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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30General SciencesKINETICS AND MECHANISM OF OXIDATION OF BENZOPHENONE OXIME BY BISPYRIDINE SILVER (I)
DICHROMATE
English0609J. DharmarajaEnglish S.VadivelEnglish A.KandasamyEnglishThe oxidation of Benzophenoneoxime by Bispyridine silver (I) dichromate (BPSDC) has been
studied in 50% (v/v) aqueous ethanol medium at 303K. The reactions show unit order dependence with respect to [Benzophenoneoxime].The reaction is acid catalyzed, the effect of
concentration of Mangnoussulphate, sodium perchlorate and dielectric constant on the reaction
rates was studied, Thermodynamic parameters were calculated from the Eyring?s plot.
Mechanism consistent with the observed kinetic results has been proposed and the related rate
law derived.
EnglishKinetics, mechanism, Benzophenoneoxime, Bispyridinesilver (I) dichromate.AIMS AND BACKGROUND The Kinetics and mechanism of oxidation of Benzophenoneoxime was carried out in EtOH-H2O medium at 30oC and the rates were calculated. Further studies in this direction may be useful to understand the mechanistic aspects of the reaction. Regeneration of carbonyl compounds from their derivatives under mild conditions is an important process in synthetic organic chemistry. Several oxidative methods are available for deoximation1 , 2, 3 . Considerable research has been done in the last years on the mechanism of oxidation by the use of modified Cr (VI) regents as oxidants4-16, pyridiniumchlorochromate has been reported as an useful reagent for the formation of carbonyl compounds from the corresponding alcohols17. Bispyridine silver (I) dichromate is a recently developed Cr(VI) oxidant and has been found quite useful as an oxidant in organic synthesis18.There seems to be no report on the kinetics and mechanism of oxidation of Benzophenoneoxime by BPSDC. Hence this paper reports on the kinetics and mechanism of oxidation of Benzophenoneoxime by Bispyrinine silver (I) dichromate.
EXPERIMENTAL Benzophenoneoxime were prepared by the reported literature procedure19.Bispyridine silver (I) dichromate was prepared by the standard procedure18.Ethanol was purified as described in the litrature19.perchloric acid, manganousshulphate, acrylonitrile and sodium perchlorate were of AnalaR grade and used without further purification. All the kinetic measurements were carried out in a glass stoppered iodine flask protected from light and thermostated to within ±0.010C, Pseudo first order conditions were maintained throughout the study. Reactions were carried out in aqueous ethanol (50-50 (v/v)) medium at 303K unless otherwise stated. The course of the reaction was followed by standard iodometric procedure. The reproducibility of rate constant was checked by duplicate measurement and were found to be within ±4% error. Product analysis; Benzophenone were found to be the products. The products have been confirmed by their melting point and IR spectra.
RESULT AND DISCUSSIONS
Oxidation of Benzophenoneoxime by BPSDC.
The kinetic results for the oxidation of Benzophenoneoxime by BPSDC along with the experimental conditions are given in tables 1 and 2. The order of the reaction was found to be first with repect to the [BPSDC] as evidenced by the plot of log[BPSDC] versus time( r= 0.999). The rate constant increased with increase in the [Benzophenoneoxime]. A plot of log kobs versus log [benzophenoneoxime] gave a straight line with a slope of 1.16 (r=0.990) indicating a first order dependence of the reaction with respect to [Benzophenoneoxime].A fractional order dependence of the reaction with respect to [HClO4] has been observed .The dependence of logkobsversus log [H+ ] is a straight line with a slope of 0.53(r= 0.996) indicating fractional order. The rate of the reaction has been found to increase with the decrease in the dielectric constant of the medium. This might probably be due to the reaction between two molecules forming a polar product20.The addition of sodium perchlorate increases the rate of the reaction suggesting that the reaction may be between an ion and a dipole type21 . Added acrylonitrile has no effect on the reaction rate, i.e., the reaction did not induce polymerization of acrylonitrile indicating the absence of the radical pathway. The added Mn2+ ion enhances the rate confirming the formation of Cr (IV) in slow step. The reaction has been conducted at five different temperature and the activation parameters ?H*and ?S*were calculated; ?H* =50.224 KJ mol-1 , ?S* =- 113.3J k-1mol-1 .
CONCLUSION Oxidative regeneration of carbonyl compounds from benzophenoneoxime by BPSDC follows different mechanistic pathway. The large negative entropies of activation support the formation of a rigid cyclic intermediate complex. The oxidation of benzophenoneoxime by BPSDC in the presence of perchloric acid in aqueous ethanol medium leads to the formation of benzophenone and a biologically active compound of hypo nitrous acid as end product. R
Englishhttp://ijcrr.com/abstract.php?article_id=1899http://ijcrr.com/article_html.php?did=18991. H. FIROUZABADI, A.SADASIAN. synth.commun.., 13,863(1983)
2. A.BHANDARI, P.K.SHARMA, K.K.BANERJI, Indian J, chem., 40A, 470(2001)
3. H. FIROUZABADI, BANDARI, ZHITKOCH, Metabolism and cancer risks. hem..res 18,(2011)
4. T.A.TURNEY: oxidation mechanisms, Butter worth, LondonP6 (1965) .
5. K.B.WIBERG: Oxidation of organic chemistry, part A, 69, Academic press, New York, vol.71, 98-105, (1965)
6. H.O.HOUSE; Modern Synthetic reaction, Ed,Benjamin, London ( 1972)
7. D.G.LEE; oxidation (Ed.R.LAugestine)M.DekkerIncNewyork ,( 1969)
8. W.A.WATERS.Quart Rev.., 277(1958)
9. A.KOTHARI, S.KOTHARI, K.K.BANERJI, IndianJchem, 447,2039 (2005)
10. A.BHANDARI, P.K.SHARMA, K.K.BANERJI; Indian J, chem.…, 40A, 470(2001)
11. A.DHAORIWAL, D.YAJURVEDI, P.K.SHARMA; Indian J.chem.,45A,1158(2006)
12. K.KRISHNASAMY, J.DHARMARAJA: OXIDATION COMMUNICATION 30,204,(2008)
13. J.DHARMARAJA, K.KRISHNASAMY:E-J chem., 5, 754,( 2008)
14. K.KRISHNASAMY,VENKATESHWA RAN,J.DHARMARAJA,j.sulfur chem.:28, 365, ( 2007)
15. J.DHARMARAJA AND K.KRISHNASAMY, Bull.pure.Applied.sci.., 27c,1,( 2008).
16. DANIELA.Knopf:Phy.chem., 13,2, 1050,(2011).
17. E.J.COREY, J.W.SUGGS: Tetrachem. Lett, 2647(1975)
18. H. FIROUZABADI, A. SARDARIAN, H. Gh.SYNTH: synth. Com, 14(1) 80(1984).
19. A.I. VOGEL: Text book practical chemistry 4th.ed, Longman and Group, London, P.269. (1978 )
20. VS. PRASADA RAO, S.B. RAHMAJI RAO: J. Indian Chem. Soc.., 404 (1994).
21. S. KABILAN, K. PANDIYARAJAN, K. KRISHNASAMY, P. SANKAR: Int.J.Chem.Kinet.443 (1995)
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareSTUDY OF GROWTH PATTERN OF SICKLE CELL PATIENTS IN CENTRAL INDIA REGION
English1015Ashish V.RadkeEnglish Sonali KhanapurkarEnglish Prathamesh H KambleEnglish L.S. KanzodeEnglishWe carried out an anthropometric study of 150 sickle cell patients from the central India region,
in the age group of 5-20 years, to study the different growth patterns. Height and weight of
cases were measured and compared with the normal healthy control of the same age group from
the same region. We found that height and weight of the cases was significantly lower than
controls. These parameters were found to be significantly lower in sickle cell anemia (SS) cases
compared to sickle cell trait (AS) cases. From the above study we can conclude that in sickle
cell disease growth and development of the patient is significantly affected and the patients of
sickle cell anemia (SS) are affected more compared to sickle cell trait cases (AS).
EnglishSickle cell disease, anthropometry, growth and development.INTRODUCTION
Sickle cell disease is important hemoglobinopathy, affecting structure, function or production of hemoglobin1 . It is an inherited disorder having high prevalence in central India, characterized by production of defective hemoglobin1 in which there is mutation of beta gene leading to substitution of valine for glutamic acid. This leads to production of abnormal globin chain causing sickle cell disease3 . It has two varieties i.e. sickle cell trait (AS) and sickle cell anemia (SS) 3 . Sickle cell disease affects almost all systems of the body causing impairment in various anthropometric measurements like height, weight etc. It also affects normal growth and development of the individuals4 . The study of anthropometric measurements in sickle cell disease patients has been carried out by many workers outside India, on small sample size. Though sickle cell disease cause major burden to the society in India, there is paucity of data on physical growth and development of sickle cell disease children in India and available data is also not much informative. Taking into consideration the above scenario, present study was carried out with the aims and objectives of: - 1. To study the growth pattern in sickle cell trait (AS) & sickle cell anemia (SS) cases. 2. To compare it with normal subject.
MATERIAL AND METHODS
We studied 150 diagnosed cases of sickle cell disease in the age of 5-20 years during June 2008 to June 2010 who attended sickle cell O.P.D. or admitted in medicine and pediatric wards of the institute. They belonged to central India region including mainly vidharbha, Madhya Pradesh. Their diagnosis was confirmed by peripheral blood smear and electrophoresis. Those patients having any skeletal deformity, any other chronic illness and pregnant females were excluded from study. Control group for this study consisted of 150 normal, healthy subjects, chosen randomly from the schools of the same region of same age group. The written informed consent was obtained from all the participants. Each participant was assessed for:- 1. Height: - Standing height was measured with an anthropometer, with the subject standing erect, heels together and line of vision directed horizontally and recorded in centimeters up to accuracy of 0.1cm5 . 2. Weight: - Weight of subject was measured with simple weighing machine without foot ware, measuring in kilograms with accuracy up to 100 grams. The zero was adjusted before taking weight 5 . All variables were presented as mean ± SD and comparison was carried out using unpaired t – test. P value less than 0.05 was considered as statistically significant.
RESULTS
Table I show the distribution of cases and controls in the study. 150 cases and controls were studied. Cases were further sub-grouped into 82 AS and 68 SS cases. Anthropometric measurements were taken from the cases and controls, findings are depicted in table II and III. Average height of total male and female sickle cell disease AS+SS group, SS group and AS group was significantly lower than controls. Mean height of male cases of sickle cell disease (AS+SS) sickle cell anemia (SS) and sickle cell trait (AS) was significantly lower than control males. Similarly, female (F) sickle cell disease (AS+SS), sickle cell anemia (SS) and sickle cell trait (AS) had significantly lower height than control females. (Table II) These findings are depicted in graph I. Similarly, average weight of total male and female sickle cell disease AS+SS group, SS group and AS group was significantly lower than controls. Mean weight of male cases of sickle cell disease (AS+SS) sickle cell anemia (SS) and sickle cell trait (AS) was significantly lower than control males. Similarly, female (F) sickle cell disease (AS+SS), sickle cell anemia (SS) and sickle cell trait (AS) had significantly lower weight than control females. (Table III) These findings are depicted in graph II.
DISCUSSION In India sickle cell disease is prevalent, especially in tribal regions and prevalence rate varies from 0- 40 % in different population groups. There is high prevalence of sickle cell disease in central India mainly among the mahar community6 . The first parameter, height was significantly lower in cases than in control, also it was lower in sickle cell anemia (SS) cases compared to that of sickle cell trait (AS) cases and higher in males as compared to females. This parameter was previously studied by Winsor T. (1944)7 , Whitten CF (1961)8 , Jimenez CT (1965)9 , Aschroft MT (1972)10, Kate B.R. (1977)11 , Cepeda ML (2000)4 , Mukherjee MB (2004)2 , Rhodes M (2009)12. Different workers found the different mean value of height. This might be due to different age group, and different population they studied but all these workers found significant decrease of height in cases than in control except that of Rhodes M (2009)12 . Findings in present study also show the similar results. Similarly, weight was significantly lower in cases than in control, also it was lower in sickle cell anemia (SS) cases compared to that of sickle cell trait (AS) cases and higher in males as compared to females.
The same parameter is studied by various authors. The value of weight obtained by other authors is shown in the table V. Different workers found the different mean value of weight. This might be due to different age group, and different population they studied but all of them found significant decrease in weight of cases than in control except that of Rhodes M (2009)12 Thus, Impairment in growth and development was more in sickle cell anemia (SS) cases compared to sickle cell trait cases. This difference is due to percentage of hemoglobin affected in these two categories. Similarly the height and weight measurements are more in males than in females, which can be explained with theirs general body make up and the genetic constitution. Sickle cell disease is a disease affecting almost all the systems of the body including normal growth and development. In sickle cell disease normal R.B.C. changes their shape to sickle shape causing lack of oxygen to normal tissue, hampering the normal growth and development13. The low growth can also be due to the inadequate food intake because of poor appetite mainly during vasoocclusive crisis2 . Some authors suggested that increased energy expenditure, in addition to anemia is also a factor affecting the growth in children of sickle cell disease12 .
CONCLUSION
In present study height and weight of cases are found significantly less in cases than in control and are less in sickle cell anemia (SS) patients than in sickle cell trait (AS) patients. From this we can conclude that the growth and development of the patient is delayed in patients of Sickle cell disease and more significantly in sickle cell anemia (SS) patients. Previously anthropometric studies in sickle cell disease patients were carried out by many workers but most of the studies were done on the small sample size and outside India. Present study is important in these aspects as it was done on large population, considering the population from region where sickle cell disease is most prevalent. The present study can be made useful for screening of patients with sickle cell disease. Similarly in such patients of sickle cell disease, counseling for marriageable couples can prevent the occurrence in their next generation and thereby it can help to decrease the overall incidence and prevalence of sickle cell disease. Also, the present study suggest that there is further need for full scale investigation of longitudinal aspects of growth and quantitative assessment of protein and calorie intake of children with sickle cell disease for the exact reasoning of decrease in growth and development.
ACKNOWLEDGEMENT Authors acknowledge the immense help received from the scholars whose articles are cited and included in reference of this manuscript. The authors are also grateful to editors and 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=1900http://ijcrr.com/article_html.php?did=19001. Kumar V, Abbas AK, Fausto N. Red Blood Cell and Bleeding Disorders. In: Robins and Cotran Pathological Basis of Disease. 7th ed. Alpers CE, Anthony DC, Aster JC,Crawford JM, Crum CP, Girolami UD et al. editors. Elsevier; 2007: p. 628-630.
2. Mukherjee Malay B, Gangakhedkar RR. Physical growth of children with sickle cell disease. 2004; 10(2): 70-72.
3. Lee GR, Foerster J, Kukens J, Paraskevas F, Grer J, Rodgers G. Abnormal Hemoglobin: General Principles. In: Wintrobes ClinicalHematology. 10th ed. Williams and Wilkins;1999. p. 1329-49.
4. Cepeda ML, Allen FH, Cepeda NJ, Yang YM. Physical growth, sexual maturation, body image and sickle cell disease. J Natl Med Assoc. 2000; 92(1):10-4.
5. Singh R, Venkatachalam PS. Radiographic studies of the new born with special reference to subcutaneous fat and osseous development. Indian J Med Res. 1963;51:522-32.
6. Balgir RS and Sharma PK – Distribution of sickle cell hemoglobin in India. Ind J Hematol 1988; 6: 1.
7. Winsor T, Burch GE. Habitus of patients with active sickel cell anemia of long duration. Arch Intern Med. 1945;76 (1):47-53.
8. Whitten CF. Growth status of children with sickle-cell anemia. Am J Dis Child. 1961; 102:355-64.
9. Jimenez CT, Scott RB, Henry WL, Sampson CC, Ferguson AD. Studies in sickle cell anemia: XXVI. The effects of homozygous sickle cell disease on the onset of menarche, pregnancy, fertility, pubescent changes, and body growth in Negro subjects. Am J Dis Child. 1966;111:497-504.
10. Ashcroft MT, Serjeant GR, Desai P. Heights, weights, and skeletal age of Jamaican adolescents with sickle cell anaemia. Arch Dis Child. 1972 ;47(254):519-24.
11. Kate BR. Anthropometry of sickle cell anaemia patients. J Anat Soc Ind 1977;26(2):99-101.
12. Rhodes M, Akohoue SA, Shankar SM, Fleming I, Qi An A, Yu C, et al. Growth patterns in children with sickle cell anemia during puberty. Pediatr Blood Cancer. 2009; 53(4):635-41.
13. Beutler E, Lichtman MA, Coller BS, Kipps TI. The sickle cell disease and related disorder. In: Williams Heamatology. 5th ed.McGraw Hill; 1995. p. 616-18.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30TechnologyEFFECT OF PROCESSING PARAMETERS ON HARDNESS AND MICROSTRUCTURE OF AUSTEMPERED DUCTILE IRON
English1621Ranjit Kumar PandaEnglish Jyoti Prakash DhalEnglish Subash Chandra MishraEnglish Sudipta SenEnglishIn the present investigation the effect of copper along with the process variables (austempering
temperature and austempering time) on hardness and microstructure of ductile iron is studied.
With increasing austempering time hardness is increasing but with increasing austempering
temperature it is decreasing. Austempered ductile iron with copper is showing some higher
hardness than the austempered ductile iron without copper. In microstructure ferrite is
increasing with increasing austempering time and austenite is increasing with increasing
austempering temperature in both the grades
EnglishAustempering, austempered ductile iron, austenite, ferrite and acicular.INTRODUCTION
A ductile iron which subjected to a peculiar isothermal heat treatment process i.e. heating to the austenitizing temperature, followed by quenching into a salt or oil bath at a temperature in the range of 445oC to 200oC and holding for the time required for transformation to occur at this temperature, is known as austempered ductile iron (ADI) and the process is known as austempering [1]. It consists of high carbon austenite and ferrite as a matrix, which is called as ausferrite [2-4]. Due to this structure ADI exhibits a combination of high strength, hardness, ductility, damping capacity and toughness. So this material has application in various fields like automotive, agricultural, construction, military component etc. [5-8]. The abrasive wear resistance of ADI is much superior to that of the parent ductile iron and comparable to that of a steel whose hardness is approximately twice that of ADI. So that it is considered as an alternative material for earth moving components [9]. The mechanical properties of ADI strongly depend on the Ausferrite structure .So researchers mainly concentrate for the improvement of properties by varying the processing parameters i.e. austempering temperature and austempering time and alloying with various elements like Cupper, Nikel, Molybdenum, Silicon etc [10-15]. In this present investigation, the effect of copper alloying as well as the effect of processing parameters like austmpering time and austempering temperature on hardness and microstructure of ductile iron were studied.
MATERIALS AND METHODS
Two grades of ductile iron samples have used in the experiment which are produced from commercial foundry, LandT Kansbhal. The difference between these two grades were one contains copper and another without copper. Chemical composition of the two grades of ductile iron samples are given below in the Table 1. 12 numbers of samples with dimension 8×8×3 mm of each grade have taken and heated to 900oC (austenisation) for 60 min and then transferred quickly to a salt bath at austempering temperatures 250, 300 and 350 oC, held for 30 min, 60 min, 90 min and 120 min and then air- cooled to room temperature. The heat treated samples were polished for hardness measurement. Rockwell Hardness test was performed at room temperature to measure the hardness of the ADI specimens in A scale. The load was applied through the square shaped diamond cone indenter for few seconds during testing of all the alloyed and unalloyed samples. Four measurements for each sample were taken covering the whole surface of the specimen and averaged to get final hardness results. A load of 60 kg was applied to the specimen for 30 seconds. Then the depth of indentation was automatically recorded on a dial gauge in terms of arbitrary hardness numbers. Microstructures of the mirror polished samples were observed using Nikon Optical microscope. The samples were etched with 2% Nital solution for 45 seconds each. X-Ray diffraction (XRD) analysis was performed for few selected samples. This technique was used to estimate the volume fractions of retained austenite and ferrite in the material after treatment. XRD was performed 30 KV and 20 mA using a CuKα target diffractometer. Scanning was done in angular range 2θ from 40° to 48° and 70° to 92° at a scanning speed of 1°/min.
RESULTS AND DISCUSSION
Hardness Measurement The hardness values in Rockwell A scale (RA) of the Copper alloyed and unalloyed samples for various austempering time and temperature are summarized in Table 2. Fig 1, 2 and 3 show the variation of hardness with respect to the austempering time at temperature 250oC, 300oC and350oC respectively for two grades (one with copper and another without copper). From these graphs it is observed that hardness is increasing from 30 min to 60 min but it is decreasing form 60 min to 90 min and for 90 min to 120 min hardness is almost same i.e. not showing significance difference for both the grades. Austempered ductile iron alloyed with cooper is showing little bit higher hardness than the unalloyed austempered ductile iron. Fig 4, 5, 6 and 7 show the variation of hardness with respect to the austempering temperature for 30 min, 60 min, 90 min and 120 min respectively for both the grades (one with copper and another without copper). It is observed that hardness is decreasing with respect to the austempering temperature. i.e with increasing austmpering temperature hardness is decresing in both grades. X-ray diffraction analysis The XRD pattern of austempered ductile iron (with and without copper) austempered at different temperatures and different times are shown in fig 8 to 11. In the XRD pattern it is observed that the austenite (111) peaks and ferrite (110) peaks are identified nearly in all cases. The maximum intensity of the austenite (111) peak is increasing with increasing temperature but ferrite (110) peak is increasing with increasing austempering time and decreasing with increasing temperature. Microstructure The microstructures of unalloyed and alloyed ductile iron samples were observed under the optical microscope and are shown in fig 12. In the microstructure it is observed that in all the samples Graphite is in spheroidal shape. Hence it is called spheroidal graphite iron (Ductile Iron). The samples which are autempered at higher temperatures having upper bainitic structure and the samples which are austempered at lower temperatures are having lower bainitic structure. It is because when the austempering temperature increasing the morphology of bainite changing from acicular to plate like. There is no significance difference between copper alloyed ductile iron and ductile iron without copper.
CONCLUSIONS
Hardness and microstructure of alloyed and unalloyed ADI were studied by means of Rockwell Hardness test, optical microscopy and X-ray diffraction analysis. From the study, it is concluded that:
As the austempering temperature is increasing hardness is decreasing for both the alloyed and unalloyed ductile iron.
As the austempering time is increasing hardness is increasing for both the grades.
The ductile iron alloyed with copper is showing little bit higher hardness compared with unalloyed ductile iron.
In microstructure austenite is increasing with increasing austempering temperature and ferrite is increasing with increasing austempering time in both the grades.
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=1901http://ijcrr.com/article_html.php?did=19011. Tanaka Y, Kage H. Development and application of austempered spheroidal graphite cast iron. Materials Transactions, JIM 1992; 33(6): 553- 557.
2. Kim Y J, Shin H, Park H, Lim J D. Investigation into mechanical properties of austempered ductile cast iron (ADI) in accordance with austempering temperature. Materials Letters 2008; 62: 357-360.
3. Myszka D. Austenite- martensite transformation in austempered ductile iron. Archives of Metallurgy and Materials 2007; 52(3): 475-480.
4. El-Baradie Z M, Ibrahim M M, El-Sisy I A, Abd El-Hakeem A A. Austempering of spheroidal graphite cast iron. Materials Science 2004; 40(4): 523-528.
5. Batra U. Fracture Behavior and Mechanism in Austempered Ductile Iron. Journal of Failure Analysis and Prevention 2005; 5: 75-81.
6. Ghaderi A R, Nili Ahmadabadi M, Ghasemi H M. Effect of graphite morphologies on the tribological behavior of austempered cast iron. Wear 2003; 255: 410-416.
7. Mandal D, Ghosh M, Pal J, De P K, Ghosh Chowdhury S, Das S K, Das G, Ghosh S. Effect of austempering treatment on microstructure and mechanical properties of high-Si steel. J Mater Sci 2009; 44:1069-1075.
8. Nofal A A, Jekova L. Novel processing techniques and applications of austempered ductile iron. Journal of the University of Chemical Technology and Metallurgy 2009; 44(3): 213-228.
9. Zimba J, Simbi D J, Navara E. Austempered ductile iron: an alternative material for earth moving components. Cement and Concrete Composites 2003; 25: 643-649.
10. Eric O, Jovanovic M, Šidjanin L, Rajnovic D. Microstructure and mechanical properties of cunimo austempered ductile iron. Journal of Mining and Metallurgy 2004; 40B (1): 11-19.
11. Batra U, Ray S, Prabhaka S R. Austempering and Austempered Ductile Iron Microstructure in Copper Alloyed Ductile Iron. Journal of Materials Engineering and Performanc 2003; 12: 426-429.
12. Refaey A, Fatahalla N. Effect of microstructure on properties of ADI and low alloyed ductile iron. Journal of Materials Science 2003; 38: 351-362.
13. Eric O, Jovanovic M, Sidanin L, Rajnovic D, Zec S. The austempering study of alloyed ductile iron. Materials and Design 2006; 27: 617-622.
14. Gazda A. Determination of thermal effects accompanying the austempering of copper–nickel ductile iron. Thermochimica Acta 2010; 499: 144– 148.
15. Eric O, Rajnovic D, Zec S, Sidjanin L, Jovanovic M T.Micro structure and fracture of alloyed austempered ductile iron. Materials Characterization 2006; 57: 211 – 217.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareINFLUENCE OF BODY MASS INDEX ON BALANCE IN SITTING AND STANDING
English2230A.KumaresanEnglish S.PrathapEnglish Vaiyapuri AnandhEnglishBackground and Objective: Functional reach test is used for assessing the dynamic balance. It
is defined as a maximal distance one can reach forward beyond arm?s length while aintaining a fixed (BOS) Base of Support in the standing position. The biomechanical activities of daily living are into mechanical and neuromuscular factors that may predispose the obese to injury. A better appreciation of the implications of increased levels of body adiposity on the movement capabilities of the obese would afford a greater opportunity to provide meaningful support in preventing, treating and managing the condition and its sequelae. Reaching forward in sitting is a challenge to a person?s postural control and is suggested to be an indicator of sitting balance.
Functional reach test is easy to assess the dynamic balance. It is portable, inexpensive, reliable,
precise and less time consuming for detecting dynamic balance. This study intends to analyze
the effect of various BMI on functional reach test during standing and sitting.
