other morphotypes ( motiles and spirochetes ), as well as for the total number of organisms were observed23 . The ethical clearance for this study was obtained from the ethical committee board of SRM University, Bharati Salai, Ramapuram, Chennai- 89. The patient who participated in the study was detailed about the study protocol and her informed consent was obtained. The authors report no conflict of interest related to the study.
Procedure for Plaque Sample Collection
Subgingival plaque samples were collected from the mesial and buccal sites of teeth and peri implantitis site with the deepest pocket by means of a sterile paper points (# 35, US Patent no - 5,833,458) (fig 4and5). Samples were placed in 0.1 mL Ethanol (99.9% pure, M.W. 46.08). After all the samples were collected, the samples were then taken to the central research laboratory, Sri Ramachandra Medical College, where the samples were then analysed for quantification of periodontal pathogens by using the REAL TIME PCR (fig 6). The processing reagent (fig 7), PCR reagents and Master Mix Kit (fig 8) were obtained from Applied Biosystems, Warrington, UK.
PRINCIPLES OF THE PCR
The Polymerase Chain Reaction (PCR) is a technique in molecular biology to amplify a single or few copies of a piece of DNA of Red complex bacteria across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence.
PRIMER DESIGN AND SELECTION
Species-specific primers (Inqaba Biotech Industries Ltd) were used to detect the presence of P.gingivalis, P. intermedia, P.nigrscens, Tforcythia, T.denticola (fig 9). The expected product lengths were 641 bp for T. forsythia, 404 bp for P. gingivalis and 316 bp for T. denticola. A pair of ubiquitous primers product length (602 bp) which matched most bacterial 16S rRNA genes at the same position was used as a positive control for the PCR reaction.
PROCESSING OF SAMPLES- (m-RNA ISOLATION)
Collected plaque samples were stored in Eppendorf tubes containing Ethanol solution (99%) at -80? C. The samples were then centrifuged under 7000 rpm for 5minutes (fig 11). The supernatant was removed and discarded. Mixture of 1gm of lysozyme powder was mixed with TRIS Hcl (1ml), EDTA 200 µl, TRITON 600 µl and sterile water Milli Q (making upto 40ml), then vortexed for 5 min and 0.8 µl of all the mix was added to each Eppendorf sample and incubated for 30 minutes at 37C (fig 12) .Sodium Dodecyl Sulphate 20µl was added to the sample , vortexed again and incubated for 30 minutes at 37C. To this centrifuged under 10000 rpm for 10 minutes and the supernatant was extracted and added to a new Eppendorf tube.
Choloroform Isoamyl Alcohol 1 ml added to the new tubes and centrifuged under 10000 rpm for 10 minutes and the supernatant was discarded and added to new Eppendorf tube. To this Sodium Acetate 1ml and Ethyl Alcohol 1ml was added and centrifuged under 10000 rpm for 10 minutes and the supernatant was discarded and Ethanol 500 µl was added to the remaining of the sample and centrifuged 10000 rpm for 5 min. The supernatant was discarded and the remaining pellet was dried for 2 hrs and add 30 µl sterile water was added to it,then freezed and sent for PCR analysis.
Quantification of Porphyromonas Gingivalis, Porphyromonas Intermedia, Porphyromonas Nigrecens, Tannerella Forsythia, Treponema Denticola using PCR Analysis
To setup PCR reaction, commercially available Sybrgreen master mix - 5ml was added with another 5ml containing Forward primer-0.5µl, Reverse primer -0.5µl, Template DNA -2µl, and Sterile water -2µl. The total 10 ml of the mix was dropped into the microwells. Then the microwells were kept for PCR analysis in the PCR machine (fig 13).
Evaluation of RT-PCR amplification
Real-time PCR data are quantified absolutely and relatively. This study employs relative quantification which relies on the comparison between expression of a target gene versus a reference gene and the expression of same gene in target sample versus reference samples. Ct (Cycle threshold) –values of each individual in each group with their pro-inflammatory mediator and their subsequent endogenous control values (standard value) obtained form RT-PCR analysis. PCR amplification efficiency can be either defined as percentage or as time of PCR product increase per cycle (from 1 to 2). . The efficiency-calibrated model is a more generalized Ct model. Ct number is first plotted against cDNA input (or logarithm cDNA input), and the slope of the plot is calculated to determine the amplification efficiency (E). Ct for each gene (target or reference) is then calculated by subtracting the Ct number of target sample from that of control sample. As shown in Equation 1, the ratio of target gene expression in treatment versus control can be derived from the ratio between target gene efficiency (Etarget) to the power of target Ct (Cttarget) and reference gene efficiency (Ereference) to the power of reference Ct (Ctreference).
Amplification is done by the values obtained from ct. Lower the value, higher the expression of the microorganisms.
STATISTICS
Since we have dealt with only one sample and this being a pilot study, we have done a descriptive analysis.
RESULTS
The subgingival plaque samples collected from the two sites namely the peri implantitis site ( i.e.Test ) and the Teeth site ( i.e.Control ) were analyzed using the RT-PCR technique. Using the RT-PCR method,the organisms studied are P.gingivalis, P.intermedia, P.nigrscens, T.denticola and T.forcythia. According to the results obtained at the end of the study (table 1), P.G ranked the highest with a score of 35.0290 at the peri implantitis site and 9.673 at the teeth site. P.G was followed by P.I, P.N, T.D and whereas T.F was the least with the score of 0.678 at the peri implantitis site and completely absent at the teeth site. The Amplification plot of putative periodontal pathogens at the peri implantitis site and teeth site in a graphical representation, was plotted against Threshold Cycle and Temperature (fig 14). It demonstates an elevated graph level of P.G, P.I, P.N, T.D and T.F respectively at the peri implantitis site whereas at the teeth site these bacterial species demonstrates almost a flat graph level. A bar graph representing the Quantitative Expression of putative periodontal pathogens at the peri implantits site (fig 15), depicts the variation in the range of the bacterial species. According to this, P.gingivalis was the highest with a score of 35.0290, P.intermedia scored 34.6758 followed by P.nigrecens with a score of 34.1236, T.denticola was minimum with 14.003 and the least was T.forcythia with a score of 0.678. Another Bar graph (fig 16) was drawn to demonstrate the Quantitative Expression of putative periodontal pathogens at the teeth site. Even here P.G was the highest with a score of 9.673, follwed by P.I which was 8.344, P.N scored 3.444, T.D was 0.665 and T.F was completely absent. A comparative Bar graph was drawn (fig 17) depicting the Quantitative Expression of putative periodontal pathogens at the peri implantits site and teeth site. According to this chart, P.G and P.I,P.N showed a three fold increase at the peri implantitis site than at the teeth site. Whereas T.D showed a one fold increase at the peri implantitis site compared to the teeth site. T.F was present only in trace amount at the peri implantitis, which was totally absent at the teeth site.
DISCUSSION
Implant failures are classified as Early or Late. Late failures maybe further subclassified into Late- Early or Late-Delayed. 80% of failures were attributed due to Late-delayed failures. Even in our study,it was a case of Late-Delayed failure of the implant which led to peri implantitis. The transmucosal abutment of the osseointegrated dental implant serves as a surface for bacterial colonization of the microbial biofilms. Like gingival crevice around the natural tooth; the peri implant mucosa which covers the alveolar bone, is closely adapted to the implant. Microbial colonization and the ensuing inflammatory reactions in the peri implant tissues might be the analogous to key events in the pathogenesis of periodontitis24,25. It is believed that the source of infecting bacteria is mainly plaque from residual teeth or saliva, and that microbiota around the implants tends to be similar to that of residual teeth. The periodontal status of remaining teeth would thus determine the bacterial composition of peri implantitis site26. Our study using RT-PCR technique quantifies the presence of P.gingivalis, P.intermedia, P.nigrcens, T.denticola and T.forcythus at the peri implantitis site and tooth site in which the peri implantitis site showed a 3 fold increase of P.G,P.I and P.N and a 1 fold increase of T.D when compared to that of the teeth with metal coping. Our study was in concurrence with the previous studies by Quirynen et al (1999), Mombelli et al (1990,2001) and Papaioannou et al (2007) were they observed a greater amounts of P.gingivalis, P.intermedia, P.nigrcens ,T.denticola and T.forcythia. In our study we saw for all the above microbes except for T.forcythia. It could be plausibly substantiated by the difference in the attachment of the biofilm on the metal coping with a ball abutment on teeth to support the overdenture than on a normal tooth without a metal coping, and biofilm on the rough surface of implant. The difference in the surface characteristics of the metal coping and implant could be a possible reason for its absence but since ours is a limited study with one sample, it cannot be a proven hypothesis. A study with a bigger sample size could possibly find an answer whether the surface characteristics of metal on teeth and implant influence the microflora of peri implantitis site. Thus, our study provides an overview of the peri implant microbiology and an assessment as to whether bacteria associated with periodontitis exert a possible risk for peri implant tissue breakdown. Hence microflora is the most important characteristic along with which confounding factors like occlusal trauma, parafunctional habits, implant design, the surface characteristics, the type of prosthetic appliance; all could essentially play a role in progression of peri implantitis. Thus, during treatment planning apart from the microflora even other factors should be taken into consideration for efficient management of peri implantitis. The treatment protocol for peri implantitis was suggested by Lang and Co workers which was referred to as Cumulative Interceptive Supportive Therapy (CIST)27. It includes treatment modalities that consists of Mechanical debridement, Antiseptic treatment, Antibiotic treatment (non surgical) and Regenerative or Access/ resective surgery (surgical).According to the CIST protocol, since the case dealt with in our study showed a pocket depth of 6-7mm with bone loss till the middle third of the implant body, along with Debridement and Antiseptic management, it required a Regenerative Surgical treatment with pre and post surgical antibiotic therapy.
CONCLUSION
Dental implants are increasingly common form of prosthetic device implanted into patients. The apparent high success for placement of endosseous dental implant under uncontrolled environmental conditions and through heavily colonized oral environment appears counterintuitive. Datas on failures and complication of dental implants should be collected and reported in a systematic manner. This would enable in a more detailed analysis of microbiology, treatment outcomes and assist in the formulation of clinical guidelines in implant placement and treatment of implant associated infections. There are no studies investigating the influence of a metal coping and a ball interface supported by other side with a ball abutment engaged endosseous implant which has the overdenture framework. Thus, this study might throw a light into a new beginning. Thus, it is concluded that proper periodontal infection control before the placement of dental implants in partially edentulous individuals may prevent early bacterial complications. And also continuous monitoring of partially edentulous teeth site making it infection free will help in the longevity of the implant.
ACKNOWLEGEMENT
Authors acknowledge the immense help received from the scholars whose articles are citied 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 review and discussed. The authors also thank and his staff in the Department of Periodontology, SRM University for their support throughout the study.
Englishhttp://ijcrr.com/abstract.php?article_id=1745http://ijcrr.com/article_html.php?did=17451. Albrektsson T, Zarb GA, Worthington P, Ericsson AR. The long term efficacy of currently used dental implants: a review and proposed criteria for success. Int J Oral Maxillofac Implants 1986; 1: 11–25.
2. Zarb GA, Schmitt A. The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part II: the prosthetic results. J Prosthet Dent 1990; 64: 53–61.
3. Mombelli A, Lang NP. The diagnosis and treatment of peri-implantitis. Periodontol 2000 1998; 17: 63–76.
4. Hultin M, Gustafsson A, Hallström H, Johansson L-Å, Ekfeldt A, Klinge B. Microbiological findings and host response in patients with peri-implantitis. Clin Oral Implants Res 2002; 13: 349–58.
5. Quirynen M, De Soete M, van Steenberghe D. Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res 2002; 13: 1–19.
6. Roos-Jansåker AM, Renvert S, Egelberg J. Treatment of peri-implant infections: a literature review. J Clin Periodontol 2002; 30: 467–85.
7. Roos-Jansåker AM, Lindahl C, Renvert H, Renvert S. Nine- to fourteen-year follow up of implant treatment: I. Implant loss and associations to various factors. J Clin Periodontol 2006; 22: 283–9.
8. Roos-Jansåker AM, Lindahl C, Renvert H, Renvert S. Nine- to fourteen-year followup of implant treatment: II. Presence of periimplant lesions. J Clin Periodontol 2006; 22: 290–5.
9. Albrektsson T, Zarb GA, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1:11e25.
10. Tonetti MS, Schmid J. Pathogenesis of implant failures. Periodontol 2000 1994;4:127e138.
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12. Kees Heydenrijk, Henny J.A Meijer et al. Microbiota around Root-Form Endosseous Implants: A Review of the Literature. Int J Oral Maxillofac Implants.
13. Chen S, Darby I. Dental implants: maintenance, care and treatment of periimplant infection. Australian Dent J. 2003;48:(4):212 20.
14. Mombelli A, Lang NP. The diagnosis and treatment of periimplantitis. Periodontol 2000 1998;17:63–76.
15. Wilson TG. Not all patients are the same: Systemic risk factors for adult periodontitis. Gen Dent 1999;47:580–588.
16. Wilson GW, Nunn M. The relationship between the interleukin-1 periodontal genotype and implant loss. Initial data. J Periodontol 1999;70:724–729.
17. Kronstrom M, Svensson B, Erickson E, Houston L, Braham P, Persson GR. Humoral immunity host factors in subjects with failing or successful titanium dental implants. J Clin Periodontol 2000;27:875– 882.
18. Mombelli A, Lang NP. Microbial aspects of implant dentistry. Periodontol 2000 1994;4:74–80.
19. Armellini D, Reynolds MA, Harro JM, Molly l. Biofilm formation on natural teeth and dental implants: what is the difference? Role of Biofilms in Device-Related Infections. 2009;3:109-22.
20. Klinge B, Gustafsson A, Berglundh T. A systematic review of the effect of antiinfective therapy in the treatment of peri-implantitis. J Clin Periodontol 2002; 29(Suppl 3):213–25.PERI-IMPLANTITIS 675
21. Mombelli A, van Oosten M, Schurch E, Lang NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 1987; 2:145–151.
22. Quirynen M, Papaioannou W, van Steenberghe D. Intraoral transmission and the colonization of oral hard surfaces. J Periodontol 1996;67:986–993.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22TechnologyEFFICIENT DISTRIBUTED ARITHMETIC BASED DISCRETE COSINE TRANSFORM CORE WITH ERROR COMPENSATION
English2026G. DhariniEnglish Sharon P.SEnglish Arun SEnglish R. RadhikaEnglishIn this paper, an error-compensated adder-tree is proposed to deal with the truncation errors by performing shifting and addition operations in parallel thus achieving low-error and high-throughput discrete cosine transform (DCT) design. The Discrete Cosine Transform is a type of Image Transform which expresses a sequence of finitely many data points in terms of a sum of cosine functions at different frequencies. The proposed scheme incorporates 9-bit distributed arithmetic (DA) - precision for this work instead of the 12 bits in the previous works, so as to meet the desired peak-signal-to-noise-ratio (PSNR). Thus, an area efficient DCT core is implemented to achieve 1 Gpels/s throughput rate for the PSNR requirements outlined in the earlier works.
EnglishDistributed arithmetic (DA)-based, 2-D discrete cosine transform (DCT), PSNR – Peak Signal to Noise Ratio.INTRODUCTION
Digital images have become attractive from the point of storage and transmission. Satellite and Medical images are good examples. They produce an enormous amount of digital data. Image compression is a technique of mapping images from a higher dimensional space to a lower dimensional space. The basic goal of image compression techniques is to represent an image with minimum number of bits of an acceptable image quality. There are several image compression techniques available. These techniques are generally categorized into two namely lossless and lossy techniques. The Discrete Cosine Transform has shown to be near optimal for a large class of images in energy concentration. The basis of DCT is decomposing the images into several segments or blocks and obtaining the corresponding frequency components of pixels. During the Quantization process the pixels of frequencies with less importance are discarded, hence the term lossy compression. The important frequency components are retained and they are used to reconstruct the image through the decompression process using the Inverse Discrete Cosine Transform. The loss of information during the reconstruction of the images can be controlled in this process during the compression stage. The proposed architecture operates shifting and addition in parallel by unrolling all the words required to be computed. Furthermore, the errorcompensated circuit alleviates the truncation error for high accuracy design. Based on low error Adder Tree, the DA-precision in this work is chosen to be 9 bits instead of the traditional 12 bits so as to achieve the desired peak-signal-tonoise-ratio (PSNR) requirements. Therefore, the hardware cost is very much reduced, and the speed is greatly improved using the proposed architecture.
DISCRETE COSINE TRANSFORM:
A Discrete Cosine Transform (DCT) expresses a sequence of finitely many data points in terms of a sum of cosine functions oscillating at different frequencies shown Fig 1.
All fast DCT implementations usually try to avoid multiplication operations by increasing the number of addition operations and decreasing the number of multiplication operations. Addition actually makes the architecture slow as the time complexity for addition is almost the same as that of fast multipliers.
DISTRIBUTED ARITHMETIC:
Distributed Arithmetic (DA) is an efficient method for computing inner products when one of Distributed arithmetic is an efficient method for the input vectors is fixed. Look-up tables and accumulators are used instead of multipliers for computing inner products and has been widely used in many DSP applications such as DFT, DCT and convolution. In particular, there has been great interest in implementing DCT with distributed arithmetic and in reducing the ROM size required in the implementations since the DA-based DCT
A. Derivation:
Distributed Arithmetic is proposed to realize inner product of vectors with optimal solutions in terms of hardware requirement. This features implementation without the need of multipliers, and at the same time, without the need of ROM as in DA approach.
A is a set of predetermined coefficients, and x are data values. Assume that the coefficient an is Q-bit two‘s complement binary fraction number. The above equation can be expressed as follows:
Thus, the inner product computation can be implemented by using shifting and adders instead of multipliers. Therefore, low hardware cost can be achieved by using DA architecture.
In this figure, input signals are sign extended bits and then fed into the Adder Matrix, which is a butterfly structure with number of output lines determined by DA precision.
B. Error Compensation:
NEDA architecture is the smallest architecture for DA-based DCT designs, but speed limitations exist in the operations of serial shifting and addition after the DA-computation.
The high-throughput shift-adder-tree and addertree, those unroll the number of shifting and addition. However, a large truncation error occurred. In order to reduce the truncation error, several error compensation methods have been presented based on statistical analysis of the relationship between partial products and multiplier-multiplicand. However, the elements of the truncation part are independent so that the previously described methods cannot be applied.
The shifting and addition computation uses a shift-and-add operator in VLSI implementation in order to reduce hardware cost. However, when the number of the shifting and addition increases, the computation time will also increase. Therefore, the shift-adder-tree presented in operates shifting and addition in parallel by unrolling all the words needed to be computed for high-speed applications. However, a large truncation error occurs and an ECAT architecture is proposed to compensate for the truncation error in high-speed applications. The shifting and addition output can be expressed as follows:
Considering high-speed implementation, the proposed 2-D DCT is designed using two 1-D DCT cores and one transpose buffer. The DAprecision and transpose buffer word lengths are chosen to be 9 bits and 12 bits, respectively, so that the system can meet the PSNR requirements stated in previous works. The proposed 8 x 8 2-D DCT core has a latency of 10 clock cycles and is operated at 125 MHz. As a result of the 8 parallel outputs, the core can achieve a throughput rate of 1 Gpixels per second.
ECAT with Other Architectures Fig. 7 shows a DA-Butterfly-Matrix, that includes two DA even processing elements (DAEs), a DA odd processing element (DAO) and 12 adders/subtractors, and 8 ECATs. The eight separated ECATs work simultaneously, enabling high-speed applications to be achieved. After the data output from the DA-ButterflyMatrix is completed, the transform output will be completed during one clock cycle by the proposed ECATs.
RESULT AND CONCLUSION The tables 1 and 2 show the performance characteristics of the proposed design and the comparison of the proposed with the older architectures. Thus a high-speed and low-error 8 x 8 2-D DCT design with ECAT is proposed to improve the throughput rate significantly at high compression rates by operating the shifting and addition in parallel. The proposed errorcompensation minimizes the truncation error in ECAT. Fig.8 shows the VHDL simulation result obtained using Xilinx ISE Simulator for proposed 1D DCT architecture. The DAprecision can be chosen as 9 bits instead of 12 bits so as to meet the PSNR needs. Thus, the proposed DCT core has the highest hardware efficiency than those in previous works. Finally, an area - efficient 2-D DCT architecture is implemented with a maximum throughput rate of 1 Gpixels/s.
ACKNOWLEDGEMENT Authors acknowledge the immense 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
Englishhttp://ijcrr.com/abstract.php?article_id=1746http://ijcrr.com/article_html.php?did=17461. Y.Wang, J. Ostermann, and Y. Zhang, Video Processing and Communications, 1st ed. Englewood Cliffs, NJ: Prentice-Hall, 2002.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareMYOEPITHELIOMA OF THE PAROTID GLAND: A CASE REPORT
English2735Atul JainEnglish Pragnesh ParmarEnglishThe present paper describe the clinical and pathologic feature of a benign myoepithelioma of parotid glad. Through 1985, only 42 other cases have been reported in the literature, 3 malignant and 39 benign. Fewer than 100 cases had been reported through 1993. The number of case report of myoepitheliomas is increasing as pathologist have become more aware of their existence. This uncommon tumor is most
commonly diagnosed in parotid gland and in the minor salivary glands of palate. The complex and varied
morphologic expression of neoplastic myoepithelium have attracted numerous investigators who have presented valuable but often contradictory data. In our opinion these tumors are still a rare variety because they are simply not well recognized. Together with the review of literature, consideration are presented on the clinical evaluation, differential diagnosis and treatment of this lesions.
EnglishParotid gland, Salivary gland, Neoplasm, MyoepitheliomaINTRODUCTION
Salivary gland neoplasms composed exclusively of myoepithelial cells (myoepitheliomas) are unusual and intriguing. Salivary Gland tumors are quite uncommon and comprise less than 3% of all neoplasm of head and neck region. [1] Among the salivary gland tumors, myoepithelioma comprise only 1 – 1.5%. [1, 2, 4] It commonly occurred in the parotid gland and few are located in oral cavity. [3, 4] Majority of Myoepitheliomas, described in literature are benign. [5] Peak age of occurrence is between 3rd – 4 th decade of life and both sexes are equally affected. [6, 7] In 1943, Sheldon was the first to classify tumors as myoepitheliomas when he categorized three such tumors in a review of 57 mixed tumors of the salivary glands. [7] Initial diagnostic criteria for benign myoepithelioma were based on the review of Barnes et al. [2] and Sciubba and Brannon. [3] The traditional definition included only solid (without myxochondroid elements) tumors containing either spindle or plasmacytoid cells. However, with the recent appreciation of the diverse phenotypic and ultra structural modifications exhibited by the neoplastic myoepithelial cells of different salivary gland tumors, the morphologic spectrum of myoepithelioma has expanded. Usually in such cases patient underwent partial parotidectomy and specimen sent for Histopathological examination which was diagnosed as Myoepithelioma of parotid gland.
CASE REPORT
We are presenting here a case of 40 years old woman presented in our hospital with painless swelling in the right side of her face for past 6 months. On examination, a well demarcated, firm mass of 4 X 2 cm in the right parotid region was palpated. The mass was well demarcated, and it had a smooth external appearance. It had a moderately firm consistency, fixed to neighbouring tissues and no pain on palpation. The oral cavity was normal on inspection. There was no associated facial weakness or cervical lymphadenopathy. Clinical diagnosis made as plemorphic adenoma and sent for Fine needle aspiration cytology. Fine needle aspiration cytology Showed sheets of plasmacytoid cells and spindle shaped cells arranged in clusters and nuclei were small and oval with homogenous chromatin. (fig.1, fig.2) Under general anaesthesia, a nodular wellcircumscribed mass was surgically excised with a surrounding supra facial portion of normal parotid gland. Right partial parotidectomy was done and specimen sent for Histopathological Examination.
Gross Examination
• Tumor with surrounding normal portion of parotid gland was measured about 4.5 X 3.5 X 1.5 cm (fig.3)
• Cut section showed well circumscribed, gray white, oval firm mass measuring 3.5 X 1.5 cm (fig.4)
Histopathological Examination
• Showed the encapsulated tumor was hypercellular & composed of sheets of round to oval cells and spindle shaped cells.(fig.5, fig.6)
• Few plasmacytoid cells with oval nuclei and eosinophilic cytoplasm were seen.(fig.7, fig.8)
The tumor had a fascicular cellular arrangement with poor intercellular stroma. There was no necrosis, cellular atypia, or mitosis. Stroma was hyalinized at places. Postoperatively, there was no facial paralysis. There was no evidence of disease at one year follow-up.
DISCUSSION
Myoepitheliomas account for less than 1.5% of all salivary gland tumors. A review of the literature through 1993 yielded approximately 100 cases. [8] The tumor appears to be rare, and this contrast with the active role of myoepithelial cells in the histogenesis of several type of salivary gland tumors. The number of case reports is increasing as pathologists have become more aware of its existence. The most common location of myoepithelioma of the head and neck are the parotid gland (40%) and the palate (21%). [2, 9] The age and sex distribution of myoepitheliomas is similar to that of mixed tumors. There are no distinctive clinical features and similar to most other salivary gland tumors, myoepitheliomas present as asymptomatic, slowly growing masses. Parotid lesions never cause facial nerve dysfunction or cervical lymphadenopathy and those of the palate rarely ulcerate. Fine needle aspiration cytology is a baseline investigative tool in the assessment of patients with salivary gland swellings. It is an accurate method of distinguishing neoplastic from non neoplastic lesions. It may not be possible to always accurately predict a specific tumor type due to the overlapping spectrum of cytological appearances found in a wide variety of salivary gland neoplasms. [6, 8] Usually peak age of occurrence is between 3rd and 4th decade of life. In this case 40 year old woman, presented with tumor.
Macroscopically, myoepitheliomas appear as well circumscribed, frequently encapsulated tumors that show no features distinct from mixed tumors except for the absence of grossly myxoid or chondroid areas. Myoepithelioma usually ranges from 1 to 5 cm in diameter. In our case tumor measures 3.5 X 1.5cm which is well demarcated with smooth external appearance. [6, 8] Grossly, myoepitheliomas have solid, tan or yellow–tan glistening cut surface. In our case gray white, oval firm mass is present. Parotid myoepitheliomas are usually encapsulated, whereas those arising in the minor salivary glands may not demonstrate a capsule. Microscopically, they show three morphologic patterns. Spindle cell pattern is most common and consist of a proliferation of spindle shaped cells with eosinophilic cytoplasm. These may be arranged in diffuse sheets or interlacing fascicles. Tumors are hypercellular and have limited myxoid or mucoid stroma. The plasmacytoid pattern shows groups of round cells with eccentric nuclei and eosinophilic often hyaline appearing cytoplasm. These may be present in sheets of closely packed cells or in groups of cells separated by a loose myxoid stroma. The third pattern shows a combination of plasmacytoid and spindle-shaped cells. The spindle cell pattern is most common in parotid tumors. In our case combination of plasmacytoid and spindle cell pattern was present. [9, 10] Myoepithelioma distinguished from pleomorphic adenoma as relative lack of ducts and absence of myxochondroid areas. The rarity of myoepithelioma and the varied phenotypic expression of myoepithelial cells may cause problems in diagnosis. Tumors consisting predominantly of spindle shaped myoepithelial cells may be difficult to differentiate from mesenchymal lesions such as fibrous histiocytoma, schwannoma or leiomyoma. Ultrastructurally, they were composed of a single cell population characterized by numerous cytoplasmic filaments, duplicity of the basement membrane material and the characteristic cytoplasmic appearance of myoepithelial cells. [10] Immunohistochemistry is usually done to differentiate between clear cell variant of myoepithelioma from other clear cell tumors of salivary gland. Muscle specific actin marker is strongly positive in other clear cell tumors whereas negative in clear cell variant of myoepithelioma. In our case there were no clear cells. With immunocytochemical techniques, myoepithelial cells stain positive for cytokeratin, muscle specific actin, occasionally express S100 protein and glial fibrillary acidic protein (GFAP). Desmin has not been demonstrated. The neoplastic myoepithelial cells consistently demonstrate cytokeratin, S100 and muscle specific actin, whereas the immunoreactivity for vimentin and GFAP is more variable. [11] Identification of myoepithelial tumors as either benign or malignant on histological ground is difficult. The criteria for a diagnosis of malignancy are the presence of cytologic abnormalities, an increased mitotic rate, and particularly an invasive growth pattern. [12] These criteria were not met in our case. According to the World Health Organization‘s classification of salivary gland tumors, ??Myoepitheliomas are characterized by a more aggressive growth pattern than pleomorphic adenomas. [12, 13] But some authors have found that the biological behaviour of myoepitheliomas appears to parallel that of the pleomorphic adenoma. [2, 8] Others believe that myoepitheliomas are monomorphic variants of mixed tumors. [3, 14]
It is our opinion, as well as that of Barnes et al [2] and Dardick et al [15] that salivary adenomas are a part of a spectrum, with monomorphic adenoma and myoepithelioma at the extremes and a wide range of pleomorphic adenomas in between, depending on the type and degree of gene expression that is coupled with neoplastic transformation. While distinguishing benign myopithelioma from benign pleomorphic adenoma may primarily be of academic interest. Benign myoepitheliomas should be carefully differentiated from malignant tumors, such as malignant myoepithelioma, mucoepidermoid carcinoma, and spindle cell squamous carcinoma. [3, 16] Surgery is the first choice of treatment for myoepithelial carcinomas. The high recurrence rate suggests that initial surgery should be radical with sufficient normal tissue margins. Adjuvant chemotherapy and radiotherapy have not been found helpful for treating these carcinomas. Treatment of benign myoepitheliomas are similar to that of mixed tumors and consist of complete surgical removal. Most myoepitheliomas have a benign course with minimal tendency of recurrence. Treatment for a benign salivary gland tumor is surgical excision with a margin of normal uninvolved tissue being included. The recurrence rate is similar to that of the pleomorphic adenoma. [3, 17] The prognosis of benign myoepitheliomas is quite favourable, but patients should undergo regular follow-up examinations to rule out local recurrence.
CONCLUSION
Myoepithelioma occurs in most major and minor salivary gland tissues, and it is generally a biologically benign lesion. By means of this case report, we have attempted to scrutinize this entity. The variability of the histopathologic structure of mixed tumors and the alteration of the histochemical characteristics of myoepithelial cells in tumors from those of normal glands made identification of tumor myoepithelial cells difficult and uncertain. However, ultrastructural study of myoepithelial cells established fine structural criteria on which positive identification could be made. While myoepithelioma has no specific clinical features, it is accepted pathologically as a distinct entity. Treatment for a benign salivary gland tumor is surgical excision with a margin of normal uninvolved tissue being included. The recurrence rate is similar to that of the pleomorphic adenoma (15–18%).
Englishhttp://ijcrr.com/abstract.php?article_id=1747http://ijcrr.com/article_html.php?did=17471. Kawashima Y, Kobayashi D, Ishikawa N, Kishimoto S, A case of myoepithelioma arising in an accessory parotid gland, The Journal of Laryngology and Otology, 2002; 116:474–6.
2. Barnes L, Appel BN, Perez H, El-Attar AM, Myoepithelioma of the head and neck: Case report and review, European Journal of Surgical Oncology, 1985; 28:21–8.
3. Sciubba JJ, Brannon RB, Myoepithelioma of salivary glands: Report of 23 cases. Cancer 1982; 49:562–72.
4. Morinie`re S, Robier A, Machet MC, Beutter P, Lescanne E, Massive infra clinic invasion of the facial nerve by a myoepithelial carcinoma of the parotid, International Journal of Pediatric Otorhinolaryngology, 2003; 67:663–7.
5. Savera AT, Sloman A, Huvos AG, Klimstra DS, Myoepithelial carcinoma of salivary glands: A clinicopathologic study of 25 patients, The American Journal of Surgical Pathology, 2000; 24(6):761–74.
6. Dean A, Sierra R, Alamillos FJ, LopezBeltran A, Morillo A, Are´valo R et al. Malignant myoepithelioma of the salivary glands: Clinicopathological and immunohistochemical features, British Journal of Oral and Maxillofacial Surgery, 1999; 37:64–6.
7. Sheldon WH, So called mixed tumors of the salivary glands, Archives of Pathology and Laboratory Medicine, 1943; 35:1–20.
8. Turgut S, Cekic A, Ergu¨l G, Aksoy F, Seckin S, O¨zdem C, Myoepithelioma of the parotid gland: A report of two cases, Ear Nose and Throat Journal, 2001; 80(3):155–8.
9. Waldron CA, Mixed tumor (pleomorphic adenoma) and myoepithelioma. In: Ellis GL, Auclair PL, Gnepp DR, editors. Surgical pathology of the salivary glands. Philadelphia: WB Saunders; 1991. Page 165–86.
10. Leifer C, Miller AS, Putong PB, Harwick RD, Myoepithelioma of the parotid gland. Archives of Pathology and Laboratory Medicine, 1974; 98:312–9.
11. Franke WW, Schid E, Freudenstein C, et al. Intermediatesized filaments of the prekeratin type in myoepithelial cells, The Journal of Cell Biology, 1980; 84:633–54.
12. Di Palma S, Guzzo M, Malignant myoepithelioma of salivary glands: Clinicopathological features of ten cases. Virchows Archiv. A, Pathological anatomy and Histopathology, 1993; 432:389–96.
13. Dardick I, Thomas MJ, Van Nostrand AW, Myoepithelioma — new concepts of histology and classification: A light and electron microscopic study, Ultrastructural Pathology, 1989; 13:187–224.
14. Batsakis JG, Myoepithelioma. Annals of Otology, Rhinology and Laryngology, 1985; 94:523–4.
15. Dardick I, Van Nostrand AW, Phillips MJ, Histogenesis of salivary gland pleomorphic adenoma (mixed tumor) with an evaluation of the role of myoepithelial cell, Human Pathology, 1982; 13:62–75.
16. Nayak JV, Molina T, Smith JC, Branstetter BF, Hunt JL, Snyderman CH, Myoepithelial neoplasia of the submandibular gland: Case report and therapeutic considerations, Archives of Otolaryngology, Head and Neck Surgery, 2003; 129:359–62.
17. De Stefani A, Lerda W, Bussi M, Valente G, Cortesina G, Tumors of the parapharyngeal space: Case report of clear cell myoepithelioma of the parotid gland, Acta Otorhinolatyngol Ital, 1999; 19:276– 82.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcarePRIMARY SJOGREN?S SYNDROME - A CASE REPORT
English3640D.Lakshmi LalithaEnglish B. Sree Hari BabuEnglish P.K BeheraEnglish D.S.S.K RajuEnglishSjogren‘s syndrome is a slowly progressive chronic inflammatory autoimmune disease, more commonly affecting females. It is characterized by lymphocytic infiltration of exocrine glands in 40%-60% patients. It may occur alone (Primary Sjogren‘s) or in association with other autoimmune diseases such as Rheumatoid arthritis (RA), Scleroderma and SLE (Secondary Sjogren‘s). The prevalence of Primary Sjogren‘s syndrome (PSS) is 0.5-1% in the general population. (1, 2) Most of the PSS patients present with the signs of Keratoconjunctivitis sicca and xerostomia and in 40% of patients, extra glandular manifestations. We present a male patient aged 44 years with the manifestation of PSS, who also showed an extra glandular site involvement.
EnglishSjogren‘s syndrome, Autoimmune disease, Auto antibodies, Primary biliary cirrhosisINTRODUCTION
Primary Sjogren‘s Syndrome is a chronic inflammatory, autoimmune disease characterized by dryness of mouth and eyes, exocrine dysfunction and lymphocytic infiltration of exocrine glands. The clinical presentation may vary. It can affect men and children though frequently seen in women of 40- 60 years. Xerophthalmia and Xerostomia are the main clinical presentation commonly called Sicca syndrome. This is the most common autoimmune disease next to Rheumatoid arthritis primarily affecting peri and post menopausal female in the ratio of 9:1. (3) It is classified into Primary and Secondary. Primary Sjogren‘s manifests as dryness of eyes (Kerato conjunctivitis sicca) and salivary gland dysfunction (Xerostomia). Secondary includes involvement of one or both exocrine tissues associated with other connective tissue disorders like SLE, RA, Scleroderma etc. The etiology of Sjogren‘s is elusive and the diagnosis is based on several clinical and laboratory findings. Various criteria are being used world wide for the diagnosis of Sjogren‘s syndrome such as Copenhagen criteria, California criteria, Green criteria and Japanese criteria. The most accepted is the European criteria proposed by the American European consensus group in 2002, adopted by Vitali et al at the University of Minnesota. (4)
I) Ocular Symptoms (1:3)
- Dry eyes daily > 3 months
- Sand or gravel sensitivity in the eyes
- Use of tear substitutes (> three times a day)
II) Oral Symptoms (1:3)
- Dry mouth daily > 3 months
- Recurrent or persistent swollen salivary glands
- Frequent sipping of water to aid in swallowing dry foods
III) Ocular Signs (1:2)
- Positive Schirmer‘s test (4 von Bijesterfeld score)
IV) Salivary Function
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4. Vitali C., Bombardieri S., Jonnson R.et al. 2002 Classification criteria for Sjogren‘s syndrome: A revised version of the European criteria proposed by the American- European Consensus Group. Ann. Rheum. Dis.; 61:554-558
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7. Aoki A, Kirino Y, Ishigatsubo Y, Senuma A, Nagaoka s.2004 Dec;27(6):397-401. Liver involvement- Primary Sjogren‘s syndrome; pubmed-NCBI
8. Montano-Loza AJ, Crispin-Acuna JC, Remes- Troche JM, Uribe M. 2007 Jul-Sep Abnormal hepatic biochemistries and clinical liver diseases in patients with Primary Sjogren‘s syndrome. Ann Hepatol.; 6(3):150-5.
9. Inoue K. Hirohara J et al 1995 Prediction of prognosis of Primary Biliary Cirrhosis in Japan. Liver; 15(2); 70-7
10. Practical guidelines to diagnosis and therapy --- Robert I Fox, Carla M Fox (Editors) DOI 10.1007/978-1-60327-957-4 Springer Publication
11. Schoenfeld Y. Gerli et al 2005: Accelerated atherosclerosis in Autoimmune Rheumatic disease. Circulation 112:3. 337
12. Watanabe t et al 1999 Anti Alpha Fodrin antibodies in Sjogren‘s syndrome and lupus erythematosus. Arch Dermatol. 135(5), 535-539
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22TechnologyDESIGN ISSUES OF EMBEDDED SYSTEM USING REAL TIME OPERATING SYSTEM IN LINUX ENVIRONMENT
English4147Anant MittalEnglish Sunil Kr. SinghEnglishThe world of embedded system faces many challenges. Due to availability of several sections of modern
applications in the present era of technology, today's demand is very high performance from systems but
with minimum resources. Embedded systems are also known as real time systems since they respond to
an input or event and produce the result within a guaranteed time period. Usage of RTOS will enable us to break the complex system into simpler tasks without disturbing the inter task timing problems. Embedded systems require only the basic functionalities of an operating system in real-time environment- a scaled down version of an RTOS. It demands reliability and the ability to customize the OS to match an application's unique requirements. But, due to the advancements in technology, we need an open source environment i.e. Linux which has the capability to provide reliable and flexible configuration to any embedded application in the next generation of embedded system design. Linux offers powerful and refined system management facilities, it is a rich tool of device support, an excellent status for reliability, robustness and broad documentation. In this paper, we try to summarize some current trends in embedded systems design and point out some of their environment characteristics, such as RTOS and Linux platform which can provide a flexible and efficient ground for satisfying the area, performance, cost, and power requirements of many embedded systems.
EnglishRTOS, Embedded Linux, Embedded processor, ASIC.INTRODUCTION
The embedded system is a combination of computer hardware, software and, perhaps, additional mechanical parts, designed to perform a specific function. An embedded computing system uses microprocessors to implement parts of functionality of non-general-purpose computers. Early microprocessor based design emphasized on input and output. Modern high performance embedded processors are capable of providing a great deal of computation in addition to I/O task. An embedded system is not a new and exotic topic confined to research. There are many live examples of embedded systems around us. MP3 players (computing capability built into a music system), PDAs (computing in what essentially is an organizer), car-control systems, and intelligent toys are a few examples of such systems already in place. Linux was developed specifically as an operating system for the desktop/server environment. More recently, there has been a growing interest in tailoring Linux to a very different hardware and software needs of the embedded applications environment.
