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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30General SciencesCOMPARISON OF MOTIVATIONAL BELIEFS IN SELFREGULATION LEARNING BETWEEN INTELLIGENT,
LEARNING-DISABLED AND NORMAL STUDENTS IN PRIMARY SCHOOL IN RASHT
English0619Shohreh GhorbanshiroudiEnglishAn insight into people trend toward academic activities plays an important role in psychology and pedagogy. The aims of this study to compare self-regulation learning among normal, intelligent, and learning-disabled children, so 76 intelligent students, 77 normal students, and 49 learning-disabled students in 12-10 age range were randomly selected from schools inRasht. Two different forms of academic self-regulation learning questionnaire (SQR) Ryan and Connell (1989) were used to collect data via 4 methods i.e. external regulation, introjections, identification, internal regulation. Statistical analysis show that in external regulation method, the learning-disabled children got higher grads than the normal and intelligent ones. In introjections and identification method, intelligent children had better averages than normal and learning-disabled ones, while in internal regulation method, there was no significant difference between intelligent and normal students, whereas these two groups were significantly different form the learning-disabled ones (pEnglishMotivational Beliefs, Self Regulated Learning, Learning DisabilityINTRODUCTION
Research and reflection on causes of people engagement to academic and scholastic activities have a special position in psychology and instruction and training instrumental and non-instrumental reasons people often present about educational affairs have been studied as a motivational beliefs (Nicholls 1984, Rotter 1966, Connell and Wellborn 1991). Several theories and views have studied and analyzed motivational beliefs. Also emphasis is placed on individual merits, expectation of success and failure and consequences control in self-efficiency theory of Bandura (1997) and control theories such as locus of control. (Rotter 1966, Crandall, et al. 1965, Connell and Wellborn 1999). In other groups of theories, such as intrinsic motivation theory (Nicholls 1984, Heyman and Dweck 1992) and self determination theory (Deci and Ryan 1985, Cameron and pierce 1994), people's reasons in engagement to scientific duties are studied. In other words, in this group of views, goals and values of duties are considered by presenting the main question of "why", in the third group of views, value and expectation are considered as a combination in motivational beliefs. (Eccles 2008, Graham 2009, vainer,2005), and finally theories also analyzed and study two elements of motivation and knowledge (Pentrich et al. 1993, Schunk and Zimmerman 2004; Bouakaterz, 1999). Thing that increases the motivational beliefs' importance in educational scopes is the relation of these beliefs with self regulated learning. Researchers and experts have stated several definitions to this type of learning such as Zimmerman and Martinez Pons (2010) who define self-regulation as a process during which learner considers learning as a regular and controllable process and is responsible for his educational consequences such as students participate in learning processes from an ultracognitive, motivational and behavioral view points actively. Other group of psychologists believes that self regulated learning. Is an individual's ability to behave based on change of internal and external conditions and includes self-executed processes in planning, execution and guidance of actions (Schunk 2005, Pintrich 2009). According to Bandura (1997), selfregulation is a use of abilities and efficiencies of self-guidance, self-control and self-governing. Accordingly, mentioned capabilities are influenced by individuals' belief about self-efficiency in different activities and behaviors. A common point of the above mentioned definitions is existence of three elements of knowledge, ultra-cognition and motivation in the self-regulation process. (Pintrich and Groot, 2010) that several views are existed in relation to each of the mentioned elements. As definitions are obvious, motivational beliefs have an important and fundamental role in self-regulated learning. One of the best theories that have been presented in this regard is a self determination theory (Chandler and Connell 1987; Deci and Ryan 1985; Ryan and Connell 1989). These researchers have explained their theories based on the concept of "Perceived locus control" of Hayder that differentiates between personal causality (that is behaviors based on internal motivation) and impersonal causality (actions based on environmental elements). In Deci and Ryan (1985) theory, the most important issue is principle of "internalization" through which individuals transform external guiding reasons of actions to internal reasons. Two general dimensions of this internalization is "autonomy" that is described as regulatory styles in an appendix (Ryan and Lynch 1989; Deci and Ryan 1985; Deci and et al. 1992; Ryan and Connell 1989). Ryan and et al. believe that individuals have four regulatory style in educational activities, in case educational behaviors are done based on external elements such as reward, threat and punishment, it is representative of external regulation. Although in introjected regulation style, individuals' reasons in educational activities are internal, external elements' pressure through threat of self-idea, anxiety and sense of guilt forces individual to act.
When an individual do an action based on internal self-values has a identification regulation in which external motivations have been internalized in an individual values system. In other words, an individual do actions that are important to him in person. And finally when an individual do an action without considering consequence of a behavior, merely to take internal pleasure, excitement and eagerness has internal regulation style. The present study has been done along with a comparison of motivational beliefs in a self-regulated learning among students of intelligent schools, normal schools and learning students with learning disabilities mentioned regulation styles by Ryan et al. (2008). Several researches have compared motivational bases of behaviors of intelligent, normal and learning disabled children under titles of locus of control, self-concept, community friendly practices, compatibility self-efficiency beliefs and etc. Wide group of researches shows that intelligent children have internal motivational bases for educational affairs than normal children. Janos and Robinson (2005) believe that in intelligent children being good, paying attention to other's well-being, and doing internally form faster than normal children. Alborzi and Mazidi (2009) found that intelligent children have internal locus of control and normal children have external locus of control. Chalpianlo and Hasani (2009) also gained the same result. Razaviye and Alborzi (2003) in comparison of community friendly practices between intelligent and normal children found that intelligent children have more internal motivations in occurring community friendly practices than their peer normal children. In other words, they are less influenced by environment elements. Alborizi and (Joukar) (2006) obtained the same by comparison of religious beliefs of the intelligent and normal children. Kelanki (1992) believes that intelligent children are superior than their normal coequals in respect of attributes of thought, self criticism, collaboration, social responsibility and reasoning. Karnes, McGinnis and Christopher (1996) also obtained the same results. Of course there are researchers that believe there isn't any difference between intelligent and normal children in respect of the mentioned attributes (Gilligan, 1982; Gilligan, Lyons and Hanmer, 1989). But generally put, most of the mentioned researches show that intelligent children are more internal than normal children. In other words, they after behave according to their internal motivations. Other group of researches have compared learning disabled children with normal and intelligent children. Results show that disabled children have external motivational bases in doing their homework than intelligent and normal children, and this causes more stress and anxiety. Accordingly, in the present research with respect to the pattern of motivational beliefs of Ryan and et al. (2008), intelligent, normal and learning disabled students were compared in four style of external, introjected, identification and internal regulations and two styles of autonomy and control. It is worth mentioning that autonomy regulation style is a combination of identification and internal regulations and control regulation is a combination of external regulation and introjected regulation. The purpose of this study is to answer the following questions: 1) Is there a meaningful difference among intelligent, normal and learning disabled children in the external, introjected, identification and internal regulations according to gender and educational conditions (intelligent, normal, learning disabled)? 2) Is there a meaningful difference among intelligent, normal and learning disabled children in two styles of control regulation and autonomy according to gender and educational conditions (intelligent, normal, learning disabled)? In addition to the above-mentioned questions, the following question is also studied in the present research: Which of these variables of age, father's educations, mother's educations, father's job, and mother's job is a better predictor of "relative autonomy indicator"?
RESEARCH METHOD
Research society and sample:
understudied society in this research included all of the elementary students of intelligent, normal and learning disabled student's schools in educational year of (2010-11) in Rasht. Selection of Normal students was done by random-cluster sampling. That is, among four educational regions in Rasht, first region one was selected as a reference region based on the opinion of primary school expert of educational organization. Then among all girl's and boy's schools of the region, one girl's and one boy's school were selected randomly of each school one grade-five class was placed randomly in a sample group and finally the sample included 77 male and female students was studied. Also of students who were accepted in an entrance exam of the intelligent, 76 intelligent male and female students were place in the sample group randomly. In addition to this, 49 disabled students in grade five were referred to the exceptional education center of educational organization, were also studied. Finally, 202 students, in age range of 10 to 12 (with the average of 11 years and standard deviation of 0.52) were studied. Demographic characteristics of the subjects are shown in table 1.
Research tools 1) Academic self-regulation questionnaire (SRQ-A):
This questionnaire was prepared by Ryan and Connell (1989) to evaluate motivational beliefs of primary and guidance school children in educational affair, and includes four styles of external, introjected, identification and internal regulation. Each regulation style is evaluated on the basis of four types of activity (reasons to do homework, reasons to have a good behavior at school, reasons to do class activities, reasons to answer the questions in a class) by eight questions. This scale questions are as a four-degree range (completely right = 4 to completely wrong = 1). Additionally, to being informed of personal and familial specifications of a subject such as age, gender, father's and mother's education and etc., these information were asked beginning of a questionnaire. Academic self regulation questionnaire has three different forms. One from is specific to the adults and the second form is particular to children in primary and guidance school levels, and the third one is specific to the disabled children. In the present research, special forms for normal children and learning disabled children have been used. It is worth mentioning that compilers in the first form of the mentioned questionnaire questioned seven activities but mentioning four activities has a better psychometry.
Validity and Reliability of a questionnaire: Validity and reliability of the questionnaire were obtained by Alborzi and Razaviye (2003). If its validity is obtained based on the factor analysis and correlation with the same tests such as: religions self regulation questionnaire (SRQ-R), friendship self regulation questionnaire (SRQ-F) and communityfriendly practices self regulation questionnaire and academic average, reliability results of the questionnaire obtained by retest methods an Cronbach's alpha are indicative of reliability of SRQA. Results show efficiency and adequacy of this scale to be used in Iranian culture. It is mentionable that SRQ-A questionnaire was used to calculate statistical "relative autonomy" index (RAI). By the use of calculation formula of relative autonomy index (2 X Intrinsic + Identified – Introjected – 2 X External), a number is obtained that is indicator of quality of undivided condition based on the regulation style. Negative score shows control regulation and positive score shows autonomy regulation style.
2) SQR-A specific to children with learning disabilities: The mentioned questionnaire was prepared by Deci, Hadge, Pearson and Tomasoun (1992) for children with learning disabilities. Test makers believe that the useable form of normal children is difficult for children with learning disabilities. Thus, a more brief form was prepared included 17 questions that has the same characteristic as the main form and studies self regulated learning in four styles of external, introjected, identification and internal regulations. In this questionnaire, total score is calculated based on the statistical "Relative Autonomy Index" (RAI).
RESULTS
Results are as the following: A. Research results in relation to frequency of types of the motivational beliefs in groups of intelligent and normal children and children with learning disabilities are as the following.
Results of the table show in normal children, external regulation style has the highest average and internal regulation style has the lowest average. That is, normal children have more external motivational beliefs in their educational affair. In the intelligent children, introjected regulation style has the highest average and internal regulation has the lowest average, and this shows that intelligent children have introjected motivational beliefs. And finally, in children with learning disabilities external regulation style also has the highest average and internal regulation has the lowest regulation. It is worth mentioning that results obtained in the control and autonomy regulation approve the results.
B. To study whether there is a meaningful difference among intelligent, normal and disabled children in external, introjected, identification and internal regulation styles according to the gender, educational conditions (intelligent, normal, learning disabled), 3- way ANOVA (Analysis of variance) 2 3 4 statistical method was used (table 4 and 5).
Written results in table 3 and 4 show that the difference among mentioned regulation styles on the basis of gender and educational conditions is meaningful if: 1) In the external regulation style, there is a meaningful difference between intelligent, normal and learning disabled children based on the educational conditions (F = 64.43, and PEnglishhttp://ijcrr.com/abstract.php?article_id=1879http://ijcrr.com/article_html.php?did=18791. Alborzi Mahboube and Joukar Bahram (2006). "A comparison of selfmanagement of prodigious school students and ordinary school students in Rasht".
2. Alborzi Mahboube and Mazidi Mohammad (2009), "A comparison of self-esteem and control center in prodigious school students ordinary school students". The first national conference on prodigious, 23-24 October.
3. Alborzi Mahboube and Razaviye Asghar (2003), "A study of validity and dynamics of questionnaire on selfeducation (SRQA)", to be published.
4. Razaviye Asghar and Alborzi Mahboube (2002), "A comparison of socially accepted moral reasons among prodigious ordinary and blind students", Psychology Magazine, Second Edition.
5. Chalpianlo Gholamreza and Hassani Ja'afar (2009), "A comparison of controcenters, self-respect, and contrastive methods in prodigies, and ordinary people", the first national conference on prodigies, 23-24 October.
6. Virjinia, Z. Arltch (2010), "Prodigious children" (Translated by Akram Kalanki), Alhoda Publications
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareA RANDOMIZED, DOUBLE BLIND STUDY TO EVALUATE THE PHARMACOLOGICAL EFFECT OF A POLYHERBAL DRUG (LIPOTAB) IN MANAGING DYSLIPIDEMIA
English2029Yasmeen ShamsiEnglish Harendra KumarEnglishCardiovascular disease (CVD) is the number one cause of death worldwide. Cardiovascular disease occurs usually due to atherosclerosis of large and medium sized arteries and dyslipidemia has been found to be one of the most important contributing factors. Lowering lipids through dietary intervention or pharmacological therapy has been shown to decrease the incidence of atherosclerotic events. Lipotab is a polypharmaceutical herbal drug, which has shown lipid lowering, antioxidant, anti-inflammatory and vasorelaxant activities in various animal models. To evaluate the efficacy and safety of Lipotab in dyslipidemic human subjects a randomized; double blind placebo controlled clinical study was conducted in Clinical Research Unit, Majeedia Hospital, Jamia Hamdard University, New Delhi. Twelve week Lipotab treatment, was discovered significantly effective than placebo in improving lipid profile of the study subjects. The results of the present study suggest that Lipotab is a safe and efficacious drug in treating dyslipidemia. This polypharmaceutical herbal drug can be valuable in prevention of atherosclerosis and cardiovascular disease by antiplatelet, fibrinolytic, antioxidant and
cholesterol lowering activities of its various ingredients.
EnglishDyslipidemia, Herbal drug, Allium sativum, Curcuma longa, Cardivascular diseaseINTRODUCTION
Cardiovascular disease (CVD) is the number one cause of death worldwide (1, 2,). About twothirds of the estimated 14.3 million annual cardiovascular disease deaths occur in the developing world (3). CVD covers a wide array of disorders, including diseases of the cardiac muscle and of the vascular system supplying the heart, brain, and other vital organs (4). Acute coronary events (heart attacks) and cerebrovascular events (strokes) often occur suddenly, and are often fatal (5). CVD usually occurs as a result of atherosclerosis of large and medium sized arteries and dyslipidemia has been found to be one of the most important contributing factors for atherosclerosis (6). Dyslipidemia is a disorder of lipoprotein metabolism; it may manifest with the elevated levels of serum total cholesterol (TC), lowdensity lipoprotein (LDL), triglycerides, and a decrease in the high density lipoprotein (HDL) concentration (7). Atherosclerosis is usually characterized by both increased LDL-cholesterol and increased triglycerides (TG) levels and often accompanied by low HDL-cholesterol levels (8, 12). However, elevated low-density lipoprotein cholesterol (LDL) is thought to be the best indicator of atherosclerosis risk (9, 10, 11, 13). Lowering lipids through dietary intervention or pharmacological therapy has been shown to decrease the incidence of atherosclerotic events (14). A plant based diet rich in fruit, vegetables, and legumes and low in saturated fat along with regular aerobic exercise programme is an effective prescription for a person with elevated risk of cardiovascular disease (15).
Drug therapy for cholesterol reduction includes statins, bile acid resins, nicotinic acid and fibrates (15). A number of medicinal plants possess antihyperlipidemic activity, literature suggests that the lipid lowering action of herbs is mediated through, inhibition of hepatic cholesterol biosynthesis and reduction of lipid absorption in the intestine (16). These herbs may be useful in reducing the risk of cardiovascular disease. Lipotab is a polypharmaceutical herbal drug consisting of Allium sativum, Curcuma longa and Nepeta hindostan.
Pharmacological study of Lipotab and its Individual Ingredients:
The results of a study examining the endothelium modulated effects of polypharmaceutical drug Lipotab and its individual ingredients in isolated aortic rings of rat suggested a direct vasorelaxant effect of the drug on the vascular smooth muscle (17). In another study evaluating the effect of Lipotab on isoprenaline (ISO)-induced left ventricular (LV) remodeling and heart failure (HF) in Wistar albino rats, the results indicated that Lipotab prevents ISO-induced LV remodeling and consequent HF in rats through its antioxidant and anti-inflammatory activity(18) The pharmacological studies showed that supplementation with Allium sativum in cholesterol fed rabbit produced lowering in total, free, ester cholesterol and phospholipids resulting in a lower degree of atherosclerosis (19). The alcoholic extract of Nepeta hindostana (whole plant) showed cardiac stimulant activity on normal and hypodynamic heart of frog and rabbit. The alcoholic extract provided significant protection from isoproterenol-induced experimental myocardial necrosis (myocardial infarction) in rats (20). The protective effects on the cardiovascular system of Curcuma longa include lowering cholesterol and triglyceride levels, decreasing susceptibility of low density lipoprotein (LDL) to lipid peroxidation (21) and inhibiting platelet aggregation (22). Water and fat-soluble extracts of Curcuma longa and its curcumin component exhibited strong antioxidant activity, comparable to vitamins C and E (23). A study of ischemia in the feline heart demonstrated that curcumin pretreatment decreased ischemia-induced changes in the heart (24). The aim of the present study was to evaluate the efficacy and safety of Lipotab tablet in dyslipidemic human subjects.
MATERIAL AND METHODS
Study Drug:
The study drug Lipotab (500 mg) tablet is a polyherbal drug which contains dried powder of Nepeta hindostana whole plant (200 mg), Allium sativum bulb (150 mg) and Curcuma longa rhizome (150 mg). Both Lipotab and placebo were supplied by Hamdard Wakf Laboratories, New Delhi, India.
Study Design:
This was a randomized, double blind, placebo controlled study, conducted in Clinical Research Unit of Hamdard National Foundation at Majeedia Hospital, Jamia Hamdard, New Delhi, during the year 2001-2004.
Participants:
Inclusion Criteria:
Subjects (men and women) aged 25-70 years were eligible for the study if they had a history of dyslipidemia for at least 3 months despite of strict diet control and had fasting TC=200-250 mg/dl; LDL 130-170 mg/dl and TG=200-300 mg/dl. Type-2 diabetes mellitus patients with dyslipidemia were also included if they had good glycaemic control (HbA1C < 6.5%) with diet only or diet and oral hypoglycemic agents.
Exclusion criteria: Subjects were excluded from the study if they had Type 1 diabetes; uncontrolled type 2 diabetes or hypertension; hypothyroidism; nephrotic syndrome or renal failure; active hepatic dysfunction; history of coronary insufficiency/ myocardial infarction or CVD; history of estrogen therapy in post-menopausal women; women taking hormonal contraceptives, and body mass index >35 kg/m2 .
Informed Consent:
All patients were included in the study after obtaining written informed consent. Eligible subjects as per the inclusion/exclusion criteria were enrolled in the study and written informed consent was obtained from all the subjects before their enrolment. At visit 1 lipid profile determinations were conducted and the participants were instructed to follow cholesterol lowering diet for 2 weeks. After this diet only period (visit-2) lipid profile determinations and laboratory safety tests were performed and the eligible cases as per the inclusion/exclusion criteria were randomly assigned to receive either Lipotab or placebo in the dose of 2 tablets once daily at 4 p.m. All the patients were instructed to maintain low cholesterol diet as they were advised 2 weeks before their inclusion in the study (visit-1). Patients underwent an interim checkup after 6 weeks (visit-3) and a final evaluation after 12 weeks (visit-4). Physical examination and laboratory tests were done at each visit. Adverse events were recorded and compliance with study medications was assessed at visit 3 and visit 4.
Efficacy Analysis:
Data for efficacy analysis were obtained from all patients who completed 12 weeks study. Lipid profile samples were drawn from 8.30 to 9.00 Am after a 12 hour overnight fast at each visit. The change in LDL- cholesterol levels was considered the primary efficacy variable. Treatment was considered effective only of each of LDL cholesterol, total cholesterol and triglyceride levels were reduced by more than 10% compared with baseline.
Safety of the Drug: - Data from the physical examination, laboratory tests and interview for adverse events were included in the analyses of safety and tolerability. Laboratory safety tests included blood urea, serum creatinine, serum bilirubin, alanine amino transferase (AST), aspirate amino transferase (ALT), haemogram with ESR and fasting and postprandial blood sugar. All data were recorded on case record forms; analysis was restricted to patients who completed the study up to 12 weeks. The changes between pre-treatment and posttreatment values of lipid profile components obtained in drug group (Lipotab) were compared with those obtained in Placebo group by using unpaired ?t? test. Statistical calculations were performed with GraphPad InStat version 3.10.
RESULTS
Total 88 subjects were enrolled in the study, 6 subjects did not meet the inclusion criteria because total cholesterol levels were 300 mg/dl (2 subjects), of the 82 cases included in the study, 9 cases (4 receiving Lipotab and 5 receiving Placebo) dropped out from the study for unknown/ personal reasons. Total 73 subjects (38 in Lipotab group and 35 in Placebo group) completed the study according to protocol up to 12 weeks (Figure-1) There were no significant differences in the characteristics between the two groups at baseline (Table-1 and 2). The incidence of dyslipidemia was highest in upper socioeconomic class (65.52%) and there was a moderate frequency of coronary risk factors, mainly obesity (32.18%), diabetes mellitus (29.88%), arterial hypertension (12.06%), and smoking (12.90%). The mean levels of lipid profile at baseline and after treatment and percentage of change in these levels are shown in Table-3. Twelve week Lipotab treatment, was significantly effective than placebo on the primary efficacy measure, reducing LDL-C by 18.80% compared with 4.36% in the placebo group (p < 0.001). Lipotab also significantly reduced total cholesterol (TC) by 15.09% compared with 3.625 in placebo group (Englishhttp://ijcrr.com/abstract.php?article_id=1880http://ijcrr.com/article_html.php?did=18801. Chaturvedi V, Bhargava B ( 2007), Health Care Delivery for Coronary Heart Disease in India- Where are we Headed. Am Heart Hosp, 5:32-37
2. Varun B. Suthar1*, Jigna S. Shah1 and Parloop A. Bhatt2 (2011), Prevalence, Assessment and Clinical Outcome Disparities in Cardiovascular Disease: IJRPC, 1(4):839
3. Mandal S, Saha JB, Mandal SC, Bhattacharya RN, Chakraborty M, Pal PP (2009), Prevalence of ischemic heart disease among urban population of Siliguri, West Bengal. Indian J Community Med. 34:19-23
4. Mathers, C. D., A. D. Lopez, and C. J. L. Murray. ?The Burden of Disease and Mortality by Condition: Data, Methods, and Results for 2001.? In Global Burden of Disease and Risk Factors, eds. A. D. Lopez, C. D. Mathers, M. Ezzati, D. T. Jamison, and C. J. L. Murray. New York: Oxford University Press.
5. World Health Organization. Prevention of Cardiovascular Disease. Guidelines for assessment and management of cardiovascular risk. Geneva, 2007
6. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), JAMA 2001;285:2486-2947
7. Chad R. Worz, Pharm.D., Michael Bottorff, Pharm.D (2003), Treating Dyslipidemic Patients with Lipid-Modifying and Combination Therapies, Pharmacotherapy ;23(5):625-637
8. Glass CK, Witztum JL (2001), Atherosclerosis: The road ahead. Cell. 104:503-516
9. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, et al (2000) AHA Dietary guidelines: Revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation, 102(18):2284-2299
10. Brown M, Goldstein JL. (1984), How LDL receptors influence cholesterol and atherosclerosis. Sci Am; 251:58–66
11. Z. Chilmonczyk,D. Siluk, R. Kaliszan, B. L, Ozowicka,J. Popl⁄awski, and S. Filipek, (2001) , New chemical structures of hypolipidemic and antiplatelet activity, Pure Appl. Chem., Vol. 73, No. 9, pp. 1445–1458
12. NCEP ATP-III, 2002: Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, 106, (25), 3143-421
13. Jacobson MS (1998), Heart healthy diets for all children: no longer controversial. J Pediatr ; 133(1):1-2
14. Byington RP, Jukema JW, Salonen JT, et al. (1995), Reduction in cardiovascular events during pravastatin therapy: pooled analysis of clinical events of the Pravastatin Atherosclerosis Intervention Program. Circulation.;92:2419–2425
15. Ashish S Phadke, (2007) A Review of Lipid Lowering Activities of Ayurvedic and Other Herbs. Natural Product Radiance, Vol. 6 (1); 81-89
16. A. Gramza, J. Korczak (2005), Trends Food Sci. Tech., 16, 351
17. Ashraf MZ, Khan MS, Hameed HA, Hussain ME, Fahim M (1999), Endothelium modulated vasorelaxant response of a polypharmaceutical herbal drug (lipotab) and its individual constituents, J Ethnopharmacol., Jul;66(1):97-102
18. Sharma A, Mediratta PK, Sharma KK, Fahim M (2011), Lipotab, a polyherbal formulation, attenuates isoprenaline-induced left ventricular remodeling and heart failure in rats, Aug; 30(8):1000-8
19. Wealth of India Vol. VII (National Institute of Science Communication Council of Scientific and Industrial Research, PID, New Delhi), 1997, 13-14
20. Satyavati GV, Gupta AK, Tondan N (1987), Medicinal Plants of India Vol.2 (Indian Council of Medical Research, New Delhi), 329-32
21. Ramirez-Tortosa MC, Mesa MD, Aguilera MC, et al. (1999), Oral administration of a turmeric extract inhibits LDL oxidation and has hypocholesterolemic effects in rabbits with experimental atherosclerosis. Atherosclerosis,;147:371-378
22. Srivastava R, Puri V, Srimal RC, Dhawan BN (1986), Effect of curcumin on platelet aggregation Srivastava R, Puri V, Srimal RC, Dhawan BN. Effect of curcumin on platelet aggregation and vascular prostacyclin synthesis. Arzneimittelforschung, 36:715-717
23. Toda S, Miyase T, Arich H, et al. (1985), Natural antioxidants. Antioxidative compounds isolated from rhizome of Curcuma longa L. Chem Pharmacol Bull; 33:1725-1728
24. Dikshit M, Rastogi L, Shukla R, Srimal RC(1995),. Prevention of ischaemia-induced biochemical changes by curcumin and quinidine in the cat heart. Indian J Med Res 101:31-35
25. Sheela C.G., Augusti K.T (1995), Effects of S-allyl cysteine sulfoxide isolalated from Allium sativum Linn and gugulipid on some enzymes and excretions of bile acids and sterol incholesterol fed rats. Indian journal of experiments) Biology, 33/10 (749-751)
26. NickH. Mashour,GcorgeI.Liv. William,H.Frishman (1998) Herbalmedicine for the treatment of cardiovascular disease, Arch.Intern. Med., 158:2225-2234
27. Jayaprakasha GK, JenabS, Negi, PS, Sakariah KK (2002), Chemical Evaluation of antioxidant activits and antimutagencity of turmeric oil: a byproduct from curcuminproduction, Zeitschrift Fuer Naturforschung. Section C. Biosciences, 57(9-10):228-3
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareRISK FACTORS FOR LOWER EXTREMITY AMPUTATION IN PATIENTS WITH DIABETIC FOOT ULCERS
English3036B A Nikhil NanjappaEnglish Karthik PEnglish T Tirou AroulEnglish S. Robinson SmileEnglishBackground: The number patients with diabetic foot ulcers presenting to surgery clinics has been increasing at an alarming rate. Diabetic foot ulcers are the most common cause for nontraumatic foot amputation. This study was undertaken to analyze both the risk factors for development of foot ulcers in diabetics and for lower extremity amputation (LEA) in patients with diabetic foot ulcers. Methods: A prospective analytical study that assessed the various risk factors associated with the development of foot ulcers in diabetics and that eventually lead to LEA in these patients. Univariate analysis and multivariate logistic regression (WALD‘s TEST) were used to assess statistical significance. Results: A total of 120 patients were included in the study, of which 53 underwent LEA. The incidence of foot ulcers was found to be higher in the following categories: males, 5th decade, associated hypertension, hyperlipidemia, and duration of diabetes more than 5 years. The significant risk factors for LEA are male gender, smoking, alcohol consumption, duration of DM more than 5 years, ABPI 5 years, male gender and peripheral vascular diseases (ABPIEnglishlower limb amputation, diabetic foot ulcers, risk factors for amputation.INTRODUCTION
Diabetic foot ulcer is a rising health problem with the surge in prevalence of diabetes. Foot ulcers have become the leading cause for hospitalization (20-30%) and the most important cause for prolonged hospitalization in diabetics. The prevalence of foot ulcers in diabetics is between 5- 10%. Upto 85% of all diabetic foot and its related problems are preventable through a combination of good foot care and health education for both patients and their healthcare providers. The holistic care of a diabetic foot ulcer needs a multidisciplinary approach: apart from glycemic control; the treatment includes meticulous debridement, sterile dressing, off-loading and appropriate antibiotics. Lower extremity amputation is one of the most feared outcomes of diabetes. About half of non-traumatic lower limb amputations are performed in diabetics and the post amputation mortality in 5 years is 39-80%. The number of diabetics in India is predicted to reach 57 million by 2025. In lines with these concerns, the slogan for World Diabetes Day 2005 was ?PUT FOOT FIRST: PREVENT AMPUTATION?. This study was undertaken to assess the risk factors that would lead to the development of foot ulcers in diabetics and lower extremity amputation (LEA) in these patients.
Aims and Objectives of the study
To identify the risk factors for lower extremity amputation (LEA) in patients with diabetic foot ulcers and also to analyze the risk factors for development of foot ulcers in patients with diabetes.