Study Design: observational study
Setting: Outpatient Department, Saveetha college of Physiotherapy, Thandalam - 602105
Outcome Measures: Quantitative parameters: Functional reach test.
Method: observational study design was used for this study. Inclusion criteria- Age: 20-30
year, Vision – Normal/ corrected vision, Vestibular – Pathologies are ruled out,
Musculoskeletal- Range of motion: the bilateral shoulder- ranges full (or) for to the test to be
carried smoothly. Exclusion criteria-Visual defect, History of vestibular problem, Restriction
range motion of bilateral shoulder joint. Ninety individual divided in to 3 groups according to
their BMI, each group 30 individuals. All the three groups asked to perform a standing and
sitting functional reach test after obtaining informed consent.
Result:. Group 1 mean maximal standing functional reach was 27.98 cm, ( S.D-2.98, range=
20.6-33.46), mean of sitting functional reach was 29.09 cm, (S.D-2.42, range=24.36-34.23) for
normal individual, Group 2 standing reach was 21.24 cm,(S.D-2.25, range=17.13-25.7), sitting
reach was 24.17cm,(S.D-2.44,range=19.63-29.03) for overweight individual and group 3
standing reach was 15.42cm (S.D-3.08, range=10.07-22.60), sitting reach was 18.26 cm (S.D-
2.10 ,range=14-21.73)for obese individuals. There is a significant difference in between the
groups. Conclusion: The statistical results of this study concludes that overweight and obese
individuals shows less forward functional reach when compared to the normal subjects. Post
hoc test shows that there is a highly significant difference were noticed in between the groups
Englishfunctional reach test, body mass index, forward reaching, overweight, obesity.INTRODUCTION
Balance is defined as forces acting on the body are balanced such that the centre of mass (COM) is within the stability limits, Boundaries of base of support (BOS). Balance and upright postural control are fundamental components of movement, this involves both the ability to recover from instability and the ability to anticipate and move in ways to avoid instability (Shumway Cook A.1995).22 Obesity is recognized as a major health problem in many parts of the world, and the condition is escalating at alarming rate obesity has reached epidemic proportion globally with more than 1.6 billion adults are overweight and at least 40million are clinically obese and major contributed to the global burden of chronic disease and disability co-exists. Obesity is complex condition with severe social and psychological dimension, affecting virtually all ages and socio economic group (2006 WHO).32 Obesity is commonly assessed by using body mass index (BMI). It is defined as the weight in kilogram divided by square of height in meters (kg/m2 ). A BMI between 25kg/m and 29.9kg/m is defined as overweight and a BMI of greater or equal to 30kg/m as obese (WHO 2006).32 In spite of significant advances in the knowledge and understanding of the multifactorial nature of obesity, many questions regarding the specific consequences of the disease remain unanswered. In particular, there is a relative dearth of information pertaining to the functional limitations imposed by overweight and obesity. The limited number of studies till date has mainly focused on the effect of obesity on the temporospatial characteristics of walking, plantar foot pressures, muscular strength and, to a lesser extent, postural balance (Wearing, Scott C. and Henning 2006).21 The biomechanical activities of daily living are into mechanical and neuromuscular factors that may predispose the obese to injury. A better appreciation of the implications of increased levels of body adiposity on the movement capabilities of the obese would afford a greater opportunity to provide meaningful support in preventing, treating and managing the condition and its sequelae (S C Wearing et al 2006).21 Sitting balance is a prerequisite for most functional activities, such as dressing, transferring and eating in a seated position (Nicholas DS.1996).Sitting balance is defined as the ability of a person to maintain control over upright postures during forward reach without stabilization. Biomechanically, specific trunk movements have to occur to maintain postural control in sitting. When weight is shifted in any plane, the trunk responds with a movement to counteract a change in the center of gravity staying within the base of support and thereby maintaining the sitting position. (Schenkman M.1990). Dean et al 1999 stated that forward reach distance in sitting was positively associated with the magnitude of the trunk and upper arm segmental motion, as well as the active contribution of the lower limbs in healthy persons3 . Reaching forward in sitting is a challenge to a person?s postural control and is suggested to be an indicator of sitting balance.4 Functional reach test is used for assessing the dynamic balance. It is defined as a maximal distance one can reach forward beyond arm?s length while maintaining a fixed (BOS) Base of Support in the standing position (Duncan PW 1992).8 Functional reach test is easy to assess the dynamic balance. It is portable, inexpensive, reliable, precise and less time consuming for detecting dynamic balance. Normative values of functional reach test for different age groups are available (Duncan et al 1990).7 this study intends to analyze the effect of various BMI on functional reach test during standing and sitting.
METHODOLOGY
Subjects willing to participate in the study were screened for inclusion and exclusion criteria. They were explained about the safety and simplicity of the procedure and information sheet was given and their informed consent was obtained. The height and weight of each volunteer were noted for calculation of body mass index. Total of 90 subjects will be recruited based upon their BMI and they will be classified into 3 groups. Group A will contain individuals with normal weight, group B will have individuals who are overweight and group C will have individuals who are obese. A yardstick was attached to the wall which helps to record the reaching ability of the individual. Detailed procedure of functional reach test is taught and demonstrated to the subjects. Functional reach test was first performed with the subjects in standing (Figure-2). The shoulder was positioned at 90 degree flexion, elbow fully extended and hand was fisted. Then the subjects was asked to reach forward as much as they can without raising the heel and avoid trunk rotation and shoulder protraction and also ensure that the individual does not lean on the wall. The reading corresponding to the 3rd metacarpal were taken before and after performing functional reach test. (Figure- 3). Functional reach test was then performed with individuals in sitting (Figure-4). The subject was made to sit unsupported with the feet flat on the floor and the hip, knees, and ankles positioned in 90 degree flexion. Foot support were provided to ensure proper sitting position and asked the individual to reach forwards. The position of the shoulder was 90 degree flexion, elbow fully extended and wrist fisted. The reading corresponding to the 3rd metacarpal was taken before and after performing functional reach test. (Figure-5). Three trials were performed is each test and the average was calculated.
DATA ANALYSIS AND RESULTS
Functional reach test was performed in standing and sitting position in 30 normal, 30 overweight, 30 obese individual. The data collected were for the age group of 20- 30 yrs. The data was used to calculate the mean of the Functional reach test in forward reach direction. Group 1 mean maximal standing functional reach was 27.98 cm, ( S.D-2.98, range= 20.6-33.46), mean of sitting functional reach was 29.09 cm, (S.D-2.42, range=24.36-34.23) for normal individual, Group 2 standing reach was 21.24 cm,(S.D-2.25, range=17.13-25.7), sitting reach was 24.17cm,(S.D-2.44,range=19.63- 29.03) for overweight individual and group 3 standing reach was 15.42cm (S.D-3.08, range=10.07-22.60), sitting reach was 18.26 cm (S.D- 2.10 ,range=14-21.73)for obese individuals.(Table-1&4) A ONE WAY ANOVA, was used to determine that normal individual had a longer reach compared with overweight and same way overweight individuals had a longer reach when compared with obese individuals.(Table-2&5). POST HOC TEST was used to determine the comparison in standing functional reach test in between the groups. (P-.000),and comparison in sitting functional reach test in between the groups. (P-.000). there was a significant difference in between the groups. (Table-3&6).
DISCUSSION According to WHO obesity is a complex condition with social and psychological dimensions affecting virtually all ages and socio economic group and also a major contributor to the global burden of chronic disease and disability co-exist. (WHO 2006)32.Currently more than 1.6 billion adults are overweight and at least 400 million of them clinically obese (WHO 2006)32 . The main finding from the present study indicates that balance is influenced by varying BMI. Obese individual shows less standing and sitting functional reach values, when compared to the normal and overweight subjects, overweight individual?s shows less standing and sitting functional reach values when compared to the normal. Statistical Data Analysis proved that there is highly significant difference which exist between the normal and overweight groups in performing standing and sitting Functional Reach Test. (PEnglishhttp://ijcrr.com/abstract.php?article_id=1902http://ijcrr.com/article_html.php?did=19021. Bernard PL, Geraci M, Huo, Amato M, Seynneso , Lantieri D,.Influence of obesity on postural capacities of teenagers: preliminary study, Ann read apt med phy. 2003 May;46(4):184-190.
2. Clark DO, Stump TE, Hui SL, Wolinsky FD,(1998) Predictors of mobility and basic ADL difficulty among adults aged 70 years and older. J Aging Health,.vol10 422- 440.(pubmed).
3. Cynthia C.Norkin, Pamela K.Levangeie., Joint structure and function, 3rd edition –. Chapter 4 – Page no : 405.
4. Dean Shephered, R adults; Sitting balance I; Trunk-Arm co-ordination and the combination of the lower limbs during self paced reaching in sitting; Gait and Posture 1999 Oct; 10(2):135- 146.
5. Demura.S.Shin-chi, Takayashi (2007) Simple and easy assessment of falling risk in the elderly by functional reach test using elastic stick.
6. Donahoe B K, Turner D, Wowell T W, The use of functional reach test as a measurements of balance in boys and girls with out disabilities ages 5 to 15 yrs. Pediatrics Phys Ther,1994; vol 6: 189-194
7. Duncan P, Weiner D, Chanler J, Studenski S : Functional reach : a new clinical measure of balance, journal of Gerontology 45:M 192-197, 1990.
8. Duncan P.W, Studenski S, Chandler J, Prescott B : Functional reach test : Predictive validity in a sample of elderly male veterans. Journal of Gerontology 47(3):493-98,1992.
9. Ferraro KF , Booth TL. (1999) Age, body mass index, and functional illness. J Gerontol B psycho Sci Soc Sci .vol 54B S339-S348.
10. Fregly A R, Oberman A, Gray Biel A, Mitchell RE. Non vestibular contributions to postural equilibrium function, Aero med 1968; 39: 33-37.
11. Galanos AN, Pieoer CF, CornoniHuntly JC,Bales C W,Fillenbaum GG.(1994) Nutrition and function: is there a relationship between body mass index and the functional capabilities of community-dwelling elderly? J Am Geriatr Soc. Vol 42,368-373.(pubmed).
12. Goulding A, Jones I E, Taylor R W, Piggot J M, Taylor D, Dynamic and static tests of balance and postural sway in boys. Effects of previous wrist bone fracture and high adiposity. Gait posture;2003 Apr. 17(2):136-141.
13. Han T S, Tijhuis MAR, Lean MEJ,Seidell JC. Quality of life in relation to overweight and body fat distribution. Am J Public Health. Vol 88,1814-1820.(pubmed).
14. Hue O, Simonean M, Marcotte J, Beerigan F, Done J, Marcean P, Marcean S, Tremblay A, Teasdale N, Body weight is a strong predictor of postural stability. Gait posture;2006 Aug 21
15. Huleus M, Vasant G, Lysens R, Claessens AL, Muls E, Brumagnes S, study of differences in peripheral muscle strength of lean versus obese women; An allometric approach. Int J obes Relat Metab Disord 2001; 25: 676-681.
16. K J Sandin and B S Smith, (1990) The measures of balance in sitting in stroke rehabilitation prognosis. Stroke Vol 21, 82-86
17. Launer L J, Harris T, Rumpel C, Madans J,(1994), Body mass index, Weight change, and risk of mobility disability in middle aged and older women: the epidemiologic follow-up study of NHANES I. JAMA.vol 271,1093-1098(pubmed).
18. Maffinletti N A, Agosti F, Proietti M, Riva D, Resnik M, Lafortuna C L, Sartorio A, Postural Instability of extremely obese individuals improves after a body weight reduction program entailing specific balance training. Journal Endocrinology Investigation: 2005 Jan; 28(1):2-7
19. Roberta A. Newton et al., Validity of the Multi-Directional Reach test: A practical measure for limits of stability in older adults. (2001) Vol 56 A(4); M248-M252.
20. S.C. Wearing and Hills (2005) musculoskeletal disorder associated with obesity: a biomechanical perspective
21. S.C.Wearing, E M Hearing, N.M. Byrte , J.R.Steel and A.P. Hills: The Biomechanics of restricted movement in adult obesity. Obesity Reviews volume;2006 Feb: page 7-13.
22. Shumway cook A and woollacott M : Motor control theory and practical application. Williams and wilkins Baltimore, 1995
23. Sobal J et al., Social Influences on Body weight In: Brownell K D, Fair Burn C G,eds. Eating Disorder and Obesity. New York, N Y: Guilford press; 1995:73-77.
24. Susan B O Sullivan., Thomas J.Schmits. Physical rehabilitation 4th edition. Page no : 191.
25. Stuck A E, Walthert JM, Nikolaus T, Buela C J, Hohmann C, Beck JB.(1999) Risk factors of functional status decine in community-living elderly people: a systematic literature review. Soc Sci Med.vol 48,445- 469.(pubmed)
26. Suzanne M,Lynch et al., Reliability of measurements obtained with a modified functwional reach test in subjects with spinal cord injury; Physical therapy, 1998 Feb: Vol 78.,128-133.
27. Teasdale N, Hue O, Marcotte J, Berrigan F, Simone M, Doss J, Marcean, Marcean S,: Reducing weight increases postural stability in obese and morbid obese men.
28. Thompson mary et al., Forward and lateral shifting functional reach in younger middle aged. And older adults; Journal of Geriatric Physical Therapy 2007.
29. Weiner DK, Duncan PW, Chandler J, SA : Functional reach ; a marker of physical frailty. JAGS 40:203-207, 1992.
30. Weiner D K et al., Does Functional Reach Improves with Rehabilitation? Archiveves Physical Medicine Rehabilitation;1993 Aug; 74(8):796-800.
31. (William Mcardle, Franky.Katch, Victor L, (Exercise Physiology – 4 th edition, Page no : 541 (18).
32. Who 2006.Http//www.Who.int/medicacentre /factsheet/fs311/en/Index.html
33. Yuk Lan Tsung et al,. Sit and reach test can predict mobility of patients recovering from acute stroke: Archives Physical Medicine Rehabilitation 2004; Vol 85;94-98
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareASSESSMENT OF NUTRITIONAL STATUS AMONG SCHOOL CHILDREN BY COMPARING IT WITH TWO TYPES OF STANDARDS FOLLOWED IN INDIA IN A RURAL AREA IN TAMIL NADU
English3137R ShankarEnglish C KannanEnglishBackground: High prevalence of low birth weight, high morbidity and mortality in children
and poor maternal nutrition of the mother continue to be major nutritional concerns in India.
Although nationwide intervention programmes are in operation over two decades, the situation
has not changed much. The 11-18 years old children if they have to reach adulthood in a
healthy state it becomes necessary to provide services with political commitment so their
nutritional status is improved Objective: To assess the nutritional status of the adolescent
school children of Sri Vidya Mandir Matriculation and Higher Secondary School near
Attaiyampatti in Salem district of Tamilnadu, by comparing it with two types of standards
followed in India. Materials and methods: It is a cross sectional study, with a total of 957
students (617 boys and 340 girls)aged between 11-18 years studying in the Sri Vidya Mandir
Matriculation and Higher Secondary School. Results : Anthropometric measurements from the
participating children were collected. The height and weight of the children were compared
with ICMR guidelines. Among the 617 boys, 70 boys (11%) satisfied the ICMR guideline
values and 62 boys (9%) were overweight compared to the ICMR guidelines. Remaining 485
boys (80%) were below the ICMR guidelines. Similarly out of the 340 girls, 51 (15%) satisfied
the ICMR guideline, 56 (16%) girls were overweight and 233 girls (69%) were below ICMR
guidelines. Regarding height 30% of the boys and 39% of the girls satisfied the ICMR
guideline values.
EnglishNutritional status, rural area, school children, Tamil NaduINTRODUCTION
Among children the nutritional requirements increases because of the increased growth rate. The monitoring of children?s nutritional status is a fundamental tool for the evaluation of their health condition. If offers a unique opportunity to objectively assess the health of the adolescent population. Anthropometry has been used during childhood and adolescence in many contexts related to nutritional status (WHO, 1995). One of the major health problems in many developing countries including India is widespread prevalence of under nutrition among school children. The scourge of under nutrition is even more acute among rural children1 . The probable reason for under nutrition may be because about 20 – 35% of the people are below poverty line in the different states of India and have low purchasing power. Ignorance of balanced diet for school children and faulty dietary habits are also likely reasons for undernutrition. Agricultural progress in the last decade has made India self sufficient in major food grains1 . Yet under nutrition continues to be major nutritional problem especially in rural population .because of the probable reasons mentioned in the above paragraph. Adolescence, a period of transition between childhood and adulthood, occupies a crucial position in the life of human beings. This period is characterized by exceptionally rapid rate of growth. The UN sub committee on Nutrition meeting held in Oslo in 1998 concluded that more data on health and nutrition of school age children are needed to assess the magnitude of the problem. It is also believed that the scale of nutritional problems may have been previously under estimated. Traditionally the main health indicator used by health planners has been mortality rate. Adolescence has the lowest mortality among the different age groups and has therefore received low priority. However, recent studies have shown that the prevalence of malnutrition and anemia is high in these age groups2 .
MATERIALS AND METHODS
A total of 965 students (625 boys and 340 girls) studying in Sri Vidya Mandir Matriculation and Higher secondary School , Attaiyampatti, Salem, were included in the study. About 90% of the students are day scholars and only 10% are hostlers. The average income of the parents of the students was roughly about Rs.7500 per month. The study has been conducted as a part of routine school health examination. The study period was from August 2009 to November 2009. Physical examination of all children was carried out, and their height (nearest to 0.5cm) and weight in kg. (Nearest to 100gms) were recorded. The mean weight and height of the children according to age and sex were compared with mean weight and height for age as per the ICMR standards3 , the classification of malnutrition as per IAP standards4 and the BMI was compared with WHO standards5 .
RESULTS
The age wise and sex wise distribution of the 957 students are given in Table 1. The total number of boys were 617 and total number of girls were 340. The distribution of the students according to their age and weight in comparison with the ICMR guideline values are given in table 2. It is seen from Table 2, that the mean weight in both males and females are less than ICMR guideline value in almost all the age groups, and the 90th percentile value is almost equal to the ICMR guideline value. The difference in weight between males and females are not statistically significant except in the age group of 13 where the females weigh more than the males and it is statistically significant (P < 0.005) Among the 617 boys, 70 boys (11%) satisfied the ICMR guideline values and 62 boys (9%) were overweight in relation to the ICMR guidelines. Remaining 485 boys (80%) were below the ICMR guidelines. Respective numbers among the total of 340 girls were 51 (15%), 56 (16%) and 233 (69%) Overall girls are better compared to boys in body weight because only 69% of the girls were below ICMR guidelines compared to 80% among the boys. This is to be noted because generally there is gender discrimination against girl children. With a low total fertility rate of 1.7 in Tamilnadu, girl children are also well looked after including nutrition. This is a possible inference. Distribution of the students according age, sex and mean height are given in Table 3. 30% of the boys and 39% of the girls satisfied the ICMR guidelines. The mean height in males is slightly less than the ICMR guideline values in all age groups whereas among girls the mean height is almost equal to the ICMR guideline values for the age groups 12, 13 and 14. Distribution of the students according to weight for age as per IAP (Indian Academy of Pediatricians) classification is given in Table 4.From the above table 5, according to IAP classification it is seen that of the total of 957 students only about 6 were in grade 4 malnutrition (80%) and in females it was 66.17% (>80%). Among malnourishment most of them i.e., about 26% belong to grade I malnourishment. Distribution of study population with reference to age and BMI are given in Table 5.Since the ICMR had not developed any standards for BMI in children, we have used WHO standards to compare the mean BMI. The mean BMI among males and females is lower in all age groups when compared to WHO guideline value. The difference in BMI between males and females is not statistically significant except in the age group of 13+,14+ and 17+ where the females BMI is more than the males and it is statistically significant(pEnglishhttp://ijcrr.com/abstract.php?article_id=1903http://ijcrr.com/article_html.php?did=19031. Kaushik Bose et al, “Age and Sex Variations in Undernutrition of Rural Bengalee Primary School Children of East Midnapore District,West Bengal, India”, Human Ecology Special Issue chapter 9 No. 14: 71-75 (2006)
2. K. Anand et al, “Nutritional Status of Adolescent School Children in Rural North India”, from the Comprehensive Rural Health Services Project, Ballabgarh, All India Institute of Medical Sciences, New Delhi 110 029, India
3. “Nutrient Requirements and Recommended Dietary Allowances for Indians”, I.C.M.R. publication 1990.
4. V.V. Khadilkar, “IAP Growth Monitoring Guidelines for Children from Birth to 18 Years”, Indian Pediatrics 2007; 44:187-197
5. “WHO reference standards of BMI for boys and girls in the age group between 5 – 18 years”, WHO (2007).
6. P. Panda et al, “Health Status of School Children in Ludhiana City”, Indian Journal of Community Medicine Vol. 25, No. 4 (2000-10 - 2000-12)
7. J Semwal e tal, “Nutritional status of school children in rural areas of Dehradun district”, Indian journal of preventive and social medicine vol.37 No.1and 2, 2006.
8. V.K. Chadha et al, “Prevalence of undernutrition among Peri-urban Children and its influence on the estimation of Annual Risk of Tuberculosis Infection” Ind J Tub,1997, 44. 67
9. Shanthi Ananthakrishnan et al, “A Comprehensive study of Morbidity in School Age Children”, Indian Pediatrics 2001;38:1009-1017.
10. S Kumar et al, “Prevalence of obesity and its influencing factors among affluent school Children of Davangere City”, Indian Journal of Community Medicine, vol.32(1) 2007.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcarePREVAILING PRACTICES OF PRELACTEAL FEEDING IN RURAL AREA OF ARATHAWADA
REGION IN MAHARASHTRA STATE OF INDIA
English3843Sonali Gajanan ChoudhariEnglish Rajesh N. LakdeEnglish Abhay Bhausaheb MudeyEnglish Deepali S. DeoEnglish Vinod L. VedpathakEnglish Prashant L. DahireEnglishTitle: Prevailing practices of prelacteal feeding in rural area of Marathawada region in
Maharashtra state of India. Objective: To study prevailing practices of prelacteal feeding and
impact of various sociodemographic factors on it. Method – A community based cross
sectional was conducted in rural area of Marathawada region in Maharashtra State of India. The
study participants were 262 mothers having youngest child in the age group of 0 to 12 months.
Questionnaire included sociodemographic structure of the family, the prelacteal practices
followed in youngest child. Results: Out of total participant mothers, 107 (40.84%) mothers
gave some kind of prelacteal feed to their baby while 155 (59.16%) did not give it. Literacy
status, type of family, socioeconomic status, place of delivery found to have impact on
prelacteal practices. Correlation with mode of delivery found to be non significant.
Conclusion: Ignorance, blindly following generation old beliefs, influence of elderly persons at
home, poverty were found to be various factors leading to prelacteal feeding and thereby
emerging as barriers to appropriate infant feeding practices.
Englishprelacteal, literacy, type of family, mode of deliveryINTRODUCTION
Childhood nutrition in most of the countries mostly originates from inadequate and faulty practices of feeding newborn and infant, coupled with exposure to contaminated environment.(1) As per BFHI, no food or drink other than for breast milk is to be given to newborn infant, unless medically indicated. It is now more than 15 years since the launch of BFHI and still the practice of Prelacteal feeds is prevalent in many developing countries and is mainly governed by different cultural norms prevalent.(2) In India also, prelacteal feeding is widely prevalent, since ancient times. Countrywide data from National Family Health SurveyIII (2005-2006) documented that as many as 57% women practiced prelacteal feeding.(3) The common substances used are honey, glucose, sugar water, Ghutti, castor oil, Cow? milk, Goat?s milk, Gangajal, Cow? urine or simply plain water.(2) Prelacteals should not be given to babies because of the following reasons.
1. Giving prelacteal feeds can lead to less frequent, less vigorous and less effective suckling at the breast since the baby feels less hungry. This in turn reduces milk production.
2. The baby is deprived of full benefits of colostrum.
3. Nipple confusion is common if prelacteal feeds are given in a bottle. Nipple confusion interferes with breastfeeding, making failure more likely.
4. Further contaminated feeds or feeding utensils, water and hands may cause infections.(4) Poor infant feeding practices are to a great extent a man made problem, which directly or indirectly contribute to infectious illnesses, malnutrition, and mortality in infants. Knowledge of various cultural practices associated with infant feeding forms an essential first step for any „need felt? intervention programme deigned to bring about positive behavioral change in infant health. (5) Considering this it was decided to study prevailing practices of prelacteal feeding and impact of various sociodemographic factors on it, in a rural area which formed the basis of a „need felt? educational intervention imparted thereafter.
MATERIAL AND METHODS
Study setting:-The present community based cross sectional study was undertaken in five randomly selected villages out of 10 surrounding villages around the rural medical college, in Marathawada region during February to April 2010. Study ParticipantsMothers having a youngest child as infant i.e. up to the age of 1 year were included in the study. Methodology The mothers having youngest child as infant i.e. in the age group of 0-12 months were first enlisted by house to house survey. Initially the pilot study was undertaken in one of the five villages for pretesting the proforma and necessary modifications were made accordingly. For identification, initial contact and to minimize the non-response, the help of medical social worker and anganwadi workers was obtained. All the enlisted mothers were called in „Anganwadi? with their children and were interviewed and interacted with the help of pretested and predesigned proforma. Questions were asked in local language. Out of total population of about 10237 in the selected five villages, 277 mothers were having a child up to 1 year of age. Out of these 277 mothers, 262 mothers were available for the interview. They had been told about the need and objectives of the present study and then only informed consent obtained from them for interview. Thus 262 participant mothers constituted the sample of study. The relevant information regarding the sociodemographic structure of the family, the prelacteal practices & beliefs followed in youngest child was recorded. At the end of interview, health education regarding importance of correct feeding practices was given and an attempt made to solve the problems associated with it. Statistical Analysis – It was done by using descriptive statistics and Chi square test.
RESULTS
In the present study mothers? age ranged from 19 to 33 years with mean age as 24.91±1.12 years. Out of total 262 participant mothers majority i.e. 139 (53.05%) were from 22 to 25 years age group followed by 58 (22.14%) in the age group 26 to 29 years. The literacy rate among mothers was 172 (65.64%) and majority 145 (55.34%) mothers were housewives. Type of family wise distribution showed 83 (31.68%) mothers belonged to nuclear family, 38 (14.5%) were from joint family and 141 (53.87%) had extended family. Most of the mothers 144 (54.96%) belonged to low socioeconomic class.