EMBEDDED SYSTEMS VERSUS GENERAL PURPOSE SYSTEMS:
An embedded system is usually classified as a system that has a set of predefined specific functions that are to be performed and in which the resources are constrained. Each embedded design satisfies its own set of functions and constraints. This is different from general purpose systems, such as the computer that sits on a desk in an office, the processor running that computer is termed a ?general purpose? processor because it was designed to perform well different tasks as opposed to an embedded system that has been built to perform a few specific tasks either very well or within very strict parameters.
a) Real time embedded systems:
Embedded systems are often wrongly classified as real-time systems. However, most systems simply do not require real-time capabilities. A real time system (defined by IEEE) is a system whose correctness includes its response time as well as its functional correctness. In other words, in a real-time system, it not only matters that the answers are correct, but when the answers are produced is also taken into consideration. Therefore, it can be defined as a system that performs its functions and responds to external, asynchronous events within a specified amount of time. It is an operating system capable of guaranteeing timing requirements of the processes under its control. While time-sharing OS like UNIX strive to provide good average performance, for a real-time OS correct timing is the key feature. There are hard and soft realtime systems depending on time constrains[1].
b) Embedded Processors:
With so many applications, all major microprocessor manufacturers are building their own embedded processors. Many companies have started using existing microprocessor cores and modifying them to suit embedded devices. AMD, for example, recently introduced its AMD-K6-2E processor in two flavours for embedded applications. Motorola has been a significant player in the embedded processors field over the last couple of years. They have the 68K cores at the low-end, Cold Fire in the midrange and PowerPC for higher-end applications. Another contender for the market share is Intel, who went the embedded way with its i960 processor, based on 1.0 micron technology. The same team was then put into developing the Strong Arm, which is based on 0.18 micron technology. This processor became quite popular, and found its way into devices like the Compaq iPAQ pocket PC, HP Jornada handheld PC, mobile phones and various digital imaging products.
c) Embedded Hardware Trends:
With the increase in interest and research of embedded systems, has come a flood of new design trends. It is hard to envision that five years from now embedded systems will bear much resemblance to the systems today, other than their basic functionalities and even those may be replaced in the future. Two of the current trends in the embedded systems world that is discussed here are that of application specific integrated circuits (ASICs) and systems on a chip (SOC)[2].
Application Specific Integrated Circuits
As the title suggests, this is an IC that has been designed for a specific application. In ASICs, the drawback is that they need heavier investments and longer time spans to develop. Apart from this, they can‘t be customized later as the software instructions for them are put on a ROM, which is difficult to modify.
System -on- a-Chip
A system-on-a-chip offers all the functions of a computer, but with a difference-all these features including a processor, chipset, video encoder, graphics processor, super I/O, clock generator, and the various buses used to interconnect, except the host memory of the system, are integrated on a single silicon chip . Like all forms of SOC, it reduces the number of chips in a system, allowing the product to be smaller and less expensive.
d) Embedded software:
C has become the language of choice for embedded programmers, because it has the benefit of processor independence, which allows programmers to concentrate on algorithms and applications, rather than on the details of processor architecture. However, many of its advantages apply equally to other high-level languages as well. Perhaps the greatest strength of C is that it gives embedded programmers an extraordinary degree of direct hardware control without sacrificing the benefits of high-level languages. Compilers and cross compilers are also available for almost every processor with C. Any source code written in C or C++ or assembly must be converted into an executable image that can be loaded onto a ROM chip. The process of converting the source code representation of your embedded software into an executable image involves three distinct steps, (as in given figure 2) and the system or computer on which these processes are executed is called a host computer. There are some very basic differences between conventional programming and embedded programming[3].
REAL TIME OPERATING SYSTEM AND EMBEDDING LINUX:
Embedded systems demand extremely high reliability (for non-stop, unattended operation), in addition to the ability to customize the OS to match an application's unique requirements. General purpose desktop OSes (like Windows) aren't well suited to the unique needs of appliance-like embedded systems. However, commercial RTOSes, though designed to satisfy the reliability and configuration flexibility requirements of embedded applications, are increasingly less desirable due to their lack of standardization and their inability to keep pace with the rapid evolution of technology. Fortunately, a new and exciting alternative has emerged: open source Linux. Linux offers powerful and sophisticated system management facilities, a rich cadre of device support, a superb reputation for reliability and robustness, and extensive documentation. Linux is available at no charge -- and with completely free source code. Open-source Linux has created a new OS development and support paradigm wherein thousands of developers continually contribute to a constantly evolving Linux code base. In addition, dozens of Linuxoriented software companies have sprung up – eager to support the needs of developers building a wide range of applications, ranging from factory automation to intelligent appliances Linux distributions are variations on the same theme -- that is, they are collections of the same basic components, including the Linux kernel, command shells (command processors), and many common utilities. The differences tend to centre based on which of the many hundreds of Linux utilities have been included, what extras are included, and how the installation process is managed. Some of the special capabilities being developed include:
- Installation of tools to automate and simplify the process of generating a Linux configuration that is tuned to a specific target's hardware setup.
- A variety of Windows-like GUIs to support a wide range of embedded requirements.
- Support for the specific needs of various embedded and real time computing platforms and environments (e.g. special Compact PCI system features).
a) Embedded Linux systems:
More recently, there has been a growing interest in tailoring Linux to a very different hardware and software needs of the embedded applications environment. A minimal embedded Linux system needs just these essential elements:
I. a boot utility
II. the Linux micro-kernel, composed of memory management, process management and timing services
III. an initialization process, to make it do something useful
IV. drivers for hardware
V. one or more application processes to provide the needed functionality
VI. a file system (perhaps in ROM or RAM)
VII. TCP/IP network stack
VIII. A disk for storing semi-transient data and swap capability[4].
b) Real time operating systems:
Real-Time Operating Systems (RTOS) are commonly used in the development, production, and deployment of embedded systems. Unlike the world of general purpose computing, realtime systems are usually developed for a limited number of tasks and have different requirements of their operating systems. This section first gives the requirements of real-time operating systems followed by how real time performance is achieved in Linux[4][5].
Real-Time Operating Systems: The Requirements
A good RTOS not only offers efficient mechanisms and services to carry out real-time scheduling and resource management but also keeps its own time and resource consumption predictable and accountable. A RTOS is responsible for offering the following facilities to the user programs that will run on top of it. The first responsibility is that of scheduling: a RTOS needs to offer the user a method to schedule his tasks. The second responsibility is that of time maintenance: the RTOS needs to be responsible in both providing and maintaining an accurate timing method. The third responsibility is to offer user tasks the ability to perform system calls: the RTOS offers facilities to perform certain tasks which the user would normally have to program on its own, but the RTOS has them included in its library, and these system calls have been optimized for the hardware system that the RTOS is running on. The last thing that the RTOS needs to provide is a method of dealing with interrupts: the RTOS needs to offer a mechanism for handling interrupts efficiently, in a timely manner, and with an upper bound on the time it takes to service those interrupts.
Linux and real time
Many (if not all) embedded applications have some sort of real time performance requirement. Many of these real-time requirements prove to be ?soft‘ - missing a deadline once in a while does not impact the overall system viability. A GPOS typically suffers from several challenges to real-time applicability: determinism in general, and response under load in specific. GPOS schedulers, optimized for time-sharing, can induce unpredictably long blocking times; drivers developed by a mix of GPOS-vendor engineers, peripheral-board vendors, and other third parties add their own variable latencies. Linux, developed for desktops and servers, is also a GPOS, but enjoys a promising future in real time embedded designs. Two primary paths existing to provide a real-time Linux: by inserting a second kernel into the system, and by refining the standard Linux scheduler and tuning Linux device drivers first to characterize the performance of standard versions of Linux. Before even attempting to enhance Linux responsiveness, it is important to measure its real-time performance thoroughly in terms familiar to real-time/embedded designers: worstcase interrupt latency, context switch, and maximum blocking times.
Comparison with existing embedded operating Systems
RTOS like QNX, PSOS, and VxWorks are designed from the ground up for real-time performance, and provides reliability by allocating certain processes a higher priority than others when launched by a user as opposed to by system-level processes. The demands for real- time performance were addressed during the initial design phase. As a result, commercial non-Linux embedded operating systems have tended to be more scalable at the low end and have better real-time performance. However embedded Linux has now evolved to the point where it can address, at low or zero cost, all but the most demanding of embedded applications .The real time performance issue can be important in the market, and embedded Linux vendors are working hard to match the real time capabilities of established products[6].
EMBEDDING LINUX:
One of the common perceptions about Linux is that it is too bloated to use for an embedded system. The standard Linux kernel is always resident in memory. Each application program that is run is loaded from disk to memory where it executes. When the program finishes, the memory it occupies is discarded, that is, the program is unloaded. In an embedded system, there may be no disk. The two ways to handle the removal of dependency on a disk are the complexity of the system and the hardware design. In a simple system, the kernel and all application processes reside in memory when the system starts up. This is how the traditional embedded systems works and is also supported by Linux.
The file systems -high availability:
An embedded Linux file system, unlike desktop or server implementations, must offer user independent support for recovery in the event of power failure. Also, power consumption, size and failure rate considerations mean that the file system is likely to be running from some variant of flash or ROM rather than hard disc or other rotating media. The Linux kernel must be rebuilt to support this device, but, again depending on the file system used, corruption can occur. Another is to make use of on-board flash memory with Disc on Chip devices, drivers must be added to Linux kernel -but there is the option of using the Journaling Flash File System (JFFS). This is a ?log structured ?file system, which means that old data is not lost when new data is written to flash.
ADVANTAGES/DISADVANTAGES OF USING EMBEDDED LINUX:
Although most Linux systems run on PC platforms, Linux can also be a reliable workhorse for embedded systems. A fully featured Linux kernel requires about 1 MB of memory. However, the Linux micro-kernel actually consumes very little of this memory, only 100 K on a Pentium CPU, including virtual memory and all core operating system functions. With the networking stack and basic utilities, a complete Linux system runs quite nicely in 500 K of memory on an Intel 386 microprocessor with an 8-bit bus (SX). Another benefit of using an open source operating system like Embedded Linux over a traditional real-time operating system (RTOS) is that the Linux development community tends to support new IP and other protocols faster than RTOS vendors do. For example, more device drivers, such as network interface card (NIC) drivers and parallel and serial port drivers are available for Linux than for commercial operating systems[7].
The core Linux operating system, the kernel itself has a fairly simple micro-kernel or monolithic architecture, meaning the whole operating system-process management, memory management, file system and drivers is contained within one binary image which is in compressed form. This provides a highly modular building block approach to constructing a custom embeddable system, which typically uses a combination of custom drivers and application programs to provide the added functionality. Linux is also well suited for embedded Internet devices, because of its support of multiprocessor systems which lends its scalability. This capability gives the designer an option of running a real-time application on a dual processor system, increasing total processing power. So you can run a Linux system on one processor while running a GUI, for example, simultaneously on another processor. The only disadvantage to running Linux on an embedded system is that the Linux architecture provides real-time performance through the addition of real-time software modules that run in the kernel space, the portion of the operating system that implements the scheduling policy, hardware-interrupts exceptions and program execution. Since these real-time software modules run in the kernel space, a code error can impact the entire system‘s reliability by crashing the operating system, which can be a very serious vulnerability for real-time applications.
APPLICATIONS
Embedded software is present in almost every electronic device you use today. However, a common obstacle for developers has been the need to develop different sets of hardware and software for different devices. In addition, the software running on the hardware chip is different. This often results in increased costs and time taken for development. Defence services use embedded software to guide missiles and detect enemy aircrafts. Communication satellites, medical instruments, and deep space probes would have been nearly impossible without these systems. Embedded systems cover such a broad range of products that generalization is difficult. Here are some broad categories.
1) Aerospace and Defence electronics (ADE)
2) Automotive
3) Broadcast and entertainment
4) Consumer/internet appliances
5) Data communications
6) Digital imaging
7) Industrial measurement and control
8) Medical Electronics
9) Server I/O
10) Telecommunications
CONCLUSION
The developments of embedded systems have been fairly dynamic over the past couple of years with the rapid digitization of various parts of our day-to-day utility items. The trend of embedded systems now involves the miniaturization of electronics so that it can fit into compact devices. In the future these systems will be moved by the forces of nature. Soon we will see more digitization of appliances, and these will be fuelled by human need. Embedded developers are a flexible, forward-looking bunch, and despite the need to reorient itself technically, they are flocking to Linux like penguins to their nesting ground. They are choosing Linux for the technical advantages cited above, for its greater reliability, for the comprehensive set of standard APIs, and to lower their cost. Linux has already altered the embedded and real-time operating system landscape in a fundamental and irreversible way.
Developers now have greater control over their embedded OS; manufacturers have spared the costs and headaches of software royalties with the users getting more value.
ACKNOWLEDGEMENT
Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1749http://ijcrr.com/article_html.php?did=17491. L. Thiele and R. Wilhelm. Design for timing predictability. Real-Time Systems, 28(2- 3):157–177, 2003.
2. H. Kopetz. Real-Time Systems: Design Principles for Distributed Embedded Applications. Kluwer Academic Publishers, 1997.
3. A. Burns and A. Wellings. Real-Time Systems and Programming Languages. Addison-Wesley, third edition, 2001.
4. http://www.dedicatedsystems.com/encyc/buyersguide/rtos/rtosme nu.htm for an RTOS Buyer's Guide
5. T.A. Henzinger, E.A. Lee, A.L. Sangiovanni-Vincentelli, S.S. Sastry, and J. Sztipanovits. Mission Statement: Centre for Hybrid and Embedded Software Systems, University of California, Berkeley, http://chess.eecs.berkeley.edu, 2002
6. http://www.opensource.org for general Open Source propaganda.
7. Embedded Systems, Linux, and the Future by Karim Yaghmour , author of Building Embedded Linux Systems 06/09/2003.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareBLOOD AND COMPONENTS USAGE IN A TERTIARY CARE HOSPITAL
English4854Mallikarjuna Swamy C MEnglish Shashikala PEnglish Kavita G UEnglishBackground: Availability of blood for transfusion, its need, quality and safety of blood transfusion depends on the geographical location as well as state of medical care in that area. Misuse or overuse of this naturally available resource has to be avoided. Aim: To review blood component usage and to assess the pattern of blood usage in a tertiary care hospital. Materials and methods: This study was conducted at a blood bank of a tertiary health care hospital. Details of the blood and component recipients in one representative month were recorded. Results: Supply of blood was found to be more in the surgical wards forming 57.36% (n=343/598) of total supply. The most common diagnosis for patients requiring blood transfusion was anemia (n=157, 26.25%). Anemia (353/620, 56.93 %) was also the most common indication for packed red blood cells (PRBCs) transfusion followed by surgery (194/620, 12.24%). Thrombocytopenia was the commonest indication for platelet transfusion (378/514, 23.85%). Highest number of fresh frozen plasma (FFP) units was utilized for patients with hypoproteinemia (79/166, 45.78%). Our audit shows that the use of PRBCs has largely replaced that of whole blood. Conclusion: Appropriate guidelines need to be set to reduce the inappropriate transfusions of blood components like PRBCs, platelets, and FFP. The clinician should always bear in mind that transfusion can lead to serious complications and benefit/risk assessment must be taken into account before each transfusion.
EnglishBlood utilization audit, transfusion appropriateness, transfusion practices.INTRODUCTION
Transfusion medicine has become one of the sophisticated medical technical discipline, that has eased modern medical therapy. Blood transfusion is done in all parts of the world. Availability of blood for transfusion, its need, quality, safety of blood transfusion depends on the geographical location as well as state of medical care in that area. As the supply of red blood cells continues there is an increasing demand for platelets. Since blood is considered as a drug, it is regulated by Food and Drug Administration. As any other drug, blood transfusion may cause side effects like transfusion reactions, transmit infections etc., everyone must be aware of the potential risks of blood transfusion. Blood transfusion is considered as similar to tissue transplantation. Keeping in mind the graft versus host reaction, blood must be ordered and transfused only when it is absolutely necessary. Misuse or overuse of this naturally available resource has to be avoided. Review of blood component usage has to be undertaken to assess the pattern of blood usage in any hospital. Hence the present was study was undertaken.
MATERIALS AND METHODS
This study was conducted at a blood bank of a tertiary health care hospital. The number of all whole blood units and blood components supplied over a period of one year was recorded and their average was calculated. Data of one month, which was closest to the average blood supply in one year, was chosen as a representative month. All the details of the blood and component recipients in this representative month were recorded, including age, gender, ABO and Rhesus blood groups, address, consultant in-charge, ward/unit where patients were admitted, diagnosis along with indications for blood transfusion. History of previous and present illness, including any previous transfusions and transfusion reactions if any were noted. Reports of salient investigations like hemoglobin, platelet count and coagulation profile were recorded. Details of usage of blood including the number and type of components transfused were noted and correlated with the clinical diagnosis and indications for transfusion.
RESULTS
The total number of whole blood and components issued from our blood bank in one year (1st October 2009 to 30th September 2010) was 19,985 units, with a monthly average of 1665 units. The supply showed some seasonal variation, with lesser unit supplied around midyear and peak during year ends (Table 1). For this study data was collected for a month (January 2010) the blood supply of which (n=1585 units) was closest to the calculated monthly average (n=1665 units), to account for seasonal variation in blood demand. In that representative one month the number of requests for blood products was from 598 patients, with many of these requests being more than one unit. The break-up supply for whole blood and various components showed that PRBC was the maximum utilized product followed by platelets, whole blood and FFP (Table 1).
Supply of blood was found to be more in the surgical wards forming 57.36% (n=343/598) of total supply; maximum blood required for general surgery (n=82/343, 23.9%). Request for medical wards constituted 42.64% (n=255/598) of all demands, with highest requirement in general medicine wards (n=180/255, 70.58%) (Table: 2).
Youngest recipient of blood unit was one day (two males and one female neonate) and the oldest was 95 year old male. Largest number of patients were in the age group 21-60 years (n=404/598, 67.55%) (Table 3). Male to female ratio was 0.89:1(Table 4).
The most common diagnosis for patients requiring blood components was anemia (n=157, 26.25%); followed by elective surgery (n=86, 14.38%) and dengue-like illness/viral fever (n=70, 11.7%) (Table 6).
Among the indications for all blood components taken together, anemia was the common indication (n=491, 30.98%) followed by thrombocytopenia (405, 25.56%) and elective surgery (353, 22.27%) (Table 7)
Among the 1585 units supplied to 598 patients, PRBCS was the maximum issued component (620/1585, 39.11%), followed by platelets (514/1585, 32.42%), whole blood (285/1585, 17.98%) and FFP (166/1585, 10.47%). Anemia (353/620, 56.93 %) was most common indication for PRBCs transfusion followed by surgery (194/620, 12.24%). Thrombocytopenia was the commonest indication for platelet transfusion (378/514, 23.85%) followed by anemia with thrombocytopenia and surgical procedures. Surgical procedures (126/285, 44.21%) were the commonest indication for whole blood transfusions followed by anemia (123/285, 43.15%). Highest number of FFP units was used for patients with hypoproteinemia (79/166, 45.78%).
DISCUSSION
Blood and blood components are no longer considered to be a low or no risk procedure, and consequently an increasing need for stricter guidelines for transfusing blood products has been recognized, not just to check infections, but also to minimize other side effects of transfusion.1 Whole blood and blood components are considered as drugs by the Food and Drug Administration (FDA) and the main aim of any blood bank is to provide safe and effective blood and blood components to the patients.2 To fulfill the demands of the blood, we need to know about the trends of blood usage and the ordering pattern in the hospital. Also it helps us to set policies in place to improvise the transfusion services. In our audit we found that blood components utilized in the hospital showed a ratio of PRBC: platelet: whole blood: fresh frozen plasma as 3.1:2.57:1.425:0.83 and whole blood: PRBCs was 3.77:1.11 which is different from most of the other studies that show whole blood to PRBC ratio as 1:3 or less.2 The utility or demand of blood and blood components was higher in patients admitted to surgical wards (57.36%) compared to medical wards (42.64%). Similar observation is reported from many other studies.2 Higher utility in surgical wards was probably because, blood and blood components are often ordered due to anticipated blood loss rather than actual blood loss, thereby leading to overuse of blood and unnecessary exposure of patients to antigens and infections. Another reason for increased usage of blood in surgical wards could be for the correction of anemia detected prior to surgery in patients requiring surgeries. According to studies, there is mounting evidence that some of the blood that is transfused is not always clinically indicated.3 Among all 598 patients who required transfusion, anemia was found to be the commonest indication (26.25%) similar to other studies.2 Of the 1585 units issued to 598 patients, PRBC was the maximum utilized component (39.11%) in our audit which is dissimilar to other studies that indicate more utilization of whole blood.2,4 Unnecessary transfusion of PRBCs could be avoided by alternative means like appropriate diet and hematinic therapy wherever possible. In both Medical and Surgical wards, it is necessary to correlate the clinical condition of the patient and the trigger values of hemoglobin and hematocrit in blood transfusion in anemic patients. Platelets were the second most commonly used blood component for transfusion 32.42% (514/585). The most common indication for platelet transfusion in our audit was thrombocytopenia (25.56%) possibly because Davangere happens to be an endemic area for dengue and dengue like illness. Indications for platelet transfusion are a count of < 20,000 /mm3 or among patients requiring surgery in less than 12 hours, a platelet count of < 50,000 /mm 3 could be the trigger level. Some studies indicate that platelet count of up to 10,000/cu.mm could be safe and platelet transfusion could be avoided.5 Indication for whole blood transfusion are patients with acute bleeding, trauma (large volume blood loss > 25%) and surgical patients, cardiac surgery and exchange transfusion in infants.4 In our audit, use of whole blood was 17.98%, maximum use was in patients undergoing surgery ( 126/285, 44.21%) followed by patients with anemia (123/285, 43.16%). The utilization of whole blood in the latter case could be replaced by PRBC wherever possible. FFP was the least used component (10.47%) in our audit, commonest indication for its transfusion being hypoproteinemia (45.78% 79 out of 166). Though least used, some of the transfusions of FFP were also found to be inappropriate. It is often used as a volume expander and a source of albumin.6 FFP should not be used for intravascular volume expansion, correction/ prevention of protein malnutrition, and when specific factor concentrates are available; alternative products that have undergone viral inactivation through complex manufacturing processes are preferable.7 In case of FFP, it is recommended to transfuse 5-6 units to correct the haemostatic defect due to clotting factor deficiency. Many times only one or two units are transfused. Many reports show inappropriate use of FFP at various centres. 8,9,10,11,12 CONCLUSION With the availability of blood component treatment, the clinicians are posed with a wide variety of choices. Inadequate and variable level of knowledge about transfusion practices among doctors increases the potential for misuse of blood.
Though the transfusion trends in our audit may not be representative of other hospitals, assessment of local transfusion practice is essential. Our audit shows that the use of PRBCs has largely replaced that of whole blood. More attempts must be made through frequent seminars and clinical meets to educate clinicians to limit the use of whole blood to only cardiac patients and acute trauma patients. Appropriate guidelines also need to be set to reduce the inappropriate transfusions of blood components like platelets, and FFP. The clinician should always bear in mind that transfusion can lead to serious complications and benefit/risk assessment must be taken into account before each transfusion.
ACKNOWLEDGEMENT
Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1750http://ijcrr.com/article_html.php?did=17501. Jain R, Jose B, Cashic P, Agarwal R, Deorari AK. Blood and blood component therapy in neonates. Indian J Pediatr 2008;75(5):489-95.
2. Gaur DS, Negi G, Chauhan N, Kusum A, Khan S, Pathak VP. Utilization of blood and blood components in a tertiary care hospital. Indian J Hematol Blood Transfus 2009;25(3):91-5.
3. Audet A, Goodnough LT, Parvin CA. Evaluating the appropriateness of red blood cell transfusions: the limitations of retrospective medical record reviews. International Journal for Quality in Health care 1996;8(1):41-9.
4. EFE S, Demir C, Dilek I. Distribution of blood and blood components, indications and early complications of transfusion. Eur J Gen Med 2010;7(2):143-9.
5. Greeno E, McCullough J, Weisdorf D. Platelet utilization and transfusion trigger: a prospective analysis. Transfusion 2007;47:201-5.
6. Wade M, Sharma R, Manglani M. Rationale use of blood components- an audit. Indian J Hematol Blood Transfus 2009;25(2):66-9.
7. Uppal P, Lodha R, Kabra SK. Transfusion of blood and components in critically ill children. Indian J Pediatr 2010;77:1424-8.
8. Thomson A, Contras M, Knowles S. Blood component treatment: A retrospective audit in five major London hospitals. J Clin Pathol 1991; 44:734-7.
9. Chang WJ, Tan MK, Kuperan P. An audit of fresh frozen plasma usage in an acute general hospital in Singapore. Singapore Med Jv2003; 44(11):574-8.
10. Schofield WN, Rubin GL, Dean MG. Appropriateness of platelet, fresh frozen plasma and cryoprecipitate transfusion in New South Wales public hospitals. MJA 2003;178:117-21.
11. Shinagare SA, Angarkar NN, Desai SR, Naniwadekar MR. An audit of fresh frozen plasma usage and effect of fresh frozen plasma on the pre-transfusion international normalized ratio. Asian J Transf Sci 2010; l4(2):128-32.
12. Makroo RN, Raina V, Kumar P, Thakur UK. A prospective audit of transfusion requests in a tertiary care hospital for the use of fresh frozen plasma. Asian J Transfus Sci 2007; 1:59-61.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesIN-VITRO OPTIMIZATION AND BIOTECHNOLOGICAL ASSESSMENT OF MUTANTS, HYBRID AND WILD STRAINS OF TWO WHITE-ROT FUNGUS, LENTINUS SUBNUDUS AND L. EDODES CULTURED BY SUBMERGE FERMENTATION (SMF)
English5578MajolagbeEnglish O.NEnglish OlokeEnglish J.K.English Deka BoruahEnglish H.PEnglishLentinus subnudus was picked in the wild during the rainy season in the month of June and then transferred aseptically onto Potato Dextrose Agar (PDA) slant by tissue culture protocol. The optimal culture conditions for biomass and exopolysaccharide production was investigated. Growth requirements
of the fungus were optimized for carbon, nitrogen, carbon-nitrogen ratio, seed culture volume and initial
pH. Temperature condition was maintained at 25oC at 100 rpm for 5 days. Each of the culture arameters investigated gave significant increament on biomass and exopolysaccharide production. For Coptimization,the highest biomass and exopolysaccharide was produced by starch (6.56gl-1, 1.84gl-1)
followed by glucose (2.01gl-1, 3.28gl-1) respectively. Tryptone and peptone N2-sources gave the highest
biomass and exopolysaccharides as 2.44gl-1 and 3.06gl-1 respectively. The optimal C:N ratio for biomass and exopolysaccharides was found to be 1:? (2.75gl-1) and 1:1/5 (5.26gl-1) respectively. Highest biomass and exopolysaccharides were also produced at pH 8.5 (1.90 gl-1) and pH 5.5 (2.00gl-1) respectively. There was no significant difference in the biomass and exopolysaccharides produced when different volume of the substrate was used. Mutants and hybrid strains of L. subnudus were produced by exposure to ultraviolet radiation and by crossbreeding with L. edodes respectively. Three (3) of the mutants that gave higher yield and better performance were selected for further biochemical analyses and then compared with the wild and hybrid varieties. Biochemical analyses such as total protein, total sugar, total phenol, total ascorbic acid content, reducing and non-reducing sugar, starch contents, anti-oxidant capacities of the wild, mutants and hybrid were performed. From our result, the mutants gave higher production and performance as compared to the wild and hybrid strains.
Englishoptimization, biomass, exopolysaccharides, Lentinus subnudus, L. edodesINTRODUCTION
Mushrooms are the fruit bodies of macroscopic, filamentous and epigeal fungi made up of hyphae which form interwoven web of tissue known as mycelium in the substrate upon which the fungus feeds; most often their mycelia are buried in the soil around the root of trees, beneath leaf litters, in the tissue of a tree trunk or in other nourishing substrate (Ramsbottom, 1989; Wilkinson and Buezaeki, 1982). Mushrooms belong to the class basidiomycetes in the order Agaricales whose fleshy fruit bodies and hymenia are borne on gills. They are ubiquitous group of fungi with many uses. They appear in traditional art work in form of drawings on textile material (Adenle, 1985).
Several authors like Fasidi and Kadiri, (1990a and 1993), Zoberi (1972 and 1973), Kadiri (1991), Oso (1975) and Nicholson, (1989) have shown in their various works that edible mushrooms are rich in ascorbic acid, amino acids, protein, minerals, glycogen, sugar and that protein is their most abundant nutrient. Also, mushrooms are sought for because of their toughness, meaty taste, desirable flavour and medicinal value. They are used extensively, as food item and for medicinal purposes (Oso, 1977., Chu et al., 2002., Akpaja, et al., 2003., Chiroro, 2004., Okhuoya, et al., 2005) and due to their high economic value and the enzymes they produce. Lentinus subnudus also known as L. squarrosulus is an highly-prized Nigeria whiterot mushroom, which can be picked in the wild during the rainy season between the month of April - August. It could be easily identified by its tough texture of matured sporophores, velvety stipe and funnel shaped whitish pileus (Jonathan, 2002) and belong to the group of the Basidiomycetes (Noda, 1998); family: Polyporaceae and Order: Polyporales. L. subnudus and other varieties of mushrooms are known to grow on a wide variety of substrates and habitats. Many species of Lentinus have been reported to live in nature and can be cultivated on special substrate and can be cultivated on pasteurized substances (Morias et al., 2000; Philippousis et al., 2001). Moreover, L subnudus have been successfully cultivated on cassava peels, rice straw, Andropogon straw, hard wood species such as Chlorophora excelsa, Spondias mombin, Terminalia ivorensis, and T. superba (Kadiri and Arzai, 2004; Adesina, et al., 2011). Optimization of industrial mushroom production depends on improving the culture process (Larraya, et al., 2003). A range of parameters including temperature, light, carbon dioxide concentration, humidity and pH have been shown to influence carpophore production Wessels, et al., 1987). Fruiting may also be stimulated by mechanical injury and chemical treatments (Hibbett, et al., 1994.). The effect of factors such as spawn grain, culture medium, oil type and rate on the culture of Psathyrella atroumbonata and L. squarrosulus has been reported (Nwanze, et al., 2004a, Nwanze, et al., 2005a; Nwanze, et al., 2005b). In our research, mutants and hybrid of L. subnudus were produced by exposure to ultraviolet radiation ( = 280nm) and crossbreeding with L. edodes respectively. Optimal culture conditions for the wild were investigated while biochemical analyses were performed for comparison of higher yield and performance among all the fungal strains.
MATERIALS AND METHODS
Organism and culture conditions
L. subnuduswt wild type (SWT) was collected from green vegetation environment growing on a decaying mango log of wood of six months. The fruiting body of the plugged fungus was washed with 90% ethanol, and then dissected longitudinally through the gill with a sharp and sterile razor blade. The mycelium was picked and transferred aseptically onto a freshly prepared Potato dextrose agar (PDA) slants. It was maintained on slants by sub-culturing in every one month interval. The ambient temperature for culture of the fungus is 25-28oC and it takes a minimum of 72 hours for optimum mycelia elongation. The fully grown fungus was maintained at 40C until when needed for use. Lentinula edodeswt wild type (EWT) was collected from Mushroom Research Centre, Himachal Pradesh Solan India. Screening of standard media for higher yield and performance Five fungal broths were used for culturing L. subnuduswt to screen for the best media with high yield performance and productivity in terms of biomass production, exopolysaccharide and enzymatic activities. Four out of the five different liquid media were used were supplied by Hi-Media Laboratory Private Ltd. Vadhani, Ind. Est. LBS Marg, Mumbai India while the other consist of a broth medium formulation according to Kwong et al., 2009. The ingredients formulation and culture conditions of each of the culture media are as stated below: Czapek Dox Broth (CDB): Sucrose (30g/l), Sodium nitrate (3.00g/l), Dipotassium phosphate (1.0g/l), Magnesium sulphate (0.5g/l), Potassium Chloride (0.5g/l), Ferrous Sulphate (0.01g/l); pH 7.3±0.2 at 25oC Mycological Broth (MB): Papaic digest of Soyabean meal (10.0g/l), Dextrose (40.0g/l), pH 7.0±0.2 at 25oC Potato Dextrose Broth (PDB): Potatoe infusion (200.00g/l), Dextrose (20.00g/l), pH, 5.1±0.2 at 25oC Yeast Mannitol Broth (YMB): Yeast Extract (1.00g/l), Mannitol (10.00g/l), Dipotassium phosphate (0.50g/l), Magnessium sulphate (0.20g/l), Sodium chloride (0.10g/l), Calcium carbonate, (1.00g/l), pH 6.8±0.2 at 25oC. Yeast Magnessium Potassium (YMK) broth: Glucose (20.0g/l), Yeast Extract (1.0g/l), MgSO4. 7H2O (1.0g/l), KH2PO4 (2.0g/l), pH 6.5±0.2 at 25oC Optimization of culture conditions for biomass, exopolysaccharide and enzymatic activities The flask culture experiments were performed in a 250 ml Erlenmeyer flask containing 100 ml of the seed culture medium. The medium was inoculated with 6mm agar plug of the fungus. The following optimal culture conditions were investigated for biomass, exopolysaccharide and enzyme activities. Carbon sources To find a suitable carbon source for biomass, exopolysaccharide and enzymatic activity of L. subnudus various carbon sources at a concentration of 10g/l were monitored for 5 days at 25oC, 100rpm on a rotary shaker incubator. The following carbon sources were used for the investigation: mannitol, starch, glucose, lactose, maltose, sucrose, fructose, mannose, galactose, arabinose, molasses and xylose. Control set-up was carbon source free in the seed culture medium.
Nitrogen Sources
To investigate the effect of different nitrogen sources on biomass, exopolysaccharide and enzymatic activity of the fungi, nitrogen compounds based on inorganic and organic nitrogen were added individually to N-source free medium at a concentration of 1g/l. Eight different N-sources were used as follows: Yeast extract, Malt extract, Beef extract, Peptone, Tryptone, NaNO3, NH4Cl, (NH4)2SO4. The experiment was set-up for 5 days at 25oC, 100rpm on a rotary shaker incubator. Nitrogen source-free medium was used as control. Carbon-Nitrogen ratio In order to investigate the effects of carbon-tonitrogen ratio (C/N) ratio on mycelial growth, exopolysaccharide and enzymatic activity of Lentinus subnuduswt, the concentration of the carbon and nitrogen in g/l were varied as follows: 1:0.1, 1:0.2, 1:0.25 1:0.33, 1:0.5. A carbon and nitrogen free media (0:0) was used as control. Initial pH To determine the optimal pH for mycelial growth, exopolysaccharide and enzymatic activity the fungus was cultivated under the initial pH ranges of 2.0 - 10.0. Experiment was carried out in 250ml Erlenmeyer flasks containing 100ml of seed culture medium on a rotary shaker incubator. The initial pH was controlled using 2 N NaOH and 2 N HCl. Volume of seed culture The effect of different volume of seed culture was investigated by culturing the fungus in 50 ml, 100 ml, 150 ml, 200 ml, 250 ml and 300 ml.