METHODS
A prospective study was conducted at Mahatma Gandhi Medical College and Research Institute, Pondicherry from June 2007 to August 2009. A total 120 patients were studied. 53 of the 120 patients underwent amputation, which was around (44.16%). The study involved risk factors such as gender, smoking, alcohol consumption, duration of diabetes, ankle-brachial index (ABPI), complications like osteomyelitis and associated complications of diabetes such as neuropathy, retinopathy and nephropathy. Univariate analysis and multivariate logistic regression (WALD‘s TEST) were done to find out statistical significance. P value of less than 0.05 is considered significant. RESULTS This was a prospective study to identify the risk factors leading to lower extremity amputation (LEA) in known diabetic patients presenting with foot ulcers. The patients were between 32 and 78 years of age with a peak incidence in the 5thdecade. The following data has been observed: 41 patients (36.7%) were in the age group of 41-50 years, 30 patients (25%) in 6th decade, 22 patients (18.3%) in the 4th decade, 19 patients (15.8%) in the 7th decade and 5 patients (4.2%) in the 8th decade. Of the 120 patients studied, 73 patients (60.8%) were male and 47 patients (39.2%) were female (Table1).The incidence of foot ulcers increases with the duration of diabetes. Of the 120 patients who presented with foot ulcers, 78 patients (65%) had diabetes for over 5 years, 86 patients (71.7%) had associated hypertension, and 98 patients (81.7%) had hyperlipidemia. The P values were 0.0000 for both and are statistically significant risk factors for the development of foot ulcers in diabetics. The site of the ulcers was most commonly in the forefoot region, seen in 87 of 120 patients (72.5%), followed by mid foot ulcers in 24 patients (20%) and hind foot ulcers in 9 patients (7.5%). The microorganisms which grew on the culture and sensitivity were predominantly Proteus in 32 patients (26.7%), followed by E.Coli in 25 patients (20.8%), Polymicrobial flora in 23 patient (19.2%), Pseudomonasin 14 patients (11.7%), Klebsiella in 14 patients (11.7%), Alpha hemolytic streptococci in 9 patients (7.5%), and MRSA (methicillin resistant Staphylococcus aureus)in 3 patients (2.4%). Of the 120 patients, 53 (44.16%) underwent amputation. 38 (71.7%) of the 53 patients were male and 15 patients (28.3%) were females. The P value was 0.0301; which is statistically significant and shows that males are more prone for LEA. Of the 53 patients who underwent LEA, 11 patients (20.7%) underwent below knee amputations and 1 patient (2%) underwent above knee amputation and minor amputation (removal of toes) was done in 41 patients (77.3%). Thirty three (62.2%) of 53 patients who underwent LEA consumed alcohol and 37 patients (69.8%) were smokers. The P values were 0.0014 for both and are statistically significant risk factors for amputation. Peripheral vascular disease or vasculopathy was studied as a risk factor for LEA. Ankle-brachial pressure index (ABPI) was calculated for all patients, ABPI 0.9 and 51 patients (96.2%) had ABPI < 0.9. The P value was 0.00035 and is statistically significant for LEA (Table 2).The duration of diabetes has always played an important role in amputation. Eight of 12 patients (66.6%) who underwent major amputation and 36 of 41 patients (87.8%) who underwent minor amputation had diabetes for more than 5 years. P value was 0.00049 and is statistically significant for LEA. Out of the 12 major amputations, 6 patients (50%) had forefoot ulcers, 4 patients (33.3%) had mid foot ulcers and 2 patients (16.7%) had hind foot ulcers. Associated complications of diabetes such as neuropathy, retinopathy and nephropathy was present in 33 (62.2%), 33 (62.2%) and 26 (49.0%) of the 53 patients who underwent amputation. Since the three parameters could not be studied in all patients of the non-amputation group, the statistical significance was not determined. Osteomyelitis was present in 27 patients (50.9%) of the 53 that underwent amputation, but the statistical significance could not be determined as all the patients of the non-amputated were not assessed for osteomyelitis. Table 3 shows the Univariate analysis of risk factors for amputation. Smoking, alcohol consumption, male gender, duration of diabetes more than 5 years and PVD (ABPI)Englishhttp://ijcrr.com/abstract.php?article_id=1881http://ijcrr.com/article_html.php?did=18811. Lipsky BA – A report from international consensus on diagnosing and treating infected diabetic foot. Diabetes metab.Res.Rev.2004; 20:68-77.
2. Reiber GE- The epidemiology of diabetic foot problems. Diabetic. Med. 1996; 3:6-11.
3. Reiber GE, Vileikyte L, Boyko, et al – causal pathways for incident lower extremity ulcer in patients with diabetes from two settings. Diabetic care 1999; 22:157-62.
4. Mehmood K, Akhthar ST, Talib A, Abbasi B, Siraj-ul-salekeen, Naqhvi IH – Clinical profile and management outcome of diabetic foot ulcers in a tertiary care hospital. J. Coll. Physicians Surg. Pak. 2008; July; 18(7):408-412.
5. Al-Maskari F, El-Sadiq M. Prevalence of risk factors for diabetic foot complications. BMC. Fam. Pract. 2007; 8:59.
6. Al-tawfiq JA, Johndrow JAPresentation and outcome of diabetic foot ulcers in Saudi-Arabian patients. Adv. Skin Wound Care 2009; 22(3); 119-121.
7. Winkley K, Stahl D, Chalder T, Edmonds ME, Ismail K- Risk factors associated with adverse outcomes in a population-based prospective cohort study of people with their first diabetic foot ulcer. Journal of Diabetes Complications 2007; 21(6):341-349.
8. Chaturvedi N, Abbot CA, Whalley A, Widdows P, Leggeter SY, Boulton AJRisk of diabetes-related amputation in South Asians vs. Europeans in the UK. Diabetes Med.2002; 19(2):99-104.
9. Davis WA, Norman PE, Bruce DG, Davis TM- Predictors, Consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes. Diabetologia 2006; 49(11): 2634-2641.
10. Nather A, Bee CS, Huak CY, Chew JL, Lin CB, Neo S, Sim EYEpidemiology of diabetic foot problems and predictive factors for limb loss. Journal of Diabetic complications 2008; 22(2):77-81.
11. Dalla Paola L, Faglia E- Treatment of diabetic foot ulcer: an overview of strategies for clinical approach. Current Diabetes Rev. 2006; 2:431-447.
12. Carlson T, Reed JF- A case control study of risk factors for toe amputation in a diabetic population. Int. Journal of Low Extremity wounds 2003; 2(1):19- 21.
13. Reiber GE: epidemiology of foot ulcerations and amputations in diabetes, 6th edition, St. Louis, MO, Mosby, 2001.
14. Slovenkai MP: Foot problems in diabetes. Med. Clin. North. America 82:949-971, 1998.
15. Ramsey SD, Newton K, Blough D, McCuloch DK, Sandhu N, Reiber GE, Wagner EH : Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care 22:382-387, 1999.
16. Amanda I. Adler, Jessie HA, Edward JB, Douglas GS: Lower-Extremity Amputation in Diabetes: the independent effects of peripheral vascular disease, sensory neuropathy, and foot ulcers. Diabetic Care, Volume 22, Number 7, July 1999.
17. Lavery L, Armstrong D, Vela S, Quebedeaux T, Fleischli J : Practical criteria for screening patients at high risk for diabetic foot ulceration. Arch Intern Med 158:157-162, 1998.
18. Pecoraro RE, Ahroni JH, Boyko EJ, and Stensel VL: Chronology and determinants of tissue repair in diabetic lower-extremity ulcers. Diabetes 40:1305-1313, 1991.
19. Faglia E, Favales F, Quarantienello A, CaliaP, Clelia P, Brambilla G, Rampoldi A, Morabito A: Angiographic evaluation of peripheral arterial occlusive disease and its role as a prognostic determinant for major amputation in diabetic subjects with foot ulcers. Diabetic Care 21:625-630, 1998.
20. Wijeyaratnae SM: revascularization in diabetic small disease of lower limbs: is it worthwhile? Ceylon Med. J. 2003: 48(1): 7-9.
21. S A Leers et al.: Realistic expectation for pedal bypass graft in patients. Journal of endovascular surgery 1998 ;volume 15; 122-127
List of Abbreavations LEA: Lower extremity amputation. ABPI: Ankle-brachial pressure index. PVD: Peripheral vascular disease. mmHg : millimeters of mercury
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareTHE DANGERS OF EXPOSURE OF PREGNANT WOMEN AND THE EFFECTS OF IONIZING RADIATION ON FETUS'S HEALTH
English3742Mohammad Javad Keikhai FarzanehEnglish Mahdi Shirin ShandizEnglish Mojtaba VardianEnglish Baharan NamayeshiEnglish Parviz Reza PoormirEnglishIntroduction: The discovery of X-rays by Rontgen in 1895 and the useful results obtained from this radiation to see the inner side of body‘s tissue and diagnosing the diseases causes the increased use of these radiation in medical centers; however, the high numbers of medical experiments and lack of observing the protection principles is led to the ocular discomfort and severe and progressive dermatitis in medicine‘s hands are significantly increased only after some months of discovery of X-ray which is led to the death of many early radiologists. On the other hand, the delayed effects resulted from these radiation has been clarified after 20 years and national and international agencies tried to devise the rotection principles and the radiologist‘s education to protect the radiologists and patients against the harmful effects of these radiation. Background: According to the performed studies, the ionizing radiation are potentially dangerous for the growing of the fetus and the pregnant women should be prevented from the unnecessary radiation except from when there are strong clinical reasons and even the conditions at which these radiation are had to be used for the pregnant women, all theprotection principles should be observed to minimize the fetus‘s dose as much as possible. Therefore, observing the standard protection principles such as justification, optimization and dose limit are necessary to prevent the occurrence of radiation effects, especially for the protection of fetus. Results and Discussion: Regarding the genetic and somatic effects of Xrays, it is essential that the newest ways of radiation protection to reduce the patients and personnel‘s dose be acquired, and due to the fact that the fetus is highly sensitive to ionized radiation, thea pregnant women should be prevented from being exposed to radiation unless a strong indication has been provided for.
Englishfetus‘s dose, Pregnant Women, radiography, exposureINTRODUCTION
Shortly after the discovery of X-ray by Rontgen, these rays was used for imaging of various parts of the body in such a way that today, the medical radiation is considered as the most significant part of artificial radiation in the world. For instance, more than 90% of the artificial radiation in England is resulted from performing the medical experiments (1). On the other hand, by developing the imaging technology and use of new imaging ways such as CT , the medical radiation of the general public are increasing so that many of these radiation methods is associated with high exposure of the patient. For example, the radiation of an elderly man for performing the abdomen CT scan experiment is 200-250 times more than radiography experiments of chest (2,3).
Review of Literature Russell established a 10-day rule in 1984 to prevent the unwanted effects of exposure being occurred for the women who are in pregnancy age. In this rule, it has been stipulated that the radiographic experiments of abdomen and pelvis for the women who are in pregnancy should be limited to the first 10 days after the starting of monthly period (4), and this rule is so significant for the medical radiation which have high attracting dose, because the possibility for the pregnancy of women in the first 10 days of monthly period is zero. On the other hand, by proposing the rule of all or none, the authority of the rule was questioned and this rule was then modified to 28 days, that is there is no ovum in the first 14 days of the monthly period, then there is no embryo to be damaged due to the exposure and the embryo monthly period is subjected to the rule of all or nothing in the second 14 days, that is whether the radiation makes no harm the embryo and is naturally grow up or it is gotten aborted because of the harm made by radiation and is wasted away. As is mentioned, this is why some restrictions are imposed for the women who are in pregnancy age without having any scientific justification and hereby the 10- day rule is modified to 28-day rule. Finally, by starting the next monthly period, women become familiar whether they are pregnant or not, and if it is observed that the person is pregnant, she is allowed to be under the radiography examination only when there is strong clinical indication for the patient‘s radiography (5,6).
DISCUSSION
There are three significant stages in the fetus‘s development in which the fetus has different rates of sensitivity to radiation: 1. The Pre-Implantation Stage (0-15 days after fertilization): In this stage, the sensitivity of embryo is low against the radiation and the embryo comprises some of undifferentiated cells which is not able to restore the effects resulted from radiation; therefore, even if the radiation make destructive effects on some cells, these damaged cells are replaced by new mitosis and the embryo naturally continues its development. In this stage, it is possible that the embryo to be died only if the embryo is affected to high exposure, but no specific risks can be observed in terms of malformation in this period. Therefore, if the embryo is faced with 10 rad dose, there is only 2% that it is died. 2. Stage of limb regeneration (15-50 days after fertilization): In this stage, the cells are fully differentiated and the fetus is highly sensitive to radiation, because the cells damaged is differentiated from other cells. Therefore, there are many defects related to growing and malformations are occurred in this stage in such a way that the low dose of radiation (10rad) can be led to innate malformations. Finally, threshold radiation dose in this period is between 2.5-5rad for occurring innate defects such as brain damage, lips malformations, teeth or outside reproductive organs which is much higher than the ordinary doses in medical imaging methods. 3. The Embryonic Stage (50-270 days after fertilization): The embryo is less affected to the radiation due to the differentiated cells and the danger of innate malformations is lower after the 10th week, but the danger of microcephaly still exists. In this stage, the most biggest undesirable effect of exposure, that is mental retardation and reduced development, can be observed after the 17th week and the radiation with high dose is required for being occurred which are more higher than the medical radiation. Therefore, in most imaging methods, there is no significant increase in the number of major malformations in the pregnant women who are undergone exposure accidentally (7-11). Table1 compares the radiation from many sources between adult people and fetus.
Due to the risk of potential ionizing radiation in the fetus‘s development, preventing from unnecessary exposures in pregnant women is necessary in radiation medicine centers, and ultrasound and MRI (without injecting the contrast material) are the replacement imaging methods that their dangers have not yet been realized in these condition . On the other hand, other than some of nuclear medicine methods which uses radioisotope of the iodine (due to vulnerability of thyroid gland) and also the radioisotopes such as iron and selenium which have long physical and biological half-life, performing most medical imaging methods in pregnancy are allowable (13,14,15).
Although the exposure with ionizing radiation in pregnancy are associated with some concerns, the dangers caused by them are really low and naturally the doses resulted from the doing diagnostic experiments is much lower than the doses led to the death of the cell (16,17). On the other hand, considering the cancers resulted from exposure, innate malformations and types of mutations observed in the Hiroshima and Nakazaki atomic explosions remainders for receiving high doses, the risks related to the medical exposure in pregnancy cannot be overlooked (18,19). For this reason, to prevent from the unwanted radiation of the fetus in pregnant women, the 10-day or 28-day rule has been devised by International Organization of Radiation Protection which stipulates that doing radiography in the women who are in pregnancy is limited to the first 10 days or 28 days after the initiation of monthly period (20-23). Generally, the women who are in pregnancy age should be questioned for doing diagnostic radiological experiments in pelvis which is undergone the initial radiation and if the patient was pregnant, doing radiography experiments should be justifiable (24-26). On the other hand, the 10-day or 28-day rule will be applied about the techniques with high dose and the radiologist pregnant women should avoid from doing interventional or fluoroscopic radiographies which causes a high dose (27-29). Finally, the International Commission on Radiological Protection proposed the current standards on radiation protection as the three principles below: 1. Justification: according to this principle, no radiation is allowed unless useful results are achieved compared to the damaging effects of exposure. 2. Optimization: applying the ?As Low As Reasonably Achievable? (ALARA) is necessary, so that the most diagnostic information should be provided by the least exposure. 3. Dose Limit : according to this principle, the radiation of people, embryo and fetus and also occupational radiation should be limited to a specific amount which using techniques such as shielding, increasing the distance to the source of radiation and reducing the time of radiation are so significant in this regard (30,31).
CONCLUSION
According to the somatic and genetic outcomes of ionizing radiation, radiation protection should be taken into consideration not only as a scientific issue, but a rational and ethical issue (32). According to the sensitivity of the fetus against ionizing radiation, unnecessary radiation for the pregnant women should be avoided unless there is a strong clinical indication (33). Being assured about the pregnancy or non-pregnancy in women before doing radiological experiments are necessary and if signs of pregnancy are observed, it must be attempted that the diagnostic information be achieved with the least exposure to the patient. On the other hand, doing some diagnostic experiments, such as chest, skull and parts of body radiography is applicable in each period of pregnancy if the fetus is completely shielded (34).
Englishhttp://ijcrr.com/abstract.php?article_id=1882http://ijcrr.com/article_html.php?did=18821. Rotnalapan S, Bona N, Koarn G. Mother Risk Update: Ionizing radiation during pregnancy Canadian family physician. 2003, 49: 873-874
2. International Commission on Radiological Protection Publication 90: Biological Effects after prenatal Irradiation (Embryo and Fetus) 2003.
3. Brenner D, Elliston C, Hall E, Bredon W.Estimated risks of radiation-induced fetal cancer from pediatric CT. AJR Am J Roentgenol. 2001; 176: 289-296
4. Faulkner K, Malone JF, Corbett RH, Craven P, Osei EK. Radiation during pregnancy in Radiological protection of patients in Diagnostic and interventional Radiology, Nuclear Medicine and Radiotherapy. (IAEA,Veinna) 2001: 507-511
5. Brateman L. Radiation safety considerations for diagnostic radiology personnel. Radiographics 1999; 19: 1037-1055
6. Campeau FE. Radiography: Technology, environment, professionalism. Philadelphia: LippincottWilliams andWilkins, 1999: 86-102
7. Schwenn MR, Brill AB. Childhood cancer 10 years after the Chernobyl accident. Curr Opin Pediatr 1997; 9 (1): 51-54
8. Steenvoorde P, Pauwels EKJ, Harding LK, Bourguignon M, Mariere B, Brouse JJ. Diagnostic nuclear medicine and risk for the fetus. Eur J Nucl Med 1998; 25: 193-199
9. Doll R, Wakeford R. Risk of childhood cancer from fetal irradiation. Br J Radiol 1997; 70: 130-139
10. Thomas SM, Bees NR, Adam EJ. Trends in the use of pelvimetry techniques. Clin Radiol. 1998; 53: 293- 295
11. Wakeford R. The risk of childhood cancer from intra-uterine and preconception exposure to ionizing radiation. Environ Health Prespect 1995;103 (11) :1018-1025
12. Little MP, Charles MW, Wakeford RA review of the risks of leukemia in relation to prenatal preconception exposure to radiation. Health Phys 1995; 68 (3): 299-310
13. AERB Safety Code, (Code No. AERB/SE/MED-2) Mumbai 2001: 1- 25
14. Simpkin DJ, Dixon RL. Secondary Shielding Barriers for diagnostic X-ray facilities: Scatter and leakage revisited.Health Phys. 1998; 74(3): 350-365
15. Shymko MJ. Minimizing occupational exposure. Radiologic Technology 1998; 70(1): 89-90
16. Faulkner K, Broadhead DA, Harrison RM. Patient dosimetry methods Applied Radiation and Isometers. 1999; 50: 113-123
17. Osei EK, Faulkner K, Kotre CJ. Radiation dose to the fetus in diagnostic radiology. Society for Radiological Protection. 1999; 72: 101- 104
18. Osei EK, Faulkner K. Fetal doses from radiological examinations. British Journal of Radiology. 1999; 72: 773- 780
19. Wagner CK, Lester RG, Saldava LR. Exposure of the pregnant patient to diagnostic radiation a guide to medical management 1997 (Medical Physics Publishing, USA)
20. Rabinson A, Grainger RG. Radiation Protection and patient doses in diagnostic radiology in Grainger and Allison‘s diagnostic radiology a text book of medical imagings. 3rd ed, New york church hill Livingstone. 1997: 169-188
21. Langer SG, Gray JE. Radiation Shielding complications of computed tomography scatter exposure to the floor. Health Phys. 1998; 75(2): 193- 196
22. Miller RW. Delayed effects of external radiation exposure: A brief history. Radiation research. 1995; 144: 160-169
23. Rubin P, Constine LS, Williams JP. Late effects of cancer treatment. Radiation and drug toxicity. in: perez CA, Brady LW, eds. principles and Practice of Radiation Oncology, 3rd ed. Philadelphia,New york: LippincottRaven, 1998: 155-211
24. Tapiovara M, Lakkisto RA, Servomaa A. APC-based monte Carlo program for calculating patient doses in medical x-ray examinations. STUK-A139, February 1997
25. Servomaa A, Tapiovaara M. Organ dose calculating medical X-ray examinations by the program PCXMC. Radiation Protection. Dosimetry, 1998; 80: 213-219
26. Mattsson S, Jacobsson L, Vestergren E. The basic principles in Assessment and Selection of reference doses: Consideration in Nuclear Medicine. Radiation Protectiondosimetry, 1998, 80: 23-27
27. KalanderWA, Scmidt B, Zankl M, Scmidt M. APC program for estimating organ dose and effective dose values in computed tomography. European Radiology 1999; 9: 555-562
28. Valentin J. Pregnancy and medical radiation (ICRP84) 2000; 30(1): 67-73 29. Icrp 80,Radiation Dose to patients from Radiopharmaceuticals. 1998; 28(3): 65-72
30. WWiner-Muram HT, Boone JM, Brown HL, Jennings SG, Mabie WC, Lombardo GT. Pulmonary embolism in pregnant patients:fetal radiation dose with helical CT. Radiology. 2002; 224(2): 487-492
31. Stabin M, Bretiz H. Breast milk excretion of radiopharmaceuticals: Mechanisms, findings, and radiation dosimetry. continuing Medical education Article. Journal of Nuclear Medicine. 2000; 41(50): 863-873
32. Russell JR, Stabin MJ, Sparks RB, Watson EE. Radiation absorbed dose to the embryo/fetus from radiopharmaceuticals. Health Phys 2000; 73(5): 756-769
33. Wall BF, Hart D. Revised radiation doses for typical x-ray examinations. The British Journal of Radiology. 1997; 70: 437-439
34. Stovall M, Blackwell CR, Cundiff J, Novack D. H, Palta JR, Louis K, et al. Fetal dose from radiotherapy with photon beams: A report of AAPM radiation therapy committee task group. Med. Phys, 1995; 22(1): 63-82
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareEFFECT OF MYOFASCIAL RELEASE ON HAMSTRINGS TIGHTNESS IN HEALTHY INDIVIDUALS
English4348Salvi ShahEnglishIntroduction: To date, there are very few reports comparing on duration of hold of end position in MFR on joint range of motion (ROM) and hamstring muscle tightness. The purpose of this study was to examine the length of time the hamstring muscles should be placed in end position of MFR. Aim of Study: To study the effect of myofascial release (MFR) in reducing the hamstrings tightness. Methodology: Study design: An experimental comparative study Sample selection: A random sample of 31 students were taken from SBB Physiotherapy college, Ahmedabad after giving due consideration to inclusion and exclusion criteria. All of them took part in study on a voluntary basis after signing consent. Sample size: Total 31.In Group A: 16 students (End position of MFR was maintained for 30 seconds) Group B: 15
students (End position of MFR maintained for 60 seconds) Inclusion criteria Normal healthy individuals, female students, age group: 16-24 years, hamstrings are tight and passive straight leg raising (SLR) range was between 30-70 ranges. Exclusion criteria Any fracture of spine or lower limb within last 6 months, tight rectus femoris and tight ilio psoas, hypersensitive to skin Outcome measure Passive Straight leg raising (SLR) test. MFR was given for total of 12 sessions with subject in prone position for 5 repetitions/session 6 days in a week for 2 weeks to both groups. Results: In Group A and Group B results showed highly significant improvement in passive SLR after 10 days of treatment at 5% level of significance. On comparing Group A and Group B the results showed no significant difference in passive SLR between both groups at 5% level of significance. Conclusion: From the present study it can be concluded that, by
MFR there was significant improvement in passive SLR range. But no significant difference in improvement of passive SLR if we hold the end position for 30 seconds or 60 seconds.
EnglishMFR, tightness, hamstringsINTRODUCTION
Flexibility is an essential component of injury prevention and rehabilitation 1 . Several modalities or physical agents have been used in conjunction with stretching to enhance further increases in range of motion. One study found that the application of ice increased short term improvement of hamstring flexibility over stretching alone2 .Research has shown hamstring flexibility can significantly increase when prolonged stretching is used in combination with shortwave diathermy3 . People encounter various kinds of muscle tightness and always keep trying to get off from it. There are number of ways to get cured and say good bye to tightness. Myofascial release (MFR) is a “curative” tool for treatment of the tightness.
Myofascial release is a collection of techniques used for the purpose of relieving soft tissue from an abnormal hold of a tight fascia 4 .Direct bodily effects range from alleviation of pain, improvement of athletic performance, and greater flexibility and ease of movement to more subjective concerns such as better posture. More indirect goals include emotional release, deep relaxation, or general feelings of connection and wellbeing. Rather than being a specific technique, MFR is better understood as a goal-oriented approach to working with tissue-based restrictions and their two-way interactions with movement and posture5 . But suddenly some “questions” appears which are “cloudy” in mind and bring same form of confusion with them. - For how many times in a day we have to apply MFR? - For how long is it effective? - For how long we have to hold end position? - Does person require any other type of stretching or flexibility exercises along with MFR for tightness? The main aim of doing this study was as follows: - To study effectiveness of MFR on hamstring muscle tightness. - To study the comparative effectiveness of two different duration hold of end position of MFR between groups. So the objective of this study was to determine if the use of MFR would decrease the tightness of hamstring muscle group determined by a Passive SLR test.
MATERIALS AND METHODOLOGY
Study design: An experimental comparative study Study setting: SBB Physiotherapy College, V.S. hospital, Ahmedabad Sample selection A random sample of 31 students were taken from SBB Physiotherapy college, V.S. hospital, Ahmedabad after giving due consideration to inclusion /exclusion criteria. All of them took part in study on voluntary basis after signing consent. Sample size 31 Group A: 16 students (End position of MFR maintained for 30 seconds) Group B: 15 students (End position of MFR maintained for 60 seconds) Selection criteria: Inclusion criteria Normal healthy individuals, female students, age group: 16- 24 years, hamstrings are tight and passive straight leg raising (SLR) range was between 30-70 ranges. Exclusion criteria Any fracture of spine or lower limb within last 6 months, tight rectus femoris and tight ilio psoas, hypersensitive to skin Outcome measure Passive Straight leg (SLR) raising test Passive SLR test is extensively used as an outcome measure6-9 to measure hamstring muscle tightness.
Procedure
Subjects who fulfilled all inclusion criteria were taken up for study. The procedure was explained to all subjects. All subjects signed consent and were allocated randomly to either group A or Group B. The intervention covered total 12 training sessions, at a frequency of 6 sessions per week and 5 repetitions in each session. The Passive Straight leg raising test (SLR) was used as criterion measurements. Goniometer was to measure angle between straight leg and table. Before the start of study and again after 2 weeks of treatment, Passive Straight leg raising (SLR) test was done. Subjects were divided into 2 groups. Group A (n=16) in which end position of MFR was maintained for 30 seconds and in Group B (n=15) in which end position of MFR was maintained for 60 seconds. MFR was given with subjects in prone position for both groups. With the use of ulnar border of hand MFR was given from proximal to distal direction using a light amount of pressure over hamstring muscle. The therapist had scaled the pressure following contact until the slack in the skin was taken up and that position was held until the tissues begins to soften. Like that hand was moved slightly as the tissue opened. The hand position was crossed in order to work as energy efficiently as possible. (Photograph 1) In Group A end position was maintained for 30 seconds and for the Group B maintained for 60 seconds. The subjects were observed for any change skin colour and asked to report if there was any discomfort during the treatment sessions. All the subjects had completed the whole treatment program of 2 weeks without any discomfort. All the subjects were instructed not to do any flexibility or stretching exercises for the lower limbs during treatment program.
RESULTS
For this study 31 people were randomly selected based on inclusion and exclusion criteria. From that 16 people were included in Group A and rests were included in Group B. In Group A end position of MFR was maintained for 30 seconds and for the Group B maintained for 60 seconds. The intervention covered total 12 training sessions, at a frequency of 6 sessions/week and 5 repetitions in each session. All the statistical analysis was done with the help of Graph Pad Demo version. Student‘s t-test (paired t-test) was applied for within group comparison of Group A and Group B for both legs. In the Group A and Group B results showed highly statistically significant improvement in passive SLR range after 12 training sessions at 5% level of significance. (Graph 1, Graph 2) Comparison between Group A and Group B Student‘s t test (unpaired t test) was applied between group comparison for Group A and Group B for both legs. On comparing group A and group B the results showed no statistically significant difference in improvements in passive SLR range at 5% level of significance. (Graph 3, Table 1 and Table 2)
DISCUSSION
The present study was conducted to see the effect of MFR on hamstring muscle tightness on healthy individuals. The results showed that, both the treatment groups showed significant improvement in passive SLR range after intervention. But results for between group analysis (Group A: End position of MFR was maintained for 30 seconds, Group B: End position of MFR maintained for 60 seconds) showed that no statistically significant difference in improvements in passive SLR range at 5% level of significance. The probable reason for this result was that MFR technique mainly involves the golgi tendon organ. The pressure associated with myofascial release causes the golgi tendon organ to sense a change of tension in the muscle and responds to this high or prolonged tension by inducing relaxation of the muscle spindles 10 . So, there was improvement in hamstring muscle tightness in both the groups with MFR. The reason for between groups results was that 30 seconds hold of end position of MFR was sufficient to stimulate golgi tendon organ, hence induce relaxation of muscle spindles. So there was a decrease in tightness of hamstring muscle and no need to hold end position of MFR for 60 seconds unnecessarily.
CONCLUSION
It can be concluded from the present study that, both groups showed highly statistically significant increase in ROM of hamstring muscles bilaterally based upon their passive SLR test; But when comparing two groups, there was no statistically significant difference in improvement of ROM of hamstring muscles bilaterally based upon their passive SLR test if we hold the end position for 30 seconds or 60 seconds. So MFR can be used to reduce tightness of hamstring muscles but no need to hold end position more than 30 seconds unnecessarily. Enhanced understanding of the effect of end position of MFR on the hamstring muscles as a result of the findings of our study will hopefully enable clinicians to provide more effective and scientifically based treatment when incorporating MFR into rehabilitation programs.
Short Comings
Study could have done on more number of people. Effect of MFR was not so long lasting. Along with MFR it was really required to do stretching and flexibility exercises for the maintenance of gained range in muscles.
ACKNOWLEDGEMENT
I would like to thank my all the staff members of SBB Physiotherapy College, Ahmedabad for their expert guidance and continuous encouragement with their keen interest in my work. I would like to thank all my friends and colleagues who helped me throughout the time of completing the study. Author acknowledges the immense help received from the scholars whose articles are cited and included in references of this manuscript. The author is also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1883http://ijcrr.com/article_html.php?did=18831. Corbin. CB, Noble L. Flexibility: a major component of physical fitness. J Phys Educ Recreat Dance. 1980; 51:57-60
2. Brodowicz GR, Welsh R, Wallis J. Comparison of stretching with ice, stretching with heat, or stretching alone on hamstring flexibility. J Athl Train. 1996; 31(4):324-327.