(Table I, Figure I) In the present study out of total 262 participant mothers, 107 (40.84%) mothers gave some kind of prelacteal feed to their baby while 155 (59.16%) did not. (Table II) Out of 90 illiterate mothers, 51 (56.67%) gave prelacteal feed to their baby. Among literate, out of 66 mothers educated up to primary, 25 (37.87%) fed prelacteal while out of 74 mothers educated up to secondary, 20 (27.03%) offered prelacteal to their baby. Similarly 7 (33.34%), 3 (42.86%) and 1 (25%) mothers educated up to higher secondary, graduate and post graduate respectively practiced prelacteal feeding. Thus out of 172 literate mothers, 56 (32.56 %) gave prelacteal feed to their baby. Significant association was observed between literacy status and prelacteal feeding (p 0.05).
DISCUSSION
Prelacteal feed is the substance or preparation which is given to the newborn, before he or she is put to breast. This practice of prelacteal feeding probably is a sort of compensation to feed the baby colostrum which is discarded for first few days by some communities.(2) In the present study, it was disheartening to note that in this age of information and communication, a very large number of mothers (40.84%) continue to administer prelacteal feeds to their baby. Fortunately 59.16% mothers did not feed it. Higher percentage of mothers feeding prelacteal to their baby was also observed in the studies by Hiwarkar P A et al (47.73%) (6), Kishore S and Garg B S (45%) (2), Bhale P and Jain S (38%) (7), Pai M et al (43.96%) (8) . Out of 90 illiterate mothers 56.67% gave prelacteal feed to their babies as compared to 32.56% literate mothers (p< 0.01). Kulkarni R N et al (9) also showed that higher percentage i.e. 68.7% of illiterate mothers had given prelacteal to their children as compared to 31.1% of literate
Englishhttp://ijcrr.com/abstract.php?article_id=1904http://ijcrr.com/article_html.php?did=19041. Betran AP, de Onis M, lauer J A, Villar J. ecological study of effect of breastfeeding on infant mortality in Latin America. BM 2001; 323:303-6
2. Kishore S and Garg B S: “Practice of Prelacteal Feeding in a Rural Community”, Indian Journal of Public Health, Vol 43, No.4, Oct-Dec, 1999.
3. National Family Health Survey- III (2005-2006), Ministry of Health and Family Welfare, International Institute of Population Sciences, Mumbai, 2007.
4. Jayashree Mondakar, Rhishikesh Thakre, wasundhara Kanbur and Arminda Fernandez: “Lactation and Infant Nutrition”, Pediatrics Clinics of India, page 57-58, July 2001.
5. Sethi V K: “Infant Practices in a Relocated Slum- a Pilot Study”. Indian Pediatrics, Vol. 40:579-580, June 2003.
6. Hiwarkar P A, Aswar N R, Durge P M, Shendre M O : “Breastfeeding and Weaning Practices in Rural Mothers”. The Journal of Obstetrics and Gynecology of India, 1998.
7. Bhale P and Jain S: “Is Colostrum Really Discarded by Indian Mothers?” Indian Pediatrics, Vol. 36, October 1999.
8. Pai M et al: “A High Rate of Caesarean Section in an Affluent section of Chennai: Is It Cause for Concern?” The National Medical Journal of India. Vol. 12, No. 4:156-158, 1999.
9. Kulkarni R N, S Anjenaya, R Gurjar: “Breastfeeding Practices in an Urban Community of Kalamboli, Navi Mumbai”. Indian Journal of Community Medicine, Vol. 24, No. 4, Oct-December 2004, 179-180.
10. Parmar V R, M Salaria, B Poddar, K singh, H Ghotra and Sucharu: “Knowledge, Attitudes and Practice Regarding Breastfeeding at Chandigarh”. Indian Journal of Public Health, Vol.44, No. 4, OctoberDecember 2000.
11. Manju Rahi, D K Taneja, Amrita Mihra, N B Mathur and Suresh Bandhan: “Newborn Care Practices in an Urban Slum of Delhi”. Indian Journal of Medical Science, Vol. 60, No. 12, page 506-513, December 2006.
12. C R Banapurmath and A Selvamuthukumarasamy: “Breastfeeding and the first breastfeeds- correlation of initiation pattern and mode of delivery in 1279 hospital delivered babies”. Indian Pediatrics, Volume 32, page 1299- 1302, December 1995.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareMOTOR ABILITIES AND ASSOCIATED IMPAIRMENTS IN CHILDREN WITH CEREBRAL PALSY
English4457Vijesh P. V.English P. S. SukumaranEnglishObjectives:- In children with cerebral palsy, the gross motor and fine motor abilities are
impaired at different levels due to the lesions in the developing brain. Even though the damage primarily affects the loco-motor system, the presence of associated impairments are common in these children. For the successful rehabilitation of children with cerebral palsy, the assessment of gross motor and fine motor abilities are very important specifically in planning the short term and long term goals. The objective of the study is to find out the gross motor and fine motor abilities of these children and how these are correlated with each other and also with the associate impairments. Methods:-100 children with cerebral palsy aged between 6-14 years who attended special schools were assessed using gross motor classification system (GMFCS) and fine motor ability classification system (MACS). The presence of associated impairments were collected from the school records of these children. Results:- Within the framework of traditional classification of cerebral palsy, these children had different levels of gross motor and fine motor abilities as measured by GMFCS and MACS. The study also revealed that there is a significant positive correlation between the gross motor and fine motor abilities of these children (rho=0.56, pEnglishGross motor ability, fine motor ability, cerebral palsyINTRODUCTION
The term cerebral palsy (CP) covers a group of non progressive, but often changing, motor impairment syndrome secondary to lesions or anomalies of the brain arising in the early stages of development1 .It is one of the most common causes of severe physical disabilities in children and results in considerable suffering to both affected individuals and their families. Studies on prevalence in industrialized nations have shown a range averaging between 1.5 and 2.5 per 1000 live births2,3,4 . In India, with a population of 1 billion, is having roughly 25 lakh people with cerebral palsy and roughly 150 children are born everyday which later develop this disorder5 . Even though the definition for cerebral palsy concentrates on the developmental delay and motor impairment, the practical picture is more complicated. The associated impairments can be observed in different levels- sensory (vision, hearing, touch), neurological (epilepsy), intellectual, speech and language6 . The increased life expectancy of cerebral palsy children over last decades have brought about an additional demand for health, educational and social services7 . The traditional classification of children with cerebral palsy includes the labeling of the child as spastic, ataxic, athetoid or as diplegic, hemiplegic etc8 . But nowadays the motor abilities and clinical manifestations of cerebral palsy are well addressed by the International Classification of Functioning, Disability and Health (ICF) which incorporates biological and social perspective of disablement to an individual?s life9 . Motor ability is one of the keen area that has to be assessed in detail. Knowledge about the gross motor and fine motor ability of the child with cerebral palsy enables the therapist in planning short term and long term goals for the rehabilitation. With the availability of numerous assessment tools for the measurement of motor ability, Gross Motor Function Classification System (GMFCS)10 and Manual Ability Classification System (MACS)11 are found to be reliable in these children with cerebral palsy. Presence of associated impairments too make the rehabilitation of the child with cerebral palsy a challenging task to the professionals in this field. This study is an attempt to assess the children with cerebral palsy based on their motor abilities and how it is associated with other impairments. The main objectives of the study were 1. To identify the extent of gross motor and fine motor abilities of children with cerebral palsy. 2. To find out the relation between gross motor and fine motor abilities of children with cerebral palsy 3. To find out the associated impairments of children with cerebral palsy. 4. To analyze the relationship between motor ability and associated impairments in children with cerebral palsy.
MATERIALS AND METHODS
Cross sectional survey method was used to collect the data. The study was done among 100 children with cerebral palsy aged between 6 to 14 years who were attending special schools in Kerala state. After obtaining the ethical clearance from f Mahatma Gandhi University, the investigators approached the special school authorities and the need and significance of the study were explained to them and also to the parents of the children with cerebral palsy. The consent form was obtained from them prior to data collection. From a pool of 112 children with cerebral palsy, 100 children were taken for the study using lottery random method. The tools used for the study included Case Record Sheet, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS). Case record sheet was prepared to collect general information about the child with cerebral palsy and his/her family from the case profile of the child which is kept in the special school. Information needed to categorization of the subjects into respective sub samples on the basis of variables such as child?s age, gender, motor type of cerebral palsy, topographical distribution, presence or absence of mental retardation, hearing, speech, visual impairments etc are included in this sheet. GMFCS is an internationally accepted tool for assessing the children with cerebral palsy based on the functional abilities and limitations. It is a five level ordinal scale grading system with different age bands.
Children in level I have the ability to walk indoors and outdoors and climb stairs without limitation, while children in level II have to use rails for walking and climbing stairs. Children in level III will use assistive devices for mobility, while wheelchair mobility is needed for level IV. In level V, independent mobility is totally restricted. For collecting data for the present study, the investigators used the GMFCS with age band 6-12 years. MACS provide a systematic method to classify how children with cerebral palsy use their hands when handling objects in daily activities. This is also an ordinal scale with five levels of description. In level I, child handles objects easily and successfully, while in level II the child handles the objects with reduced quality and speed. In level III, the child handles the objects with difficulty and in level IV child handles the objects in a limited manner in adapted situations. Children in level V need total assistance in handling the objects. After developing a proper rapport with the child and the parent, the investigators started the process of data collection initially with the case record sheet. The data obtained from the school record were cross checked physically and verbally with the child and the parent. Grouping of children with cerebral palsy into different levels using GMFCS and MACS were also done. The entire procedure took around 60-90 minutes per child. Statistical Methods The results were analyzed using SPSS version 17 for windows using Spearman?s correlation coefficient.
RESULTS
Age and gender The mean age of the children with cerebral palsy participated in the study was 9.85 (SD=1.69) years with 61 children belonging to male category and 39 in female category. Motor type and topographical distribution The demographic profile of the children with cerebral palsy were shown in table 1 from which it can be seen that out of 100 children, 81 were spastic in nature ,16 were choreoathetoid, 2 were ataxic and one was in floppy type.Also,52 were diplegic while 37 were quadriplegic and 11 were hemiplegic in limb distribution. Associated impairments Out of 100 children, 94 were having different levels of mental retardation such as 78 were in mild category,48 were moderately retarded while 4 were severely affected. Also, 24 children were having visual impairments, while 15 were showed hearing impairments, 48 were having different types of speech impairments, 37 were having behavioural problems and 35 were having epileptic attacks. Thus most of the children were multiply handicapped. (position for Table No 1 ) Gross motor and fine motor abilities The distribution of 100 children with cerebral palsy according to their motor ability are shown in figure 1 and table 2 and 3. Thirty five percentage children were independent in their gross motor functions while 47% were independent in their fine motor functions. Table 4 and figure 2 explains the cross tabulation of gross motor function (GMFCS) and fine motor function (MACS) of these children from which it is clear that 23 children were independent in their gross motor function (GMFCS- I) and fine motor function (MACS- I) while 6 children were severely limited in their self mobility (GMFCS-V) and object handling capacity(MACS-V) (position for Table 2 , 3 and 4 , Figure 1 and 2) The correlation between gross motor and fine motor functions in children with cerebral palsy as measured by GMFCS and MACS are found to be significantly positive (Spearman?s rho 0.56,pEnglishhttp://ijcrr.com/abstract.php?article_id=1905http://ijcrr.com/article_html.php?did=19051 Mutch LW, Alberman E, Hagberg B, Kodama K, Velickovic MV. Cerebral palsy epidemiology: where are we now and where are we going? Developmental Medicine and Child Neurology 1992; 34: 547-555.
2 Pharoah PO, Cooke T, Johnson M A, King R, Mutch LM. Epidemiology of cerebral palsy in England and Scotland, 1984-1989. Arch Dis Child Fetal Neonatal Ed 1998; 79:21-25.
3 Wellesley DG, Hockey KA, Gontgomery PD,Stanley FJ. Prevalence of intellectual handicap in Western Australia: a community study. Med J Austr 1992.; 94-96.
4 Grether JK, Cunnins SK, Nelson KB. The California cerebral palsy project. Paediatr Perinat Epidemiol 1991; 6: 339-35.
5 . Topp M, Uldall P, Langhoff-Roos J. Trend in cerebral palsy birth prevalence in eastern Denmark: birth year period 1979-1986. Paediatr Perinat Epidemiol1997; 11: 451-460.
6 Purohit AK. Cerebral palsy in SAARC countries. Present status and road map to improve. Asia-Pacific Childhood Disability Updates2005;163-164
7 Lord J. Cerebral palsy: A clinical approach. Arch Bhys Med Rehabili1984; 65: 542-548.
8 Delgado MR, Albright A.L. Movement disorders in children: definition, classifications and grading systems. Journal of Child Neurology2003; 18: 51-58.
9 World Health Organization. International Classification of Functioning, Disability and Health, Short Version. Geneva:2001.
10 Russell D, Rosenbaum PL, Cadman DT, Gowland C, Hardy C,Jarvis S. . The gross motor function measure: a means to evaluate the effects of physical therapy. Developmental Medicine and Child Neurology1989: 31: 341-352.
11 Eliasson AC, Krumlinde-Sundholm L, Rosblad B, Beckling E, Arner M, Ohrvall AM,Rosenbaum PL. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability (see comment). Development Medicine and Child Neurology 2006;48:549-554.
12 Gunel MK, Mutlu A, Tarsuslu T,Livanelicglu A. Relationship among the manual ability classification system, the gross motor function classification system, and the functional status in children with spastic cerebral palsy. Eur. J. Paediatr 2008; 168: 477-485.
13 Carnahan K D , Armer M, Hagglun G. Association between gross motor function and manual ability in children with cerebral palsy. A population based study of 359 children. B M C Musculoskelet Disord 2007;. 8:50.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareSALIVARY FERRITIN - A CONCISE UPDATE ON CURRENT CONCEPTS
English5862Nithya JagannathanEnglish Prasanna NeelakantanEnglish Pratibha RamaniEnglish Priya PremkumarEnglish Anuja NatesanEnglish Herald J. SherlinEnglishFerritin is a ubiquitous and highly conserved iron-binding protein. Increasingly, perturbations
in cellular iron and Ferritin are emerging as an important element in the pathogenesis of disease. Ferritin levels seem to reflect the magnitude of iron stores in the body and decreased or increased serum Ferritin levels are used as a marker for anaemia and iron overload disorders. Serum Ferritin was discovered in the 1930s, and was developed as a clinical test in the 1970s. However, the presence of Ferritin in saliva was not documented until 1984. The salivary Ferritin values are usually higher than the iron stores present in the body and these values are subject to change in iron deficiency anaemia, iron overload disorders and protein malnutrition.
The biological system maintains the salivary Ferritin levels at a higher level, probably for the
iron dependent enzymatic functions of the saliva, thus conserving the iron through saliva. This paper gives an update of Ferritin and its presence in saliva and various mechanisms which cause a rise in Ferritin.
Englishsaliva, Ferritin, iron deficiency, anaemia, malnutritionINTRODUCTION
Although essential for most forms of life, too much iron is harmful. To cope with these antagonistic phenomena an ironstorage molecule, Ferritin, has evolved. Ferritin evolved as the only protein able to solve the problem of iron/oxygen chemistry and metabolism1 . Aquated, ferrous iron is oxidized with oxygen to concentrate as many as 4000 iron atoms as a solid oxomineral in the centre of the Ferritin protein2 . Ferritin is a highly specialized ubiquitous iron storage protein and has generally been thought to function as a “housekeeper” storage protein which can release iron required for cellular proliferation and metabolic renewal3 . It stores iron and releases it in a controlled fashion. Ferritin levels seem to reflect the magnitude of iron stores in the body and decreased or increased Ferritin levels are used as a marker for anaemia and iron overload disorders4 . Ferritins are part of the extensive „Ferritin-like superfamily? of proteins within which all members are believed to share the characteristic fourhelical bundle structural motif5 . Ferritin is found mainly in the cytoplasm of the reticuloendothelial cells, liver cells, and to a lesser extent in the developing red cell precursors in the bone marrow6.
Historical Perspective: Ferritin, an iron storage protein was initially discovered by Laufberger and colleagues in 1937, who isolated a new protein from horse spleen which contained up to 23% by dry weight of iron. Discovered early in the 20th century, Ferritin began yielding its secrets at the century?s end7 . Pauline, in 1952 was the first to introduce to Ferritin crystals in the laboratory of Nobel laureate Dorothy Hodhkins.and he isolated Ferritin from horse spleen in 1957 in the old Scala Cinema in Sheffield, UK. The appearance of Ferritin in human serum was documented several years thereafter8 . Since 1972, when the first sensitive immunoassay for Ferritin was described, there have been an impressive number of studies on serum Ferritin concentration in normal and disease states, and the clinical usefulness of the serum Ferritin assay in evaluating body iron status is now well established9 . Serum Ferritin continues to be a useful and convenient method of assessing the iron storage, although it is now known that many additional factors, including inflammation, infection and malignancy may elevate serum Ferritin and complicate the interpretation of this value10. The presence of Ferritin in Saliva has been documented by Agarwal and coworkers in 198411 . Structural Aspects of Ferritin As early as 1944, Granick and Hahn claimed that the iron-cores were particulate 'micellar' in form12. Farant in 1954 demonstrated the structure of Ferritin electron microscopically and considered it to be a tetrad with four subunits, the iron being deposited at the four corners of a cube with a diameter of about 55 A13 . In 1960, Kerr and Muir described the ironcore of Ferritin as consisting of six subunits arranged at the apices of a regular octahedron14. The growth of threedimensional structure of Ferritin suggested that tetragonal crystals were grown for apoFerritin and Ferritin co-crystallized with apoFerritin in an orthorhombic form15 . Human Ferritin is a globular protein complex and a high molecular weight iron compound keeping iron in a soluble and non-toxic form. The protein shell consists of a component named apoFerritin with a molecular weight of approximately 4,50,000 Daltons. It is composed of 20-24 subunits which forms a hollow sphere of internal diameter about 70A and is made up of heart (H) and liver (L) subunits, with molecular masses of 21 kDa and 19 kDa, respectively16, 17. In the centre core of this shell, these is presence of variable number of iron atoms up to about 4500 , accommodated as a microcrystalline core, or micelle, of hydrated ferric phosphate(FeOOH)8 (FeO:OP03H2). It consisting of 24 protein subunits and is the primary intracellular iron-storage protein18,19. Iron may compromise upto 20% of the molecule which may have a molecular weight as high as 9,00,00020 . Salivary Ferritin: Saliva is a complex fluid composed of a wide variety of organic and inorganic substances in the form of protein, various enzymes, sodium, potassium, thiocyanates and some minerals such as iron, copper and chromium. These minerals are present in saliva at a gradient which is comparable with serum. They collectively act to modulate the oral environment21 . a. Salivary Ferritin in Iron deficiency anaemia Agarwal and coworkers observed that saliva contains Ferritin and changes in Ferritin levels have been observed in iron deficiency and its levels in saliva were much higher than the normal11. Lagunoff and Benditt in 1963 first observed Ferritinlike particles in occasional mast-cell granules and suggested that Ferritin may be taken up as such by the granules and then transformed into another form. This was the first step in the discovery of salivary Ferritin22 .
The exact mechanism by which anaemia caused a rise in salivary Ferritin is not exactly known. The levels of salivary Ferritin in normal subjects is 95-105 µg/ dl whereas the levels increases up to 130 – 170 µg/ dl in iron deficiency anaemia23 . However, it may be speculated that the iron dependent enzymatic functions of the saliva also help in the conservation of iron through saliva of iron deficient patients 23 . Changes in Salivary Ferritin occur even before the hematological changes and hence these measurements are clinically significant in monitoring the iron status24 . Other possibilities include endocytosis of Ferritin by the ducts of salivary glands and its excretion into the saliva and presence of high molecular weight iron binding properties of saliva22,25. Internalization of Ferritin in the intercalated ducts in the form of lysosomes in the parotid duct could serve as a possible mechanism for the increased salivary levels. This mechanism hitherto has been established in rats, but evidence is not conclusive in human beings. This may also be the mechanism for alterations in the proteins in saliva before it reaches the oral cavity 25 . Furthermore saliva possesses a marked iron binding ability and the high molecular weight iron binding substance in saliva might have a function in health and disease, both because of its molecular weight and its resistance to acid peptic digestion26 . Another possible mechanism may also be attributed to the increased salivary manganese levels which inhibit the salivary Ferritin transport leading to its retention thereby raising the salivary Ferritin in iron deficiency anaemia. However, the scanty literature on this aspect does not allow us to draw an exact pathogenesis for the rise of Ferritin27. Activity of the enzyme arginase, in human saliva has been found to be more in serum. It is possible that iron and manganese share a common cellular transport mechanism and thus excesses of one element inhibit transport of the other 26 . Ferritin is usually present in the saliva of all men with iron deficient anaemia and in 73% of iron deficient women. In normal individuals, salivary Fe3+ are met only in 50% of men and 32% of women27 . b. Salivary Ferritin in Iron Overload disorders: The salivary ferritin shows a considerable rise in iron overload disorders. However the ratio of serum and salivary ferritin remains constant, demonstrating that there is a proportional rise in salivary ferritin and serum ferritin maintaining a constant value23 . c. Salivary Ferritin in Protein Energy Malnutrition: The salivary Ferritin is remarkably reduced in grade I PEMand shows a mild decrease in grade III PEM. Whether the change is basically related to protein deficiency or is due to low iron stores in these patients is difficult to say11 .
CONCLUSION
The role of saliva as a diagnostic tool has been a topic of interest in the recent years. Salivary Ferritin would add as a monitoring tool in diagnosis of iron deficiency anaemia and will aid to improve the quality of life of iron deficient individuals. Thus the presence of Ferritin in saliva could serve as a diagnostic tool in various field works and epidemiologiacal surveys.
ACKNOWLEDGEMENT
I acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. I am also grateful tothe editors of all those articles, and books from where the literature for this article has been reviewed and discussed. The authors thank Dr. Prasanna Neelakantan, Endodontist, Saveetha Dental College for his contribution in preparing the manuscript.
Englishhttp://ijcrr.com/abstract.php?article_id=1906http://ijcrr.com/article_html.php?did=19061. G. C. Ford, P. M. Harrison, D. W. Rice, J. M. A. Smith, A. Treffry, J. L. White, J. Yariv; Ferritin: Design and Formation of an Iron-Storage Molecule; Philos Trans R Soc Lond B Biol Sci. 1984;304 (1121): 551-65.
2. E.C.Theil, Ferritin: At the Crossroads of Iron and Oxygen Metabolism, J Nutri. 2003 (Supplementary issue); 1549S – 1553S
3. A Giordani, J Haigle, P Leflon, A Risler, S Salmon, M Aubailly, J C Maieère, R Santus, P Morliere, Contrasting effects of excess ferritin expression on the iron-mediated oxidative stress induced by tert-butyl hydroperoxide or ultraviolet-A in human fibroblasts and keratinocytes, J Photochem Photobiol B,2000; 54(1): 43-54
4. G Balla, H S. Jacob, J Balla, M Rosenberg, K Nath, Freadpple, J W. Eaton, Gregory M, Ferritin: A Cytoprotective Antioxidant Strategem of Endothelium, J Biol Chem, 1992; 265 (25): 18148-18153
5. SC Andrews , The Ferritin-like superfamily: evolution of the biological iron storeman from a rubrerythrin-like ancestor, Biochimica et Biophysica Acta, 2010; 1800(8): 691-705.
6. Jacobs, F. Miller, M. Worwood, M.R. Beamish, Ferritin in the serum of normal subjects and Patients with Iron Deficiency and Iron Overload, Brit Med J, 1972; 4: 206-208
7. W. Wang, Serum ferritin: Past, present and future, Biochim. Biophys. Acta , 2010; 8:760-769
8. M. Worwood, Iron in Biochemistry and Medicine, II In: A. a. W., M. Jacobs (Eds.), , Academic Press, London; 1980: 204–244.
9. G.M. Addison, M.R. Beamish, C.N. Hales, M. Hodgkins, A. Jacobs, P. Llewellin, An immunoradiometric assay for ferritin in the serum of normal subjects and patients with iron deficiency and iron overload, J. Clin. Pathol, 1972; 25: 326–329.
10. G. Zandman-Goddard, Y. Shoenfeld, Ferritin in autoimmune diseases, Autoimmun. Rev.2007; 6: 457–463.
11. PKAgarwal, KN Agarwal, DK Agarwal, Biochemical changes in saliva of malnourished children, Am J Clin Nutr,1984; 39(2): 181-184
12. Granick, S, Ferritin. IV. Occurrence and immunological properties of ferritin. J. Biol. Chem. 1943; 149: 157– 16
13. J.L Farant , An electron microscopic study of ferritin, Biochimica et Biophysica Acta, 1954; 13: 569-576
14. D.N.S. Kerr, A.R. Muir, A demonstration of the structure and disposition of ferritin in the human liver cell, Journal of Ultrastructure Research, 1960; 3(3): 313-319
15. Vekilov PG, Feeling-Taylor AR, Yau ST, Petsev D, Solvent entropy contribution to the free energy of protein crystallization, Acta Crystallogr D Biol Crystallogr, 2002 ; 58:1611-6.
16. Harrison, P. M. In Iron Metabolism (Gross, F., ed.), Springer-Verlag, Berlin; 1964: 40.
17. M. Worwood, J.D. Brook, S.J. Cragg, B. Hellkuhl, B.M. Jones, P. Perera, S.H. Roberts, D.J. Shaw, Assignment of human ferritin genes to chromosomes 11 and 19q13.3– 19qter, Hum. Genet. 1985; 69: 371–374.