The 50 ml, 100 ml, 150 ml were carried out in 250 ml flask while the 250 ml and 300 ml experiment was performed in 500 ml flask. Harvest and Quantification of Biomass and Exopolysaccharides from culture broth (a) Biomass: The mycelia biomass was harvested from the seed culture on the 5th day of cultivation by filtering with 0.45 diameter Whatman Filter paper and the wet weight determined. The wet biomass was dried at 60oC until a constant weight was obtained (Kwon et al., 2009). (b) Exopolysaccharide (eps): Exopolysaccharides was derived from the liquid culture broth by 99% (v/v) acetone precipitation method, stirred vigorously and left overnight at 4 oC in a refrigerator. The precipitated crude eps was recovered by centrifugation at 10,000 rpm for 10 mins and then filtered with 0.45µm Whatman filter paper. The precipitated eps was oven dry to a constant weight and the weight of the polymer estimated. Production of Mutants Lentinus subnudusmt mutant types (SMT) were produced by exposing an actively growing culture (5days old) of the fungus on Potato Dextrose Agar (PDA) plate to an ultravioletradiation ( = 280nm) at different time durations of 15 minutes interval for 4 hrs. Mycelia plugs obtained from the culture were transferred onto the centre of a fresh PDA plates, incubated at 25oC. Production of Hybrid by crossbreeding L. subnudusht hybrid type (SHT) was produced by cross-breeding L. subnuduswt (SWT) and L. edodeswt (EWT) as follows: EWT was cultured on PDA plate and incubated at 25oC. On the fourth day after inoculation, SWT was inoculated onto the same plate at a distance of 8mm apart with the culture conditions remaining the same. The junction where the two fungal strains intersect was picked with a sterilized cutter and then inoculated onto a freshly prepared PDA media. The new fungal strain obtained was used as the hybrid type. Comparison and screening of mutants for higher yield performance in biomass, exopolysaccharide and protein contents A total of eighteen (18) fungal strains were cultured in the optimized culture conditions as follows Glucose 10g/l, Yeast Extract 10g/l, K2HPO4 0.5 g/l, CaCO3 1.0 g/l, MgSO4.7H2O 0.2g/l and NaCl 0.1g/l. The initial pH of the medium was adjusted to 5.5 using 2N NaOH and 2N HCl. Equal size of each fungal agar plugs kept on PDA slants were inoculated into 100 ml substrate volume, cultured for 5 days at 25oC. The wet and dry weight of the biomass from each culture flask was determined as earlier discussed above. The exoploysacharides was obtained by acetone precipitation method as already mentioned. The EPS was lyophilized and the dry weight estimated. The extracellular protein was determined according to Lowry et al., (1951). SMT060, SMT-120 and SMT-135 were selected out of the eighteen mutants based on biomass, exopolysaccharides and protein production levels. Biochemical analysis i. Total Protein estimation Total protein was estimated by FolinCiocalteau's method as modified by Lowry et al., (1951) using bovine serum albumin as standard. The blue colour developed was measured at 660 nm against the blank and standard solution of protein was also run simultaneously. ii. Enzyme Activity assay Two extracellular lignocellulotic enzymes (Pyranose 2-oxidase and Laccase) associated with white-rot fungus were extracted and assayed accordingly as follows: a. Determination of Pyranose 2-oxidase Activity assay Pyranose 2- oxidase (P2OX) activity was determined using the chromogen ABTS [(2,2- azinobis(3-ethylbenzthiazolinesulfonic acid)] (ε420 = 3.6 x 104 mM-1 cm-1 ) according to the modified method of Danneel et al., 1993. The standard 1 ml assay mixture contains 10mM ABTS, 2U of Horseradish Peroxidase Type II Sigma, 100 μmol D-glucose, in 10 mM sodium phosphate buffer (pH 6.5), 100µl of the diluted enzyme was used. The mixture was incubated at 30oC in Water-bath B-480 (manufactured by Buchi, Switzerland) for 3mins. Oxidation of ABTS was monitored by spectrophotometer at 420nm. b. Determination of Laccase Activity assay: Laccase activity assay was determined according to the modified method of Shin and Lee, 2000; Saranyu and Rakrudee, 2007 as follows: The routine assay for laccase was based on the oxidation of [(2,2-azinobis(3- ethylbenzthiazoline-6-sulfonate) diammonium salt] (ABTS) (Sigma) (ε420 = 3.6 x 104 mM1 cm-1 ). 50µl of the enzyme was incubated in 940µl of 0.1 M Sodium acetate buffer (pH 4.5) containing 10µl of 10mM ABTS incubated at 30oC in Water-bath B-480 for 10mins. The reaction mixture was stopped by adding 50µl of 50% (w/v) Trichloroacetic acid (TCA). Oxidation of ABTS was monitored by spectrophotometer at 420nm. iii. Estimation of total sugar content of the exopolysaccharides The total sugar contents (TSC) of the exopolysaccharides produced from the submerge cultures of wild, mutants and hybrid fungal strains were estimated using Anthrone method with glucose as standard, according to Sadasivam and Manickam 1992. Briefly, 100mg of the sample was weighed into a boiling tube, hydrolyzed in boiling water for 3h with 5ml of 2.5 N HCl. The sample was cooled to room temperature and then neutralized with solid sodium carbonate until effervescence ceases. The volume was made up to 100ml and then centrifuged. The supernatant was collected and 0.5 and 1 ml aliquots taken for analysis. The volume was made to 1 ml in the tubes by adding distilled water. 4 ml of anthrone reagent was added to the tubes heated for 8 minutes in a boiling water bath. The sample tubes were cooled rapidly and the green to dark green colour read at 630 nm. iv. Estimation of starch content by Anthrone method 0.1g of the sample was weighed and homogenized in hot 80% ethanol to remove the sugars. This was centrifuged and the residue was retained. The residue was washed repeatedly with hot 80% ethanol till the washings did not give colour with anthrone reagent. The residue was dried well over a water bath. 5.0 ml of water and 6.5 ml of 52% Perchloric acid was added to the residue. This was centrifuged and the supernatant saved. The extraction process was repeated using fresh Perchloric acid and then centrifuged. The supernatant was pooled and made up to 100 ml with distilled water.1 ml aliquot of the sample was used for analysis.. 4 ml of anthrone reagent was added, heated for 8 minutes in a boiling water bath. The tubes were cooled rapidly and the intensity of green to dark green colour read at 630 nm. v. Estimation of reducing and non-reducing sugars by DNS method Reducing and non-reducing sugar components of the exopolysaccharides were determined using Dinitrosalicyclic acid (DNS) reagent as follows: 100mg of each sample was weighed and the sugars were extracted with 5ml of hot 80% ethanol twice. The supernatant was collected and evaporated on water bath. 10ml of water was added to dissolve the sugars. 1ml aliquot of each of the sample was taken for analysis and the volume made up to 3 ml in testtube. Each sample was prepared in triplicate. 3ml of DNS reagent was added and mixed together. The solution was heated for 5mins in a boiling water bath. After the colour has developed, 1ml of 40% Rochelle salt solution was added when the contents in the tube were still warm. The tubes were cooled under running tap and the absorbance was measured at 510nm. The amount of reducing sugar in each of the sample was calculated using glucose as standard. vi. Determination of total phenols in the exopolysaccharides Total soluble phenols were estimated using Folin-Ciocalteu reagent (FCR) with catechol as standard (Malick and Sigh 1980). The blue coloured complex was taken at 650nm against a reagent blank. vii. Estimation of Ascorbic acid using 2, 6- dichlorophenol indole phenol titration method 5ml of the working standard was taken with a pipette into a 100ml conical flask. 10ml of 4% oxalic acid was added and this was titrated against the dye. 1g of each of the sample was extracted in 4% oxalic acid and the volume made up to 100ml. This was then centrifuged at 10,000 rpm for 15 mins. 5 ml of the supernatant was taken and 10ml of 4% oxalic acid added. This was titrated against the dye. The end point was the appearance of pink colour which persisted for a few minutes. The amount of the dye consumed is equivalent to the amount of the ascorbic acid. viii. Determination of antioxidant activities of the exopolysaccharides. Methanol and dichloromethane extractions were used for determining hydrophilic and lipophylic antioxidant activities of the exoploysaccharides (Arnao et al., 2001). Sample Extraction (a) Methanol extraction 1g of the eps was mixed with 10ml methanol and then homogenized using vortex. The homogenate were kept at 4oC for 12 hours and then centrifuged at 10,000 rpm for 20 mins. The supernatants were recovered and stored at -20oC until analysis. (b) Dichloromethane extraction The pellet obtained from the methanol extract was re-dissolved with 10ml dichloromethane, and homogenized for anti-oxidant activity. The homogeneate was centrifuged at 10,000 rpm for 20 mins. The supernatants were recovered and stored at -8 oC until further analysis. Briefly, 150µl of each of the extract for each sample was mixed with 2850 µl of the ABTS. It was kept for 2 hours in a dark condition. Absorbance was taken at 734nm using spectrophotometer. The standard curve was obtained using Trolox and results were expressed in µM Trolox Equivalent (TE)/g fresh weight. Statistics Analysis of the data was performed by one-way analysis of variance (ANOVA), One-Sample ttest and Karl Pearson Correlation coefficient was determined. Differences at P < 0.05 were considered to be significant. Analysis was done using Ms Excel Sheet 2007, Origin Lab 8 and Graph Pad Prism 5 statistical softwares. Each experiment was repeated three times with three replicates each. RESULTS AND DISCUSSION Submerge culture of L. subnuduswt (SWT) in different standard media Our first attempt was to culture SWT in five different media by sub-merge fermentation for biomass, exopolysaccharide, protein production and enzyme assay. Among all the five media used, YMKB gave the highest biomass (60±6.39mgl-1 ) and exopolysaccharide (960±10.83 mgl-1 ) production and least in CDB which yielded 19.50±4.58 mgl-1 and 100±20.53 mgl-1 biomass and exopolysaccharide respectively, although higher exopolysaccharide was also recorded by MB as shown in Table 1. Total protein estimated was highest in YMB (1.734±0.93 mgml-1 ) and least in PDB (0.186±0.05 mgml-1 ). There were significant differences (P < 0.05) between the biomass, exopolysaccharide and protein produced among the five broth media used. Previous researchers already reported that submerge culture obviously give rise to potential advantages of higher mycelial production in a compact space and shorter time without significant problem of contamination (Bae et al., 2000; Park et al., 2001; Sinha et al., 2001). Enzyme assay done showed highest laccase and Pyranose 2-oxidase activity in CDB and YMKB as 13.345 Uml1min-1 and 12.87 Uml-1min-1 respectively (Table 1). Effect of different carbon sources In order to determine the suitable carbon source for higher biomass and exopolysaccharide production, SWT was cultured in broth media, each containing various carbon sources. Each of the carbon sources was added to the synthetic media at a concentration of 1% (w/v) and then cultured for five days. The fungus showed a good growth response to most of the carbon sources as compared to the control experiment in which no carbon source was added. As shown in Fig. 1, starch gave the highest biomass production (6.56gl-1 ) followed by dextrose (2.01gl-1 ) among all the twelve carbon sources investigated. This is contrary to previous report on the optimization for mycelial biomass and exopolysaccharide production in submerge cultures of Cordyceps militaris (Jeong, et al., 2009). For exopolysaccharide production, the highest yield was recorded in molasses (3.96 gl1 ), followed by maltose (3.68 gl-1 ) as carbon sources. Although, glucose has already been reported by some previous investigators as a good carbon source for biomass and exopolysaccharides production in submerge cultures (Xu et al., 2003; Nour El-Dein et al., 2004; En-Shyh and Shu-Chiao, 2006), our result shows that L. subnudus was able to utilize both monosaccharides and disaccharides sugar compounds for biomass and exopolysaccharides production. This result is in accordance with nutritional requirement for biomass and exopolysaccharide production in several mushrooms (Sudhakaran and Shewale 1988; Fang and Zhong, 2002b; Ji-Hoon et al., 2004; Jeong, et al., 2009). Lactose and arabinose gave the lowest biomass and eps yield as 0.15 gl-1 and 0.16 gl-1 respectively. This result is in consonance with that of previously reported investigators where arabinose gave lowest biomass yield (Madunagu 1988, Jonathan and Fasidi, 2001), although contrary to report by Gbolagade et al (2006). In order to further understand the relationship between biomass and exopolysaccharide produced as a result of various carbon sources used, Pearson coefficient of correlation (r) was worked out. The outcome shows that there is no correlation between biomass and exopolysaccharide (r = - 0.087), suggesting that, both products are independent of each other although there was significant difference among the values obtained (P < 0.05). We also observed in our results that mushrooms may show different growth responses to carbohydrate utilization as compared to results already reported by other researchers. Effects of different nitrogen sources To investigate the effect of different nitrogen sources on biomass and exopolysaccharides production in submerge culture of L. subnudus, eight nitrogen sources were used consisting of five organic and three inorganic nitrogen sources. The basal medium was supplemented with the nitrogen sources at a concentration of 0.1% (w/v). A nitrogen limited control was also set-up. Among the nitrogen sources tested, tryptone gave the highest biomass production (2.44gl-1 ), followed by ammonium sulphate (1.36gl-1 ) and ammonium chloride (1.30gl-1 ) as shown in Fig. 2. Moderate biomass yield were recorded in beef and yeast extract, peptone and sodium nitrate with the lowest in meat extract (0.045gl-1 ). For eps production, peptone gave the highest yield (3.06gl-1 ), followed by ammonium chloride (2.66gl-1 ), with moderate yields in beef, meat and yeast extract. Reduced production of exopolysaccharide was recorded for both sodium nitrate and ammonium sulphate, whereas, tryptone gave the lowest yield (0.62gl-1 ). This means that a nitrogen source used to improve biomass production may not necessarily support a high yield of exopolysaccharides in L. subnudus. 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Fig. 1 Effect of different carbon sources on biomass and exopolysaccharide production in submerge culture of L. subnuduswt Data are means of three replicates; Error bar represents standard error of means of observed values; r = Pearson correlation coefficient Arb: arabinose; Dxtr: dextrose; Frt: fructose; Gal: galactose; Lact: lactose; Mantl: mannitol; Mann: mannose; Mol: molasses; Strch: starch; Sucr: sucrose; Xyl: xylose; Ctrl: control.
Fig. 2 Effect of different nitrogen sources on biomass and exopolysaccharide production in submerge culture of L. subnuduswt Data are means of three replicates; Error bar represents standard error of means of observed values; r = Pearson correlation coefficient BE: beef extract; YE: yeast extract; PEP: peptone; TRYP: tryptone; ME: meat extract; CTRL: control.
Fig. 3 Effects of carbon-nitrogen ratio on biomass and exopolysaccharides production in submerge culture of L. subnuduswt Data are means of three replicates; Error bar represents standard error of means of observed values; r = Pearson correlation coefficient
Fig. 4 Effect of initial pH on biomass and exopolysaccharide production in submerge culture of L. subnuduswt Data are means of three replicates; Error bar represents standard error of means of observed values; r = Pearson correlation coefficient
Fig. 5 Effect of seed culture volume on biomass and exopolysaccharide production in submerge culture of L. subnuduswt Data are means of three replicates; Error bar represents standard error of means of observed values; r = Pearson correlation coefficient
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesBACKWARD STOCHASTIC DIFFERENTIAL EQUATIONS UNDER G-BROWNIAN MOTION WITH DISCONTINUOUS DRIFT COEFFICIENTS
English7986Faiz FaizullahEnglish Rahman UllahEnglishThe main objective of this paper is to introduce the upper and lower solutions method for backward stochastic differential equations under G-Brownian motion (G-BSDEs). The existence of solutions for backward stochastic differential equations under G-Brownian motion having a discontinuous drift coefficient is shown with the method of upper and lower solutions. As an example, a scalar stochastic differential equation under G-Brownian motion having the unit step function as a drift coefficient is considered.
EnglishUpper and lower solutions, backward stochastic differential equations, G-Brownian motion, discontinuous drift coefficient, existence.INTRODUCTION
To measure super hedging and risk in finance under volatility uncertainty, the G-Brownian motion and the related stochastic calculus were introduced by Peng [16, 17]. He introduced the backward stochastic differential equations under G-Brownian motion (G-BSDEs) and developed the existence and uniqueness of solutions for GBSDEs with Lipschitz continuous coefficients, see [18] chapter IV page 83 or the appendix of this paper. Later, X. Bai and Y. Lin extended the existence and uniqueness theory of the GBSDEs to the integral Lipschitz coefficients [2]. Also see [20] for the stability theorem of GBSDEs. Now here in contrast to the above, we introduce the method of upper and lower solutions and establish the existence theory for G-BSDEs with discontinuous drift coefficients, such as in the following scalar G-BSDE
CONCLUSION Upper and lower solutions method is a very useful technique for the existence theory of boundary value problems (BVP). This method is widely used in ordinary and partial differential equations [3, 6, 12]. But a very limited literature is available on the method of upper and lower solutions for stochastic differential equations [8, 9]. The mentioned method for stochastic differential equations under G-Brownian motion (G-SDEs) was established by Faizullah and Piao in [5]. Furthermore, this is still an open problem to develop the method of upper and lower solutions for classical backward stochastic differential equations.
ACKNOWLEDGEMENTS
The research of F. Faizullah is supported by the China Scholarships Council (CSC) and partially by National University of Sciences and Technology (NUST) Pakistan. We are very grateful to Prof. Daxiong Piao for his motivations and some useful suggestions for this work. We also thank to the anonymous reviewers for their valuable suggestions. Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1752http://ijcrr.com/article_html.php?did=17521. Assing S., Manthey R. The behaviour of solutions of stochastic differential inequalities. Probability Theory and Related Fields, 1995; 103: 493-514.
2. Bai X., Lin Y. On the existence and uniqueness of solutions to stochastic differential equations driven by G-Brownian motion with Integral-Lipschitz coefficients, 2010; arXiv:math.PR/1002.1046v2.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareSOLITARY BONE CYST AN INCIDENTAL FINDING DURING ROUTINE ORTHODONTIC EVALUATION A CASE REPORT
English8793Anila CharlesEnglish Sangeetha DuraisamyEnglish Herald J SherlinEnglishSolitary bone cyst is a non-epithelial lined cyst occurring frequently in the long bones and occasionally in
the jaw bone. This cyst is most commonly located in mandibular posterior region and incidence rate is higher in the second decade of life. Clinically the cyst is asymptomatic in the majority of cases and is often accidentally discovered during routine radiological examination. Panoramic radiograph is a routine diagnostic radiograph used in the orthodontic patients. The lesion is manifested in Orthopantomograms (OPG) as a well defined unilocular radiolucent lesion with characteristic scalloping of the border when extending between the roots of the teeth. The definite diagnosis of solitary bone cyst is achieved during surgery when an empty bone cavity or cavity filled with a straw colored fluid without epithelial lining is observed. Careful curettage of the lesion favors progressive bone regeneration, offering a good prognosis and an almost negligible relapse rate. A case of incidental finding of solitary bone cyst in the routine radiographic investigation of an orthodontic patient is presented.
EnglishSolitary bone cyst, incidental finding, orthodontic diagnosis, OrthopantomogramsINTRODUCTION
Lateral cephalogram and Orthopantomograms are commonly used diagnostic radiographs for orthodontic treatment planning.1,2 It has been reported in the literature that more than 90% of orthodontists advice these radiographs routinely for orthodontic diagnosis. 3 Solitary bone cysts are fluid-filled or empty intra-osseous lesions found frequently in the mandible and rarely in the maxilla. Commonly used names include simple bone cyst, traumatic bone cyst, hemorrhagic bone cyst and unicameral bone cyst, extravasation cyst, idiopathic bone cyst, and primary bone cyst.4,5 The solitary bone cyst is described in the WHO classification as a non-neoplastic osseous lesion because of lack of epithelial lining.6 The prevalence of solitary bone cyst is estimated to be 1% of the jaw cyst with a sex predilection for males.7 The solitary bone cyst is most frequently diagnosed in the second decade of life with age distribution ranging from 25 to 75 years.4,8,9 In an evaluation carried out on 26 cases of TBC, 30.77% had trauma history, 69.23% had some relation to orthodontic treatment, and 50% of all cases had been diagnosed during initial orthodontic documentation. 10 Positive history of trauma is frequently associated with solitary bone cyst and is regarded as an etiological factor in the development of the lesion. The cyst is usually asymptomatic and majority of the cases are diagnosed as an incidental finding in the radiographs, while in few cases pain and swelling may be a presenting symptom.11,12 Other unusual symptoms include tooth sensitivity, labial paresthesia, fistulas, and delayed eruption of permanent teeth adjacent to the cyst and displacement of the inferior dental canal.11,4,9,12,13,14 The associated teeth are usually vital without any mobility or displacement. The lamina dura may or may not be lost and occasional root resorption may occur.11,15,16,4,8,9 Occasionally the bony cavity is filled with sero-sanguineous or serous fluid. In majority of the cases no visible lining was seen, rarely a thin membrane, granulation tissue or blood clot was described. 11,17,15,4,8 Since the specimen available for the histopathological is scant, confirming the diagnosis by histopathological examination is often difficult. The lining of the cyst is a loose vascular fibrous tissue membrane of variable thickness with no epithelial lining, although fragments of fibrin, red cells, hemosiderin pigment and scattered small multinucleate cells are often found. The adjacent bone is normal or sometimes shows osteoclastic resorption on its inner surface. 18,4,8,12,19 The following is a case report of a solitary bone cyst which was diagnosed as an incidental finding in the routine diagnostic radiographs. Case report A Sixteen year old Indian female patient reported to a private dental clinic with a complaint of protruded teeth and unaesthetic smile. On profile examination, an orthognathic profile with normal nasolabial angle, mentolabial sulcus and chin were present. Intraoral examination revealed a constricted maxilla with bilateral posterior cross bite and anterior open bite. Intraoral hard tissue and soft tissue examination did not reveal any significant findings. Lateral cephalogram and panoramic radiograph (OPG) were advised as a part of routine orthodontic diagnostic investigation. Panoramic radiograph revealed a well-defined unilocular radiolucency of 1.5cm x 2cm involving the right body of the mandible extending from mesial aspect of second premolar to the mesial root of first molar. (Fig 1) There were no clinical signs and symptoms like pain or swelling and no cortical expansion noted in the region of the cyst. Patient history does not reveal any trauma related to the orofacial region. The teeth involved were asymptomatic without any pain or mobility. The clinical diagnosis suggested includes odontogenic keratocyst and lateral periodontal cyst. Pulp testing confirmed the vitality of the teeth involved excluding the possibility of cysts of pulpal origin. Following radiographic examination needle aspiration of the lesion was done which was negative. Since the lesion was asymptomatic and patient‘s primary concern was inability to bite, an non extraction treatment plan was decided based on cephalometric and model analysis findings sparing the tooth involving the lesion. Orthodontic treatment was initiated with 0.22? slot Roth prescription pre adjusted edgewise. Under local anesthesia a triangular mucoperiosteal flap from the mandibular first premolar region to the second molar region was reflected. Using a small, round surgical bur and electric drill, the exposed cortical bone was removed between the second premolar and first molar, and the cavity was entered with an explorer through the small bur hole. An empty cavity was encountered that was devoid of tissue or fluid, and there was no evidence of lining tissue on the walls. (Fig 2) The hole was gradually enlarged and careful curettage of the inner part of the buccal cortex was performed in a vertical manner. Small chips of bone along with the soft tissue fragments obtained during the surgery were sent for histopathological examination. The operative findings were strongly suggestive of solitary bone cyst; therefore, no further treatment was performed apart from curettage. The cavity was irrigated and aspiration dried allowing blood to fill the cavity, and the mucoperiosteal flap was sutured to its original position. Sutures were removed after one week and healing was uneventful. The histopathological examination revealed normal bone trabeculae along with lining vascular fibrous connective tissue. Numerous areas of hemorrhage, extravasated RBCs and resorbing bone were also found. (Fig 3) Since the surgical and histopathological diagnoses were consistent with that of solitary bone cyst no further treatment was indicated. Postoperative recalls and vitality tests for the involved teeth were performed at frequent intervals. Panoramic radiographs 6 months after the surgical intervention revealed evidence of bone repair. (Fig 4) DISCUSSION The diagnosis in this present case is well documented radiographically and histopathologically. Most of the clinical and radiographic characteristics were typical of solitary bone cyst. Panoramic radiograph is the most commonly requested radiograph in the dental practice since various hard tissue and soft tissue pathologies can be detected 20. In orthodontic diagnosis panoramic radiograph is used to detect the clinically missing teeth, presence of impacted supernumerary teeth, to evaluate the periodontal status, eruption patterns and the status of impacted third molars.21 Almost 95% of cases reported in the literature are seen in the posterior region of the mandibular body and symphysis. Fewer cases are reported in the ramus, condyle and the maxilla, predominantly in the anterior part.4,8,18,19,22 Studies have shown that the 8.7% of patients undergoing orthodontic treatment are diagnosed with pathology or abnormality as an incidental finding during pretreatment panoramic radiographs. The most common incidental findings include idiopathic osteosclerosis, thickening of mucosal lining in maxillary sinus, periapical granuloma, cysts, marginal bone loss and odontomas. Certain incidental findings like idiopathic osteosclerosis and thickening of sinus lining do not require any intervention. Cysts, odontomas and periapical inflammatory lesions require management regardless of the orthodontic treatment.26 In radiographs the cyst appears as a radiolucent area with an irregular but definite outline with or without bone condensation in the periphery. Scalloping is a prominent feature of solitary bone cysts especially when the cyst envelops the roots of the erupted teeth. Occasionally expansion of the cortical plate is observed.4, 23 Numbers of theories have been proposed for the pathogenesis of the solitary bone cyst. The most widely accepted explanation is based upon the traumatic etiology.15 According to this theory, there is a failure of organization of the blood clot with resultant degeneration of the clot producing an empty cavity within the bone. Other theories include low-grade infection, intra-osseous vascular abnormalities, degeneration of bony tumours and local alteration of bone metabolism.8,12 Accurate radiographic interpretation and diagnosis is essential 21 to suggest the finding. Although some bone cysts resolve spontaneously surgical intervention is usually indicated not only for confirming the diagnosis, but also because the simple exploration of the cyst may be curative. Therefore, curettage of the cyst wall is generally indicated. Careful curettage of the cystic lining without causing damage to the dental roots or inferior alveolar nerve results in uneventful healing and resolution of the cyst in most of the cases. Hemorrhage in the bone cavity results in clot formation and normal healing15,18,4,8,24,25 Osseous regeneration can be verified after some months, which was also observed in the described case. Accurate pulp vitality tests supported by good-quality roentgenograms are necessary to determine whether the lesion is pulpal in origin, requiring endodontic therapy. CONCLUSION Incidental findings are more common during routine orthodontic diagnostic procedures and diligent care needs to be employed in assessing any changes during the treatment, as these asymptomatic cysts are detected only by radiographic examination. Surgical intervention should be done to prevent further expansion of the cyst. Periodic assessment of the tooth and cystic region help patients avoid subsequent complications.
ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in the 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.
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11. MacDonald-Jankowski D: Traumatic bone cysts in the jaws of a Hong Kong Chinese population. Clinical Radiology 1995; 50:787-791.
12. Beasley JD: Traumatic cyst of the jaws: report of 30 cases. J Am Dent Assoc 1955; 92:145-152.
13. Curran J, Kennett S, Young A: Traumatic (hemorrhagic) bone cyst of the mandible: report of an unusual case. J Can Dent Assoc 1973; 39:853-855.
14. Hughes C: Hemorrhagic bone cyst and pathologic fracture of the mandible: a case report. J Oral Surg 1969; 27:345-346.
15. Harnet JC, Lombardi T, Klewansky P, Rieger J, Tempe MH, Clavert JM. Solitary bone cyst of the jaws: a review of the etiopathogenic hypotheses. J Oral Maxillofac Surg. 2008;66:2345-8
16. Whinery JG: Progressive bone cavities of the mandible. Oral Surg Oral Med Oral Pathol 1955; 8:903-916.
17. Rushton M: Solitary bone cysts in the mandible. Br Dent J 1946; 81:37-49.
18. Kaugars G, Cale A: Traumatic bone cyst. Oral Surg 1987; 63:318-323.
19. Kuttenberger J, Farmand M, Stoss H: Recurrence of a solitary bone cyst of the mandibular condyle in a bone graft. Oral Surg Oral Med Oral Pathol 1992; 74:550- 556.
20. Bruks A, Enberg K, Nordqvist I, Stockel HA, Janson L, Svensson B. Radiographic examinations as an aid to orthodontic diagnosis and treatment planning. Swed Dent J 1999; 23:77-85.
21. Kulberg A, Norton L. Pathologic findings in orthodontic radiographic images. Am J Orthod Dentofacial Orthop. 2003; 123:182- 184.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesHALO CMES RELATED GEOMAGNETIC STORMS AND THEIR RELATION WITH X-RAY SOLAR FLARES, RADIO BURSTS AND INTERPLANETARY MAGNETIC FIELD
English94100P.L.VermaEnglishGeomagnetic Storms (Dst ?-75nT) associated with halo coronal mass ejections, observed during the
period of 23rd solar cycle (1997-2007) have been studied with X-ray solar flares, radio bursts and interplanetary magnetic field. The observed halo coronal mass ejection associated geomagnetic storms
have been divided in three categories , moderate geomagnetic storms, magnitude Dst ?-75nT to ? -100nT, intense geomagnetic storms, magnitude Dst ?-100nT to ?-200nT and severe geomagnetic storms, Dst ?- 200nT .It is observed that most of the halo CME related geomagnetic storms are intense or severe geomagnetic storms .The association rates of moderate, intense and severe geomagnetic storms have been found, moderate 18.52%, intense 48.15% and severe 33.33% respectively. Further it is inferred that all the halo CME related geomagnetic storms are associated with X- ray solar flares of different categories. The association rates of geomagnetic storms with different types of flare are found 09(33.33% ) X class flare, 13( 48.15% )M class flare, ,03(11.11 )% C class flare and 02( 7.41%) B class flare .Most of halo CME related geomagnetic storms are found to be related with type IV and type II radio burst 25(92.59. %) .The association rate of type IV and type II radio burst have been found 15(60) % and 10(40) % respectively. Majority of the halo CME related geomagnetic storms are found to be related with interplanetary shocks 26(96.30%) also .It is also determined that geomagnetic storms are closely related to interplanetary magnetic fields. Positive co-relation have been found between magnitude of geomagnetic storms and magnitude of jump in interplanetary magnetic field with correlation coefficient 0.72 between magnitude of geomagnetic storms and magnitude of interplanetary magnetic field, 0.85 between magnitude of geomagnetic storms and maximum value of southward component of interplanetary magnetic field.
EnglishCoronal mass ejections, X-ray solar flares, radio bursts, solar wind plasma parameters and geomagnetic stormsINTRODUCTION
The geomagnetic field is influenced by several solar activity and interplanetary phenomena like sunspots, solar flares, coronal mass ejections (CMEs), magnetic clouds interplanetary shocks, disturbances in solar wind plasma. The major classes of solar activity tend to track the sunspot number during the cycle, including, radio burst, solar flares, filaments, and coronal mass ejections (CMEs) .This activity is transmitted to earth through the solar corona and its expansion into the heliosphere as the solar wind. The solar activity, solar flares and coronal mass ejections are most energetic solar events in the heliosphere and are widely recognized as being responsible for production of geomagnetic disturbances in geomagnetic field. It is generally believed that long intervals of enhanced southward interplanetary magnetic field (IMF) and the high solar wind speed are the primary causes of intense geomagnetic disturbances and that the solar sources of such geoeffective solar wind structures are usually CMEs [2,6,13,14]. Evidence has been presented that the properties of the earth-directed CMEs, such as the internal structure of the magnetic field may determine whether or not a geomagnetic storm subsequently occurs [1].This suggests that the magnetic field serves as a link between flares, CMEs and geomagnetic storms. Several scientists have studied interrelationship between solar flares coronal mass ejections and geomagnetic storms, [10, 12] and have concluded that flares, CMEs and geomagnetic storms are closely related magnetically. Gopalswamy et al. [3] have studied magnetic clouds ,coronal mass ejections and geomagnetic storms and they have found that 86% magnetic clouds are associated with full and partial halos coronal mass ejections .The remaining 14% of magnetic clouds are associated with non-halo CMEs originating from close to the disk center. They have concluded that magnetic clouds associated with partial halo and halo coronal mass ejections are most potential candidates for production of geomagnetic storms .They have further concluded that magnetic clouds associated with non halo CMEs may also cause geomagnetic storms. Gopalswamy et al. [4] analyzed 378 halo CMEs covering almost whole of solar cycle 23 and found that 71% of frontside halos are geoeffective. Michalek, G.et al [5] have concluded that halo coronal mass ejections (HCMEs) originating from regions close to the center of the sun are likely to be geoeffective. They have showed that only fast halo CMEs (with space velocities higher than ~1000 km/s) and originating from the western hemisphere close to the solar center could cause intense geomagnetic storms. The main cause of geomagnetic storms is believed to be the large IMF structure which has an intense and long duration southward magnetic field component, Bz [7,8].Verma P.L. et al [9] have studied geomagnetic storms Dst < - 50nT observed during the period of 1997-2006, with halo and partial halo coronal mass ejections associated with X-ray solar flares of different categories and concluded that halo and partial halo CMEs associated with X ray solar flares are most potential candidates for production of geomagnetic storms.Yurchyshyn [11] have analyzed data for major geomagnetic storms and found a relationship between hourly averaged magnitude of the Bz component of IMF and projected speed of CMEs launched from the central part of the solar disk. They have concluded that CMEs with V> 1000 Km/s are capable to generate geomagnetic storms. In this investigation, Halo CMEs related geomagnetic storms observed during the period of 1997to 2007 have been studied with with X-ray solar flares, radio bursts and interplanetary magnetic field to know the physical process responsible for geomagnetic storms.
Experimental Data
In this investigation hourly Dst indices of geomagnetic field have been used over the period 1997 through 2007 to determine onset time, maximum depression time, magnitude of geomagnetic storms. This data has been taken from the NSSDC omni web data system which been created in late 1994 for enhanced access to the near earth solar wind, magnetic field and plasma data of omni data set, which consists of one hour resolution near earth, solar wind magnetic field and plasma data, energetic proton fluxes and geomagnetic and solar activity indices. The data of coronal mass ejections (CMEs) have been taken from SOHO – large angle spectrometric, coronagraph (SOHO / LASCO) and extreme ultraviolet imaging telescope (SOHO/EIT) data. To determine disturbances in interplanetary magnetic, hourly data of average interplanetary magnetic field has been used, these data has also been taken from omni web data(http;//omniweb.gsfc.nasa.gov/form/dxi.htm l)). The data of X ray solar flares radio bursts, and other solar data, solar geophysical data report U.S. Department of commerce, NOAA monthly issue and solar STP data (http://www.ngdc.noaa.gov/stp/solar/solardatase rvices.html.) have been used. . Interplanetary shocks data are taken from the list of the shocks derived by PM group.
DATA ANALYSIS AND RESULTS
In this study I have observed 27 geomagnetic storms associated with halo coronal mass ejections (CMEs), occurred during the period 1997 to 2007.I have divided observed geomagnetic storms in three categories, geomagnetic storms Dst ≤-75nT >100 nT as moderate, Dst≤-100 nT >200nT as intense and Dst≤-200 nT as severe .It is found that most of halo CMEs related geomagnetic storms (81.48 %) are intense or severe geomagnetic storms .I have 27 halo CMEs related geomagnetic storms in list out of which 22 halo CMEs related geomagnetic storms have been found intense or severe geomagnetic storms .The association rates of moderate, intense and severe geomagnetic storms have been found 18.51%,48.15% and 33.33% respectively. From the data analysis of observed halo CMEs related geomagnetic storms and radio bursts, most of the halo CMEs related geomagnetic storms (92.59)% have been found to be related with type II and type IV radio bursts and majority of them are associated with type IV radio bursts . The association rates of type IV and type II radio bursts have been found 15 (60.00%) and 10 (40%) respectively. From the further analysis it is observed that, halo CMEs related geomagnetic storms are also related with X-ray solar flares of different categories and majority of them are related with M class solar flares. The association rates of halo CMEs related geomagnetic with different X-ray solar flares are found 09 (33.33)% X class flare, 13 (48.15% ) M class flare ,03 (11.11)% C class flare and 02(7.41)% B class flare respectively .The data analysis of observed halo CMEs associated geomagnetic storms and interplanetary shocks, majority of the halo CMEs related geomagnetic storms are found to be related with interplanetary shocks 26 (9630%) .From the data analysis of halo CMEs related geomagnetic and interplanetary magnetic field, I have found that halo CMEs related geomagnetic storms are closely related to disturbances in interplanetary magnetic fields and southward component of interplanetary magnetic field. Further to see how the magnitude of halo CMEs related geomagnetic storms are correlated with the magnitude of jump in interplanetary magnetic fields , a scatter diagram has been plotted between the magnitude of halo CMEs related geomagnetic storms and magnitude associated disturbances in interplanetary magnetic fields in Fig.1.From the Fig it is clear that maximum halo CMEs related geomagnetic storms which have large magnitude are associated with such JIMF events which have relatively large magnitudes value. I have determined positive co-relation between magnitude of halo CMEs related geomagnetic storms and magnitude of JIMF with correlation coefficient 0.72 .Further to see how the magnitude of halo CMEs related geomagnetic storms are correlated with magnitude of JIMFBz events, a scatter diagram have been plotted between the magnitude of halo CMEs related geomagnetic storms and magnitude of value of JIMFBz events in Fig.2. From the Fig it is clear that maximum halo CMEs related geomagnetic storms which have large magnitude are associated with such JIMFBz events which have relatively large magnitudes values .Positive correlation with correlation coefficient 0.85 have also been found between magnitude of halo CMEs related geomagnetic and magnitude of southward component (IMF Bz) .
CONCLUSION
From our study, most of the halo CMEs related geomagnetic storms have been identified as intense or severe geomagnetic storms and associated with different types of X ray solar flares and type IV and type II radio bursts. Majority of the halo CMEs related geomagnetic storms are associated with interplanetary shocks. Large positive co-relation have been determined between magnitude of halo CMEs related geomagnetic storms and magnitude of IMF with correlation coefficient 0.72 and magnitude of halo CMEs related geomagnetic storms and magnitude of southward component of IMFBz with correlation coefficient 0.85.These results shows that halo coronal mass ejections associated with X-ray solar flares and radio bursts are very much effective in producing moderate, intense and severe geomagnetic storms .Further it is concluded that interplanetary shocks and disturbances in interplanetary magnetic fields are closely related to moderate ,intense and severe geomagnetic storms.
ACKNOWLEDGEMENT
The author would like to thank Prof. P.K Shukla, S.K.Nigam and B.P.Chandra for valuable suggestions. The author is grateful to OMNIWEB and SOHO data group whose data have been used in this study. Authors acknowledge the immense 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 from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1754http://ijcrr.com/article_html.php?did=17541. Cane, H. V., Richardson, I. G., & St. Cyr, O. C.,2000: Geophys. Res. Lett., 27, 3591.
2. Gopalswamy, N., Yashiro, S., Michalek, G., Xie, H., Lepping,P. R., and Howard, R. A. 2005 : Geophys. Res. Lett., 32, L12S09. Doi: 10.1029/2004GL021639.
3. Gopalswamy, N., S. Akiyama, S. Yashiro, G. Michalek, and R. P. Lepping, 2008: J. Atm. Sol. Terr. Phys., 70, 245.
4. Gopalswamy N. Letter 2009: Earth Planets Space, 61, 1–3.
5. Michalek, G., N. Gopalswamy, A. Lara, and S. Yashiro,2006: Space Weather, 4, S10003, doi: 10.1029/2005SW000218.
6. Srivastava, N. and Venkatakrishnan, P., 2004: J. Geophys. Res., 109. A10, 103.1- 13.
7. Tsurutani, B. T. and Gonzalez, W. D.: 1995: J. Atmos. Solar Terr. Phys., 57, 1369– 1384.
8. Tsurutani, B T Gonzalez, W D F Tang, S I Akasofu and E J Smith, 1988: J. Geophys. Res. 93, 8519.
9. Verma P.L. Tripathi A.K. & Sharma, Sushil, 2009: J. Plasma Fusion Res. SERIES, 8,221- 225.
10. Webb, D. F., Cliver, E. W., Crooker, N. U., St. Cyr, O. C., & Thompson, B. J.,2000: J. Geophys. Res., 105, 7491.
11. Yurchyshyn, V. 2004: Astrophys. J., 614, 1054.
12. Zhao, X. P., & Webb, D. F., 2003: J. Geophys. Res., 108, 1234.
13. Zhang, J., Dere, K., Howard, R. A., and Bothmer, V.:2003: Astrophys. J., 582, 520– 533.
14. Webb, D. F., Cliver, E. W., Crooker, N. U., Cyr, O. C. St., and Thompson, B. J.: 2000:J. Geophys. Res., 105, 7491–7508.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22TechnologyRECENT DEVELOPMENT ON BIODIESEL-A REVIEW
English101110Aman HiraEnglish Alok ChoubeEnglishThis paper represents the recent development done in biodiesel. It‘s also highlighting the global trend in
biofuel demand and supply, its economic viability, environmental issue and about the next generationbiofuel which may overcome alarming issue related to depletion of conventional fossil reservoir. sThe biodiesel is an alternative diesel fuel that can be produced from renewable feed stock such as vegetable oil waste fry oil and animal fat, however due to technical deficiency they are rarely used purely or with high percentage in unmodified diesel engine. The paper also shows the global trend in bio fuel demand and supply its economic viability its implication for GHG emission and about the next generation bio fuels which will overcome the scientific, technical and sustainability barrier which will result in significant green house gas saving compare to fossil fuels.
EnglishINTRODUCTION
High economic growth, underway for several decades in most developing countries across the globe, has resulted in robust demand for various energy sources. A greater need for mobility and peoples‘ aspirations for improved living conditions have together become the main driver for increasing primary oil demand, which is projected, according to most recent energy ?outlooks? by the IEA (International Energy Agency) and OPEC (Organization of Petroleum Exporting Countries), to rise by about 1.0% per year, reaching approximately 105 million barrels per day (mb/d) level by 2030. The transport sector, in particular, relies almost entirely on oil supplies for fuel. Several factors, including energy price increases, increased market volatility, in particular during 2008 and 2009; heavy dependence of many countries on imported oil; lingering debate about the ultimate size of remaining, recoverable fossil fuel reserves; and, not least, growing concerns about the environmental impact of fossil fuel usage have provided the impetus for the current strong interest in, and support for, biofuels in many parts of the world. The contribution of biofuels as an alternative energy source is currently very small, but this may change, should the high growth rates of the last few years be sustained in the coming years and decades. Because biofuels are seen as a clean alternative to fossil fuels, several countries have initiated policies to provide generous government support to biofuel development and production. A number of countries have also established a regulatory framework to promote and facilitate the use of biofuels in the domestic transportation sector. However, there are growing concerns about the overall energy efficiency of different feedstocks, the life cycle environmental benefits of biofuel production and use, the economic rationale of these alternative sources of energy, and the implications for food security and prices. Considering that most of the present generation of biofuels use agricultural commodities such as sugarcane, sugar beet, maize, wheat, barley, rapeseed, soybean, palm oil, and cassava as feedstocks, any developments in the biofuel sector – and formulation of government policies promoting them – are bound to have considerable impact on agricultural production, availability and food prices. This, in turn, raises important questions about food security and poverty across the globe. This study is a synthesis of recent development on the status of biofuels. It provides an overview of the global trends in biofuels supply and demand, as well as a review of the policies that are being implemented or considered in major countries to promote current (first) and next generation biofuel development. The study also discusses the potential of biofuels to address energy security concerns and reduce greenhouse gas emissions, as well as the ongoing debate over the implications of biofuel development on food security and rural development, biodiversity, deforestation, water resources and air quality. It also assesses the status of next generation technologies and their potential role in minimizing the sustainability problems associated with first generation biofuels. The analysis points out remaining uncertainties and open questions and outlines policy directions which can best promote the development of biofuels, while addressing, among other concerns, those of oil producing and consuming countries.
Global trends in biofuel supply and demand Current production and the medium- to longterm outlook Global
production of biofuels has been growing rapidly in recent years, more than tripling from about 18 billion litres in 2000 to about 60 billion litres in 2008. Supply is dominated by bioethanol, which accounted for approximately 84% of total biofuel production in 2008. Despite this exponential increase, biofuels still represent a very small share of the global energy picture. Total biomass accounted for 3.5% of total primary energy supply in 2007, according to the OPEC World Oil Outlook (OPEC WOO 2009), with liquid biofuels accounting for about 0.28% of total energy demand and about 1.5% of transport sector fuel use (IEA WEO 2009) Currently, production is concentrated in a small number of countries (Table 1). Together the US and Brazil account for about 81% of total biofuel production and about 91% of global bioethanol production Since 2005, the US has surpassed Brazil as the largest bioethanol producer and consumer, accounting for 50% of global production in 2008 (SCOPE 2009). The EU follows as the third major producer with 4.2%. In contrast, about 67% of biodiesel is produced in the EU, which is also the largest consumer, with Germany and France combined accounting for 75% of total EU production and 45% of global production.
According to a recent study by Hart's Global Biofuels Center (Hart/GBC 2009), global demand for ethanol and biodiesel combined is expected to nearly double between 2009 and 2015 from 95.3 to 183.8 billion litres. Ethanol, while accounting for 80% of this latter figure, will only represent 12% to 14% of total global gasoline demand. Although global ethanol supply generally matches demand in 2009 and 2010, it is expected to exceed it in 2015, reaching 168.6 billion litres compared to expected demand of 147.3 billion litres. Similarly, biodiesel supply is projected to almost double by 2015, reaching 94 billion liters. Hart/GBC estimates supply based on current capacity and projected capacity to be in place by the 2015 time frame. Hart/GBC based on the assumption that policy requirements and targets will be implemented and fulfilled and by using gasoline and on-road diesel demand figures estimated in another Hart/GBC study. The apparent supply/demand imbalance, according to Hart/GBC, will be taken care of by 2015 through some or all of several expected routes; 1) governments increasing blending limits; 2) many proposed projects cancelled; 3) continued low utilization rates; and 4) many existing plants scrapped. Interestingly, projected supply is well above targeted demand, which increases uncertainty in the motor fuels market, and creates a disincentive to invest in both the upstream and downstream of this domain. The supply/demand medium-term outlooks (2009, 2010 and 2015) for major ethanol and biodiesel producers and consumers are summarized in table 2
Over the medium term, the US and Brazil are likely to continue to dominate ethanol supply and demand. However, their combined share of production may decrease to 73% of the global total, as the role of countries in the Asia-Pacific region, mainly China, India, Indonesia and Malaysia, rapidly increases. By 2015, the latter region's total production could represent about 22% of global supply.With respect to biodiesel, the EU is assumed to continue dominating consumption in 2009 and 2010, but its share is also projected to decrease, from 60% to 40%, by 2015 as consumption in Asia-Pacific grows steadily
BIO FUEL TYPE
Different biofuels types can be produced from biomass in a number of ways. Generally, biofuel conversion technologies are categorized as first and second (next/advanced) generation biofuels. First generation biofuels, ethanol from sugar and starchy crops and biodiesel from oilseed crops and animal fat, use well-established and simple conversion technologies. Second (next) generation biofuels, from cellulosic biomass and algae, use less proven technologies. The most common types of biofuels are ethanol and biodiesel. Key aspects and requirements of the main production technologies, as well as uses of each, are briefly described below.