3. Draper DO, Castro JL, Feland B, Schulthies S, Eggett D. Shortwave diathermy and prolonged stretching increase hamstring flexibility more than prolonged stretching alone. J Orthop Sports Phys Ther. 2004; 34(1):13-20.
4. Prentice WE. Arnheim‘s Principles of Athletic Training. Madison, WI: McGraw-Hill; 2003:85-90.3.
5. Myofascial Release Keith Eric Grant and Art Riggs
6. Tanigawa MC: Comparison of the hold-relax procedure and passive mobilization on increasing muscle length. Phys Ther 52:725-735, 1972
7. Medeiros JM, Smidt GL, Burmeister LF, et al: The influence of isometric exercise and passive stretch on hip joint motion. Phys Ther 57:518-523, 1977
8. Moore MA, Hutton RS: Electromyographic investigation of muscle stretching techniques. Med Sci Sports 12:322-329,1980
9. Halkovich LR, Personius WJ, Clamann HP, et al: Effect of Flouri-Methane® spray on passive hip flexion. Phys Ther 61:185-189, 1981
10. Jacklyn K. Miller, Ashley M. Rockey Foam Rollers Show No Increase in the Flexibility of the Hamstring Muscle Group UW-L Journal of Undergraduate Research :IX ,2006
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareAN EVALUATION OF DIAGNOSTIC IMPORTANCE OF FIBREOPTIC BRONCHOSCOPY AND INDUCED SPUTUM IN THE DIAGNOSIS OF SPUTUM SMEARNEGATIVE PULMONARY TUBERCULOSIS
English4955Thakur GajwaniEnglish Jitendra AhujaEnglishIntroduction: Induced sputum is less invasive and economical procedure than bronchoscopy. A single induced sputum sample and bronchoscopy are very useful for diagnosing of Sputum smear-negative pulmonary tuberculosis (SSN-PTB). Our aim is to find out which procedure is better in diagnosis of sputum negative pulmonary tuberculosis. Methods: It is a cross-sectional prospective study in which consecutive patient were selected with possibly active pulmonary uberculosis, the diagnostic give way three induced sputum tests were weighed against with bronchoscopy. Patients whichever produced no sputum otherwise (acid fast) smear negative sputum. Bronchoscopy was only carried out if at least two induced sputum samples were smear negative. Results: Of 147 patients who completed all tests, 51 (34 %) had smear negative and culture positive specimens, 26 (51%) on bronchoscopy and 49 (96%) on induced sputum (pEnglishSputum smear-negative pulmonary tuberculosis (SSN-PTB), Induced sputum, bronchoscopyINTRODUCTION
Tuberculosis (TB), a significant preventable and treatable cause of death, is a foremost health problem globally. According to the recent estimates, there were 8.8 million new TB cases in 2005, 7.4 million of them in Asia and sub-Saharan Africa; 1.6 million people died of TB, including 1,95,000 patients co-infected with the human immunodeficiency virus (HIV).1, 2 Detection of active pulmonary tuberculosis (PTB) disease is an important element of TB control as early treatment turn into these patients noninfectious and break up the chain of transmission of TB. According the programme conditions, Revised National Tuberculosis Control Programme (RNTCP) of Government of India, 3 the diagnosis of PTB is rely on sputum smear examination. Sputum microscopy is a highly specific test, an inexpensive, appropriate technology for periphery also and is an essential part of the directly observed treatment, short-course (DOTS) strategy of the WHO. On the other hand, in patients with a compatible clinical symptoms, sputum smears do not shows acid-fast bacilli (AFB) in all patients, ?smear negative - culture positive‘ state has been found in 22% to 61% of the cases.4, 5 Mycobacterial cultures take at least six to eight weeks time for confirming the diagnosis and in so doing an important time is vanished or patient may receive empirical treatment. The clinicians still face Sputum smearnegative pulmonary tuberculosis (SSNPTB) as a common problem in children who are unable to make a sufficient sample of sputum and patients with immunosuppressed states like AIDS patients, commonly have SSN-PTB. Delayed diagnosis may be an important cause of excess mortality in people living with HIV who have smear-negative pulmonary and extra pulmonary tuberculosis. Bronchoscopy is commonly used for investigating patients with SSN-PTB. Still, there is a wide range in the diagnostic tests are available yield from bronchoscopy in suspected TB,6,7 and bronchoscopy is expensive, needs experts to perform and some time inconvenient to patients. A cheaper non-invasive test which may adopt by RNTCP could be performed at peripheral centers and means of providing the same information as bronchoscopy would be beneficial. Induced sputum testing has previously been reported to be a useful test in the diagnosis of subjects with SSN-PTB .8 Mc Williams et al9 compared the induced sputum test and bronchoscopy in the diagnosis of TB, and reported that the diagnostic value of induced sputum test was more than bronchoscopy. We have compared the results of three induced sputum tests with bronchoscopy washings in 200 patients with possibly active pulmonary tuberculosis.
METHODS
The present study, approved by the institutional ethics committee, was conducted in tertiary level hospital over a period from November 2010 to November 2011. Inclusion criteria comprised: Clinically suspected cases of pulmonary tuberculosis, aged 16-75 years, with three sputum smears negative for AFB and a chest radiograph suggestive of pulmonary tuberculosis was included in the study after obtaining an informed consent. Exclusion criteria were severe asthma or severe chronic obstructive pulmonary disease (COPD) (forced expiratory volume in 1 second (FEV1) Englishhttp://ijcrr.com/abstract.php?article_id=1884http://ijcrr.com/article_html.php?did=18841. World Health Organization. Global tuberculosis control surveillance, planning, financing. WHO Report 2007.Geneva: World Health Organization; 2007. WHO/HTM/TB/2007.376
2. Dye C. Global epidemiology of tuberculosis. Lancet 2006;367: 938-40.
3. TB India 2007. RNTCP Status Report. New Delhi: Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India; 2007.
4. Narain R, Subbarao MS, Chandrasekhar P, Pyarelal.Microscopy positive and microscopy negative cases of pulmonary tuberculosis. Am Rev Respir Dis 1971; 103: 761-3.
5. Kim TC, Blackman RS, Heatwole KM, Rochester DF. Acid fast bacilli in sputum smears of patients with pulmonary tuberculosis: prevalence and significance of negative smears pretreatment and positive smears post treatment. Am Rev Respir Dis 1984; 29: 264-8.
6. Arshad Altaf Bachh, Rahul Gupta, Inaamul Haq, Hanumant Ganapati Varudkar. Diagnosing sputum/smearnegative pulmonary tuberculosis: Does fibre-optic bronchoscopy play a significant role? Lung india,2010, 27 : 2, 58-62
7. Willcox PA, Benetar SR, Potgieter PD. Use of the flexible fibreoptic bronchoscope in diagnosis of sputumnegative pulmonary tuberculosis. Thorax1982;37:598–601.
8. Merrick ST, Sepkowitz KA, Walsh J, et al. Comparison of induced versus expectorated sputum for diagnosis of pulmonary tuberculosis by acid fast smear. Am J Infect Control1997;25:463–6.
9. T McWilliams, A U Wells, A C Harrison, S Lindstrom, R J Cameron, E Foskin Induced sputum and bronchoscopy in the diagnosis of pulmonary tuberculosis Thorax 2002;57:1010–1014
10. Anderson C, Inhaber N, Menzies D. Comparison of sputum induction with fiber-optic bronchoscopy in the diagnosis of tuberculosis. Am J Respir Crit Care Med1995;52:1570–4.
11. Schmidt RM, Rosenkranz HS. Anti microbial activity of local anaesthetics: lidocaine and procaine. J Infect Dis1970;121:597–607
12. Al Zahrani K, Al Jahdali H, René P, et al. Yield of smear, culture and amplification tests from repeated sputum induction for the diagnosis of pulmonary tuberculosis. Int J Tuberc Lung Dis2001;5:855–60.
13. Larson JL, Ridzon R, Hannan MH. Sputum induction versus fibreoptic bronchoscopy in the diagnsosis of tuberculosis. Am J Respir Crit Care Med2001;163:1279–80.
14. Centres for Disease Control. Guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities, 1994. MMWR1994;43: RR-13
15. Leers W. Disinfecting endoscopes: how not to transmit Mycobacterium tuberculosis by bronchoscopy. Can Med Assoc J1980;123:275–83.
16. Nelson KE, Larson PA, Schraufnagel DE, et al. Transmission of tuberculosis by flexible fiberbronchoscopes. Am Rev Respir Dis1983;127:97–100.
17. Steere AC, Corrales J, and von Graevenitz A. A cluster of Mycobacterium gordonae isolates from bronchoscopy specimens. Am Rev Respir Dis1979;120:214–6.
18. Dawson DJ, Armstrong JG, and Blacklock ZM. Mycobacterial crosscontamination of bronchoscopy specimens. Am Rev Respir Dis1982;126:1095–7.
19. Pappas SA, Schaaff DM, DiCostanzo MB et al. Contamination of flexible fibreoptic bronchoscopes. Am Rev Respir Dis1983;127:391–2.
20. Lim TK, Cherian J, Poh KL, Leong TY. The rapid diagnosis of smearnegative pulmonary tuberculosis: a cost-effectiveness analysis. Respirology 2000; 5: 403-9.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareINTER AND INTRA-RATER RELIABILITY OF THE CRANIOCERVICAL FLEXION TEST BY USING MODIFIED
SPHYGMOMANOMETER AS A PRESSURE BIO-FEEDBACK
English5662Harshit SoniEnglish Dharti HingarajiaEnglish Sushant DeyEnglish Nishant TejwaniEnglishBackground and Objective: The Cranio-Cervical Flexion Test (CCFT) is a reliable clinical and research test to measure the endurance of the Deep Cranio-Cervical Flexors (DCCF) muscles via Activation Score (AS) and Performance Index (PI) by using Chattanooga Pressure Biofeedback unit (CPBU). In India, we use modified sphygmomanometer instead of CPBU for this test, but the data on reliability of the instrument is scarce. So present study was carried out to check inter and intra-rater reliability of the CCFT by using modified sphygmomanometer. Methods: 50 subjects were selected from the age group of 17 to 22 years. For inter-rater reliability the AS and PI were measured on each subject by two different experienced Physiotherapists and For intra-rater reliability the same was measured on two occasions with 7 days gape by the same therapist. ICC-Pearson was calculated to check inter and intra-rater reliability. Results: For AS and PI good inter-rater reliability determined by the ICC= 0.709 and 0.752 respectively and excellent intra-rater reliability determined by the ICC=0.820 and 0.885 respectively. Conclusion: The CCFT by using modified sphygmomanometer showed
good inter-rater and excellent intra-rater reliability.
EnglishCranio-Cervical Flexion Test, Modified Sphygmomanometer, Deep Cranio-Cervical Flexors, ReliabilityINTRODUCTION
The Cranio-Cervical Flexion Test (CCFT) is a clinical test of the anatomical action of the deep cervical flexor muscles, the longus capitis, and colli.1 It has evolved over 17 years as both a clinical and research tool and was devised in response to research indicating the importance of the Deep Cranio-Cervical Flexors (DCCF) in support of the cervical lordosis and motion segments and clinical observations of their impMATERIAL AND METHODSairment with neck pain.1-5 CCFT is a low-load test performed in the supine position with the patient guided to each stage by feedback from a pressure sensor placed behind the neck.1 The features assessed in this test are the Activation Score (pressure that subject can achieve and hold for 10 seconds) and the Performance Index (calculated by multiplying the activation score by the number of successful repetitions) of the DCCF during the performance of five progressive stages of increasing craniocervical flexion range of motion.1,6 The CCFT using Chattanooga Pressure Biofeedback unit (CPBU) is considered as the most reliable tool as proven by both clinical and EMG studies compared to other tests for the measurement of DCCF muscle endurance in subjects with and without neck pain.1,7,8,9 In previous Indian studies, modified sphygmomanometer has been used as a pressure sensor instead of CPBU for the measurement of DCCF muscle endurance.10,11,12,13 The modified Sphygmomanometer has been found to be a reliable instrument for the measurement of the DCCF isometric muscle strength in subjects with and without neck pain,14 but the data on reliability of the instrument for the measurement of DCCF muscle endurance is scarce which signifies the need of the present study. The main aim of this study is to check inter and intra-rater reliability of the CCFT by using modified sphygmomanometer as a pressure biofeedback to measure DCCF muscle endurance.
MATERIAL AND METHODS
This study was a Co-relational study, conducted at the SPB Physiotherapy College, Surat. The co-relational procedure was ethically revised and approved by the Research and Ethical committee of SPB Physiotherapy College, Surat
Sample Population and Sample Size: 50 asymptomatic subjects; male (n=20) and female (n=30) were selected from the age group of 17 to 22 (Mean age 19.86) years. The study population covers the students of SPB Physiotherapy College, Surat and were recruited according to the inclusion and exclusion criteria mentioned below:
Inclusion Criteria: 1. Subjects with no history of neck pain and 2. Subjects within the age group of 17 to 22 years.
Exclusion Criteria:
1. Subjects with any history of neck pain,
2. Subjects with history of any surgery in and around cervical spine,
3. Subjects performing regular exercises of the neck muscles After meeting suitable criteria, the written informed consent was obtained from each subject after explaining the details of CCFT to be conducted on them. Primary assessment for demographic characteristics and outcome measures was taken. The Same procedure for CCFT was used as described by Jull G 20001 , but in present study modified sphygmomanometer has been used instead of CPBU in original procedure.
(a) Outcome Measure : Activation Score (AS) and Performance Index (PI)
(b) Data Collection: For inter-rater reliability the AS and PI were measured on each subject by two different experienced Physiotherapists, rater-1 and rater- 2 (Figure-1 and Figure-2). For intra-rater reliability the same was measured on two occasions with 7 days gape by the same therapist i.e. rater-2 (Figure-1).
(c)Data Analysis: Two-tailed Intra-class Correlation Coefficient (ICC-Pearson) was calculated by SPSS13.0 version to check inter and intra-rater reliability at 0.01 level of significance for AS and PI separately.
RESULTS
There were no drop outs throughout the study, all 50 subjects were examined by both the therapist timely as per the methodology. Mean age of the subjects was 19.86±1.25 years. Mean weight was 54.98±12.34 kg and mean height was 163.78±9.77cm. Mean BMI was 20.38±3.49. Mean, Standard deviation, standard error of mean and confidence interval at 99% confidence level for activation score and performance index were as per tabulated in table-1 ICC for activation score and performance index measured by two different therapists were 0.71 and 0.75 respectively which shows good inter-rater reliability. (Table-2) ICC for activation score and performance index measured by same therapist at 7 days gape were 0.82 and 0.89 respectively which shows excellent intra-rater reliability. (Table-2)
DISCUSSION
As a result of present study we found good inter-rater and excellent intra-rater reliability determined by ICC (Table - 1 and Table – 2). For quantitative measurements, ICC is the principal tool with Intra-class correlation 0.93 and confidence limits 0.88 – 0.96.15 The criteria for reliability have been defined as ICC: 0- 0.2 = poor, 0.21-0.4 = fair, 0.41-0.6 = moderate, 0.61-0.8 = good and 0.81-1 = excellent.16,17 These findings are matched with the findings [ICC(1,1)=0.81 and 0.93 for AS and PI] of study carried out by Jull G et al, 1999 using CPBU on asymptomatic subjects with age group (30±10) and sample size (n=50) similar to our study16 and also with the findings [ICC(1,1)=0.84 and 0.90 for AS and PI] of study carried out by Marta et al, 2007 with smaller sample size (n=10)6 . However, findings of our study differ from the findings of studies carried out by James G et al, 2010 [ICC(1,1)=0.98, SEM=8.94 for PI]7 and Sue Hudswell et al, 2005 [ICC(1,1)=0.78 for AS and PI, ICC(2,1)=0.57 and 0.54 for AS and PI]9 . The clarification of difference in these findings can be attributed to smaller sample size (n=19) and large SEM (8.94) in the former study and to the selected sample population (which included patient with neck pain) in the later study. (Table-3) Hence, modified sphygmomanometer can be used as a clinical and research tool as a pressure biofeedback instead of CPBU in CCFT as it shows good inter-rater and excellent intra-rater reliability. Cost effectiveness and easy availability of modified sphygmomanometer also accounts for its preference instead of CPBU for Indian therapists.
Future Implications: 1. This study can be explored for all age groups; middle-aged and elderly. 2. Future studies can be carried out with large sample size. 3. Additional research on the same topic can be done which includes symptomatic patients with different cervicogenic disorders.
CONCLUSION
The Cranio-Cervical Flexion Test by using modified sphygmomanometer showed good inter-rater and excellent intra-rater reliability. So that we proved that the modified sphygmomanometer can be used as a pressure bio-feedback instead of Chattanooga Pressure Bio-Feedback in Cranio-Cervical Flexion Test as it is cost effective and easily available for all Physiotherapist.
ACKNOWLEDGEMENTS
First we would like to thank God to bless us enough courage and ability to pursue this work. We are thankful to ?Research Ethical Committee? of SPB physiotherapy College, Surat, for granting us permission to commence on the research. There are no words to gratitude sufficient enough to thank our honorable trusties and Principal Dr. Beena Dave. Who inspired and helped us to choose such a valuable topic for research. We are greatly thankful to all 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. Last but not the least We are thankful to all our subjects who participated with full cooperation and showed voluntary interest, without them this study would not have been possible. Finally we are thankful to all those who directly or indirectly contributed to this study.
Englishhttp://ijcrr.com/abstract.php?article_id=1885http://ijcrr.com/article_html.php?did=18851. Jull G, S.O'Leary, D Falla. Clinical Assessment of the Deep Cervical Flexor Muscles: The Craniocervical Flexion Test. J Manipulative Physiol Ther. 2008;31:525-533
2. Fountain FP, Minear WL, Allison PD. Function of longus colli and longissimus cervicis muscles in man. Arch Phys Med Rehabil. 1966;47:665- 9.
3. Kamibayashi LK, Richmond FJR. Morphometry of human neck muscles. Spine 1998;23:1314-23.
4. Mayoux-Benhamou MA, Revel M, Vallee C, Roudier R, Barbet JP, Bargy F. Longus colli has a postural function on cervical curvature. Surg Radiol Anat. 1994;16:367-71.
5. Vitti M, Fujiwara M, Basmajian JV, Iida M. The integrated roles of longus colli and sternocleidomastoid muscles: an electromyographic study. Anat Rec. 1973;177:471-84.
6. Marta Pérez-de-Heredia, Alberto Molero-Sánchez, Juan C. MiangolarraPage, César Fernández-de-las-Peñas. Performance of the Craniocervical Flexion Test, Forward Head Posture, and Headache Clinical Parameters in Patients With Chronic Tension-Type Headache: A Pilot Study. J Orthop Sports Phys Ther. 2007;37(2):33-39
7. James G, Doe T. The craniocervical flexion test: intra-tester reliability in asymptomatic subjects. Physiother Res Int. 2010 Sep;15(3):144-9.
8. Chiu TT, Law EY, Chiu TH. Performance of the craniocervical flexion test in subjects with and without chronic neck pain. J Orthop Sports Phys Ther. 2005 Sep;35(9):567- 71.
9. Sue Hudswell, Michael von Mengersen, Nicholas Lucas. The cranio-cervical flexion test using pressure biofeedback: A useful measure of cervical dysfunction in the clinical setting? Int J of Osteopathic Medi. 2005;8(3):98-105.
10. Parminder Kaur et al. Relationship of cervicothoracic curvature with muscle strength and endurance in subjects with neck pain. Abstract presented in WCPT-AWP and IAP CONGRESS 2009 – Mumbai.106
11. Akash Chopra et al. Comparative study of multimodel approach and applied relaxation in computer users with intermittent chronic neck pain. Abstract presented in WCPT-AWP and IAP CONGRESS 2009 – Mumbai. 116
12. Patil S P, Torne Pratibha. Effect of endurance training of deep cervical short flexors on correction of forward head posture. Abstract presented in 45th Annual Conference of IAP 2007 – Kolkata.
13. Singh Smita, P Dakshinamurth. Effect of weak core stabilizers on functional reach performance and dynamic reach test. Abstract presented in 45th Annual Conference of IAP 2007 – Kolkata.
14. Vernon HT, Aker P, Aramenko M, Battershill D, Alepin A, Penner T. Evaluation of neck muscle strength with a modified sphygmomanometer dynamometer: reliability and validity. J Manipulative Physiol Ther. 1992 JulAug;15(6):343-9.
15. Li Lu, Nawar Shara: Reliability analysis: Calculate and Compare Intraclass Correlation Coefficients (ICC) in SAS. Statistics and Data Analysis; NESUG 2007:1-4.
16. Jull G, Barrett C, Magee R, Ho P. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia 1999;19(3):179–85.
17. Landis JR, Koch GG. The measurement of examiners agreement for categorical data. Biometrics 1977;33:159-71.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30TechnologyCOMPARISON OF WATER SAVINGS OF PADDY RICE UNDER SYSTEM OF RICE INTENSIFICATION (SRI)
GROWING RICE IN MWEA, KENYA
English6373J.A. NdiiriEnglish B.M. MatiEnglish P.G. HomeEnglish B. OdongoEnglish N. UphoffEnglishRice is the greatest consumer of water among all crops and uses about 80% of the total irrigated freshwater resources. The high demand for rice in Kenya due to urbanization has led to increases in price. In Mwea, rice is grown under continuous flooding. This system of rice production depends on a continuous supply of water for irrigation and soils with high water holding capacities yet, the main rice growing season coincides with the low rainfall season. Thus, water rationing during this period is inevitable. To be able to meet the growing demand with the depreciating water resources sustainably, new innovative ways of rice crop production are needed. System of Rice Intensification (SRI) is a new innovation that offers an opportunity to reduce water demand accompanied by yield increase of rice. Field experiments were conducted in 2010/2011 at Mwea Irrigation Agricultural Development (MIAD) of Mwea Irrigation Scheme (MIS) during the main growing season (August 2010- January 2011) to assess the effects on water savings for three varieties of rice grown under SRI versus CF. The results showed that SRI gave the highest savings on water, yields hence water productivity for all the three varieties. Yield increased by 0.6t/ha, 2t/ha and 1.5t/ha while water savings were 2528m3/ha, 2268m3/ha and 2846m3/ha for the Basmati 370, BW 196 and IR 2793-80-1 varieties, respectively. Similarly, calculations showed water productivity (kilograms of rice per cubic meter of irrigation water supplied) averaging 120% higher for the three varieties under SRI management (2.16 kg/m3 vs. 0.98 kg/m3).
EnglishSRI, Rice, Mwea, Water savings, Water productivityINTRODUCTION
Water available for agriculture is diminishing due to rapid population growth and climate change along with rising demand for food. This is especially true for rice due to urbanization, which has led to an upward shift in demand for rice worldwide as people change their eating habits (Mishra, 2009). Increased rice supply, on the other hand, is constrained due to lack of sufficient water availability as this crop is the largest consumer of water in the agricultural sector (Bera, 2009; Mishra, 2009; Prasad, 2009; Prasad and Ravindra, 2009; Thakur et al., 2011). Rice production in Kenya is based mostly on the conventional practice of continuously flooding the paddy fields (Republic of Kenya, 2008). This method is not sustainable due to the already existing competition for water among farmers within and outside the scheme (Mati et al., 2011). Thus, innovative ways for efficient use of water need to be put in place to ensure sustainable rice production (Bouman et al., 2005; Mati and Nyamai, 2009; Mishra, 2009). The System of Rice Intensification (SRI), developed in Madagascar over 25 years ago (Laulani?, 1993; Sarath and Thilak, 2004), offers this opportunity to improve food security through increased rice productivity by changing the management of plants, soil, water and nutrients while reducing external inputs like fertilizers and herbicides (Berkelaar, 2001; Thakur et al., 2009; Uphoff, 2003; Vermeule, 2009). The system proposes the use of single, very young seedlings with wider spacing, intermittent wetting and drying, use of a mechanical weeder which also aerates the soil, and enhanced soil organic matter (Uphoff et al., 2009). All these practices are aimed at improving the productivity of rice grown in paddies through healthier, more productive soil and plants by supporting greater root growth and by nurturing the abundance and diversity of soil organisms (World Bank Institute, 2008; Stoop et al., 2002). Previous research has shown yield increases of between 50- 100% while irrigation water inputs can be reduced by between 25% and 50% with SRI (Bera, 2009; Berkelaar, 2001; McDonald et al., 2006; Sarath and Thilak, 2004; WBI, 2008). However, little is known about SRI and the impact of its adoption on water savings in Mwea scheme and Kenya as a whole. This study investigated whether SRI practices, particularly transplanting quickly one young seedling per hill, alternate wetting and drying and wider spacing could have significant effects on plant growth and subsequently on water productivity. A detailed comparison of the performance of rice plants grown under SRI and under conventional management practices for three varieties is presented here. Soil and climatic conditions, fertilization and weeding method were the same for both sets of trial.
MATERIALS AND METHODS
Experimental site and soil
This field experiment was conducted in 2010/2011 at the Mwea Irrigation Scheme in Kenya. The experimental site is situated between latitudes 37°13‘E and 37°30‘E and longitudes 0°32‘S and 0°46‘S. The region is classified as tropical with a semi-arid climate, having an annual mean air temperature of 23-25°C with about 10°C difference between the minimum temperatures in June/July and the maximum temperatures in October/March. Annual mean precipitation is 950 mm, with annual sunshine of 2485 h. Land preparation for both CF and SRI was standard wet tillage and harrowing. This was done by first flooding the paddies for three days then paddled to soften and mix the mud as illustrated in Wanjogu et al., 1995. For nursery establishment, germinated seeds for SRI practice were broadcasted on raised beds on 31 August 2010 while those for the conventional practice were broadcasted on 11 August 2010. The soils have been classified previously as Vertisols (Sombroek et al., 1982). The topsoil contained 0.014% available N, 29 ppm available P, and 0.042 meq/100g available K, 1.13% organic carbon, and had a pH value of 6.3 at the start of the experiment. Experimental design and treatments The experimental design was a randomized split-plot design with three replications and subplot sizes of 3m by 3m. In the main plots, rice was grown under the two alternative crop management systems (treatments) of SRI and conventional practices with continuous flooding (CF). Three rice varieties (Basmati 370, BW 370 and IR 2793-80-1) were grown on the plots, with three replications each. Basmati 370 is an aromatic, low tillering, and shortduration, 120 days; BW 196 is a long duration of 150 days and considered high tillering while IR 2793-80-1 is mediumlong duration of 140 days and medium yielding - close to BW 196. Each plot was surrounded by consolidated bunds and lined with plastic sheets installed to 0.3m deep to prevent seepage and nutrient diffusion among plots, followed by 1m wide channels for irrigation. The spacing was 20cm by 20cm for SRI practice and 10cm by 10cm for CF practice. Crop management and irrigation The nursery was adjacent to the main field so that transplanting could be performed quickly to minimize injury to the young plants (WBI, 2008). Seedlings were transplanted on 8 September with 8-dayold seedlings at a rate of one seedling per hill for SRI. At 8 days old, seedlings were still in their second phyllochron as recommended for SRI practice (Stoop et al., 2002). For the CF practice, 28-day-old seedlings were transplanted at a rate of three seedlings per hill. This is the conventional way of growing rice in the scheme. The difference in plant populations was thus 25 compared with 400 per square meter. Both sets of treatments received the same basal fertilizer supply of 125kg/ha DiAmmonium Phosphate (DAP) and 62kg/ha Mulate of Potash (MoP) 1 day before transplanting. All plots received an additional 125kg/ha of Sulphate of Ammonia (SA) 10, 30 and 60 days after transplanting (DAT) according to Wanjogu et al., 1995. No herbicide, insecticide or chemical disease control measures were used. The CF treatments were continuously flooded with water to a depth of 5cm except at the end of the tillering stage when the depth was reduced to 3 cm. The SRI plots were kept saturated at the first week after transplanting. After that and up to panicle initiation stage, plots were maintained with a thin layer (2 cm) of standing water for 2 days and without standing water for 5 days before reirrigation with the river water. At this stage, the cracks ranged between 1-1.5 cm and the moisture content of the soil at 10 cm depth was 40% while that at 20 cm depth was 80%. A rice growth staging system by Wanjogu et al., 1995 was followed to describe the rice growth stages. Climate data and water measurements Data on daily rainfall, pan evaporation, wind speed, daily minimum (Tmin) and maximum temperature (Tmax) were collected from the weather station (Table 1) at the research farm located 500 m away from experimental plots. Water was supplied through a concrete channel to a plot channel and subsequently to the plots. A trapezoidal Parshall flume was installed at the gate provided for each plot during the construction of bunds for the purpose of supplying and measuring water for both practices. However, for the SRI plots, water measurement was made during irrigation and when draining excess water. Water measurement for the CF plots was made only during irrigation. The amount of water applied was estimated by reading both water height and time taken for the water to flow through the Parshall flume and into the plot to the required level, and then converted to the volume of water required for the cropping season (Herschy, 1995; ASTM D1941-91). Each plot was irrigated separately. All plots were drained at 14 days before harvest. Water productivity was estimated as grain yield divided by total water supplied into the plot (rainfall and applied) (Boumann and Tuong, 2000) and expressed as kgm3 . The SRI plots were weeded four times, while CF plots were weeded three times during the growing season. Manual weeding, where weeds were uprooted, was used in both practices since the rotary weeder was not available at the time of the trial. Assessing root dry weight Three hills from each replicate were randomly selected at the early-ripening stage of each variety for collection of root samples. This was done using an auger of 10 cm diameter to remove soil of 20 cm deep along with the hill (Kawata and Katano 1976). A uniform soil volume (1571 cm3 ) was excavated to collect root samples from all the treatments. Roots were carefully washed and dry weight measured (Yoshida 1981). Root volume was measured by the water displacement method of putting all roots in a measuring cylinder and getting the displaced water volume. Measurement of yield and yield components Yields are normally 3-5 t/ha, 7-9 t/ha and 9-11 t/ha for Basmati 370, IR 2793-80-1 and BW 196 varieties, respectively (MIAD Manager, personal comm. 2010). Harvesting for Basmati 370, BW 196 and IR 2793-80-1 under SRI was done after 135 days, 151 days, and 135 days, respectively, while plots under CF were harvested after 141, 172 and 156 days, respectively, giving differences of 6, 21 and 21 days, respectively. All plants in an area of 3m by 3 m for each replicate were harvested for determination of yield per unit area, and grain yield was adjusted to 14.5% seed moisture content using the following equation: Yield in t/ha = [(100- MC)/86*GW*10000]/Plot area Where; MC= Moisture Content after drying, GW= Grain Weight per plot area Harvest Index (HI) was calculated by dividing dry grain yield by the total dry weight of aboveground parts (Thakur et al., 2009). Average tiller number and panicle number were determined from the crop harvested from 1 m2 area per replication. Panicle length, number of grains per panicle, and number of filled grains were measured for each panicle individually harvested from the sample area. The per cent of ripened grains was calculated by dividing the number of filled grains by the number of total grains. Statistical analysis All data were analyzed statistically using analysis of variance (ANOVA) technique as applicable to split-plot design (Gomez and Gomez 1984). The significance of the treatment effect was determined using Ftest; and to determine the significance of the difference between two treatment means, least significant difference (LSD) was estimated at performance of rice at 5% probability level. If the LSD was less than the difference in means between two treatments, then the two treatments were significantly different and vice versa.