18. Granick, S. Ferritin: Its Properties and Significance for Iron Metabolism, Chem. Rev, 1946; 38: 379
19. Haggis, G. H. The iron oxide core of the ferritin molecule, J. Mol. Biol, 1965; 14(2), 598
20. A. Jacobs, F. Miller, M. Worwood, M. R. Beamish, C. A. Wardrop, Ferritin in the Serum of Normal Subjects and Patients with Iron Deficiency and Iron Overload Brit Med J, 1972; 4: 206-208
21. Jenkins GN, Saliva In: Physiology and biochemistry of the mouth, 4th edition, 1978; 284-359
22. Lagunoff, D, E . P. Benditt, Proteolytic enzymes of mast cells . Ann . N. Y. Acad. Sci. 1963; 103 :185
23. O.P.Mishra, Salivary Iron status in children with iron deficiency and iron overload, J Trop Ped, 1992 ; 38 (2) : 64-67
24. JS Rennie, DG MacDonald, JH Dagg . Iron and the oral epithelium: a review. J R Soc Med 1984; 77:602-607.
25. A. R. Hand, R. Coleman, M. R. Mazariegos, J. Lustmann, L. V. Otti , Endocytosis of Proteins by Salivary Gland Duct Cells ,J Dent Res ,1987; 66(2):412-41
26. Peter L. Reilly, Peter S. Davis, Donald J. Deller. Iron Binding Properties of Saliva, Nature, 1968; 217: 68
27. Rafik GS, Lyudmila IL, Tamara IV, Mikhail GV, Electron paramagnetic resonance in biochemistry and medicine; 2001 Feb: 111-112
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareINVITRO ANTIBACTERIAL SCREENING OF ARCTOSTAPHYLOS UVA URSI LEAF EXTRACT ON SELECTED ORAL PLAQUE FORMING MICROORGANISMS
English6368Lakshmi.TEnglish Aravind Kumar SEnglish Arun A.VEnglishOral health influences the general quality of life and poor oral health is linked to chronic
conditions and systemic diseases. dental caries/plaque is an extremely prevalent infectious
disease that has been shown to be associated with serious health problems. The objective of our
study is to evaluate the antibacterial activity of ethanolic leaf extract of Arctostaphylos Uva ursi
against selected cariogenic oral bacteria that causes dental plaque in fixed orthodontic
appliances patients. Arctostaphylos Uva ursi is used medicinally since second century. the
ethanolic extract of uva ursi leaf were used to find out the antibacterial potency against
streptococcus mutans, streptococcus mitis streptococcus sanguis ,streptococcus salivarius,
streptococcus sobrinus and Lactobacillus acidophilus. the extract exhibited significant
antibacterial activity against streptococcus mitis, streptococcus mutans ,streptococcus sanguis
& streptococcus salivarius, streptococcus sobrinus with minimum bactericidal concentration of
1mg/ml and 5mg/ml respectively. whereas, the extract does not show antibacterial activity
against Lactobacillus acidophilus.
EnglishArctostaphylos Uva ursi, anti bacterial evaluation, MBC, oral bacteria, dental plaque.INTRODUCTION
Orthodontic treatments may induce oral ecologic changes, leading to increase of Streptococcus mutans in saliva and plaque.[1,2 3] Orthodontic brackets play a significant role in gathering microbial plaque .[4, 5] Orthodontic appliances, both fixed and removable, impede the maintenance of proper oral hygiene and result in plaque accumulation. Many studies report that changes in the dental flora occurs after starting the orthodontic treatment. Human dental plaque was one of the ecosystems in which microorganism was first observed. dental plaque refers to the aggregates of bacterial cell embedded in a polysaccharide and protein matrix which adheres to the teeth by a characteristic bacterium, Streptococcus mutans. This organism metabolizes sucrose in a peculiar way, producing an extracellular adhesive polysaccharide , a sticky insoluble glucan which promotes the firm adherence of the organisms to the tooth surface contribute the formation of dental plaque, subsequently leads to localized decalcification of the enamel surface .[6,7] Arctostaphylos uva ursi which is also known as bearberry, grows in the northern United States and Europe. In fact, until the discovery of sulfa drugs and anti-biotics, Uva Ursi is the treatment of choice for bladder and related infections through modern day scientific research in test tubes and animals, researchers have discovered that Arctostaphylos uva ursi's antibacterial properties, which can fight infection, are due to several chemicals, including arbutin and hydroquinone.[ 8] The herb also contains tannins that have astringent effects, helping to shrink and tighten mucous membranes in the body. That, in turn, helps reduce inflammation and fight infection.uva ursi is used to treat cystitis. It increases renal circulation and stimulates tubular function. [9] The leaves, long used by practitioners of herbal medicine, have antiseptic effects. The leaf extract is also a diuretic, helping to remove excess liquids from the body. As a popular home remedy, Arctostaphylos uva ursi was traditionally used for treatment of renal infections, and renal stones. It was also recommended for treatment of bronchitis. The herb has also been used as a general tonic for weakened kidneys, liver or pancreas. Native Americans used it as a remedy for headaches, to prevent and cure scurvy and to treat urinary tract infections. [10] This herb helps prevent postpartum infection. Arctostaphylos Uva Ursi is also helpful for chronic diarrhea. as a nutritional supplement and muscle relaxant, it soothes, strengthens, and tightens irritated and inflamed tissues. The herb neutralizes acidity in the urine, increasing urine flow, therefore reducing bloating and water retention, making it beneficial for weight loss. Arctostaphylos Uva Ursi's astringent properties may also assist in the treatment of some bed wetting problems. [11] Japanese researchers conducted a study on comparing arbutin extracted from Arctostaphylos Uva ursi with indomethacin and proved it as good anti inflammatory drug, the results was published in Journal of pharmacological society of Japan. Research shows uvaursi possess potent anti bacterial,anti fungal ,anti plaque, [12] anti viral activity. Several anti-plaque agents are being available in the market. However, due to several unwanted side effects associated with these agents stimulated the search for alternate agents .[13] In recent years, there has been focus on plants or plant products used in folk dental practice for curing oro dental infections .[14] Hence an attempt was made to evaluate the antibacterial potency of Arctostaphylos Uva ursi leaf extract against selected oral microbes causing dental plaque in fixed orthodontic appliance patients.
MATERIALS AND METHODS
Plant material Arctostaphylos Uva ursi ethanolic leaf extract were obtained from Green Chem Herbal Extracts and Formulations. Bangalore, India Test microorganisms Bacterial strains used were streptococcus mutans (ATCC 25175) ,streptococcus salivarius (ATCC 25975),streptococcus mitis (ATCC 9811),streptococcus sanguis(ATCC 10556) streptococcus sobrinus (ATCC 27607)Lactobacillus acidophillus (ATCC 4356).The organisms were obtained from Department of Microbiology , Saveetha Dental College and Hospitals, Chennai . Methodology The herbal extract 200mg were weighed aseptically into a sterile tube and dissolved in 2ml of sterile Tryptic soy Broth (TSB).From the stock solution various concentrations were prepared,viz.,62µg,125 µg, 250 µg,500 µg/100µl ,1mg,5mg,10mg/100µl respectively in to wells of micro plates.100µl of these concentration were taken and the plates were incubated at 37°C for 24hrs.
Screening of Antibactericial activity The tested organisms was grown in (TSB) Tryptic soy broth medium [Hi media ,Mumbai] for 24hrs at 37°C and concentration was adjusted to 0.5 McFarland standard.[15-17]The above concentration of extracts were taken in 100µl quantities in a U bottom micro culture plates. 100µl of the bacterial suspension was added to each well. control well received plain broth without plant extract. the plates were kept in sealed covers and incubated at 37°C overnight and growth/no growth was detected. All the tests were done in duplicate to minimize the test error. Minimum Inhibitory Concentration (MIC) Minimum inhibitory concentration of herbal extracts against tested microorganism was determined by broth culture method .[18] A series of two- fold dilution of each extract ( 62 µg/100µl to 10mg/100µl) was made in to which 100μl of the standardized bacterial suspension containing 106 organisms was made in Tryptic soy broth as specified by National Committee for Clinical Laboratory Standards (NCCLS, 1990)[22]The control well received plain broth without herbal extract .The plates were incubated at 37°C for 24 hours and observed for visible growth. As the extracts were colored, MIC could not be read directly by visual methods. hence subcultures from all the wells were made and growth/no growth is detected. then the MBC were obtained. Minimum Bactericidal Concentration (MBC) The MBCs were determined by selecting wells that showed no growth . The least concentration, at which no growth was observed, were noted as the MBC RESULT and DISCUSSION The human mouth is a unique infrastructure. Our teeth is capable of holding a great deal of germs.In fact, dental plaque itself contains 1,000 bacteria. For this reason, dental plaque is considered the human body?s most diverse form of biofilms.[19] Dental plaque , a colorless biofilm that forms around the tooth surfaces. It can attach on every tooth surface especially on intedental surface, occlusal surface, irregular surface of the tooth enamel, and close with the gingival tissue. The biofilm forms just 1-2 minutes after brushing your teeth. The teeth are covered by a film of salivary mucoproteins which is colonized by 350 different kind of bacteria. The most important are Streptococcus mutans, salivaris, mitis, Lactobacillus, acidophillus etc.They use carbohydrates stuck on the tooth surface for their metabolism and multiply making dental plaque thicker and more complex. Dental plaque can also give rise to dental caries (tooth decay) or periodontal disease such as gingivitis and periodontitis.[20] Fixed orthodontics may be associated with accumulation of Mutans Streptococci (MS), enamel demineralization, and an increased number of carious lesions, predominantly in sites adjacent to brackets.[.21 ] Multi bracket orthodontic appliances increase dental plaque retention and make teethbrushing more difficult for patients. As a result, advice from the orthodontist on oral hygiene along with patient motivation regarding teeth brushing are particularly important One change that alters the nature of dental plaque is the placement of orthodontic bands and arch wires. In a study Bloom and Brown [22 ] found an average increase of 90,000 lactobacilli/ml of saliva in orthodontic patients after the placement of bands and arch wires. Since lactobacilli require a special plaque environment, this 3,500% increase represents a striking change in the plaque after banding procedures. In our study table 1 indicates that Arctostaphylos Uva ursi ethanolic leaf extract shows No growth (MBC) at a concentration of 5mg/ml against streptococcus mutans and streptococcus mitis.and streptococcus sobrinus. The extract also shows No growth (MBC) at a concentration of 1mg/ml against streptococcus sanguis and streptococcus salivarius. In conclusion , Arctostaphylos Uva ursi leaf extract is highly effective against streptococcus sanguis , streptococcus salivarius and less effective against streptococcus sobrinus streptococcus mutans and streptococcus mitis comparatively.however the extract showed no activity against lactobacillus acidophillus. Our finding suggest the presence of No growth is an indication of high effectiveness of the extract whereas presence of Growth indicates the less effectiveness of the extract , that is documented in table 1
CONCLUSION
Orthodontics help both children and adults not only with achieving a beautiful smile but with dental health as well. For instance, overcrowded teeth can cause problems with brushing and flossing creating the perfect breeding ground for cavity-causing bacteria and plaque. The occurrence of mutans streptocooci and streptococcus sobrinus together makes the oral environment more conductive to caries/plaque. acid production by both S. mutans and S. sobrinus plays an important role in the pathology of dental caries/plaques..the results of our study clearly indicates that ethanolic extract of Arctostaphylos Uvaursi possess good anti bacterial activity against oral plaque forming microbes , hence we conclude that Arctostaphylos uvaursi as an potent antibacterial herb to treat dental plaque associated with fixed appliances patients undergoing orthodontic treatment. further studies are also required to isolate and elucidate the bioactive principle responsible for anti bacterial activity of the herbal extract.
ACKNOWLEDGEMENT
Our Heartfelt thanks to Mr.Rajendran, Green Chem Herbal Extracts and Formulations, Bangalore, India for Providing us the ethanolic leaf extract of Uva ursi as a gift sample to conduct this In vitro Study and we wish to thank Dr.Auxilia Hemamalini, HOD of Microbiology , Saveetha Dental College and Hospitals,Chennai for providing the test organisms for the study.
Conflict of Interest
Nil
Englishhttp://ijcrr.com/abstract.php?article_id=1907http://ijcrr.com/article_html.php?did=19071 F. Lundström and B. Krasse, “Caries incidence in orthodontic patients with high levels of Streptococcus mutans,” European Journal of Orthodontics, vol. 9, no. 2, pp. 117–121, (1987).
2 F. Lundström and B. Krasse, “Streptococcus mutans and lactobacilli frequency in orthodontic patients; the effect of chlorhexidine treatments,” European Journal of Orthodontics, vol. 9, no. 2, pp. 109–116, (1987).
3 S.-J. Ahn, B.-S. Lim, and S.-J. Lee, “Prevalence of cariogenic streptococci on incisor brackets detected by polymerase chain reaction,” American Journal of Orthodontics and Dentofacial orthopedics Volume 131, Number 6 June (2007).
4 S.-J. Ahn, B.-S. Lim, H.-C. Yang, and Y.-I. Chang, “Quantitative analysis of the adhesion of cariogenic streptococci to orthodontic metal brackets,” Angle Orthodontist, vol. 75, no. 4, pp. 666– 671, (2005).
5 B. Øgaard, E. Larsson, R. Glans, T. Henriksson, and D. Birkhed, “Antimicrobial effect of a chlorhexidine-thymol varnish (cervitec) in orthodontic patients. A prospective, randomized clinical trial,” Journal of Orofacial Orthopedics, vol. 58, no. 4, pp. 206–213, (1997).
6 Scherp HW (1971) Dental caries: Prospects for prevention. Science. 173, 1199-1205.
7 Ooshima T, Minami T, Aono W, Tamura Y and Hamada S (1994) Reduction of dental plaque formation in humans by Oolong tea extracts. Caries Res. 28, 146-149.
8 Beaux D, Fleurentin J, Mortier F. Effect of extracts of Orthosiphon stamineus Benth, Hieracium pilosella L., Sambucus nigra L. and Arctostaphylos uva-ursi (L.) Spreng. in rats. Phytother Res. 13(3):222- 225(1999).
9 Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Boston: Integrative Medicine Communications; 2000:389-393.
10 Chauhan B, Yu C, Krantis A, Scott I, Arnason JT, Marles RJ, Foster BC. In vitro activity of uva-ursi against cytochrome P450 isoenzymes and Pglycoprotein. Can J Physiol Pharmacol. 2007;85(11):1099-107.
11 Sunshine herbs available at http://hartonweb.com/nspherbs/sunshineherbsyuma.com/?sn=71 0-9
12 Schee A (1989) Modes of action of currently known chemical antiplaque agents other than chlorohexidine. J. Dental. Res. 68, 1609-1601.
13 Memory FE (1986) In: Proceedings of the International Seminar on Clinical Pharmacology in Devceloping Countries (Eds. Saxena RC and Gupta TK), pp: 1-9.
14 J.H Jorgenson and John turniegd Susceptibility test methods dilution and disc diffusion methods,Manual of Clinical microbiology vol 1 ,9th edition pg no.1153-1172.ASM Press Washington.
15 Betty A.Forbes., Daniel F.Sahm., Alice S.Weissfeld. Bailey and Scott?s Diagnostic Microbiology 11th edition Mosby page no 229 – 257.
16. Ananthanarayan R and Paniker„s: Textbook of Microbiology: 8th edition: Publishers University Press: Hyderabad (2009): 618.
17. Jennifer MA: Determination of Minimum Inhibitory Concentrations: Journal of Antimicrobial Chemotherapy 2001; 48, (SI): 5 -16.
18. National Committee for Clinical Laboratory Standards: Methods for Disc Susceptibility Tests for Bacteria that Grow Aerobically: NCCLS Document M2-A7: National Committee for Clinical Laboratory Standards: Wayne, USA: 2000; 7.
19. http://www.dentalcareplan.com/treatment-dental-plaque/
20. Dentalplaque biofilms available at http://dentalcarestamford.com/pdf/Dent a%20Plaque%20Biofilms.pdf
21. Derks A, Katsaros C, Frencken JE, van?t Hof MA, Kuijpers-Jagtman AM. Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances Caries Res. 2004 Sep-Oct; 38(5): 413-420.
22. Bloom, R.H., and Brown, L.R.: A Study of the Effects of Orthodontic Appliances on the Oral Microbial Flora, Oral Surg, 17:758-767, 1964.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareANTIMICROBIAL EFFICACY OF DIFFERENT ROOT CANAL PREPARATION TECHNIQUES USING K- FILES AND K- NITI FLEX - AN INVITRO STUDY
English6979Arul PariEnglish Arun Prasad RaoEnglish ThayumanavanEnglish C.VijayEnglishEnterococcus faecalis is the most commonly isolated or detected species from oral infections
including marginal periodontitis, infected root canal and periradicular diseases. So, the
elimination of bacteria, their products and substrate enhances the success rate of endodontic
therapy. Thus, this study was done to compare the antimicrobial efficacy of two different root
canal techniques using K-file and K-Nitiflex. 30 intact right and left maxillary premolars
extracted for orthodontic reasons were included in this study, after pulp extirpation, teeth were decoronated and autoclaved. Root canals were inoculated with Enterococcus faecalis
suspension incubated at 37° for 24 hours. Six teeth were randomly allocated to five groups such as Step back preparation using K-file, Step back preparation using K-Nitiflex , Standard
preparation using K-file, Standard preparation using K-Nitiflex and Saline irrigation. A pretreatment and Post- treatment sample was obtained and its prevalence was evaluated using cultivation. All the data were statistically evaluated. The results suggest that the reduction in bacterial counts were statistically significant with step back using K-file and K-Nitiflex file and also standard technique using K-file and K-Nitiflex file. Finally, the present study concludes, that mechanical effects along with the adjunctive chemical substances possessing antimicrobial properties would effectively eradicate root canal infections.
EnglishRoot canal therapy, Enterococcus faecalis, step back technique, standard technique, K-Nitiflex, K-File.INTRODUCTION
Root canal therapy is an invaluable measure to preserve teeth that would otherwise need to be extracted. With a better understanding of root canal anatomy and improved materials, advancing technology, root canal therapy is achieving an increasingly high over all success rates. However bacteria inside the root canal system have significant impact on this success rate.10 A few bacterial species, predominantly facultative anaerobes16 causing apical periodontitis are responsible for the root canal failures.15,17 Root canal failures result from these microorganisms that have leaked into the canal after the obturation or from bacteria not eliminated during therapy. Therefore improving the cleaning and disinfection phase of treatment is of crucial importance and has led to the advancement of instrumentation and irrigation.27 During endodontic treatment, bacterial reduction or elimination may be achieved by both chemomechanical preparation and intracanal dressings. The removal of irritants from the root canal is conducted by means of mechanical action of instruments with flow and backflow of the irrigant solution.22 In addition; antibacterial irrigants may significantly help to eliminate bacterial cells from the root canal system. Sundqvist et al (1998) recovered numerous species of anaerobic bacteria from failed root canal systems. Some of the bacterial species found out were Enterococcus faecalis, Streptococcus anginosus, Bacteriods gracilus and Fuso bacterium nucleatum.26 From all the cases studied Enterococcus faecalis was found to be the most prevalent agent for the cause of failures.26 Enterococcus faecalis is a non spore forming fermentative, facultative anaerobic, gram positive coccus. Infact, the prevalence of Enterococci in primary endodontic infections and in persistent infections had been almost exclusively reported by using cultivation.16,26 Bystrom and Sundqvist (1985) used physiological saline solution during instrumentation; found that bacteria persisted in about half of the cases despite treatment on five successive occasions. Teeth where the infection persisted were those with a high number of bacteria in the initial sample. Bystrom and Sundqvist (1985)3 found Enterococcus faecalis to be highly resistant to antimicrobial medicaments, such a calcium hydroxide. Efforts to eliminate bacteria from the root canal system are accomplished by thorough cleaning and shaping of the root canal followed by an interim dressing of calcium hydroxide and adequate filling of the empty space.3 An adequate cleaning and enlargement of root canal is a prerequisite for a successful root filling.
To deal with complex problem of preparing curved root canals, several instrumentation techniques such as step back method, standard method, balanced method and ultrasonic method were proposed.19 Moreover, recent advances in technology allowed the introduction of endodontic files manufactured from nickeltitanium alloy, with more elastic flexibility, as well as improved resistance to torsional fracture.
AIMS AND OBJECTIVES
1. To determine the efficacy of step back technique using K-file and K-Nitiflex in reducing Enterococcus faecalis in artificially inoculated root canals.
2. To determine the efficacy of standard technique using K-file and K-Nitiflex in reducing Enterococcus faecalis in artificially inoculated root canals.
3. To compare the efficacy in the reduction of microbial counts among the step back and standard technique using K-file and KNitiflex.
MATERIALS AND METHODS
The present study was conducted in Division of Pedodontics and Preventive Dentistry in association with Department of Microbiology, RMDCH, Annamalai University.
Selection criteria:
Thirty intact human right and left maxillary first premolars
Teeth extracted for orthodontic reasons.
Teeth that had two root canals.
Materials used:
K-file
K-Nitiflex
Pfizer selective medium
Inoculation loop
Bacteriological incubator
Petriplates
Aluminium foil
Airotor Handpiece
Endoblock (Dentsply)
Micropipette
Paper points
Autoclave, Hot air oven
Vials
Standard Enterococcus faecalis ATCC (259212)
Conventional access preparation were made, decoronated and autoclaved.
Inoculation of root canal
Enterococcus faecalis suspension equivalent to 0.5 McFarland's standard at the log phase of growth was used for inoculation. Teeth randomly were inoculated with O.lml/canal suspension under aseptic conditions. Even distribution along the working length was facilitated using sterile K # 15 file. The end point of the preparation length was assigned by macroscopic control at a distance 1mm coronal from the root apex. Thereafter teeth were wrapped in sterile aluminium foil and incubated at 37°C for 24 hr. Six teeth were randomly allocated to each of five groups Group 1: Step back preparation using Kfile Group 2: Step back preparation using KNitiflex Group 3: Standard preparation using K-file Group 4 : Standard preparation using KNitiflex Group 5 : Saline irrigation
Sample collection: Pre treatment sample was obtained by inserting ≠15 moistened sterile paper points into the root canal and removed after 30 seconds. The paper points were placed into 200µl sterile physiological saline and vortexed for 30 seconds. In all the four instrumental groups (group 1- 4) the size of the master files was ≠ 40. After preparation, canals were irrigated with 0.1ml of sterile physiological. In group 5 treatment consisted' irrigation with 1ml of physiological saline only. Posttreatment samples were obtained from all 5 groups. Pre and post treatment samples of each tooth were serially diluted in the physiological saline to give a final dilution of 101 , 102 , and 103 .
Preparation of media
The media used in this study for culturing Enterococcus faecalis was Pfizer selective Enterococcus agar. It was prepared as per the manufacturer?s protocol.
Agar Plating and Colony Counting
100µl of diluted samples were pipetted out on the surface of Pfizer selective Enterococcus agar and spread evenly. The plates were then incubated at 37° C for 24 hours. To avoid bias, procedures was carried by the same investigator. Colonies of Enterococcus faecalis were identified as a 0.5 mm entire edge, raised colonies with a brown halo. The colony count of each plate was recorded and the mean CFU/ml was determined.
Statistical evaluation: All the data was entered into a data based on Microsoft excel and analysed using SPSS with paired„t? test and one way ANOVA. Difference at the 5% level (PEnglishhttp://ijcrr.com/abstract.php?article_id=1908http://ijcrr.com/article_html.php?did=19081. Baumgartner JC, Falker WA. Bacteria in the apical 5mm of infected root canals. / Endod. 1991:17: 380-3.
2. Bergholtz G, Crawford JJ. Endodontic microbiology in: Walton RE, Torbinejad Meds, Principles and practice of Endodontics. Philadelphia : WB Saunders. 1989: 277.
3. Bystrom A, Sundqvist G. The antibacterial action of sodium hypochloride and EDTA in 60 cases of endodontic therapy. Int Endod J. 1985; 18: 35-40.
4. Carrotte P. Preparing the root canal. British Dental Journal 2004; 197: 603- 613.
5. Dalton C, Orstavik D, Trope M. Intracanal bacterial reduction with nickel-titanium rotary instrumentation. / Endod. 1997; 23: 2.
6. Edgar Schafer, Klaus Bossmann, Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulation against Enterococcus faecalis invitro. / Endod. 2005; 31: 53-56.
7. Evans M, Davies JK, Sundqvist G, Figdor D, Mechanisms involved in the resistance of Enterococcus faecalis to calcium hydroxide. Int Endod j. 2002;35:221-8.
8. Fadia E, Bou Dagher, and Ghassan M, Yared, Comparison of three files to prepare curved Root canals. / Endod. 1995; 21: 264-265.
9. Figdor D, Davies JK, Sundqvist G. Starvation Survival growth and recovery of Entercoccus faecalis in human serum. Oral Microbiol Immunol. 2003; 18: 234-9.
10. Friedman S, Mor C. The success of endodontic therapy - healing and functionality, CD A Journal. 2004; 32: 493-503.
11. Friedman S. Abitbols, Lawrence HP, Treatment outcome in endodontics. The Toronoto Study Phase I : Initial Treatment. / Endod. 2003; 29: 787-93.
12. Hancock HH, Sigurdsson A, Trope M, Moiseiwitsch J. Bacteria isolated after unsuccessful endodontic treatment in a North an population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 91: 579-86.
13. Hubble TS, Hatton JF, Nallapareddy SR, Murray BE, Gillespie MJ. Influence of Enterococcus faecalis proteases and the collagenbinding protein, pace, on adhesion to dentin. Oral Microbial Immunol. 2003; 18:121-6.
14. Jett BD, Huycke MM, Gilmore MS, Virulence of Enterococci. Clin Microbiol Rev. 1994; 7; 462-78.
15. Kakehashi S, Stanley HR. Fitzgerald RJ. The effect of surgical exposures of dental pulps in germ-tree and conventional laboratory rats. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1965; 20: 340-9.
16. Molander A, Reitc, Dahlen G, Kvist T., Microbiological status of root filled teeth with apical periodontitis. Int Endod J 1988: 31-1-7.
17. Moller A J, Fabricius R, Dahlen G, Ohman AE, Influence on periapical tissues of indigenous oral bacterial and necrotic pulp tissue in monkeys. Scand J Dent Res. 1981; 89: 475-84.
18. Mullaney TP. Instrumentation of finely curved canals. Dent Clin North Am. 1979; 23: 575-592.
19. Pataky, Ivan Nangi, Ayne Grigar, Arpad Fazekas. Antimicrobial efficacy of various root canal preparation techniques. / Endod. 2002; 28: 603-605.
20. Rocas IN, Siqueria JF, Santos KRN, Association of Enterococcus faecalis with different forms of periradicular diseases. / Endod. 2004; 30: 315-20.
21. Sedgley CM, Lennan SL, Lewell DB. Prevalence, Phenotype and genotype of oral Enterococci. Oral Microbial Immunol 2004; 19: 95-1001.