ETHANOL
Ethanol is currently produced from sugar crops (sugarcane, sugar beet, sweet sorghum) or starchy crops (corn, wheat, cassava) through a process of fermentation and then distillation, employing first generation technology. The basic production process of ethanol from both types of crop is similar. However, the energy requirement for starch-based ethanol is significantly more than that of sugar-based ethanol due to the additional process involved in converting starches into sugar. Energy and GHG balances are, therefore, more favourable for ethanol production from sugar crops than from starch crops. Production of ethanol from sugar cane results in a variety of by-products (co-products) including bagasse, a residual fibre which is used as a primary fuel source for sugar mills. According to the OFID/IIASA study (OFID/IIASA 2009), this makes a sugar mill more than self-sufficient in energy, allowing sugarcane-based ethanol to achieve energy balances ranging from two to eight times more energy output, when compared to fossil use input. Often co-generation of heat and electricity is possible and surplus electricity can be sold on to the consumer electricity grid, thus offering an additional source of income. Surplus bagasse has industrial applications and can also be used as livestock feed. Ethanol production from starchy crops produces highvalue livestock feed and distillers‘ grain. Ethanol can be used in blends of up to 10% in conventional spark ignition engines or in blends of up to 100% in modified engines (this is the practice only in Brazil; other countries using high blends go up to 85%). Though ethanol energy content is 66% of that of gasoline, it has a higher octane rating and, when mixed with gasoline, ethanol improves vehicle performance and reduces CO2 emissions. Ethanol also has very low sulphur content, thus its use reduces SO2 emissions, a component of acid rain. On the other hand, ethanol use could increase nitrogen oxide (NOx) emissions, which play an important role in the formation of ground ozone and acid rain.
BIO DIESEL
Conventional biodiesel is produced from vegetable oil and animal fat through a process known as esterification. Major feedstocks are rapeseed, soybean, palm and jatropha. The production process provides additional coproducts, typically bean cake, an animal feed, and glycerine, which can be used in several industries.Biofuel blend with diesel or used in pure form in compression ignition engines without engine or infrastructure modification. Its energy content is only about 88 – 95% that of diesel, but the fuel economy of both are generally comparable as biodiesel raises the cetane level and improves lubricity.
LITERATURE REVIEW
Mallikappa D.N , Rana Pratap Reddy, Ch.S.N. Murthy (2011) has conducted a test on double cylinder direct injection compression ignition engine they have test on cardonal as an alternative fuel for the diesel engine. Brake specific energy consumption decreases (25- 30%) and increased in brake power, HC emission up to B20 and more at B25, The CO emission increased with higher blend
Huseyin Aydin, Cumali Ilkhlc(2010) used ethanol as an additive to research the possible use of higher percentage biodiesel in an unmodified diesel engine. Commercial diesel fuel, 20% biofuel and 80% diesel fuel called B20 and 80% biodiesel and 20% of ethanol is BE20 effect being tested on fuel the engine torque , power and brake specific fuel consumption and brake thermal efficiency. The experimental result showed that performance C I engine improved with use of BE20
K. Sureshkumar, R. Velraj, R. Ganesan(2008) has carried out the performance analysis in an unmodified diesel engine with pongamina pinnata methyl ester and blend with diesel BSEC,BSFC has improved at B40.The CO for diesel is more as compared to PPME blend under different load condition. The CO2 emission increased with increased in load.
DEEPAK AGARWAL, AVINASH KUMAR AGARWAL(2007) has conducted using various blend of jatropha oil with mineral diesel to study the effect of reduce blend viscosity and various parameter such as thermal efficiency , BSFC was improved. Smoke capacity is improved in preheated jatropha.
DEEPAK AGARWAL, LOKESH KUMAR, AVINASH KUMAR AGARWAL(2007) has conducted a performance test on linseed oil, mahua oil, rice bran oil and linseed oil methyl ester (LOME) in a stationary single cylinder engine , four stroke diesel engine compared it with mineral diesel. Economic analysis was also done and it is found that the use of vegetable oil and it derivative as diesel fuel substitute and has similar cost as that of mineral diesel.
M. Pugazhvadivu, K. Jeyachandran(2005) has conducted experimental investigation on waste frying oil an non edible vegetable oil was used as an alternative fuel for diesel engine. The high viscosity of waste frying oil was reducing by preheating. The waste frying oil is preheated to 135?c could be used as diesel fuel substitute for short term engine operation.
Sukumar Puhan, N.Vedaramann, G.Sankaranarayanan, Boppanna V. BharatRam (2004) Has investigation , Mahua oil Ethyl ester was prepared by transterification using sulfuric acid (H2SO4) as catalyst and tested in 4 stroke direct injection natural aspiration diesel engine. It is showed that brake thermal efficiency of engine for MOEE was compared with diesel is 26.36%whereas 26.42 for MOEE and Emission of CO, HC, oxide of nitrogen are reduced.
F.K Forson, E.K Oduro, E HammondDonkoh (2003) has represented a test on a single cylinder direct injection engine operating on diesel fuel and jatropha oil and blends of diesel and jatropha oil in proportion of 97.4%/2.6%, 80%/20%, 50%/50% by volume. The test showed the jatropha oil could be conveniently used as diesel substitute in diesel engine and it mainly increased in BTE ,BP and reduced in specific fuel consumption.
M. Abu-Qudais, O.Haddad, M. Qudaisat (1999) has shown the effect of ethanol fumigation and ethanol diesel fuel blend on the performance and emission of a single cylinder diesel engine. The result show that both fumigation and blend method have same behavior and it mainly increased in BTE and reduce in emission.
O.M.I Nwafor, G. Rice (1996) has shown that vegetable oil have substantial prospect as long term substitute for diesel fuel. The result show improvement in BTE of engine and emission output of engine improved
RESEARCH AND DEVELOPMENT
Many biofuel producing countries fund RandD for biofuel technology. Current funding is particularly directed towards second generation biofuels, mainly cellulosic ethanol and biomass to liquid biodiesel. Comprehensive and accurate data on the level of expenditure on biofuel RandD are not available, but what is available from the EU Commission does indicate accelerated expenditure, especially by industry. A recent EU report, estimates the total expenditure by EU countries, both public and private, in 2007 to be around 347 million Euros, with industry contributing the lion share at 269 million Euros.
COST, ECONOMIC VABILITY OF BIOFUEL
Liquid biofuels compete directly with gasoline and diesel. Given the relative size of energy markets in comparison with agricultural markets, energy prices tend to drive the prices of biofuels and biofuel feedstocks. Since feedstocks account for the largest share of total biofuel production costs, the relative prices of agricultural feedstocks and fossil fuels will determine the competitiveness of biofuels. The relationship differs according to crops, locations, and technologies used in biofuel production. According to an OECD-FAO study (2008), estimated average production costs of biofuels in major producing countries, using different feedstocks, are lowest for Brazilian sugarcane ethanol. For this feedstock, energy costs are negligible because Brazil uses the sugarcane coproduct, biogases, as a process fuel. In Europe and the US, this is not the case but revenues from selling other co-products offset some of the costs. The net production costs, however, after subtracting co-product values, still remain lowest for Brazilian ethanol. The OECD-FAO study also found that Brazilian ethanol is the only biofuel which is consistently priced below its fossil fuel equivalent. For all other biofuels, net production costs exceed the price of fossil fuel Table 3 and Table 4 provide recent compilations of production costs for ethanol and biodiesel from different sources.
IMPLICATIONS FOR GREENHOUSE GAS (GHG) EMISSIONS
Fossil energy balance–the ratio of energy contained in biofuels to the fossil energy used in their production–is usually taken as a measure for evaluating the energy performance of different biofuel production pathways. The balance is also a useful measure of a particular biofuel‘s relative effectiveness in contributing to energy supply and can be indicative of its GHG emission impact. Studies of the fossil energy balance for different biofuels (summarized in Table 5) indicate that their net contribution to energy supply can vary widely. The variations in estimated fossil energy balances—across feedstock‘s, fuels and for some feedstock/fuel combinations—depend on feedstock productivity, agricultural production processes and conversion technologies. The high fossil energy balance, sugarcane biofuel, reflects the use of a co-product, bagasse (the biomass residue from sugarcane) as an energy input for its processing, as well as the feedstock‘s own productivity.
Biofuels are, in theory, carbon neutral as their combustion releases the carbon dioxide that was sequestered by the plant through photosynthesis back into the atmosphere. In addition, growing biomass can increase soil carbon stock. Therefore, biofuels‘ potential for reducing GHG emissions is significant. However, emissions occur throughout the biofuel life cycle system: during the harvesting, storage and transportation of raw material production, as well as during biofuel processing, and finished product storage, transportation, distribution, and use. In addition, the possibility of generating co-products could have implications for net GHG emissions as these are considered "avoided emissions". Thus, fossil energy balance is only one determinant of the emissions impacts of biofuels; fertilizers and pesticides, soil treatment, irrigation technology and land use change can also have major impacts.
NEXT GENERATION BIOFUELS Next
(second and third) generation biofuel technologies are considered to offer the solution for the sustainability problems associated with first generation biofuels. Second generation biofuels use cellulosic biomass which include, herbaceous lignocellulosic species such as miscanthus, switchgrass and reed canary grass (perennial crops) and trees such as poplar, willow and eucalypt (short rotation crops), as well as forestry and agricultural residue. Algae are also being evaluated as a more promising advanced feedstock option in the distant future (often referred to as third generation).Feedstock‘s for second generation biofuels generally produce higher biomass yields per hectare than most first generation crop feedstocks (the exception being sugar cane crop feedstocks). In addition to their fast growth and short-rotation characteristics, essentially the entire crop is available as feedstock. Given their relatively high projected energy conversion efficiency (IEA 2008), second generations feedstocks are projected to have higher overall energy yields. They require less tillage and chemical inputs. They also allow a wide range of land to be used for cultivation including degraded and marginal land, therefore reducing or avoiding the potential for land use competition with food and animal feed production. However, some feedstocks are considered invasive10 (or potentially so) and thus could have negative impacts on water resources and biodiversity. Cellulosic biomass has lower handling costs than first generation biofuel crops and is easier to store, given its resistance to deterioration. On the other hand, it can often be bulky and thus require well developed and costly transportation infrastructure (FAO 2008). Second generation biofuels can also reduce life-cycle GHG emissions because of the higher energy yields per hectare and the potential of leftover plants (mostly lignin) to be used as process energy. The technology, however, is at an early stage of development. Substantial technological and economic barriers impede its commercial deployment, including high production costs, logistics and supply challenges. Another important barrier is the set of agricultural/forestry sector changes needed to regularly supply the lignocellulosic feedstock depend on changes in agricultural management, as well as policy changes, both of which will take time to implement.
CONCLUSION
Various investigation and studies on current production , cost , economic viability of bio fuel and implication of GHG emission impact of bio fuel it has indicate that it offer excellent promises as an alternative fuel for compression ignition engine in its transportation sector. Biofuel has been found to be an alternative fuel for compression ignition engine with different blending ratio it helps in improving the thermal efficiency of engine, reducing the brake specific energy consumption. Next generation biofuel currently under development hold better promises but require extensive RandD to overcome scientific , technical and sustainability barrier. Future biofuel production and use should meet several essential criteria, bio fuel should result in significant green house gas saving compared to fossil fuel.
ACKNOWLEGEMENT
Author acknowledged the immense help received from the scholar whose article are cited and include in reference of this manuscript. The author are also grateful to author/editor/publisher of all those article , journal and book from the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1755http://ijcrr.com/article_html.php?did=17551. Mallikappa D.N, Rana Pratap Reddy, Ch.S.N. Murthy (2011) Performance and emission characteristics of double cylinder CI engine operated with cardanol bio fuel blends
2. Huseyin Aydin, Cumali Ilk?l?c (2010) Effect of ethanol blending with biodiesel on engine performance and exhaust emissions in a CI engine
3. K. Sureshkumar, R. Velraj, R. Ganesan (2008) Performance and exhaust emission characteristics of a CI engine fueled with Pongamia pinnata methyl ester (PPME) and its blends with diesel
4. Deepak Agarwal, Avinash Agarwal (2007) Performance and emissions characteristics of Jatropha oil (preheated and blends) in a direct injection compression ignition engine
5. Deepak Agarwal, Avinash Agarwal, Lokesh kumar (2007) Performance evaluation of a vegetable oil fuelled compression ignition engine
6. M. Pugazhvadivu, K. Jeyachandran (2005) Investigations on the performance and exhaust emissions of a diesel engine using preheated waste frying oil as fuel
7. Mag´n Lapuerta, Octavio Armas, Reyes Garc´a-Contreras (2006) Stability of diesel–bioethanol blends for use in diesel engines
8. Avinash Kumar Agarwal (2006) Biofuels (alcohols and biodiesel) applications as fuels for internal combustion engines
9. Mustafa Canakci, Ahmet Erdil, Erol Arcaklioglu Performance and exhaust emissions of a biodiesel engine
10. M. Pugazhvadivu, K. Jeyachandran Investigations on the performance and exhaust emissions of a diesel engine using preheated waste frying oil as fuel
11. Sukumar Puhan, N. Vedaraman, G. Sankaranarayanan Performance and emission study of Mahua oil (madhuca indica oil) ethyl ester in a 4-stroke natural aspirated direct injection diesel engine
12. F.K. Forson, E.K. Oduro, E. HammondDonkoh Performance of jatropha oil blends in a diesel engine
13. M. Abu-Qudais, O. Haddad The effect of alcohol fumigation on diesel engine performance and emissions
14. Yage Di, C.S. Cheung Comparison of the effect of biodiesel-diesel and ethanol-diesel on the gaseous emission of a directinjection diesel engine
15. S. Jindal, B.P. Nandwana, N.S. Rathore Experimental investigation of the effect of compression ratio and injection pressure in a direct injection diesel engine running on Jatropha methyl ester
16. Ajav EA, Singh B, Bhattacharya TK, Experimental study of some performance parameters of a constant speed stationary diesel. Engine using ethanol–diesel blends as fuel Biomass Bioenergy
17. Anselm Eisentraut, Information Paper on Sustainable Production of Second - Generation Bio-fuel- Potential and perspectives in Major economies and developing countries
18. Banse, M., A. Tabeau, G. Woltjer, G. and H. van Meijl, Impact of European Union Biofuel Policies on World Agricultural and Food Markets, paper submitted for the GTAP Conference, 2007
19. Bhattacharyya S, Reddy CS, Vegetable oils as fuels for internal combustion engines: a review, Journal of Agriculture Engineering Resources
20. Fabien Roques, Olivier Sassi, Céline Guivarch, Henri Waisman, Renaud Crassous, Jean-Charles Hourcade, Integrated Modeling of Economic-EnergyEnvironment Scenarios - The Impact of China and India‘s Economic Growth on Energy Use and CO2 Emissions, Centre International de Recherché sur l‘Environnement et le Développement (CIRED), 2008.
21. Fargione, F, J. Hill, D. Tilman, S. Polasky, and P. Hawthorne, Land Clearing and the Biofuel Carbon Debt. Science 319, 2008.
22. Francis Songela and Andrew Maclean, Study Report- Situational Analysis on Bio-fuel Industry within and outside Tanzania”, October, 2008
23. George Francis, Raphael Edinger and Klaus Becker, A concept for simultaneous wasteland reclamation, fuel production, and socioeconomic development in degraded areas in India: Need, potential and perspectives of Jatropha Plantations? Natural Resources Forum 29, 12–24, 2005.
24. India, 2002. India Vision 2020. Planning Commission, Government of India. Available at http://planningcommission.nic.in/plans/pla nrel/pl_ vsn2020. Pdf
25. J. Narayana Reddy, A. Ramesh, Parametric studies for improving the performance of a Jatropha oil-fuelled compression ignition Engine, Technical Note, Renewable Energy, 1994–2016, 2006.
26. Planning Commission, Report of the committee on Development of Bio-Fuel, Government of India, 16 April 2003.
27. R. Bosch and Ullmann, J, The Influence of Biodiesel Properties on Fuel Injection Equipments, Presentation to the Seminar International on Biodiesel, Curitiba, 24-26 October, 2002.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareROLE OF FAT MASS AND MUSCLE MASS ON FUNCTIONAL PERFORMANCE OF ELITE INDIAN JUNIOR TENNIS PLAYERS
English111117Shibili NuhmaniEnglish BN PatiEnglish MD Abu ShapheEnglishObjective: To find out the correlation of fat mass and muscle mass with functional performance of elite Indian junior tennis players Design: Correlation design Setting: Tennis academies all over Delhi and National Capital Region Subjects: 100 elite Indian junior tennis players Measurement: The anthropometric data (fat mass and muscle mass) of each athlete has measured and has been correlated with all the three functional performance tests. Result and Conclusion: Pearson's correlation test was used to correlate the anthropometric data and functional performance test results. The study result showed that there was positive correlation exists between muscle mass and the entire three functional performance tests. At the same time there is an inverse correlation exist between fat mass and functional performance.
Englishanthropometry, functional performance, fat mass, muscle mass, junior tennis playersINTRODUCTION
Tennis is a world class competitive sport attracting millions of players and fans worldwide. It is the only major sports to be played on a variety of surfaces with different ball types and matches are played of best of three or five sets. Tennis is an immensely popular global sport with 205 nations affiliated to the international governing body, the international tennis federation (ITF) and over 25 million active players in USA alone. The general consensus on fitness development was that tennis players should incorporate flexibility, strength and endurance training in their programmes to minimise asymmetry and injuries, while simultaneously enhancing performance1 . It demands a complete physical conditioning program including exercises to develop flexibility, agility, cardio respiratory capacity, speed, strength, power and muscular endurance.2, 3 The interest in anthropometric characteristic and body composition of the players of different sports has increased over last decades. It has been well described that there are specific physical characteristics in many sports such as anthropometric profile that indicate whether the player would be suitable to compete the highest level in specific sports.4,5,6 Athletic performance is, to a large degree, dependent on the athlete's ability to sustain power (both anaerobic ally and aerobically) and to overcome resistance, or drag. Both of these factors are Interrelated with the athlete's body composition. Coupled with the common perception of many athletes who compete in sports where appearance is a concern for the athlete and the common perception of these athletes (swimming, diving, gymnastics, and figure skating), attainment of an ideal body composition often becomes a central theme of training. Besides the aesthetic and performance reasons for wanting to achieve an optimal body composition, there may also be safety reasons. During past two decades great changes have taken place in tennis with respect to technique and tactic, even more with respect to physical performance of the players. Most of the scientific literature has focus on physiological and biomechanical characteristic of the players. At present there is no data available regarding body composition and anthropometry of junior players of India and regarding their performance. There for the aim of this study was to find out how anthropometry andbody composition of elite Indian junior players influence their functional performance METHODS Subjects were recruited on the basis of voluntary participation through informed consent Subjects were recruited from different tennis academies all over Delhi and National Capital Region. Procedure The subjects from different tennis academies were being informed of the study. Subjects and their parents were informed about the nature, purpose, importance and possible risk of the study. Written parental or guardian consent were obtained before the players were permitted to participate. The research committee of the Singania University approved all the procedures. The subjects who match the criteria will be selected for the study. Anthropometric and body composition measurement will be taken for the entire subject. Instruction to the subject Subjects were refrained from strenuous exercise at least 48 hours prior to the testing and procedure and consume their normal pre training diet prior to the testing session Subjects were asked to report any discomfort during the session The subjects were asked for their full co operation and to do the procedures to their best of the ability. Protocol The entire protocol consist of 2 phases a. Pre-test measurement b. Protocol or intervention Pre test measurement included measurement of fat mass and muscle mass. Both muscle mass and Fat mass was measured by using Bio impedance analyser. The following functional performance tests were measured for each athlete after anthropometry. A. Sergeant chalk jump test B. 40 yard sprint test C. T test One minute of rest period was allowed between all functional performance tests7 . Three trials of functional performance test were performed with 30 seconds rest period between each trial7 . The best score from each functional performance test were taken from each test and recorded. RESULTS A total number of 100 elite Indian junior tennis players participated in the study. Mean age, height and weight of the athletes were 15.34+ 2.16, 170.54 + 5.43, and 65.36 +3.41 respectively. The anthropometric data (fat mass and muscle mass ) of each athlete has measured and has been correlated with all the three functional performance tests. The result of the study shows as follows Muscle mass and athletic performance The mean value of muscle mass was 37.32+ 5.09 The result shows that there is positive correlation exist between muscle mass and functional performance of the athletes (refer Table 1, graph 1,2,3) Fat mass and functional performance The mean value of fat mass was 8.055 + 5.7392 The result shows that there is negative correlation exist between fat mass and functional performance (refer Table 2, graph 4,5,6) DISCUSSION The purpose of the study was to find out the correlation between body composition (BMI and fat mass) and functional performance of Indian junior tennis players. A total number of 100 elite junior tennis players from different parts of the country participated in the study. The anthropometric data‘s like of each athlete has been measured and which has been correlated with the scores of different functional performance test scores of the athletes The result of the study showed that 1. There was a positive correlation exist between muscle mass and functional performance tests 2. There was an inverse correlation exist between fat mass and functional performance tests The result of the study indicated that there was an inverse correlation exists between body fat percentage and performance. Some of the previous studies have shown that the physical performance is negatively correlated with body fat and positively correlated with skeletal muscle mass16, 17. An excess subcutaneous adipose tissue means that greater muscular effort and therefore increased energy expenditure is required. In runners a high level of adipose tissue leads to a higher body weight and impairment of performance as more weight has to be moved, which does not contribute to the power development. In a recent study conducted by Arrese AL et al (2006)18 it has been noted that the loss of body fat is specific to the selected muscle group used during training and the race performance is enhanced with decreased skin fold thickness at lower limb. Body fat seems to have a special effect on African athlete‘s especially African runners. It was noticed in a study conducted by Bosch AN et al (1990)19 in study conducted among African athletes. They have a lower skin fold thickness at legs and arms suggesting a smaller mass of subcutaneous adipose tissue. But in other studies effect of body fat on race performance is controversial. Hagan et al20 found a positive correlation between performance time and body fat in female athletes where as Christensen and Ruhling21 found that percentage of body fat did not correlate with the performance. The study of Heltland et al22 demonstrated that regional and total body fat was inversely correlated with performance in treadmill test (-0.61 < r < -0.52, p < 0.0001). In runners decreased skin fold thickness in lower limb are measured after a longer training period, which may be particularly useful in predicting running performance23. In the study of Logos and Eston23 3 years of training has decreased the skin fold thickness and change in performance was related to the change in skin fold thickness of the triceps(r= -0.61,P = 0.001) , front of the thigh ( r = 0 . 74, P < .601) and medial calf(r = - 0.66,PEnglishhttp://ijcrr.com/abstract.php?article_id=1756http://ijcrr.com/article_html.php?did=17561. Groppel JL, Robert EP. Applied physiology of tennis. Sports Med. 1992 Oct;14(4):260- 8.
2. T J Chandler 2000. ?Physiology of racket sports?. In Exercise and sport science, 905– 917. Philadelphia, PA: Lippincott Williams and Williams.
3. Groppel J and Roetert. E. P 1992. Applied physiology of tennis. Sports Medicine, 14: 260–268
4. T. Reilly, J. bangsbo A. Franks. Anthropometric and physiological predispositions for elite soccer. Journal of Sports Sciences, 2000, 18, 669-683
5. T.R. Ackland , K.B. Ong , D.A. Kerr, B. Ridge. Morphological characteristics of Olympic sprint canoe and kayak paddlers. Journal of Science and medicine in sports . Volume 6 , issue 3 September 2003, 285- 294
6. Jan Bourgois, Albrecht L. Claessens, Melissa Janssens, Bart Van Renterghem, Ruth Loos, Martine Thomis, Renaat Philippaerts, Johan Lefevre and Jacques Vrijen . Anthropometric characteristics of elite female junior rowers. Journal of Sports Sciences, 2001, 19, 195-202
7. Todd A E vans,Christopher Ingersoll,Kenneth L Knight,Teddy Worrel. Agilty following the application of cold therapy. J Athl Train. 1995 September; 30(3): 231–234..
8. HE Leedy, AH Ismail, WV Kessle. Relationships between physical performance items and body composition. Research quarterly, 1965 ,36:158-63
9. Riedenau RP, Welch BE,Crips CE et al . Relationship of body fat to motor fitness test scores. Research quarterly,1968,29:200-3
10. Alejandro L arrese and Enrique S . Ostariz .Skin fold thicknesses associated with distance running performance in highly trained runners. Journal of Sports Sciences. Volume, issue 1 , 2006
11. Andrew N Bosch, Brian r Goslin , Timothy D Noakes and Steven c . Dennis Physiological differences between black and white runners during a treadmill marathon. European journal of applied physiology and occupational physiology . volume 61, number 1-2, 68-72
12. R D Hagan, S J Upton, J J Duncan, L R Gettman. Marathon performance in relation to maximal aerobic power and training indices in female distance runners. Br J Sports Med 1987;21:3-7
13. C.L.Christensen, R.O.Ruhling.Physical cha racteristics of novice and experienced wom en marathon runners. Br J Sports Med 1983;17:166-171
14. M. L. Hetland, J. Haarbo, C. Christiansen. Regional body composition determined by dual-energy x-ray absorptiometry. Relation to Training, Sex Hormones, and serum lipids in male long-distance runners. Scandinavian Journal of Medicine and Science in Sports.Vol.8 Issue .2 pages 102– 108, April 1998
15. A Legaz, R Eston. Changes in performance, skin fold thickness and fat patterning after three years of intense athletic conditioning in high level runners. Br J Sports Med 2005;39:851-856
16. G J Slater, A J Rice, I Mujika, A G Hahn, K Sharpe, D G Jenkins. Physique traits of lightweight rowers and their relationship to competitive success. Br J Sports Med 2005;39:736-74
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesEFFECT OF TANK COLOURATION ON THE SURVIVAL, GROWTH AND DEVELOPMENT RATE OF BLUE SWIMMING CRAB, PORTUNUS PELAGICUS (LINNAEUS, 1758) LARVAE
English118124Azra M. NEnglish Wendy WEnglish Talpur A.DEnglish Abol-Munafi A. BEnglish Ikhwanuddin MEnglishThe purpose of this study was to investigate the effect of background tank colouration on survival, growth, and development rate of Portunus pelagicus larvae. The results demonstrated that highest survival was achieved in black background colour tanks was statistically significantly different (pEnglishBackground, Larval rearing, Megalopa, Survival, Portunus pelagicus, ZoeaINTRODUCTION
Blue swimming crab, Portunus pelagicus has been collected for years from intertidal zone, estuaries, shallow inshore and jetties in coastal areas in various part of the world. Therefore, the demand for the crab have been exceeded the capacity of the crab fishery [1]. Consequently, to facilitate continued growth of the crab industry especially in Malaysia, the development of commercial seed production technology, which would improve the survival, is required. The seed production development of P. pelagicus in Malaysia is in the trial stages. Until date, P. pelagicus for local consumption or for culture is caught from the wild [2]. Hence, further research on seed production technology of P. pelagicus would be considered as the way to increase P. pelagicus seeds that would solve the problems associated with fishery catches in order to maintain environment ecology sustainable. Many countries like Japan, Philippines, India, Indonesia, Thailand, Bangladesh, Vietnam, Australia and USA are actively involved in crab culture and research [3]. Since, the P. pelagicus aquaculture is very new in Malaysia, with no appropriate techniques established for the commercial production of juvenile crabs for P. pelagicus [4, 5]. Castine et al. [6] reported that current seed production for Portunid decapods is inconsistent. Due to the lack of necessary biological information required for the development of appropriate grow-out techniques, the industry is still in the developing phase. Extensive information on the culture techniques is still required to develop sustainable seed production of P. pelagicus crab. There are few studies on the effects of tank coloration on crustacean larvae such as in prawn [7, 8] has been conducted. Nevertheless, there is only one specific work on hatchery-rearing techniques for juvenile‘s production of Portunid crab by using four different tank colours by [8]. The prime objective of this study was to investigate the effect of tank colouration on survival, growth, and development rate in early stages of the P. pelagicus larvae.
MATERIALS AND METHOD
Seawater for broodstock and larviculture
Seawater for crab culture was treated according to Talpur et al. [9]. UV treated seawater was filtered through a 10 µm net and then disinfected with active chlorine for 24 h. This procedure, which eliminated almost all naturally occurring bacteria, treated water was supplemented EDTA (after 24 h of chlorine treatment) to settle down the heavy metals was followed by neutralization with sodium thiosulphate (same concentration of chlorine) at the beginning of the experiment. The culture water exchange began from the day second, using disinfected seawater.
Water parameter
The water parameters for broodstock and larviculture were maintained as constant including salinity 30 ppt, pH > 8.0, temperature at 30 ºC using 110-V heater and dissolved oxygen (DO) > 5 mg L-1 during the conducting trials. Water parameters were measured daily on site with YSI 556 Multi-probe meter (USA). Broodstock Healthy berried females were collected from Strait of Tebrau, Johor, West Malaysia, (1o 22‘ N and 103o 38‘ E) and were transported to marine hatchery of Institute of Tropical Aquaculture, Universiti Malaysia Terengganu, Malaysia. Berried female was disinfected according to Talpur et al. [9] and one berried crab per (300 L) tank was placed in the hatching tank with 3 cm substrate of thick sand tray with adequate aeration and 100% water exchanged daily. During incubation period, the berried females were not fed. The berried females were monitored daily for hatching. After hatching, the larvae were transferred to another tank filled with disinfected seawater. Energetically moving larvae at surface were collected and used for stocking in rearing tanks. Stocking and feeding The larvae culture tanks used were 200 L capacity filled with 150 L disinfected seawater and the stocking density at 100 larvae L-1 , about 15,000 larvae per tank. Feeding scheme used for rearing P. pelagicus larvae from Zoea1 until Megalopa stages as described method by Ikhwanuddin et al. [2]. Larvae were fed with rotifers (Brachionus sp.) at the rate of 30-35 individuals mL-1 and Nannochloropsis sp. (5x106 cells mL-1 ) from Zoea 1 to Zoea 4 stage and. Artemia sp. nauplii were provided from Zoea 3 to Zoea 4 stages. The rotifers were cultured with microalgae Nannochloropsis sp., while Artemia sp. nauplii were hatched daily and harvested washed and fed directly to larvae. Larvae were fed once daily in the morning at about 10.00 A.M.
Identification of larval stages
The different crab larval stages from Zoea 1 to Megalopa stage were observed under profile projector based on morphological characters.
Experimental design
200 L plastic tanks were used for larval rearing and all tanks were sprayed with five different background colours including black, white, red, orange and yellow. All trails were conducted in three replicates. Control tanks were without any background colour. Total 15 larvae rearing batches were conducted in this study. Moderate aeration was provided in the larval rearing tanks. Throughout the study, 12 h light and 12 h dark photoperiod was maintained. Dead larvae are
removed daily to prevent contamination. Larvae numbers were estimated daily through volumetric method from the rearing tanks. Fifty percent of water was changed daily in larval rearing tanks. To remove left over feed, detritus, and dead larvae each day, the aeration stopped temporarily and settled particles were removed from the tank bottom by siphoning. The experiment terminated when all larvae had either died or metamorphosed to the Megalopa stage.
Specific growth rate (SGR)
Randomly sampled 10 larvae from each culture tank were collected for every Zoea stage for specific growth rate (SGR) study. Sampled crab larvae were put into disposal scintillation vials (Bjorn bottle) preserved in 10 % of formalin, and weighed under the microbalance. The mean BW for each treatment for different larval stages was calculated to determine the specific growth rate (SGR) using following formula:
Statistical analysis of data
Effects of treatments on water quality, larvae survival and growth were evaluated by analysis of variance (ANOVA) using SPSS for Windows, version 16.0 at significant differences pEnglishhttp://ijcrr.com/abstract.php?article_id=1757http://ijcrr.com/article_html.php?did=17571. Ikhwanuddin, M., Shabdin, M.L. and AbolMunafi, A.B. 2009. Catch Information of Blue Swimming Crab (Portunus pelagicus) From Sarawak Coastal Water of South China Sea. Journal of Sustainability Science and Management. 4 (1): 93-103.
2. Ikhwanuddin, M., Nor Adila, T., Azra, M.N., Hii, Y.S., Talpur, A.D. and AbolMunafi, A.B. 2011. Determination of Live Prey Ingestion Capability of Blue Swimming Crab, Portunus pelagicus (Linnaeus, 1758) Larvae. World Journal of Fish and Marine Sciences. 3 (6): 570-575.
3. Soundarapandian, P., Thamizhazhagan E. and Samuel N.J. 2007. Seed production of commercially important blue swimming crab Portunus pelagicus (Linnaeus). Journal of Fisheries and Aquatics Science 2(4): 302-309.
4. Ikhwanuddin, M., Azra, M.N., Yeong, Y.S., Abol- Munafi, A.B. and Shabdin, M.L. 2012. Live Foods for Juveniles‘ Production of Blue Swimming Crab, Portunus pelagicus (Linnaeus, 1766). Journal of Fisheries and Aquatic Science. 7(4): 266-278.
5. Ikhwanuddin, M., Azra, M.N., Talpur, A.D., Abol- Munafi, A.B. and Shabdin, M.L. 2012. Optimal Water Temperature and Salinity for Production of Blue Swimming Crab, Portunus pelagicus 1st Day Juvenile Crab. Aquaculture, Aquarium, Conservation & Legislation. 5 (1): 4-8.
6. Castine, S., Southgate P.C. and Zeng, C. 2008. Evaluation of four dietary protein sources for use in microbound diets fed to megalopae of the blue swimmer crab, Portunus pelagicus. Aquaculture 281: 96- 99.
7. Tume, R.K., Sikes, A.L., Tabrett, S. and Smith, D.M. 2009. Effect of background colour on the distribution of astaxanthin in black tiger prawn (Penaeus monodon): Effective method for improvement of cooked colour. Aquaculture. 296: 129-135.
8. Rabbani, A.G and Zeng C. 2005. Effects of tank colour on larval survival and development of mud crab, Sylla serrata. Aquaculture Research. 36: 1112-1119.
9. Talpur, A.D., A.J. Memon, M.I. Khan, M.M. Ikhwanuddin, M. Danish Daniel and A.B. Abol-Munafi (2011). A Novel of Gut Pathogenic Bacteria of Blue Swimming Crab Portunus pelagicus (Linnaeus, 1758) and Pathogenicity of Vibrio harveyi a Transmission Agent in Larval Culture under Hatchery Conditions. Research Journal of Applied Sciences 6 (2): 116-127.
10. Yasharian, D., Coyle, S.D., Tidwell, J.H. and Stilwell W.E. 2005. The effect of tank colouration on survival, metamorphosis rate, growth and time to metamorphosis freshwater prawn (Macrobrachium rosenbergii) rearing. Aquaculture Research 36: 278-283.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22TechnologyTHERMAL ANALYSIS OF EXHAUST WASTE HEAT FOR COOLING USING NH3-H2O ABSORPTION REFRIGERATION SYSTEM
English125131Om PrakashEnglish Ritesh Kumar ChaurasiyaEnglishThis research paper includes the detailed thermodynamic analysis of waste heat from DG set system and power plants and also the analysis of NH3-H2O vapour absorption refrigeration system. This work proposes the direct utilization of waste heat to power absorption refrigeration system. This analysis includes heoretical calculation of heat required for generator, refrigerating effect produced and equired mass flow rate of refrigerant for the typical power generating unit. This research shows that considerable amount of cooling effect and energy saving would result from direct utilization of the exhaust waste heat of DG set system or power plants which will reduces the losses of energy, therefore reduces the emission of green house effect gasses..
EnglishWaste heat, Vapour absorption refrigeration system (VARS), Circulation ratioINTRODUCTION
Most of industrial process uses a lot of thermal energy by burning fossil fuel to produce steam or heat. After the processes, heat is rejected to the surrounding as waste. This waste heat can be converted to useful refrigeration by using a heat operated refrigeration system, such as an absorption refrigeration cycle 1 . Despite a lower coefficient of performance (COP) as compared to the vapor compression cycle, absorption refrigeration systems are promising by using inexpensive waste energy from industrial processes, geothermal energy, solar energy etc 2 . The absorption refrigeration system is heatoperated unit, which uses a refrigerant that is alternately absorbed by and liberated from the absorbent. Absorption units operate on the simple principle that under low absolute pressure, water will boil at a low temperature. The two-shell cooling units use heat to produce refrigeration efficiently. The lower shell contains an absorber and evaporator, while the upper shell consists of generator and condenser sections 3 . A survey of absorption fluids suggested that, there are some 40 refrigerant compounds and 200 absorbent compounds available 4 . However, the most common working fluids are NH3-H2O and LiBr-H2O. It is reported that LiBr-H2O has a higher COP than for the other working fluids though it has a limited range of operation due to the onset of crystallization occurring at the point of the recuperator discharge into the absorber and stopping solution flows through the device 5 . In this research work vapour absorption refrigeration systems based on ammonia-water (NH3-H2O) pair has been considered in which ammonia is the refrigerant and water is the absorbent. These systems are more versatile than systems based on water-lithium bromide as they can be used for both sub-zero (refrigeration) as well above 0 oC (air conditioning) applications. The NH3-H2O system requires generator temperatures in the range of 125°C to 170°C with air-cooled absorber and condenser and 80°C to 120°C when water-cooling is used. The coefficient of performance (COP), which is defined as the ratio of the cooling effect to the heat input, is varies from 0.6 to 0.7 6 . This research includes thermodynamic analysis of waste heat from power generating units and NH3-H2O vapour absorption refrigeration system. The unique feature of present work is that the direct utilization of waste heat to power in the NH3-H2O absorption refrigeration system will reduces the losses of energy resulting in reducing pollution.
MATERIALS AND METHODS
Waste heat energy sources For the analysis of cooling effect produced by waste energy, three systems are considered including:
1. A typical DG set system of 5 MW operating at different loads. The details are given in the table 1.
2. The combined cycle gas turbine power plant in Pragati Power Corporation Ltd., Delhi. It consists of 2 x 104 MW Frame 9-E Gas turbine and 1x122MW steam turbine. These turbines, namely gas turbine#1 (GT1) and gas turbine #2 (GT2) are selected for the present analysis. Performance data of gas turbines are given in table 2.
3. 500 MW steam power plant installed in MTPS-DVC, Bankura, in which the waste heat from the boiler exhaust is utilized. The performance data of boiler is given in table 3.
Cooling System
NH3- H2O Vapour absorption chiller specifications:
Average Generator temperature = 100 0C.
Average Condenser temperature = 46 0C.
Average Absorber temperature = 40 0C.
Average Chilled-water temperature= 7 0C. COP of the system= 0.6.
Calculation of heat energy
Available maximum exhaust heat, heat available for generator and refrigeration effect from above sources are calculating as per the relation given in table 4. Available maximum exhaust heat = mex.Cp,ex.(Tex - Ta) kW Heat available for generator (Qg) = mex.Cp,ex.(Tex - Tg) kW Refrigeration effect (Qe) = COP * Qg kW
Thermal analysis of NH3-H2O vapour absorption refrigeration system using available exhaust heat Assuming pure ammonia vapours are evolved in generator, we have for pressures from the table of properties of ammonia 9 . Pc = Psat (Tc) Pe = Psat(Te) Strong solution concentration of NH3 from enthalpy-composition diagram for NH3 – H2O system ξss [sat. liquid at absorber temperature (Ta) & pressure (Pa)] Weak solution concentration of NH3 from enthalpy-composition diagram for NH3 – H2O system ξws [sat. liquid at generator temperature (Tg) & pressure (Pg)] The concentration of NH3 in vapour leaving generator ξv [sat. vapour at generator temperature (Tg) & pressure (Pg)] The properties of NH3-H2O solution at different temperature state ( Figure 1) are given with the help of enthalpy-composition diagram for NH3 – H2O system, and given in table 5.
Now specific strong solution circulation rate λ = (ξv – ξws)/ (ξss – ξws) Specific weak solution circulation rate λ -1 Mass flow rate Required mass flow rate of refrigerant, mr = Qe / (h4-h3) (1) mass flow rate of strong solution, mSS = λmr (2) mass flow rate of weak solution, mWS = (λ-1)mr (3) Heat transfer rates at various components
Evaporator Qe
Absorber
From energy balance: Qa = mrh4 + mwsh8 – mssh5 (4)
Generator
From energy balance Qg = mrh1 + mwsh7– mssh6 (5) Condenser From energy balance Qc = mr (h1-h2) (6)
Solution pump work
(assuming the solution to be incompressible) WP = vsol(P6-P5) = (P6-P5)/ρsol (7) Where m = Mass (kg) Cp = Specific heat (kJ/kg K) COP = Coefficient of performance P = Pressure (kPa) T = Temperature (0C) ξ = Mass fraction λ = Circulation ratio Q = Heat energy (kW) h = Specific enthalpy (kJ/kg) W = Work (kJ) v = Specific volume (m3 /kg) ρ = Density of the flue gas kg/m3 Subscripts ex exhaust flue gas a absorber g generator e evaporator c condenser r refrigerant ss strong solution ws weak solution sat saturation state p pump sol solution hx heat exchanger v superheated water vapour The theoretical calculated values of mass flow rate of refrigerant, strong and weak solution along with heat transfer rate at various components with respect to refrigerating effect for this analysis are given in table 6 and mass flow rate of refrigerant required for calculated values of refrigerating effect from different available waste heat sources are also shows in chart 1.
RESULTS
The purpose of the present research was to analyze the methods and means of utilizing the waste heat of power generating units for driving an absorption refrigeration system. The following results are calculated from the research work: ? In the steam power plant (500 MW), the waste heat analysis applied to boiler (MTPSDVC Bankura) could produce cooling effect up to 13667.91 kW. ? In the combined cycle power plant of 330 MW, waste heat analysis applied to GT1 & GT2 of (PPP-Delhi), produces the cooling effect up to 2727.22 & 2889 kW respectively. ? In the DG set system of 5 MW, waste heat analysis at 100%, 90%, 70% & 60% load, produces the cooling effect up to 2186.61, 1846.8, 1415.94 &1144.13 kW respectively
DISCUSSION
The present research work concluded that direct utilization of waste heat to heat solution in generator and the operation of an absorption refrigeration system on that hot exhaust flue gas could be a successful approach. The theoretical analysis for both the power generating units and the NH3-H2O vapour absorption refrigeration system showed that the suggested inexpensive heat recovery load would be in the form of hot flue gases will be in the operating range of the absorption refrigeration cycle. It is recommended that the utilization of rectification column and dephlegmator in NH3- H2O absorption refrigeration system could improve the performance of the system.