RESULTS Grain yield and yield components The System of Rice Intensification plots produced significantly (P=0.026) larger grain yield for all varieties (26% on average) than CF plots. The long-duration and high-yielding BW 196 variety had the highest percentage increase (51%), followed by the mid-duration IR 2793-80-1 at 16% and finally the short-duration at Basmati 370 at 11% (table 2). Among the yield components, grains per panicle, grain-filling percentage, and grain weight were significantly (P < 0.05) affected by cultivation practice and variety (Table 2). IR had the highest number of grains per panicle, followed by Basmati 370 and lastly BW 196. However, SRI panicles had significantly lesser (P=0.85) number of filled grains than CF panicles, although significantly higher (0.006) grain weight than CF. Thus, most of the percentage increase in grain yield and hence in net income is a result of higher grain weight. Overall, SRI plots had significant improvement in various yield components compared with CF plots. Root dry weight The results of root dry weight showed a significant (P= 0.042) improvement in root growth in the SRI plants of all varieties (Table 5). Basmati 370 and BW 196 root dry weight under SRI practice was more than double that of CF practice. However, on an area basis, the root dry weight for IR 2793-80-1 variety was more in CF than SRI practice. Water productivity and water savings During the cropping season, rainfall received was 346.4 mm. However, the SRI plots were drained leaving 61.3 mm, 69.6 mm and 61.3 mm for the Basmati 370, BW 196 and IR 2793-80-1, respectively. Because the rice varieties took different durations, the rainfall amount utilized by the varieties was different. It was 282.1 mm, 346.4 mm and 264.4 mm for Basmati 370, BW 196 and IR 2793-80-1, respectively, under CF practice. There was significant water savings with SRI compared to CF (Table 4). BW 196, the long-duration variety, had the highest consumption, followed by IR 2793-80-1, which was close to Basmati 370. However, IR 2793-80-1 had the highest water savings in both seasons. SRI demonstrated significantly higher water productivity (1.72 kg/m3 , 1.42 kg/m3 and 3.35 kg/m3 for Basmati 370, BW 196 and IR 2793-80-1) compared to CF with 0.89 kg/m3 , 0.61 kg/m3 and 1.54 kg/m3 for the varieties respectively. Average water productivity for the three varieties under SRI management was 2.16 kg/m3 , 120% more than the 0.98 kg/m3 average under conventional management. DISCUSSION System of Rice Intensification (SRI) is an effective water-saving methodology. The objective of the evaluation in this study was to assess the impact of SRI practices on yields and water productivity of paddy rice. The results showed that for all varieties, using SRI methods increased yields and reduced water use thus increasing water productivity. The reduction in water use under SRI practice ranged between 26%-31%. Water productivity was much higher for SRI practice than CF, doubling the grain produced per amount of water input (table 4). Clearly, the rice plants responded better to alternate wetting and drying of the soil compared to conventional CF. Previous studies have shown that yield increase with SRI practices involves some improvement in nutrient availability. Inubushi and Wada (1987) found that drying and rewetting Japanese soils not only generated or enlarged a nutrient pool that mineralized rapidly according to first-order kinetics, but also increased the size of a more stable nitrogen pool which mineralized more slowly. This could be explained by an increase in the availability of organic substrates through desorption from soil surfaces (Seneviratne & Wild, 1985; Cabrera, 1993) as well as through an increase in the extent of organic surfaces exposed (Birch, 1958; Cabrera, 1993). This suggests that wetting-and-drying cycles are one of the mechanisms by which the soil nitrogen pool is replenished from successively more recalcitrant or physically protected nitrogen pools (Elliot, 1986). It is also argued that alternate wetting and drying can maintain or even increase grain yield because of the enhancement in root growth, grain-filling rate and remobilization of carbon reserves from vegetative tissues to grains All this is consistent with the hypothesis that SRI water management practice of drying and wetting cycles is beneficial to plant growth through an increase in nutrient availability.
Under flooded conditions, despite the fact that ample water is available to the rice plant, there are numerous constraints introduced in terms of nitrogen supply. Lowland rice generally loses more than 60% of applied nitrogen through ammonia volatilization from the floodwater (Ceesay et al., 2006). Microbial activity is reduced, and as a result, the decomposition of soil organic matter is reduced by 50% under anaerobic conditions. Zinc deficiency has been reported as a widespread nutritional disorder in flooded rice. Further, recent research is showing that in continuously flooded rice soils, much of the nitrogen in soil organic matter becomes bonded to aromatic rings and thus is not readily available to the crop (Schmidt-Rohr et al., 2004). The microbial biomass nitrogen is an important repository of plant nutrients that is more labile than the bulk of soil organic matter and able to contribute substantial amounts of nutrients in the soil. Of the factors that contribute to high nitrogen availability and high nitrogen useefficiency under SRI management practices, repeated wetting and drying process may have the greatest influence. SRI‘s water management practices of intermittent irrigation also help in improving root systems (Bouman et al. 2007). According to Kirk and Soilivas, 1997, 75% of roots of rice plants growing in continuously flooded soil remain shallow, in the top 6cm. CF can also cause degeneration of as much as three-fourths of a rice plant's roots by the flowering stage (Kar et al. 1974). This degenerative physiological process presumably has some limiting effect on rice plant performance (Kirk & Bouldin, 1991). Lack of aeration of the soil affects not only root health and functioning but also the populations of beneficial organisms that contribute to plant nutrition and health. Yanni et al., 2001; Feng et al., 2005; Dazzo and Yanni, 2006 have shown that Diazotrophic rhizobacteria render growth promoting services to rice plants by living within them as endophytes. There is also evidence that phosphorus solubilization and availability are increased by alternate wetting and drying of soil (Turner & Haygarth, 2001; Turner et al., 2006; Oberson et al., 2006). Mycorrhizal associations may also be contributing to plant nutrition with SRI practices as these symbiotic fungi, which require aerobic soil conditions, can greatly increase the volume of soil from which plant roots can acquire nutrients (Sieverding, 1991; Pinton et al., 2000). In more aerobic soils, mycorrhizal fungi can enhance the yields of rice (Solaiman & Hirata, 1997; Ellis, 1998). In Mwea irrigation scheme, yields and increases in the area under rice cultivation are currently constrained by the amount of irrigation water available to support production. There is high demand for water in the entire scheme, thus not all farmers grow their crop during the main rice growing season (August-December). Farmers who grow their crop out of this season (January-April) experience high losses in yields due to unfavorable weather conditions. For sustainable rice production and agriculture in general, ways of minimizing water usage are needed. SRI offers opportunities to raise production while using less water. By reducing the need for and use of agrochemical inputs, it can also contribute to food security and environmental quality. CONCLUSIONS This study has shown that SRI water management practice is capable of producing considerably higher rice yields as well as save on water usage than conventional water management practice. SRI practices can address some key constraints for rice production in Kenya and in many other countries. It can reduce water requirements for production (while increasing yield) hence increase water productivity. FAO, 2006 indicate that a 1% increase in water productivity in food production makes available extra 24 liters of water per day per capita. Investing in agriculture and in agricultural water management, therefore, is an attractive strategy for freeing water for other purposes. Water scarcity is likely to become a more significant problem around the world. Adopting cultivation practices such as SRI that use less water is the way forward. ACKNOWLEDGEMENT This research is being supported by the JKUAT Innovation Fund, the Mwea Irrigation and Agricultural Development Center, and farmers in the Mwea scheme. I thank them and my supervisors very much for their inputs to 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 and books from where the literature for this article has been reviewed and discussed.
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28. Pinton R, Varanini Z, Nannipieri P. eds. The Rhizosphere: Biochemical and Organic Substance at the Soil-Plant Interface. New York: Marcel Dekker; 2000.
29. Prasad SC. Rethinking innovation and development: Insights from the System of Rice Intensification (SRI) in India. The Innovation Journal: The Public Sector Innovation Journal 2007; 12 (2) 3: 25.
30. Prasad S, Ravindra A. South-South Cooperation and the System of Rice Intensification (SRI). SRI presentation to Kenyan friends during the first National workshop on SRI in Kenya, Nairobi. 2009
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32. Sarath P, Thilak B editors. Comparison of productivity of System of Rice Intensification and conventional rice farming systems in the Dry-Zone Region of Sri Lanka. Proceedings of the 4th International Crop Science Congress of New directions for a diverse planet: 2004 Sep 26-Oct 1; Brisbane, Australia. ISBN 1 920842; 2004; 20: 9
33. Schmidt-Rohr K, Mao JD, Olk DC. Nitrogen-bonded aromatics in soil organic matter and their implications for a yield decline in intensive rice cropping. Proceedings of the National Academy of Science 2004; 101: 6351- 6354.
34. Seneviratne R, Wild A. Effect of mild drying on the mineralization of soil nitrogen. Plant and Soil 1985; 84: 175- 179.
35. Sieverding E. Vesicular-Arbuscular Mycorrhiza Management in Tropical Agro ecosystems. Bremen. Deutsche Gesellschaft fu¨ r Zusammenarbeit; 1991.
36. Soejima H, Sugiyama T, Ishihara K. Changes in the chlorophyll contents of leaves and in levels of cytokinins in root exudates during ripening of rice cultivars Nipponbare and Akenohoshi. Plant Cell Physiology 1995; 36: 1105- 1114.
37. Solaiman MZ, Hirata H. Responses of directly seeded wetland rice to arbuscular mycorrhizal fungi inoculation. Journal of Plant Nutrition 1997; 20: 1479-1487.
38. Sombroek WG, Braun HMH, van der Pouw BJA. The exploratory soil map of Kenya and agro climatic zone map of Kenya scale 1:1million. Exploratory Soil Survey Report No.E1. Kenya Soil Survey, Nairobi, 1982.
39. Stoop WA, Uphoff N, Kassam A. A review of agricultural research issues raised by the system of rice intensification (SRI) from Madagascar: opportunities for improving farming systems for resource-poor farmers. Agricultural Systems 2002; 71: 249- 274.
40. Thakur AK, Uphoff N, Antony E. An assessment of physiological effects of System of Rice Intensification (SRI) practices compared with recommended rice cultivation practices in India. Experimental Agriculture 2009; 46 (1): 77-98.
41. Thakur KA. Critiquing SRI criticism: beyond skepticism with empiricism. Current Science 2010; 98:10.
42. Thakur K A, Rath S Patil DU. Effects on rice plant morphology and physiology of water and associated management practices of the system of rice intensification and their implications for crop performance. Paddy and Water Environment 2011; 9 (1): 13-24.
43. Turner BL, Haygarth PM. Phosphorus solubilization in rewetted soils. Nature 2001 May 17; 411: 258.
44. Turner BL, Frossard E, Oberson A. Enhancing phosphorus availability in low-fertility soils. In. Uphoff N, Ball A, Palm C, Fernandes E, Pretty J, Herren H, Sanchez P, Husson O, ,Sanginga N, Laing M, Thies J. eds. Biological Approaches to Sustainable Soil Systems. Boca Raton: FL. CRC Press; 2006. P. 191-205.
45. Uphoff N. Higher yields with fewer external inputs? The system of rice intensification and potential contributions to agricultural sustainability. International Journal of Agricultural Sustainability 2003; 1:38- 50.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30TechnologyA NOVEL APPROACH FOR MINING PECULIAR DATA FROM LARGE DATA SET USING PATTERN
MATCHING AND PECULIAR RULE MINING
English7480S.Shahar BanuEnglish V.SaravananEnglishGenerally, data mining (sometimes called data or knowledge discovery) is the process of analyzing data from different perspectives and summarizing it into useful information that can be used to increase revenue, cuts costs, or both. Data mining allows users to analyze data from many different dimensions or angles, categorize it, and summarize the relationships identified. Technically, data mining is the process of finding correlations or patterns among dozens of fields in large relational databases. There are many types of data mining techniques. The main and most objective mining method is peculiarity mining. This method mines the peculiar data among the large set of data. In this paper there are certain set of rules which found to find relevant data among large set of data in large set of databases.
EnglishData mining, peculiar data,peculiar rules,pattern matching1. INTRODUCTION
Data mining or knowledge discovery refers to the process of finding interesting information in large repositories of data. The process of data mining is composed of several steps including selecting data to analyze, preparing the data, applying the data mining algorithms, and then interpreting and evaluating the results. The application of data mining techniques was first applied to databases. A better term for this process is KDD (Knowledge Discovery in Databases).Data mining (DM) is a multi staged process of extracting previously unanticipated knowledge from large databases, and applying the results to decision making. Data mining tools detect patterns from the data and infer associations and rules from them. The extracted information may then be applied to prediction or classification models by identifying relations within the data records or between databases. Those patterns and rules can then guide decision making and forecast the effects of those decisions. In order to discover new, surprising, interesting patterns hidden in data, peculiarity oriented mining and multi database mining are required. The main objective of this work is to fetch the peculiar data. The availability of large quantity of data in the large set of databases from the World Wide Web and business data management systems has made the dynamic separation of data into new categories as a very important task for every business intelligence systems. We find the association or relation between the dataset in the databases. The main aim is to fetch the peculiar data among the data. This paper describes the attribute level entity level and record level peculiarity to get the rules. Several software implementations are carried out to demonstrate the peculiarity-based mining. The term data mining also refers to the step in the knowledge discovery process in which special algorithms are employed for identifying interesting patterns in the data. These interesting patterns are then analyzed yielding knowledge.
2. Literature Review
Ribeiro, Kaufman and Kerschberg,[1995] have described a way of multi-database mining by incorporating primary and foreign keys, as well as developing and processing knowledge segments[1]. Wrobel[1997], has extended the concept of foreign keys to include foreign links, since multi-database mining also involves accessing non-key attributes. Aronis et al. introduced a system called WoRLD that uses spreading activation to enable inductive learning from multiple tables in multiple databases spread across the network. Liu, Lu and Yao [1998],have proposed an alternative multi-database mining technique that selects relevant databases and searches only the set of all relevant databases. Their work has focused on the first step in multi-database mining, which is the identification of databases that are most relevant to an application. A relevance measure was thus proposed to identify relevant databases for mining with an objective to find patterns or regularity within certain attributes. This can overcome the drawbacks that are the result of joining all databases into a single huge database upon which existing data mining techniques or tools are applied. The approach is effective in reducing search costs for a given application. Zhong[1999] have proposed a way of mining peculiarity patterns from multiple statistical and transaction databases based on previous work. A peculiarity pattern is discovered from the peculiar data by searching the relevance among the peculiar data. A data item is peculiar if it represents a peculiar case described by a relatively small number of objects and is very different from other objects in a data set. Although it looks like an exception pattern from the viewpoint of describing a relatively small number of objects, the peculiarity pattern represents a well-known fact with common sense, which is a feature of the general pattern. Wu and Zhang[2001] have advocated an approach for identifying patterns in multi-database by weighting .Kargupta [2001], have built a collective mining technique for distributed data. Grossman have built a system, known as Papyrus, for distributed data mining. Existing parallel mining techniques can also be used to deal with multi-databases. K-means is the simplest and the most popular clustering technique that is widely used in various fields of science and technology. The medical industry is also increasing with the data for aids patients. It is difficult for classifying and finding the DNA pattern of the AIDS documents. We use pattern matching and/or document clustering analysis in the research area of artificial intelligence and data mining. Its fundamental task is to utilize the alphabets to compute the percentage of related relationship between the records or the documents and to accomplish automatic classification without earlier knowledge. Document clustering is to utilize clustering technique to gather the documents of high resemblance collectively by computing the documents resemblance. There are several pattern matching and clustering approaches available in the literature to fetch the relevant data, record or the document in distributed environment. But most of the existing mining techniques suffer from a wide range of limitations. The existing mining approaches face the issues like practical applicability, very less accuracy, scalability, more classification time etc. Thus a novel approach is needed for providing significant accuracy with less classification time. Also, mining need to mine the peculiar data from the dataset. Whenever we use data mining techniques it gives the 80% relevant and 20% irrelevant data from the dataset, but there is no peculiarity. Here the specialty and the main objective of the thesis is bring the peculiar data from the dataset.
3. Proposed work:
The main aim of this work is to develop an improved peculiarity mining technique with very high classification accuracy. Peculiarity rules are a new class of rules which can be discovered by searching relevance among a relatively small number of peculiar data. Peculiarity oriented mining in multiple data sources is different from, and complementary to, existing approaches for discovering new, surprising, and interesting patterns hidden in data.Within the proposed framework, we give a formal interpretation and comparison of three classes of rules, namely, association rules, exception rules, and peculiarity rules, as well as describe how to mine interesting peculiarity rules in multiple databases. Peculiarity represents a new interpretation of interestingness, an important notion long identified in data mining. Peculiarity, unexpected relationships/rules, may be hidden in a relatively small number of data. Peculiarity rules are a typical regularity hidden in many scientific, statistical, and transaction databases. They may be difficult to find by applying the standard association rule mining method due to the requirement of large support. In contrast, peculiarity oriented mining focuses on some interesting data (peculiar data) in order to find novel and interesting rules (peculiarity rules). The second keyword is multiple databases, which are the objects of discovery and learning. Mainstream KDD (Knowledge Discovery and Data Mining) research is limited to rule discovery in a single universal relation or an information table. Multidatabase mining is to mine knowledge in multiple related information sources. By considering the two related issues of peculiarity and multiple databases, we propose a framework of peculiarity oriented mining in multi databases. The identification of peculiarity rules, as well as algorithms of mining peculiarity rules, will enhance the effectiveness of data mining and extend its domain of applications. Studies on peculiarity oriented mining can be divided into three phases: 1. Developing methods of peculiarity oriented mining, 2. Extending peculiarity oriented approaches to multiple data sources, and 3. Enabling peculiarity oriented mining in a distributed and cooperative mode. There are various problems associated with the existing data mining approaches. Existing data mining algorithms suffer from problems of practical applicability. The accuracy of the existing DM approaches is a major concern. The time taken for active DM is more in large databases. The main aim of this work is the development of an improved peculiarity mining technique with very high classification accuracy. Peculiarity rules are discovered from peculiar data evaluated using unified knowledge-based statistical criteria. The main task of mining peculiarity rules is the identification of peculiar data. Peculiar data are a subset of objects in the database and are characterized by two features: 1) very different from other objects in a data set and 2) consisting of a relatively small number of objects ?
Relevance among Peculiar Data
A peculiarity rule is discovered by searching the relevance among peculiar data. Let X(x) and Y (y) be peculiar data found in two attributes X and Y, respectively. We deal with the following two cases: If both X(x) and Y (y) are symbolic data, the relevance between X(x) and Y (y) is evaluated by: R1 = P(X(x)|Y (y)) P(Y (y)| X(x) 1. That is, the larger the product of the probabilities, the stronger the relevance between X(x) and Y (y) is. If both X(x) and Y (y) are continuous attributes, the relevance between X(x) and Y (y) is evaluated by using the method developed in the KOSI system that finds functional relationships. Equation (1.) is suitable for handling more than two peculiar data found in more than two attributes if X(x) (or Y (y)) is a granule of peculiar data. The above-stated methodology can be extended for mining from multiple databases. The proposed approach is evaluated using the datasets namely real time Data set, AIDS patient‘s data set, collected from AIDS counseling centers. There are various ways used to improve the performance of the proposed approach. The parameters used for evaluating performance are Time, Accuracy. 4. Implementation The medical AIDS patient‘s data consists of multiple records in multiple date with peculiar cases. The only peculiarity data is been mined using association rule, exception rule and peculiarity rule. Then finally the performance is evaluated according to the three approaches [rules] which are used. The medical data is collected from the Government Hospital AIDS counseling centers.
4.1 Algorithm for finding peculiar data
1. Initialize the p (Pattern)
2. Retrieve a record R and read the origin field O
3. string s =50 then R is peculiar data and display R 10. else 11. display count 12. end if 13. step 2 until EOF 14. stop In a single system we developed a small code in dot net framework which is connected with SQL and Ms-access data storage. The data are inserted and retrieved using the peculiarity mining technique. It is nothing but while retrieving the data which says the peculiarity by counting the number of occurrences of the pattern in the origin field of the each record. The length of the origin field is more than 500 characters. It is a combination of AGCT molecule of the DNA. where the pattern indicates the diseases of Malaria, Flue, AIDS etc., In this work we are very peculiarly about the pattern which retrieve the HIV-I, disease based record. Whenever we mine the data it says the number of occurrences only. When reach above 50% it retrieve the record and says it is a peculiar record. From the above algorithm we can find out that the pattern will be compared in the origin string from the first letter to the last letter. if it occurs the count is incremented. Here the key value is the count variable. According to the count variable value we can get the peculiar record.
5. Experimental results
From the experimental results, the this approach namely Peculiarity rules is to produce very good accuracy of about 99.6%, less classification time of about 0.57 seconds, better convergence in only about 20 iterations and better efficiency.
From the above table Table1 and Figure 5.1,we can conclude and find out that the peculiarity mining approach is giving more efficiency than the other techniques. Where in the first approach the we are using 80 records with 5 fields and using centroid method. Also it is checked in C Language for Time complexity and efficiency. The Second approach is done with 90 records with 7 fields and the fields are not unique. It is implemented and checked in JAVA. Finally the Peculiarity in Single system is having more than 10000 records and more than 25 Data bases. It is implemented and checked with two kinds of databases as Ms-Access and SQL server. The efficiency and complexity is much better than the other. It is find out through the coding developed in ASP.NET with C#.net. It is checked in Single system as well as in LAN. It is very good in performance level in web based Mining also. The web based mining is given for Multiple Databases. 5.1 Sample output: The following is the output obtained from the AIDS patient‘s data set. Figure 5.2 showsthe peculiar data and figure 5.3 shows the number of occurrences of the particular data.
6. CONCLUSION
This paper deals with peculiarity mining with the AIDS data set, where the implementation is compared in single system, P2P system and multiple data base in web based system. In the proposed approach, the patterns are generated initially for the available vague data sets. With the help of those generated pattern, the clustering of data are carried with the help of k-means approach (modified). This proposed approach utilized a pattern matching algorithm based on multi database to search the peculiar data in the global situation.
Englishhttp://ijcrr.com/abstract.php?article_id=1887http://ijcrr.com/article_html.php?did=18871. Ribeiro, K. Kaufman, and L. Kerschberg, 1995, Knowledge Discovery From Multiple databases. In: Proceedings of KDD95. 240-245.
2. S.Wrobel,1997, An algorithm for multi- Relational discovery of subgroups.In: J.Komorowski and J. Zytkow (eds.)Principle of Data Mining and Knowledge Discovery, 367-375.
3. J.Yao and H. Liu, 1997,Searching Multiple Databases for Interesting complexes. Proc. of PAKDD, 198- 210.
4. H. Lu, and J.Yao, 1998, identifying Relevant Databases for Multi Database mining Proceedings of PacificAsia conf on Knowledge discover and Data mining 210–221.
5. N.Zhong,Y.Yao, and S. Ohsuga 1999 Peculiarity Oriented mining in multi Database mining Proceedings of PKDD,136-146.
6. H. Kargupta, K.Sivakumar,B.Park and S.Wang, 2000, Collective Principal Component Analysis from Distributed Heterogeneous Data. Principles of Data Mining and knowledge discovery, 452- 457.
7. S.Zhang,2001, Knowledge discovery Multi- databases by analyzing Local instances. PhD Thesis, Deakin University,
8. Kargupta,W.Huang,K. Sivakumar, And E. Johnson, 2001, distributed clustering Using collective principal component analysis. Knowledge and Information Systems, 3(4) : 422-448.
9. Zhang and S. Zhang,2002 , Association Rules Mining: Models And algorithms. Springer- Verlag Publishers in Lecture Notes on Computer Science, p. 243.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareCHANGES IN PHYSICAL PERFORMANCE AMONG HEALTHY PRE AND POST- MENOPAUSAL FEMALES - A CROSS SECTIONAL STUDY
English8188Bimali IEnglish Narayan AEnglishPurpose: To compare changes in physical performances (strength, flexibility and balance) between healthy Pre-Menopausal (40-45 years) and Post-Menopausal females (45-55 years) with natural history of menopause. Methods: Sixty pre and postmenopausal females were included. Strength was measured by hand held dynamometer, Flexibility with flexometer and Balance through postural sway. Results: Analysis of Variance (ANOVA), student paired t-test and Bonferroni test were used for the analysis. Level of significance < 0.05 was considered statistically significant with 95% CI. No significant difference was found for strength (p=0.081) and flexibility (p=0.116). But, loss of Balance (p=0.000) was found to be highly significant among the Post Menopausals. Conclusion: Lower limb muscles flexibility and upper limb strength did not show any significant changes among immediate Post Menopausal females; but static balance was significantly affected among the Post Menopausals causing diminished Physical Performance with age advancement.
EnglishBalance, Flexibility, Menopause, Physical Performance, Strength.INTRODUCTION
Menopause refers to the natural end of women years of having a regular monthly period, which also implies the end of her ability to get pregnant.1 It is a transition period characterized by physiological, psychosocial, and sociological changes that accompany the depletion of ovarian function.1-3 Acceleration in the loss of muscle mass and strength has been observed in women during Post Menopausal years.2-4 Although the underlying mechanism is still controversial, a growing body of evidence suggests that estrogen acts directly on the skeletal muscles through estrogen receptors in regulation of Physical Performance.5-7 Physical Performance is an ability to perform a physical task at a desired level.1 Muscular strength, Flexibility, and Balance are key components of Physical Performance. Poor Physical Performance predicts frailty, disability and loss of independence among elderly.1-3,8,9 Physical Performance is lower in women when compared to men and it increases with age beyond 55.4 This suggests that gender specific factors across life may influence maximum level of Physical Performance achieved and performance rate declines with age. One factor that has been implicated for this is ?Menopause‘. Decreased muscular strength has been proven to be the predictive of health deterioration in general; while limited flexibility and impaired balance are related to an increased risk of falls in older adults.4 Studies indicates that diminished muscular strength after menopause have a relation with hypoestrogenism. In a study, author had opined that ankle dorsiflexor torque plays important role to maintain static balance in the first years of menopause.7 The average Menopausal age of Indian female is 45 years and the western female is 51 years.10 Available literatures had analyzed the changes in Physical Performance due to menopause compared to Pre-Menopausal subjects.2,3,4 But subjects in these studies were of varying etiology of menopause i.e. hormonal therapy, hysterectomy, oophorocystectomy, natural ageing etc. and were in late menopausal age. Therefore this study aims to analyze the changes in Physical Performances due to natural menopause at an early age. The differences in Physical performance are analyzed by measuring the strength, flexibility and balance between Pre-Menopausal (40 – 45 yrs) and immediate Post-Menopausal females (45 – 55 yrs) with history of natural menopause.
MATERIALS AND METHODS
The subjects were selected randomly from Kasturba Medical college hospital and the local community around Mangalore city through the community screening camps. Among the 75 females participated for screening, 60 fulfilled the inclusion criteria and were included in the study. 15 subjects excluded through screening had osteoarthritic knee (OA), low back ache (LBA), vertigo, history of fall etc. A written informed consent was obtained after explaining the study procedure. Institutional ethical approval was obtained (IEC/KMC/03/2010–2011). The subjects were recruited in the study based on following inclusion and exclusion criteria:
The outcome measures for physical performance were done for; a) Strength- by Jamar® Hand Dynamometer 1-3 ; ( refer figure:1) b) Flexibility- by Flexometer1,2,16 and, ( refer figure:2) c) Static balance- analyzed through time taken (in seconds) for the appearance of postural sway (1st and 2nd sway) using protractor with eyes open/closed for Left/Right legs individually (refer figure: 3). Data was documented for each of the outcome measures.
Testing Procedure
The testing procedure adopted for each outcome measures are as follows;
Strength: Subjects were made to sit on a chair with arms at right angle and elbow by the side of the body with forearm supported. Jamar® Hand Dynamometer 1-3 was held in the dominant hand and directions given to squeeze the Dynamometer with the maximum isometric effort and maintain the same for about 5 seconds.
Flexibility: Subjects were asked to keep the back and head against a wall with the legs straight ahead and knees flat against the floor (i.e. long sitting). Then, a flexometer was placed against the subjects‘ feet. While keeping the back straight, subjects were asked to stretch their arms out towards the box. Subjects were instructed not to jerk or bounce to reach further and hold the full reach position for two seconds, and score (i.e. reach distance) was recorded.
Balance:
Protractor drawn on a flex paper was placed on the wall and subjects were asked to stand in front of it without shoes. Axis of the protractor was aligned along the vertex of subject‘s head. Then subjects were made to stand on right and left leg alternately with arms across their chest and hands touching the shoulders. They were asked to look straight ahead with the eyes open and focus on an object about 3 feet in front. The therapist stood in front of the subject at 5 feet distance. Tests were terminated when the leg touched the floor, or the arms moved from their start position or when the subject swayed more than 15? . Reading (in seconds) was taken on first sway and then on 15? sway.
Data analysis
Statistical Package for Social Science (SPSS) version 13.0 used for the statistical analysis. The level of significance < 0.05 was considered to be statistically significant with 95% confidence interval. Analysis of Variance (ANOVA) and student paired t-test were used to compare the values between the two groups. Bonferroni test was used for the multiple analyses of the Sways.