22. Siqueira JF Jr, Araujo MCP, Garcia PF, Fraga RL, Sobia Dantas CJ, Histological evaluation of the effectiveness of five instrumentation techniques for cleaning the apical third of root canals. / Endod. 1997; 23: 499- 502.
23. Siqueira Jr JF, Aetiology of root canal treatment failure : Why well treated canal fail Int Endod J. 2001; 34; 1-10.
24. Siqueira Jr. Kenioc Lima Fernades AC. Mechanical reduction of the bacterial population in the root canal by three instrumentation techniques. / Endod. 1999; 25: 352-35.
25. Siren EK, Haapasalo MRP, Rantak, Salmi p, Kerosuo ENJ, Microbiological findings and clinical treatment procedures in endodontic cases selected for microbiological investigation. Int EndodJ. 1997;30:91- 5.
26. Sundqvist G, Figdor P, Persson S, Sjogren, Microbiological analysis of teeth with failed endodontic treatment and the outcome of conservative retreatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85: 86-93.
27. Torabinejad M, Khademi A, Babagoli J, Choy Johnsaw, A new solution for the removal of smear layer. / Endod, 2003; 29; 170-75.
28. Walia H, Brentley W, Gerstein H. An Initial investigation of the t bending and torsional properties of Nitinol root canal files. / Endod. 1988; 14: 346-50.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareDOES PROLONGED SITTING WORK AMONG MIDDLE AGED WOMEN IMPAIR KNEE JOINT POSITION SENSE? A COMPARATIVE STUDY
English8088Saranya SubramanianEnglish Amitesh NarayanEnglishObjectives: Work, when performed in prolonged sitting position can have an impact on knee jointposition se nse (JPS) due to altered weight transmission and may contribute to early degeneration of knee joint. However no literature is available that compares the knee JPS between the women involved in prolonged sitting type of job to non-working women. Hence this study compares theknee JPS between working and non-working women to find the impact of prolonged sitting. Materials and Methods: Knee JPS was measured in both knee joints by active repositioning method with a standardized goniometer in terms ofabsolute and relative error on 80 subjects (40 in each group). Subjects were selected through random convenient sampling. Result: There were no significant differences in-terms of both absolute and relative error between the groups (P< 0.05) in both the knees. Conclusion: This is the first study (to the
best of our knowledge)`which has analysed the position sense error between the working and nonworking women group. It was found that prolonged sitting has no influence on knee JPS and this could be a least contributing factor for the development of the knee joint degeneration in any women at 40-50 years of age.
side at 45°, 60° respectively. And RE of right side at 60° strongly correlated with RE of right side 80°, left 60°, 80°. Other strong positive correlations between errors of different angles are given in table- 5. DISCUSSION Joint position sense may be impaired in case of decreased feedback from the joint receptors in case of prolonged non-weight bearing positions when adopted e.g. seated office work.11,12,14 The impaired position sense could be a contributing factor for the initiation of early stage of structural damage in the knee rather being secondary to the disease.7 Also because the progressive development of articular surfaces degeneration of knee joint is solely not the disease of aging, but potentially have etiological link with the occupation.12 The aim of the study was to determine the differences in knee joint position sense among working and non-working middle aged women to see the scientific basis of posture related changes and to detect the development of early signs of degenerative changes in the joint. Hence the age range of 40 - 50 yrs was considered for the study, since the degenerative changes in the joints among women sets in at 51 yrs of age on an average;12 and the average age at which osteoarthritis becomes clinically symptomatic, was found to be 59-60 years for females involved in desk job.12 In this study the age and BMI of the subjects of both the groups were not statistically significant, (p= 1.31, 0.68) suggesting that the confounding factors were controlled. Our understanding while designing the study was that there will be subtle differences in knee joint position sense between working and nonworking females, since working women would have probably uniform sitting pattern for a fixed number of hours compared to the non-working subjects. But the results indicated that in this age range, among both the groups, changes in the joint position sense at all angles were relatively equal; Average AE of working women was 6.624°±5.033° and non-working was 5.665°±4.957°. Average RE of working women was 2.84°±8.13° and non-working women was 2.46°±7.185° (pEnglishKnee joint position sense, middle aged women, degeneration, prolonged sitting. Running title: Does prolonged sitting impair knee JPS?INTRODUCTION Work, when performed in awkward postures or with excessive effort, may result in fatigue and discomfort, leading to micro trauma of the surrounding structures.1 It can be controlled by identifying workplace stressors and managing them by adopting morenormal ergonomic sitting pattern.2 Proprioception is defined as, „the ability to detect, without visual input, the spatial position and/or movement of limbs in relation to the rest of the body?.3,4 The physiological systems that contribute to proprioceptive acuity include visual and vestibular systems, articular, cutaneous and muscle mechanoreceptors which finely controls muscle contraction; enabling smooth, coordinated movements.5 The role of the proprioception has become increasingly important as proprioceptive dTesting Procedure for Knee Joint Position sense:eficiency facilitates the injury, 6 and may lead to poor control and greater mechanical load on the joint, which in turn leads to an increased risk of development of degenerative changes in the joint.7 Proprioception is affected by factors such as age, physical activity, muscle fatigue and degenerative arthritis of the joint.3, 4 Any activity that puts excessive weight-bearing force across the joint, after activities like prolonged squatting, sitting, and standing;affects the protective stabilizing mechanisms of proprioception and may initiate or contribute to the abnormal joint forces and hence to the degenerative changes in a joint.8 The knee joint is one of the largest and most complex synovial joint of the body having predominant dynamic functions.9The degenerative joint disease (DJD) of knee joint is a leading cause of disability among the middle aged women in India and its impact on the public health is substantial.10 The risk of developing the proprioceptive deficits in the knee joint in middle age can be attributed to the occupation to an extent. It has been estimated that the jobs involving prolong bending, squatting, standing and sitting predisposes to structural damage to the knee joint.11A study had reported that approximately 27% office workers are prone for knee joint degeneration because of their sitting type of job.12 The relative prevalence of arthritic changes among white collar professionals in age group 20- 59 years was 0.1 and prolonged sitting may be a risk factor with the relative risk of 1.1 (odds ratio).13 However, this was not a major risk factor for degenerative changes over the knee joint and the white collar professionals were considered as „low risk group? for developing degenerative changes in the knee.11, 13 The evidences have concluded that impaired proprioception is involved in the early degenerative changes in the knee joint7 during active life. Therefore early detection of the degenerative changes in terms of joint position sense deficits is key to develop preventive measures in the workplace to reduce knee pathologies in the community.13 However; the available studies related to this subject are very much limited. So we planned to trace the pathophysiology of degenerative changes in the knee joint, in terms of joint position sense errors, which we hypothesized to be affected in women, who is involved in seating work environment for a prolonged period.
MATERIALS AND METHODS This study was approved by the Time-Bound ethical committee, KMC, Mangalore (Ref No: (IEC/KMC/03/2010-2011) before its commencement. A total of 106 subjects were screened (working and non-working) from the banks, offices and community through physiotherapy camps in and around Mangalore. Working women included women who are involved in desk job, who sits on an average of 7 hrs/day (a pilot study was carried-out before the commencement of this study and 7 hrs was identified as average time of working). Through this process 80 subjects (40 in each group) were included as per inclusion and exclusion criteria proposed for the study. Rest 26 were excluded as 8 subjects had knee pain, knee joint crepitus and early arthritic changes, 7 were working in small scale industry at home, 5 subjects had underwent hysterectomy, 3 were asthmatic, 2 had history of seizures, and 1 had undergone TKR. The sample size was calculated with the formula {(Zα+Zβ)2 .σ 2 }/δ2 ,where Zα and Zβ value is 1.96 and 1.28 respectively. A written informed consent was obtained from all 80 subjects after explaining the study procedure and purpose. The demographic details were obtained and subjects were assessed by the following procedure for the knee joint position sense.
Testing Procedure for Knee Joint Position sense: Subjects were made to sit on a high couch with folded towels placed behind the lower thigh so that it appears horizontal, having 90° angle with trunk at hip joint. The relaxed knee (i.e. Tibia) assumed right angle with the hip (i.e. Femur). Reference mark was applied on the lateral aspect of the testing knee joint. A transparent degreecalibrated clinical goniometer was placed in a manner that the proximal arm orienting along the long axis of the femur and distal arm along the tibia. Subjects relaxed and eyes open; examiner lightly grasped the foot and passively extended the knee from the resting position (~90° flexion) to the chosen test position- which was unknown to the subjects. Then the subjects were blindfolded and the same procedure was repeated. The knee was kept in the selected test position for ~4 s. At this time the subject was asked to perceive their knee position. Next the examiner re-supported the foot and lowered the relaxed leg to the initial resting position. Now the subjects were then asked to actively extend the knee to the perceived test position, and to hold in this response position for ≥ 5 sec and the goniometric measurement of joint position sense in degrees was obtained. Finally, the foot was re-positioned back to the initial resting position by the subject. Two practice sessions were done with eyes open and closed. The procedure was carried on at three angles of extension 45º, 60º, and, 80º randomly selected by chit method by the subject. 30 seconds of rest was given and the subject was asked to reproduce the perceived position after blinding. Three trials for each angle were done. The differences between the target and estimated angle were noted down, and the relative and absolute error was calculated.
Statistical analysis: For statistical analysis, data was interpreted with the Statistical Package for Social Science (SPSS) version 13.0. The level of significance of < 0.05 was considered to be statistically significant with 95% confidence interval.
Unpaired T-test was used for the comparison of BMI and age, for both the groups (working and non-working).
Mann-Whitney U test was used for the comparisons of the absolute and relative errors between the groups.
The correlations between the variables like BMI, age, menopausal history were evaluated with Pearson?s correlation test.
RESULT
The working and non-working groups comprised of 40 females each had age range of 40-50 years. The mean age and BMI of both the groups are shown in table 1. There was no statistical difference between the groups with respect to age and BMI (p=0.19, 0.68 respectively). To test the primary hypothesis, i.e. comparison between the knee joint position errors of the working and non-working group (table 2) the Mann-Whitney U test was used and there was no statistical significant difference between the groups in terms of the absolute and relative errors. The mean AE of working group was 6.623±5.04° and that of the non-working group was 5.665±4.95°. The mean RE of the working group was 2.84±8.13° and that of the nonworking group was 2.46±7.185°. In addition to the main hypothesis, the correlation of post and pre- menopausal history with the absolute and relative errors of both the groups was analyzed. The results are displayed in the table 3, which shows that there is no significant difference between the menopausal history and the errors in both the groups. The age and the BMI of both the groups were compared with the errors and the following findings were obtained: (table 4).
a) The age and the errors of both the groups combined did not show statistical significance (p= 0.409)
b) The relative errors on right side at 60°,80° and left side at 80° had a weak positive correlation with the BMI with p values 0.031, 0.012 and 0.041 respectively. The absolute and relative errors within the groups were analyzed and the correlations between AE and RE of the right and left side were observed. The AE of right side at 45° and 60° strongly correlated with AE and RE of left We also analyzed the effect of menopause on joint position sense error, which was found to have no correlation; this indicates that in this age range menopause do not affect the joint position sense. Since the effect on musculoskeletal changes for women begins at the age of 51 years, therefore similarities were detected between the post and pre-menopausal groups with respect to joint position sense error. The uniqueness of this study was that AE and RE demonstrated good correlation at 45° and 60° for both right and left knees respectively.
This suggests that in future, the AE and RE terms can be used interchangeably at these angles for the knee joint position sense error. The limitations of the study were non consideration of joint velocity on position sense error, influence of lifestyle (mode of transport) and psychosocial aspects (stress levels). This study also does not involve gender comparison to know which gender would have demonstrated more differences in joint position error with same working nature. Suggestions for further research: Comparison of joint position sense error between working females and males; Use of more precise objective tools e.g. electro-goniometer, to measure position sense errors among same age range and subject type; The same study in small age cohorts with 2 years band from 50 - 51,51 - 52…… to know at what age actual joint position sense declination occurs; Consideration of joint velocity using instruments like isokinetic dynamometerduring position sense detection. Clinical outcomes of the study 40 - 50 years of age may not be the age when early signs of degenerative changes at knee to be detected; AE and RE can be interchangeably used at 45° and 60° for knee extension; Menopausal history may not have relation with the knee joint position sense for women between 40 - 50 years of age.
ACKNOWLEDGEMENTS
Our gratitude to the members of Lion?s club, LIC office, Mangalore for their support rendered for bringing out the study.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=1909http://ijcrr.com/article_html.php?did=19091. Easy Ergonomics-A practical approach for improving the workplace. Salem.www.orosha.org.
2. Healthy Work-Managing stress and fatigue in the workplace.1st ed. Occupational safety and health service, Department of labour, Wellington, New Zealand; 2003.
3. Bayramoglu M, Toprak R, Sozay S. Effects of Osteoarthritis and Fatigue on Proprioception of the Knee Joint. Arch Phys Med Rehabil 2007;88:346-50.
4. Koralewicz LM, Engh GA. Comparison of proprioception in arthritic and age-matched normal knees. J Bone Joint Surg Am 2000;82:1582-8.
5. Felson DT et al. The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis Rheum 2009;61:1070-6.
6. Akseki D, Akkaya G, Erduran M, Pinnar H. Proprioception of the knee joint in patellofemoral pain syndrome. ActaOrthopTraumatolTurc 2008;42:316-21.
7. Lund H et al. Movement detection impairment in patients with knee osteoarthritis compared to healthy controls: A cross- sectional case-control study. J Musculoskelet Neuronal Interact 2008;8:391-400.
8. Wall S. Degenerative joint disease of the knee and hip- Structural yoga therapy research paper (cited 2007 January), Available from suewall@snet.net.
9. Palastanga N, Field D, Soames R. Anatomy and Human movement –structure and function. 4thed .Edinburgh: Elsevier science;2002.p.334-71.
10. Hooper MM, Tending to the musculoskeletal problems of obesity. Cleve clin J med 2006;73:839-45.
11. Jones GT, Harkness EF, Nahit ES, McBeth J, SilMan AJ, Mactarlane GJ. Predicting the onset of knee pain: results from a 2-year prospective study of new workers. Ann Rheum Dis 2007;66:400-6.
12. Vingard E et al. Occupation and osteoarthritis of the hip and knee: A registerbased cohort study. Int J Epidemiol 1991;20:1025-31.
13. Rossignol M, Leclerc A, Hilliquin P. Primary osteoarthritis and occupations: a national level cross sectional survey. Occup Environ Med 2003;60:882-6.
14. Riskowski JL, Mikesky AE, Bahamonde RE, Alvey TV, Burr DB. Proprioception, gait,kinematics, and rate of loading during walking: Are they related? J Musculoskelet Neuronal Interact 2005;5:379-87.
15. Grigg P, Greenspan BJ. Response of primate joint afferent neurons to mechanical stimulation of knee joint. J neurophysiol 1977;40:1-8.
16. Clark FJ, Larwood KJ, Davis ME, Deffenbacher KA. A metric for assessing acuity in positioning joints and limbs. Experimental brain research 1995;107:73-9.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareTHE STUDY OF DORSAL VENOUS ARCH OF HAND IN LIVING ADULT MALES IN UDAIPUR DISTRICT OF RAJASTHAN
English8992Charu TanejaEnglish Mohd.YounusEnglish Deepak S.HowaleEnglishIn this study, the present observation is only a preliminary study of hand veins- that is
formation of Dorsal Venous Arch, Cephalic Vein and Basilic Vein which will be helpful to
reduce complications especially at the Anatomical snuff box. The veins of the hand especially
cephalic vein are selected for introducing canula of intra venous infusion set. This position of
infusion needle with canula helps the patient to have an easy movement of hand. But while
introducing the needle the synovial sheaths of the tendons or radial artery in anatomical snuff
box must not be pricked by needle. We studied 100 local individuals of age group 25-50 years.
Torniquet is placed above the wrist. As every clinician requires a sound knowledge of
variations of veins of hand is felt essential as such an attempt is made to observe the dorsal
venous arch/network in at least 100 individuals to give an opinion.
EnglishLiving Adult male, Torniquet, Dorsal Venous Arch.INTRODUCTION
Mammal?s Human cardiovascular system is highly developed and consists of 3 subsystems namely Arterial, Venous and Lymphatic. Arteries are thick walled tubes carrying oxygenated blood to all parts of the body, while veins and lymphatics are thin walled tubes draining blood from all parts of the body to Kidney, Liver, Lungs and Heart for filteration, analysis, purification & pumping respectively. Veins and lymphatics collect blood which is rich in metabolic endproducts, with Carbondioxide & diverts the blood towards the heart that is into the right atrium. The composition of the blood present in arteries and veins differs, majorly because of the presence of RBC with Carboxy Haemoglobin in veins. The great Flemish Anatomist Andrea? S Vesalius1 who is considered as “Father of Modern Anatomy” argued & clarified with demonstration that “There is a circulatory system with two separate systems that is Arterial & Venous system” during 1540's. English physician William Harvey2 in 1653 was the first scientist to elaborate the work of Andreas Vesalius and expressed that there is “Circulation of blood and that there is anastomosis between Veins & Arteries Separately .The whole circulatory system is connected to heart & lungs”.I am thankful to Principal of Geetanjali Medical College & Hospital and HOD of my Department,Dr.L.K.Jain who helped me a lot in my work.
MATERIALS AND METHODS
Dorsal Venous Arch of 100 individuals were considered for the present study that is 200 hands were observed. All the individuals selected were of labour and farmer category that is those who are hard working. Individuals were all of Low socio-economic level. The age groups considered were between 25-50 years. Other materials required for the study are:- (i) Torniquet (ii) Cotton Towel (iii) Pick pen marker – blue colour (iv) Kodak Digital Camera (Easy share) (v) Soaps (vi) Towels Method: Individuals were asked to wash their hands, with soap provided. Hands were wiped with a cotton towel, provided. Palmar and Dorsal surfaces were observed for any skin infections. Individuals with any change in skin texture were not considered. Torniquet is placed 3 cm proximal or above the anterior distal crease of the wrist. A photograph of each hand with prominant Dorsal Venous Arch was taken with in 2 minute. Immediately the veins were coloured with blue sketch pen and photographs were taken, within 5 minutes, to avoid inconvenience to the individual. Torniquet is removed subsequently from the hand. Same procedure is repeated to the both hands. 10-12 individuals were observed at a time. Photographs were all observed in detail.
Observations:
The Veins of the hand, forearm and cubital fossa are given importances as they are superficial and can be easily blocked at the arm to make them prominent. Especially at forearm and cubital fossa the veins perforate the deep fascia to open into deep veins, a situation which helps to fix the veins. The hand veins i.e. Dorsal venous arch /network are superficial and can be made prominent by putting a tourniquet at the wrist. But these veins cannot be fixed as they are situated in a modified loose areolar fascia, and the vein slips while introducing the needle. The veins of the hand especially cephalic vein are selected for introducing canula of intra venous infusion set. This position of infusion needle with canula helps the patient to have an easy movement of hand. But while introducing the needle the synovial sheaths of the tendons or radial artery in anatomical snuff box must not be pricked by needle. As every clinician requires a sound knowledge of variations of veins of hand is felt essential as such an attempt is made to observe the dorsal venous arch/network in atleast 100 individuals to give an opinion. The following observations were carried out in 100 individuals: 1)Dorsal Venous Arch-FormationNormally-Table-I All the veins are formed at the sides of terminal phalanx and coursed along the lateral side of fingers accompanying digital arteries. Formation: The arch is majorly formed by the union of digital vein of the thumb, digital veins of little finger and 3 metacarpal veins. 2) Dorsal Digital Veins Of Middle 3 Fingers -Table-II: Lengths were measured from middle of middle phalanx till the formation of metacarpal veins at the inter digital cleft. 3) Meta carpal Veins -Table-III: These veins are formed at the interdigital cleft by the fusion of 2 dorsal digital veins of adjacent fingers i.e. index – middle, middle- ring & ring-little fingers. 4) Position Curvature Of Dorsal Venous Arch –Table-IV: The position of the dorsal venous arch varied form individual to individual and in both hands of the same individual. 5) Cephalic vein-Formati.on-Table-V The Normal formation of cephalic vein has been observed to be by the joining of dorsal digital vein of thumb (fused or unfused) joins with the dorsal digital vein of index finger with the lateral end of dorsal venous arch and continues upwards as cephalic vein. 6) Basilic vein-Formation-Table-VI Formation of Basilic vein is observed on both hands of all the individuals Normally this vein is formed by the fifth dorsal digital vein from medial side of little finger joining with the medial end of the dorsal venous arch to form the Basilic vein.s.
DISCUSSION AND CONCLUSION
The present study accepts that veins especially superficial Veins of hand vary from individual to individual & in the same individual on both sides. The following are few concluding opinions and suggestions after observing many patients from different hospitals. All aseptic measures must be implemented. Needles must not be introduced into the veins at the wrist or dorsum of the hand. The tip of the needle should not pierce the synovial sheaths of tendons especially when Cephalic Vein is selected, as such situations may lead to synovitis, with restricted movement of the thumb at a later stage. Injury to periosteum of metacarpals or carpal bones must be avoided as the veins of Dorsal venous arch are difficult to fix. Cannula must not be retained in the vein for more than 24 hrs as far as possible. Endothelial scraping of the vein may lead to cellular reaction & cause pain to patient leading to Phlebitis. Such a site of the endothelium initiates Thrombus formation followed by other complications like Embolus formation.
Englishhttp://ijcrr.com/abstract.php?article_id=1910http://ijcrr.com/article_html.php?did=19101) ANDREA?S VESALIUS1 (1530- 1543) - “A history of veins” The epitome of Andrea?s Vesalius, 1982 Mc Milan Publications,.
2) AKHLOUFI M.BENDADA. A - “Hand and Wrist physiological features for near inflated biometrics” vol: III, 2008 Canadian conference.
3) B.K.TANDON “Essentials of Human Anatomy” 3rd edition year 1995 Pg.No: 105 S.Chand Publications.
4) G.J.ROMANES “Cunninghams Text book of Anatomy” 11th edition year 1972, Page No. 914 Oxford university press,.
5) HENRY GRAYS -“The superficial veins of the upper extremity” Gray?s Anatomy 38th edition, year 2000 Page No. 1589 Elsevier publication.
6) HOLLINSHEAD?S W. HENRY “Veins of the Dorsum of the Hand” Anatomy for surgeons Vol : III, year 1958 Page No.;563,.
7) INDERBIR SINGH -“Atlas of Human Anatomy” 1st Edition year 2004 Pg.No: 115 Jaypee Brothers Medical publishers.
8) INDERBIR SINGH -“Atlas of Human Anatomy” 3rd Edition. year 2006 Pg.No: 126 Jaypee Brothers publications.
9) MASTER NICOLAUS (12th Century A.D.)-“A History of the Arteries and Veins” Lectures on the Anatomy of the brain Ed.Gustav Scherz, in 1960.
10) MOSES MAIMONIDES -“History of Veins”. The medical aphorisms of Moses Maimonides, 2nd Vol. year 1970 Yeshiva University press,.
11) ROOVE V.L TERRAMANI.T “Initial experience with Dorsal Venous arch Arterializations for limb salvage” vascular surgery. Year 2004. Indexed med line publishers.
12) W.J HAMILTON “Text book of Anatomy” 2nd edition year 1953 Pg No: 372 St Martin press Mc Milan Company.
13) W.J HAMILTON, MOSSMAN, J.D. BOYD “Text Book of Human Embryology” 3rd edition year 1962, Pg.No:159,193. Cambridge W.Heffer & Sons Ltd.
14) W.J HAMILTON “Text book of human anatomy”2nd edition year (reprint) 1976, Pg No:274-275. Mc Milan press Tead law.
15) WILLIAM HARVEY2 “Lectures on the whole of anatomy” 2nd edition year 1951 university of California press.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30TechnologyA STUDY ON MAGNETORHEOLOGICAL FLUID (MRF) DAMPER
English93100D.V.A. Rama SastryEnglish K.V.RamanaEnglish N.Mohan RaoEnglishVibration signals indicate machine?s health. In most of the cases, it stipulates the requirement
of bringing down vibration intensity to operational limit. Researchers are focusing over different types of vibration isolators and their optimization in terms of space occupancy,weight, cost and reliability. In this paper, an attempt has been made to introduce the basic concepts of Magnetorheological Fluids (MRF) which can be used as a semiactive vibration isolator, for the beginners and researchers. The scope of MR fluids in future, problems are also presented.
EnglishSemi active vibration isolator, Magnetorheological fluid, Magnetorheological fluid damperINTRODUCTION
Vibrations in a machine are unavoidable due to characterization of kinetic energy. Efforts are to be made at the design stage to reduce the intensity of vibration to extend the life of the machine. Vibration isolation is the procedure by which the undesirable effects of vibration are reduced. The need for vibration isolation is becoming increasingly important for precision structures and sensitive high technology equipment.
Also it is becoming vital to design more reliable devices with a higher bandwidth, smaller size, and lower power requirement. Semi-active control has recently been an area of much interest because of its potential to provide the adaptability of active devices without requiring a significant external power supply for actuators. Semi-active control has been developed as a compromise between passive and active control. Instead of opposing a primary disturbance as is the case with active control, semi-active control scheme applies a secondary force to the system. A semi-active control system cannot provide energy to a system comprising the structure and actuator, but it can achieve favorable results by altering the properties of the system, such as stiffness and damping [1].
The close attention received in this area in recent years can be attributed to the fact that semi-active control devices offer the adaptability of active control devices without requiring the associated large power sources. In addition, as stated earlier, semi-active control devices do not have the potential to destabilize (in the bounded input/bounded output sense) the structural system. Extensive studies have indicated that appropriately implemented semi-active systems perform significantly better than passive devices and have the potential to achieve the majority of the performance of fully active systems, thus allowing for the possibility of effective response reduction during a wide array of dynamic loading conditions [2-5].