ACKNOWLEDGEMENT
Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1758http://ijcrr.com/article_html.php?did=17581. Srikhirin P, Aphornratana S and Chungpaibulpatan S, A review of absorption refrigeration technologies. Renewable and Sustainable Energy Review. Elsevier 2001 Dec; 5 (4): 343-372.
2. Crepinsek Z, Goricanec D and Krope J., Comparison of the Performances of working fluids for absorption refrigeration systems.WSEAS transactions on heat and mass transfer, WSEAS 2009 July; 4 (3) 65- 76.
3. A. EI Masry Osama, Performance of waste heat absorption refrigeration system. The 6th Saudi Engineering Conference; December 14- 17, 2002; KFUPM, Dhahran; 2002. p. 531-545.
4. Marcriss R.A, Gutraj J.M and Zawacki T.S. Absorption fluid data survey: final report on worldwide data: Dept. of Energy (US). Prepared by Institute of Gas Technology. Virginia: National Technology Information Service;1988. Contract No.: DEAC05840R21400.
5. Li Z. F and Sumathy K, Technology development in the solar absorption airconditioning systems. Renewable and Sustainable Energy Reviews. Elsevier 2000 Sept; 4 (3): 267-293.
6. Kalogirou S. Recent Patents in Absorption Cooling Systems, Recent Patents on Mechanical Engineering 2008; 1(1); 58-64.
7. Bureau of Energy Efficiency. BEE Exam Guidebooks, Chapter 9- DG Set System, pp 165-178.
8. Kothandaraman C. P. and Subramanyan S. Heat And Mass Transfer Data Book. Property Values. 6th ed. New Delhi: New Age International Publishers; 2007. P.1-38.
9. Arora, C. P. Refrigeration and air conditioning. Vapour-Absorption System. 2 nd ed. New Delhi: Tata McGraw – Hill; 2006. p. 427-65.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesAPPROACHING 'NEED' IN A NEED BASED DESIGN FOR THE ELDERLY
English132139Satyaki SarkarEnglishMore people are now given the chance to live longer than in the past and old age is now being experienced by an ever-increasing number of people. As more and more people become aged, concern
shifts from medically prolonging life to ensuring that a prolonged life is worth living. The rapid growth of the elderly population, the wide diversity in their profiles and the varied inter-related influences need significant consideration of researchers, policy planners and service providers so as to provide them the
best possible environment to interact based on their need. This paper is based on the idea that there are
significant needs of the elderly people for daily sustenance and it is a challenge to provide congenial environment to them. Understanding the needs and aspirations of an ageing population is a complex business, and yet one that is fundamental. It is essential to integrate the evolving process of global ageing within the larger process of development by responding to their need. This discussion paper attempts to review various facets of needs of an ageing population and their implications for multi-directional research. The discussion is structured around findings from literature studies and attempts to approach into the need for the elderly through Need-based Design.
EnglishAgeing, Needs, Quality of Life, Need Based DesignTHE GLOBAL PERSPECTIVE
By 2050 there will be more people in the world over 60 than there will be people under age 15. This is a historic reversal of proportions and it is unprecedented in human history (United Nations, 1999). For centuries, cultures around the globe have celebrated the prospect of longer lives for their citizens. People across the world now are living longer and, in some parts, healthier lives. Until recently only select segments of the world population, especially the privileged classes in more affluent societies could realize this dream. However, improved public health and changing economic conditions have dramatically increased human lifespan in most countries around the world. This indeed is one of the crowning achievements of the last century but also provides a significant challenge as longer lives needs to be planned. Often more visible in developed countries, ageing is an issue that needs to be appraised with much significance also in developing countries just like developed countries. Ageing of the population is one of the most important demographic facts that are hogging the limelight in the 21st century. As is seen across the world, people are living longer, birth rates are decreasing and consequently the elderly population is increasing both numerically and pro rata. These phenomena are referred to as global ageing when speaking about worldwide data, or population ageing when considering specific regions of the world. The number and proportion of older persons is increasing at a faster rate than any other age group in the population. Today, one out of every ten persons in the world is aged 60 or over. By 2020, the corresponding figure will be about one out of every eight. Two thirds of all older persons live in developing countries - numbering in 2002 some 400 million persons. Women comprise by far the greater number and proportion of older populations in almost all societies: the disparity increasing with advancing age (UNFPA 2002). Ageing of the population affects all facets of the society to include health, social security, environment related issues, education, business opportunities, socio-cultural activities and family life. While global ageing represents a success of medical, social, and economic advances over disease, it also presents tremendous challenges, against the existing models of social support. It affects economic growth, trade, migration, disease patterns and prevalence, and fundamental assumptions about growing older (National Institute of Ageing, US Dept of State). The International Strategy for Action on Ageing, adopted at the Second World Assembly on Ageing as the Madrid International Plan of Action on Ageing (2002), provides an unparalleled opportunity to propel concerns about older persons, especially the older poor, into the forefront of the development agenda (UNFPA 2002). There has been a constant effort to make ageing process a great success in the society. The policy makers, planners, designers and other stakeholders of the process work to make ageing successful so that the protagonist finds joy in living. Design elements in the built environment, and their location of facilities, are all components of a community that can either encourage or discourage active living in elderly. However, considerable controversy has arisen over its causes, and consequences. This controversy has been fueled in part by the fact that as more and more people becomes aged, concern shifts from medically prolonging life to ensuring that a prolonged life is worth living. The concept itself is rather paradoxical as it combines a positive term (successful) with one usually perceived as negative (ageing). Efforts are being made to balance the two and benefit the target group to the maximum.
THE NEED AMONGST ELDERLY
Older persons have similarly as all other people the right to be assessed as individuals, on the basis of their abilities and needs, regardless of their age, sex, colour of skin, disability or other characteristics (UN 2009). These individuals may have varying skills, abilities, support systems, living arrangements, levels of education, health and wealth — all influenced by their diverse experiences and differing circumstances. It is expected that the abilities and needs of future seniors will be no less diverse; in fact, with the rapid changing social system and the global economy, it is likely they will be more so than current seniors. These needs are best described by the psychologist Abraham Maslow who first introduced his concept of a hierarchy of needs, ?A Theory of Human Motivation? in 1943. Maslow categorizes people‘s needs into: Physiological, Safety/security, Belongingness/Social, Self-Esteem and SelfActualization. The needs deal with coping, helping, enlightening, empowering and edifying information (Maslow 19430). Maslow‘s concept revolved around the fact that Physiological or survival needs take precedence followed by safety and security priority. Maslow referred to the first four levels of needs already mentioned as deficit needs, or D-needs. If you don‘t have enough of something -- i.e. you have a deficit -- you feel the need. Maslow saw all these needs as essentially survival needs. Love and esteem are also considered a health determinant (Huitt, 2004). The Loss Continuum Model (Pastalan, 1982) refers to ageing as progressive series of losses that reduce one‘s social participation. The role of the larger social and physical community and social supports for a more positive ageing in place needs further research. One way of discussing how universal design modifications may affect the physical and emotional state of an individual may be explained using Lawton‘s Competence and Environmental Press Model. M. Powell Lawton‘s Ecological Theory of Aging (ETA) has provided a theoretical and practical foundation for the field of gerontology since the 1970‘s (Barry, 2008). ?The competence-press model (Lawton and Nahemow, 1973) asserts that adaptive behavior involves balancing individual abilities (competence) and demands of the environment (press)?. Lawton recognized the imbalance between an individual‘s functional ability and the environment and therefore suggested that individual as well as the home and community resources plays pivotal role in determining environment. M. Powell Lawton (1983) has defined ??the good life‘‘ (in old age) as consisting of four independent dimensions:
i. Behavioral competence (health, perception, motor behavior, and cognition)
ii. Psychological well-being (happiness, optimism, congruence between desired and attained goals)
iii. Perceived quality of life (subjective assessment of family, friends, activities, work, income, and housing)
iv. Objective environment (realities of housing, neighborhood, income, work, activities, etc.)
So how does Maslow‘s Hierarchy of needs and Lawton‘s Environmental Theory of Aging relate There are five foundational needs that need to be met in order to provide an individual with a balanced and complete self at old age. The needs are defined by three areas, the self and the immediate environment (as mentioned by Lawton), the self and the immediate familiar surroundings (Barry, 2008), and the self and others (Beyond 50.05, 2005). These may also include [i] utility, [ii] safety, [iii] identity, [iv] comfort, [v] emotion and [vi] spirituality. The relationships between these categories are seen to be an interactive structure rather than a linear hierarchical arrangement. The impact of these aspects on the aged population intensifies more as the years go by. These can be seen at both physical and psychological levels like.
Possible sensory and perceptual changes
Potential decrease in physical mobility, changes in muscular efficiency and coordination
Generally slower, less strong, accurate and confident in walking, climbing, gripping, lifting, pushing and pulling
Experience changes in customary roles, rights and duties.
Potential loss in comprehension and orientation,
All these inconveniences seem to interact with the social life impregnated with problems of changing of values in our society. Older people's needs are also considered in relation to place of stay which is also a part of their environment. Such issues include location, neighbourhood considerations and land use requirements for special housing outside the house, and internal spaces and user-friendly designs inside the house along with its mechanisms to encourage older people to downsize. The aged population crippled with changed capacity, reduced ability and increased needs require at least the same environments and advantages in late life that they found in earlier years. In the backdrop of these physical, cognitive, emotional and social problems, most important need of aged population revolves around a decent level of quality of life and satisfaction. All the aspects of ?Health status?, ?Lifestyle?, ?Life satisfaction?, ?Mental health? and ?Well-being? together reflects the multidimensional nature of Quality of Life of an aged person (Barua et al. 2007). Quality of life is a holistic approach that not only emphasizes on aged individuals‘ physical, psychological, and spiritual functioning but also their connections with their environments; and opportunities for maintaining and enhancing skills. The way aged population define satisfaction and quality of life changes dramatically from the way people have perceived them while they were young. Maybe the inversion of priorities, wishes and desires comes with age, which leads to reprioritization. Hence the fundamental to appreciating changing priorities, changing dependency and support ratio is the need of these people. Further there is a need to define and articulate the roles and responsibilities of the society in responding to the needs of an aging population which enable them to maintain a balanced and complete self. A designer‘s goal is to provide the solutions that best support and provide every opportunity to fulfill those needs. APPROACHING NEEDS OF THE AGED POPULATION Basic human needs are universal. They are the same for all people for all time. But their satisfiers – the ways to fulfill them – are not. Need addresses both the basic human needs of individuals within the community and the needs of a sustainable global society, both now and in the future as defined by the Brundtland Commission. In their broadest sense, development and human needs are components of the same equation. For many aged people it is the primary need to be able to remain in habitual and congenial environments. Efforts are currently made to make public spaces 'older person-friendly'. Environments around the elderly must provide solutions that address these distinctions in capacity, ability and need for daily living. To access the health of a built environment and to test its suitability to aged, few pertinent questions on the built environment becomes relevant like How are the spaces and the services distributed in the actual built environment? Are the spaces easily navigable and walkable? What is the nature of use of the existing spaces and facilities by aged population? How responsive is the actual built environment for the elderly? However, the diversity of older people and their different needs are difficult to be fully recognized. Planning focus has tended to be on combating maximum possible issues. There is still a need to understand older people's various requirements in their use of space, reflecting their diversity and different backgrounds. While some are experienced who are used to finding their way in unfamiliar spaces, others may suffer cognitive impairment which makes previously familiar areas unrecognizable and means they need different cues in their environment. The designers are mostly interested in the physical attributes of housing, although researches have shown that psychological well being is one of the most intrinsic aspects of successful ageing (Carp, 1976; Lawton and Nahemow, 1973; Schwirian and Schwirian, 1993). Successful ageing is a process which encompasses the avoidance of disease and disability thereby maintaining high physical and cognitive function, and sustained engagement in social and productive activities. Besides being social and psychological friendly, the physical environment itself should be used to form friendship and encourage socialization and relationships. The design professional faces a tremendous task and challenges to keep abreast of technological advances and research pertaining to many facets of human beings and the built environment (Benktzon, 1993; Pinto et al., 2000; Sagdic and Demirkan, 2000). Few designers presently realize the need for fresh thinking about design – new approaches to the subject, new strategies and new research methods that could help them better understand and respond to the needs of old users. It is worth to be considered that development of products began to shift away from the harder technical and functional performance factor to softer, more human aspects of emotional engagements, lifestyle and aspirations (Clarkson, Coleman, Keates and Lebbon, 2003). Moreover most design oriented research on older user tends to focus on the physiological isolation rather than with the context of social and cultural activities (Huppert 2003). Design model needs to be proposed in order to design and develop safe and functionally appropriate environment for elderly that will promote and maintain their independent living. There is a growing recognition that the physical environment can enhance or impede the independence and mobility of the elderly. Sanoff (2000) stated that ??the elderly, a rich resource of knowledge and experience, have often been excluded from the design process‘‘ …. although they are not a homogenous group they are…. ??unique individuals with a common goal-living life with dignity‘‘. The response to these issues lies in understanding the need of the aged and approach to design of built environment for them. Research across the world suggests that responding to need of the aged centers around few important approaches namely ? Usability ? Need Based Design ? Human Factors Integration ? Requirements analysis Needs Based Design for aged organizes the process we adopt to create, build and maintain the physical and social infrastructure of the communities that they live in and is a platform to help the aged move towards, and beyond, sustainability. Approach to Need Based Design for elderly revolves around providing design, development for their ease in interaction with society, and planning teams with a platform, strategy and method for designing, constructing and maintaining the physical and social infrastructure for them. Technology and design have always responded to need. But technology is subordinate when it comes to the area of ageing. Need Based Design for aged provides a new way to think about, propose and pursue a congenial environment by addressing complex and interrelated problems faced by aged population. It uses a systems thinking approach centered on their needs within society and outside it to create healthy and vibrant communities. In view of the complexities in need based requirements and possible conflicts, trade-off practices finds suitability in the design process. User‘s Need Based Design hence unify multi-disciplinary design; enabling them to meet their goal. This should also focus on the questions of ?why‘ certain environment, structures, systems and processes have greater potential for helping users to reach success. One way of achieving it is to retrieve the past design information and then study and analyze the user‘s need-based preferences in design of similar spaces and features so to provide designers with easy access to relevant designs and related knowledge. It is of paramount importance to ensure that all ?user‘s need‘ based requirements are derived as low level user requirements before being transposed into system requirements. If that is not possible, the change-as-little-as-possible principle needs to be adopted as the most effective approach. The human factor approach to development of technologies for the elderly must be integrated into the design process for the systems. Need analysis research should be conducted both to refine our understanding of needs and to identify potential solutions for the target groups. Need assessment and requirement analysis are the most important steps to start off a need based system design for the elderly. The entire elderly people design program needs to be based on design for dynamic diversity. Also it is important to evolve appropriate methodologies to enable creation of an environment where elderly needs are responded and they are partners in development. The solution remains to this is through adopting alternative and innovative methodologies in to respond to need so as to make equitable, affordable and quality environment accessible to the elderly population.
CONCLUSION
We will live an ever-increasing part of our life in old age and this is expected to continue with increased health, wealth, technological advancements and education. The issues and challenges of such large, ageing populations are complex, but becoming increasingly better understood. Although aging individuals appear to age better now than in decades past, ageing still brings a variety of physical, mental and emotional changes that impact people‘s daily lives. From most of the literature studies, it is evident that there is an increased understanding of ageing, and an ever growing number of older adults but people still have to deal with age related expectations and prejudices. Quality of life in old age is hence to a large extent determined by conditions, events and decisions during childhood and adulthood, including by environment and lifestyle factors. Still there is a need for creating basic prerequisites for a supportive, integrating and friendly environment for the elders. Age-friendly environment and socially cohesive community that offer opportunities for an active life and contacts between generations have crucial impact on maintaining the independence and quality of life of older people. Because ageing is so personal and case specific it is important to monitor the changes of an ageing individual. This paper is based on the idea that there are significant needs of the elderly people for daily sustenance and it is a challenge to provide congenial environment to them. Hence not only recognizing but approaching complexity as a real and practical problem needs to be realized. We also need to accept that design complexity for the aged population is not something that can be dealt with by the use of approaches and tools aimed at reducing complexity by ?borrowing? methods and approaches from the realm of science. It has to be approached through human factor integration, requirement analysis and finally Need Based Design. Design needs to be formulated that respects ageing-related changes and limitations enhance dignity, safety, selfsufficiency and independent living. The literal idea of sustainability through Need Based Design of elderly may lead to new design innovations, recommendations and ultimately opportunities of independence!
ACKNOWLEDGEMENT
Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1759http://ijcrr.com/article_html.php?did=17591. Barry, Jane. 2008. Everyday Habits and Routines: Design Strategies to Individualize Home Modifications for Older People, Washington State University Department of Interior Design
2. Barua, A. Mangesh, R. Harsha Kumar, HN. Mathew, S. 2007. A cross-sectional study on quality of life in geriatric population. Indian J Community Med, 32 (2), pp. 146 - 147
3. Benktzon, M., 1993. Designing for our future selves: the Swedish experience. Appl. Ergon. 24 (1), pp. 19–27.
4. Beyond 50.05: A report to the Nation on Livable Communities, 2005. Creating Environments for Successful Aging, AARP Public Policy Institute, The University of Virginia, p. 80
5. Caldwell, J.C. 2001, Prospects for the aged in the developing world, UNFPA Symposium on the Aged, IUSSP Conference, Salvador de Bahia, p. 3
6. Carp, F.M. 1976. Housing and living environments of older people. In:Bistockm, R.H., Shanas, E. (Eds.), Handbook of Ageing and the Social Sciences. Van Nostrand, New York, pp. 244–271.
7. Clarkson J, Coleman R, Keates S and Lebbon C. 2003. From Margins to Mainstream, Inclusive Design: design for the whole population, Springer Verlag, London, pp. 1-25
8. Evans, J. N. 2009. Designing opportunities of independence for a booming cohort: minimizing in-home modifications, Master of Arts in Interior Design report, Washington State University
9. Gitlin, L. N. Mann, W. Tomita, M. and Marcus, S. M. 2001. Factors associated with home environmental problems among community-living older people. Disability and Rehabilitation, 23, pp. 777-787.
10. Harvard School of Public Health. 2003. Reinventing Aging: Baby Boomers and Civic Engagement. Funded by Metlife FoundationbJuly 2008 pp. 52.
11. Hermalin, A.I. 1997. Drawing policy lessons for Asia from research in ageing, AsiaPacific Population Journal, 12, 4, pp. 89- 102.
12. Huitt, W. 2004. Maslow's hierarchy of needs. Educational Psychology Interactive, Valdosta, GA: Valdosta State University.
13. Huppert, F. 2003. Designing for old users, in Clarkson J, Coleman R, Keates S and Lebbon C (ed) Inclusive Design: design for the whole population, Springer London, pp. 31 – 49
14. Lawton, M.P. and Nehemow, L. 1973. Ecology and the aging process. In Eisdorfer, C. Lawton, M.P. (Eds.) Psychology of adult development and aging. Washington DC. American Psychological Association. pp. 619-674.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesDESIGNING MOBILE BASED FUZZY EXPERT SYSTEM FRAMEWORK FOR VIRAL INFECTION DIAGNOSIS
English140147Maitri PatelEnglish Paresh VirpariaEnglishA lot of research has been carried out in medicine and artificial intelligence domain and several fuzzy expert systems have been developed for diagnosing severe disease, such as liver disorders, blood disease, tuberculosis and many more. A very common disease, viral infection is caused due to viruses that use host cells to reproduce and disturb the immune system. In this paper the framework to construct a fuzzy expert system for mobile users is proposed to diagnose viral infections. The fuzzy expert system shall be hosted on the web-server and web-services shall be used as a communication medium between the fuzzy expert system and the handheld devices. Thus the mobile users will be able to achieve quick assistance for their common disease symptoms which a medical practitioner would suggest when they visit the clinic. With the world converging towards handheld devices, assistance in terms of medicine for common diseases on such devices can be very fruitful with respect to time and security.
EnglishFuzzy Expert System, Mobile Application, Web-service, Knowledge Engineer, Artificial IntelligenceINTRODUCTION
Expert Systems have been proven very effective in a number of problem domains where generally intelligence possessed by human expert is needed. Application domains include law, basic and applied science, military operations, commerce and the list goes on. Webbased fuzzy expert systems are web applications which deal with fuzzy set of data to produce results based on the expert knowledge stored in the expert system‘s knowledge base. A survey of web-based fuzzy expert system in [1] describes various applications in the field of health sector, agriculture, real-time applications like flood forecasting system, vehicle registration fee computation, applied mechanics and materials and tourism. With the advent of mobile technology, different web applications are converging towards mobile applications due to the flexibility and easy access to all sorts of resources. In this context, this paper tries to mobilize one more type of application in the health sector domain.
Background
Expert Systems
Expert systems (ES), one of the products of artificial intelligence (AI) which emerged during early 1970s, has become one of the most important innovations of AI because they have been shown to be successful commercial products as well as interesting research tools [2]. Expert system is a bunch of code dealing with encoded knowledge to solve problems in specialized domain that requires human expertise. The information from the experts is taken and coded to generate the knowledge base which thereafter is used for inference and reasoning processes. The knowledge base is developed by performing some encoding techniques on the information available from the domain experts and other sources like databases, journals, articles and texts. This knowledge base is tested, refined if necessary and used thereafter by the system.
Fuzzy Expert Systems
In the real world, the situations are hardly possible to refer by dichotomous value (yes or no). Eventually, it was very difficult to map the real data to a strict Boolean value 0 or 1. To address the uncertainties in the real world by reasoning through probability theory and statistics gave rise to fuzzy set and fuzzy logic. Fuzzy logic refers to the logic that describes uncertainty and vagueness. A fuzzy set refers to an ordered pair of an element and its membership. Membership refers to the degree with which the element belongs to the fuzzy set. Collection of fuzzy membership functions and rules to analyze the data is called a fuzzy expert system [3].
Fuzzy Expert Systems in Healthcare
Formalizing medical entities as fuzzy sets and reasoning in a rule-based system has been described in [4] and the authors have built a rule based system which uses fuzzy logic to diagnose Lung Diseases. The system takes input as a set of symptoms consisting of patient‘s clinical status and results in terms of diagnosis of Lung Diseases. Fuzzy expert systems have been developed for diagnosis of diseases like heart, diabetes, asthma as in [5], [6] and [7]. The pattern used for fuzzy expert system is the symptoms for diseases are mapped to the severity of the symptom to construct the rulebase. Inference engine is designed using one or combination of membership function along with the appropriate algorithm to predict the severity or presence of the disease.
Mobile Expert Systems
In recent time (over a decade) it has become possible to link up and share any type of data anytime and anywhere. Having said this, the first device that comes to our mind is the mobile phone – a portable communication device that provides mobility irrespective of time and region. As the technology advances, these mobile phones have leaped from talking devices to devices which are capable of transferring data and voice. Integrating expert systems with mobile has resulted into easy, quick and ultimate utilization of expert knowledge. Using mobile, expert system can be accessed eliminating time and region boundaries, with a small pre-requisite of signal availability.
Expert systems using Mobile in healthcare
The significance of application of artificial intelligence to solve problems in mobile learning has been described in [8]. Problems in mobile learning are discussed and how artificial intelligence is beneficial in solving these problems is explained in the paper. To provide Islamic Medication (IM) without consulting IM experts, research has been carried out in [9]. Therapies for physical and internal illness are made available to the mobile user by displaying the verses and instructions from Quran and Hadith through the expert system in between.
Expert systems using Mobile for viral infections
Viruses are capsules consisting of genetic material which are even smaller than bacteria cause viral infections [10]. A virus particle called ?virion‘ consists of nucleic acid segments that are enclosed in capsid. Depending on the nature of their nucleic acid contents, viruses are categorized either DNA or RNA viruses. When the virus come in contact with host cell (where virus resides), it secretes its genetic material (DNA or RNA) inside the cell to infect it [11]. This infected cell is controlled by virus either by killing the cell or by altering its normal functions and replicates to infect other cells. Some viral infections can be detected based on symptoms and for some various tests like blood test, urine test shall be done. Antiviral drugs are the medicine used either to interrupt the replication process of viruses or strengthen the immune system of the host [12]. To address this area of medicine, a fuzzy expert system can be developed which can be accessed by mobile users. This paper refers the prototype for construction of a fuzzy expert system to diagnose viral infections and offer corresponding remedies.
Literature Review
Lot of research has been carried out in developing intelligent systems in last two decades. One of the much focused domains is healthcare sector. A fuzzy expert system for the management of malaria has been presented in [13]. 35 patients were tested by the system. The authors considered set of 5 diseases and set of signs and symptoms for each disease. Weighing factors were assigned to each set of signs and symptoms and a triangular fuzzifier was employed on these weighing factors to convert them to triangular fuzzy values. For each patient, rules will be fired from the rule-base to generate the respective output membership function strength (range: 0-1) using Root Sum Square inference technique. The output fuzzy set is thereby defuzzified using discrete Centre of Gravity technique giving the possibility of malaria in terms of percentage. In [14], computer package has been developed using java to implement fuzzy expert system and UML is used to demonstrate the structure and behaviour of proposed packages. Deriving a system-level fuzzy conclusion from individual rule-level fuzzy conclusions and de-fuzzification is implemented using two java classes – java.awt.Polygon and java.awt.geom.Area. Polygon class defines fuzzy conclusions and Area class defines enclosed area of twodimensional space along with their geometrical manipulations. Using the clipping method for triangular membership function, rule-level fuzzy conclusion is calculated for a single fuzzy rule. For multiple fuzzy rules, system-level fuzzy conclusion is estimated by applying some geometrical operations on all of the individual rule-level fuzzy conclusions. Thereafter, the Center of Area (COA) defuzzification method is applied to determine the defuzzified value. A console based, windows-based and two webbased applications are discussed in the paper to validate the proposed package. An ICD10 based Medical Expert System has been discussed in [15] which offers advice, information and recommendation to the physician using fuzzy temporal logic. The system uses ICD coding to represent data and clustering algorithm to produce the most possible diseases for the given symptoms. Apart from the knowledge base, the system also consists of a temporal database to store the past and current history of the patient. The system also separates the rules into temporal and nontemporal (fuzzy) rules. The inference engine is composed of a scheduler - which schedules the rules to be fired and an interpreter – which fires the rules using forward chaining inference technique. Least square method is used to generate the curve. Interpolation and extrapolation techniques are used to make the first level decision. Using the same technique, set of other decisions are made using temporal information manager and inference engine. Eventually, the decision manager makes a decision based on the top scores. Another malaria control programme has been discussed in [16] whose main aim is to develop a technology based healthcare solution to prevent control and eventually eliminate malaria.
Responsible and designated malaria staff is trained and given mobile phones for routine checkup, new case investigation and treatment activities. Information about patients is captured even in places where telephone signals are not available and are synchronized later when signals are reachable, thus eliminating the paper based methods. Summary statistics and maps of all the cases covered by the health service area can be generated. The Diabetes Diagnosis System described in [5] is one more web-based fuzzy expert system application to diagnose the diabetes disease. The system is implemented using Fuzzy Expert system and Sungeno‘s inference technique. Based on the user answers to the questionnaire of diabetes risk factors and symptoms, the system generates an estimated result giving some recommendations to prevent or lower the risk, which may in turn be interconnected with the user life style and medication. In this paper, the architecture for fuzzy expert system for diagnosis of viral infection using mobile is proposed. A fuzzy expert system can be developed and hosted on a web-server. A client can be installed on the mobile handheld device which communicates with the web-server through web-services.
Architecture
The Fig. 1 below shows the architecture of the proposed model. The model can be broadly subcategorized into two – system and user.
System The system is developed with two main components – one component will be deployed on the web-server and the other on the user handheld device. The web-server mainly consists of the fuzzy expert system and the webservice to handle the communication with the handheld device.
Web-Server Component
Fuzzy Expert System
The fuzzy expert system proposed here computes the action in terms of remedy for the user symptoms. Similar to any other expert system, this fuzzy expert system also comprises of two main sub-components.
Knowledge Base
The knowledge base is developed by the knowledge engineer. The knowledge engineer and the domain expert(s) together list the possible symptoms and severity for a disease and corresponding remedies. Thereafter the knowledge engineer reforms this list into predigested form which is nothing but a complex set of pattern-action (symptoms-remedy) rules. To build the knowledge base, an interface should be developed which can take the patterns and action to generate the rules. This eventually will construct a rule-based knowledge system. Inference Engine Inference engine applies a control structure to identify the symptom pattern and provide the remedy. Various inference mechanisms are being used such as triangular membership function or trapezoidal membership function can be applied to come to a conclusion. Based on the conclusion, medicine can be decided or any other remedy can be suggested.
Web-service
The web-service is a medium which can be used for the mobile to talk to the web-server. Whenever user makes a request, it propagates from the mobile device to web-server using web-service and when expert system generates a response, it is carried to the mobile device through the web-service.
Handheld device
On the handheld device, two clients need to be installed. The first would be able to fetch user input in terms of symptoms. These would be directed to the second client that ultimately would convert the user input in a format that is understood by the web-service residing at the web-server.
Client Application
This application would be the user interface through which the input variable will be initialized for our fuzzy expert system. The symptoms inserted to the system would be acting as the input variable, more specifically linguistic variable. Web-service client The web-service client is the client component to invoke the actual web-service servicing at the web-server. The main task of the web-service is to convert the user-data into a compatible format, recognized by the web-service ready to serve at the other end. Actors Without the actors, system is of no use. There are three possible actors for the system categorized depending on their role.
Domain Expert
Domain expert is a person with special knowledge and skills in a particular area. This knowledge is acquired through the experience and learning over a period of time. In our system, the domain experts would be medical practitioners and doctors who are well versed in diagnosing viral infections. Knowledge Engineer Knowledge Engineer is a technical person who is more focused on mapping the domain expertise to form a complex set of pattern-action to develop the knowledge base. As per our proposed system, the knowledge engineer will be dealing with the domain experts for knowledge acquisition and thereafter work on it to form rules that can be stored in the knowledge base. To include all the possible symptoms along with their severity that can be mapped to the linguistic variables later used by the inference engine and develop concise rules is the important and crucial task of the knowledge engineer.
User
User is a common person who would be using this system. User may be a patient or a helper to the patient who wants to diagnose whether he/she is suffering from viral infection. If the system detects positive result for diagnosis, it would eventually give the remedies to control the disease.
Flow Diagram
The flow diagram for the proposed architecture is shown in the below Fig. 2. Following are the steps for a single request cycle. Step 1: The user provides the input in the form for symptoms using the handheld device. Step 2: The device invokes the pre-processed web-service client which converts the input data into request data format to be sent to the webserver. Step 3: At the web-server, first the input data is extracted from the request data format and the expert system is invoked with input data as the parameters. Step 4: The expert system consults the knowledge base to fetch the rules and applies them on the input data to produce the output data which are the actual actions or remedies to be taken in account of the symptoms. Step 5: This output data is thereafter reformed into the output data format and sent back to the client device. Step 6: The handheld device formats the received data for the user. The resultant data would be composed of action to be taken for the symptoms keyed by the user at the start of the request.
This architecture will be very beneficial to a common man, if implemented. For not so strong symptoms, this system can guide the user to take immediate actions which a general practitioner would suggest. It would save time because without going to the clinic or hospital, the system gives remedies for common diseases like viral infections especially acute viral infections.
DISCUSSION AND CONCLUSION
Mobile applications are more secure since we can identify the device user rather than a webapplication where user tracking is difficult and is generally based on IP address or user authentication, which can be easily shared or hacked. Keeping this into account, the design is proposed for a fuzzy expert system for mobile users to diagnose viral infections in this paper. The basic working of the system deals with the symptom acquisition from the user and expert system driving the action and remedies derived from the rule-based knowledge base. Webservices are put forward for communication. Many web-based fuzzy expert systems are developed so far to aid different user categories. The next task is to implement the system. Also the same architecture can be used in other domain and implemented to provide assistance through web-services. Thus usage of expert system in the medical domain can be very beneficial to the mobile users in the busy world and safe in terms of security. Without taking doctor‘s appointment, the handheld device users will be able to get the remedies for common disease – viral infection.
ACKNOWLEDGEMENT
We would like to acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. We 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1760http://ijcrr.com/article_html.php?did=17601. M. Patel, P. Virparia and D. Patel. Web based Fuzzy Expert System and Its Applications - a Survey. International Journal of Applied Information Systems 2012 Mar; 1 (7): 11-15.
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6. A. S. Nursazwina. Development of Web Based Fuzzy Expert System for Disease Diagnosis: Diabetes Diagnosis System, Universiti Teknologi Mara Digital Repository, Thesis, 2006. Digital Repository. http://eprints.ptar.uitm.edu.my/1925/
7. M. H. F. Zarandi, M. Zolnoori, M. Moin and H. Heidarnejad. A Fuzzy Rule-Based Expert System for Diagnosing Asthma. International Journal of Science and Technology, Transaction on Industrial Engineering 2010; 17(2): 129-142.
8. Q. Liu, L. Diao, G. Tu. The Application of Artificial Intelligence in Mobile Learning. Proceedings of the 2010 International Conference on System Science, Engineering Design and Manufacturing Informatization; 2010 Nov; 1 p. 80-83.
9. L. T. Jung, R. Kasbon, H. Daud. Mobile Islamic Medication Expert Systems. In: Informatics 2008 and Data Mining 2008, MCCSIS'08. Proceedings of IADIS Multi Conference on Computer Science and Information Systems; 2008 July 22-27; Amsterdam; 2008.
10. Viral Infections - MedlinePlus. http://www.nlm.nih.gov/medlineplus/virali nfections.html Access date 15 May 2012.
11. H. P. Rang, M. M. Dale, J. M. Ritter and R. J. Flower. Rang and Dale‘s Pharmacology. Elsevier Science Health Science, 6th ed; 2007. p. 679-681.
12. Overview of Viral Infections - The Merck Manual Home Health Handbook. http://www.merckmanuals.com/home/infec tions/viral_infections/overview_of_viral_in fections.html Access date 15 May 2012.
13. X. Y. Djam, G. M. Wajiga, Y. H. Kimbi and N. V. Blamah. A Fuzzy Expert System for the Management of Malaria. International Journal of Pure and Applied Sciences and Technology 2011 Aug; 5 (2): 84-108.
14. C. Lin, S. Chen. An easy-to-implement fuzzy expert package with applications using existing Java classes. Expert Systems with Applications: An International Journal 2012 Jan; 39 (1): 1219-1230.
15. P. Chinniah and Dr. S. Muttan. ICD 10 Based Medical Expert System Using Fuzzy Temporal Logic. International Journal of Computer Science and Information Security 2009 Dec; 6 (3): 084-089.
16. P. Meankaew, J. Kaewkungwal, A. Khamsiriwatchara, P. Khunthong, P. Singhasivanon, W. Satimai. Application of mobile-technology for disease and treatment monitoring of malaria in the ?Better Border Healthcare Programme‘. Malaria Journal 2010 Aug; 9: 237.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesA COMPARATIVE STUDY OF LUNG FUNCTIONS TEST BETWEEN ATHLETES AND NON-ATHLETES
English148153Karanjit SinghEnglish Vishaw GauravEnglish Mandeep SinghEnglishThe purpose of the study was to compare the lung volumes and capacities between athletes and non athletes. Sixty college going young male subjects (athletes: N=30 and non-athletes: N=30) of 18-25 years were randomly selected from different colleges affiliated to Guru Nanak Dev University, Amritsar,
Punjab, India. All the participants were assessed for height, weight and body mass index. Lung functions
test was performed with a computerized spirometer following the procedures and predicted values recommended by the American Thoracic Society. Lung functions parameters i.e. forced vital capacity, expiratory reserve volume, inspiratory reserve volume, vital capacity, inspiratory capacity and tidal volume were measured.The independent samples t-test used for data analysis. The level of p 0.05 was considered significant. Statistical analysis showed significant differences between athletes and nonathletes of all the lungs function variables. It was observed that all lung function parameters of athletes were higher than non-athletes (pEnglishLungs Function Test, Athlete, Non-athlete, Spirometer.INTRODUCTION
Respiratory system is an important system of a human body where gaseous exchange takes place with diffusion of enormous amounts of oxygen into the blood during physical activity (Khurana, 2005). The lung function tests, like other physiological tests must be of the utmost importance for measuring the fitness of an individual from a physiological point of view (Astrand and Rodahl, 1970). Lungs function parameters tend to have a relationship with lifestyle such as regular exercise and nonexercise (Wasserman et al., 1995; Twisk et al., 1998).The apparently simple function of the lung is to deliver O2 to gas exchanges surface and exhaust CO2 to atmosphere. Lungs functions test is a powerful tool to measure volumes and capacities of an athlete in physiology lab. In addition to measuring volumes and capacities, it provides information regarding response to training or exercise and monitors the response following respiratory problems including exercise induced bronco spasm (McGraw-Hill‘s 2001). Due to regular exercise, athletes tend to have an increase in respiratory capacity when compared to non-exercising individuals. Exercise is stressful condition which produces a marked change in body functions and lungs are no exception. Sedentary life styles could be associated with less efficient pulmonary functions. There are several studies that have shown significant improvement in pulmonary functions as a result of the effect of exercise (Chandran et al., 2000; Shivesh et al., 2007).However, there are studies which show non-significant change in pulmonary functions as an effect of exercise (Hamilton and Andrew 1976; Kuppu and Vijayan 1988). In athletes lung volumes and capacities alters during resting state and intense exercise. Lung function tests provide qualitative and quantitative evaluation of pulmonary function and are therefore of definitive value in the diagnosis and therapy of patients with cardio -pulmonary disorders as well as those with obstructive and restrictive lung disease (Belman and Mittman, 1980; Robinson and Kjeldgaard, 1982). The parameters used to describe lung function are the lung volumes and lung capacities. The pulmonary functional capacities of normal sedentary individuals have been studied extensively in India (Singh, 1959; Rao et al., 1961; Singh, 1967; Jain and Ramiah, 1969; Gupta et al., 1979). Therefore, the purpose of the study was to compare the lung function parameters between athletes and non athletes.
MATERIAL AND METHODS
The present study was conducted on Sixty college going young male subjects (athletes: N=30 and non-athletes: N= 30) of 18-25 years age. The subjects were selected as athletes who have been participated in inter-university championships and subjects selected as nonathletes who have been not participated any sporting activity. All subjects randomly selected from the different colleges affiliated to Guru Nanak Dev University, Amritsar, Punjab, India. The age of each subject was calculated from the date of birth as recorded in his institute. The height of the subjects was measured with anthropometric rod to the nearest 0.5 cm. The weight of subjects was measured by using portable weighing machine to the nearest 0.5 kg. Body mass index was calculated as body weight adjusted for stature. Lung functions testing were performed with a computerized spirometer following the procedures and predicted values recommended by the American Thoracic Society. All Spirometric measurements were performed under standard conditions of body temperature and ambient pressure and with water vapor saturation with the subjects sitting down and wearing a nose clip. The forced vital capacity, expiratory reserve volume, inspiratory reserve volume, vital capacity inspiratory capacity and tidal volume were measured in each subject and recorded in absolute values. Each subject performed 3 acceptable maneuvers according to the American Thoracic Society recommendations.
Statistical analysis:
The lung functions test were compared in both the athletes and non-athletes groups by the‘ Independent samples t‘ test. Data were expressed as Mean value and SD. Statistical significance was indicated by ?P‘ value Englishhttp://ijcrr.com/abstract.php?article_id=1761http://ijcrr.com/article_html.php?did=17611. Adegoke, O A and Arogundade, O. 2002. The effect of chronic exercise on lung function and basal metabolic rate in Nigerian athletes. African Journal of Biomedical Research, 5: 9-11.
2. Armour, J, Donnelly, P.M. and Bye, P.T. 1993. The Large Lungs of Elite Swimmers: An Increased Alveolar No. Eur Respir J, 6(7): 237-247.
3. American Thoracic Society. 1995. Standardization of spirometry, 1994update. Am J Respir Crit Care Med., 152(3):1107- 1136.
4. Astrand, P.O. and Rodahl, K.1970.Textbook of Work Physiology. McGraw- Hill Kogakusa Ltd. .
5. Belman, M.J. and Mittman, C. 1980. Ventilatory muscle training improves exercise capacity in chronic obstructive pulmonary disease patients Am Resp Dis., 121. 273-279.
6. Birkel, D.A. and Edgren, L. 2000. Hatha Yoga improved vital capacity of college students. Altern Ther Health Med, 6: 55-63.
7. Bjourstrom, R. L. and Schocne, R.B. 1987. Control of ventilation in elite synchronized swimmers, 63, 1091-1095
8. Bloomfield, J., Blansby, B.A., Ackland, T.R. and Elliot, B.C. 1985. The anatomical and physiological characteristics of prepubertal adolescent swimmers, tennis players and non competitors. Austrr_Sci Med Sport, 17:19-23.