RESULTS
In this study, 60 female subjects participated from Dakshina Kannada district of Karnataka state. Participated subjects mean age was 42.13 ±1.73 years for Pre-Menopausals (n= 30) and 52.10 ±2.02 years for Post-Menopausals (n= 30). I. Hand Grip Strength (refer table: 1) In the Pre-Menopause groups the mean strength was 12.67 ±2.0 kilograms and for Post-Menopause groups the same was 11.73 ±1.9 kilograms having p value of 0.081. It suggests similarities in hand grip strength between the pre- and postmenopausal subjects. II. Flexibility (refer table: 1) The mean flexibility range for Pre and Post menopause groups were 21.13 ±2.7 and 20.03 ±2.0 centimeters respectively with p value of 0.116. It shows that flexibility differences between the two groups were not significant, suggesting that both groups carry similar flexibility ranges. III. Balance (refer table: 2,3) a. Unilateral Right Leg Stance with Eyes Open and Closed: In Pre Menopause group the mean unilateral 1 st sway with eyes open was observed at 60.27 ±17.6 seconds and for 2 nd sway at 67.40 ±18.41. While with eyes closed the 1 st sway was seen at 21.50 ±4.35 and 2 nd sway at 24.93 ±4.7 seconds. But among the Post-Menopausals, the mean unilateral 1 st sway with eyes open occurred at 49.73 ±13.44 seconds and 2nd sway at 53.83 ±13.53. With eyes closed the 1 st sway was at 17.73 ±4.45 and 2 nd sway occurred at 20.63 ±4.48 seconds. The results indicates that differences in 1 st and 2 nd sways between the two groups (p=0.00) were highly significant. But, differences were non-significant between the two sways within both the groups with eyes open, while highly significant differences were found between the 1 st and 2 nd sway (p=0.00) within the groups with eyes closed.
b. Unilateral Left Leg Stance with Eyes Open and Closed:
Among Pre Menopausals with eyes open the 1st and 2nd sway occurred at 46.13 ±10.47 and 50.07 ±10.48 seconds respectively; but for Post-Menopausals the mean unilateral 1 st sway were seen at 38.40 ±8.6 and 2 nd sway at 41.97 ±8.53 seconds. With eyes closed 1st sway occurred at 18.93 ±2.54 seconds and 2 nd sway at 22.6 ±2.6 among the Pre-Menopausals; but 1 st sway was seen at 15.37 ±2.69 and 2 nd sway at 18.93 ±2.81 seconds in the PostMenopausals. The result shows highly significant differences in1st and 2nd sways between the two groups (p=0.00) and also within the group (p=0.00). Multiple comparisons between the groups also demonstrated significant differences for the 1st sway; and highly significant for the 2nd sway. Between the two groups, results demonstrated highly significant differences (p=0.00) between 1st and 2nd sways.
DISCUSSION
The findings of this study suggest that balance ability, but not the Hand Grip Strength and flexibility is affected among early Post-Menopausals; as the Hand Grip Strength and Flexibility were almost similar between the two groups. This could be because of narrow age differences among the subjects. Since reduction in muscle strength/flexibility secondary to aging occurs rapidly after 65 years of age (i.e. especially of lower limb muscles12,13,19 ) and accelerated drop in muscle strength of hand grip muscles occurs after 55 years age.4 But static balance was reduced significantly among the Post-Menopausals. The most optimal reason for this outcome can be attributed to the three strategies adopted by an individual to maintain the upright posture and to recover the balance: hip, ankle, and stepping strategy. One rely on ankle strategy when displacements are in small ranges within the limit of stability.21 But when oscillations are more and frequency is high, or when the supporting weight bearing surface is small than the foot area; then one shifts to encompass the hip strategy in order to maintain the balance. Also, if the body perturbation is greater, than more people tend to decrease the ankle response leading to increase in hip strategies. In such situation postural sways increases automatically. This condition probably would have been the reason among PostMenopausal females that would have facilitated the activation of other muscular groups to maintain the body posture.15,22 Muscles closest to the base of support are particularly important to maintain the balance. In a study correlation were reported between the static balance and the ankle dorsiflexor strength among PostMenopausal females, and suggestions were made about the importance of ankle dorsiflexors strength in maintaining the balance.20 Therefore, decrease in balance leading to the appearance of early sway among Post-Menopausal females. Other reason could be the age related decline in muscle strength of lower limb that would have lead to the occurrence of second sway faster than the first sway among the PostMenopausal females.14 But, since in this study we analysed only the upper limb strength (i.e. Hand Grip strength) and not the lower limb; therefore, this observation cannot be conclusively justified. The sharp increase in the incidence of falls due to loss of balance in women around the time of menopause has been attributed to the menopause-related reductions in serum estradiol level (component of estrogen hormone).20 This study found improvement in postural sway after hormonal therapy among Post-Menopausal females20 indicating that reduction of estrogen hormone would cause increase in postural sway among such subjects. Thus the findings of our study indicate that Balance, but not flexibility and strength, deteriorate during the transition through natural menopause. Since compromised Physical Performance can have substantial impact on the quality of life, which is inevitable with increased life expectancy; therefore, one need to be free of illness in order to function efficiently and effectively in old age. The findings also suggest that Hand Grip Strength and Muscle flexibility may not directly impact the balance quality. So, as healthcare professional we need to develop appropriate preventive measures to improve the balance among early Post-Menopausal females. The limitations of this study was the nonconsideration of the trunk and lower limb muscle strength and flexibility of the muscles anterior to the hip joints, since these muscles plays major role in maintaining the posture and balance. Based on the study findings, we opined that future research should involve trunk and lower limb muscle strength and flexibility as they play important role for posture in general and balance in particular.14 Also one can apply Posturography23 to assess the dynamic balance with focus on various functional life style situations.
ACKNOWLEDGEMENT
The authors would like to acknowledge all the females who participated in this study, Chetana Child development Center and Lions Club, Mangalore. We are also grateful to the authors‘ /editors /publishers of all the articles that have been used as a reference for this study.
Englishhttp://ijcrr.com/abstract.php?article_id=1888http://ijcrr.com/article_html.php?did=18881. Cheng HM, Wang SH, Yang FY, Wang HP, Fuh LJ. Menopause and Physical performance. Menopause 2009;16:892-96.
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3. Sowers M, Tomey K, Jannausch M, Eyvazzadeh A, Nan B, Randolph J. Physical functioning and menopausal states. Obstet Gynecol 2007;110:1290- 96.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30TechnologyVIBRATIONAL SPECTRAL STUDIES, NLO AND NBO ANALYSES OF 2-CHLORO-4-NITROBENZOICACID
BASED ON DENSITY FUNCTIONAL THEORY
English89104V. BalachandranEnglish A. JanakiEnglish A. LakshmiEnglishIn this work a combined theoretical and experimental study of 2-chloro-4-nitrobenzoic acid (CNBA) is reported using density functional theory (DFT) calculations as well as Raman and IR spectra have been recorded in the region 4000?400 cm?1 and 3500?100 cm?1, respectively. The optimized molecular geometry, normal mode wavenumbers, infrared intensities and Raman activities, corresponding vibrational assignments and intramolecular hydrogen bonds were investigated with the help of B3LYP method using 6-311G and cc-pVDZ basis sets. A detailed interpretation of the infrared and Raman spectra of CNBA is reported. The theoretical spectrograms for FT-IR and FT-Raman spectra of the title molecule have been constructed. The observed and calculated frequencies are found to be in good agreement stability of the molecule arising from hyper-conjugative interactions, leading to its bioactive charge delocalization have been analyzed using natural bond orbital (NBO) analysis
English2-chloro-4-nitrobenzoic acid; Density functional theory; FT-IR; FT-Raman spectra; vibrational frequenciesINTRODUCTION
Recent spectroscopic studies of benzoic acid and its derivatives have been motivated by their biological and pharmaceutical importance. The aromatic acids are crystalline substances, generally slightly soluble in water and well soluble in polar organic solvents (alcohol, chloroform, benzene). Aromatic acids have all the properties characteristic of the carboxylic acids of the aromatic series. In medicine, aromatic acids are employed as weak antiseptics, and their salts as carriers of specifications [1]. Benzoic acid acts as a better inhibitor compared to salicylic acid with equal concentration [2]. The industrial applications are as a corrosion inhibitor, as an additive to nucleating agents for polyolefin, as a dye intermediate, as a stabilizer in photographic processing, and as a catalyst. Organic substances produced naturally in the higher plants, are used for controlling growth or other physiological functions. Benzoic acid is one of the most commonly used preservatives in cosmetics, foodstuffs, and drug preparations [3,4]. To the best of our knowledge, very few fields have been developed specifically for carboxylic acids. However, the lower acids like formic, and acetic acids have been extensively studied, and a few studies exist for the higher acids. Quantum chemical calculations involving carboxylic acids have to account for the electron-rich carboxyl group. Consideration of these factors motivated us to undertake the vibrational spectroscopic studies of the title compound for the electron rich carboxyl group. Consideration of these factors motivated us to undertake the vibrational spectroscopic studies of the title compound benzoic acid. The goal of present study is to give a complete description of the molecular geometry and molecular vibrations of the title compounds. The assignments of bands in the vibrational spectra of molecules are an essential step in the application of vibrational spectroscopy for solving various structural chemical problems.
EXPERIMENTAL DETAILS
The compound under investigation namely CNBA was obtained by Lancaster Chemical Company, UK, which is of spectroscopic grade, and hence used for recording the spectra as such without any further purification. The room temperature Fourier transform infrared spectrum of the title compound was measured in the region 4000–400 cm 1 at a resolution of ±1 cm 1 using a BRUKER IFS-66V FT-IR spectrometer equipped with KBr pellet was used in the spectral measurements. The FT-Raman spectrum of CNBA was recorded on a BRUKER IFS 66V model interferometer equipped with an FRA-106 FT-Raman accessory in the region 3500–100 cm 1 stokes region using the 1064 nm line of a Nd:YAG laser for excitation operating at 200 mW power. COMPUTATIONAL DETAILS The entire calculation was performed at B3LYP/6-311G and B3LYP/cc-pVDZ methods on personal computer using Gaussian 09W [5] program package, invoking gradient geometry optimization [6]. The optimized structural parameters were used in the vibrational frequency calculations at the B3LYP/6-311G and B3LYP/cc-pVDZ level to characterize all stationary points as minima. The natural bonding orbital (NBO) calculations were performed using NBO program as implemented in Gaussian 09W[5] package at B3LYP/cc-pVDZ level in order to understand various secondorder interactions between the filled and unfilled orbitals of the system, which is a measure of the intramolecular delocalization or hyperconjugation. By combining the results of the GAUSSVIEW program [7] along with symmetry considerations, vibrational frequency assignments were made with a high degree of accuracy. The Raman activities (Si) calculated by the Gaussian-09 program were converted to relative Raman intensities (Ii) using the following relationship derived from the basic theory of Raman scattering.
where 0 is the exciting frequency (in cm 1 units), i is the vibrational wave number of the ith normal mode, h, c, and k are universal constants, and f is the suitably chosen common normalization factor for all the peak intensities. The simulated FT-Raman and FT-IR spectra were plotted from the calculated intensity values using pure normal Lorentzian band shape with a band width of 10 cm 1 . The analysis for the vibrational modes of CNBA was presented in some detail in order to better describe the basis for the assignments. All the parameters were allowed to relax and all the calculations converged to an optimized geometry which corresponds to a true energy minimum, as revealed by the lack of imaginary values with wavenumber calculations. The Cartesian representation of the theoretical force constant has been computed at the fully optimized geometry by assuming the molecule belongs to Cs point group symmetry. The transformation force field from Cartesian to internal local symmetry coordinates, scaling the subsequent normal coordinate analysis (NCA), calculation of potential energy distribution (PED) were done on a PC with the version V7.0–G77 of the MOLVIB program written by Sundius [8, 9]. RESULTS AND DISCUSSION Molecular geometry The molecular structure along with numbering of atoms of CNBA is shown in Fig. 1. The maximum number of potentially active observable fundamentals of a non-linear molecule which contains N atoms is equal to (3N−6), apart from three translational and three rotational degrees of freedom [10]. Since the molecule do not possess any rotational, reflection or inversion symmetry. The most optimized structural parameters (bond length, bond angle) by B3LYP, with 6-311G and ccpVDZ basis sets were shown in Table 1. From the theoretical values, we can find that most of the optimized bond lengths are slightly larger than the experimental values, due to that the theoretical calculations have been carried out on isolated molecule in gaseous phase whereas the experimental results correspond to molecules in solid state. The optimized bond lengths of C−C in phenyl ring of similar molecule [11]. One can notice that the theoretical results as the experimental ones show that the lengths of C3−C4 and C5−C6 bonds are shorter than the other bonds of the ring, leading to a pseudoquinoidal character of the benzene ring. The optimized C−N bond lengths are 1.4708Å for B3LYP/6-311G method and 1.4843Å for B3LYP/cc-pVDZ method, which are also in agreement with those of values reported in the literature [12]. For the C−O bonds, the calculated lengths (Table 1) are slightly shorter than in 2-aminobenzoic acid (1.320Å) [13]. It is interesting to note that both N14−O15 and N14−O16 bond lengths in nitro group is same, that is 1.2647 Å whereas in 2- nitropyridine both the N−O bond lengths are different. This effect can be attributed to the repulsion between the loan electron pair on the N ring nitrogen atom.
Vibrational assignments
A detailed description of vibrational modes can be given by means of normal coordinate analysis. For this purpose, the full set of 57 standard internal coordinates containing 12 redundancies were defined as given in Table 2. From these, a non-redundant set of local symmetry coordinates were constructed by suitable linear combinations of internal following the recommendation by Rauhut and pulay et al .[14] and they are presented in Table 3. The theoretically calculated DFT force fields were transformed to this later set of vibrational coordinares and used in all subsequent calculation. The experimental FT-IR and FT- Raman spectra are shown in Fig 2 and 4, respectively.
The observed and calculated wavenumbers and normal mode descriptions for the title compound are reported in Table 4. When using computational methods to predict normal vibrations for relatively complex polyatomic molecules, scaling strategies are used to bring computed wavenumbers. The vibrational frequencies obtained from B3LYP were suitably scaled using the various scale factors for stretching, in-plane bending, out-of-plane bending, and ring vibrations. The vibrational assignments in the present work are based on the B3LYP frequencies, infrared intensities, Raman activities as well as characteristic group frequencies. In agreement with Cs symmetry, all the 45 vibrations are distributed as 17 stretching vibrations, 15 inplane and 13 out-of-plane vibrations of same symmetry species. Assignments were made through visualization of the atomic displacement representations for each vibration, viewed through GAUSSVIEW [7] and matching the predicted normal wavenumbers and intensities with experimental data. It is convenient to discuss the vibrational spectra of CNBA in terms of characteristic spectral regions as described below. C−H vibrations Since CNBA is a trisubstituted heterocyclic aromatic system, it has only one C−H moiety. The hetero aromatic structure shows the presence of C−H stretching vibrations in the region 3100−3000 cm−1 which is the characteristic region for the ready identification of C−H stretching vibrations [15]. The expected C−H stretching vibrations correspond to the scaled vibration stretching modes of C4−H unit. The vibrations assigned by Gauss view program package at 3117, 3063, 3038, and 3118, 3060, 3041 cm 1 by B3LYP/6-311G and B3LYP/ccpVDZ levels respectively, show good agreement with weak FT-IR band at 3110 cm 1 and 3060, 3042 in FT-Raman band. In general in-plane and out-of-plane aromatic C−H deformation vibrations occur in the region 1300−1000 and 600−1000 cm 1 , respectively. The C−H in–plane bending vibration computed at 1160, 1128, 1120 cm 1 by B3LYP/6-311G method shows good agreement with FT-IR band at 1126, 1118 and 1160 cm 1 in FT-Raman band. The C−H out-ofplane bending vibration appears at 896 and 798 cm 1 in FT-IR and in FT-Raman at 898 cm 1 shows good agreement with computed B3LYP method. In general the C−H vibrations (stretching, in-plane and out-of-plane bending) computed by both the methods show good agreement with experimental observation as well as literature data. C–C vibrations The C−C aromatic stretching, known as semicircle stretching vibration predict at 1593/1595 cm 1 by B3LYP method show deviation from the experimental observation in FT-IR band at 1596 about 1 cm 1 . The C−C aromatic stretch, known as semicircle stretching, predicted B3LYP/6-311G at 1485 cm 1 is in excellent agreement with experimental observations of 1485 cm 1 in FT-IR band. The calculated values for the ring breathing mode is coincide satisfactorily with medium strong FTIR band at 830 cm 1 [16] The theoretically calculated C−C−C out-of-plane bending and inplane bending modes have been found to be consistent with the recorded spectral value and they are shown in Table 4. COOH vibrations O−H stretching band is characterized by very broad band appearing near about 3400 cm 1 . The band observed at 3350 cm 1 has its origin in the O−H stretching vibration. However the calculated wave number shows positive deviation of 11/13 cm 1 may due to the presence of hydrogen bonding. The C=O stretching is a characteristic frequency of carboxylic acid. The band appearing at 1708/1700 cm 1 is assigned as C=O stretching vibration in FT-IR/FT-Raman spectra. The theoretically computed value of 1710/1707 cm 1 shows very good agreement with experimental results. OH in-plane bending occurs between 1440 and 1395 cm 1 and out-ofplane bending occurs between 960 and 875 cm 1 . A band at 1310 cm 1 in FT-IR is assigned as OH in-plane bending vibration and frequency at 1050 cm 1 is assigned as OH out-of-plane bending vibration. However the calculated value of OH out-of-plane bending deviates negatively by about 233 cm 1 may be due to fact that OH out-of-plane bending deformation mode. The present assignments agree well with values available in the literature [17−21]. C−COOH vibrations In CNBA, the band at 1240 cm 1 in FT-IR spectrum corresponds to C−COOH stretching vibrations. However the calculated results do support this. The bands at 263/265 cm 1 is computed to C−COOH in-plane and 196/199 cm 1 out-of-plane bending by B3LYP method. The computed value of above said vibrations coincides exactly at 198 cm 1 . The above results are in good agreement with earlier work [22]. The force constant values computed at B3LYP level of theories at cc-pVDZ and 6-311G basis sets have been shown in Table 5. These force constant values on comparison with related molecules are found to deviate approximately by one unit. NO2 vibrations The asymmetric and symmetric stretching vibrations of NO2 generally give rise to bands in the regions 1500−1570 and 1300−1370 cm 1 in nitro benzene and substituted nitro benzenes [23], respectively. In accordance with above conclusion the band at 1522 cm 1 in FT-IR corresponds to NO2 symmetric stretching vibrations. The theoretically scaled values at 1525 and 1520 cm 1 by B3LYP method exactly correlates with experimental observations. The deformation vibrations of NO2 group (rocking, wagging and twisting) contribute to several normal modes in the low frequency region [24, 25]. It follows from Table 4, the band observed at 726 cm 1 in FT-IR and 720 cm 1 in FT-Raman spectra correspond to NO2 rocking vibration of the title molecule. It should be emphasized that the wave number calculated by B3LYP/6-311G method for the NO2 rocking mode at 725 cm 1 is in very good agreement with the corresponding experimental data. The NO2 wagging vibration contributes mainly to the normal mode, which is observed as a band at 660 cm 1 in FT-IR spectrum and 666 cm 1 in FT-Raman spectrum. The theoretically calculated value by B3LYP/6- 311G method at 665 cm 1 shows an excellent agreement with experimental data. It should be emphasized that the wave number calculated by B3LYP method at 53/50 for NO2 torsion mode is in agreement with the assignment proposed by Kanna Rao and Syam Sundar [26]. However, this type of vibrations is not supported by experimental data. C Cl vibrations The vibrations belonging to the bond between the ring and the halogen atoms are worth to discuss here, since mixing of vibrations are possible due to the lowering of the molecular symmetry and the presence of heavy atoms on the periphery of molecule [27]. The assignments of C Cl stretching and deformation vibrations have been made by comparison with similar molecules, the halogen substituted benzene derivatives [28]. Mooney [29] assigned vibrations of C X group (X=Cl, Br and I) in the frequency range of 1129 480 cm 1 . The strong FT-Raman band at 735 cm 1 corresponds to C Cl stretching mode. The theoretical wave number of C Cl 738 cm 1 coincides very well with the scaled value. The C Cl in-plane and out-of-plane bending vibration are assigned to the FT-IR bands at 240, and 160 cm-1 , respectively. Computed IR intensity and Raman activity analysis Computed vibrational spectral IR intensities and Raman activities of the corresponding wave numbers by B3LYP/6-311G and B3LYP/ccpVDZ basis set have been collected in the Table 5. Comparison of the IR intensities and Raman activities calculated by B3LYP/6-311G and B3LYP/cc-pVDZ levels with experimental values exposes the variation of IR intensities and Raman activities. These variations may due to the substitution of the chlorine, acid and nitro group atoms.
Vibrational force constant
The output files of the quantum mechanical calculations contain the force constant matrix in Cartesian coordinates and in Hartree/ Bohr2 units. These force constants were transformed to the force fields in the internal local-symmetry coordinates. The force field determined was used to calculate the vibrational potential energy distribution among the normal coordinate. In this molecule the values show the variation due to the substitution of the chlorine, acid and nitro groups. They are listed in Table.5. NBO analysis Natural bonds orbital analysis picture of CNBA because all orbital are mathematically chosen to include the highest possible percentage of the electron density. Interaction between both filled and virtual orbital spaces information correctly explained by the NBO analysis, it could enhance the analysis of intra- and inter-molecular interactions. The second-order Fock matrix was carried out to evaluate donor (i) – acceptor (j) i.e. donor level bonds to acceptor level bonds interaction in the NBO analysis [30]. The result of interaction is a loss of occupancy from the the concentration of electron NBO of the idealized Lewis structure into an empty non-Lewis orbital. For each donor (i) and acceptor (j), the stabilization enrgy E(2) associates with the delocalization i to j is estimated as j i i j ij i F E E q 2 (2) ( , ) ) where qi is the donor orbital orbital occupancy, are i and j diagonal elements and F(i, j) is the off diagonal NBO Fock matrix element. Natural bond orbital analysis provides a convenient basis for investigating charge transfer or conjugative interaction in molecular systems. Some electron donor orbital, acceptor orbital and the interacting stabilization energy resulted from the secondorder micro-disturbance theory are reported [31, 32]. The larger E(2) value the more intensive is the interaction between electron donors and acceptor i.e. the more donation tendency from electron donors to electron acceptor and the greater the extent of conjugation of the whole system [33]. Delocalization of electron density between occupied Lewis type (bond or lone pair) NBO orbital and formally unoccupied (anti bond or Rydgberg) non-Lewis NBO orbital correspond to a stabilizing donor-acceptor interaction. NBO analysis has been performed on the CNBA molecule at the ccpVDZ level in order to elucidate, the intra-molecular rehybridization and delocalization of electron density within the molecule. The intra molecular interaction is formed by the orbital overlap between (C1−C14) and * (C2−C3) bond orbital, which results intramolecular charge transfer causing stabilization of the system. The electron density of O16−H17 is 1.97e. The most important interactions in the CNBA molecule having lone pair O11 (2) with that of anti bonding N9−O10, results the stabilization of 19.79 KJ/mol. The interaction between lone pair O16 with anti-bonding C14−O15 resulting stabilization energy 46.12 KJ/mol, which denotes larger delocalization, is shown in Table 6.
Prediction of first hyperpolarizability a NLO property There is an intense current research activity in the area of molecular activity in linear and nonlinear optics, devoted to the search for efficient, stable, simple organic molecules exhibiting large hyperpolarizabilities [34 37]. Even though several promising structural motifs have been identified, aromatic backbone molecules are still common and show large non-linear optical properties. Organic non-linear materials have attracted a keen interest in recent years owing to their potential applications in various photonic technologies. Significant effects have focused on studying the electronic and structural properties of donor acceptor substituted π-conjugated organic molecules with large molecular nonlinear optical (NLO) response (β, first-order hyperpolarizability). Two factors are attributed to NLO properties of such molecules in an electric field: the altered ground state charge distribution by the donor and acceptor moieties and the enhanced –π-electronic charge redistribution through the π -conjugation. The experimental spectroscopic behavior described above is well accounted for by ab initio calculations in π-conjugated systems that predict exceptionally large Raman and infrared intensities for the same normal modes. It is also observed in our title compound that the bands at 1350, 1050, 896,798, 726 and 660 cm 1 in FT-IR spectrum have their counterparts in Raman 1352, 1045, 898, 800, 720, and 666 cm−1, which shows that the relative intensities in IR and Raman spectra are comparable. The first hyperpolarizability β is associated with the intramolecular charge transfer (ICT), resulting from the electron cloud movement through the π-conjugated framework from electron donor to electron acceptor groups. A reliable prediction of molecular hyperpolarizability requires adequate basis sets and therefore must involve both diffuse and polarization functions. As the basis becomes larger, one expects a better description of the molecule and, accordingly, more accurate results. In the view of these points, B3LYP/6- 311G method has been used for present study in order to see the effects of the level of theory and basis sets. The title is molecule fully optimized at B3LYP/6-311G method in the Gaussian 09 program. The tensor components of the static first hyperpolarizabilities β, and, βvec- , are calculated for the title molecule by taking into account the Kleinman symmetry relations and the squared norm of the Cartesian expression for the β tensor. The relevant expressions used for the calculation are shown below: The total static dipole moment is
The total static dipole moment, polarizabilities and first hyperpolarizabilities of CNBA were calculated. Table 7 lists the values of the electric dipole moments (Debye) and dipole moment components, polarizabilities and hyperpolarizabilities of the CNBA. Analyzing the β and β vec, it can be seen that there is the additive contribution of off-diagonal β-vectors to the total due to substitution in benzene. Such kind of behavior (large off diagonal contributions) has high practical utility in the research on NLO materials [38]. The total dipole moment (µ) and mean polarizability are 3.7448, 2.9383 Debye and 85.62 10 30esu, 85.62 10 30respectively. The µ×β value shows that there is significant increase in optical nonlinearities of the title molecule.
Mulliken population analysis:
Mulliken Atomic Charges Mulliken atomic charge calculation [39] has an important role in the application of quantum chemical calculation to molecular system. Because the atomic charges affect dipole moment, polarizability, electronic structure and more a lot of properties of molecular systems. The total atomic charges of CNBA were obtained by Mulliken population analysis with 6-311G basis set are listed in Table.8. For the title compounds the Mulliken atomic charge of C14 and H17 atoms occupies the higher positive value and becomes high acidic. Their corresponding Mulliken atomic charges of CNBA are 0.508843 and 0.402492, respectively. For CNBA molecule the O15 and O16 atoms have negative value. This clearly indicates the presence of intra molecular weak hydrogen bonding (C?O…H).
CONCLUSION
In the present work, we have performed the experimental and theoretical vibrational and HOMO, LUMO analysis of CNBA for the first time. The equilibrium geometry computed by B3LYP/cc-pVDZ level for both the bond lengths and bond angles are performed better. The vibrational frequencies analysis by B3LYP method agrees satisfactorily with experimental results. On the basis of agreement between the calculated and experimental results, assignments of all the fundamental vibrational modes of CNBA were examined and proposed in this investigation. Therefore, the assignments made at higher level of theory with higher basis set with only reasonable deviations from the experimental values, seem to be correct. NBO results reflect the transfer mainly due to N9−O10 and C14−O15. This study demonstrates that scaled B3LYP calculations are powerful approach for understanding the vibrational spectra of medium sized organic compounds. Finally, the calculated HOMO−LUMO energies show that charge transfer occur within the molecule which is responsible for bioactive and NLO properties of the molecule. For CNBA molecule the O15 and O16 atoms have negative value. This clearly indicates the presence of intra molecular weak hydrogen bonding (C?O…H).
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30General SciencesA STUDY OF SPORTS INFRASTRUCTURE IN COLLEGES FOR WOMEN AFFILIATED TO GURU NANAK DEV UNIVERSITY, AMRITSAR, INDIA
English105110Brij Bhushan YadavEnglish Amritpreet SinghEnglish Vishaw GauravEnglishGuru Nanak Dev University has occupied a unique place in the Indian Universities by winning Maulana Abul Kalam Azad (MAKA) Trophy for record 21 times. To investigate its unparallel achievements in sports, relevant data for the study was collected from 27 colleges for women affiliated to Guru Nanak Dev University, Amritsar, India. A standardized questionnaire was used for data collection. Information regarding number of physical education teacher and coaches, total point/sports performance, ground staff, play fields, total budget/expenditure on sports, total number of sports person‘s participation in inter-college tournaments and total strength of students of the colleges were collected which were taken as independent variables, sports performance of respective college was treated as dependent variable. The colleges under study are spread over five districts in Punjab, i.e. Gurdaspur ,Amritsar, Jalandhar, Kapurthala and Nawansahar , correlation and step wise regression equation was used to analyse the data. The results of present study indicated that the budget/expenditure incurred on sports in the colleges was the most important factor which can be held responsible for achievement in sports performance of the college in sports arena.
EnglishMAKA trophy, sports performance, budget/expenditure.INTRODUCTION
The sports accomplishments can be attributed to many factors working in a whole some manner to compound an ideal amalgam of training methodology, psychological factors and to cap it all the much needed sports facilities. The highlevel performance rest largely upon their different abilities coupled with sports facilities, which plays a decisive role in achieving higher level performance in sports. When all other abilities compound at the peak level, the winning of laurels in competitions also depend upon the facilities one had been enjoying in the sports syndrome. It is becoming all the more imperative to specify these sports facilities and characteristic in specifics sports categories urgently required in the women college falling under the domain of Guru Nanak Dev University, Amritsar. Guru Nanak Dev University was established at Amritsar, India on November 24, 1969 to commemorate Guru Nanak Dev's birth quincentenary celebrations. Guru Nanak Dev University campus is spread over 500 acres near village of Kot Khalsa, nearly 8 km west of the Amritsar City on Amritsar - Lahore national highway. The University, which can take pride and boast of having annexed Maulana Abul Kalam Azad trophy for creditable, 21 times, claiming runner-up position ,12 times and attaining 3rd position twice. The ?Maulana Abul Kalam Azad (MAKA) Trophy? is given to overall top performing University in Inter-University tournaments of the preceding year. Government of India instituted `Maulana Abul Kalam Azad (MAKA) Trophy‘ award in 1956-57. The overall top performing university in the Inter-University tournaments is conferred with Maulana Abul Kalam Azad (MAKA) Trophy, which is a rolling trophy along with a cash prize of Rs.10 lakh. Universities securing second and third positions are also provided with cash prize of Rs.5 lakh and Rs.3 lakh, respectively.It is an unenviable position ever matched by any universities within Indian Union. The affiliated college who contribute their full might in pinnacling excellence and capabilities play the pivotal role in the development and excellence of sports. On the basis of the performance in Intercollege tournaments, various universities team are selected for participation in Inter universities competitions. Some of researchers have conducted the studies related to the infrastructure of sports in schools, colleges and sports of different states of India (Walia, 1971; Khatri ,1974; Singh, 1967 and Jaisy, 1963). Walia had undertaken a survey of facilities of physical education and sports for the students of Higher Secondary Schools of Delhi State in 1971, and found that most of the schools did not have sufficient equipment for students to develop their sports. Lack of sports funds, equipment grounds was severely felt in schools. Sports fund was used in majority of schools for the purposes other than sports. Even whatever little was provided by the Government in budget was not properly utilized. Singh (1976) made a survey entitled "Critical Evaluation of Sports Facilities available in the college of Punjab State." He had concluded that the shortage of women physical education teachers was more than the male physical education teachers. Under-qualified physical education teachers had been employed in most of the colleges. Sixty five colleges out of seventy three respondent colleges fell short of 576 acres giving an average shortage of 9.3 acres play area per college. The position of developed play fields in affiliated colleges of Punjab University was better than that of colleges in the other universities of Punjab. There are number of mind boggling queries regarding the sports infrastructure in educational institutions affiliated to Guru Nanak Dev University, Amritsar. The study was planned to execute and highlight some dormant characteristics regarding infrastructure facilities etc., which cry for the light. Experts in the field, senior physical education teachers working in the colleges and the coaches was consulted to note down the variables which more supposed to effect sports performance of the colleges. The objective of this study was to find out the factors affecting sports performance of the colleges for women affiliated to Guru Nanak Dev University, Amritsar, India.