Magnetorheological fluids and their characteristics
Recently, a very attractive and effective semi-active system featuring Magnetorheological Fluid (MRF) dampers has been proposed by many investigators [6-8]. Magnetorheological is a branch of Rheology that deals with the flow and deformation of the materials under an applied magnetic field. Magnetorheological (MR) fluids are suspensions of noncolloidal (0.05-10 μm), multi-domain, and magnetically soft particles in organic or aqueous liquids [2]. They are able to change reversibly from free-flowing, linear viscous liquids to semi-solids having controllable yield strength under a magnetic field [9]. Their apparent viscosity changes significantly (105 −106 times) within a few milliseconds, when the magnetic field is applied. The inert-particle forces originating from the magnetic interactions lead to a material with higher apparent viscosity. This dipolar interaction is responsible for the chain like formation of the particles in the direction of the field as shown in Fig. 1[9]. Particles held together by magnetic field and the chains of the particles resist to a certain level of shear stress without breaking, which make them behave like a solid. This phenomenon develops a yield stress which increases as the magnitude of the applied magnetic field increases [10]. One of the advantages of MR fluids is the higher yield stress value. Low voltage power supplies for MR fluids [11] and relative temperature stability between –40°C and +150°C make them more attractive materials for vibration isolation. In MR fluids, materials with lowest coercivity and highest saturation magnetization are preferred, because as soon as the field is taken off, the MR fluid should come to its demagnetized state in milliseconds. Due to its low coercivity and high saturation magnetization, high purity carbonyl iron powder appears to be the main magnetic phase of most practical MR fluid compositions. MR fluids have been prepared based on ferromagnetic materials such as manganese-zinc ferrite and nickel zinc ferrite of an average size of 2 μm. The robustness and the simple mechanical design of Magnetorheological (MR) dampers make them an obvious choice for a semi-active control device. They require minimal power while delivering high forces suitable for fullscale applications. They are fail-safe since, they behave as passive devices in case of a power loss [13]. MR devices can be divided into three groups of operational modes or a combination of the three based on the design of the device [10, 12]. In the valve/shear mode, of the two surfaces that are in contact with the MR fluid, one surface moves relative to the fluid. This relative motion creates a shear stress in the fluid. The shear strength of the fluid may be varied by applying different levels of magnetic field. In the direct shear/flow mode, the fluid is pressurized to flow between two surfaces which are stationary. The flow rate and the pressure of the fluid may be adjusted by varying the magnetic field. In the squeeze film mode, two parallel surfaces squeeze the fluid in between and the motion of the fluid is perpendicular to that of the surfaces. The applied magnetic field determines the force needed to squeeze the fluid and also the speed of the parallel surfaces during the squeezing motion[14]. A magnetic circuit is necessary to induce the changes in the viscosity of the MR fluid. By using Kirchoff?s Law of magnetic circuits, the necessary number of amp-turns (NI) is NI=∑HiLi=Hfg+ Hs L ................ .(1) where Hf and Hs are the magnetic field intensity of the fluid and the steel, respectively, g is the length of the gap where the fluid flows, and L is the total length of the steel path. From equation (1), it is clear that, to increase the total magnetic field intensity, the number of amp-turns have to be kept at a maximum while minimizing the length of the fluid gap and the steel path. However, sufficient cross-section of steel must be maintained such that the magnetic field intensity in the steel is very low. Also, too small a fluid gap would cause the damping force to be too high when no magnetic field is applied. The magnetic circuit typically uses low carbon steel, which has a high magnetic permeability and saturation. This steel effectively directs magnetic flux into the fluid gap.
Properties of commercial MR fluids
Basic composition and density of four commercial MR fluids are given in Table 1 and ranking of fluids on the basis of various material properties are given in Table 2[10]. The MR fluids within the preyield region exhibit viscoelastic properties and these are important in understanding MR suspensions, especially for vibration damping applications.
MR damper
Several different designs of MR dampers have been built and tested in the past. The first of these designs is the bypass damper as shown in Fig.3 (a), where the bypass flow occurs outside the cylinder and an electromagnet applies a magnetic field to the bypass duct [15]. While this design has a clear advantage that the MR fluid is not directly affected by the heat build-up in the electromagnet, the presence of the bypass duct makes it a less compact design. In another design, the electromagnet is inside the cylinder and the MR fluid passes through an annular gap around the electromagnet as shown in Fig. 3(b). This design uses an accumulator to make up for the volume of fluid displaced by the piston rod which is going into the damper[16]. A variant to this is a twin tube MR damper that has two fluid reservoirs, one inside of the other, as shown in Fig. 3(c). In this configuration, the damper has an inner and outer housing. The inner housing guides the piston rod assembly, in exactly the same manner as in a mono tube damper. The volume enclosed by the inner housing is referred to as the inner reservoir. Likewise, the volume that is defined by the space between the inner housing and the outer housing is referred to as the outer reservoir.
The inner reservoir is filled with MR fluid so that no air pockets exist. However, most of these dampers were intended for large-scale applications such as vibration isolation of buildings and bridges. A linear, double-shaft MR damper with the electromagnet placed inside the cylinder is suitable for small-scale applications and is intended for use with parallel platform mechanisms where a damper will adjust the damping in each leg connector of the mechanism.The MR damper utilizes the unique properties of the MR fluid. In this design, the MR fluid flows through the annular gap between the housing and the magnetic body as seen in Fig. 4.
The damper operates in a combination of valve and direct shear modes. A magnetic field is created along this gap through the use of a coil which is wrapped around the magnetic body. When the magnetic field is applied, the viscosity of the magnetorheological fluid increases in a matter of milliseconds. The field causes a resistance to the flow of fluid between the two reservoirs. This way, the damping coefficient of the damper is adjusted by feeding back a conditioned sensor signal to the coil. Double-ended MR dampers have been used for bicycle applications [17] gun recoil applications [18], commercial applications [19-21], and for controlling building sway motion caused by wind gusts and earthquakes [22].
Problems with MR dampers and future scope:
a) Large size MR dampers limit their use in marine applications due to limited space especially in submarines. Design of MR dampers small in size needs to be further researched.
b) Non-linear behavior of MR dampers makes it difficult to devise control strategies to control the vibration. Studies on this are done by Mao et al. [23]. This effect further needs to be researched.
c) Control strategies further need to be researched to control the vibration in varying conditions. Jansen and Dyke [24] had done some studies on this area.
d) Reliability and maintainability should be further investigated to ensure success.
e) Implementation of MR dampers in real structures. Some studies were done on applications of MR damper in automobile industry [25-31], train suspension system [32], seismic protection of buildings [33-35], cablestayed bridges [36].
f) To increase the self-sufficiency of the damping system, investigations into development of a self-powered MR damper should be pursued.
CONCLUSION
The ability to tune the rheological properties of Magnetorheological (MR) fluids has led to vast research opportunities in the field of mechanical vibration control. Such opportunities have directed researchers to explore such topics as semiactive or adaptive vibration control; a very promising and important application in the attenuation of vibrations. Commercial applications are clearly expanding and in future, will probably be driven by equipment manufacturers looking to add value to their products through the introduction of smart fluids. Three areas where significant developments might be expected can be – automotive, civil and aerospace engineering.
ACKNOWLEDGEMENTS
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1911http://ijcrr.com/article_html.php?did=19111. S. J. Dyke, B. F. Spencer, M. K. Sain, and J. D. Carlson: Experimental verification of semi-Active structural control strategies using acceleration feedback, Proc. 3rd International Conference on Motion and Vibration Control, Japan, 1996, Vol. III, pp. 291- 296.
2. Hoogterp, F. B., Saxon, N. L., Schihl, P. J., “Semi-active Suspension for Military Vehicles,”Society of Automotive Engineering International Congress and Exposition, Detroit, Michigan, March, 1993.
3. Karnopp, D., Crosby, M.J., “System for Controlling the Transmission of Energy Between Spaced Members,” US Patent No. 3,807,678, 1974.
4. Karnopp, D., Crosby, M. J., Harwood, R. A., “ Vibration control using semiactive force generator,” Journal of Engineering for Industry, Transactions of the ASME, May 1974, v 96 Ser B, n 2,pp.619-626.
5. Miller, L. R., Nobles, C. M., “The design and development of semi-active suspensions for a military tank,” Society of Automotive Engineering Future Transportation Technology Conference and Exposition, San Francisco, California, August, 1988.
6. Sassi, S., Cherif, K., Mezghani, L., Thomas, M., Kotrane, A.: An innovative magnetorheological damper for automotive suspension: from design to experimental characterization. Smart Mater. Struct. 2005, Vol. 14, pp.811– 822
7. Lam, A.H.-F., Liao, W.-H.: Semi-active control of automotive suspension systems with magneto-rheological dampers. Int. J. Veh. Des. 2003, Vol. 33(1/2/3),pp.50–75.
8. Nguyen, Q.H., Choi, S.B.: Optimal design of MR shock absorber and application to vehicle suspension. Smart Mater. Struct. 18(3), 035012 (2009)
9. Chen K C, Yeh C S, A mixture model for magneto-rheological materials, Continuum Mech Thermodyn, 2002, 15, pp.485−510.
10. M. R. Jolly, J. W. Bender and J. D. Carlson, Properties and Applications of Commercial Magnetorheological Fluids, Journal of Intelligent Material Systems and Structures, 1999, Vol. 10, No. 1, pp. 5-13.
11. Ginder J M, Davis L C, Elie L D. Rheology of magnetorheological fluids: Models and measurements , Proceedings of the fifth International Conference on ER Fluids and MR Suspensions. Sheffield, UK, 1996.
12. R. Bolter and H. Janocha, Design Rules for MR Fluid Actuators in Different Working Modes, in proceedings of the SPIE, Symposium on Smart Structures and Materials, 1997, Vol. 3045, pp.148-159.
13. M.D. Symans and M.C. Constantinou: Experimental testing and analytical modeling of semi-active fluid dampers for seismic protection. Journal of Intelligent Material Systems and Structures, 1997, Vol. 8, No. 8 pp. 644- 657.
14. M. Yalcintas: Magnetorheological fluid based torque transmission clutches, Proc. 9th International Offshore and Polar Engineering Conference, Brest, France, 1999, pp.563-569.
15. H. Sodeyama, K. Sunakoda, H. Fujitani, S. Soda, N. Iwata, and K. Hata: Dynamic tests and simulation of magneto-rheological dampers. Computer-Aided Civil and Infrastructure Engineering, January 2003, vol. 18, No.1, pp. 45-57.
16. R.A. Snyder, G.M. Kamath, and N.M. Wereley: Characterization and analysis of magnetorheological damper behavior under sinusoidal loading. AIAA Journal, 2001, Vol. 39, No.7, pp. 1240-1253.
17. Ahmadian, M.: Design and development of magnetorheological dampers for bicycle suspensions. American Society of Mechanical Engineers, Dynamic Systems & Control Division Publication, DSC, 1999, Vol. 67, pp.737-741
18. Ahmadian. M., J. C. Poynor, J. M. Gooch: Application of magnetorheological dampers for controlling shock loading. American Society of Mechanical Engineers, Dynamic Systems & Control Division Publication, DSC, 1999, Vol.67, pp. 731-735.
19. Carlson D, D. M. Catanzarite and K. A. St. Clair: Commercial magnetorheological fluid devices, Lord Corporation, 2001.
20. Carlson, J. D., W. Matthis, and J. R. Toscano.: Smart prosthetics based on magneto-rheological fluids, Proc. SPIE 8th Annual Symposium on Smart Structures, Newport Beach, CA, March 2001, pp.308-316.
21. Designing with MR fluids, Lord Corporation Engineering note, Thomas Lord Research Center, Cary, NC. 1999.
22. Dyke, S. J., Spencer, B. F. Jr., Sain, M. K., and Carlson, J. D: Seismic response reduction using magnetorheological dampers, Proc. 13th Triennial World Congress, International Federation of Automatic Control, San Francisco, CA, June/July, 1996. Vol. L, pp. 145–150.
23. Mao, M., Choi, Y.-T., and Wereley, N. M: Effective Design Strategy for a Magneto-Rheological Damper Using a Nonlinear Flow Model. Smart Structures and Materials 2005: Damping and Isolation, SPIE, Vol. 5760, pp. 446-455.
24. Laura M. Jansen and Shirley J. Dyke: Semi-Active Control Strategies for MR Dampers: A Comparative Study. ASCE Journal of Engineering Mechanics, 2000, Vol. 126, No. 8, pp. 795–803.
25. Wang E R, Ma X Q, Subhash R, Su C Y: Force tracking control of vehicle vibration with MR-dampers, Proc. 2005 IEEE International Symposium on Intelligent Control, Limassol, 2005.pp.995-1000.
26. Choi S B, Lee B K, Hong S R: Control and response characteristics of a magetorheological fluid damper for passenger vehicle. Journal of Smart Structure and Integrated Systems, 2000, Vol.3 (2), pp.438–443.
27. Lai C Y, Liao W H.: Vibration control of a suspension system via a magnetorheological fluid damper. Journal of Vibration and Control, 2002, Vol. 8(4), pp.527–547.
28. Wang E R, Ma X Q: Semi-active control for vibration attenuation of vehicle suspension with symmetry MR-damper. Journal of Southeast University, 2003, Vol. 19(3), pp.264–269.
29. Hiu F L, Liao W H: Semi-active control of automotive suspension systems with magnetorheological dampers, Hong Kong: The Chinese University of Hong Kong, Shatin, 1999.
30. Lai, C. Y. and Liao, W. H.: Vibration control of a suspension system via a manetorheological fluid damper. Journal of Vibration and Control, 2002, Vol. 8, pp.527–547.
31. Kim C, Ro P I: A sliding mode controller for vehicle active suspension systems with nonlinearities, Journal of Automobile Engineering, 1999, Vol.212, pp.79- 92.
32. Liao W H, Wang D H.: Semi-active vibration control of train suspension systems via magnetorheological dampers. The Chinese University of Hong Kong, 1999.
33. Lin P Y, Roschke P N, Loh C H, Cheng C P.: Hybrid controlled base isolation system with semi-active magnetorheological damper and rolling pendulum system. Taipei: National Center for Research on Earthquake Engineering, 1999.
34. Johnson E A, Ramallo J C, Spencer Jr B F, Sain M K: Intelligent base isolation systems, Proc. Second World Conference on Structural Control, Kyoto, 1999, pp.367-376.
35. Li H N, Chang Z G, Song G B: Studies on structural vibration control with MR dampers using μGA. Proc. 2004 American Control Conference, Massachusetts, 2004, pp.6478-6482
36. Wu W J, Cai C S.: Experimental study of magnetorheological dampers and application to cable vibration control. Journal of Vibration & Control, 2006, Vol.12, pp.67-82
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareHOST RESPONSE MODULATION: A MYTH OR REALITY?
English101107Kriti AgarwalEnglish Jaideep MahendraEnglish Little MahendraEnglish Jananni .MEnglish Rajeshree.REnglishPeriodontitis is a complex microbial disease involving various mechanisms that results in
destruction of connective tissue and bone. Past understanding of etiology and pathogenesis of
periodontal disease focused on the microbial aspect. Based on this the therapeutic efforts were
focused on mechanical or chemotherapeutical removal of bacterial plaque. The plaque biofilm
though considered the prime etiologic factor; it has been just associated with the initiation of
disease. Recent investigations have recognized the crucial role played by host responses involved in the progression & severity of the disease. So therapeutic efforts now is focused on altering (modulating) the host responses. The recent treatment strategy lies in modifying the host responses which will also help in evading the other risk factors like environmental and genetic that can modify the periodontal disease susceptibility. Host Modulation Therapy?s are emerging treatment concept in management of periodontal disease. This review focuses on the present concept of host modulation in comprehensive periodontal management and various chemotherapeutic agents currently applied in Host Modulation Therapy.
EnglishINTRODUCTION
Periodontal diseases, which cause the destruction of the supporting structures of the dentition, are common chronic infectious diseases of the oral cavity. They are initiated by Gram negative toothassociated pathogens organized as a biofilm, whose presence elicits a host inflammatory response. Thus, periodontal treatment through the ages has focussed on the reduction of bacterial infection by mechanical removal of plaque and calculus from tooth surfaces i.e. SRP. However, recent research into the pathogenesis of periodontal diseases has led to an important paradigm shift. It is now recognised that the major component of the soft and hard tissue destruction seen in periodontitis occurs as a result of activation of the host?s immuneinflammatory defence mechanisms in response to the presence of bacterial plaque.1 Host-derived pro-inflammatory mediators and cytokines,togetherwith proteolytic enzymes such as matrixmetalloproteinases (MMPs), play a significantrole in the changes in connectivetissue and bone metabolism thatlead to the breakdown of periodontalligament (PDL) and alveolar boneresorption. Host modulatorytherapy (HMT) can be combinedwith traditional periodontal therapiesthat reduce the bacterial burden (e.g.SRP) and also risk factor modification(e.g. smoking cessation therapy) toconstitute a comprehensive treatmentstrategy for periodontitis. Three most important potential approaches to host modulation include: a) inhibition of matrix metalloproteinases (MMPs) with antiproteinases b) blocking production of proinflammatory cytokines and prostaglandins with anti inflammatory drugs and c)inhibition of active osteoclasts with bone sparing agents.2 To date, thereis one approved, systemic therapy that isprescribed as a host response modifier inthe treatment of periodontal disease andthat is adjunctive subantimicrobial dosedoxycycline (SDD) which downregulates theactivity of MMPs.
MATRIX METALLOPROTEINASES (MMPs)
Acting as the prototypical endotoxin, lipopolysaccharides(LPS), amajor component of the outer membraneof Gramnegative bacteria, initiate the cascadeof events leading to periodontal tissue destruction.3 The MMPs comprise a family of zinc dependentproteolytic enzymes. MMPs areprimarily responsible for degrading theextracellular matrix in a variety ofpathological conditions including rheumatoidarthritis, osteoarthritis, autoimmuneulcerative skin lesions and alsotumour cell invasion and metastasis.4MMPsalso play a key role in periodontitis, andare produced by each of the major celltypes found in human periodontal tissuesincluding fibroblasts, keratinocytes,macrophages, PMNs (neutrophils) andendothelial cells.5 They are implicated in a number ofprocesses in normal bone remodeling, including boneresorption and bone formation. MMPs are usedas a biomarker of periodontalseverity and as a response to therapy.
Inhibition of MMPs
Currently, clinical therapy inhibiting the mediatorsof connective tissue breakdown (eg MMP) is used for the adjunctivetreatment of periodontitis. This is accomplishedthrough the non-antimicrobial activities of low-dosetetracycline and tetracycline analogs via the inhibitionof MMP-8 and -13 protease mechanisms.6The tetracyclineanalog doxycycline hyclate, available for usespecifically in periodontal disease, is the only collagenaseinhibitor approved by the United States Foodand Drug Administration (FDA) for any human disease.7A major concern, however,was that the long-term administrationof doxycycline might be associated withthe development of antibiotic resistance.Indeed, when antibiotic doses of tetracycline(250 mg daily for 2–7 years) hadpreviously been given to patients withrefractory periodontitis, up to 77% ofthe patients? cultivable subgingival microfloraexhibited tetracycline resistance.8 In light of thisconcern, a low, subantimicrobial dose of doxycycline (SDD) preparation wasintroduced, containing 20 mg doxycycline,as opposed to the 50 or 100 mgdose that is available for antibioticpurposes.9 SDD (20 mgtwice daily) administered for just 2weeks inhibited collagenase activity by60–80% in the gingival tissues ofpatients with chronic periodontitis.9 Because the low-dose formulationsof these drugs have lost their antimicrobial activity,the therapeutic action witnessed is primarily due tothe modulation of the host response. This subantimicrobial-dose doxycycline (SDD) approach has becomewidely established as an effective adjunctivesystemic therapy in the management of periodontitis,along with the traditional mechanical therapies ofscaling and root planing (SRP).
In a recent systematic review,the effectiveness of SRP accompanied by MMP inhibition(by SDD), as an adjunctive treatment, showedimproved outcomes that persisted for 9 months inadults with chronic periodontitis as observed in gainsin clinical attachment level (CAL) and probing depth(PD) reduction.2Recentstudies11, 12 demonstrated the abilityof SDD to be used to maintainbonemass while reducing periodontaldiseaseprogression.In another early clinical study13the efficacy and safety of SDD were evaluated in conjunctionwith SRP in subjects with chronic periodontitis.Here, the more severe the periodontitis, the greaterthe observed attenuation of disease activity by SDD therapy. Although there is strong evidenceto suggest that inhibition ofMMPs in patients with periodontaldisease clearly offers potential indisease management when coupledwith mechanical therapy, suchas SRP, there is only preliminary evidence available to suggest the value of MMP inhibitorytherapies for patients with periimplant diseaseor in those conditions requiring surgical management.2,9
It has been shown that SDD (marketed as Periostat) hasno antibacterial activity and does not produce resistantstrains even after months of use. Adverse effects are alsominimal, with a side effect profile similar to placebo.However, like all tetracyclines, there is the potential formultiple drug interactions, particularly with calcium andmagnesium containing preparations. The drug should alsonot be given to patients who are known to be allergic tothe tetracyclines and is to be avoided in pregnancybecause of the risk of tetracycline stain in developingteeth. Currently, SDD is the only drug regimen approvedspecifically for host modulation in the treatment ofperiodontitis. It is not entirely clear how long SDD needsto be used, but the drug can be safely administered for upto 9 months. One protocol for the use of the drug calls for SDD to be prescribed for 3 months at the beginning oftreatment (scaling and root planing) with reevaluation atthe end of the three month trial of the drug. If thepatient has responded well with respect to changes inclinical parameters, the drug can be discontinued. Forthose individuals not responding well to phase 1 therapy,the drug can be continued as additional treatment isrendered.
Bisphosphonates as bone-sparing agents
Bisphosphonate drugs have wellcharacterized modulatoryroles on osteoclast function and bone metabolism.14Notably, at the tissue level, they decreasebone turnover by decreasing bone resorption and byreducing the number of new bone multicellular units.At the cellular level, they decrease osteoclast and osteoblastrecruitment, decrease osteoclast adhesion,and decrease the release of cytokines by macrophages. Based on these properties, severalgenerations of oral bisphosphonate drugs have beensuccessfully developed for the treatment of postmenopausalosteoporosis, osteopenia, and Paget?s diseaseof bone.15Because of these same properties, apossible use for this class of drugs in the managementof periodontal disease was put forth.A few clinical studies have been performed to examinea possible use for bisphosphonates in the managementof periodontal bone loss. In a study15 of 40subjects with chronic periodontitis,a statistically significantdecrease in the proportion of teeth demonstratingbone losswas observed.
ADVERSE EFFECTS WITH BISPHOSPHONATE DOSING
Bisphosphonates are administered by intravenous (IV)infusion (in the case of treatment for metastatic bonecancers) or orally (for the treatment of decreased bonedensity in osteoporosis). Because of a significant rateof non-compliance and the subsequent decrease inclinical efficacy, IV bisphosphonate delivery has beenused extensively for malignant bone diseases, as wellas in breast, prostate, and lung cancer.17However, anumber of publications18,19 documented the retrospectivereports associating IV bisphosphonate delivery andosteonecrosis of the jaws (ONJ).Clinically, ONJis essentially exposed bone in the maxilla or mandiblethat does not healwithin 8 weeksof identification by health careprofessionals (HCPs). Compromised healing was successfully treated withsystemic antibiotics, local microbial mouthrinse, andaggressive defect management via detoxification andamixture of bone graft and tetracycline. 17This suggeststhat dental health care professionals should treat patients undergoinglong-termoral bisphosphonate treatment with caution. Overall, the use of bisphosphonates for the managementof periodontal diseases has limited promise,especially in affecting alveolar bone loss. However,despite their different mode of action, additional studiesare needed to evaluate their potential as alveolarbone–sparing agents.Considerations related tothe duration of use are relevant, given the reportedrisks associated with ONJ related to the long-term useof high-dose bisphosphonates, contrasting the potentialbenefits of the short-term oral use of these drugs.Despite progression in this area of research and a betterunderstanding of the reported risks, a number ofquestions for future consideration of bisphosphonatesin the treatment of periodontal diseases remain, whichshould be addressed.
TREATMENT RECOMMENDATIONS FOR PATIENTS WITH OSTEOPOROSIS RECEIVING BISPHOSPHONATE THERAPY19:
Patients informed of risks
Oral hygiene and dental care emphasized
Not necessary to require dental examination prior to bisphosphonate therapy or alter dental management
For patients on bisphosphonates >3 years:
Periodontal disease treatment nonsurgically or conservative surgical therapy Dental-implant placement with informed consent Endodontic treatment preferable to extraction or periapical surgery For invasive procedures, a drug vacation may be helpful but has not been validated
Non steroidal anti inflammatory drugs
Non steroidal anti inflammatory drugs (NSAIDS) have been traditionally utilized in the treatment of pain and acute and chronic inflammation. The antiinflammatory activity of NSAIDS occurs through the inhibition of prostaglandin synthesis. NSAIDS limit the progression of periodontitis through the ability to reduce inflammation and to decrease bone resorption. Several studies have indicated along with SRP, systemically administered NSAIDS like flurbiprofen, naproxen and meclofenamate sodium decrease the rate of alveolar bone loss.
The potential harmful side effects of chronic NSAID therapy include gastrointestinal upset and bleeding. The use of NSAID in periodontitis is still under investigation.
CONCLUSION
There has been a great deal of basic and clinical researchfocusing on the underlying mechanisms ofthe major enzymatic drivers of the aggressive tissuedestruction found in periodontitis. Major drivers of this damage are MMPs and other osteoclastderivedmediators of bone resorption, all of which actas part of the host inflammatory response. Modificationof this host response via the use ofMMPinhibitors,along with the use of bisphosphonates as blockers ofperiodontal tissue destruction, has shown promise inthe therapeutic treatment of these disease states. Althoughquestions remain regarding optimizing treatmentefficacy while limiting any potential adverseeffects, the evidence clearly suggests a strong potentialfor the modulation of the host response in aidingdisease management, when coupled with traditionalmechanical therapy.20
Future approaches
An emerging concept in the study ofinflammation is the idea that inflammation is activelyterminated following an insult rather than just fading away.Resolution of inflammation appears to be promoted byactive mediators designated resolvins and protectins.These specialized molecules are synthesized at the site ofinflammation and help to terminate inflammation and promote regeneration in several ways, includingpromoting removal of cellular debris and reducingrecruitment of neutrophils. Inhibition of inflammatory cytokines through recombinant human IL- 11 is being investigated. The antiinflammatory actions of omega-3 fatty acids havealso been verified for treatment of rheumatoid arthritis(RA). When used to treat RA, omega-3 fatty acids havebeen shown to reduce pain and inflammation and toreduce the need to take other medications such asNSAIDs.
Englishhttp://ijcrr.com/abstract.php?article_id=1912http://ijcrr.com/article_html.php?did=19121. Offenbacher S: Periodontal diseases pathogenesis. Annals of Periodontology 1996; 1: 821–878.