9. Chandran, C.K., Nair, H.K. and Shashidhar, S. 2000. Respiratory functions in kalaripayattu practitioners. India J Physiol Pharmacol, 48(2): 235-240.
10. Cordain, L., Tucker, A., Moon, D. and Stager, J. 1990. Lung volumes and maximal respiratory pressures in collegiate swimmers and runners. Res Q Exerc Sport 61: 76-80.
11. Fanta, C.H., Leith, D.E. and Brown, R. 1983. Maximal shortening of inspiratory muscles: effect of training. J Appl Physiol, 54: 1618-1623.
12. Gupta, P., Gupta, L. and Ajmer, R. L., 1979. Lung functions in Rajasthan subjects. lnd.J.Physiol.Pharmacol. 23 (1): 9-14.
13. Haberg, J.M. 1988. Palmonary function in young and older athletes and untrained men. J Appl Physiol., 65(1): 101-105.
14. Hamilton, P., Andrew, G.M. 1976. Influence of growth and athletic training on heart and lung functions. Eur J Appl Physiol, 36: 27- 38.
15. Jain, S. K. and Ramiah, T. J., 1969. Normal standards of pulmonary function tests for healthy Indians 15-40 yrs old, comparison of different prediction equations. Ind.J.Med.Res. 57: 1433-1466.
16. Khurana, I. 2005.Textbook of Medical Physiology, Elsevier Health Sciences in: Physiology of Exercise and Sports, 1221- 1230.
17. Kuppu, R.K.V. and Vijayan, V.K. 1988. Maximum expiratory flow volume loop in Southern Indian College Sportsmen. Ind J Physiol Pharm, 32(2): 93-99.
18. Lakhera, S.C., Kain, T.C. and Bandopadhyay, P. 1994. Changes in lung functions during adolescence in athletes and non athletes. J Sports Med Phys Fitness, 34(3): 258- 264.
19. Mc Graw-Hill‘s 2001.Ordering and Interpretation of the Lung Function Test. Pocket Guide to Lung Function Tests, 3rd ed.
20. Mehrotra, P.K., Verma, N.S., Tiwari, S. and Kumar, P. 1998. Pulmonary functions in Indian sportsmen playing different sports. Ind J Physiol Pharmacol, 42(3):412-416.
21. Newman, F., Smalley, B.F. and Thomson, M.L. 1961. A comparison between body size and lung function of swimmers and normal school children. J Physiol (Lond) 156:9-14.
22. Onadeko, B.O., Falase, A.O. and Ayeni, O. 1976. Pulmonary function studies in Nigerian sportsmen. Afr. J. Med. Sci. 5,291- 295.
23. Rao, M. N., Sengupta, A., Saha, P. N. and Devi, S.A., 1961. Physiological norms in Indians. Indian Council of Medical Research Spl., report series no. 38.
24. Rensburg, J.P., Linde, V.D., Ackerman, P.C., Kieblock, A.J. and Strydom, N.B. 1982. Physiological profile of squash players. S Afr Med J. 62:721-723.
25. Robinson, E.P. and Kjeldqard, J.M.1982. Improvement Inventilatory muscle function with running. J. Appl. Physlol, 52:1400- 1405.
26. Shivesh, P., Sushant, M. and Ujjwal, R. 2007. Athletes, yogis and individuals with sedentary lifestyles. do their lung functions differ? Ind J Physiol Pharmacol, 51(1):9-14.
27. Singh, H. D. 1959.Ventilatory function tests, normal standards in male adults. J.lnd.Med.Prof. 5: 2483-2486.
28. Singh, H. D., 1967. Peak flow rate in Indians. lnd.J.Physiol.Pharmacol.11:129- 130.
29. Twisk, W., Staal, B.J., Brinknian, M.N., Kemper, H.C. and Van Mechelen, W. 1998. Tracking of lung function parameters and the longitudinal relationship with lifestyle. Eur, Resp. J. 12 (3), 627-34.
30. Vrijens, J., Pannier, J.L.and Bouckaert, J. 1982. Physiological profile of competitive road cyclists. J Sports Med, 22: 207-16.
31. Wassreman, K, Gitt, A., Weyde, I. and Eckel, H.E. 1995. Lung function changes and exercise-induced ventilatory responses to external restive loads in normal subjects.Respiration ,62 (4), 177-84.
32. Wilmore, J.H., and Costill, D.L. 1999. Physiology of Sports and Exercise. 2nd ed. Human Kinetics, Champaign, 490–507.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareBLOOD STREAM INFECTIONS IN INTENSIVE CARE UNIT PATIENTS: A SINGLE CENTRE RETROSPECTIVE STUDY OF DISTRIBUTION AND ANTIBIOTIC RESISTANCE PATTERN IN CLINICAL ISOLATES
English154162Anamika VyasEnglish Ramavtar SainiEnglish Pooja GangradeEnglish Mrityunjay KumarEnglishIntroduction: Blood stream infections are an important cause of serious morbidity and mortality. Blood stream infections occur more frequently in patients hospitalized in intensive care units than in other units.
The knowledge of distribution and antibiotic resistance pattern of causative microbial agents in these infections is important for their prevention and empirical antibiotic treatment while awaiting culture and sensitivity results. Aim: The aim of the study was to describe the distribution of etiological agents causing blood stream infection in intensive care unit patients and their antibiotic resistance pattern, so that a guideline can be formulated for clinicians to choose an effective empiric antibiotic therapy. Methods: This was a retrospective study. Samples representing blood stream infections were sent from ICU to icrobiology laboratory for culture and sensitivity testing. Microbiological profile and antibiotic resistance pattern of clinical isolates was studied. Results: Positive cultures were obtained in 42 (11.9%) cases. Among culture positive isolates 56.1% were gram positive bacteria wherease (39%) and (4.9%) were gram negative bacilli and yeast respectively. Coagulase negative staphylococci (31.7%) was predominant organism followed by E.coli (24.4%), Staph aureus (12.2%), Enterococcus faecium (9.8%),Klebsiella pneumonia(7.3%) and nonfermenters (7.3%), Linezolid, Quinpristin/Dalfopristin, Vancomycim was the most active drugs for gram positive cocci wherease Amikacin and Carbapenams were most active drugs for gram negative bacilli. Nonfermenters showed multidrug resistance and were sensitive to tigecycline and colistin. Conclusion: This study provide information on distribution and antibiotic resistance pattern of microorganism causing blood stream infection. It may be a useful guide for physician to start empiric antibiotic therapy in cases of blood stream infections and in formulating antibiotic therapy policy in our hospital. It will provide a baseline reference data for future studies to detect changes in distribution and antibiotic resistance pattern of clinical isolates causing blood stream infection.
EnglishBlood stream infection (BSI), Intensive Care Unit (ICU),Antibiotic resistance, Gram positive, Gram negative.INTRODUCTION
Blood stream infections (BSIs) are an important cause of serious morbidity and mortality and are among the most common health care associated infection.1 Illness associated with blood stream infection ranges from self limiting infections to life threatening sepsis that require rapid and aggressive antimicrobial treatment.2 Blood stream infections (BSIs) occur more frequently in patients hospitalized in intensive care units than in other units. Debilitated condition of the patient due to underlying diseases, invasive diagnostic and therapeutic procedures, contaminated life support equipment, prolonged use of in-situ invasive devices, therapy with multiple antimicrobials predispose these patients to life threatening BSI.3,4 BSIs in such patients not only extends the hospital stay but also causes an increase in hospital mortality rate and cost of care. Throughout the 1960s and 1970s, gram negative organisms were most frequently isolated from patients with nosocomial BSIs. Since then, infections due to gram positive organisms have become increasingly frequent.5,6,7 With the spread of multidrug resistant bacteria, the treatment of BSI has become a challenging task for the Physician when selecting a regimen with which to treat patients because in almost all cases, antimicrobial therapy is initiated empirically before the results of blood culture are available. This is only possible with knowledge of the most frequently isolated etiological agents and their likely antimicrobial resistance pattern in a given place. Early initiation of appropriate antimicrobial treatment is critical in decreasing morbidity and mortality among patients with blood stream infections.8 Keeping in mind that the profile of BSIs varies between institutions and the high mortality and morbidity associated with disease, a right choice of empiric therapy is of utmost importance. Therefore, the present retrospective analysis was carried out to determine the distribution of microbial agents responsible for bloodstream infections in ICU of a tertiary care hospital and to get an up dated knowledge about their resistance pattern. This will not only help the clinician in selecting the antibiotics for empirical therapy till the result of culture and sensitivity are known but also help the clinician in identifying the changing pattern of etiological agents and their drug resistance pattern for future reference as well as in formulation of guideline on antibiotic prescribing policy and other infection control measures. MATERIALS AND METHODS Present study was based on the retrospective analysis of data about blood culture results of specimen submitted for culture to Microbiology laboratory. Permission was taken from Institutional Human Research Ethics Committee for the study. A total of 355 blood samples were processed during study period of 6 months (Oct. 2011 to march 2012). All the samples were collected from intensive care units (Medicine, Surgery, Paediatrics) of GMCH – a 750 bedded, tertiary care, teaching hospital providing a full range of medical, surgical and super specialty facilities. Processing of samples was done at the department of microbiology. The patients hospitalized more than 48 hours in the ICU were included in this study. The diagnosis of BSI was based on criteria of the center for disease control.9 Patients presenting with the evidence of infection at the time of admission and patients with a hospitalization period of less than 48 hours in ICU were excluded from study.Under the appropriate aseptic precautions 8-10ml of blood from adults and 1-3ml of blood from children was drawn by venipuncture and inoculated into BACT/ALERT FA/PF disposable blood culture bottle commercially available (by BIOMERIEUX,FRANCE). After inoculation blood culture bottles were sent to microbiology lab where the inoculated bottles were vented in BACT/ALERT 3D a fully automated blood culturing system by (BIO MERIEUX FRANCE). Anaerobic blood culture media was not used. Positive growth was identified up to species level by colonial morphology, gram staining and biochemical reactions utilizing automated identification system (VITEK2 COMPACT SYSTEM, BIOMERIEUX, FRANCE) according to manufacturer‘s instructions. Isolation and identification of bacteria was followed by susceptibility testing that was performed with(VITEK2 COMPACT SYSTEM,BIOMERIEUX, FRANCE), applying the criteria suggested by the clinical and laboratory standard institute.10 Any result from the same patient with the same organism identification and the same sensitivity pattern received with in five days was considered a repeat culture and is counted only once in data base. An analysis of the distribution and the antibiotic resistance pattern of bacterial isolates was performed. RESULT During the six months study period 355 samples from patients admitted in ICU‘s of our tertiary care hospital were analyzed retrospectively. 42 (11.9%) blood culture samples were positive for growth. Of these 41 (97.6%) were monomicrobial and 1 (2.4%) was polymicrobial. Among 41 monomicrobial growth, 39 (95.1%) yielded growth of bacterial isolates and 2 (4.9%) yielded growth of yeast (candida). Among bacterial isolates 23 (56.1%) were gram positive cocci and 16 (39%) were gram negative bacilli (Table-1) The most common microorganism isolated from blood culture sample was Coagulase negative staphylococci (CoNS) (31.7%) followed by Escherichia coli (24.4%), Staph aureus (12.2%), Enterococcus faecium (9.8%), Klebsiella pneumoniae (7.3%), Nonfermenters (7.3%) (Table-2). The antibiotic resistance pattern of gram positive and gram negative organism is shown in the (Table-3 and 4) respectively. Oxacilln resistance was noted in 84.5% and 60% isolated strains of Coagulase negative staphylococcci and Staph aureus respectively. 8 out of 13 isolated strains of Enterobacteriacea (61.53%) were positive for ESBL test. Antibiotic resistance among Nonfermenter : Pseudomonas aeruginosa and Acinetobacter baumanii complex strains isolated displayed multidrug resistance (MDR-P. aeruginosa and Acinetobacter were defined as resistant to three or all four following antibiotics: (Ceftazidime, Ciprofloxacin, Gentamicin and Imipenam). They were sensitive to Colistin and Tigecycline respectively. (Data not shown as the number of isolates were very low). DISCUSSION Patient with blood stream infections have remained a challenge for clinicians to treat. Prompt diagnosis and effective treatment are necessary to prevent complications and to reduce mortality from BSI. Data from Ibrahim et.al11showed that mortality rates doubled up from 30% to 60% when inappropriate empirical therapy was given to ICU patients with BSI. Knowledge of the hospital epidemiology and antimicrobial susceptibility pattern of blood isolates help physician to effectively manage blood stream infections because considerable differences in the distribution and antibiotic resistance of blood isolates are reported even from hospital of similar size and mixture of patients of the same country. On the basis of prior knowledge of common causative agents and their susceptibility to prescribed antibiotic ,empiric therapy is started and later changed according to final culture and susceptibility report. In the present retrospective analysis 11.9% cultures were positive for growth. It has been reported between 11.6%-42% in different studies.12-17This variation probably reflects different populations, clinical settings, age groups, selection of patients, number of blood cultures collected, blood culture medium formulation, type of blood culture system used for bacterial detection.
Most of the cultures (97.6%) in the present study yield mono microbial growth. The poly microbial growth isolation rate was 2.4%. The reported polymicrobial isolation rate varies between 1 to 15 percent. The polymicrobial growth could mean contamination or a severe infection with bad prognosis.18,19 In our study gram positive bacterial isolates were more (56.1%) than gram negative bacilli (39%).This finding is in accordance with the studies by Falagas et al.12,Arora et al.14 , Karlowsky et al.20and Ahmed et al.21Among the gram positive bacterial isolates, Coagulase negative staphylococci (CoNS) accounted for (31.7%) wherease S. aureus was isolated in 12.2%cases. Our results are consistent with the result of other studies. Data from the SCOPE (Surveillance and control of pathogen of epidemiologic importance) project revealed that the most common pathogen causing nosocomial BSI were CoNS (32%) and S.aureus (16%).6 Another data published from national nosocomial surveillance system for ICU associated primary blood stream infections identified CoNS (37%) and S. aureus (12.6%) as the leading pathogen. The increase in the frequency of CoNS BSI isolates can be explained by increased use of invasive intra vascular devices. The trend for CoNS may reflect a change from regarding these organism as skin flora to viewing them as clinically significant. The interpretation of blood cultures positive for Coagulase negative staphylococcci has inherent difficulties and require careful reasoning. Gram negative pathogens were lower on the rank of organism and included E.coli (24.4%) followed by Klebsiella pneumoniae (7.3%) and Pseudomonas aeruginosa (4.9%). These results are similar to other study where these organisms have been among the leading gram negative pathogen.22 Candida were isolated in (4.9%) cases. This is consistent with the study of Arora et al.14 and Narain et al.23 where as in other studies the incidence is much higher.24 Extensive use of antibiotics, aggressive treatment of neoplastic diseases, an expanding population of patients with AIDS with prolonged survivors, use of indwelling devices for ICU and many other factors are responsible for considerable prevalence of fungemia. Increased antimicrobial resistance rate among microorganisms isolated from BSI are a significant problem worldwide. In developing country like India, although the majority of the population depends on public health care system, increasing fraction is being managed by private facilities. Heterogenecity is also reflected in health care practices. As a result different patterns of antimicrobial resistance and antimicrobial use may emerge with in country. Methicillin resistant Staph aureus (MRSA), Vancomycin resistant enterococi (VRE), Extended spectrum β-Lactamase producing Klebsiella sp. and E-coli, Carbapenam resistant enterobacteriaceae,pseudomonas aeruginosa,acinetobacter spp. are seen more frequently in ICU patient than in non-ICU patients in many countries. In the present study 60% of the S. aureus and 84.5% of the Coagulase negative staphylococci isolated showed resistance to oxacillin. our findings coincides with the studies by Falagas et al.12, Karlowsky et al.20 who also reported considerable proportion of S. aureus and CoNS resistant to oxacillin. With other tested antibiotic the rate of resistant was reasonably high. However we observed that no strain of S.aureus isolated showed resistance to vancomycin. Similar finding was noted in other studies.12,15 So vancomycin can be safely used in multidrug resistant strain. Linezolid and quinpristin/ dalfopristin , tigecycline were sensitive in all isolated strain of S.aureus . Rifampicin and clindamycin had a good activity against S.aureus so these drugs can be used as a cost effective alternative for S. aureus treatment as they are less expensive. Enterococi displayed markedly high level of drug resistance to most commonly used antibiotics. All the enterococcal isolates in present study were resistant to ampicillin, quinolones, high strength Gentamicin. Resistance to vancomycin was noted in 1 isolate .(25%). No resistance was seen against linezolid and quinpristin/dalfopristin. In another study 50- 60% enterocci isolates were resistant to all antibioties tested.25 In present study gram negative bacilli showed high resistance rate to majority of antibiotics. Other workers also have reported majority of gram negative isolates in their study as multidrug resistant.16 Ampicillin/sulbactam, ceftriaxone and other cephalosporins, quinolones (ciprofloxacin) showed high resistance for gram negative bacteria. These drugs have been commonly over used in out patients for many years hence high resistance rate is expected. The alarming finding in the present study was higher rate of resistance in enterobacteriaceae to cephalosporins which is a marker for presence of ESBL. In present study 61.5% isolated strain of enterobacteriaceae showed positive ESBL test. In India ESBL production among enterobacteriaceae has been reported to be between 74.4 %- 80.9%. This high rate of resistance to cephalosporin is due to abundant use of cephalosporins in the hospitals. It is a very trouble some development as the mortality is reported much higher with ESBL producing enterobacteriaeae. High resistance rate of gram negative bacilli can also be explained by the site where our study was performed (ICU‘s only) and the higher percentage of extended spectrum β-lactamases among gram negative bacilli (61.5%) which limits the therapeutic options in infection caused by such strain due to two broad factors: cross resistance (eg. to aminoglycosides, cotrimoxazole or fluoroquinolones) and the spectrum of these enzymes. In all vancomycin, linezolid and quinpristin/dalfopristin were most effective drugs for gram positive pathogens whereas amikacin and carbapenams were most active for gram negative bacilli(Enterobacteriaceae). Although the number of nonfermenters isolated in present study was less but the alarming finding was that isolated nonfermenters were multi drug resistant sensitive to only tigecycline and colistin (Data not shown). Doripenam and tigecycline are now available but with the degree of resistance encountered it is a matter of time before these antibiotics are exhausted. CONCLUSION The present retrospective analysis provided much needed information on the distribution of bacterial pathogens in blood stream infections and their antibiotic resistance pattern. The study conducted showed both Gram positive and Gram negative bacteria were responsible for blood stream infections. We observed resistance to several antimicrobial agents used as a first line and inexpensive treatment of BSI,such as ampicillin,penicillin,gentamicin,ciprofloxacin. The rise in antibiotic resistance in blood isolates emphasizes on rational and judicious use of antibiotics according to the antibiotic susceptibility/ resistance pattern of the institution. Specific antibiotic utilization strategies like antibiotic restriction, combination therapy and antibiotic recycling may help to decrease or prevent the emergence of resistance. Moreover there is need for strict aseptic precaution and sound infection control practices on the part of health care workers. These results also highlights the important role of local microbiology laboratories to detect resistance or reduced susceptibility in time to assist in evidence based antimicrobial treatment, to provide a baseline reference data for future studies, to detect changing trends in antimicrobial resistance pattern of pathogen at earliest thus can help in setting up priorities for focused intervention efforts and in formation of antibiotic prescribing and infection control policies of institution. Our result seem helpful in providing useful guidelines for choosing an effective antibiotic in cases of septicemia and for choosing salvage therapy against multidrug resistant strain.Our result should be interpreted cautiously since the study included a single referral hospital with few numbers of bacteria isolates as well as short study period.
ACKNOWLEDGEMENT
Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1762http://ijcrr.com/article_html.php?did=17621. Diekma DJ, Beekman SE, Chapin KC et al. Epidemiology and outcome of nosocomial and community onset bloodstream infection. j Clin Microbiol 2003; 41: 3655-60.
2. Young LS. Sepsis syndrome. In: Mandell GL, Bennett JE, Dolin R, eds. PrincipleandPracticeofinfectiousdiseases. Churchill Livingstone,1995; 690-705.
3. Warren DK, Zack JE, Elward AM, Cox MJ, Fraser VJ. Nosocomial primary bloodstream infections in intensive care unit patients in a non teaching community medical center : a 21-month prospective study. Clin Infect Dis 2001; 33 :1329-35.
4. Jang TN, Kuo BI, Shen SH, Fung CP, Lee SH, Yang TL, et al. Nosocomial Gram negative bacteremia in critically ill patients: epidemiologic characteristics and prognostic factors in 147episodes. Jformos Med Assoc 1999; 98 : 465-73
5. National Nosocomial Infections Surveillance (NNIS) system report,data summary from January 1992-April 2000, issued June 2000. AmJ Infect Control 2000; 28:429–48
6. Edmond MB, Wallace SE, McClish DK, Pfaller MA, Jones RN, Wenzel RP. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clin Infect Dis 1999; 29:239–44
7. Diekema DJ, Pfaller MA, Jones RN. Agerelated trends in pathogen frequency and antimicrobial susceptibility of bloodstream isolates in North America. SENTRY Antimicrobial Surveillance Program,1997– 2000. Int J Antimicrob Agents 2002; 20:412-8.
8. Diekema DJ, Pfaller MA, Jones RN, Doern GV, Winokur PL, Gales AC, Sader HS, Kugler K, Beach M: Survey of bloodstream infections due to gram-negative bacilli: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, and Latin America for the SENTRY antimicrobial surveillance program, 1997. Clin Infect Dis 1999; 29:595-607.
9. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM, CDC definations for nosocomial infections,1988.Am J Infect Control 1988;16:128-40..
10. National Committee for Clinical Laboratory Standards: Performance standards for antimicrobial susceptibility testing : 2009. In Supplemental tables, M100-S19. NCCLS, Wayne, PA; 2009
11. Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 2000; 118:146–55.
12. Falagas ME, Bakossi A, Pappas VD, et al. Secular trends of blood isolates in patients from rural area population hospitalized in tertiary center in a small city in Greece. BMC Microbiology 2006; 6: 41. Availabel at URL http://www.biomedcentral.com/1471- 2180/6/41
13. Roy I, Jain A , Kumar M, Agarwal SK:Bacteriology of Neonatal Septicaemia in a Tertiary Care Hospital of Northeren India. Indian Journal of Medical Microbiology, 2002;20:156-59.
14. Arora U Devi P. Bacterial profile of blood stream infections and antibiotic resistance pattern of isolates. J K Sci 2007; 9:186-190.
15. Garg A, Anupurba S, Garg J et al: Bacteriological Pro-file and Antimicrobial Resistance of Blood Culture Iso-lates from a University Hospital. JIACM 2007; 8 (2): 139-43.
16. Sharma M, Goel N, Chaudhary U Aggarwal R, Arora DR. Bacteraemia in children. Indian J Pediatr 2002; 69:1029-32
17. Kumhar GD, Ramachandran VG and Gupta P: Bacteriological Analysis of Blood Culture Isolates from Neonates in a Tertiary Care Hospital in India. J Health Popul Nutr 2002; 20 (4): 343-347.
18. Polymicrobial bacteraemias in England, Wales and Northern Ireland:2003. CDR Weekly 2003;14: No.51.
19. Nimra LF, Batchoun R. Communityacquired bacteraemia in a rural area: predominant bacterial species and antibiotic resistance. J Med Microbiology 2004; 53:1045-49.
20. Karlowsky JA, Jones ME, Draghi DC, Thornsberry C, Sahm DF, Volturo GA. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002. Annals of clinical microbiology and antimicrobials 2004;3:7.
21. Ahmed SH, Daef EA, Badary MS, Mahmoud MA, Abd-Elsayed AA.Nosocomial blood stream infection in intensive care units at Assiut University Hospitals (Upper Egypt) with special reference to extended spectrum β-lactamase producing organisms. BMC Research Notes 2009, 2:76
22. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB: Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004, 39:309-17.
23. Narain S, Shastri JS, Mathur M, Mehta PR. Neonatal systemic candidiasis in a tertiary care centre. Indian Journal of Medical Microbiology, 2003;21:56-58
24. Chakrabarti A, Chander J , Kasturi P , Panigrahi D.Candidaemia: a 10 -year study in an Indian teaching hospital. Mycoses1992:35:47-51.
25. Kumar Surinder,Rizvi Meher,Vidhani Shalini,Sharma VK.Changing face of septicaemia and increasing drug resistance in blood isolates. Indian journal of medical microbiology,2003;21;56-58.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesCOMPARISON OF THE EFFECT OF PROPHYLACTIC KNEE BRACE ON STATIC BALANCE AMONG COLLEGIATE FOOTBALL PLAYERS USING DOMINANT AND NON DOMINANT LEG
English163167Md. Javed KhanEnglish Shibli NuhmaniEnglish Chaya GargEnglish Mamta LodwalEnglish Moazzam H KhanEnglishObjective: To find out and compare the effect of prophylactic knee brace on static balance among collegiate football player in dominant and non dominant leg. Design: Experimental study. Setting: Jamia Hamdard University, Participants: 60 male healthy collegiate football players. Main Outcome Measure: Static balance. Results: It was seen that the two groups i.e. dominant leg and non dominant leg has yielded no significant improvement in static balance within group and between groups. There was no significance difference data in static balance in dominant leg without brace and with brace (p=0.983) and non dominant leg without brace and with brace (p=0.53). Between groups analysis there was also no significant differences in static balance (p=0.993). Conclusion: The finding suggests that there was no improvement in static balance in dominant and non dominant leg without brace and with brace in healthy collegiate football player.
EnglishProphylactic Knee Brace, Static Stability, dominant and non dominant legINTRODUCTION
A brace can be defined as a device that claps objects together to resist deforming forces and to support weakened structure1 .External bracing is used for prevention of knee injuries, enhancement of performance andprevention of giving way in an injured knee. Knee injuries account up to 60% of all sport injuries, with the ACL accounting for almost half the knee injuries. The medial collateral ligament is one of the most commonly injured ligaments of the knee in football players. Most injuries result from a valgus force on the knee8. Knee injuries continue to plaque the athletic population especially in the sports of football. Advances in the treatment and rehabilitation of sports related knee injuries and have hastened recovery time and subsequent return to sport. However, prevention of knee injuries remains elusive despite attempts to limit the frequency and severity of knee injuries and is used primarily in football. Prophylactic knee braces are designed to reduce the likelihood or severity of knee ligament injuries in a relatively normal knee There are two basic design of prophylactic knee braces4 .Lateral bar with various hinge designs strapped to soft tissue, Medial and lateral bars with plastic cuffs or straps as well as various as well as various hinges. Knee braces grip bone indirectly through soft tissue. Pressure applied to skin is transmitted to the underlying fat, muscle, blood vessel and nerve. This external compression from the brace increase intramuscular pressure6 . Researchers have conducted many epidemiological studies on the effectiveness of prophylactic knee braces on knee injury prevention, some reported reduction of knee injuries and other reported an increase in knee injuries3 and some reported no effect4 . Psychological support may be the greatest benefit in footballer when using prophylactic knee brace. Balance can be defined as the ability to maintain or make adjustment in order to keep the body‘s centre of gravity over the base of support (Irrangle et al 1994, Nashner 1993). Somato sensory information from the feet in contact with the support surface is the preferred sensory input for the control of balance in healthy athlete 9 . Centre of balance data can be considered a proprioceptive measurement as assessed in the closed kinematic chain. Normal centre of balance can be defined as point between the feet where the ball and heel of each foot has 25% of body weight10 . The balance developed however, is static in nature and thus it improves balance in which you must hold the body in one position. There is no transfer to active sports in which there is dynamic movements. To improve balance, especially dynamic balance is needed in sports. You must do active movements and at the same time, keep your body in balance5 . Stability of knee joint is maintained by the shape of the condyles and menisci in combination with passive supporting structure. These are the 4 major ligaments, anterior cruciate ligament, Posterior Cruciate Ligament, Medial Cruciate Ligament and Lateral Cruciate Ligament. Significant contributions are also made by the postero-medial and posteo-lateral capsular components and the ilio-tibial tract. The muscle acting over the joint provide secondary dynamic stability7 MATERIALS AND METHODS A sample, consisting total of 60 healthy male football players, between 18 to 26 yrs participated in the study. All the subjects were informed about the nature, purpose, and possible risk involved in the study and an informed written consent was taken from them prior to participation. Subjects were randomly assigned into two groups. Group A- Dominant leg, Group B- Non dominant leg. Static stability was checked on dominant leg and non dominant leg without brace and with brace both the sides. Procedure: Prior to testing subjects were given a trail of 2 minutes with and without prophylactic brace. Then subjects were asked to stand with one limb with other limb raise so that raised foot is near but not touching the ankle of their stance limb. Each subject were asked to focus on a spot on the wall at eye level in front of him for duration of eye open test, prior to raising the limb the subject were instructed to cross his arms over his chest. The investigator used stop watch to measure amount of time the subject is able to stand on one limb. Time commenced when the subjects raised the foot off the flow, time ended when the subject either 1. Used his arms (uncrossed arm) 2. Used the raised foot (move it toward or away from the standing limb or touched the floor) 3. Moved the weight bearing foot to maintain his balance (i.e. rotate foot on the ground) 4. A maximum of 45 seconds had elapsed The procedure is repeated 3 times and each time is recorded on data collection sheet. The best of the average of 3 is recorded. At least 3 minutes of rest were allowed between 3 trail tests to avoid fatigue.
RESULTS
Within group analysis:- The comparison for within group differences was using Paired Sample T-Test which was conducted to see differences between dominant and non dominant leg without brace and with brace. Dominant side: There was no significance difference data in static balance in dominant side without brace and with brace (p=0.983) (refer Table 1) Non dominant leg: There was no significance difference data in static balance in non dominant side without brace and with brace (p=0.053) (refer Table 2)(refer graph 1) Between group analysis: Between group analysis using Independent Samples Test showed no significance difference in dominant and non dominant leg without brace and with brace (p=0.993) (refer Table 3) (refer graph 2) DISCUSSION The purpose of this study was to determine whether wearing a prophylactic knee brace design improves static balance to the dominant and non dominant leg. A total of 60 healthy subjects were participated in the study. In groupA, 60 subjects with dominant side without brace and with brace evaluated. In other group -B 60 subjects non dominant side, without brace and with brace evaluated. Static balance was the outcome measure of the study. The static balance was measured by unipedal stance test (UPST). All the variables were measured before and after applying the brace. Results showed both the groups, dominant leg and non dominant leg don‘t have significant differences in the static balance. However, no improvements in static balance in healthy collegiate football players within the group and between the groups using prophylactic knee brace. Barrett et al 11 suggested that wearing a knee brace improves joint position sense in knees in which proprioception is impaired. Our subjects did not have a history of such joint position deficits and used healthy subjects with no history of knee problems. Hansen 12 showed no deficits in isokinetic muscle performance while wearing prophylactic knee braces. Several studies using the Acro Brace (the precursor to the McDavid Knee Guard) indicated that this prophylactic knee brace had no effect on running, speed and agility (A Johnson, unpublished data, 1969 and TL May, unpublished data, 1981) 13 A similar study by Clover (unpublished data, 1983) showed no decline in running speed while wearing the Anderson Knee Stable. Down et al (unpublished data, 1990) reports that wearing of a prophylactic knee brace on each knee did not change the overall timing of the gait cycle or range of motion at the knee, hip and ankle joint. Regalbuto et al 14 showed that brace placed incorrectly or positioned improperly caused changes in the forces generated at the knee joint. Retrospectively, researchers began conducting longitudinal studies comparing injury rates before and after the prophylactic knee brace was being used. Subsequently, the results of these long-term epidemiological studies suggest that prophylactic knee bracing does not reduce the incidence and/or severity of injuries to the knee joint of college football players. Hansen 88 and Clover (unpublished research, Riverside, Calif, 1984) suggesting that prophylactic knee brace's have no effect on isokinetic muscular function. Knee bracing improved centre of balance under one dynamic condition during the double leg stance. There was no difference in centre of balance between the braced and un braced groups during the single leg stance while on a stable or dynamic condition. Currently footballers are using different type of braces like McDavid Knee Guard and Acro Brace etc. the type of brace we used in the study was Tynor Knee Brace. So before reaching a final conclusion prophylactic knee braces have no significant effect on static balance. The effect of other braces on balance also has to be checked. Healthy collegiate football player used to undergo lots of different type of training session which improves the balance. This may be another reason which does not give any significant improvement in static balance after applying of knee braces. The finding of the present study failed to show any significant improvement in static balance of collegiate football players after the application of prophylactic knee brace. CONCLUSION The finding of the study suggests that there was no improvement in static balance in dominant and non dominant leg without brace and with brace in healthy collegiate football player. ACKNOWLEDGEMENT The authors acknowledge the immense help received from the scholars whose articles are cited and included in the 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1763http://ijcrr.com/article_html.php?did=17631. Drez D: Knee braces. In Jackson D, Drez D : The Anterior Cruciate Deficient Knee. St. Louis, Mosby, 1987, pp 286-289
2. Wirth M, Delee J: The history and classification of knee braces. Clin Sports Med 9:731-736, 1990
3. Thomas W Kaminski, David H Perrin; effect of prophyla
4. Ian Chen, Paul D Kim, Christopher S Ahmad William M Neville; Cur Rev Musculoskeletal med [2008] 1:108-11
5. Albright JP, Powell JW, Smith W et al; medial collateral ligament knee sprain in high school football players; Journal of Sports Medicine 22:12-18, 1994
6. Lundin O, Styf J: Intramuscular pressure varies with the tensile force used at knee brace application. Trans Orthop Res Soc 310, 1993
7. Trinath K Kakarlapudi West J Med. 2001 April; 174 (4): 266-272
8. Ian Chen, Paul D Kim, Christopher S Ahmad William M Neville; Cur Rev Musculoskeletal med [2008] 1:108-113
9. Deppen RJ, Iand fried MJ, efficacy of prophylactic knee bracing in high school football players, J Orthop Phys Ther 1994; 20:243-246
10. Hartel JN; effect of lateral ankle joint anesthesia on joint position sense, postural sway and centre of balance. Charlottesville, VA, University of Virbinia 1994
11. Barrett DS, Cobb AG, Bentley G. Joint propioception in normal, osteoathritic and replaced knees. J Bone Joint Surg Br. 1991; 73B: 53-56
12. Hansen BL, The Effect of the Anderson Knee Stabler on Strenght, Power, and Endurance of the Quadriceps and Hamstring Muscle Groups. Boulder, CO: University of Colorado; 1981.
13. Hawkins HA. Effect of the Arco Knee Guard on Running Speed. Terre Haute, IN: Indiana State University; 1977. Thesis
14. Regalbuto MA, Rovick JS, Walker PS. The forces in a knee brace as a function of hinge design and placement. Am J Sports Med. 1989; 17:535-543
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareSCREENING OF SUBCLINICAL SENSORY IMPAIRMENT IN HAND AMONG DIABETIC BLINDS
English168176Janakiraman BalamuruganEnglish Ravichandran HariharasudhanEnglishBackground: Prior to hand rehabilitation of blinds with diabetic retinopathy, assessment of tactual deficits is the key towards the functional outcomes of rehabilitation. Force sensitivity threshold and spatial resolution testing are easy tools in detecting subclinical impairment of peripheral nerves. Both are reliable, less expensive, very accurate and less time consuming in detecting sensory deficits. This study
attempts to use force sensitivity threshold and spatial resolution testing to identify subclinical sensory impairment in hand among diabetic blinds. Objectives: To identify subclinical diabetic peripheral neuropathy in late blind adult subjects with diabetic retinopathy. Study Design: Observational study. Study Setting: Opthalmology and Endocrine departments of Madha Medical College and Hospital, Chennai and Sree Balaji Medical College Hospital, Chennai. Interventions: Not applicable. Outcome measures: Quantitative parameters include cutaneous force threshold and spatial resolution threshold. Methods: Sixty participants of three different categories, twenty in each category, participated in the study. The 20 subjects of each group (Diabetic blind group, Non Diabetic late blinds, and Blind folded sighted group) were subjected to force sensitivity threshold test and tactile spatial resolution test after obtaining consent. Statistical Analysis: The data was analyzed using one way ANOVA and Kruskal Wallis test, 5% level of probability was used to indicate statistical significance Result: The mean of force sensitivity among Experimental group consisting of diabetic blinds was 1.127gm, (S.D: 0.99, range: 0.04-
2.00), mean of spatial resolution capacity of static 2 point test was 3.25mm, (S.D: 0.76, range: 2 - 4), moving 2 point test was 2.85mm (S.D: 0.489, range: 2 - 4). Control group 1, mean force sensitivity was 0.3415gm, (S.D: 0.715, range: 0.02-2.00), mean of spatial resolution capacity of static 2 point test was 1.80mm, (S.D: 0.41, range: 1 - 2), moving 2 point test was 1.10mm (S.D: 0.308, range: 1 - 2). Control group 2, mean force sensitivity was 0.64gm, (S.D: 0.91355, range: 0.04-2.00), mean of spatial resolution
capacity of static 2 point test was 2.20mm, (S.D: 0.41, range: 2 - 3), moving 2 point test was 1.50mm (S.D: 0.513, range: 1 - 2). Conclusion: The study result shows that there is a significant difference between the groups. Diabetic blinds performed significantly poorer than the controls in terms of Force sensitivity threshold and spatial resolution.
EnglishDiabetic retinopathy, Diabetic neuropathy, Monofilament testing, Two Point discrimination tests, hand rehabilitation.INTRODUCTION
Sense of touch is a critical component of normal tactile hand function and provides us the ability to effectively perceive and manipulate the environment with our hand28. Diabetic retinopathy is an ocular neurovascular complication which has emerged as one of the fore most cause of blindness 20 years ago7, 21 . The age of onset for Diabetes mellitus has also gone down considerably so, people who get Diabetes early in their life is at greater risk of developing Diabetic neuropathy4 . Paramedic those who dealt with diabetic blinds has reported that tactual disturbances caused by Diabetic peripheral neuropathy is a major impedance and residual tactile sensitivity is an important predictor of outcomes of hand rehabilitation5, 27 . It‘s very important to understand that in subjects with total or partial visual compromise, the sensorimotor ability of hand will determine the quality of life and degree of independence6 . So the re-education and rehabilitation of the diabetic blinds is banked on their intact sensory cues and sensory integrity 18. There are only few studies that have really emphasized focus on addressing the sensory deficits of upper extremities in Indian diabetic subject. In contrast more studies were love on more sensorimotor function of the lower extremities in diabetic subjects8 . In order of decreasing sensitivity for two point discrimination, the tongue was found to be most sensitive, followed by the lips, fingers, palm, toes, forehead16(Weber‘s and Weinstein 1968)17. Motor control alone doesn‘t ensure skilful use of hand; rather, the synthesis of movement and sensitivity endows the hand with its exquisite abilities9 . So, greater the loss of sensibility the more significantly the hand function is impaired1 . The static and moving two point discrimination tests are tests of innervations density to find out the ability to discriminate between two identical stimuli placed close together on the skin2 . The monofilament discrimination test assesses the threshold of stimulus necessary for the perception of light touch to deep pressure and its value in detecting early nerve changes3 . Sensory deficits precedes the clinical onset of Peripheral neuropathy in Diabetes Mellitus subjects (Ozaki I 2001)26. To build a pre evaluation test battery is essential towards the special challenges faced by blindness rehabilitation professionals10. This study quantifies sensibility deficits in diabetic blinds.
MATERIALS AND METHODS
All the subjects were approached through private advertisement and through demographic data collected from various eye and diabetic rehabilitation centres. A total of 60 subjects of three different categories were approached for their consent to participate in the study after their willingness, the subjects were explained about the procedures of screening after inclusion and exclusion criteria‘s were done. All 60 subjects were right handed, both sex and with age limit of 55 – 65 years. The data collection was done in Madha college of physiotherapy. Inclusion criteria for, Experimental Group (diabetic blinds) are total duration of diabetes > 15 years, duration of blindness ≥ 5 years11, for Control Group 1 (Non Diabetic late blind) was subjects without Diabetes mellitus as a cause for blindness. Inclusion for Control Group 2 (Blind folded sighted subjects) was Non-Diabetic sighted subjects. Exclusion criteria for all groups were previously diagnosed Peripheral neuropathy25 , any systemic or regional diseases affecting sensory functions, Cervical disc disease or spondylosis, radiculopathies, any central nervous system disorders, Cognitive disorders15,24 . Among the three groups the Diabetic blind group contains 20 diabetic late blind subjects with the cause of blindness was diagnosed by Physician as Diabetic retinopathy, the period of blindness being 5 years. The other two group i.e., Late blind group contains 20 non diabetic blind adult subjects and normal blinded sighted group contains 20 subjects. In keeping with BellKorotsky testing procedures 5 set monofilaments of different colour like Blue, Purple, Orange, Light red, and Dark red of increasing diameters was used to assess / evaluate the force threshold sensitivity of subjects in their finger pads in their right hand12. Cutaneous force sensitivity threshold were measured in grams. The patient‘s hand is fully supported and vision occluded (control group 2). The subject is instructed to give a verbal response when the filament is felt. The stimuli were applied with sufficient force to just produce skin deformation13. Static and moving two point discrimination test was then performed in sitting position, with the right hand supported on a table and vision occluded using a discrimination device the millimeter calibrations of the device is checked for its validity22. The device has adjustable ends so the width between the ends was varied in millimeter increments. One or Two points were randomly applied parallel to the longitudinal axis of finger pulps13, 25. To eliminate the subject ability to guess the answers almost/at most care was taken to ensure that 2 point was applied at same time and with equal force14. The subjects were instructed to respond by verbal answers, if the subject were not able to accurately detect two points, the width between the points is increased until the two points were perceived30. To acquire accuracy and reliability the sensory testing requires concentration by the patient and should be performed in a great distraction free environment19 .