METHODOLOGY
SAMPLE
Sample of the study in hand was affiliated to Guru Nanak Dev University, Amritsar, India. In this study 27 colleges for women affiliated to Guru Nanak Dev University were selected. It is pertinent to mention here that the sake of competition to provide level ground for the colleges they were divided into ?A‘ and ?B‘ categories by the university. The college with strength upto 700 was placed in the ?B‘ category. The competitions are arranged within its own category. Similarly, the colleges above the strength of 700 are placed in the ?A‘ category and they compete within themselves. The period over which this data in collected was spread over four session ranging from 1996 to 2000.The colleges under the study were those who got affiliation to the university between 1996 to 2000. The institutions that came into existence after 2000 were not involved in the study. DATA COLLECTION A questionnaire was prepared standardized and sent to the colleges involved in the study. Information related to physical education teacher and coaches, total point/performance, ground staff, play fields, total budget/expenditure incurred on sports, total number of sports person‘s participation in inter-college tournaments and total strength of students in the colleges was requested from the colleges concerned. The researcher personally visited the colleges to have first hand information. All the questionnaire was returned duly filled in and hence there were hundred percent returns. Information regarding number of physical education teacher and coaches, total point/sports performance, ground staff, play fields, total budget/expenditure on sports, total number of sports person‘s participation in intercollege tournaments and total strength of students of the colleges were collected which were taken as independent variables, sports performance of respective college was treated as dependent variable The variables used for study are shown in Table 1.
STATISTICAL ANALYSIS
Correlation and step wise regression equation was used to elicit findings. The equation used is as follow:-
RESULTS AND DISCUSSION
The data collected relates to colleges affiliated to Guru Nanak Dev University of Women colleges only from 1996-2000. The number of such colleges is 27. There district wise distribution is given in Table No. 2.
Table No.2 indicates the maximum number of colleges exist in Jalandhar district with eight colleges, including ?A‘ & ?B‘ division together. The district of Amritsar has six colleges both in ?A‘ & ?B‘ division are added together. The Gurdaspur district has seven and Kapurthala district has five colleges, each including ?A‘ and ?B‘ division categories. The new district Nawansahar was cut out of Jalandhar district and has only one college which falls in ?B‘ division category. Further analysis of data of Female colleges as shown in Table No.- 3. For knowing the performance effecting colleges from the independent variable included in the study. Multiple regression analysis was used. The regression equation is given below.
REGRESSION EQUATION:
Performance = -1.911 + 0.0253(Physical Education Teacher & Coaches) – 0.540 (Ground staff) + 0.142 (Play Fields) + 0.0001 (Total Budget) + 0.123(Total Sportspersons participation in Intercolleges tournaments) – 0.00181 ( Total Strength of students in the Colleges).
The above Table No. 3 shows the correlation of Independent Variables with the Dependent Variables, which is sports performance. To have total picture of the above relationship, detailed stepwise regression analysis is used, and the findings are shown in Table No. 4.
Result of stepwise regression analysis of data is related to women colleges affiliated to Guru Nanak Dev University from its five district in given in Table No. - 4. This shows the contribution of different variables related to overall performance of sports, which is dependent variable. The distribution of Independent Variable related to performance in ascending order is displayed and the value of R2 . This value is 0.97, when all the Independent Variables are included in the analysis. This value shows that almost 97% performance of the colleges can be responsible for the given Independent Variable, which we have added. These Independent Variables have already been shown in Table No. – 3 with their correlation with dependent variable as shown against each. Scrutinizing the R2 value, the Independent Variables are deleted one by one in the ascending order of their importance and the consequent change in R2 is noted. These results are also added in the Table No. - 4. The first variable to be deleted is Ground staff (No.3), after the deletion of this variable the value of R2 is 0.97. This means even after deletion of this variable the contribution of Independent Variables remains at 97%. The value of F is calculated and comes out 0.665. This value of F is found to be insignificant at o.o1 level of significance .The significant change in the value of shows its relative significance in determining the sports performance of the colleges. The next variable deleted was Physical Education Teacher & Coaches. There is still no change in the value of R2 (0.97). This indicates the relative insignificant contribution of this variable in the sports performance of the colleges. Similarly the variables no. 4, whose value is 0.97 has no significance contribution towards the Dependent Variable i.e. Sports performance. The analysis further brings to light that variable no. 7 and 6, which are Total Strength of students in the college and Total number of sportspersons participation in Inter Colleges Tournaments are with the value of R2 0.96 and 0.94 respectively. The calculating of F(R2 change) is found to be significant at 0.05 level of significance. The last variable i.e. Total Budget / Expenditure has R2 of 0.97. That shows that there 97% contribution of this variable towards performance of the women colleges of the University. The R2 change calculated value is 1706.88, which significant at 0.05 level of significance. The women colleges there are three Independent Variable no. 7, 6 and 5 which have shown significant contribution towards the sports performance of the colleges. These variables are Total strength of students in the colleges, Total number of sportspersons participation in Inter Colleges Tournaments and Total Budget / Expenditure, which is spent on sports promotion and competitions. It can be construed from the analysis that those colleges having more number of students shall participate in more sports and games Inter college competition of the University. Some of the Women colleges do not participate in many of the sports competitions. When fewer teams are seen entering the competitions. Sometimes there are only 3 – 4 teams participating in the women section. This implies that for better performance more women students be encouraged to participate in sports.
CONCLUSION
The results revealed that those colleges having more number of students shall participate in more sports and games in inter college‘s competition of the university. Some female colleges do not participate in many of the sports tournaments when fewer teams are seen entering the tournaments. Sometimes there are only three to four teams participating in the women section. This shows that for better performance more female students be motivated to participate in sports. It has also be seen that total strength of students in the colleges and total number of sports women participating in sports are other two variables significantly contributing to the overall sports performance of the college in credit to the budget/expenditure. The results of present study showed that the budget/expenditure incurred on sports in the colleges play the most important role in the performance of the college in sports arena.
ACKNOWLEDGEMENT
Authors would like to thank department of Physical Education and Sports, Guru Nanak Dev University, Amritsar (Punjab, India) for providing assistance in collecting the relevant information for undertaking quality research.
Englishhttp://ijcrr.com/abstract.php?article_id=1890http://ijcrr.com/article_html.php?did=18901. Jaisy, JV (1963). Physical education of girls in Indian schools. Unpublished Ph.D. thesis, Madras University, Madras.
2. Khatri,Sarao (1974).A survey of the facilities for physical activities and sports for the students of Higher Secondary Schools of Delhi State . Unpublished M.A. Physical Education Thesis, Punjabi University, Patiala.
3. Singh, Partap (1967). Evaluation of the working Physical Education centers under Muncipal Corporation of Delhi. Unpublished M.P.Ed. Thesis, Punjabi University, Patiala.
4. Singh, Gian (1976) .Critical Evaluation of Sports Facilities available in the college of Punjab State. Unpublished M.P.Ed. Thesis, Punjabi University, Patiala.
5. Walia (1971). Survey of facilities of physical activies and sports for the students of higer secondary schools of Delhi state. Unpublished M.P.Ed. Thesis, Punjabi University, Patiala.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareDRUG USE IN MEDICINE OUT-PATIENT DEPARTMENT: A PROSPECTIVE STUDY IN A TERTIARY CARE TEACHING HOSPITAL
English111118Arvind Kumar YadavEnglish Neha SharmaEnglishObjective: To study the prescribing pattern of drugs in patients attending medicine outpatient department and to evaluate the drug used for rationality with the help of W.H.O core drug prescribing indicators. Methods: This prospective study was carried out in medicine outpatient department of a tertiary care teaching hospital for two months. The data was collected
from patients of all age and from either sex after taking written informed consent, in a proforma which included the patient‘s demographic details and the drugs prescribed. Data were analyzed for drug use pattern. Results: Total 450 prescriptions (2143 drugs) were analyzed. The analysis of pattern of drug use revealed that NSAIDS, vitamins, and antibiotics were the most frequently prescribed drug groups. Amongst antibiotics penicillin group was most commonly prescribed group. Amoxicillin and clavulanic acid combination was found be the most commonly prescribed antibiotic. FDCs in the form of multivitamin preparations were found to be highest in number. FDCs accounted for 36.73% of medicine formulations prescribed in our study. WHO core drug prescribing indicators show polypharmacy, and less drug prescribing by generic names. Only 35.09% of drugs were prescribed from the WHO Essential drug list. Antibiotics and injections were prescribed in 41.55% and 8.2% of encounters respectively. Conclusion: There is a need to educate the prescriber on rational drug therapy for benefits and safety of the patients. There is also need to conduct similar studies at frequent intervals of time, which would reflect the changing pattern of drugs in medicine out-patients.
EnglishPrescribing pattern, fixed dose combinations, polypharmacy, essential drugsINTRODUCTION
Irrational prescription of drugs is a common occurrence in clinical practice so, it is necessary to define the prescribing pattern and to target the irrational prescribing habits for giving feedbacks to clinicians for the benefit of the patients. [1] Irrational drug use can lead to reduction in quality of drug therapy, increased risk of side effects and drug resistance. [2] In the recent years studies on drug utilization have become potential tool to be used in the evaluation of health care system. Drug utilization research was defined by W.H.O (World Health Organization) in 1977 as ?the marketing, distribution, prescription and use of drug in the society, with special emphasis on the resulting medical, social and economic consequences?. [3] The assessment of drug utilization is important for clinical, educational and economic purposes. [4]
The ultimate goal of drug utilization research must be to assess whether drug therapy is rational or not. Rational use of drug implies the prescription of a well documented drug in an optimal dose on a right indication, with the correct information and at an affordable price. [3] Without knowledge on how drugs are being prescribed and used, it is difficult to determine rational drug use and to suggest measures to change the habits for the benefit of patients. Various factors influence the prescribing behavior of clinicians and to change the behavior it is necessary to understand the reasons behind it. [5] The important criteria for rational use are accurate diagnosis, proper prescribing, correct dispensing, suitable packing and patient adherence. [2] To assess the scope for improvement in rational drug use in OPD, the World Health Organization (WHO) has formulated a set of ?core drug use indicators‘. The WHO indicators are to be used to focus on the local health problems. The core prescribing indicators measure the performance of the prescriber, the patient care indicators measure what patients experience at health facilities, and facility indicators measure whether the health personnel can function effectively. [3] There has been constant development of many therapeutic agents and new therapeutic strategies, so drug utilization pattern needs to be evaluated from time to time so as to increase the therapeutic efficacy and decrease adverse effects. [6] Previously only few studies have been conducted to study the pattern of prescription in Rajasthan. No such study is carried out at our institute so the present study was undertaken to investigate the prescribing pattern of drug use in patients attending the medicine outpatient department of a tertiary care teaching hospital and to evaluate the drug used for rationality with the help of W.H.O core drug prescribing indicators and other drug prescribing parameters.
MATERIALS AND METHODS
This study was carried out in medicine outpatient department (OPD) of a tertiary care teaching hospital. This hospital satisfies the health care needs of thousands of patients of city and patients coming from nearby areas. This prospective study was carried out in medicine OPD on Monday to Saturday between 10 am to 12 noon during the period of May 2011 to June 2011. The data was collected from patients of all age and from either sex, who visit the medicine out-patient department of the hospital. All cases with drug prescription were included during the study period and the patients not willing to give information were excluded from the study. A total of 450 patients were included during the study period of two months. Approval from the institutional ethics committee was taken before starting the study. Written consent was taken from the patients or their relatives in an ?Informed Consent Form‘, after explaining them about the study in brief, in their local language. The data was collected in a case record form from the patient‘s case paper. This includes patient‘s demographic details, O.P.D registration number, provisional diagnosis/or diagnosis, chief complaints and complete prescription (Drug name, dose, frequency, and duration of prescription). Many of the drugs were prescribed by their brand names. Some drugs were prescribed from the hospital pharmacy by generic names. The generic names of drugs and generic contents of each formulation were obtained from commercial publication like Indian Drug Review (IDR). All the data/ or the parameters were expressed in percentage and finally the analysis was done for WHO core drug prescribing indicators (Average number of drugs per prescription, percentage of drugs prescribed by generic names, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of drugs prescribed from the essential drug list).[3] Other parameters like prescribing frequency of drug or drug group and also prescribing frequency of fixed dose combinations (FDCs) were also analyzed. All the data collected was analyzed by using appropriate statistical tests.
OBSERVATIONS & RESULTS
A total of 450 patients were included during the study period of two months. Of these 217 (48.22%) were males and 233 (51.78%) were females. The age of patients ranged from 12 years to 85 years. The adult age group (18-65 years) was found to be highest in number [407 (90.44%)] who visited medicine OPD. (Figure 1) Total 2143 drugs were prescribed in 450 patients in 1609 medicine formulations. The average number of drugs per patient was 4.76. Other WHO drug prescribing indicators are shown in Table 1. Various groups of drugs were prescribed in 450 patients. Most commonly prescribed drug group was NSAIDS (11.71%) followed by vitamins (10.31%), antibiotic (8.73%), and anti ulcer drugs (8.35%). (Table 2) The most commonly prescribed group of antibiotic was penicillin group (50.27%) followed by quinolones (29.95%), tetracyclines (10.70%), macrolides (3.74%). Most commonly prescribed antibiotic was found to be amoxicillin and clavulanic acid combination. (Table 3) Total number of fixed dose combinations was found to be 591 out of total 2143 drugs in 1609 medicine formulations. Most frequently prescribed FDC was multivitamin complex (9.51%), followed by rabeprazole and domperidone (3.42%). (Table 4).
DISCUSSION
Prescribing pattern of medicines reflects the physician‘s attitude towards the disease and the role of drugs in its treatment. Correct diagnosis of a disease and its management with medicines, constitute important aspects of patient care. The age distribution of the patients showed that the adult age group was found to be highest in number who visited medicine OPD. The large population of adult patients attending the OPD was also observed in a previous study. [7] A possible reason could be that this study was done in medicine OPD so patients below 12 (Pediatric patients) and older patients with multiple diagnosis which usually in-door patients were not included. Gender analysis revealed that female patients were slightly more in number (51.78%) compared to males (48.22%). Similar pattern was found in other study. [2] WHO core drug prescribing indicators measure the performance of health care providers in several key dimensions related to the appropriate use of drugs in outpatient settings. The average number of drugs per prescription was 4.76 which are higher than the recommended limit of 2.0. [8] In our study this could be because of higher percentage of involvement of FDCs in prescriptions. Similar findings have been reported in other studies from India. [9, 10, 11] Studies conducted in Nigeria (3.2) and Nepal (2.91) have also shown similar finding. [12, 2] This shows that polypharmacy and overprescribing are common in practice. Polypharmacy may lead to drug-drug interactions, adverse drug reactions, and cost of therapy. [13] Various reasons can account for this situation like lack of self confidence in doctors for diagnosing and treating common disease conditions; unrealistic expectations and demand for quick relief from the patients; availability of non-essential and irrational drug combinations; and aggressive medicine promotion and unethical marketing practices of pharmaceutical companies. [14] Most of the drugs in our study were prescribed by brand name; only 0.009% of drugs in our study were prescribed by generic name. This value is much less than other studies. [7, 9, 10, 12] The low percentage of drugs prescribed by generic names in our hospital is a matter of concern and the reasons for these should be investigated. This could be because our study was done in a private hospital where medical promotion of drugs by brand names is common and also involvement of more number of FDCs in prescription which are usually prescribed by brand name. Generic prescribing decreases the risk of wrong medicines being given to patients as many medicines with different generic names have similar brand names. Prescribing medicines by generic names avoids the confusion and makes the medicine therapy rational and cheaper. Moreover in the teaching institutions world over, in textbooks, in scientific journals and in the research publications, medicines are always mentioned by generic names. Despite this, most doctors prescribe the medicines by their brand names. The reasons for this could be tradition, aggressive medicine promotion, availability of multi-ingredient fixed dose drug combinations etc. [13] Antibiotics and injections were prescribed in 41.55% and 8.2% of encounters respectively which is lower than that reported by other studies. [10, 15] The lower number of encounters with an antibiotic or injection prescribed in our study is a welcome sign and has to be encouraged. Irrelevant use of the antibiotics can lead to the increased adverse events and increased chance of the bacterial resistance to the antimicrobial. [16] Use of the injection should be limited because it can cause local toxicity and also increase the risk of the toxicity and overall cost of the treatment for the patients. [17] Only 35.09% of drugs were prescribed from the WHO Essential drug list in our study. 39.6% and 66.9% of drugs were prescribed from the essential drug list in studies conducted in Nepal and India respectively. [7, 10] The low rate of prescribing of essential drugs is a matter of concern. Lack of awareness about essential drug concept and essential drug list among prescriber could be the cause of less prescribing from the Essential drug list. In our study it could be because of excessive use of multivitamin and combination preparations. It must be noted though that Essential drugs are primarily meant for primary healthcare systems while we studied drug utilization in a tertiary care teaching hospital. Increase in the use of essential medicines makes the medicine therapy more rational. [18] In our study most commonly prescribed drug group was NSAIDS followed by vitamins, antibiotics, and anti ulcer drugs. Other studies conducted in India have shown similar pattern. [9, 10] Amongst antibiotics, penicillin group was the most frequently prescribed drug group followed by quinolones, tetracycline, and macrolides.
Most commonly prescribed antibiotic was found to be amoxicillin and clavulanic acid combination which is a rational combination. These both drugs in this combination have similar pharmacokinetic properties which make this combination rational. Study done in Nepal has shown use of combination of ampicillin and cloxacillin which is an irrational combination which only adds cost and adverse effects of both drugs. [7] The antibiotics used in our hospital were well established one like penicillin group and this is to be welcomed. The use of antibiotics should be in accordance with the sensitivity patterns of microorganisms in the particular area. [19] If the organisms are sensitive to older antibiotics they should be used. The newer antibiotics are expensive and patients may not be able to afford a full course and they may opt for a truncated course increasing the likelihood of resistance. The newer antibiotics should be kept in reserve. Also, more data is available for older antibiotics which have been used in a larger number of patients and for a longer period of time. FDCs accounted for 36.73% of medicine formulations prescribed in our study. Multivitamin preparations were found to be most common FDC. In a previous study in Uttaranchal, India, FDCs accounted for 59% of drugs, [9] while study done in Nepal, FDCs accounted for 59% of drugs prescribed and multivitamin preparation was highest in number. [7] The use of combination products reduces the number of pills to be taken, cost of packing and dispensing fee. The patient adherence may be improved, as lesser number of drugs has to be ingested. There is an inverse relationship between patient adherence and the complexity of the regimen. [2] However, a problem noted was the use of irrational drug combinations in a few instances like multivitamin preparations are mostly considered as irrational, [20] which are prescribed in our study as well as in other studies. [7] It requires special attention to prevent excessive use of multivitamin preparations in prescriptions. Any drug utilization study based on the WHO core drug use indicators has limitations. Determining the quality of diagnosis and evaluating the adequacy of drug choices is beyond the scope of the prescribing indicators. In this study mean cost of drugs and mean duration of prescription were not calculated. Sample size is small in this study because data was collected for a period of two months only and data was collected for 2 hr only per day. Seasonal variation cannot be evaluated. So Further studies in this area using a larger sample size and for longer duration should be carried out, and a well designed training programme should be conducted on rational drug use. Prescriber education may be helpful in encouraging rational prescribing.
CONCLUSION
Drug use studies are a necessary tool for assessing prescribing patterns in hospitals, recognizing areas for improvement and improving drug prescribing practices in these facilities. For achieving the goal of rational use of medicines it is not sufficient to choose the right medicines only but also they must be employed in the most appropriate manner. This study revealed ample scope of improving the prescribing pattern by keeping the number of medicines as low as possible, prescribing medicines by generic names, prescribing more medicines from essential dug list, less use of antibiotic and injection. Some of the drug combinations being used were irrational. So rational fixed dose combinations should be encouraged and unnecessary use of multivitamin preparations should be avoided. There is need for some interventions to improve the standards of drug prescription. More studies are needed to be conducted to sensitize the practitioners about rational prescribing.
ACKNOWLEDGEMENT
We 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=1891http://ijcrr.com/article_html.php?did=18911. Das B. Prescribing trend of fixed-dose drug combinations in a tertiary hospital in Nepal. J Inst Med 2000; 22:145-49.
2. Alam K, Mishra P, Prabhu MM, Shankar PR, Subish P, Bhandari RB, et al. A study on rational drug prescribing and dispensing among outpatients in a tertiary care teaching hospital of Western Nepal. Kathmandu Uni Med J. 2006; 15:436-44.
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8. World Health Organization. How to investigate drug use in health facilities: selected drug use indicators. EDM research series no.7. Geneva. World Health Organization; 1993; 1:1-87.
9. Rishi RK, Sangeeta S, Surendra K, Tailang M. Prescription audit: experience in Garhwal (Uttaranchal), India. Trop doct. 2003; 33:76-9.
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20. Poudel A, Palaian S, Shankar PR, Jayasekera J, Izham MIM. Irrational fixed dose combinations in Nepal: need for intervention. Kathmandu Uni Med J 2008; 6:399-405.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30General SciencesAN INVITRO STUDY OF CISPLATIN INDUCED NEPHROTOXICITY IN GOAT KIDNEY
English119126N.SangeethaEnglishCisplatin (CP) is one of the most active cytotoxic agents in the treatment of cancer and has adverse side effects such as nephrotoxicity and hepatotoxicity. The present study was designed to determine the cisplatin induced nephrotoxicity by determining Urea, Creatinine, Malondialdehyde (MDA), reduced glutathione (GSH), Glutathione peroxidase (GPx), Superoxide dismutase (SOD) and Catalase (CAT) in goat kidney homogenates. A significantly (pEnglishCisplatin, Nephrotoxicity, Oxidative stress, Antioxidant enzymes.INTRODUCTION Cisplatin (cis-diamine-dichloroplatinum) is a prominent member of the effective broad spectrum antitumor drugs. However, its clinical usage is restricted due to some adverse side effects, such as ototoxicity and nephrotoxicity1-3 .However, at high doses, less common toxic effects, such as hepatotoxicity, may arise4-6 . Continued aggressive high-dose cisplatin chemotherapy necessitates the investigation of ways for prevention of the dose limiting side effects that inhibit the cisplatin administration at tumoricidal doses. In several studies, it had been documented that injection of CP produced a marked decrease in renal blood flow and glomerular filtration rate. The alterations in the kidney and liver functions induced by CP are closely associated with an increase in lipid peroxidation and reactive oxygen species (ROS) in the tissues 7, 8. Indeed, some recent studies have suggested that oxidative stress plays an important role in cisplatininduced liver damage 9-12 . ROS such as hydrogen peroxide, hydroxyl radical, singlet oxygen, superoxide anion and peroxyl radical are formed inside cells by exposure to several endogenous and exogenous agents, causing damage to many important biomolecules that have been implicated in several diseases13.These prooxidants are kept in check by endogenous antioxidants, but under disease conditions, the balance is shifted in favor of prooxidants, leading to oxidative stress. Excess ROS causes significant oxidative damage by attacking biomolecules such as membrane lipids, DNA and proteins in cells14 . The oxidative stress is associated with many disease states including neurological diseases such as Alzheimer‘s brains and Parkinson‘s disease, chronic heart disease, and kidney and liver diseases15 . Endogenous antioxidants such as reduced glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD), Catalase (CAT) are compounds that act as free radical scavengers. These antioxidants are electron donors and react with the free radicals to form harmless products such as water. Therefore, antioxidants protect against oxidative stress and prevent damage to cells16. Thus, the aim of the present study was to investigate the cisplatin-induced oxidative damages of goat kidney by biochemical methods. MATERIALS AND METHODS Sample Collection: The kidneys with intact capsules were taken from goat in the slaughter house approximately 15 to 20 min after electrocution; the renal artery and vein were flushed with ice-cold Eurocollins, pH 7.4, consisting of 177mM glucose, 10mM NaHCo3, 15 mM Kcl, 42 mM K2HPO4 and 15 mM KH2PO4 supplemented with 2 mM glycine. Freshly prepared homogenate were mixed with buffer (4mM Cacl2, 1.5% BSA). Experimental Design: The kidney homogenate samples were divided into 2 groups: Group I: Control (10% Kidney homogenate) Group II: 10% Kidney homogenate treated with 0.033 mM Cisplatin. Chemicals: Cisplatin was purchased from Dabur Pharmaceuticals Company. All the chemicals used were of analytical grade and were purchased either from Sigma chemical or Qualigens. Biochemical Measurements: Kidney homogenates were centrifuged for 15 min at 15000g and then clear supernatants were removed for analyses. The levels of Urea17 and Creatinine18 were determined and the results were expressed in mM/ mg of protein and µM/ mg of protein respectively. Malondialdehyde (MDA) level19 was measured and expressed as nmol / mg of protein. Measurement of tissue Glutathione (GSH)20, Glutathione peroxidase (GSHPx)21, Superoxide dismutase (SOD)22 , Catalase (CAT)23 activities were performed. The activities of antioxidant enzymes were expressed as nmol/ mg of protein for GSH, U/ mg of protein for GSH-Px, µmol / mg of protein for SOD and µmol/ min/ mg of protein for CAT. Statistical Analysis: Descriptive statistics were calculated for all the outcome variables and expressed as mean±s.d. The results were analyzed statistically according to the Student‘s ttest. The p values Englishhttp://ijcrr.com/abstract.php?article_id=1892http://ijcrr.com/article_html.php?did=18921. Ek Born A, Lindberg A, Laurell G, Wallin I, Eksborg S, Ehrsson H, 2003. Ototoxicity, nephrotoxicity and pharmacokinetics of cisplatin and its monohydrated complex in the guinea pig. Cancer Chemotherapy and Pharmacology, 51: 36–42.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareA STUDY ON EFFECT OF TWO DIFFERENTIAL EXERCISES PROTOCOL TO PREVENT FALL IN ELDERLY
English127133Abhishek SharmaEnglish Anjan DesaiEnglish Khusbu DesaiEnglish Jignesh SutharEnglishObjectives: The main objective of this study is to compare the effectiveness of balance exercises in elderly. Design: Comparative Pre test and post test experimental design. Setting: Total 30 elderly subjects were taken from old age home, Surat. And given two different exercises protocol. Participants: A sample of 30 elderly were taken from after giving due consideration to inclusion and exclusion criteria. Informed consent was taken from each subject before starting. Intervention: Total 30 Group 1: Exercises to 15 subjects with Single leg standing, Tandem walking, Walking in ?fig of 8?Beam walking, Group 2: Exercises to 15 subjects with Walk : Sideways, Normal Standing with Reaching Activities, Weight Shifting : side-to-side, forward-to-backward, Full Tandem Standing. Measurements: Tinetti Performance Oriented Mobility Assessment tool4 was used. Results: Both Group 1 and Group 2 results showed highly significant improvement in balance after 4 weeks of exercise at 5% level of significance. There was more improvement in balance in group-1 than group – 2 at 5% levelof significance. Conclusion: From the present study it can be concluded that different protocols
of regular exercises improves the balance and prevent fall in elderly.
EnglishBalance, Tinetti Performance Oriented Mobility Assessment and ExercisesINTRODUCTION
Ageing refers to biological process of growing older in a deleterious sense. The chronological criterion to identify the old in America has been set at 65 years. However, the onset of health problems of elderly may occur in early 50s or may be only in 40s.The present chronological criterion to identify the old may change in future, as the mean age of population increases each decade and more individuals live in to their ninth decades. Elderly are further classified as: Young Old: 65-75 years. Middle-old: 75-85 years; Old: old > 85 years. Balance is a state of equilibrium characterized by cancellation of all forces by equal opposing forces. Balance is a set of biological strategies designed to maintain the body in erect posture. Balance and coordination depend on the interaction of multiple body organs and systems including eyes, brain and nervous system, cardiovascular system and muscles. There are mainly three mechanisms responsible for maintaining balance. Under normal circumstances, the body undergoes oscillation around a fixed point. As balance mechanisms deteriorate with increasing age, sway increases. Ocular Mechanism: - Under normal circumstances, visual cues are constantly used to correct minor deviation from the fixed point. Vestibular Mechanism: - The vestibular is mainly involved with rotator movements of the head and neck, whereas the eolith organ is involved with acceleration and deceleration. Proprioceptive Mechanism: - Position sense is important for maintaining balance.³ Sensory information from proprioceptors in the spine and major weight-bearing joints may be impaired with ageing and arthritis. Failure of these mechanism leads to an increased likelihood of falls.15 Age and lack of physical activity may both be responsible for a poor balance control. The risk of developing problems in one or more of the sensory, motor, or adaptive brain components of balance increases with age as the body is exposed to degenerative or infectious diseases, or the effect of injuries accumulated over a lifetime. Thus, balance problems among older adults are frequently caused by combinations of subtle degenerative, infectious or injury processes that individually are not clinically significant. Poor balance has repeatedly being shown to be a risk factor for falls in community-dwelling older adults. Balance has three basic dimensions-maintenance of a position, stabilization for voluntary movements and reaction to external disturbances. Most injurious falls occur during the performance of routine daily activities such as walking, transferring, stopping, bending or reaching.