STATISTICAL ANALYSIS AND RESULTS
For statistical calculations, the mean of force sensitivity threshold and spatial resolution of three groups was used. The results were evaluated with one way Analysis of variance/ Non – parametric Kruskal wallis test were done with the help of SPSS package 1.4 for windows. The mean of Experimental Group consisting of Diabetic blinds was 1.127gm, (S.D – 0.99, range- 0.04-2.00), mean of spatial resolution capacity of static 2 point discrimination test was 3.25mm, (S.D – 0.76, range- 2 - 4), moving 2 point discrimination test was 2.85mm (S.D – 0.489, range- 2 - 4). Control Group 1, mean force sensitivity was 0.3415gm, (S.D – 0.715, range- 0.02-2.00), mean of spatial resolution capacity of static 2 point discrimination test was 1.80mm, (S.D – 0.41, range- 1 - 2), moving 2 point discrimination test was 1.10mm (S.D – 0.308, range- 1 - 2). Control Group 2, mean force sensitivity was 0.64gm, (S.D-0.91355, range0.04-2.00), mean of spatial resolution capacity of static 2 point discrimination test was 2.20mm, (S.D – 0.41, range- 2 - 3), moving 2 point discrimination test was 1.50mm (S.D – 0.513, range- 1 – 2) (Table 1). There is a significant difference when comparing Diabetic blind group with the Non diabetic late blind group and Blind folded sighted groups. The significance was set as P < 0.01. This significance existed in both Force threshold and spatial resolution testing methods, implies that Diabetic blinds are bilaterally prone to loss of tactile sensation along with the blindness caused by retinopathy, while the data‘s of blindfolded sighted subjects and non diabetic late blinds were kept as the reference values.
DISCUSSION
Diabetic retinopathy is responsible for 4.8% of the 37 million cases of blindness due to eye diseases throughout the world i.e. 1.8 million persons (WHO 2010 released to IAPB). The evaluation of hand sensation is of paramount importance in guiding the hand rehabilitation outcomes among Diabetic retinopathy blinds. It assesses the patient's current ability of tactile functions and forms a basis for constructing an effective screening tool and hand rehabilitation approach for Diabetic blind subjects, who mostly relies on their dominant hand in future for their object localisation and identification. The current study clearly shows that there is significant evidence suggestive of detectable sensory impairment in diabetic blind adults prior to the appearance of clinical symptoms of peripheral neuropathy. Interestingly Table 1 shows that non diabetic blinds are more sensitive to cutaneous force sensitivity and more spatially accurate than the control group 2. The same has been supported by Daniel Goldreich et al (2003). This noteworthy tendency is attributed to the increased manual experience in the non diabetic blind controls, which resulted in sensory enhancement effect and shows statistical significance Bernbaum et al (1989). Though the tools used in current study possess high reliability and validity, the slightest limitation of this study would be the usage of 5 set nylon monofilaments; future studies can be performed with multiple fraction sets like a 14 set monofilament to easily identify subclinical sensory impairment in diabetic patients so as to prevent complications.
CONCLUSION
This study with the statistical results (figure 1) concludes that diabetic blinds are also impeded by peripheral neuropathic changes in the upper limb nerves, along with Diabetic retinopathy. This may pose a mammoth challenge for hand rehabilitation professionals, treating these subjects. Both cutaneous force sensitivity threshold and spatial resolution testing have proved to be very reliable in identifying the subclinical changes in the peripheral nerves of Diabetic blind subjects.
CLINICAL IMPLICATIONS
Early diagnosis helps prevention and improves prognosis. So to develop a sensory evaluation tools to identify sensory impairment sustained by diabetic blind subjects due to upper limb peripheral neuropathy, which is important to hand rehabilitation professionals to develop a appropriate prevention program and rehabilitation protocol.
ACKNOWLEDGEMENT
We acknowledge the immense help received from the scholars whose articles are cited in references of this manuscript. The authors are also grateful to editors, reviewers and publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. We are also indebted to the following people for their support, guidance, patience and willingness to share their time and expertise. Prof. V. Anandh, Principal, Saveetha college of PT for his moral support. Mr.S.Nagaraj and P.Anandha raja Asst Professors Madha college of PT for their constructive comments. We humbly acknowledge Dr. Karim, HOD, Opthalmology dept, Sree Balaji Medical college and Hospital for his immense contribution by guiding us to get patients. support and encouragements.
Englishhttp://ijcrr.com/abstract.php?article_id=1764http://ijcrr.com/article_html.php?did=17641. Von Prince K and Butler, B. Measuringsensory function of hand in peripheral nerve injuries, American journal of Occupational therapy, 6: 385, 1967.
2. American society for surgery of the hand: The hand examination and diagnosis, ed. Z, Churchill Livingstone, Newyork, 1983, Page-106.
3. Bell-Krotoski;- Jand Tomana K.L: The repeatability of testing with Semmes Weinstein Monofilaments, Journal of hand surgery 12A (11): 155, 1987.
4. Martin JH, ?Receptor physiology and submodality coding in the somatic sensory system?, Principles of neural science, 2nd edition, Elsevier, Newyork, 1985, Pg- 287- 300.
5. Dellon, AL, ?Evaluation of sensibility and reeducation of sensation in the hand?, Williams and Wilkins, Baltimore, 1981, Pg: 29.
6. Dr. Rajiv Gupta, "Diabetes in India: Current Status" Express Health Care Magazine, August 2008.
7. A Ramachandran, AK Das et al, "Current Status of Diabetes in India and Need for Novel Therapeutic Agents", JAPI, June 2010, V0l: 58, Pg No:7 – 9.
8. Dr Aravind,"Diabetic retinopathy screening", Vol. 6 No.9 August and September 2010.
9. Saumya Paul et al, "Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN–DREAMS III): Study design and research methodology", BMC, Optholmology, Vol:7, 2011.
10. Mcintyre AK, ?Cutaneous receptors; The physiology of Peripheral nerve disease?,WB Saunders, Philodelphia, 1980.
11. Kandel, ER, ?Central representation of touch: Principles of neural science? 2nd edition, Elsevier, New York, 195, Pg: 323- 325.
12. Werner JL et al, ?Evaluating cutaneous pressure sensation of the hand?, American journal of occup ther, 24: 347, 1970.
13. Bell JA, ?Light touch-deep pressure testing using Semme Weinstein monofilaments?, Rehabilitation of hand, 3rd edition, CV Mosby, Philodelphia, 1990, pp: 585-593.
14. American society for surgery of the hand, ?The hand examination and diagnosis?, 2nd edition, Churchill livingstone, Newyork, 1983, pp:106.
15. Louis et al, ?Evaluation of normal values of for stationary and moving two point discrimination in the hand?,J Hans surg, 9A,(4),552, 1984.
16. Bell Krotoski j and Tomanak, ?The repeatability of testing with Semmes – Weinstein monofilaments?, J hand surg, 12A (11):155, 1987.
17. Levin SL, et al, ?Von frey's method of measuring pressure sensibility in the hand? J hand surg, 3(3), 211, 1978.
18. American Diabetes Association. Diabetes 2001: vital statistics. Washington (DC): American Diabetes Association; 2002.
19. Perkins BA. Diabetic neuropathy: a review emphasizing diagnostic methods. Clin Neurophysiol 2003; 114:1167-75.
20. Rahman M. How peripheral neuropathy should be assessed in people with diabetes in primary care A population-based comparison of four measures. Diabet Med 2003,20:368-74.
21. Bernbaum M, Albert SG, McGarry JD. Diabetic neuropathy and Braille ability. Arch Neurol 1989;46:1179-81.
22. Casanova JE, Casanova JS, Young MJ. Hand function in patients with diabetes mellitus. South Med J 1991;84:1111-3. 23. Lederman SJ. Tactual roughness perception: spatial and temporal determinants. Can J Psychol 1983;37:498- 511.
24. Turvey MT. Dynamic touch. Am Psychol 1996;51:1134-52.
25. Gibson JJ. The senses considered as perceptual systems.Boston:Houghton Mifflin;1966.
26. Moberg E. Criticism and study of methods for examining sensibility in the hand, Neurology 1962;12:8-19.
27. Oldfield RC. The assessment and analysis of handedness. The Edinburgh Inventory. Neuropsychologia 1971; 9:97-113.
28. Lamb GD, Tactile discrimination of textured surfaces:psychophysical performance measurements in humans. J Physiol 1983; 338:551-65.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22TechnologyOPTIMIZATION AND VALIDATION OF FORECASTING PARAMETERS TO QUANTIFY BULL-WHIP EFFECT IN A SUPPLY CHAIN
English177190T.V.S. RaghavendraEnglish A. Rama Krishna RaoEnglish P.V.ChalapathiEnglishSupply chain is a bridge between demand and supply. It conveys the demand to the supply point and
delivers the quantity to the demand point. It is a network, that facilities the functions of procurement of
materials, transformation of these materials into intermediate and finished products and the distribution of
these finished products to customers. The Bullwhip Effect represents the information distortion in a
Supply chain. It represents the phenomenon where orders to supplier tend to have larger variance than
sales to the buyer. The customer demand is distorted. This demand distortion also propagates to upstream stages in an amplified form in the supply chain. The demand forecasting is one of the key-factors to influence the bull-whip effect. Winter‘s Triple Exponential smoothening model is applied to forecast the future demand. The purpose of this study is to analyze the impact of exponential smoothing parameters on the bullwhip effect for Supply Chain Management (SCM). A simulation model is developed to determine the Forecasted demand and bullwhip ratio value. Further, accuracy of Forecasting alculated by the Winter‘s model is examined by applying Tracking Signal Technique. A sensitivity analysis is done to experiment with the different values of parameters in the forecasting technique. It is found that longer
lead times and poor selection of forecasting model parameters lead to strong bullwhip effect in SCM. The
optimized values of parameters help to reduce the bullwhip ratio. The most significant managerial mplication of this study lies in applying best forecasting technique with accuracy testing of forecasting model, to mitigate the bullwhip effect. The managers are suggested to utilize the best exponential smoothing by selecting lower values for alpha and beta and a mid-value for gamma to keep the bullwhip
ratio low, besides the forecasting accuracy.
EnglishBullwhip ratio; Forecasting; Exponential smoothing constants; MAD; SCM; Tracking SignalINTRODUCTION
The sources of uncertainty in a supply chain, lie in the process of matching demand that includes delivery lead times, manufacturing yields, transportation times, machining times and operator performances [10], all lead to uncertainty in the supply chain performance. SCM includes a set of approaches and practices to reduce the uncertainty along the chain through enabling a better integration among `suppliers, manufacturers, distributors and customers [6]. It is the efficient management of the end-to-end process, which starts with the design of the product or service and ends with the time when it has been sold, consumed, and finally, discarded by the consumer‘‘ [12]. Demand forecasting is an essential tool for production and inventory planning, capacity management and the design of the customer service levels. The need to forecast the demand at each level of the supply chain amplifies the forecast errors, known as bullwhip effect in the supply chain. It represents the phenomenon where orders to supplier tend to have larger variance than sales to the buyer, and the customer demand is distorted [7]. This demand distortion also propagates to upstream stages in an amplified form. In return, high inventory levels and poor customer service rates along the supply chain constitute. They are the typical symptoms of bullwhip effect. In addition, production and inventory holding costs as well as lead times increase, while profit margins and product availability decrease [3][8]. In the earlier research, the similar problem is analytically examined by [1][2] for autoregressive demand structures and with linear trend in the demand, ignoring the demand seasonality.].This paper hence presents the sensitivity analysis part and validates forecasting accuracy using Tracking Signal concept. Setting of experimental design is identified, followed by simulation results. Conclusions are in the final section. A simulation model is developed to reduce the bullwhip effect with forecasting parameter optimization [9]. Tracking signal is computed by dividing the total residuals by their mean absolute deviation (MAD). If the tracking signal is within 3 standard deviations, then applied forecasting model is considered to be good enough. Literature survey Uncertainty can be defined as unpredictable events in a supply chain that affects pre-planned performance [5]. The bullwhip effect was first noticed and studied by [4] in a series of simulation analysis. He named this problem as ??demand amplification‘‘. It is suggested [11] that operations managers be provided necessary training on the bullwhip effect. However, [7] indicates that bullwhip effect is present, even though all members of the supply chain behave in an optimal manner unless the supply chain is redesigned with different strategic interactions. Of all causes, the major emphasis has been placed on demand forecasting. Researchers had developed different methodologies to explore the impact of demand forecast on bullwhip effect. Few AR models are developed to quantify the bullwhip effect [1] with the moving the average forecasting model in a two-level supply chain. Their findings support the significance of reducing lead times to mitigate the bullwhip effect. Under similar assumptions, [2] also investigated the double exponential smoothing forecasting technique for demand process with a linear trend. [13] The impact of forecasting parameters, demand patterns and capacity tightness of the supplier on the performance of the supply chain in terms of total cost and service level is investigated by [13]. In fact, demand forecasting has been recognized as one of the four main causes of the bullwhip effect [7]. As described by [9], Winter?s triple exponential smoothening model is used to determine forecasted demand and the optimized values of forecasting parameters are calculated. The changes occurring by altering the values of parameters in the given range is computed. The time horizon (Year) is divided into three seasons based on either actual demand for the product (or) seasonality index An attempt is made to analyze, the effect of changes in given range of optimal values of smoothening constants in the given season. Finally Tracking Signal values are computed to validate forecasting accuracy.
Model Development
The supply chain consists of four members as, a manufacturer, a distributor, a retailer and a consumer as shown in Fig 1.
An attempt is made to apply Winters? Triple Exponential Model to calculate the forecasted demand values for the given Factory, Distributors and Retailers data. Corresponding values of ordering quantity for Factory, Distributors and Retailers are calculated.
The Winter?s Triple Exponential Smoothing Model is used to calculate the forecast demand for Manufacturer, Distributors and Retailers. The formula as follows
At the beginning of each period, the retailer receives the delivery of the distributor. Mean while the actual customer demand emerges at the marketplace. The retailer fulfils the customer demand (plus back-orders if any) by on-hand inventory, and any unfulfilled customers demand are backordered. After the actual customer demand is satisfied, the retailer analyzes the historical demand data and makes a demand forecast. The retailer decides the quantity of items to order for the distributor using its inventory control policy. In this case, the manufacturer, Distributor and Retailer follows a simple “order up to policy” to manage the inventory. The ordering quantity is determined by the following relation.
Qt = Ft + z σt
Where Ft is forecasted demand, σt is the standard deviation of forecasting error and z is constant chosen to meet a desired service level. It should be noted that z is also known as the safety factor. Let the retailer selects a 95 % fill rate and selects a threshold z value of 1.65.Since the model explicitly analyzes the impact and focuses on the role of forecasting models on the bull-whip effect and this has a significant diversion from the model. A similar assumption has also been made in several studies [2].
According to [7], the bullwhip ratio is given by the relation
Comparative Analysis A comparative analysis is carried out for before and after application of Winters‘ triple exponential smoothening model to determine the forecasted demand, ordering quantity and bullwhip ratio. They are presented in Table 1 to Table 4. They are further illustrated graphically in Fig. 3 to Fig. 7. Sensitivity Analysis: The Part – I of sensitivity analysis deals with changes occurring in the values of bullwhip ratio, when for one parameter takes value in the specified range for 3 seasons and other two parameters are kept constant. They are presented in Table. 5. They are illustrated graphically in Fig. 8 to Fig. 13. The Part – II of sensitivity analysis deals with calculation and analysis of Tracking Signal for Factory, Distributor and Retailer‘s statistics on month-wise for 3 years. They are presented in Table. 6 and Table. 7. They are illustrated graphically in Fig. 14 and Fig. 15.
Development of Soft-ware Programme
A Computer programme is developed in ?C – Language?. It takes input values as Three years‘ actual demand statistics and values of α, β and γ
SENSITIVITY ANALYSIS
Part – I
Analyzing the effect Range of Values of α, β, γ on Bullwhip Effect
The values of Alpha varies in the range ( 0.7 to 0.9) while values of Beta and Gamma are kept at a constant values as 0.01 each. The values of Beta varies in the range ( 0.005 to 0.05) while values of Alpha and Gamma are kept at a constant values as 0.76 and 0.01 respectively. The values of Gamma varies in the range ( 0.005 to 0.05) while values of Alpha and Beta are kept at a constant values as 0.76 and 0.01 respectively. The values are presented in the Table 4.1.
Part – II :
Analyzing Tracking signal for both Retailer?s and Distributor's statistics
The values of Tracking signal for both retailers‘ and distributors‘ data is calculated and tabulated. The tabulated values are as shown below and analyzed to test the accuracy of forecasted model applied to the given data.
CONCLUSIONS
The Distributor and Retailer are advised to follow a specific Forecasting method to estimate the future forecasting demand and ordering quantity for next periods. Winters‘ Triple Exponential Smoothening model is suggested.
From the study of comparative analysis, the Bullwhip Ratio is minimum for Lower value of Alpha, lower values of Beta and small higher values of Gamma.
The Year is divided into Three Seasons namely Higher, Medium and Lower. An analysis of the relation between Bullwhip Effect with a range of values of Alpha, Beta and Gamma with variations of Seasonality is determined and the following inferences are drawn.
1) During High Seasonality, to minimize the Bullwhip Effect, the values of Alpha should be at the lowest.
2) During High Seasonality, to minimize the Bullwhip Effect, the values of Beta should be at the lowest.
3) During High Seasonality, to minimize the Bullwhip Effect, the values of Gamma should be at the lowest.
4) During Medium Seasonality, to minimize the Bullwhip Effect, the values of Alpha should be at the lower value near to optimal value.
5) During Medium Seasonality, to minimize the Bullwhip Effect, the values of Beta should be at the higher value.
6) During Medium Seasonality, to minimize the Bullwhip Effect, the values of Gamma should be at the lowest value.
7) During Low Seasonality, to minimize the Bullwhip Effect, the values of Alpha should be at the optimal value
8) During Low Seasonality, to minimize the Bullwhip Effect, the values of Beta should be at the optimal value.
9) During Low Seasonality, to minimize the Bullwhip Effect, the values of Gamma should be at the higher value.
After analyzing the phenomena (pattern) of Tracking signal for Retailer‘s Statistics, and Distributors‘ statistics, the following inferences are drawn
*Tracking signal curve for Retailers‘ Statistical data is having a range of +3.0 to - 3.0 for many months during the 3 years of time horizon considered, except with 2 peaks of over estimation at July 2007 and January 2009 months, as shown in Table 6 and followed by graph Fig 14.
*Tracking signal curve for Distributors‘ Statistical data is having a range of +4.0 to - 4.0 for many months during the 3 years of time horizon considered, except with 1 peak of over estimation at March 2010 month, as shown in Table 7 and followed by the graph Fig 15.
*Hence the applied winters‘ model is found to be more accurate.
Englishhttp://ijcrr.com/abstract.php?article_id=1765http://ijcrr.com/article_html.php?did=17651. Chen, Y.F., Drezner, Z., Ryan, J.K., SimchiLevi, D., 2000a. Quantifying the bullwhip effect in a simple supply chain: The impact of forecasting, lead times and information. Management Science 46, 436–443.
2. Chen, Y.F., Ryan, J.K., Simchi-Levi, D., 2000b. The impact of exponential smoothing forecasts on the bullwhip effect. Naval Research Logistics 47, 269–286.
3. Chopra, S., Meindl, P., 2001. Supply Chain Management. Prentice-Hall, Englewood Cliffs, NJ.
4. Forrester, J., 1961. Industrial Dynamics. MIT Press, Wiley, New York.
5. Koh, S.C.L., Gunasekaran, A., 2006. A knowledge management approach for managing uncertainty in manufacturing. Industrial Management and Data Systems 106 (4), 439–459.
6. Koh, S.C.L., Demirbag, M., Bayraktar, E., Tatoglu, E., Zaim, S.,2007. The impact of supply chain management practices on performance of SMEs. Industrial Management and Data Systems 107 (1), 103
7. Lee, H., Padmanabhan, V., Whang, S., 1997a. The bullwhip effect in supply chains. Sloan Management Review 38, 93–102
8. Metters, R., 1997. Quantifying the bullwhip effect in supply chains. Journal of Operations Management 15, 89–100.
9. T.V.S. Raghavendra, A. Ramakrishana, P.V.Chalapathi. 2011, Quantification of bullwhip effect with forecasting parameter optimization in a supply chain. International Journal of Industrial Engineering and Technique, volume 3, Number 4, pp 427- 444.
10. Simchi-Levi, D., Kaminsky, P., SimchiLevi, E., 2003. Designing and Managing the Supply Chain. McGraw-Hill, New York.
11. Sterman, J.D., 1989. Modeling managerial behavior: Misperceptions of feedback in a dynamic decision making experiment. Management Science 35 (3), 321–339.
12. Swaminathan, J.M., Tayur, S.R., 2003. Models for supply chain in E-business. Management Science 49 (10), 1387–1406.
13. Zhao, X., Xie, J., Leung, J., 2``002. The impact of forecasting model selection on the value of information sharing in a supply chain. European Journal of Operational Research 142, 321–344.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareSURGICAL RECONSTRUCTION OF INTERDENTAL PAPILLA USING AN INTERPOSED SUBEPITHELIAL CONNECTIVE TISSUE GRAFT: A CASE REPORT
English191197R.VijayalakshmiEnglish Plato PalanthingalEnglishPeriodontal plastic surgery enables enhanced esthetics in the anterior maxillary region. Reconstruction of
the interdental papilla is one of the most challenging and least predictable of treatments. Several surgical
and nonsurgical procedures to rebuild lost papillae have been presented; however, good results have been
elusive. A case report is presented here to demonstrate a technique by which a collapsed interdental papilla can be surgically reconstructed by a novel surgical procedure based on an advanced papillary flap combined with a connective tissue graft intended to augment the soft tissue in the interdental area.
EnglishPapilla reconstruction, black triangle, connective tissue graftINTRODUCTION
Periodontal plastic surgery enables enhanced esthetics in the anterior maxillary region where minor surgical procedures can improve gingival contour. One goal of periodontal plastic surgery is the reconstruction of the interdental papilla that has been lost1. Several surgical and nonsurgical approaches have been suggested to solve this esthetical problem. Orthodontic approximation can be combined with apical positioning of the contact point through stripping2 and in certain cases, change of the tooth contact area can also be achieved with appropriate restorative techniques. Periodic curettage stimulates the regrowth of interdental papilla3. Several surgical procedures that rebuild lost papilla have also been presented. Principles of papilla preservation combined with roll techniques have been reported4&5. A pedicle graft using a buccal semilunar incision with coronal displacement of the gingivopapillary unit and subepithelial connective tissue graft has also been applied6. Surgical reconstruction of interdental papilla with buccal and palatal thickness flap and a connective tissue graft has also been presented7. Insufficient blood supply is the major limiting factor in all the surgical papilla reconstructive and regeneration techniques. The recipient site of the interdental space borders the nonvascularized tooth surfaces, providing small surface area for grafting. Therefore techniques using pedicle or advanced flaps clearly shows better results than those with free grafts8. This case report presents a case in which the semilunar coronally repositioned papilla with connective tissue graft6 was used to surgically reconstruct lost papilla.
CASE REPORT
Case description
A 22 year old male presented with chief c/o spacing in his upper front tooth region. The patient was not medically compromised. Intraoral examination revealed, class I papilla loss [Fig 1], in 11,21 region according to Nordland and Tarnow classification9 . The treatment plan was to complete phase I therapy and after reevaluation, to proceed with surgical therapy. Informed consent was obtained from the patient. Ethical committee clearance was obtained for the same. Phase I therapy was completed for the patient. The site was re-evaluated after a period of 4 weeks. It was decided to proceed with the surgical phase. After administration of local anaesthesia, 1.8 ml of 2% xylocaine with adrenaline by infiltration, a semilunar incision is made between the mesial line angle of the teeth[11,21] in the alveolar mucosa with no.15 blade and a pouch-like preparation is performed into the interdental area [Fig 2]. Intrasulcular incisions are made with no.15 blade around the mesial and distal half of 11 and 21, to free the flap from the root surfaces and allow coronal displacement of the gingivalpapillary unit. The gingival-papillary unit was relieved using an Orban knife [Fig 3 and 4]. The soft tissue was completely released from the root and bone, and the whole flap became mobile, allowing for the coronal displacement of the papillary unit. A buccal or palatal void could be seen between the soft tissue and the bone. To maintain the whole unit coronally, the dead space was filled with connective tissue graft. A connective tissue graft [Fig 5], procured from the palate by trap door approach was placed into the pouch [Fig 6] to support the coronally positioned interdental tissue. Suturing of the semilunar incision was initiated with 4-0 black silk suture and primary closure was obtained [Fig 7]. Later the palatal donor site was sutured [Fig 8]. No periodontal dressing was used nor was antibiotic therapy recommended. The post operative care consisted of 0.12% chlorhexidine rinses 3 times a day for 4 weeks, with no mechanical cleansing of the interproximal area.
Follow-Up
Suture removal was done on the 10th postoperative day. Healing was uneventful. Six months after the procedure, the interproximal space was still completely filled and the height and volume of the reconstructed papilla had been maintained [Fig 9].
DISCUSSION
There may be several reasons for loss of papilla height and the establishment of black triangles between teeth. The most common reason in the adult individual is loss of periodontal support due to plaque-associated lesions. However, abnormal tooth shape, improper contours of prosthetic restorations and traumatic oral hygiene procedures may also negatively influence the outline of the interdental soft tissues10. The case presented here comes under class I of Nordland and Tarnow (1998) classification9. Since the distance between bone crest and contact point was ≤5mm and papilla height was less than 4mm, surgical intervention was proposed to increase the volume of the papilla11. Harvesting of the graft was performed just before the surgical detachment of the papilla to prevent the displacement of a blood clot between the bone and grafted connective tissue. Blood clots, even small ones might compromise immediate blood supply to the graft and therefore induce partial necrosis of the transplanted tissue12. The most predictable soft tissue grafting is achieved by the use of pedicle grafts because the blood supply is derived directly from the base of the mobilized flap. The pedicle flap along with submerged grafted tissue and the primary closure of the recipient site provides an environment of maximum blood supply to the grafted tissues. These factors, as well as the meticulous and careful management of the soft tissues, are important surgical considerations for a predictable and successful result13. Since the graft receives nourishment from all directions, flow of plasma and in growth of capillaries from surrounding tissues can be achieved. Depending on the extent of success following the procedure, it can be repeated after several months of healing. The present procedure can be combined with reshaping of the proximal contour of adjacent teeth to enhance results.
CONCLUSION
This case report has shown that the surgical technique using an interposed subepithelial connective tissue graft can regenerate a lost interdental papilla. The reconstructed papilla remained stable and without any signs of clinical inflammation 6 months after the surgery. Clinical studies using large sample sizes are necessary to determine the success rate and probability of this surgical technique. We hope that this case-report would become part of a meta-analysis in the future to help plan an evidence-based treatment.
ACKNOWLEDGEMENT
Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1766http://ijcrr.com/article_html.php?did=17661. Miller PD, Allen EP. The development of periodontal plastic surgery. Periodontology 2000.1996; 11:7-17.
2. Ingber JS. Forced eruption: Filtration of the soft tissue cosmetic deformities. International Journal of Periodontic and Restorative dentistry 1989; 9: 417-425.
3. Allen Shapiro: Regeneration of Interdental Papillae Using Periodic Curettage. The International Journal of Periodontics and Restorative Dentistry: 1985;5(5):27-33.
4. Beagle JR. Surgical reconstruction of the interdental papilla. Case report. International Journal of Periodontic and Restorative dentistry 1992; 12:145-151.
5. Nemcovsky CE. Interproximal papilla augmentation procedure. A novel surgical approach and clinical evaluation of ten consecutive procedures. International Journal of Periodontic and Restorative dentistry 2001:21; 553-559.
6. Han TJ, Takei HH. Progress in gingival papilla reconstruction. Periodontology 2000.1996:18; 467-473.
7. Azzi R, Etienne D, Carranza F. Surgical reconstruction of Interdental papilla. International Journal of Periodontic and Restorative dentistry 1998; 18:467-473.
8. Rappapart NH, Netscher DT. Plastic surgery techniques applicable to periodontal flap surgery. Periodontology 2000.1996; 11:95- 102.
9. Nordland and Tarnow. A classification system for loss of papillary height. Journal of Periodontology 1998; 69; 1124-1126.
10. Iyer Satishkumar Krishnan, Mohit G. Kheur: Esthetic considerations for the interdental papilla: Eliminating black triangles around restorations: A literature review. The Journal of Indian Prosthodontic Society: 2006; 6(4):164-169.
11. Jan Lindhe, Niklaus P Lang. In: Periodontal plastic surgery. Clinical Periodontology and Implant Dentistry 2008; 5:997.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareCORRELATION OF PERIODONTAL DISEASE SEVERITY WITH RHEUMATOID DISEASE ACTIVITY AMONG RHEUMATOID ARTHRITIS PATIENTS IN CHENNAI: A CROSS SECTIONAL STUDY
English198207A.M.Deva PriyaEnglish P.K.SaraswathiEnglish K.H.Pani ShankarEnglish M.G.Krishna BabaEnglishAim: The current study aims to determine whether there is a relationship between Rheumatoid arthritis
disease activity and severity of chronic periodontitis in the study population. Methods: 100 patients aged
20-70 years, diagnosed with Rheumatoid arthritis and Chronic periodontitis were selected for the study.
The rheumatoid disease activity was assessed using DAS 28 and severity of periodontitis was classified
based on clinical attachment loss. Physical disability was elicited using Indian Health Assessment Questionnaire and Oral hygiene status was measured using Oral Hygiene Index. Results: Among the 100 Rheumatoid Arthritis patients with periodontitis, 11 were males (11%) and 89 were females (89%). Rheumatoid disease activity showed no correlation with periodontal disease severity (r value 0.01,p value>0.05) . Functional disability of the patients showed a significant correlation with their oral hygiene
status (r value 0.232,p valueEnglishFunctional disability, Oral hygiene status, Periodontitis, Rheumatoid arthritisINTRODUCTION
Periodontal medicine is an emerging branch of Periodontology that has been establishing a strong relationship between periodontal and systemic health or disease1 . Studies have shown significant association between Periodontal Disease (PD) and coronary heart disease2 , diabetes3 , stroke4 , respiratory disease5 , preterm low birth weight delivery6 .Rheumatoid Arthritis (RA) has been included in the group of systemic diseases known to influence the periodontium. Periodontitis is a chronic destructive inflammatory disease of the supporting structures of the teeth. RA is a progressive inflammatory disorder characterised by proliferation of the synovial membrane and persistent uncontrolled inflammation resulting in chronic destructive polyarthritis7 . Both the diseases are chronic inflammatory diseases with excessive level of proinflammatory cytokines, Matrix MetalloProteinase (MMP) and prostaglandins and decreased level of Tissue Inhibitors of MMPs, eventually leading to destruction of hard and soft tissues. They are of different etiology but share similar pathologic, immunologic, environmental and genetic factors. Smoking and HLA-DRB1 shared epitope alleles are common risk factor for both the diseases 8, 9 . Porphyromonas gingivalis, an important periodontal pathogen possesses a unique enzyme Peptidyl Arginine Deiminases (PAD) that causes citrullination of proteins, generating citrullinated peptides leading to generation of autoantigens that could possibly initiate autoimmunity in RA10 and link both the diseases. Periodontopathic bacteria like Porphyromonas gingivalis, Tannerella forsythensis, and Prevotella intermedia have been identified in Rheumatoid Arthritis synovial fluid11. While causal relationship is unlikely there is a possibility of common dysregulation of host inflammatory response in both the diseases which needs to be established. The relationship between Rheumatoid Arthritis and Periodontitis is hypothesised to be bidirectional with RA affecting the progression of periodontal disease and vice versa but results are not confirmatory. Self reported epidemiological studies12,13, cross sectional and case control studies14,15,16 have shown that RA patients have a higher prevalence of periodontitis , more number of missing teeth and severe periodontal destruction with deeper pockets and attachment loss. Ribeiro et al17 , Havemose-Poulsen et al18, Al Katma et al19 , Ortiz20 et al have reported that Periodontitis exacerbates the severity of rheumatoid arthritis and could be a possible risk factor for development of RA .Clinical trials19,20 have provided evidence that non surgical treatment of periodontal disease can reduce the severity of rheumatoid disease severity . Data from First National Health and Nutrition Examination Survey21 and ARIC22 study suggests that periodontitis patients have an increased risk of incident or prevalent RA but findings from the Nurses Health Study23 study found no such association. As limited studies are available and conflicting results have been published, this study was undertaken, to determine whether there is a relationship between the severity of rheumatoid arthritis and severity of periodontitis. Aims of the study were 1. To assess the severity of RDA and to correlate it with the severity of periodontitis, oral hygiene status, and functional disability among the RA patients with periodontitis. 2. To correlate the oral hygiene status with the functional disability of the RA patients 3. To correlate the number of missing teeth with clinical rheumatologic variables.
MATERIALS AND METHODS
This observational study was conducted in the outpatient clinic of Rheumatology department, Government General Hospital, Chennai. Ethical clearance was received from the Ethical committee of Madras Medical College, Chennai. 100 patients presenting for the first time to the outpatient clinic and diagnosed with RA were selected for the study. The patients were diagnosed with Rheumatoid Arthritis based on the 1987 Revised American Rheumatism Association Criteria for the classification of Rheumatoid Arthritis24 . Patients aged between 20 – 70 years were selected for the study. RA patients with Clinical Attachment Loss (CAL) associated with periodontal inflammation were selected and periodontal disease was defined as ≥ 2 sites with interproximal CAL ≥ 4mm, not on the same tooth or ≥ 2 sites with interproximal Probing Pocket Depth (PPD) ≥ 4mm, not on the same tooth25. Patients were included in the study if they had at least 8 teeth in the oral cavity, not taken antibiotics within the past 6 months and had no oral prophylaxis or periodontal therapy before. Patients who had CAL associated with malpositioned tooth, improper restorations or crowns, aggressive tooth brushing were not included. Patients were excluded from the study if they were under medication with drugs like anticonvulsant, calcium channel blockers, immunosuppressant that can influence the periodontium, gave a history of hypertension, diabetes mellitus and xerostomia, had medical conditions requiring antibiotic prophylaxis before periodontal examination, smokers, pregnant, lactating women and refused to give informed consent. Written informed consent was obtained from all the patients. Rheumatoid Disease Activity (RDA) was measured using Disease Activity Score28 (DAS 28). DAS is a clinical index developed, to evaluate the status and course of RA disease activity; it combines information from swollen joints, tender joints, acute phase response and general health into one continuous measure of rheumatoid inflammation. DAS 28(4) consists of 28 Tender joint count (TJC), 28 swollen joint count (SJC), Erythrocyte sedimentation Rate (ESR) and General health on visual analogue Scale (VAS).The rheumatologic examinations were performed by specialist rheumatologist and the periodontal examination was performed by a single Periodontist. The swollen joint count reflects the amount of inflamed synovial tissue and it influences the range of joint motion. Tender joint count is associated more with the level of pain. VAS is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured. It is usually a horizontal line, 100 mm in length, marked 0 at left extreme to 100 on the right extreme. The patient marks on the line the point that they feel represents their perception of their current state of health. The VAS score is determined by measuring in mm from the left hand end of the line to the point that the patient marks. All the RA patients were referred for routine haematological lab investigations in the same hospital.ESR and Rheumatoid Factor (RF) titre was recorded from the lab for the study patients. ESR was measured using Westergren Method and the results are given in millimetre value. RF was measured using latex agglutination method. Functional Disability was elicited Using Indian Health Assessment Questionnaire (HAQ)26. RA patients develop difficulty in doing their daily activities and measurement of this disability is routinely done in all outcome studies. Majority of the patients were not educated and also in view of their physical disability, the questionnaire was explained to the patients by the Periodontist and the response was recorded and scoring was given. Clinical oral examination consisted of recording the number of teeth present, number of missing teeth, Oral Hygiene Index (OHI), PPD and CAL .The cumulative end point of periodontal disease is CAL .It is the distance between the base of the pocket and fixed point on the crown, such as cementoenamel junction and is a valid method for assessment of loss of attachment of junctional epithelium from the cementoenamel junction.CAL was measured manually using Williams periodontal probe. Attachment loss was recorded at 6 sites around all teeth. Mean CAL was calculated and based on 1999, American Academy Of Periodontology criteria for chronic periodontitis27, the patients were classified as mild, moderate and severe periodontitis. OHI given by Greene and Vermillion, Waggener28 was used to measure existing debris and calculus as an indicator of oral cleanliness. Data collected was analysed statistically using Microsoft SPSS 15 package. Association between the variables was studied using Pearson chi square test and correlation was done using Pearson correlation coefficient.
RESULTS
Among the 100 Rheumatoid Arthritis patients with periodontitis, 11 were males (11%) and 89 were females (89%). Mean age of the study population was 41.94 years (SD±11.85).Mean and standard deviation of the variables assessed in the study were number of tender joints 20.89(SD±6.86), swollen joints 12.45(SD±8.28), DAS 28(4) 6.87(SD±0.98), RF 208.1(SD±105.2), PPD 2.49(SD±0.70), CAL 2.99 (SD±1.61), DIS 1.49 (SD±0.79) and OHI score 6.97(SD±2.66). Based on DAS 28(4), the patients were classified as having mild, moderate or severe RDA (Table1).Majority of patients had severe RDA. Based on CAL, patients were categorised as having mild, moderate or severe periodontitis.50% of the patients had mild periodontitis (Table1). Frequency distribution of study population based on severity of periodontitis and RDA is shown in Table 2 .Five patients had moderate RDA of which 3 had mild periodontitis and 2 had moderate periodontitis. Among patients with severe RDA, 47 patients had mild periodontitis, 38 had moderate and 10 had severe periodontitis. Distribution of study population based on severity of Functional disability and oral hygiene status is also shown in Table 2. Among the patients with different degree of functional disability majority of the patients had poor oral hygiene. RDA showed no correlation with CAL (Table 3). Functional Disability and the number of swollen joints showed a significant correlation with oral hygiene status (Table 3).Mean number of missing teeth among RA patients was 5.22 (SD±5.38). DIS and ESR showed a significant correlation with the number of missing teeth (Table 3). Non parametric test was also done to test the association between variables as they were ranked based on severity. Patients with severe rheumatoid arthritis showed a significant association with periodontal disease (chi square 23.5, df 2,p valueEnglishhttp://ijcrr.com/abstract.php?article_id=1767http://ijcrr.com/article_html.php?did=17671. Offenbacher S. Periodontal Diseases: Pathogenesis. Ann Periodontol 1996; 1: 821 – 878
2. Mattila,K.J.,Valtonen,V.V.,Nieminen,M.S. andAsikainen,S. Role of infection as a risk factor for atherosclerosis,myocardial infarction,and stroke. Clinical Infectious Diseases 1998; 26:719 -734
3. Grossi S.G,Genco R.J. Periodontal disease and diabetes mellitus: a two way relationship. Ann Periodontol 1998; 3:51-61
4. Scannapieco FA, Bush RB, Paju S. Associations between periodontal disease and risk for atherosclerosis, cardiovascular disease, and stroke: a systematic review Ann Periodontol 2003;8:38-53
5. Scannapieco FA, Bush RB, Paju S . Associations between periodontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease: A systematic review. Ann Periodontol 2003;8:54-69
6. Jeffcoat MK, Hauth JC, Geurs NC, Reddy MS, Cliver SP, Hodgkins PM, Goldenberg RL. Periodontal disease and preterm birth: results of a pilot intervention study.J Periodontol 2003; 74:1214-8
7. Harris,E.D.,Jr.Clinical features of Rheumatoid Arthritis.In:Textbook of Rheumatology,eds.Kelly,W.N.,Harris,E.D.and Sledge,C.B.,5thedition,1997.p898.Philadelph ia:WB Saunders
8. P.M.Bartold,R.I.Marshall,and D.R.Haynes.Periodontitis and Rheumatoid Arthritis: A Review.J Periodontol 2005;76:2066-2074
9. Mercado FB,Marshall RI,Bartold PM:Interrelationships between rheumatoid arthritis and periodontal disease.J Clin Periodontol 2003;30:761-772
10. Wegner,N.Wait R,Aroka A,Eick S,Nguyen K.A,Lundberg K,Kinloch A,Culshaw S,Potempa J andVenables P.J.Peptidylarginine deiminase from Porphyromonas gingivalis citrullinates human fibrinogen and alpha enolase implications for autoimmunity in rheumatoid arthritis.Arthritis Rheum 2010;62,2662 -2672
11. Moen K,Brun JG,Valen M,Skartveit L,Ribs Eribe EK,Olsen I,Jonsson R.Synovial inflammation in active rheumatoid arthritis facilitates trapping of a variety of oral bacterial DNAs.J Dent Res 2006;85:1074- 1078
12. Mercado FB,Marshall RI,Klestov AC, and Bartold PM.Is there a relationship between rheumatoid arthritis and periodontal disease.J Clin Periodontol 2000;27:267-272
13. Dumitrescu AL.Ocurrence of self reported systemic medical conditions in patients with periodontal disease.Rom J Intern Med 2006;44:35-48
14. Mercado FB,Marshall RI,Klestov AC, and Bartold PM.Relationship between rheumatoid arthritis and periodontitis.J Periodontol 2001;72:779-787
15. Eduardo de Paula Ishi,Manoel Barros Bertolo,Carlos Rossa Jr,Keith Lough Kirkwood,Mirian Aparecida Onofre.Periodontal condition in patients with rheumatoid arthritis. Braz Oral Res 2008;22:72-77
16. Addie Dissick, Robert S. Redman,Miata Jones, Bavana V. Rangan, Andreas Reimold, Garth R. Griffiths,Ted R. Mikuls, Richard L. Amdur, John S. Richards, and Gail S. Kerr..Association of Periodontitis With Rheumatoid Arthritis: A Pilot Study.J Periodontol 2010;81:223-230
17. Ribeiro J,Leao A,Novaes AB.Periodontal infection as a possible severity factor for rheumatoid arthritis.J Clin Periodontol 2005;32:412-416
18. Anne Havemose-Poulsen, Jytte Westergaard, Kaj Stoltze, Henrik Skjødt, - Bente Danneskiold-Samsøe, Henning Locht, Klaus Bendtzen, and Palle Holmstrup.Periodontal and hematological characteristics associated with aggressive periodontitis, Juvenile idiopathic arthritis, and rheumatoid arthritis J Periodontol 2006; 77:280-288
19. Al Katma MK,Bissada NF,Bordeaux JM:Control of periodontal infection reduces the severity of active rheumatoid arthritis J Clin Rheumatol 2007;13:134-137
20. Ortiz P,Bissada N.F,Palomo L,Han Y.W,AlZahrani M.S,Paneerselvam A and Askari A.Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors J Periodontol 2009; 80:535-540
21. Demmer RT,Molitor JA,Jacobs DR Jr,Michalowicz BS.Periodontal disease ,tooth loss and incident rheumatoid arthritis :results from the first National Health and Nutrition Examination Survey and its epidemiological follow – up study. J Clin Periodontol 2011;38:998-1006
22. Molitor J.A,Alonso A,Wener M.H,Michalowicz B.S,Beck J.D,Gersuk V.H,Buckner J.H and Folsom A.R.Moderate to severe adult periodontitis increases risk of rheumatoid arthritis in non smokers and is associated with elevated ACPA titres. The ARIC study. Arthritis Rheum 60.S433
23. Arkema EV,Karlson E.W and Costenbader KH.A prospective study of periodontal disease and risk of rheumatoid arthritis.J Rheum 2010;37:1800-1804
24. Arnett FC,Edworthy SM,Bloch DA et al.The American Rheumatism Association1987 revised criteria for the classification of rheumatoid arthritis.Arthritis Rheum 1988;31:315-324
25. Page RC,Eke PI.Case definitions for use in population based surveillance for Periodontitis.J Periodontol 2007;78:1387- 1399.