METHODS
Study design: This study design was a purposive controlled trial pre test and post test experimental design.
Sample size and sampling method: Thirty subjects of 65 years or above were selected by means of simple random sampling procedure.
Study population: The subjects who fulfilled the following criteria were taken as study population.
Inclusion Criteria: Subjects of 65 years of above of both sexes were taken for the study.
Exclusion Criteria: Subjects with History of impairment of hip, thigh and knees, Recent fracture or any injury to lower limb, Inflammatory condition to lower limb, Sensory Deficits, Previous surgery to cranium, spine or lower limb, Hyper mobility to ankle and knee joint, Rheumatoid arthritis, Any neurological problem, Amputation or severe pain in the lower limb.7
Sampling Technique and Sample Size All subjects who fulfilled the inclusion criteria were selected for the study which counts to a total of 30.
Study setting: This study was conducted from 1st June‘ 09 to 30th June‘ 09 at Shree B.G. Patel, College of Physiotherapy, Anand and Old Age Home, Surat.
Data Collection Method: Balance of all the subjects was measured on 1st day and on 30th day by Tinetti test. Group Allocation:
The experimental group – 1: This group was treated with following exercises two times a day for 30 consecutive days. Single leg standing, Tandem walking, walking in ?fig of 8?Beam walking.12, 17 The experimental group – 2 This group was treated with following exercises two times a day for 30 consecutive days. Walk: Sideways, Normal Standing with Reaching Activities, Weight shifts: side-to-side, forward-to-backward, Full Tandem Standing. Material: Tinetti Balance Assessment tool, Standard Chair without Armrest, Paper, Pen, Pencil, Chock, Scale, Measure tape, Stop Watch, Beam Outcome measures:
Tinetti Performance Oriented Mobility Assessment tool was used to measure an older adult‘s gait and balance abilities.4 Collection of Data All subjects were selected randomly for two experimental groups after screening them for inclusion and exclusion criteria. All the subjects evaluated by Tinetti balance and gait assessment scale before and after the intervention.10 Informed consent were taken from each subjects before starting the treatment, the subject was positioned comfortably and assessed thoroughly about their condition. The experimental group 1 :- This group was treated with following exercises two times a day for 30 consecutive days-Single leg standing with 30 second holding time, 5 repetitions for each side; Tandem walking on the path of 5 meters, 3 rounds; Walking in ?fig. of 8? manner, 5 rounds; Beam (length: 93?, height: 3.5?) walking, 3 rounds. The experimental group 2 :- This group was treated with following exercises two times a day for 30 consecutive days-Walk : Sideways, on path of 20 meters 2 rounds; Normal Standing with Reaching Activities, 30 repetitions; Weight Shifting : side-toside, forward-to-backward, 20 times for both; Full Tandem Standing,30 second holding time, 5 repetitions. Tinetti Performance Oriented Mobility Assessment (T-POMA): The Tinetti assessment tool is an easily administered task-oriented test that measures an older adult‘s gait and balance abilities. The equipment needed is hard armless chair, Stopwatch or wristwatch and 15ft walkway.14 Total time to complete task is 10-15 minutes. Scoring: A three-point ordinal scale13, ranging from 0-2. ?0? indicates the highest level of impairment and ?2? the individual‘s independence. Total Balance Score is 16; Total Gait Score is 12 and Total Test Score is 28.Interpretation:25-28 = low fall risk19-24 = medium fall risk< 19 = high fall risk.12
DISCUSSION
Results of the present study showed that there was a significant improvement in outcome measures of balance in both groups. (tt =1.7010 tc= 5.6022) .We reject the null hypothesis and accept the alternative hypothesis as difference was seen in balance performance in group-1 and group-2 after giving balance training for 30 consecutive days(tc > tt).When comparing two groups, there was more improvement in balance in group-1 is treated by balance exercises like Single leg standing, Tandem walking, Walking in ?fig. of 8? and Beam walking than group – 2 which is treated by Side walking, Standing with Reaching Activities, Weight Shifting : side-to-side, forward-to-backward, Full Tandem Standing for 30 consecutive days. The reason for significant difference may be that Proprioception will increases with these balance exercises.11 This is supported by the study done by, Gerome C. Gauchard, et.al. (2003) who concluded that proprioceptive exercises appear to have the best impact on balance regulation and precision. Besides, even if bioenergetics activity improves postural control19 in simple tasks, more difficult postural tasks show that this type of activity does not develop a neurosensorial. Proprioceptive input threshold as well, probably an account of higher contribution of visual afferent. Secondly specific muscles which will help body to maintain balance will be trained through these exercises thus balance improves. This is also supported by the study done by, Kurt Murer, et.al. (2007) who concluded twice – weekly lower extremity strength training of 12 weeks duration in hostel – dwelling elderly and lower extremity physical function when additional functional exercises are added. The Tinetti Balance score and the chair stand test of the physical performance assessment improved significantly. Thirdly, Subject in the training group reported filling much comfortable after training and expressed a desire to continue the exercise. Finally, we found that age group of 65 years and above improve their performance significantly on one leg and were able to walk faster after 30 days training program.1 Those subjects who had the lowest before training showed the most pronounced improvement and also subject in the training group – 1 will be improve static as well as dynamic stability after giving exercises in age group of 65 years and above.
RESULTS
Total 30 subjects were randomly divided into 2 groups: Group 1 and Group 2.15 subjects were taken in each group. All the statistical analysis was done with the help of Graph Pad Demo version. Graph 1, 2, 3 displays the group statistics of mean, group-1 Tinetti assessment tool and group- 2 Tinetti assessment tool among the 30 subjects respectively. Student?s t-test was applied. We reject the null hypothesis as no difference was seen in balance performance in group-1 and group-2 after giving balance training for 30 consecutive days. Significant difference in balance performance was seen at 5% level of significance.
CONCLUSION
Thirty subjects of age 65 years and above participated in this study. Group-1 was given more of dynamic balancing exercises and group-2 was given more of static balancing exercises. Dynamic balancing exercises have more effect. The study shows improvement in balance performance of elderly persons after 30 days in both groups. But group-1 shows statistically significant improvement than group-2.
ACKNOWLEDGMENTS
We are sincerely grateful to the god who showered his blessings and his helping hand for our research. From the bottom of our heart we are thankful to our principal who helped us in every walk of our research and his support. The knowledge he shared with us and his encouragement helped us a lot. We would like to mention special thanks to my entire faculty who were always a standing rock for our great work. We are privilege to thank our respected elderly subjects without whom this research was not been possible. We acknowledge the immense help received from the scholars whose articles are included in references. We are grateful to authors/editors/publishers of all those articles, journals, and books from where the literature for study reviewed. Conflict of Interest: None Ethical Committee Clearance There was no ethical committee formed in the institution during the time in which research was performed.
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20. Barnett A, Smith B, Lord SR, Williams M, Baumand A. Community based group Exercise improves balance and reduces falls in at-risk older people: A randomized controlled trial. Age and Ageing. 2003 Jul; 32(4):407-14.
INFORMED CONSENT
Name:
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You are invited to participate in a study conducted by Abhishek Sharma and Jignesh Suthar, Shree B.G. Patel, College of Physiotherapy, Anand, Gujarat, India. We hope to learn what are effects of two different exercise protocols in improving balance. You were selected as a possible participant in this study because study deals with elderly subjects. If you decide to participate ,we Abhishek Sharma and my colleagues will test the balance and do gait analysis, will teach two different exercise protocols to two different groups ,it will take one month to complete the study and was made to do twice a day for 30 days. There are chances of falls or injuries though less, there are chances of getting tired or you may get faint or may have serious cardio respiratory problems. We cannot guarantee, however that you will receive any benefits from this study. Any information that is obtained in connection with this study and that can be identified with you will remain confidential and will be disclosed only with your permission or as required by law If you decide to participate, you are free to withdraw your consent and to discontinue participation at any time without penalty. If you have any questions, please ask us. If you have any additional questions later, Jignesh Suthar, Shree B.G. Patel, College of Physiotherapy, Anand will be happy to answer them
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareSUPERNUMERARY HUMERAL HEADS OF BICEPS BRACHII MUSCLE
English134138Jaideo Manohar UghadeEnglish Prashant Nashiket ChawareEnglish Poorwa Baburao KardileEnglish Sudhir Vishnupant PanditEnglishBackground: Biceps is the muscle of anterior compartment of the arm. The biceps in Latin means two heads. The two heads, long head and short head of biceps normally arise from scapula. The present study was carried out on twenty cadavers belonging central Indian population, to study the supernumerary head of biceps. Out of 40 arms studied, supernumerary head was seen in 5% of specimens, on left side. The knowledge of such variations is important in planning of surgery and post operative care provided by the physiotherapists.
EnglishBiceps brachii, Supernumerary head, Humeral headINTRODUCTION
Biceps brachii is the muscle of anterior compartment of arm, normally having two heads; long head and short head. Long head arises from the coracoid process and short head from the supraglenoid tubercle of the scapula1 . The supernumerary heads of biceps has been reported previously ranging from three heads to seven heads2,3 . The most commonly reported variation was the biceps with third heads3,4. Frequency of occurrence of third head of biceps in cadavers showed variation in different populations. In Chinese frequency is 8 %, European white 10%, African black 12%, Japanese 18% and in South Africans black and white population it ranged from 8% to 20.5%2,3,4,5,6. The attachment of the supernumerary head fascicles are described from the coracoid process, pectoralis major tendon, proximal head of the humerus, articular capsule of the humerus or from humerus itself. The supernumerary head arising from humerus is called as the humeral head of the biceps brachii muscle3,7 . The supernumerary heads were classified as superior, inferomedial, and infero-lateral humeral heads6 . In 10% cases the third head of biceps may arise from the superomedial part of brachialis and is attached to bicipital aponeurosis and medial side of tendon insertion1 . In the present study we reported two cases of supernumerary humeral head of biceps originating from inferomedial and inferolateral part of humerus which is quite rare.
MATERIALS AND METHODS
The study was conducted at Shri Vasantrao Naik Government Medical College, Yavatmal. The study included both right and left upper limbs of 20 formalin fixed cadavers (n=40) irrespective of age and sex. The arm was dissected carefully as described in Cunningham‘s dissection manual8 , to display the full length of the biceps muscle from proximal attachment to the distal attachment. All other related structures were also exposed. The additional heads were examined for the origin and course at lower end9 .
RESULTS
Among the 20 cadavers studied (n=40), the third head of biceps was observed in two male cadavers (5%). The other 38 limbs the biceps had two normal heads. In first observation, 79 year male cadaver variation observed was unilateral on the left side. Short head originated from tip of the coracoid process and long head from the supraglenoid tubercle. The supernumerary third head from the lateral aspect of humerus just below the insertion of deltoid and coracobrachialis (inferolateral head). The belly of the third head directed downward, medially and fused with common tendon of biceps just above the base of cubital fossa from the posterior aspect. The musculocutaneous nerve was present on the medial side, in between the third head and the brachialis which had normal origin. (fig 1,2) The second observation was made on male cadaver of 64 years on the left side. The origin of the short head and long head was normal. The supernumerary humeral third head was seen arising from medial aspect of the humerus just below the insertion of coracobrachialis and above the origin of brachialis muscle (inferomedial head). The origin of brachialis was normal and musculocutaneous nerve was present on the lateral side of the supernumerary head. (fig 3) Both the supernumerary heads received twig from the musculocutaneous nerve, were unilateral and on the left side. In both case, all the three bellies fused and was inserted normally on the lower half of radial tuberosity and bicipital aponeurosis. No other obvious abnormalities were observed.
DISCUSSION
The variation in number of head of biceps is well known. The number of heads of biceps ranged from three to seven2,3. In our study we encountered three head of biceps in two cases (5%) out of 40 limbs studied. Gray‘s Anatomy reported the incidence of this variation to be as much as 10% while in South African population the incidence varied with ethnicity between 20.5% in blacks to 8.3% in whites1,2. In north Indian population the incidence was around 2.3% which was less when compared to our study while in population of southern coast of India the incidence was 7.1% which was more as compared to our study4,9. The other Indian study reported incidence of 9.37% of third head of biceps3 . In our study we observed two types of supernumerary humeral head; inferolateral and inferomedial heads of biceps brachii. The accessory head of Biceps brachii are classified according to their location as superior, inferomedial and inferolateral humeral heads. Most of the accessories head of Biceps brachii belong to these 3 groups. Among all, inferomedial humeral head is the most common variation, which takes origin from the anteromedial surface of humerus just beyond the insertion of coracobrachialis and is inserted into the conjoint tendon of biceps brachii3,6,11,12 . Gray‘s anatomy reported third head arising from the superomedial part of the brachialis as 10% (inferomedial humeral head) while in our study this incidence was 2.5% and also inferolateral humeral head incidence was 2.5%1 . Population along the western region of India reported inferomedial humeral head of humerus in 3.12% but inferolateral humeral head was not reported3 . While in South African population the origin of inferomedial head of biceps were twice the origin of inferolateral head2 . Humeral origin of supernumerary head of biceps allow flexion of the elbow joint irrespective of the position of the shoulder joint as the third head only crosses the elbow joint. The dual origin of the third head may contribute to supination of the forearm, as the muscle origin is in a lateral position (inferolateral) relative to the rotational axis of the arm. The medial brachial origin (inferomedial) head may contribute to pronation of the forearm irrespective of shoulder joint position2,13. In addition to allowing elbow flexion independent of shoulder joint position, the third head of biceps brachii may enhance the strength of elbow flexion2,4,13 . Embryological studies revealed this variation of the third head of Biceps brachii as a portion of the brachialis muscle supplied by the Musculocutaneous nerve, in which its distal insertion has been translocated from the ulna to radius. This may be helpful primarily in supination and secondary flexion of the forearm3,14 . Phylogenetically the inferomedial head which arises from the insertion area of coracobrachialis, possibly represents a remnant of the long head of coracobrachialis, the ancestral hominoid condition2 . The unusual bone displacement which comes subsequent to fracture has been implicated to the presence of the supernumerary head of biceps4,13. It may affect the strength of elbow flexion and may also compress the neurovascular structure3,15 .
CONCLUSION
The anatomists and clinician should be aware of such variation. The knowledge of the supernumerary head of biceps is important for the orthopedician, traumatologist and neurovascular surgeon as it may influence the outcome of the surgery. This is also important in planning of surgery and post operative care provided by the physiotherapists.
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=1894http://ijcrr.com/article_html.php?did=18941. Johnson D, Ellis H, editors. Pectoral Girdle and Upper Limb. Gray‘s Anatomy: The Anatomical Basis of Clinical Practice. 39th ed. Elsevier Churchill Livingstone; 2005. p.853
2. Asvat R, Candler P, Sarmiento EE. High incidence of the third head of biceps brachii in South African population. J Anat 1993;182:101-4
3. Varlekar P, Meghatar NK, Mehta CD. Incidence of the third head of biceps brachii in Western Indian Population. NJIRM 2011 Oct-Dec;2(4):65-7
4. Cheema P, Singla R. Low incidence of the third head of the biceps brachii in the North Indian Population. Journal of Clinical and Diagnostic Research 2011 Nov Suppl-2;5(7):1323-6
5. Bergman RA. Thompson SA, Aifi AK. Catalogue of human variation. Munich, Urban and Schwartzenberg, 1984:27-30
6. Rodriguez-Niedenfuhr M, Vazquez T, Choi D, ParkinI, Sanudo JR. Supernumerary humeral heads of the biceps brachii muscle revisited. Clin Anat 2003;16:197-203
7. Lee JH, Choi IJ, Kim DK. The third head of the biceps brachii muscle originated from the pectoralis major muscle. Korean J Anat 2008;41:231-2
8. Romanes GJ, editor. The upper limb. Cunnigham‘s Mannual of Practical Anatomy. 15th ed. Oxford Medical Publications; 1996. p.33-73
9. Kumar H, Das S, Rath G. An anatomical insight into third head of biceps brachii muscle. Bratisl Lek Listy 2008;109(2):76-78
10. Rai R, Ranade AV, Prabhu LV, Paio MM, Prakash. Third head of biceps brachii in an Indian population. Singapore Med J 2007;48(10):929-31
11. Poudel PP, Bhattarai C. Study on the supernumerary heads of biceps brachii muscle in Nepalese. Nepal Med Coll J 2009;11(2):96-98
12. Abu-Hijleh MF. Three-headed biceps brachii muscle associated with duplicated musculocutaneous nerve. Clin Anat 2005;18:376-9
13. Sweiter MG, Carmichael SW. Bilateral three headed biceps brachii muscles. Anatomische Anzeiger 1980;148:346-9
14. Testut L. Tratado de Anatomía Humana. Barcelona, Salvat, 1902. p 1022
15. Warner JP, Palleta GA, Warren RF. Accessory head of biceps brachii: case report demonstrating clinical relevance. Clin Ortho Res 1992;280:179-81
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareA STUDY TO EVALUATE AND COMPARE ORAL STEREOGNOSTIC ABILITY AND ORAL TACTILE SENSIBILITY OF SATISFIED AND DISSATISFIED SUBJECTS WEARING COMPLETE DENTURE PROSTHESIS
English139145Anupama PrasadEnglish Chethan HegdeEnglish Krishna Prasad D.EnglishContext: Evaluating oral stereognostic ability and tactile sensibility in subjects wearing complete denture prosthesis may provide not only useful information about the sensory abilities of denture patients, but may also aid in interpreting the role of adaptation and adjustment to thecomplete denture prosthesis and its co-relation with advancing age. Aim: To evaluate and compare oral stereognostic ability and oral tactile sensibility of subjects wearing removable complete denture prosthesis. Settings and Design: Subjects who are wearing complete denture prosthesis for a period of more than six months . A set of six three dimensional test pieces with different shapes. A standardized, sterilized, machine rolled cotton bud. Materials and Methods: Denture satisfaction of subjects wearing complete denture prosthesis was analysed with the help of a questionnaire. A set of six three dimensional test pieces with different shapes were used for the assessment of oral stereognostic ability of the subject . Another set of same shapes but larger to correlate the shape of the test piece in the mouth with the one on display. The stereognostic ability to identify the shape was scored. A standardized, sterilized, machine rolled cotton bud was used for the assessment of oral tactile sensibility. The sensual perception when the bud lightly touched the dorsal surface of the tongue was assessed by the time taken by the subject to respond to the sense of touch. Statistical analysis used: Statistical analysis carried out using Spearman‘s rho, and Mann- Whitney U test . Results : There was high negative correlation(pEnglishoral stereognosis, oral tactile sensibility, denture satisfaction.INTRODUCTION
The loss of teeth may be a significant factor in declining the oral sensory ability of an individual. Due to increased life expectancy there are more elderly citizens who are now seeking a more comfortable oral environment and improved appearance1 .The ability to predict patient‘s performance with complete denture prosthesis remains deceptive2 , irrespective of the clinical proficiency employed in the fabrication of the prosthesis. There are reasons to assume that adaptation and adjustment to the complete denture prosthesis play a role in patient‘s satisfaction3 . Evaluating oral stereognostic ability and tactile sensibility in subjects wearing complete denture prosthesis may provide not only useful information about the sensory abilities of denture patients, but may also aid in interpreting the role of adaptation and adjustment to the complete denture prosthesis and its co-relation with advancing age4 . METHODS Source of data: The study was conducted on fifty edentulous subjects wearing complete denture prosthesis for more than six months.
MATERIALS AND METHODS
The subjects who were wearing complete denture prosthesis for a period of more than six months , aged between 50 to 60 years were selected for the purpose of the study whose prosthesis were professionally assessed to be good. The subjects were thoroughly examined to rule out any mucosal lesions that might influence the results of the evaluation. Subjects who were under the influence of drugs, drug addicts, intoxications, sedatives, psychic and perverted habits were not included in the study. Subjects were selected irrespective of their gender, caste, creed, colour and socioeconomic status. Patient‘s denture satisfaction was analysed with the help of a questionnaire based on which they were categorized as satisfied (11-21 score) and dissatisfied (0-10 score). A set of six , three dimensional test pieces with different shapes fabricated with heat cure acrylic resin, having 5mm thickness, diameter varying from 10-14mm and secured with threads to prevent accidental swallowing were used for the assessment of oral stereognostic ability of the subjects3,4,5,6,7. Another set of same shapes but bigger in size was kept outside for identification (figure1). These different shapes are: Heart- shaped, triangular, circular, square, semi- circle, rectangle. Heart- shaped and triangle, circle and semi-circle, square and rectangle were taken as similar shapes 3,4,5,6,7 . Heat cured acrylic resin test forms of six different shapes were obtained by processing wax patterns of planned thickness and radius. Each test form was placed on dorsal surface of extended tongue and then taken into mouth (figure2). Subject was instructed to move the form around, manipulate the test forms which helped him or her in identification- e.g. Sucking, chewing, pressing against palate or lips and then to point to one of the reference forms on display as soon as the oral identification of the stimulus was achieved. The stereognostic ability to identify the shape was then scored on a three point scale7,8 .The test was conducted on fifty subjects blindfolded during the procedure randomly. The answers were scored on a three point scale: two points for correct identification of test form , one point for identification of similar test form, zero point for incorrect identification of the test form. The answers given by patient on each form were then summed. Hence each patient received a total oral stereognosis score varying from 12 for all correct identification and 0 for all incorrect identification. It was then finally categorized as good (9-12 score), average (5-8 score) and poor (0-4 score). A standardized, sterilized, machine rolled cotton bud was used for the assessment of oral tactile sensibility. Tactilekinaesthetic perception (TKP) is the processing, arrangement, evaluation, and integration of sensations, which are transmitted via both surface and depth sensibility. The cotton bud was lightly touched on to the dorsal surface of the tongue(figure 3) and the sensual perception was assessed by the time taken (120+/-4seconds) by the subject to respond as YES or NO to appreciate and respond to the sense of touch and was thus scored on a three point scale. An answer by patient as ?NO? even after the roll of cotton touched the surface of tongue for more than 120+/-4 milli seconds was scored as ?0? points and was considered to have poor oral tactile sensibility. An answer by patient as ?YES? when the roll of cotton has just lightly touched the surface of the tongue for less than 120+/-4 milli seconds was scored ?2? points and considered to have an good oral tactile sensibility. An answer by patient as ?YES? when the roll of cotton touches the surface of the tongue properly was scored ?1? points and considered to have an average oral tactile sensibility.
RESULTS
Graph 1 compares oral stereognostic ability and tactile sensibility of satisfied and dissatisfied subjects wearing complete dentures. Among 39 (78%) of satisfied subjects wearing complete denture prosthesis, four( 8%) subjects had good oral stereognostic ability, 26( 52%)subjects had average oral stereognostic ability and nine (18% )subjects had poor oral stereognostic ability .On the other hand 13 (26%) subjects had good tactile sensibility , 26 (52%) subjects had average tactile sensibility and none of the subjects had poor tactile sensibility. Among the dissatisfied group of 11(22% )subjects representing the total sample taken, eight(16%) subjects had good oral stereognostic ability ,three (6%) subjects had average oral stereognostic ability and four(8%) subjects had good oral tactile sensibility and seven (14%) subjects had average oral tactile sensibility score. Table1 correlates denture satisfaction score with oral stereognosis ability score using Spearman‘s rho test in satisfied and dissatisfied patients wearing complete denture prosthesis and was found denture satisfaction and oral stereognosis ability to be having negative correlation r = - 0.473 with P < 0.001 . Table 2 correlates oral tactile sensibility score with the median of satisfaction score using Mann-Whitney U test. Among the 34 subjects with average oral tactile sensibility correlated with median satisfaction score of 14.000, Inter quartile ratio of 7.500 was obtained and among the 16 subjects with good oral tactile sensibility correlated with median satisfaction score of 16.000, Inter quartile ratio of 5.348 were obtained with z = 0.67800 and probability P value= 0.498 showing no significant correlation between oral tactile sensibility and denture satisfaction.
DISCUSSION
The purpose of the present study was to evaluate and correlate denture satisfaction, oral stereognostic ability and oral tactile sensibility in completely edentulous patients wearing removable complete dentures which were professionally assessed to be good. It was noted that dissatisfied denture patients took less time for identification of forms than satisfied denture patients. It seems likely that correlation of tactile sensibility to adaptation occurs indirectly via denture retention. Gender is considered of no importance8 . Good denture retention requires close contact of base with underlying tissues, closer this fit is, more receptors are stimulated when the denture is loaded, and tactile sensibility therefore increases1 . In the present study, during evaluation of patient‘s satisfaction in subjects wearing complete dentures, it was seen that even with dentures which were professionally assessed to be good there were differences among subjects in denture satisfaction, which signifies that even with good dentures patients had difficulty in adaptation problems as noted by Brill N, Tryde G, Schubeler S9 . According to Capra NF 10, sensory nerves that supply mechanoreceptors in the mucosal lining of the oral cavity, pharynx and larynx provide the substrate for a variety of sensations. They are essential for perception of complex or composite sensory experiences including oral kinaesthesia and oral stereognosis2 . They also contribute to initiation of reflexes and co-ordination and timing of patterned motor behaviours. The response of oral mechanoreceptors to natural stimuli is determined to a large degree by morphological factors such as nature of relationship between nerve ending and certain cellular specializations, their distribution in mucosa, the diameter of their primary afferent nerve fibres and central distribution of these fibres in the brainstem. The ability to recognize threedimensional forms and shapes (oral stereognosis) requires a special combination of stimulation of tactile and pressure receptors and the proprioreceptors of the muscles11.Because of morphological similarities between certain cutaneous mechanoreceptors, the mucosal lining may be considered as an internal continuation of large receptor sheets for localization and detection of mechanical stimuli10 . The tongue may compensate for the loss of role of palate in oral sensation in complete denture wearers. It might suggest that role of tongue in stereognosis is far more important than the input of palatal receptors in this regard and that dentures made of appropriate occlusal vertical dimension and proper arch forms confine tongue in a normal space, allowing it to more easily recognize shapes11,12 . In the present study it is seen that denture satisfaction is subjective and one among every five patients was dissatisfied which may be due to the fact that these patients had a strong and healthy neuromuscular supply and the nerve endings on their surface mucosa was very sensitive to even minute irregularities and surface details on the denture to which they could not adapt easily. The loss of the natural teeth results in the complete loss of the sensory input which has been provided by the periodontal ligament. The same sensory rnechanism that maintained the mandibular posture in the infant is also called upon to maintain it in the adult when the natural teeth are lost. It may also have the additional input from receptors located in the tissue around the dentures13. Normal subjects could distinguish two separate points of contact at the tip and anterior part of the dorsum of the tongue when the distance between the points was greater than 2 to 3 mm. However, two-point discrimination could not be determined on the lateral and posterior dorsal regions of the tongue when the points were less than 1 cm. apart14,15 . The study had certain shortcomings in that oral tactile sensibility had only three parameters like good, average and poor with very small values 2, 1 and 0 respectively which prevented statistical correlation. It would be wise to take wide range of scoring criteria as taken for oral stereognostic testing so that the parameters could be correlated in a better way. This entire area of proprioceptive response to the placement of a prosthodontic replacement needs additional research and study.
CONCLUSION
Within the limitations of this in vivo study, the following conclusions were drawn: 1. Oral stereognosis is inversely related to denture satisfaction, as the oral stereognostic score increased, denture satisfaction score decreased .
2. Oral tactile sensibility had very little correlation with patient denture satisfaction. There was average value of oral tactile sensibility score in both satisfied and dissatisfied patients. 3. Oral tactile sensibility had very little correlation with oral stereognostic ability. Oral tactile sensibility was same in patients whether they had good, average or poor oral stereognostic abilities.
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=1895http://ijcrr.com/article_html.php?did=18951. Muller F, Hasse-Sander I, Hupfauf L. Studies on adaptation to complete dentures .Part I : Oral and manual motor ability. J Of Oral Rehab 1995; 22: 501- 7.
2. Litvak H, Silverman SI, Garfinkel L. Oral stereognosis in dentulous and edentulous subjects. J Prosthet Dent 1971;139-151.
3. Mohammed Q. Al-Rifaiy, Sherfuddin H, Abdullah MA. Oral Stereognosis in predicting denture success. The Saudi Dental Journal 1996; 8:122-30.
4. Muller F, Link IK, UTZ H. Studies on adaptation to complete dentures. Part II Oral stereognosis and tactile sensibility. J Of Oral Rehab 1995; 22: 759- 67.
5. Bhandari A, Hegde C, Prasad DK. Relation between oral stereognosis and masticatory efficiency in complete denture wearers: an in vivo study. Braz J Oral Sci 2010;9:358-61.
6. Shetty M, Prasad DK, Rani G, Shetty NS . Oral Stereognosis- A diagnostic tool. JIAOMR 2007;19: 400-4.
7. Pow EH, Leung KC, McMillan AS, Wong MC, Li LS, Ho SL. Oral stereognosis in stroke and Parkinson's disease: a comparison of partially dentate and edentulous individuals. Clin Oral Investig 2001; 5: 112-7.
8. Jacobs R, Bou Serhal C, van Steenberghe D. Oral stereognosis: a review of the literature. Clin Oral Investig 1998; 2: 3–10.
9. Brill N, Tryde G, Schubeler S. Aspects of occlusal Sense in natural and Artificial Teeth. J Prosthet Dent 1962; 12: 123-8.
10. Capra NF. Mechanisms of oral sensation. Dysphagia 1995;10: 235-47.
11. Ingervall B, Schmoer R. Effect of surgical reduction of the tongue on oral stereognosis, oral motor ability and the rest position of the tongue and mandible . Am J Ortho Dentofac Orthop 1990; 64:569-72.
12. Ikebe K, Amemiya M, Morii K, Matsuda K , Furuya M , Yoshinaka, Yoshinoka M, Nokubi TA. Association between oral stereognostic ability and masticatory performance in aged complete denture wearers. Int.J.Prosthodont 2007; 20: 245-50.
13. Mantecchini G, Bassi F, Pera P, Preti G. Oral stereognosis in edentulous subjects rehabilitated with complete removable dentures. J Oral rehab 1998; 25: 185-9.
14. Crum RJ, Loiselle RJ, Oral perception and proprioception: A review of the literature and its significance to prosthodontics .J Prosthet Dent.1972; 28(2):215-30.