26. Kumar A, Malaviya AN, Pandhi A. Validation of an Indian version of the Health Assessment Questionnaire in patients with rheumatoid arthritis. Rheumatology 2002;42:1457-9
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesACHIEVEMENT ORIENTATION AMONG UNIVERSITY LEVEL INDIVIDUAL AND TEAM ATHLETES
English208212Amandeep SinghEnglish Gurmeet SinghEnglishThe aim of the present study was to determine achievement orientation (competitiveness, win orientation
and goal orientation) among university level individual and team athletes. For this purpose, six hundred
(N=600) male athletes (individual sports N1 = 300 and team sports N2 = 300) of age ranging from 18 to 25 years were selected as subjects from various colleges affiliated to Guru Nanak Dev University, mritsar, Panjab University, Chandigarh and Punjabi University, Patiala. Sport Orientation Questionnaire (SOQ) developed by Gill and Deeter (1988), was used for collection of the data. The Student‘s t-test for
independent data was applied to find out the significance of differences among individual and team
athletes. The level of significance was set at 0.05. Results revealed significant between group differences
among individual and team athletes on the variable achievement orientation. While comparing the mean
values, it has been observed that the individual sports athletes have demonstrated significantly better than the team sports athletes on the variable achievement orientation. Considering the various parameters as applied on different set of subjects the results proved to be variant in nature and scope in relation to achievement orientation.
EnglishAchievement Orientation, Individual Sports, Team Sports.INTRODUCTION
The socio-psychological dynamics of an individual and team athletes are important components of sports psychology that emerged as a distinct scientific discipline, a specialization within the psychology. To analyze and explain the competitive behaviour of an individual or team athletes, we must understand and interpret their socio-psychological dimensions in movement context. Achievement Orientation is defined as the need to perform well or the striving for success. Atkinson(1964,1974) quote ?General achievement motivation is widely recognized as a capacity to experience pride in accomplishment or a disposition to strive for success across varied achievement situations and standards.‘ Achievement Orientation is a multidimensional psychological constraint which measures the individual differences in sport achievement orientation. In the present study, a psychological tool i.e. ?Sport Orientation Questionnaire‘ (SOQ) developed by Gill and Deeter (1988) to measure the achievement orientation by considering the dimensions; competitiveness, win and goal orientations was used.. Untiring efforts are being made in sports to create new records, to achieve new heights and to set new standards of excellence, which becomes possible not only taking into consideration the physical factors but socio – psychological factors as well. The variable under investigation i.e. achievement orientation may play an important role in achieving the desired goals. Therefore the purpose of the present study was to find out the significant differences between individual and team sports athletes with regard to the variable achievement orientation.
MATERIAL AND METHODS
Subjects:
A sample of six hundred (N = 600) male athletes, which includes three hundred (N1=300) individual sports (i.e. athletics, weightlifting, judo, boxing and swimming) and three hundred (N2=300) team sports (i.e. volleyball, basketball, football, handball and kabaddi) athletes, ranging between 18 to 25 years of age, was selected. The purposive sampling technique was used for the selection of the subjects. The samples were taken from the colleges affiliated to Panjab University, Chandigarh, Guru Nanak Dev University, Amritsar and Punjabi University, Patiala.
Tool used: Sport Orientation Questionnaire (SOQ) developed by Gill and Deeter, 1988, was used as a tool for data collection.
Methodology:
Achievement orientation among university level individual and team athletes was determined by administering Sport Orientation Questionnaire (Gill and Deeter, 1988), which is a multidimensional, sport specific measure of individual differences in sport achievement orientation. Three subscales of sports achievement orientation i.e. competitiveness, win orientation and goal orientation were taken into consideration which consists of thirteen, six and six items respectively. Each item is scored from 1 to 5 (i.e. A=5, B=4, C=3. D=2, E=1). The subjects were instructed to read each statement carefully and encircle the letter that indicates how much you agree or disagree with each statement on the scale: A, B, C, D, and E.
Statistical analysis:
The Statistical Package for the Social Sciences (SPSS) version 16.0 was used for all the analyses. The Student‘s t-test for independent data was applied to find out the significance of differences among individual and team athletes. The level of significance was set at 0.05.
The results of achievement orientation among university level individual and team athletes are presented in table-2. Table exhibited the mean values of individual and team athletes on competitiveness as 55.52 (±6.29) and 50.67 (±7.57), on win orientation 23.28 (±3.82) and 21.52 (±4.00) and on goal orientation 24.89 (±3.46) and 22.46 (±4.34) respectively. Analysis of data revealed, significant between-group differences were found for all the three subscales of achievement orientation i.e. competitiveness (t=8.5259*), win orientation (t=7.2769*) and goal orientation (t=7.5927*). Table also showed the mean values of individual and team athletes on Achievement Orientation as 104.26 (±11.59) and 94.66 (±12.15) and?t‘ 9.9061*, since the computed value of ?t‘ for all the dimensions were greater than the tabulated t.05 (598) =1.645. Thus it may be concluded that Achievement Orientation found to be statistically significant. The graphical representation of responses has been exhibited in Fig. 1.
DISCUSSION
The purpose of this study was to determine the significant difference of achievement orientation among university level individual and team athletes. Analysis of data revealed that significant between-group differences were found for all the three subscales of achievement orientation i.e. competitiveness (t=8.5259*), win orientation (t=7.2769*) and goal orientation (t=7.5927*). While comparing the means, individual sports athletes have exhibited higher mean values on all the three subscales (i.e. competitiveness, win orientation and goal orientation) of the variable achievement orientation. Considering the various parameters as applied on different set of subjects the results proved to be variant in nature and scope in relation to achievement orientation. Hayashi (1996) conducted a study on Hawaiian male weightlifters and their Anglo-American counterparts. It was observed that Hawaiians identified the weight-room environment, and individual differences in achievement goals, through an interdependence-based orientation. These results are similar to the present study. Ryska and Yin (1999) suggested that athletes' perceptions of situational rather than dispositional aspects of achievement goals are more highly affected by the playing structure present in youth sport teams. These affects are also observed in the present study. Results of the present study are not in lines with the study conducted by Singh (1999). He worked on inter-college level 476 subjects of individual and team game athletes. Individual and team game athletes showed sameness on all three variables of achievement orientation. There were no significant differences among athletes belonging to different sport groups in competitiveness, win orientation and goal orientation.
CONCLUSION
It is concluded from the above findings that significant between group differences were found among individual and team athletes on the variable achievement orientation. Significant between-group differences were also found for all the three subscales of achievement orientation i.e. competitiveness, win orientation and goal orientation. While comparing the mean values, it has been observed that the individual sports athletes have demonstrated significantly better than the team sports athletes on the variable achievement orientation. Individual sports athletes have exhibited higher mean values as compared to the team sports athletes on all the three subscales (i.e. competitiveness, win orientation and goal orientation) of the variable achievement orientation.
ACKNOWLEDGEMENTS
Authors acknowledge the immense 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 would like to thank departments of Physical Education, of concerned colleges affiliated to Guru Nanak Dev University, Amritsar, Panjab University, Chandigarh and Punjabi University, Patiala for providing assistance in collecting the relevant information for undertaking quality research.
Englishhttp://ijcrr.com/abstract.php?article_id=1768http://ijcrr.com/article_html.php?did=17681. Atkinson, J.W. (1964). An Introduction to Motivation. Princeton, NJ: Van Nostrand.
2. Atkinson, J.W. (1974). The Main Springs of Achievement-Oriented Activity. In J.W. Atkinson and J.O Raynor (Eds.), Motivation an Achievement. New York: Halstead.13- 41.
3. Gill, D.L. and Deeter, T.E. (1988). Development of the Sports Orientation Questionnaire. Research Quarterly for Exercise and Sports, 59(3), 191-202.
4. Hayashi, Carl T. (1996). Achievement Motivation among Anglo-American and Hawaiian Male Physical Activity Participants: Individual Differences and Social Contextual Factors. Journal of Sport and Exercise Psychology. Human Kinetics Publishers, Inc.
5. Ryska, T.A. and Yin, Z. (1999). Dispositional and Situational Goal Orientations as Discriminators among Recreational and Competitive League Athletes. The Journal of Social Psychology, 139(3), 335-342.
6. Singh, Karamjit. (1999). A Study of SocioPsychological Characteristics of University Level Individual and Team Athletes. Unpublished Ph.D. Thesis, Faculty of Education (Physical Education), Panjab University, Chandigarh.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22General SciencesDRUG-INDUCED HEPATOTOXICITY AND GENOTOXICITY IN PULMONARY TUBERCULOSIS PATIENTS RECEIVING DIRECTLY OBSERVED THERAPY, SHORT-COURSE (DOTS)
English213223Manish Pratap SinghEnglish Ashish Kumar SaxenaEnglish Sarika SaxenaEnglishThe aim of the study was to evaluate hepatotoxicity and genotoxicity in patients suffering from
pulmonary tuberculosis. It was carried out on the pulmonary tuberculosis male patients from directly
observed therapy, short-course (DOTS) Centre Fatehpur district (U.P) India. Patients were divided into
three groups- 1) Before treatment 2) After treatment and 3) Control. Toxicity levels in the blood samples
were determined by standard liver function tests (ALT & AST) by spectrophotometry. The study
indicates significant increase in the level of liver transeaminases (ALT & AST, P < 0.05) in the after
treatment group. Antioxidant analysis shows that the patients who suffer from oxidative stress have
reduced Glutathione (GSH) and high Melonaldehyde (MDA) levels. After treatment with anti-TB drugs
the level of GSH increases (P < 0.05) while level of MDA decreases (P < 0.05). Further genotoxic effect
of anti-TB drugs was evaluated on lymphocytes by COMET assay which showed observable DNA
damage in after treatment study group patients (P < 0.05). LDH expression profile of different isoforms of
lactate dehydrogenase(LDH) on native polyacrylamide gel electrophoresis(PAGE) indicates that in
pulmonary tuberculosis patients the LDH 3 isoforms was expressed more as compares to the other
isoforms which may be due to damage in the lung cell lining by the mycobacterium. In some after
treatment patients LDH 5 isoform level increased, which is an indication of liver injury due to hepatotoxic
and genotoxic effect of anti-TB drugs on the patients.
EnglishAntioxidants, Transeaminases, Comet assay, lactate Dehydrogenase, Lipid peroxidationINTRODUCTION
Tuberculosis (TB), a ubiquitous, highly contagious chronic granulomatous bacterial infection, is still a leading killer of young adults worldwide. Pulmonary tuberculosis is India‘s biggest public health problem. Every year, approximately 1.8 million people develop tuberculosis, of which 0.8 million are new smear positive highly infectious cases. Directly observed therapy, short-course (DOTS) is the key to success for anti-tuberculosis chemotherapy nowadays. It involves the use of a multi-drug regimen with isoniazid (H), rifampicin (R) and pyrazinamide (Z) as essential drugs and a fourth drug, streptomycin (S) or ethambutol (E), is usually added in countries with high prevalence of drug resistance. These four drugs are administered together for 2 months (the intensive phase), followed by a continuation phase of 2 drugs, HR for 4 months (2HRZS or 2HRZE/ 4HR), in a fully supervised fashion. The most frequent adverse effects of anti tuberculosis treatment are hepatotoxicity, skin reactions, gastrointestinal and neurological disorders. Hepatotoxicity is the most serious one and is the focus of the present study [1]. Most studies on ATDH have been performed in Europe, Asia and the USA and the incidence varies between different world regions. Orientals are reported to have the highest rates, especially Indian patients [2, 3]. Significant transaminase elevations are reported in about 0.5% of all patients treated with isoniazid monotherapy [4, 5]. In general, rifampicin is a well-tolerated drug and hepatotoxicity occurs in about 1–2% of patients treated with prophylactic rifampicin monotherapy [6]. Hepatotoxicity is a major toxic effect of pyrazinamide. When the drug was introduced in the 1950s, a high incidence of hepatotoxicity was reported and the drug was nearly abandoned. Being directly in the path of airborne materials, the lung tissue is particularly at risk from oxidative stressors such as cigarette smoke, atmospheric pollutants, and other in- haled environmental toxins [7]. GSH and GSH- associated enzymes present in the epithelial lining fluid (ELF) of the lower respiratory tract may be the first line of defense against such challenges [8, 9]. Sustained oxidative challenge to the lung results in depletion of GSH and other antioxidants from the lungs. Lipid peroxidation products (LPPs) diffuse from the site of inflammation and can be measured in blood. The granulomatous destruction of the lung tissue itself may cause the liberation of toxic radicals, or indeed, it may be that the activated macrophages release highly reactive radicals which may then cause the local disruption of the essential structure including membrane lipids, deoxyribonucleic acid and proteins and hence, cause tissue destruction [10]. M. tuberculosis is expected to sustain a variety of potentially DNA-damaging assaults in vivo, primarily from host generated antimicrobial Reactive oxygen intermediates (ROI) and reactive nitrogen intermediates (RNI). DNA is a biological target for RNI and ROI, and interaction with toxic radicals is mutagenic [11]. Furthermore, damage to cellular components required for the protection or propagation of DNA can indirectly affect chromosomal integrity; while detoxification reactions might themselves yield endogenous damaging adducts. The study was designed to evaluate the hepatotoxicity and genotoxicity of antituberculosis drugs in tuberculosis patients. MATERIAL AND METHODOLOGY When tuberculosis is confirmed by the laboratory tests the patients are advised to receive DOTS therapy. In the present study, for preliminary examination detailed clinical history of all test subjects was recorded and filed. Thirty healthy individuals aged between 20 to 45 years who were symptomless, free from any clinical abnormality and those who were not taking any drug, constituted the control groups. Before start of treatment 5 ml blood was intravenously withdrawn from each test subject and collected in a vial. Similarly blood sample of control subjects was also collected and preserved. Serum was separated by centrifugation of whole blood at 1000 rpm for 15 min. Vials containing serum and whole blood were kept in an ice bucket and cold chain was maintained during transportation. Shaking was avoided to protect from haemolysis. After 3 months of therapy the same procedure was repeated again. Study The whole blood and serum obtained from patients before treatment and after treatment was analyzed in laboratory following standard protocols to study hepatotoxicity and genotoxicity induced by antitubercular drugs. Tests for Hepatotoxicity: Transaminases (AST- and ALT) [12] The substrate (0.5 ml) was incubated at 37 C for 5 minutes followed by adding 0.1 ml of serum and incubation for 60 minute and 30 minute for AST and ALT, respectively. For control tubes, 0.5 ml of substrate was taken and 0.1 ml of serum was added to it. Standard was prepared by mixing 0.1 ml of working standard with 0.4 ml of substrate, along with 0.1 ml of water. Blank was prepared after taking 0.5 ml of substrate, 0.1 ml water. DNPH was allowed to react at room temperature in all the tubes for 20 minute. 5 ml of 0.4 N NaOH was added and mixed well. The contents were incubated for 10 minutes at room temperature and optical density (OD) was read at λ 510 nm. Lipid Peroxidation [13] 1.0 ml of blood in 1ml KCl solution was incubated at 37 C for 30 minutes. Proteins were precipitated by adding 1 ml of 10% TCA and then centrifuged at 2,000 rpm for 15 minute. 1 ml supernatant was taken as an aliquot in a separate tube to which 1 ml of TBA solution was added. The tubes were kept in boiling water bath for 10 minutes. After cooling the tubes, the optical density was read at λ 535 nm. Reduced Glutathione [14] 0.1 ml of blood was taken in a tube to which 0.9 ml of distilled water and 1.0 ml sulphosalicylic acid was added. The contents were mixed thoroughly and then centrifuged at 5,000 rpm for 10 minutes. Now 0.5 ml of supernatant was taken in a tube and similarly blank and standards were prepared by taking 0.5 ml of distilled water and 0.5 ml of GSH standard respectively. To all the tubes, 4.5 ml of tris buffer and 0.5 ml of DTNB solution were added. After 6 minutes OD was read at λ 412 nm. Native-page for studying lactate dehydrogenase enzyme expression profile Glass plates of vertical gel electrophoresis apparatus were washed and sealed with 1% agar. Separating gel (8%) was poured in between the plates then immediately a comb was inserted. After polymerization the comb was removed and samples (50 microgram) were loaded in wells. Proteins were allowed to run in running buffer at constant voltage of 100 V. After electrophoretic separation, the gel was processed for LDH specific staining. The gel was soaked in a glass petri plate containing LDH staining dye [10 mg/ml NAD, 1 mg NBT/ml, 1 mg/ml PMS, 12 ml of Sodium lactate as substrate and 60 ml tris-HCl buffer (0.2M, pH-8.0)] and incubated at 37 0C for 10-15 min till LDH bands started appearing. Once all the bands became clearly visible, the reaction was stopped by adding tap water and the gel was fixed and stored in the 7% acetic acid, which then photographed with the help of gel documentation system. Single Cell Gel Electrophoresis (COMET ASSAY) [15] 100 μl normal melting agarose was spread on frosted microscopic slide and allowed to solidify at 4?C for 10 minutes. Whole blood and low melting agarose were taken in the ratio of 1:4, 100 µl was cased on precoated slides then kept at 4?C for 20 minutes. After solidification the slides were immersed into the chilled lysis buffer for 1 h in dark at 4?C. After completion of lysis step, the slides were placed for 20 minutes in an ice cold electrophoresis chamber containing alkaline electrophoresis buffer for unwinding. The electrophoresis was subsequently conducted for 20 minutes at 25 volt/300 mA. At the end of electrophoresis, the slides were washed thrice with neutralizing buffer for 5 minutes each and just before visualization, slides were stained with coating 40 µl ethidium bromide, rinsed with dH2O twice and nucleus was observed under florescence microscope (Leitz Autoplan, excitation filter λ 595 nm, green filter). All the preparations were done under dark/red light at 4?C. Observations were recorded by software Lieica Qwin V3. RESULTS The study was carried out in 30 known tuberculosis patients and 30 healthy control subjects from DOTS centre Fatehpur district U.P, India. All study groups was male and aged between 20 to 45 years. The affected patients showed symptoms of prolonged fever, cough (with or without haemoptysis), anorexia, weight loss, but without other systemic symptoms tuberculosis or evidence of bronchiectasis. As tuberculosis was confirmed in the patients they were started with anti-TB drugs. The Directly Observed Treatment, Short-course (DOTS) constitutes the cornerstone of the current strategy for control of tuberculosis (TB). However as noted earlier, the three key drugs, isoniazid, pyrazinamide and rifampicin, used in the regimen are potentially hepatotoxic and may lead to drug-associated hepatitis. Most of the hepatotoxic reactions are dose-related; some are, however, caused by drug hypersensitivity. The immunogenetics of anti-TB drug induced hepatotoxicity, especially inclusive of acetylaor phenotype polymorphism, has been increasingly unraveled. Drug-induced hepatic dysfunction usually occurs within the initial few weeks of the intensive phase of anti-TB chemotherapy. Results of the present work confirm previous findings about the subject and also support those using new parameters such as COMET assay. Effect of Anti-TB Medicines on Hepatocellular Markers Increases in the levels of the liver enzymes alanine amino transferase (ALT) and aspartate amino transferase (AST) in serum, in combination with increased bilirubin levels, are generally considered to be the most relevant signal of liver toxicity. ALT is considered a more specific and sensitive indicator of hepatocellular injury than AST. An increase of ALT activity in the range of 2-4 fold and higher compared to concurrent control average or individual pre-treatment values in non-rodents, should raise concern as an indication of potential hepatic injury unless a clear alternative explanation is present. ALT is an enzyme produced in hepatocytes, the major cell type in the liver. The level of ALT in the blood (actually enzyme activity is measured in the clinical laboratory) increases in conditions in which liver cells are damaged or die. As cells are damaged, ALT leaks out into the bloodstream. As summarized in fig 1 and 2, results indicate a significant increase in the activities of AST as well as ALT (P ≤ 0.05) in tuberculosis medicine receiving group when compared with control and before treated group, which is confirmed by one way ANOVA.
Effect of Tuberculosis Medicines on Lipid Per oxidation And Reduced Glutathione: Whether oxidative stress is involved in antitubercular therapy is still a matter of debate, but it is considered to be an important parameter in measuring cell damage. Oxidative stress results from an imbalance between oxidants and antioxidants in favor of the oxidants. Nonenzymatic scavengers (antioxidants) as well as enzymatic systems (e.g. glutathione conjugation) are involved in the detoxification of reactive oxygen species. TB patients with Anti Tubercular Drugs Hepatotoxicity have been shown to have low plasma levels of reduced glutathione and high malondialdehyde, which is an oxidative stress parameter, which maybe as a result of oxidative stress from the anti-TB therapy. Fig. 3 and 4 depicts the effect of therapeutic agent of Tuberculosis medicine on LPO and GSH in liver. TB medicines induced intoxication significantly increased TBARS level and significantly decreased GSH content in blood as seen by statistical analysis (P≤ 0.05).
Lactate dehydrogenase expression profile in native PAGE Serum lactate dehydrogenase (LDH) concentration is an indicator of tissue injury. It can increase in a variety of interstitial diseases such as pulmonary tuberculosis. LDH level was found increased in all patients with active PTB as compared to controls. Total serum LDH and its tissue specific isoforms were estimated in TB patients before and after receiving drugs. There are five isoforms of lactate dehydrogenase present in the almost all the tissues of the body and different isoforms of LDH express upon different injuries. After anti-TB drugs treatment TB patients had elevated level of LDH based on visible staining intensity of LDH1, LDH2 and LDH3 isoforms as compared to control. Expression profile indicated that the tubercular drugs significantly increased the hepatotoxicity in liver as after receiving drugs the LDH 5 level increased as compared to the level in control patients and before treatment patients. LDH 3 is expressed more in lung injury, and expression of LDH 3 increased significantly in both before treatment and after treatment group with comparison to control. This isoenzyme was expressed due to damage in the cell lining of lungs. Profile also indicated that the density of LDH 3 was more in before treatment group as compared to after treatment group. (Fig. 5).
Assessment of DNA damage induced by Anti-TB drugs: The single cell gel electrophoresis (comet assay) allows detection of DNA fragmentation in single cells, and was initially used for DNA damage estimation. Graph showed the effect of anti-TB drug on tail DNA damage, and tail length. The DNA damage was expressed as percent DNA migration in the tail and 20-25 nuclei were counted in each slide. In all antiTB drug treated groups, the tail length and percent DNA was significantly increased (tail length 1.64). DNA damage was observed and the tail length as well as percent DNA damage was significantly high. All anti-TB drug groups showed almost an increase of 3 folds in the (tail length 1.64 and damage 4.05%). Before treatment tuberculosis patients were also noted (0.287 tail length and 1.48% damage) and control group (tail length 0.228 and damage 0.334%) respectively, controlled DNA damage which was also confirmed with the tail length (fig. 6).
DISSCUSSION This study was performed to analyze hepatotoxicity and DNA Damage in pulmonary tuberculosis patients for evaluation of the genomic effects of anti-TB drugs. There is clear evidence of a genotoxic activity of these drugs in human lymphocytes, when evaluated by COMET assay. The results of our study also show significant differences between all study groups. Anti-TB drug-induced Hepatotoxicity is one of the most prevalent drug-induced liver injuries. Identification of patients at increased risk for drug induced hepatotoxicity is important because hepatotoxicity causes significant morbidity. In malnutrition, glutathione stores are depleted which makes one vulnerable to oxidative injury as in a malnourished person liver metabolizes drug at a slower pace. In a study done in India, incidence of Hepatotoxicity was found to be three times higher in malnourished patient‘s mortality and modification of drug regimen may be required [16]. Patients enrolled in the study were given combination of anti-TB drugs which makes it difficult to conclude which drug was the main culprit for causing hepatotoxicity. Although, INH is the major drug incriminated to induce hepatic injury, role of other possible hepatotoxic drugs (RMP and PZA) can also be speculated. Previous studies conducted have proven that the risk is in the order of INH + RMP>INH>PZA>RMP>E [17]. INH and RMP in TB patients significantly raise the risk of anti-TB drug–induced hepatitis [18, 19]. The exact mechanism of hepatotoxicity caused by PZA is not known. RMP is considered to be less hepatotoxic but is a powerful enzyme inducer, which may enhance INH Hepatotoxicity [20, 21]. Formation of hydrazine, which is the key intermediate of INH metabolism and which is a potent acylating agent capable of causing liver necrosis is facilitated by RMP. In some metaanalysis study INH and RMP given together produce hepatotoxicity more than INH alone [22]. Since INH, RMP and PZA are always given in combination; it is difficult to diagnose the drug causing hepatotoxicity. The biochemical mechanism and pathogenesis of drug-induced hepatotoxicity are still not entirely clear for most offending agents. These uncertainties also apply to the hepatotoxicity induced by anti-TB agents. While a doserelated toxicity may exist, a direct correlation between serum drug levels and hepatotoxicity has not been well reported. Thus, the clinical relevance of therapeutic monitoring of serum Rifampicin and Isoniazid concentrations in managing anti-TB drug-associated toxicity is still being explored [23]. The present study is a comprehensive evaluation of concentrations of circulating antioxidants and markers of oxidative stress in tuberculosis patients. Our results show lower antioxidant potential such as reduced glutathione and enhanced lipid peroxidation products (MDA) in before treatment TB patients. After receiving the tubercular drugs the patients showed marked increase in glutathione concentration and decrease in lipid peroxidation products. Our findings further support a role for oxidative stress in the pathogenesis of tuberculosis and suggest lower anti oxidant capacity and higher oxidative stress in the TB patients than in healthy human control [24]. In the present study, it was observed that the free radicals activity increased and total antioxidant status (enzymatic and non-enzymatic) was low in all TB cases, irrespective of treatment status, indicating that there is an oxidative stress. The decrease was more pronounced in the untreated (TB) indicating that the anti-oxidants were nearly completely utilized to scavenge the superoxide free radicals. Malnutrition may also influence anti-oxidant status and oxidative stress [25]. TB patients are unable to produce sufficient amount of antioxidants to cope up with the increased oxidative stress in them. Serum LDH still remains as one of the important parameters to assess the cell/tissue specific stress or pathology, caused by Mycobacterium tuberculosis. Expression profile indicates that the anti-tubercular drugs significantly increase the hepatotoxicity in liver because after receiving drugs the LDH 5 level increases significantly as compared to the control patients and before treatment patients. Some before treatment group also show little intensity of LDH 4 and LDH 5 because the mycobacterium also induces some injury to patients who may be suffering from any other disease. LDH 3 is more expressed in lung injury, and expression of LDH 3 significantly increased in both before treatment and after treatment group with comparison to control. This isoenzyme is expressed due to damage in the cell lining of lungs. Profile also indicates that the intensity of LDH 3 was more in before treatment group in comparison to after treatment group. Tuberculosis, as a chronic bacterial infection, is expected to induce chromosomal damage in the host by production of cytokines and active metabolites of host immune cells and also by production of microorganism exo/endotoxins [26]. The information available on whether tuberculosis infection per se is clastogenic or not is little and contradictory [27, 28]. Moreover, drugs commonly used in tuberculosis treatment may have a mutagenic effect on the human genome, as may any other foreign chemical agent. This is of greater concern in the newly employed short course regimens, which expose patients to a greater number of drugs, namely Isoniazid (INH), Rifampicin (RIF), Ethambutol (ETB) and Pyrazinamide (PZI). Since the discovery and general use of anti-TB drugs, their possible mutagenic effects, either alone or in combination, have been studied by many investigators. Mutagenic effects of INH in combination with other drugs have been observed by other investigators [29]. Similar results were obtained in patients exposed to long term anti-TB regimens and short term therapy [30] who are in accord with our results.
CONCLUSION In the present study it was found that anti tubercular drugs exert significant genotoxicity and hepatotoxicity on the pulmonary tuberculosis patients. This may poses a challenge for physicians treating tuberculosis. The hepatotoxicity may either be pre-existent or may develop during the course of disease or as an adverse reaction to anti-TB drugs. If, however in serious situations, it is considered necessary to continue anti-tubercular drugs, special precautions need to be taken. The long duration of TB treatment is one of the main problems to overcome. Improvement of the bactericidal effect of the anti-TB drugs will reduce treatment length and consequently increase treatment adherence and efficacy. ACKNOWLEDGEMENT Authors would like to acknowledge the kind help and advice received from Dr. Sunita Sharma during the research work and Mr. Harshal Mishra for valuable comments and suggestions. The authors are highly indebted to Department of biotechnology MITS Gwalior for providing us the research facilities to carry out this work. Finally, authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1769http://ijcrr.com/article_html.php?did=17691. Frieden T.R., Sterling T.R., Munsiff S. S., Watt C.J., Dye C., Tuberculosis, Lancet, 2003, 362, 887–99
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4. Nolan C.M., Goldberg S.V., Buskin S.E., Hepatotoxicity associated with isoniazid preventive therapy: a 7-year survey from a public health tuberculosis clinic, JAMA, 1999, 281, 1014–18
5. Fountain F.F., Tolley E., Chrisman C.R., Self T.H., Isoniazid hepatotoxicity associated with treatment of latent tuberculosis a 7-year evaluation from a public health tuberculosis clinic, Chest, 2005, 128, 116–23
6. Villarino M.E., Ridzon R., Weismuller P.C., Rifampin preventive therapy for tuberculosis infection: experience with 157 adolescents, Am. J. Respir. Crit Care Med., 1997, 155, 1735–8
7. Kidd P.M., Phosphatidylcholine, a superior protectant against liver damage, Alternative Med Rev., 1996, 1,258-274
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9. Pacht E.R., Timerman A.P., Lykens M.G., Deficiency of alveolar fluid glutathione in patients with sepsis and the adult respiratory distress syndrome, Chest, 1991, 100, 1397-1403
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241412EnglishN2012June22HealthcareSTRATEGIC ANALYSIS OF INDIAN NUTRACEUTICAL REGULATORY SCENARIO THROUGH MARKET RESEARCH
English224232Ajay PiseEnglish Shilpa PiseEnglish D. SreedharEnglish Manthan JanodiaEnglish Virendra LigadeEnglish Udupa N.EnglishObjective of study: To analyse Indian Nutraceutical regulatory scenario. Research Methodology: A questionnaire was designed including open and closed ended questions. Data was collected through primary data collection method by visiting retail stores to know about the Nutraceutical product in selected area. Convenient, non-probability sampling process was adopted for the study. Sampling Unit: retail shops, medical shops, malls from selected localities of southern Karnataka. Sampling size of 70 was calculated by standard formula to achieve desired confidence level of 97% . Percentage analysis method was adopted for Data Analysis, Statistic calculator (version 3.0) by StatPac Company was used for data processing. This study has revealed that, child Nutraceutical Products are in high demand followed by Nutraceuticals for Pregnant / Lactating Mothers and Weight Gain Products therefore, it is very important to regulate the manufacturing, labeling, and advertisement of the Nutraceutical products targeted to Children, Pregnant and lactating mothers. Increasing trends in preventive therapy is a major driving force for nutraceutical market followed by increase in self medication. It is also important to regulate the advertisement of Nutraceuticals to restrict misleading claims in advertisements. In order to increase the sale of Nutraceutical product, it is advised that, manufacturers should reduce the price of product and make more efforts to spread awareness about the benefits of nutraceutical product. This study reveals that, Nutraceutical manufacturer have tremendous opportunities to explore Nutraceutical market.
EnglishINTRODUCTION
We understand that global Nutraceutical market is growing very rapidly. In the context of Indian scenario, Nutraceutical market is growing fast with the 20% CAGR5. Increasing awareness about the health, disease prevention, high cost of the medication, and handy disposable income are the factors which contributed in increasing demand of the Nutraceuticals. To explore this market, many Nutraceutical and Pharmaceutical companies have launched nutraceutical products in the healthcare market. Today, healthcare market in India is flooded with Nutraceutical products. Absence of proper regulatory framework and dilemma over the understanding and adopting the term ?Nutraceuticals? has became undue advantage for Nutraceutical manufacturers. Manufacturing, Labeling, Sale and Advertisement of such products needs proper regulatory framework to safeguard the interest of customers and control the Nutraceutical market. It has been observed that there is no universally acceptable definition for Nutraceuticals. Several scholars have proposed different definitions. Also, there is a dilemma on classification of nutraceuticals and understanding the difference between Functional Food, Dietary Supplement, and Medicated Food. To avoid this dilemma, we have attempted to propose definition and classification of Nutraceuticals. This study focuses on understanding and analysis of regulatory issues related to nutraceuticals in Indian Nutraceutical market.
RESEARCH METHODOLOGY
Data was collected through primary data collection method by visiting retail stores to know about the Nutraceutical product in selected area. Convenient, non-probability sampling process was adopted for the study. Sampling Unit: retail shops, medical shops, malls from selected localities of southern Karnataka. Sampling size of 70 was calculated by standard formula to achieve desired confidence level of 97% .
Sampling Size calculation:
Best estimate of the population size = 1500 Best estimate of the rate in the population (%) = 6% Maximum acceptable difference (%) = 6% Desired Confidence level of result (%) = 97% Required Sample size for desired confidence level=70 Data Analysis and Statistical Tool: Percentage analysis method was adopted for Data Analysis, Statistic calculator (version 3.0) by StatPac Company was used for data processing.
Data presented in above table suggests that Child Nutraceutical Products are in high demand followed by Nutraceuticals for Pregnant / Lactating Mothers and Weight Gain Products. Children and Pregnant mothers are considered as vulnerable group of population. Therefore it is very important to regulate the manufacturing, labeling, and advertisement of the Nutraceutical products targeted to Children, Pregnant and lactating mothers.
Above information suggests that increasing trends in preventive therapy is a major driving force for nutraceutical market followed by increase in self medication. It is observed that people are becoming more cautious about their health and tends to use nutraceutical products to prevent disease. Nutraceutical products are also popular among ?Baby Boomers‘. Increase in the disposal income is also one of the major driving forces for Nutraceutical market.
Data presented in above graph reflects that advertisement plays important role in consumer education about the product. Therefore, we can interpret that advertisement is an effective tool for product promotion. It is important to regulate the advertisement of Nutraceuticals to restrict misleading claims in advertisements
From the above data we can interpret that majority of consumers prefer to buy Nutraceutical products in traditional dosage form. Traditional dosage form includes capsule, tablet, solution, etc. Whereas nontraditional dosage form include mixture (liquid and solid), gels, etc.
From the above graphical presentation of collected data we can conclude that High Price of the nutraceutical products is major challenge for its sale. Some group of respondents is of the opinion that lack of awareness about the benefits of nutraceutical products is also major challenge in selling Nutraceutical product. In order to increase the sale of Nutraceutical product, manufacturers should reduce the price of product and make more efforts to spread awareness about the benefits of nutraceutical product.
This question is posed to analyse frequency of demand for nutraceutical products. Above data suggests that nutraceutical products are always in demand. This shows market growth for nutraceutical products. Nutraceutical manufacturer have tremendous opportunities to explore Nutraceutical market.
This question is posed to know about the factors influencing decision of customers. Data presented in above graph reveals that advertisement of the product is major factor to influence the decision of consumer. Advertisement includes product promotion through print, oral, electronic media. Word of mouth publicity through friends, colleagues is another influencing factor. Therefore, it is important for the Nutraceuticals manufacturer to give more emphasis on advertisement while promoting the product. It is also important to regulate advertisement of Nutraceutical products.
CONCLUSION
After analyzing information and data from the above study, we can derive following conclusionGlobal Nutraceutical market is growing very rapidly. In context of Indian scenario, Nutraceutical market is growing fast with the 20% CAGR. Increasing awareness about the health, disease prevention, high cost of the medication, and handy disposable income are the factors which contributed in increasing demand of the Nutraceuticals. Nutraceutical market is considered as one of the fastest growing market. Therefore it is important to regulate this market to safeguard the interest of consumers.
Nutraceuticals, around the world, falls under a grey area. Most of the food and Pharmaceutical companies are using term ?Nutraceuticals‘ as marketing gimmick. Though the Nutraceutical market is growing with fast rate and demand is increasing rapidly, no specific regulations are framed for Nutraceuticals in India. Absence of proper regulatory framework for manufacturing, labeling, advertising and sales of the nutraceuticals has became undue advantage for Food and Pharmaceutical companies to launch Nutraceutical products in healthcare market. It has been observed that there is no universally acceptable definition for Nutraceuticals. Several scholars have proposed different definitions, but essence of all definition remains same ?Food as Medicine‘. There is a dilemma on classification of nutraceuticals and understanding the difference between Functional Food, Dietary Supplement, and Medicated Food. To avoid this dilemma, we have proposed a definition of Nutraceuticals which can be adopted widely. In order to regulate the manufacturing of Nutraceutical products, Nutraceuticals can be classified in two broad categories i.e. Regular Nutraceuticals and Novel Nutraceuticals. Regulatory requirements for manufacturing of Regular Nutraceuticals and Novel Nutraceuticals should be different. It should not be compulsory to get manufacturing approval from FDA for regular nutraceutical product. But the product should be registered with FDA (at regional / district level) before launching it in the nutraceutical market. Child Nutraceutical Products are in high demand followed by Nutraceuticals for Pregnant / Lactating Mothers and Weight Gain Products therefore, it is very important to regulate the manufacturing, labeling, and advertisement of the Nutraceutical products targeted to Children, Pregnant and lactating mothers. I#ncreasing trends in preventive therapy is a major driving force for nutraceutical market followed by increase in self medication. It is also important to regulate the advertisement of Nutraceuticals to restrict misleading claims in advertisements. In order to increase the sale of Nutraceutical product, it is advised that, manufacturers should reduce the price of product and make more efforts to spread awareness about the benefits of nutraceutical product. This study reveals that, Nutraceutical manufacturer have tremendous opportunities to explore Nutraceutical market.
ACKNOWLEDGEMENT
Authors acknowledge the immense 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.
Englishhttp://ijcrr.com/abstract.php?article_id=1770http://ijcrr.com/article_html.php?did=17701. Ekta K. Kalra, ?Nutraceutical - Definition and Introduction? cited from http://www.aapspharmsci.org/view.asp?art =ps050325.
2. P A Francis, ?A Regulation for Nutraceuticals? cited from http://www.pharmabiz.com/article/detnews. asp?articleid=12303§ionid=47.
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