15. Catalanotto FA, Henkin RI. Manual and Oral Sensation in Patients with Cushing's Syndrome. J Dent Res 1977; 56 (7): 866-70.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30HealthcareFREE RADICALS STATUS IN TEMPOROMANDIBULAR JOINT DISORDER- A LITERATURE REVIEW
English161165B. SaravananEnglish R.Devaki VijayalakshmiEnglish S.KarthikEnglish P.JayamathiEnglishIncreased production of reactive oxygen species (ROS) contributing to oxidative stress, significantly influences many diseases including temporomandibular joint (TMJ) disorder. Temporomandibular joint disorder (TMJD) is an inflammatory disease which emphasizes that mechanical stresses lead to the oxidative stress of articular tissues. But, studies on the defense mechanism against oxidative stress in the pathogenesis of TMJD have received little attention. Hence, we made a novel attempt to review the pathogenesis of TMJD to explore the possible role of ROS in the degenerative TMJ disease.
EnglishINTRODUCTION
Temporomandibular joint (TMJ) is a synovial joint located between the mandibular fossa of the temporal bone and the condylar process of the mandible with an articular disk interposed between them. Deviations in this intimate relationship between the bony surfaces and the articular-disc often leads to disorders of the TMJ. TMJ disorders are a heterogeneous collection of signs and symptoms that can be generally characterized by the presence of pain, temporomandibular joint noise and limitation of jaw movement1 . Studies suggest that upto 70% of patients seeking treatment for TMJ disorder have articular disk displacement leading to degenerative changes in the TMJ. Clinical management of these patients depends upon whether the disease process is self- limiting or not. Therefore it is necessary to differentiate an adaptive state from a disease process before a therapeutic measure is instituted; as only an astute discernment of the underlying molecular changes encompassing a degenerative event in the TMJ can provide a beneficial and comprehensive structure to the interventional regimen planned for the patient.
Pathogenesis of Temporomandibular joint disorder
Few studies carried out in the molecular mechanisms involved in degenerative TMJD, suggests that mechanical stresses lead to the oxidative stress of articular tissues. Milam 2 showed various models of degenerative TMJ disease and postulated that excessive mechanical stress could be of a magnitude sufficient to damage tissues directly or indirectly, triggering a cascade of molecular events leading to disease in susceptible individuals. These events involve the production or release of various kinds of reactive oxygen species, reactive nitrogen species, cytokines, various other inflammatory mediators, and collagen degrading enzymes. Under normal circumstances, these molecules may be involved in the remodeling of articular tissues in response to changing functional demands. However, if functional demands exceed the adaptive capacity of the TMJ or if the affected individual is susceptible to maladaptive responses, then a disease state will ensue. Though the pathophysiology of TMJ syndrome is not entirely understood, it is believed that the etiology of TMJ dysfunction syndrome is likely to be multifactorial and arises from both local insults and systemic disorders. Local problems frequently arise from articular disc displacement and hereditary conditions affecting the structures of the joint itself, such as hypoplastic mandibular condyles. Endothelial cells and synovial cells in the TMJ when subjected to mechanical stress promotes oxidative stress of articular tissues 3 . In normal, healthy individuals, the metabolic process results in balanced levels of reactive oxygen species (ROS) and antioxidants. If the normal oxidant/antioxidant balance is disturbed, it can result in a proliferation of free radicals. Recent scientific research have shown that oxidative stress not only aggravates the inflammation in oral tissues, but also is a contributing factor to systemic inflammatory diseases, including rheumatoid arthritis and cardiovascular disease 4 . Hyaluronic acid forms the central axis of proteoglycans and it maintains the viscosity of synovial fluid within joints. Following exposure to free radical systems, this polymer fragments (Hyaluronic acid) 5 leads to destabilization of connective tissues and loss of synovial fluid viscosity. A number of natural defense mechanisms exist for limiting oxidative damage 6 . In TMJ diseases, it has been suggested that ROS alter the molecular configuration of hyaluronic acid, and also produces degradation of collagen and proteoglycans of the articular cartilage 7and8 .
Role of free radicals
Free radicals play a vital role in the pathogenesis of degenerative joint diseases 2 . Although oxygen free radicals participate in many physiological processes, they can be harmful to tissues when their action is left uncontrolled. Both cellular and extracellular molecules may be destroyed 9 . A susceptible site for peroxidation is cellular membrane which leads to increased production of lipid peroxides an indicator of inflammation. Cai et al 9 measured the activity of oxygen free radicals in the synovial fluid (SF) of the TMJD patients and observed that the concentration of lipid peroxides were significantly higher in the TMDJ patients than in the normal control subjects. The pro-inflammatory mediators such as cytokine, IL-l (Interleukin -1), affects various cells in TMJ compartments, thereby inducing inflammation 10 , activation of collagen- as well as proteoglycan degrading enzymes, followed by the inflammatory process, causing deleterious effects in the TMJ . 11 Currently, the importance of reactive oxygen species such as superoxide and hydroxyl radicals as causative agents of inflammation has been recognized 12 . Previous studies have shown that superoxide is an important mediator of inflammation and tissue injury 13 , 1 4 . Superoxide can degrade synovial fluid and collagen, depolymerize hyaluronic acid and convert arachidonic acid, a membrane lipid into biologically active mediator, which results in further tissue injury 14. Nitric oxide, which is an endotheliumderived factor, regulates blood pressure, vascular tone, neural signaling and immunological functions. It may function as a inflammatory mediator in the TMJ region. Recently, increased nitric oxide production has been shown to play a role in the pathogenesis of synovitis in the TMJ. Nitric oxide concentration in TMJ fluid is closely associated with inflammatory changes and painful TMJ. 15
Antioxidant system
The antioxidant mechanisms are the evolutionary designs that avidly react and annihilate ROS before they inflict oxidative damage to tissues and cells 16 . ROS can cause DNA and protein damage, initiate lipid peroxidation, oxidize α1- antitrypsin and stimulate the release of proinflammatory cytokines 16 . Milam et al 3 reported that free radicals in normal TMJs might not cause TMJ disease if endogenous free radical scavenging mechanisms (antioxidant enzymes) prevent their accumulation. However, if the scavenging capacity of affected articular tissues is exceeded by an overwhelming production of free radicals, significant tissue damage could occur. Nitzan et al 17 reported that TMJ with oxidative stress may indicate increased exposure to free radicals and a decrease in antioxidant potential capacity of the system, or a combination in synovial fluid.
This insufficient scavenging activity leaves free radicals to cause further damage and prevent the re-establishment of a normal lubrication system in various joint components. Antioxidants available in supplement form include the enzymes superoxide dismutase (SOD), catalase and glutathione peroxidase, vitamin A, beta-carotene, and vitamins C and E, and the trace mineral selenium 18 . SOD can protect the joint against the toxic effect of the superoxide radical by catalyzing its dismutation to molecular oxygen and hydrogen peroxide. Sumii et al 19 reported that SOD activity in the SF from patients with rheumatoid arthritis was higher than that of the normal group. This result may imply that inflammation exaggerates the SOD synthesis as a defense mechanism against overwhelming superoxide radicals.
Lin et al 20 have provided preliminary evidence that SOD is effective at reducing symptoms in patients with TMJ disorders who had not previously responded to exhaustive trials of conventional therapy. SOD helps to protect the cells from the damage of free radicals, and revitalizes the cells 21 . It has been reported that SOD, catalase, and glutathione peroxidase activities in erythrocytes from patients with rheumatoid arthritis were scored much lower than those from patients with osteoarthritis, suggesting that the erythrocytes in rheumatoid arthritis patients might be more susceptible to ROS damage 22 . Guven et al 23 studied the activity of superoxide dismutase (SOD) in the synovial fluid of patients with TMJD, measured the relationship between the activity of SOD and the severity of the disease, and concluded that the reduction of SOD activity may result from insufficient scavenging capacity of free radicals 23 . However, SOD activity in SF does not differ between rheumatoid arthritis and osteoarthritis, though it is higher than that of the normal group 19 . Cai et al 9 measured the activity of oxygen free radicals and the level of antioxidant enzyme superoxide dismutase (SOD) in the synovial fluid (SF) of TMJD patients found that the levels of SOD activity were significantly higher in the TMJD patients than in the normal control subjects.
CONCLUSION
Studies on the defense mechanism against oxidative stress in the pathogenesis of TMJ disorders have received little attention.Further investigations and studies are required to determine the role of antioxidants that scavenge the free radicals in TMJ disorders. This might also offer a potential for the development of new treatment regimen, including application of metal chelaters and radical scavengers specific for the pathophysiology of TMJD. ACKNOWLEDGEMENT The author is 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=1897http://ijcrr.com/article_html.php?did=18971. Fonseca RJ, Oral Maxillofacial surgery Temporomandibular disorders,2000; 4: pp94
2. Milam SB. Pathogenesis of degenerative temporomandibular joint arthritides. Odontol 2005; 93:7–15
3. Milam SB, Schmitz JP. Molecular biology of temporomandibular joint disorders: proposed mechanisms of disease. J Oral Maxillofac Surg 1995; 53:1448-1454.
4. Jayamathi Govindaraj and Pamela Emmadi and Rengarajulu Puvanakrishnan Therapeutic effects of proanthocyanidins on the pathogenesis of periodontitis— An overview Indian J Exp Biol, 2011; 49:83-93
5. Greenwald RA and Moy WN, Effect of oxygen derived free radicals on hyaluronic acid, Arth Rheum 1980; 23: 455.
6. Chapple ILC and Matthews JB, The role of reactive oxygen and antioxidant species in periodontal tissue destruction, Periodontol 2000, 2007;43:160
7. Burkhardt H, Schwingel M, Menninger H, Macartney HW, Tschesche. H Oxygen radicals as effectors of cartilage destruction.Direct degradative effect on matrix components and indirect action via activation of latent collagenase from polymorphonuclearleukocytes. Arthritis Rheum 1986; 29:379-387.
8. Roberts CR, Roughley PJ, Mort JS Degradation of human proteoglycan aggregate induced by hydrogen peroxide. Protein fragmentation, amino acid modification and hya luronic acid cleavage. Biochem J. 1989; 259:805- 811.
9. Cai HX, Luo JM, Long X, Li XD, Cheng YFree-radical oxidation and superoxide dismutase activity in synovial fluid of patients with temporomandibular disorders. J Oro fac Pain. 2006; 20(1):53
10. Carleson J, Alstergren P, Appelgren A, Appelgren B, Kopp S,Theodorsson E, et al. A model for the study of experimentally induced temporomandibular arthritis in rats: the effect of human recombinant interleukin-1 alpha on neuropeptidelike immunoreactivity. J Orofac Pain 1996; 10:9-14.
11. Kubota E, Kubota T, Matsumoto J, Shibata T, Murakami Kl Synovial fluid cytokines and proteinases as markers of temporomandibular joint disease. J Oral Maxillofac Surg 1998; 56:192- 198.
12. Klebanoff SJ: Phagocytic cells: Products of oxygen metabolism, in Basic Principles and Clinical Correlates. New York, NY, Raven Press, 1988, p 391
13. Foshi D, Trabucchi E, Musazzi M, et al: The effect of oxygen free radicals on wound healing. Int J Tissue React. 1988; 6:373.
14. Lynch R, Fridovich I: Effect of superoxide radicals on the erytrocyte membrane. J Biol Chem 1978; 253:1838.
15. Suenaga S, Abeyama K, Hamasaki A, Mimura T and Noikura T.Temporomandibular disorders: relationship between joint pain and effusion and nitric oxide concentration in the joint fluid. Dento maxillofacial Radiol 2001; 30, 214 – 218
16. Protective effects of proanthocyanidin on endotoxin induced experimental periodontitis in rats. Jayamathi Govindaraj, Pamela Emmadi, Deepalakshmi. Vijayalakshmi Rajaram, Geetha Prakash and Rengarajulu Puvanakrishnan Indian J Exp Biol 2010;48:133- 142
17. Nitzan DW, Goldfarb A, Gati I, et al: Changes in the reducing power of synovial fluid from temporomandibular joints with anchored disc. J Oral Maxillofac Surg 2002; 60:735
18. Halliwell B: How to characterize a biological antioxidant. Free Radical Res Commun 1990; 9:1.
19. Sumii H, Inoue H, Onoue J, Mori A, Oda T, Tsubokura T Superoxide dismutase activity in arthropathy: its role and measurement in the joints. Hiroshima J Med Sci 1996; 45:51-55.
20. Lin Y, Pape HD, Friedrich R: Use of superoxide dismutase (SOD) in patients with temporomandibular joint dysfunction- A preliminary study. Int J Oral Maxillofac Surg. 1994 ; 23:428
21. Null G: Superoxide dismutase, in The Clinician‘s Handbook of Natural Healing. Kensington Books, New York, 1997, p 137
22. Imadaya A, Terasawa K, Tosa H, Okamoto M, Toriizuka K Erythrocyte antioxidant enzymes are reduced in patients with rheumatoid arthritis. J Rheumatol 1988;15:1628-1631
23. Guven O, Tekin US, Durak I, Keller EE, and Hatipoglu M, Superoxide Dismutase Activity in Synovial Fluids in Patients With Temporomandibular Joint Internal Derangement. J Oral Maxillofac Surg 2007; 65:1940-1943
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524146EnglishN-0001November30General SciencesMEANS OF LIVELIHOOD AMONG THE WEAVER COMMUNITY OF SHANTIPUR OF NADIA DISTRICT
English166173Pradipta DubeyEnglish Subhrangsu SantraEnglishThe history of handloom of Santipur of Nadia district has long dating back from 15th Century; Where Santipur was placed as the centre of Vaishnavite culture and Bhakti movement. Even at present handloom is the closest contestant of the primary sector i.e. agriculture. People earn their more or less same income through preparing shrees than agriculture activities, even some time more from earlier then latter. Though the main share of profit goes to the middlemen, still they are acting as bread provider. The installation charge of a loom is so high which is not possible for any individual in backward class communities to own it and perform their own business. Even if possible the same, but not possible to get raw materials and to market the final product by the poor people. The present paper seeks to find out the Cost and Benefit of individual weaver as well as middlemen in the locality involved in the activity. Finding shows that land less poor families got an opportunity to maintain their livelihood through handloom. Middlemen also received the maximum portion of the profit. Still it is not possible to remove the middlemen without finding an alternative who can take the responsibility to supply raw materials and marketing the final product. Again study suggested that it can only be possible through Public-Private partnership.
EnglishShantipur, Handloom, Middlemen, Livelihood, Cost and benefitINTRODUCTION
The dispersed, unorganized and often household based micro and small enterprises are capital-saving, labourintensive, and eco-friendly avenues of livelihood. In India, they are the largest sources of employment after agriculture and are found in both rural as well as urban areas. In nearly three decades, the structure of rural employment has not changed much.1 Symbolically for Indian culture and heritage, handlooms cater to 65 lakh persons for their living by skilfully blending myths, faiths, symbols, and imagery. Today, the handloom industry directly and indirectly provides livelihood to 124 lakh people, of which 60% are women while 12% belongs to Scheduled Caste category and 20% from Scheduled Tribe (Ministry of Textiles, 2001). Majority of them have no cultivable land or other assets. While the exact numbers are not available, a major portion of the handloom weavers belong to minority communities. Indian handloom products range from coarse cloth to very fine fabrics from a variety of fibres such as cotton, silk, tasar, jute, wool, and synthetic blends. Each region has its signature handcrafted textiles that are unique in design and style. What is woven is, however, inseparable from where and how it was woven, that was from the structure of production. There were independent weavers, weavers organized into co-operatives, and there were those working under master weavers. Present Situation With the largest number of handlooms in the world, India produces approximately 6541 million sq m of handloom cloth annually. While the total production of cloth has increased by about 30% between 1996–97 and 2004–05, the production of handloom sector has declined by about 23%. Between 2000 and 2005, the average annual growth rate of handloom production has been 6.99%. West Bengal, Tamil Nadu, Uttar Pradesh, Andhra Pradesh, Assam, and Manipur are the major handloom States and accounting 75% of handloom weaving in the country. As per the Second Handloom Census, (1995-96) Assam (10.97 lakh), West Bengal (2.22 lakh), and Manipur (2.15 lakh) together accounted for 64% of the handloom units. Almost all handloom production in India is for domestic markets. According to the Directorate General of Handlooms, though handlooms account for 10% of our textile exports, only 1.3% of working looms produce fabric for export markets. Europe is the largest destination, accounting for nearly half of the total exports in 1999–2000.
The bustling town of Shantipur in Nadia district of West Bengal, India, is just 90 kilometres (2 hours drive away from Kolkata, the capital city of West Bengal) north of the metropolis of Kolkata. It has recently gained the status of municipality. Neighbouring Fulia, still a village is often uttered in same breath with Shantipur, their contrasting backgrounds notwithstanding. Together they are perhaps the most renowned Bengal handloom saree weaving centre in Bengal. Shantipur and Fulia sarees are household names across India. Shantipur – Fulia region has over 125,000 handlooms, churning out Shantipuri, Tangail, and Jamdani handloom sarees in a variety of yarns like cotton, tussar and silk. Dhotis, dress materials, stoles and scarves are also woven. History There are records of handloom saree weaving activity in Shantipur, a centre of Vaishnavite culture and Bhakti movement2 , as early as the 15th century. Weaving flourished throughout the medieval era, and the famed indigo-dyed Neelambari (of a particular saree, name derived from Neel, its blue colour) made the Shantipur saree a household name. There is a strong sense of identity among Shantipur weavers. They united to agitate against the stranglehold of the Dadni system of the British East India Company and even took their grievances to colonial courts during the19th century3 . In the decades leading up to independence several innovations were introduced in the loom and pattern of weaving, Shantipur saw gradual inflow of techniques like the Barrel Dobby, facilitating the conversion from Throw Shuttle to Fly Shuttle (1920s), the Jacquard Machine (1930s), and sectional warping and sizing that allowed production of warp yarns 350 yards long (1930s).4 Traditional Styles Shantipur saree: The ?Neelambari‘ saree was the first product that made Shantipur famous. The indigo dyed, midnight blue cotton handloom saree was so alluring that it was called ?an enemy of modesty!? The Unique Selling Point of the Neelambari lay in the fineness of the yarn and dyeing quality. Very fine hand spun yarn of 250 – 300 s was used for weaving, resulting in a powder fine texture. A heady mix of fine weaving and subtlety of design, the Neelambari was the last word in sophistication. Today traditional handloom sarees woven in Shantipur have 68s to 80s counts cotton yarn in the warp and the weft. Cotton and 2 Aditi Mukherjee, Dec.22,2009, Bengal Handloom.com 3 Aditi Mukherjee, Dec.22,2009, Bengal Handloom.com 4 Bengal Handloom.com silk yarn is used as extra warp in the border, and so is zari. There is also the ?do- rookha? technique of weaving double sided design, where the saree looks same on both the sides. Another unique feature of Shantipur sarees is the finishing. The weavers here use starch (made from sago or popped rice) once while sizing the warp yarn and again, either by hand when the saree is still being woven or by fixing the saree to a frame after weaving is completed. Fulia Tangail: Weavers of Tangail, near Dhaka in modern Bangladesh, were famous for the incomparable Dhakai Jamdani saree. After partition of Bengal during the run up to the independence, the majority of these weavers immigrated to West Bengal, and settled down at Fulia with government patronage. Fulia weavers added a new jest to the handloom weaving scenario in Shantipur region. They developed their own version of the Dhakai, called ?Tangail Jamdani,‘ and a combination of Shantipur and Tangail styles called the ?Fulia Tangail‘. The Tangail Jamdani is similar to the Dhakai Jamdani in that it uses interlocking extra weft cotton yarn to produce floral or geometric motifs. However, it has a softer feel and sparser distribution of motifs. The Fulia Tangail incorporates vibrant colours and large, intricate designs woven in double jacquard. These sarees are also being woven in mulberry and tassar silk apart from cotton. Jamdani: Traditional Jamdani, the pride of Bengal handloom, is now woven in Habibpur and Ramchandrapur near Fulia. The true Jamdani saree is woven without using even a jacquard machine. The weaver uses fine needle-like spindles to conjure magic with extra weft work that can rival the most intricate embroidery. Muslin yardage: Shantipur and its adjoining areas had a tradition of fine muslin yardage weaving, with 600s yarns being used. However, at present there is no major muslin weaving activity in Shantipur. The finest muslins are now woven in Kalna, across the Ganga. It‘s not that the Bengal handloom saree weavers of Shantipur and Fulia have remained confined in a time warp (pardon the pun!). A number of innovations in techniques and products have taken weaving in the region to the next level.
Business of Shantipur:
A. business Partners It has been found that there are some divisions in weaver‘s community. Some of them are master weavers and some are the weavers who work under these master weavers.
Master Weavers - Previously this category of weavers were engaged in weaving only, but today they undertake the overall responsibility of this business from of raw material to the weavers, provide design and pay wages to grass root level weavers; and then supply sarees to Mahajans. Mahajans provide design and information regarding colour combination and a better price realization for the saree, but on the other hand make the transactions on credit. There are around 700 master weavers actively involved in production activities of the cluster. It is estimated that in total, these master weavers have 16,050 working looms, and equal number of weavers working as labours. A part of the production of master weavers is also sold in the local hat i.e. market of Santipur. Most of the weavers do possess 4 looms in one shade. There are few master weavers having 10, 20, 30, 40, 50, 60 looms under one shed. The master weavers apart from the weaving earning of one loom earn profit margins from the products weaved on the loom engaged by the labour. Weavers - There are about 20,000 working looms and 60,000 persons involved directly / indirectly in the weaving and preparatory activities. The women basically undertake the preparatory works like separation of hanks, sizing, pirn winding. Dyers - Dyeing is basically carried out in the dyeing unit. There are about 90 units engaged for dyeing as a commercial activity. These units, based on the quantity of yarn dyed are categorized into large, medium and small units. Designers - There are about 100 small designers involved actively to create and supply new design after exploring their own creativity and imagination in the line of the demand or choice of the consumers. However our definition of modern education does not allow them to be treated as educated. They have their own mechanism to upgrade their own skills. For Lack of exposure their skill are traditional based. Their main role in the cluster is to do costing for the master weaver, and supply them the punch cards for the Jacquard.
b. Steps of business The basic raw material of the cluster is cotton yarn, procured in the form of hank by the weavers / master weavers from the local yarn dealers and Mahajans. Besides cotton yarn the cluster also uses art silk and golden Zari for designing.
Bleaching and Dyeing: The yarns are bleached and dyed in the form of hank and latter dried in sun light putting on bamboo bars.
Sizing: Sizing is a process where starch (Sago or Boiled Rice or Khoi) is coated on the warp yarns for importing strength; enhance abrasion resistance to withstand the stress and strains exerted during weaving process. There by it reduces the yarn breakage and improves quality and efficiency of weaving. The loom sizing is also carried out after weaving to reduce reed marks, to impart stiffness to the fabric to bring into proper look.
Warping and Beaming: The warping is a process of making desired length and width of warp sheet by combining many small packages called bobbins/spools. Sectional warping process is carried on a wooden drum from a wooden peg creel. The Sectional warping process facilitates warp patterning and handling delicates fine spun and filament yarn.
Pirn Winding: After dyeing and sizing of weft yarns, the weft package called pirn is prepared on Charkha. Pirn winding is the process of transferring the yarns from the hanks into bobbin/pirn of the shuttles used in the weft while weaving.
Designing: Designing through jacquard is the most value addition option for the cluster. New Designs are collected from various sources by the Mahajans and converts into new jacquard designs with the help of local designers. Sometimes local designers also introduce some new designers out of their creativity.
Weaving: The weaving is performed by the skilled weavers of the family. The looms being used are mainly traditional fly shuttle pit looms with jacquards. C. Type of business The weaving activity was initiated in 1409, during the regime of Gaur Ganesh Danu Mardhandev. Saree weaving was practiced during 1683 - 1694 during the ruling of Nadia king Rudra Roy.5 The production got systematized and was well organized leading to good recognition during the period of Mughal empire. Saree was exported to Afghanistan, Iran, Arab Greece and Turkey. The healthy trend continued till the early twentieth century. Now the weaving activity has flourished to a large extent. Most of the household are engaged in the weaving activities either as their primary activity or secondary. While observing and studying the area different 5 Feel Handloom.com types of weavers activities are found out. These are discussed below:
Weaver as the Mahajan: These traders initially supply the design and colour combination to the master weavers and the master weaver arranges the production. The traders in turn supply these sarees to the traders of Bara Bazar, Kolkata. From Kolkata these products are distributed to different districts of the state and to other country.
Weaver as the Master Weaver:
Previously this category of weavers were engaged in weaving only, but today they undertake the overall responsibility of supplying the raw material to the weavers, provide the design and pay wages to the grass root level weavers; and then supply the sarees to Mahajans. Mahajans provide design and colour information and a better price realisation for the saree, but on the other hand make the transactions on credit. A part of the production of master weavers is also sold in the haat (local Market) of Santipur. The master weavers apart from the weaving earning of one loom earn profit margins from the products weaved on the loom engaged by the labour.
Weaver as the simple weavers:
These group comes from the middle income group who own at least one loom of their own and do all the works mostly by themselves and sometimes if the situation permits hire labourers. Weavers mainly get orders from the master weavers or the Mahajans and do produce the product in their loom. The women basically undertake the preparatory works like separation of hanks, sizing, pirn winding.
Weaver as the labourers:
There is also this group who comes from a poor economic background work as labour either in the weaver or mostly in the master weaver‘s looms. They generally get their wages on weekly basis depending on the number of products they are producing.
D. profit of business
We have shown here two Statement sheet for two products generally produced in this area one for Scarf and another for Sarees.
Total net profit Rs. 3,00,000/-
Percentage of profit Rs. 15%
Total net profit Rs. 1,180/-
Percentage of profit Rs. 13.1%
Reflection
Ststement-1 shows that the percentage of material cost and weaver‘s wage are 58.8 and 41.2 respectively. At the time of selling of 10,000 Scarfs the master weaver earn profit Rs.3,00,000 after investing Rs.17,00,000 in a month that is 15 per cent (approx). Daily wage of weavers is Rs.140. In case of Statement -2, for the production of sarees the percentage of material cost and other and weaver wage are 48.8 and 51.2 respectively. The percentage of profit of Master weavers is 13.1 per cent. In case of second activity weavers get around Rs. 133 a day, if he or she wants to offer labour. The demand of weavers in this area is much higher because of the huge rate of margin of profit earn by master weavers. Actually master weavers are paying higher attention to run this business. The wage rate in agricultural sector for unskilled labourer is around Rs. 100 a day. So, ultimately weaving industry is the prime source of livelihood among the poor landless labourer. It is also true that the nature of exploitation by master weavers / middlemen is very high but the weavers have no other alternative. Number of weavers co-operative Societies were formed by the department of Co-operation, Government of West-Bengal with the additional financial help of National Cooperative Development Corporation (NCDC) in this area and naturally they have failed to provide employment opportunity towards land less labourers due to several reasons that is another area of discussion. So the poorer have no other alternatives but to go with the exploiters (master weavers). Our further study may be conducted to find out the way of reducing exploitation of poor, it may be through Public-Private Partnership (PPP) or other.
Englishhttp://ijcrr.com/abstract.php?article_id=1898http://ijcrr.com/article_html.php?did=18981. De, Anup. ‘Diagonistic Report of Santipur Handloom Cluster‘, Textiles Committee. [2008], West Bengal.
2. Government of India, ?Census of handlooms in India 1995-96‘, Development Commissioner for Handlooms, Ministry of Textiles, Government of India (1996).
3. Government of India, Report of the Fact Finding Committee (Handlooms and Mills), Ministry of industry and Commerce, 1942
4. Government of India, Report of the High Powered study Team on the problems of the handloom industry, Ministry of Commerce, New Delhi, July, 1974
5. http://feelhandlooms.com [accessed 13 January 2012]
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7. Jain, Ruby and Rachna Goswami. ?Livelihood Through Handloom Weaving‘, International Research Journal, Vol. I Issue 12. Jaipur. September 2010. ISSN-0975-3486 RNI: RAJBIL 2009/30097.
8. Mitra, Ashis, Choudhuri Kumar, Prabir and Mukherjee Arup. ?A Diagnostic Report on Cluster Development Programme of Shantipur Handloom Cluster: Part 1, Evolution of the cluster and cluster analysis?. Indian Journal of Traditional Knowledge, Vol. 8(4). Visva-Bharati University, sriniketan. Birbhum. October 2009. pp 502-509.
9. Mukherjee, Aditi. ?The Handloom Story of Shantipur-Phulia ?, Blog post, Bengal Handloom website. 22 December 2009 [accessed 7 January 2012].
10. National Sample Survey Organisation 61st Round 2004-05, NSS Report No. 515: Employment and Unemployment Situation in India, New Delhi, September, 2006.
11. Niranjana, Seemanthini and Vinayan, Soumya, ?Report on Growth and Prospects of the Handloom Industry‘. 2001. Planning Commission commissioned study.
Concept of Variables
i) Saree - A dress worn primarily by Hindu women; consists of several yards of light material that is draped around the body. ii) Mahajan - The word "Mahajan" is an amalgam of two Sanskrit words: Maha meaning great, and Jan meaning people or individuals. Over the years, the word Mahajan has come to be used a generic job title that refers to people involved in money lending. iii) Shantipur - It is a city and a municipality in Nadia District in the Indian state of West Bengal. This small town has been declared a city recently. The fort area of this city, also known as DaakGharh (calling or gathering room) is thought to have been built by Raja Krishnachandra of Nadia. is famous for handloom sarees from ancient times. After the partition of India, many weavers came from Dhaka of Bangladesh and started to reside here in Phulia region, which is a Panchayat area of Santipur. iv) Jamdani - It is a type of figured muslin that is one of the greatest accomplishment of the Indian weavers. The origin of figured muslin is not clear. It is mentioned in the Sanskrit literature of Gupta period (4th – 6 th century AD). It is known that in the Mughal period the finest Jamdani were produced in Dhaka (Bangladesh), the work being characterised by extremely elaborate designs. Nowadays there are two types of Jamdanis are available i.e., Dhakai Jamdani and Tangail Jamdani. v) Zari - Zari (or Jari as traditionally called) is basically a tinsel thread meant for weaving and embroidery. vi) Scarf - A scarf is a piece of fabric worn around the neck, or near the head or around the waist for warmth, cleanliness, fashion or for religious reasons. They can come in a variety of different colours.