2. Reddy MS, Geurs NC, Gunsolley JC: Periodontal host modulation with antiproteinase, anti-inflammatory and bone sparing agents. A systematic review. Annals of Periodontology 2003; 1: 12-37.
3. Kinney JS, Ramseier CA, Giannobile WV: Oral fluid based biomarkers of alveolar bone loss in periodontitis.Ann N Y Acad Sci 2007;1098:230-251.
4. Birkedal-Hansen, H: Role of matrix metalloproteinases in human periodontal diseases. Journal of Periodontology 1993;64: 474–484.
5. Preshaw PM, Hefti AF, Jepsen S, Etienne D, Walker C, Bradshaw H:Subantimicrobial dose doxycycline as adjunctive treatment for periodontitis.A review. J Clin Periodontol 2004; 31: 697–707.
6. Ashley RA: Clinical trials of a matrix metalloproteinase inhibitor in human periodontal disease. SDD Clinical Research Team. Ann N Y Acad Sci 1999; 878:335-346.
7. Sorsa T, Tja¨derhane L, Konttinen YT, et al: Matrix metalloproteinases: Contribution to pathogenesis, diagnosis and treatment of periodontal inflammation.Ann Med 2006; 38:306- 321.
8. Kornman KS, Karl EH: The effect of long-term low-dose tetracycline therapy on the subgingival microflora in refractory adult periodontitis. J of Periodontology 1982; 53: 604–610.
9. Golub, LM, Ciancio SG, Ramamurthy NS, Leung M, McNamara TF: Lowdose doxycycline therapy: effect on gingival and crevicular fluid collagenase activity in humans. Journal of Periodontal Research 1990; 25: 321– 330.
10. Golub LM, Lee HM, Ryan ME, et al: Tetracyclines inhibit connective tissue breakdown by multiple nonantimicrobial actions. Adv Dent Res 1998; 12: 12-26.
11. Payne JB, Stoner JA, Nummikoski PV, et al: Subantimicrobial dose doxycycline effects on alveolar boneloss in post-menopausal women. J Clin Periodontol 2007; 34:776-787.
12. Reinhardt RA, Stoner JA, Golub LM, et al: Efficacy of sub-antimicrobial dose doxycycline in post-menopausal women: Clinical outcomes. J Clin Periodontol 2007; 34:768-775.
13. Caton JG, Ciancio SG, Blieden TM, et al: Treatment with subantimicrobial dose doxycycline improves the efficacy of scaling and root planing in patients with adult periodontitis. J Periodontol 2000;71: 521-532.
14. Tenenbaum HC, Shelemay A, Girard B, Zohar R, Fritz PC.: Bisphosphonates and periodontics: Potential applications for regulation of bone mass in the periodontium and other therapeutic/diagnostic uses. J Periodontol 2002;73:813-822.
15. Kamel HK: Update on osteoporosis management in long-term care: Focus on bisphosphonates. J Am Med Dir Assoc 2007;8:434-440.
16. Jeffcoat MK, Reddy MS : Alveolar bone loss and osteoporosis: Evidence for a common mode of therapy using the bisphosphonate alendronate. In: Davidovitch Z, Norton LA, eds. Biological Mechanisms of Tooth Movement and Craniofacial Adaptation,vol. 1. Cambridge, MA: Harvard Society for the Advancement of Orthodontics; 1996:365-373.
17. Wang HL, Weber D, McCauley LK: Effect of long-term oral bisphosphonates on implant wound healing: Literature review and a case report. J Periodontol 2007; 78:584-594.
18. Ficarra G, Beninati F, Rubino I, et al: Osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment. J Clin Periodontol 2005;32: 1123-1128.
19. Khosla S, Burr D, Cauley J, et al: Bisphosphonate associated osteonecrosis of the jaw: Report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2007; 22:1479-1491.
20. Giannobile WV:Host response therapeutics for periodontal disease. J Periodontol 2008; 79:1592-1600.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareBILATERAL ACCESSORY MENTAL FORAMEN- A CASE REPORT
English108110Raju SugavasiEnglish Sujatha.MEnglish Indira Devi.BEnglish Sirisha.BEnglishAccessory mental foramen of the mandible is not a common anatomical variation. Presence of
any such variation during implant placement, regional anesthesia and surgical correction of the
jaw deformities may develop neurovascular complications. In order to avoid complications, the
probability of the existence of an accessory mental foramen should be kept in mind. During
routine osteology demonstration classes we noticed an accessory mental foramen on both sides
of mandible. So particular attention should be paid to the possible occurrence of one or more
accessory mental foramen during surgical procedures involving the mandible. The clinical
implications of such variation are discussed in this paper.
EnglishMandible, mental foramen, anesthesia, accessory mental foramen.INTRODUCTION
The anatomical position of the mental foramen usually lies midway between the upper and lower boarders of the body of the mandible, either below the first pre molar teeth or the second. The mental neurovascular bundle emerges from the mental foramen. The posterior boarder of the foramen is smooth and accommodates the nerve as it emerges posterolaterally[1] . The inferior alveolar nerve divides into mental and incisive branches near the mental foramen. The mental nerve leaves the mandible via the mental foramen whereas the incisive nerve remains within the bone and supplies the anterior teeth. The mental nerve may extend anteriorly for 2–3 mm within the mandible before curving back to the mental foramen, called the anterior loop of the mental nerve. The intra osseous course of the mental nerve is of particular importance in dental implant surgery. The nerve may be damaged if the inter foraminal area of the mandible is invaded during surgery or while harvesting block grafts from the symphysial region. The mental foramen is most usually single in humans, when it is double or multiple the additional foramens are termed as accessory mental foramen.
Case report:
During routine osteology demonstration classes for the undergraduate students, we observed an accessory mental foramen bi laterally in an adult mandible, as shown in figure-01 .The accessory mental foramen is located anterolateral aspect of body of mandible just anteroinferior to the normal mental foramen, between the canine and premolar tooth, mid way between upper and lower borders of body. As measured by the measuring tape it is about 12-14 mm superior to the inferior border.
DISCUSSION
According to previous studies by different authors, the incidence of accessory mental foramen is as follows. Sawyer DR et al (1998)[2] reported the incidence of accessory mental foramen as 2.6% in French, 1.4% in American Whites, 5.7% in American Blacks, 3.3% in Greeks, 1.5% in Russians, 3.0% in Hungarians, 9.7% in Melanesians, and 3.6% in Egyptians. According to Toh H et al (1992) [3] accessory mental foramen is less rare, with a prevalence ranging from 6.7 to 12.5% in Japan in a Japanese population. Absence of mental foramen has also been reported, According to De Freitas et al (1979) [4] mental foramen was absent in 3 cases out of 2870 sides of 1435 dry skulls. Cagirankaya LB et al (2008) [5] reported that accessory mental foramen is rare, with a prevalence ranging from 1.4 to 10 %. According to Naitoh M (2009) [6] theory, the mental foramen is incomplete until the 12th gestational week, when the mental nerve separates into several fasciculi at that site. It has been suggested that separation of the mental nerve earlier than the formation of the mental foramen could be a reason for the formation of the accessory mental foramen. Accessory foramen of the mandible is common. They may transmit auxiliary nerves to the teeth from facial, buccal, transverse cervical cutaneous and other nerves[7] .
CONCLUSION
This article reviews the clinical importance of accessory mental foramen. The Accessory mental foramen and their occurrence are clinically significant in dental anesthetic blocking techniques, surgical correction of jaw deformities and periapical surgeries. Care should be taken to the accessory mental foramen and nerve during dental implant surgery and in any surgical procedure involving the mandibular molar and premolar region, so that the rate of paralysis and hemorrhage in mental region can be reduced. In harvesting the block grafts from symphysial region, the nerve may be damaged, so the intra osseous course of the mental nerve is of particular importance.
ACKNOWLEDGEMENTS
To begin with, I express my deep sense of gratitude to Dr. Kanchana latha professor and HOD of Anatomy, Dr. Uday Kumar and my colleagues for their proper guidance, precious suggestions and priceless encouragements to accomplish my work. I am very much greatful to the research scholars and so many authors whose efforts have helped me to update my knowledge of Anatomy and stirred up my zeal to continue the work. I am immensely indebted to IJCRR (international journal of current research and review) editors and publishers for the opportunity given to me to contribute to the subject of anatomy.
Englishhttp://ijcrr.com/abstract.php?article_id=1913http://ijcrr.com/article_html.php?did=19131. Standring S. Gray?s Anatomy. The Anatomical basis of clinical practice. 40th ed. Edinburg. Elsevier Churchill Livingstone. 2008; 31: p.530.
2. Sawyer DR, Kiely ML, Pyle MA. The frequency of accessory mental foramina in four ethnic groups. Archives of Oral Biology. 1998; 43(5): 417 - 420.
3. Toh H, Kodama J, Yanagisako M, Ohmori T. Anatomical study of the accessory mental foramen and the distribution of its nerve. Okajimas Folia Anat Jpn. 1992; 69: 85 - 87.
4. de Freitas V, Madeira MC, Toledo Filho JL, Chagas CF. Absence of the mental foramen in dry human mandibles. Acta Anat(Basel). 1979; 104(3): 353-355.
5. Cagirankaya LB, Kansu H. An accessory mental foramen. A case report. J Contemp Dent Pract. 2008; 9(1): 98 - 104.
6. Naitoh M, Hiraiwa Y, Aimiya H, Gotoh K, Ariji E. Accessory mental foramen assessment using cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107(2): 289 - 294.
7. Standring S. Grays Anatomy. The Anatomical basis of clinical practice. 40Th ed. Edinburg. Elsevier Churchill Livingstone. 2008; 31: p.532.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareSTUDY OF OBSERVING THE STANDARDS AND SECURITY PRINCIPLES IN DIAGNOSTIC
RADIOLOGICAL CENTERS IN SISTAN AND BALUCHESTAN HOSPITALS, IRAN
English111117Mohammad Javad Keikhai FarzanehEnglish Mojtaba VardianEnglish Mahdi Shirin ShandizEnglish Baharan NamayeshiEnglish Mohammad zareiEnglishBackground and Objective: Due to the fact that outfitting and establishing a radiological
center has many costs and the technologies related to this equipment are continually developing and progressing, taking into consideration and observing the international standards of these centers are necessary and is led to increased efficiency and useful lifetime of the apparatuses and economy in economic costs. This article aims to study the condition of diagnostic radiological parts of Sistan and Baluchestan hospitals and its comparison with the standards determined for these centers through national and international organizations like ICRU1, NCRP2 and ICRP3. Materials and Methods: In this descriptive study, the condition of
physiological atmosphere, the condition of personal protection apparatuses of radiographers
and patients as well as the status of radiography apparatuses has been studies using a threepartite questionnaire. In the next stage, the collected data have been through questionnaire, dosimeter and thermometer compared to the standard amounts and the qualitative and quantitative statuses of the radiographic centers has also been analyzed. Findings: The results achieved in this study indicate that the compatibility mean of the status quo with the international standards is 58 percent. In addition, none of these radiological centers are provided with standard darkroom and sufficient alarming signs and there was no archives regarding personnel protected from radiation in 44 percents of his center. Radiographic rooms have some defects and problems in 50% and lack of radiation leakage in 64%. Conclusion: According to the results achieved and the significant differences between
international standards and the condition of the centers under study, applying the periodic
monitoring and regularly quality control programs are necessary.
EnglishSistan and Baluchestan, Radiography Standards, Radiation Protection, Radiology.INTRODUCTION
Radiography is one of the most significant methods to diagnose many diseases and the effective use of this technology is made possible only through observing the standards. Hence, taking into consideration the current condition in radiographic centers and its comparison with standards such as ICRU, NCRP and ICRP is a key factor to be assured about the appropriate function this apparatuses. On the other hand, the radiographic center is the most expensive one in each medical center and the investment made in this center is more than the one in other centers in such a way that the measures taken for being radiation protection, ionized air conditioning, the purchase and installment of the radiographic apparatuses and also providing the required physical atmosphere to different imaging apparatuses imposed much costs to the medical center, especially that the biological effects of the radiation are emphasized for the radiographers, patients and entourages(1). According to the reports issued, more than 80% of the referents to hospitals have a kind of radiography and the problem in giving services in these centers in one hand caused an inappropriate radiography being presented and the necessity to be repeated, and also it is led to an inappropriate diagnosis and or lack of diagnosis on the other hand which is resulted to the lack of patient?s health being endangered (2). On the other hand, if the protective principles are not observed and inappropriate radiographies are made, the ionizing radiation using in these centers put the personnel and patients health in danger (3). The studies performed in 51 public and private centers in Tehran showed that this center has many problems in terms of the issues related to radiological personnel, 89%, the radiographic room 82%, protective coverings, 77% and radiation leakage 37% (4). On the other hand, quality control of radiological apparatuses is one of the most significant methods to diagnose the current problems in such a way that applying the quality control programs in some centers in Iran is led to the employees and patient?s dose be reduced more than 70 % on average and concurrently the quality of radiographic images are significantly increased (4). Finally existing some problems such as lack of uniformity of X-ray field, the failure of collimator in appropriate adjusting the field of view, lack of conformity between the optical field and Xray field, lack of observing the radiation protection principles, lack of providing film and appropriate drug, lack of using radiation protection especially for children, lack of appropriate filtration of the apparatus and the defect of various parts of emerging and fixing apparatus are led to irreparable damages being made to the personnel and patient?s health (5,6). Therefore, according to the necessity mentioned, this study aims to take into consideration the amount and type of defects in radiological centers of Sistan and Baluchestan?s hospitals and a final result being presented to resolve this problem.
MATERIALS AND METHODS
The criteria being studied in this article have been divided into four groups as follows:
1- The condition of radiographic room and control room in terms of dimensions, light, radiation leakage, Cast conditioning ( height, condition, Cast), the condition of entrance door(position,height, being locked from inside) and warning posters for pregnant women, the danger of exposure (number, type and the place being installed), exposure Red Light, conservative equipments, loudspeaker, the distance of the tube from control room, the size of lead glass, height and position of lead glass to the X-ray room, flooring condition and walls ( safety shield) (2,3,7,14,16,18).
2- The condition of radiographic rooms in terms of the type and duration of the apparatus, the keys to move tube in different directions, the keys to move radiography bench, film sync, the function of grid, the condition of tube elbow and the condition of fluoroscopy (8,9,10,11).
3- The condition of darkroom in terms of entrance door, dimensions, the place and position related to radiographic room, light leakage, inner construction in terms of light reflection, ventilator ( power and anti-light), the lamp of the darkroom (the type of filter, the distance from the film and the power of lamp), film inbox ( light leakage), the preparation of drug, the required lighting, the fixing and emerging apparatus (type and duration), the condition of emerging and fixing pomp, the warmer of emerging and fixing apparatus, the rollers, the store to preserve drugs and no radiating films (light, moisture and ventilation)(12,13,15,17).
4- The condition of dosimeter of radiographic centers in terms of the number of dosimeters, using dosimeters, controlling the beige films, the medical brochures of the personnel employed in the center, periodic experiments, the one who is responsible for the center?s physical health, the applications of lead shields (lead coverings, lead glasses, Thyroid shied shields, Gonad shield, lead glasses, lead gloves) (2,3,7,14,16,18). At the final stage, the information related to the condition of physical atmospheres, the condition of radiographic apparatuses, the personnel information and the equipments for personnel and patient?s protection were collected by referring to the radiological centers. To perform the dosimetery, the one named DIADOS E made in PTW manufacture calibrated for the X-rays with 40 kvp to 150 kvp was used. In addition, a thermometer with measurement range of - 10 to 150 degrees centigrade and ±1 accuracy was used to check the temperature of emerging and fixing medicine. A building meter was also used to measure the dimensions.
Findings
The condition of 9 radiological centers, both educational and non-educational, was examined in this study, the number of studies apparatuses were 21 ones in which 5 apparatuses were useless and out of service. The functional duration of the apparatuses was 1 to 32 years with the mean functional duration of 10 years. The results of this study indicate that the condition of radiographic rooms, compared to the defined standards on average was 50% (figure 1), the condition of radiological apparatuses 77% (figure 2), the condition of control room was 65% (figure 3) and the condition of darkroom was 44% (figure 4) and the dosimeter condition and personnel protection was 52% (figure 5).
In performed studies, it was observed that the condition of side rooms are desirable in 25% compared to defined standards. In addition, the results of applied studies of radiological centers showed that 44% of the concerned centers have more than 20% of radiation leakage. On the other hand, none of the studied centers have the required maintaining equipment and hardware of radiological centers. The results achieved showed that 66% of darkrooms in radiological centers are defected with observable light leakage and there is no lamp system in the darkroom. On the other hand, 55% of the centers under study had not appropriate emergence and fixation temperature in a standard condition which indicates the inappropriate condition of emerging and fixing apparatuses. In addition, 53% of Casts are defected in all hospitals in terms of appropriate efficiency. 77% of the radiological centers have direct fluoroscopic problems and only 33% of the hospitals are provided with thyroid shield, Gonad shield, lead glasses and lead coverings. Concerning the sign alarms, 55% of the hospitals under study were in an appropriate condition in terms of exposure danger lamp, the warning poster of pregnant women and also the poster of exposure danger. The condition of radiological centers regarding controlling the exposure personnel shows that 44% of radiographic centers were bereft of medical brochure and the periodic experiment results of the personnel. Furthermore, 33% of the studied radiological centers did not choose a person responsible for medical physics to supervise and follow the cases related to personnel protection and periodic control.
DISCUSSION
The study of the findings achieved in this study indicates this reality that the radiological centers have not been controlled and supervised in an organized way. On the other hand, the results obtained show that only 33% of the hospitals are provided with thyroid and Gonad shield and lead glasses and coverings, which this amount is unpromising given the fact that these apparatuses are essential for the protection of children and adolescents against the radiation. This study also indicate that quality control of radiological apparatuses are essential for optimizing the radiological centers and also preventing from the economical resources being wasted away.
Englishhttp://ijcrr.com/abstract.php?article_id=1914http://ijcrr.com/article_html.php?did=19141. Douglas J. Simpkin. Evaluation of NCRP No. 49 assumptions on workloads and use factors in diagnostic Radiology Facilities. Medical physics. 1996; 23(4):577-584.
2. Keane BE, Tikhonov KB. Manual of Radiation Protection in Hospitals and General Practice. WHO.1995; 3(2):190- 197.
3. Benjamin R. Archer. History of the shielding of Diagnostic X-ray Facilities. Health physics .1995; 69(5): 750-758.
4. Said dabbaghzadeh,et al. investigating the Security Principles of radiography centers.Hakim journal.2002;5(1):23-30
5. Johan B,Tony P. Chesney's Radiographic Imaging. Black wolf. 1997; 20(3):72-78.
6. Douglas J. simpkin. A General solution to the shielding of medical x and y Rays by the NCRP Report No .49 methods. Health physics. 1987; 52, (4):431-436.
7. B.R.Archer , j.i. Thomby , S.C Bushong. Diagnostic X-ray shielding design Based on and Empirical Model of photon Attenuation. Health physics. 1983; 44(5): 507- 517.
8. E.lynn McGuire .A revised schema for performing diagnostic X-ray shielding calculations. Health physics. 1986; 50(1): 99-105.
9. Douglas j. simpkin. Shielding a Spectrum of Workloads in Diagnostic Radiology. Health physics. 1991; 61(2): 259-261.
10. Douglas J. simpkin. Fitting Parameters for medical diagnostic x-ray transmission data. Health physics. 1988; 54(3): 345- 347.
11. Douglas J.simpkin.Transmission of scatter radiation from computed tomography (CT) scanners determined by a Monte Carlo calculation. Health physics. 1989; 52(2): 211-229.
12. Rehani MM, Arun Kumar LS, Berry M. Quality assurance in diagnostic radiology. lnd 1 Radiol Imag. 1992;4(2): 43-119. 13.
13.Manton DJ, Roebuck EJ, Fordham GL. Building and Extending a Radiology Department. London Royal Society of Medicine Servine. 1988; 41(3): 63-79.
14. Simone P, Radiation Protection in the X-ray Department. Butter worth Heinemann. 1994; 15(2): 53-97.
15. Boothroyd AE, Russell JGB. The lead apron: room for improvement.BJR. 1987; 60(1): 203-207. 16.
16.Moores BM, Stieve FE, Eriskat H, et al. Technical and Physical Parameters for Quality Assurance in Medical Diagnostic Radiology Tolerances, Limiting Values and Appropriate Measuring Methods. London British Institute of Radiology. 1989; 18(2): 45- 56.
17. Douglas j. simpkhn. Shielding Requirements for Mammography. Health physics.1987; 53(3): 267-279.
18. National Council on Radiation Protection.Medical X-ray and Gammaray Protection for Energies up to 10 MeV; Equipment Design and Use. NCRP Report.1968; 33(1): 22-35.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareMORPHOMETRIC AND OSTEOMETRIC STUDY OF MENTAL FORAMEN
English118123Varsha ShenoyEnglish P. SaraswathiEnglish Gunapriya RaghunathEnglish S. VijayalakshmiEnglishObjective: Mental nerve is sensory nerve of lower lip, gingiva and vestibule. Mental nerve
emerges through the mental foramen, a foramen on the antero lateral aspect of body of
mandible. To anesthetise the mental nerve local anesthetic must be injected at the point where it emerges out fr om mental foramen. Hence it was decided to study the mental foramen.
Methods: Sixty human dry mandibles were studied to measure the distance of mental foramen
from symphysis menti, alveolar ridge, base of mandible and posterior border of ramus of
mandible. The shape, direction of mental foramen were recorded. Location of mental foramen
in relation to the lower teeth was also recorded and all the parameters were tabulated and
analysed. Results and Conclusion: According to the present study mental foramen was located
1.3cm below the alveolar ridge, 1.25 cm above the base of mandible, 2.5 cm postero-lateral to
symphysis menti, 6.4 cm anterior to the posterior border of ramus and was most commonly in
line with 2nd lower premolar tooth. The shape was round and direction was postero-superior in
most of the cases.
EnglishMental foramen, mental nerve, alveolar ridge, implant, orthognathic surgery.INTRODUCTION
The mental foramen (MF) is situated on the anterolateral aspect of the body of mandible on either side. The mental nerve and vessels which appear through the MF provide sensory nerve supply and blood supply to the soft tissues of the chin, lower lip and gingiva.1 Since the location of MF differ among various racial and ethnic groups, in the present study it was decided to locate MF in relation to the neighbouring bony landmarks.
MATERIALS AND METHODS
A total of 60 dry human mandibles were studied. Only the mandibles with the teeth or intact alveolar ridge were studied. Mandibles of children and mandibles with reabsorption of the alveolar ridge were excluded from the study.
I. Following parameters were studied using vernier caliper on both sides to locate the MF:
(1) Distance from MF to symphysis menti(SM) - (MF-SM)
(2) Distance from MF to alveolar ridge - (MF-AR)
(3) Distance from MF to inferior border of the mandible - (MF-MB)
(4) Distance from MF to posterior border of ramus of mandible - (MF-PB) (Figure 1).
II. The position of MF was noted in relation to mandibular teeth and was documented as:
a) In line with the 1st premolar (1st PM)
b) Between the 1st and 2nd premolar (1st &2nd PM)
c) In line with second premolar (2nd PM).
d) Between second premolar and 1st molar (2nd PM &1st M) e) In line with 1st molar (1st M).
III. The direction of opening of MF was recorded as: Postero-superior (PS), superior (U), lateral (L), posterior (P) or anterior (A). A comparison of the mean values between sides was performed using the t-test, p-valueEnglishhttp://ijcrr.com/abstract.php?article_id=1915http://ijcrr.com/article_html.php?did=19151. A.K. Datta. Essentials of Human Anatomy Head and neck. 3rd ed. Kolkata: Current books International; 1999.
2. Tabinda Hasan, Mahmood Fauzi, Deeba Hasan Bilateral absence of mental foramen – a rare variation. International Journal of Anatomical Variations 2010; 3: 167-9.
3. Deepa Rani Agarwal, Sandeep B. Gupta. Morphometric Analysis of Mental Foramen in Human Mandibles of South Gujarat. People?s Journal of Scientific Research 2011; 4(1): 15-8.
4. Rajani Singh and A. K. Srivastav Study of Position, Shape, Size and Incidence of Mental Foramen and Accessory Mental Foramen in Indian Adult Human Skulls. Int. J. Morphol 2010; 28:1141- 6.
5. NM Al Jasser and AL Nwoku. Radiographic study of the mental foramen in a selected Saudi population. Dentomaxillofacial Radiology 1998; 27:341-3.
6. Shankland WE 2nd. The position of the mental foramen in Asian Indians. J Oral Implantol 1994; 20:118-23.
7. Mwaniki DL, Hassanali J. The position of mandibular and mental foramina in Kenyan African mandibles. East Afr Med J 1992; 69: 210-3.
8. Wandee Apinhasmit , Supin Chompoopong , Dolly Methathrathip , Roengsak Sansuk, Wannapa Phetphunphiphat. Supraorbital Notch/Foramen, Infraorbital Foramen and Mental Foramen in Thais: Anthropometric Measurements and Surgical Relevance. J Med Assoc Thai 2006; 89: 675-82.
9. Ngeow WC, Yuzawati Y. The location of the mental foramen in a selected Malay Population. J Oral Sci 2003; 45:171-5.
10. S. Rupesh, J. Jasmin Winnier, Sherin Anna John, Tatu Joy, Arun Prasad Rao and Venugopal Reddy. Radiographic Study of the Location of Mental Foramen in a Randomly Selected Asian Indian Population on Digital Panoramic Radiographs. Journal of Medical Sciences 2011; 11: 90-5.
11. Gintaras Juodzbalys, Hom-Lay Wang. Guidelines for the Identification of the Mandibular Vital Structures: Practical Clinical Applications of Anatomy and Radiological Examination Methods. J Oral Maxillofac Res 2010 (Apr-Jun); 1(2).
12. Pogrel MA, Smith R, Ahani R. Innervation of the mandibular incisors by the mental nerve. J Oral Maxillofac Surg 1997; 55: 961-3.
13. Oliveira Junior E M, Araújo A L D, Da Silva C M F, Sousa-Rodrigues C F, Lima F J C. Morphological and morphometric study of the mental foramen on the M-CP-18 jiachenjiang point. Int. J. Morphol 2009; 27: 231-8.
14. Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol 2006; 77: 1933-43.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareSTUDY OF OESTROUS CYCLE AND HISTOMORPHOMETRY OF OVARY IN DMPA AND A
POLYHERBAL DRUG TREATED ADULT FEMALE ALBINO RATS
English124129Girija SivakumarEnglish Kamakshi.K.EnglishThe main aim of the present work is to study the effect of DMPA and a polyherbal on the
estrous cycle and to see the morphometrical changes in the ovary and the serum hormone leves of progesterone and estrogen in adult female albino rats. Animals were divided into four groups groups I as control. Group II,III and IV animals were treated with Injectable contraceptive DMPA at a dose of 0.3mg/kg.body wt./day/animal for one complete estrous cycle (four consecutive days at same interval everyday. Every day the vaginal smear was taken by cotton swab method and stained to see the cyclicity. On the fifth day, Group II animals were
sacrificed. Group III animals were treated with polyherbal drug at a dose of 500mg/kg.body wt./day/animal for next one consecutive cycle and were sacrificed on 9th day. Group IV animals were withdrawn with the injectable contraceptive and from the 5th day to 9th day animals were maintained till day 9 and they were also sacrified on 9th day. Animals of all the
groups were sacrificed by euthenesia method and ovaries were collected after proper perfusion and fixed in 10% formalin for histological and histomorphometric study. Control group of animals showed regular estrous cycle with four stages – proestrous,estrous,metestrous and
diestrous. DMPA treated group of animals showed prolonged diestrous stage. Polyherbal drug
treated group showed a recovery to the normal cyclicity whereas the Group IV animals though
there was a recovery it was very slow and in some animals the stage remained in diestrous stage itself. Ovary showed atretic follicles and more of corpus luteum when compared to control and group III animals showed more of mature and secondary follicles when compared to group IV animals.
Englishoestrous cycle – DMPA – polyherbal drug – histomorphometryINTRODUCTION
The menstrual cycle in women has been disturbed by various stress factors like chemical, physical, hormonal imbalance, emotional, psychological etc., All these disturbances lead to many changes in their reproductive cycle which includes irregular menstrual cycle, ovarian disturbances, etc., Various treatments have been taken by those women to regularize and normalize their disturbance in the reproductive cycle and reproductive organs and many of them end in vain. The main aim of the present work is to study the stress related changes occurring in reproductive cycle and the ovarian changes observed and a trial has been taken to observe the recovery of the animals by a poly-herbal drug formulation. The work has been carried out as trial in animal study using adult female albino rats as the estrous cycle can be compared with the menstrual cycle in human. ( Short,1972)
MATERIALS AND METHODS
Adult female albino rats weighing about 110-120gms were selected for the present study. Animals were procured after the approval of CPCSEA (No.01/002/2000), (No.01/010/2003). Demedroxyprogesteroneacetate (DMPA) which is commercially available in the name of Depo-provera was used as a chemical stress to induce disturbance in the estrous cycle in animals. A polyherbal drug formulation containing Crocus sativus,Cinamonumcamphora,Abromaaugu sta, Vitisquandragularis,Saracaindica was used to observe the recovery of the animal in its reproductive changes. These herbs were believed to have uterotonic effects (Thirugnanam,1994; Shanmugam,1989;Warrier,1994,Sangeetha, Mathur, Prakash,1989;Murugesa mudaliar,1998; KirtikarandBabu,1999) Animals were divided into four groupsof six animals each. Animals were caged in such a way three female and one male in the same cage with a meshed partition. All the animals were monitored for their normal estrous cycle by doing vaginal smear for two consecutive cycles and confirmed with their normal cyclicity. Then the animals were grouped and experimented. Group – I Control; Group – II DMPA treated; Group III – Polyherbal drug treated; Group IV – Withdrawal of DMPA. Group I animals were maintained with the normal feed and water till the end of the experiment. Group II animals were treated with DMPA at a dose of 0.03mg/kg.body wt./day/animal. This is to induce a disturbance in the estrous cycle of the group II animals (Amatayaku,1979). Group III animals were treated with polyherbal drug formulation from the day 5 after they were treated with DMPA same as like group II animals. It was given at a dose of 500mg/kg.body wt./animal. Polyherbal drug was given for the next following estrous cycle. Group IV animals were treated with DMPA same like group II,drug was withdrawn from 5th day and the animals were monitored from day 5 till the end of the experimental period. Tissues were subjected to histological study using routine Haematoxylin and Eosin stain and Histomorphometric study using Ocular and Stage Micrometer. Volume of the follicles, corpus luteum, were studied using reticule (BloomandFawcett,1968). Progesterone and Estradiol Hormonal assay were done using RIA kit (Coat-a-count method) of M/s Diagnostic Products Corporation (DPC), USA (Berquist et.al., 1983).
Methods
Control group of animals were subjected to vaginal smear study at a regular interval of 6 hours every day till the end of the experiment. Group II animals were treated with DMPA intramuscularlyeveryday at a dose of 0.3mg/kg.body wt./day/animal for one complete estrous cycle at regular interval Everett,1996). The first injection was given at 6pm once identifiedwith itsproestrous stage. On the fifth day the same time all the animals were sacrificed. Group III animals were treated with DMPA in the same way simultaneously along with Group II animals and from the fifth day for the next consecutive cycle they were treated with the polyherbal drug formulation orally at a dose of 500mg/kg.body wt./day/animal for four consecutive days. On the 9th day all the animals were sacrificed. Group IV animals were also treated with DMPA same like group II and after the 4th day, the animals were left free to monitor their recovery without any drug administration. On the 9th day group I, III and IV were sacrificed and tissues were collected for the study of all parameters. Animals were sacrificed by euthenesia. First animals were anaesthetized and were then sacrificed using overdose of chloroform. Then the animals were perfused properly using normal and formal saline. Ovaries were removed and fixed in 10% formalin for morphology, histology and histomorphometric studies. Ovaries were stained by routine Haematoxylinand Eosin method (Bancroft,1982). Histomorphometric studies were done on follicular and the luteal size (HirshfieldandMidgley,1978a).
Observations
Observations were made in all the four groups of animals on the following aspects Vaginal cytology, Morphology,Histology,MorphometryandHist omorphometry and progesterone and estradiol assay.
Vaginal cytology: In the control group, the vaginal cytology exihibited all the regular four stages of estrous cycleproestrous,estrous,metestrous and diestrous at regular intervals as per the literature study (Long and Evans,1922). All the stages existed as per the indicated duration. Vaginal smear showed different types of cells at different stages (Mandl,1951)Proestrous stage contains nucleated cells of different sizes and shape. Estrous stage showed cornification and squamatization of cells as a result of which the nucleus were seemed hidden and were not identified. Also the cells existed either single or in cluster of two or three cells. The vaginal liquid appeared clear and watery. In metestrous stage the cells got infiltered with leucocytes due to which the periphery of the cornified cells were bounded by leucocytes. The diestrous stage had only leucocytes and none other cells were identified. This stage is refered to as resting stage where no reproductive activity will take place. The vaginal fluid appears highly viscous and milkfish white inappearance. The duration of each stage had been shown in the tabulated column. In the DMPA treated group, the vaginal smear showed only a prolonged stage of diestrous stage as a result which it contains only leucocytes and none other cells. That indicates the animal remains in the resting stage (BhowmikandMukherjea,1988). In Polyherbal drug treated group, vaginal smear showed the recovery of different stages of estrous cycle that were identified with the control group. Cells of different types like nucleated in proestrousstage,squamatized cells in estrous stage were identified. In the group IV, after the withdrawal of DMPA the vaginal smear showed recovery of the normal cycle but the duration seemed to be longer than the polyherbal drug treated group. All the vaginal observations were shown in the tabulated column and compared by the bar diagram.
Morphology : Group I animals showed small oval ovary where as in group II the ovary became enlarged and irregular shaped structure. Group III and Group IV animals showed a varied size and shape when compare to group II animals.
Histology : In group I animals, the ovary showed follicles of different stages – primary, secondary, mature and graffian follicles (Mandl,andZukerman, 1952). Corpus luteum found to be present more in number in diestrous stage as it a resting stage. In group II animals, almost all the ovary showed more number of corpus luteum than the follicles and the size of the corpus luteum also found to be bigger than the group I animals (Oateberg,1979). In group III and IV animals, there was a considered increase in the number of follicles when compared to group II animals. There was difference in the follicular existence in group III and group IV animals. Histological studies were shown in the photographs.
Histomorphometry:Studies like size of the follicles of different stages, size of the corpus luteum, and volume of the ovarian tissue were tabulated and represented by bar diagrams. Follicular and Luteal diameters were measured and compared by bar chart.
Hormonal study : In the control group of animals, the progesterone estrogen levels fluctuate during different stages of estrous cycle (Nequin,AlvarezandSchwartz,1979). In DMPA treated group, the animals remained in prolonged diestrous stage and the hormonal assay were done at the diestrous stage in all the group of animals (PageandButcher,1982). The hormonal changes were tabulated and represented by graphical diagrams. Group III and IV animals show a recovery to their normal cyclicity and that of the group III is faster and regular in recovery than the group IV animals which are slow in recovery and also some animals remained in diestrous stage itself.
CONCLUSION
Group I animals showed normal estrous cycle with the four stages as per the literature study. Ovaries showed different stages of the growing follicles and the size of the corpus luteum remained as same as per the literature study. Group II animals showed a prolonged diestrous stage where the vaginal cytology smear showed the existence of leucocytes only. Ovary showed extensive number of corpus luteum. Ovarian follicles remained atretic condition and few primary follicles were identified. Group III animals which were treated with polyherbal drug formulation showed a gradual and fast recovery to normalcy with the evidence of the presence of cornified epithelial cells, nucleated cells and leucocytes at specified stages. Ovaries showed the gradual existence of follicles of different stages and the corpus luteum. In group IV, vaginal smear showed the recovery from the prolonged existence of diestrous stage, but in a slow manner and in some animals the recovery were not observed in the experimental period. Ovaries started showing few secondary follicles and one or two mature follicles. From the above study, it was clearly noticed that there was drastic effect of the usage of contraceptive (DMPA) on the estrous cycle and eventually disturbed the normal histology and histomorphometry of ovary. The treatment of the polyherbal drug on the contraceptive treated animals seemed to be very effective in regularizing the estrous cycle and subsequently produced changes in bringing back the normal histology of the ovary and it was proved by the histomorphometric studies. The withdrawal of DMPA also showed some effect in bringing back the normal cycle of the animal but not as effective as group III and also found to be less when compared to normal group. The serum progesterone and estrogen levels also found to be regularized in group III which were remaining in a single concentration in group II. They found to be more or less same in both Group III and IV.
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=1916http://ijcrr.com/article_html.php?did=19161. Allen,E.(1922) The oestrous cycle in the mouse. American Journal of Anatomy 30:297-371
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30HealthcareDETERMINATION OF THE INFLUENCE OF CA AND MG ON NEUTRON WELL LOG RESPONSE WITH MONTE CARLO MCNP SIMULATION
English130138Mojtaba VardianEnglish Mohammad Javad Keikhai FarzanehEnglish Abdolrahman VardianEnglishThis article is a study on simulating the influence of Ca and Mg on the behavior of neutron well
log in various rock types and arrangement of the curves in various rock types and investigating
the physical principle governed on this arrangement and also, determining the correct distance
of detectors from neutron source for preventing of overlapping of the curves and, indicating the
energy dependency of the neutrons in making the well logs curves and the placement of neutron detectors, to each other.
The simulation code of neutral particles by Monte Carlo method (MCNP) can be used for imulating the response of nuclear devices worked based on production and / or detection of
neutral particles. In the present study, a model of thermal neutron probe has been simulated.
The results of this study indicate that for a ratio of near to far detectors counting, there is the
lowest porosity in a dolomite environment and the middle porosity is in calcite environment
and in a sandstone environment, the highest porosity. In other word, by drawing the calibration
curves of all three environments in a chart, the dolomite curve is located in the lowest place and
calcite curve is in the middle and sandstone curve is in the upper place of these two curves.
Physical principles governed on the behavior of calibration curves and also, the arrangement of placement of them in various environment to each other can associate with two components
including, the ability of an environment for moderating neutrons in various energies, the neutrons moderating speed in various environments. Also, the detector should be placed in proper distance from the source, depended on the neutron detected energy, to prevent the curve overlapping. It is the first time to study the simulation of the influence of Ca and Mg in the behavior of neutron well log in a Naturally Fractured Gas-Condensate Reservoir in Khuff Formation (Kangan and Upper Dalan Formation) which is a heterogeneous formation.
EnglishMCNP, neutron well log behavior, Ca and Mg influence, Monte Carlo method.INTRODUCTION
Regarding the costs and present limitations in determining the reservoir characteristics through well test, well log generally is used for determining the reservoir characteristics. In order to study the behavior of well log device, especially nuclear well log in various conditions, the simulation of nuclear well log response in various conditions and different environments is required. Such a simulation is not available widely, because in one hand it requires awareness about information of designing nuclear well log and on the other hand, enough skill for simulating them through nuclear simulation devices like nuclear calculating simulation code, MCNP. In this study, a general thermal compensated neutron well log has been simulated. This neuron well log has been simulated to have behavior like practical well logs and also determine the physical parameters governed on its behavior. Neutrons interact with the materials within and around the well and sensitive detectors count the scattered neutrons. Porous formation may contain water, oil, gas or combination of them. The neutron well log includes a neutron source and neutron detectors that shield against neutron source, then, the respond of the detector is dependent on the formation porosity and its saturation with the oil and gas. Then, determining of the porosity, requires the necessary measurement for determining of the characteristics of materials around the well and presence of the water or oil or gas within formation porosities. These measurements are usually based on the performance of measurement tool in various conditions of the well and also receiving information from another well log tool [1]. Calculation of interacting nuclear particles in relevant matters to nuclear well log is very difficult, since they work in a 3- dementional space and particles penetrate in different depths, and scatter towards the detectors [2]. The result obtained from this study, cause the better understanding of the behavior of neutron well log in various conditions of formation and well, and determine some considerable points in designing and making of a neutron well log. The neutron well log tool in this study has been simulated by calculating code of neutral particles of Mont-Carlo (MCNP) has published by Los Alamos laboratory. The history of the particles for solving equations of transferring particles has been simulated in a statistically space. Energy and the place of beginning of the neutrons movement from the source until the end of particle life time, for each particle, statistically is chosen from probability distribution function (PDF) to penetrating in to the formation and returning to detector [3].
MATERIALS AND METHODS A well log curve is a graph against depth, supplies parameters and measured physical quantities in a well and derived parameters from them in from of curve. The simulated thermal neutron well log tool includes 2 Helium thermal neutron detectors and a 16 curie neutron source Am-Be. The distance between center of each detector and source and also their volumes are among important parameters of designing. A block of Boron Carbide is located between near and far detectors to not count the neutrons moved from the near detector and passed out of that by far detector. Also, a block of water and Boron Carbide is located between neutron source and near detector to prevent reaching the emitted neutrons from source to near detector. The set of the detectors, source and attractive blocks is located in an aluminum chamber and all of them are located in an iron cover [4]. Hydrogen has the most effect in neutron well log because when neutrons interact to Hydrogen nucleus, due to co-weighted with neutron, loses the most amount of energy, and have high collision cross section, too. In well log, when a neutron source, bombard the formation around the well with high-energy neutrons and high counting rate, a neutron cloud mass in circular from surrounds the source that radius of this neutron cloud changes with changing of the type of formation and existing hydrogen in formation. By increasing hydrogen in formation, more neutrons moderate and thus the detectors count reduce [5] Neutron population especially thermal neutron population reduces by increasing distance from source. Usually counting in a neutron detector inversely is associated with the hydrogen amount of the formation. When the hydrogen content of the formation is high, more neutrons moderated and thus attract in formation, and when the hydrogen content of the formation is low, less neutrons attract to formation and thus, in relation to previous state, more neutrons reach to the detectors. The near detector count is more than the far detector count, and as result, near detector is better than far detector in statistical error. Instead, neutrons reached to near detector have more sensation to present elements in formation and for that reason, the far detector?s behavior is more independent to present elements in formation than near detector [6]. Because, the elements constituting the formation are light elements and thermal neutrons detect, the most effective neutrons interaction with formation is respectively, elastic scattering and neutron absorption. The action of losing neutron energy is called neutron moderation and an element that caused losing energy is called moderator [7]. With regard to that the calibration curve of the well log tool is done in the type of calcite in various amount of porosity, after moving a well log in to a well, measuring the near and far detector count and obtaining their ratio and placing them in the calibration curve, the amount of porosity that results is related to the porosity into calcite. Now, if the formation around the well is other than calcite, for obtaining the porosity in that environment there needs to have matrix correction curve, to be able to do the necessary correction on obtained porosity, and obtain porosity in new environment [8]. Matrix correction curve, is resulted from the ratio of counting in near detector to far detector, when the type of the simulated environment and its porosity changes. Now, to examine the physical principle governed on these curves, there should be referred to the near and far detectors counting in each case. Physical principle governed on the detectors counting can be classified in to two classes: A. The neutrons moderating ability of various energies in various environments. B. The neutrons moderating speed of various environments in various energies. RESULT AND DISCUSSION Because neutrons are neutral in electrical charge, then neutrons are not influenced by electron within atom and positive charge of atoms nucleus. Thus, neutrons pass from cloud of atom?s electron and directly interact to atoms nucleus. The quantity explained the rate of neutron interaction to nucleus, is called interaction cross section. Interaction of neutron to materials nucleus is in different forms, each of them have especial interaction cross section. Another parameter used widely in nuclear engineering equations is macroscopic interaction cross section and show with symbol . Macroscopic interaction cross section also can define for all kind of neutrons interaction like microscopic scattering interaction cross section ( s N s ). Fig. 1, shows the matrix correction curve of porosity in neutron well log simulated by calculating code of MCNP4C.
Now, to determining the physical principle governed on these curves, there should be referred to the far and near detectors counting in each cases. From the counting of the simulated detectors in neutron well logs by simulating code of MCNP4C, there is observed that the near detector counting in sandstone is more than in dolomite and in dolomite is more than in calcite. Counting far detectors in each 3 cases is also similar to the near detector. Now, by examining the principal governed on these detectors counting, the physics governed on matrix correction curves will be reach. The physical principles governed on the detectors counting can be classified in to two classes: A. The neutrons moderating ability of various energies in various environments. B. The neutrons moderating speed of various environments in various energies.
A. The neutron moderating ability of various energies in various environments: One of the important parameters in moderating neutron in an environment is interaction cross sections of neutron in various energies with constituting elements of that environment. With regard to simulating results of MCNP4C about near and far detectors counting in various rock types that, the near and far detectors counting in sandstone are more than dolomite and in dolomite is more than calcite. Then, it is expected that moderating power in calcite is more than dolomite and in dolomite is more than sandstone. Because of the light elements constitute calcite, dolomite and sandstone environment and also the thermal neutron is detected, then the most important neutron interaction includes elastic scattering interaction and absorption. With the principals governed on neutron interaction cross section in interaction with molecules, the elastic scattering collision cross section is calculated and set in table 1 for several energies. According to table 1, elastic scattering cross section in dolomite is more than calcite and in calcite is more than sandstone which is the inverse of detectors count. Thus, this result indicates that the elastic scattering interaction can?t be determinant of behavior neutron well log curves alone. In the other hand, neutron absorption cross section in low neutron energies is more important than elastic scattering cross section, and also neutron absorption cross section affect on both moderating process and neutron counting, so the neutron absorption cross section should be compared in various environment especially in low energies. With regard to chemical formulation of calcite (CaCO3) and dolomite (CaMg(CO3)2), and also the way of producing dolomite, occurred by replacement of Mg with Ca, the difference of calcite and dolomite is in presence of Mg in dolomite instead of Ca in calcite.
Thus, according to molecule neutron cross section law, the difference between calcite absorption cross section and dolomite absorption cross section in different energies can be determined with difference in Ca absorption cross section and Mg absorption cross section. According to fig. 2, the neutron absorption cross section of Ca, is more than neutron absorption cross section of Mg, and this lead to that in various energies, the neutron absorption cross section of calcite is more than neutron absorption cross section of dolomite.
So according to above, the valuable result is that in high energy neutrons, the scattering cross section in dolomite is more than calcite and in calcite is more than sandstone, and in low energies, absorption cross section in calcite is more than dolomite and in dolomite is more than sandstone. Therefore, the power of moderating in low energies in calcite is more than dolomite and in dolomite is more than sandstone, and in high energies, also the moderating power of dolomite is more than calcite and in calcite is more than sandstone. These are the main secret of neutron well log behavior. The very important obtained result from the above is that by changing the detection neutron energy, the matrix correction curves arrangement will change. Now, this subject is confirmed by simulating code of MCNP4C. In high detected neutron energy (fast and moderate energy), the detector counting in dolomite is less calcite and in calcite is less than in sandstone, because in this energy span elastic scattering interaction is more effective than absorption interaction, that it is admitted with above explanations (fig. 3). In low detected neutron energy (epithermal and thermal energy), detector counting in calcite is less than in dolomite and in dolomite less than sandstone (fig. 4).
A very important point exists in making neutron well logs is determination the precise place of the detectors (especially near detector) from neutron source. The reason of this is overlapping between obtained curves from neutron well log in certain distance between neutron source and the detector. One the very important results from simulating neutron well log by MCNP4C code is determining overlapping distance in neutron well log. In fact, in overlapping distance, the curves arrangement displaced. This point is also important that by reducing neutrons energy, the overlapping distance increases. B .The neutron moderating speed of various environments in various energies: Since that simulating results of neutron well log through MCNP4C code in calcite, dolomite and sandstone environment are very near to each other so, examining the effective phenomena in detectors counting is also difficult. Now, for more precise consideration, the dependency of the detector distance from the source to energy spans is stated. Since, the near detector is in the distance of about 40 cm from neutron source, so it is logical that the number of the thermal neutrons in approximate distance of 35-45cm is effective in the detector counting. It is also true about epithermal neutrons, so that the number of present epithermal neutrons in 30-40cm is effective in thermal neutrons detector counting. In the case of neutrons with moderate energy, this distance is about 15- 35cm. In the case of the fast neutrons this distance is about 5-30cm .So called distances in these energy spans, are called effective distance which influence on thermals neutrons detectors counting. Moderating speed is also, one of the effective parameters in the near and far detectors counting. Increasing the hydrogen content of each environment cause to increase the moderating speed, and thus neutrons absorb from less distance to their source. In this stage, because of examining the physical principle on the matrix correction curve, the hydrogen content of calcite, dolomite and sandstone has been considered equal and only the rock type changes. Here, moderating speed has been appeared so that, in each environment that attracting of neutrons is done faster, or from less distance to source, that environment has higher moderating speed. Now, the moderating speed of each environment is examined by MCNP4C. The MCNP4C result show that in high (fast and moderate) detected neutron energies, the moderating speed in calcite is more than in dolomite and in dolomite is more than sandstone (fig. 5, fig. 6).
There is concluded that in high energy span, the moderating speed in calcite is more than dolomite and in dolomite is more than sandstone but the moderating power in dolomite is more than calcite and in calcite is more than sandstone. One important result from this point is that if the neutron probe work according to detection of the neutron with energy near to source neutron energy, the probe curves change in some situation and the probe will be useless. The MCNP4C result show that in low (epithermal and thermal) detected neutron energies, the moderating speed in calcite is more than in dolomite and in dolomite is more than sandstone (fig. 7, fig. 8).
When the source energy is in energy span of 100Kev-2Mev, the results of simulating relative to counting the neutrons with moderate energy, epithermal and thermal in effective distances from the source in each energy span is also like to previous figs. in the same section, that due to being repeated, it is avoided of mentioning them. The cause of the curves is also similar to the previous states in the same section. when the source energy is in moderate energy span (1ev-100kev), the related results to counting neutrons with epithermal and thermal energy in effective distances from the source in each energy span and when the source energy is in epithermal energy span (0.1ev-1ev), the related results to counting thermal neutrons in effective distance from the source is examined in this energy span, It is proved that the results of these energy spans are also similar to previous states in the same section. The cause of the curves is also similar to the previous states in the same section. An important result from explanation in parts A and B can be concluded that the behavior of neutron well log in various environments is dependent on detected neutrons energy and the distance of the detectors from the source. Another very important point obtained in this section from the simulating by MCNP4C code for designing neutron well log, is the effect of neutron source energy and the effect of detected neutrons energy and distance dependency of the detector from the source, to energy of the detected neutrons and source neutrons, that have considerable effect on behavior of each curve alone, and on the curves behavior to each other. Both of explained factors in parts A and B about the near and far detectors counting are effective in neutron well log. Both of mentioned factors are adaptive to neutron counting in near and far detectors. Both cases of A and B that is simulated in this study, is simulated for the conditions that the matrix type is fixed and the formation porosity and as a result the fluid content of formation changes, to examine the behavior of neutron well log calibration curve which is the first and the most principal curve in neutron well log. That simulation results were like the obtained results in this study which due to being repeated, it is avoided of mentioning it.
Englishhttp://ijcrr.com/abstract.php?article_id=1917http://ijcrr.com/article_html.php?did=19171. M. Duijvestijn, A. Hogenbirk, A. Koning, ”Sensitivity to Nuclear Data in Oil-Well Logging Application,” Journal of Nuclear Sience and Technology (August 2002) 1384-1387
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3. F. Brimeister, “MCNP-A General Monte Carlo N Particle Transport Code version 4C,” Los Alanos National laboratory
4. H. Scott, P. Wraight, J.Thornaton, J.Olesen, R.Hertzog, Mc. D. Keon, Das. T. Gupta, I. Albertin, ”Response of a Multidetector Pulsed Neutron Porosity Tool,” Transaction of the SPWLA 35th Annual Logging Symposium, Tulsa, Okiahoma, USA, June 19-22,1994, paper J
5. I. V. Serov, T. M. John, J. E. Hoogenboom, ”a New Effective Monte Carlo Midway Coupling Method in MCNP Applied to a Well Logging Problem,” ELSEVIER-Applied Radaition and Isotopes, Vol.49, No.12 (1998), 1737-1744
6. A. Mendoza, W. Preeg, C. Torresverdin:”Monte Carlo Modeling of Nuclear Measurements in Vertical and Horizontal Wells in the Presence of Mud-Filtrate Invasion and Salt Mixing” SPWLA 46th Annual Logging Symposium, New Orleans, Louisiana, USA, June 26-29,2005
7. A. Drabina, T. Zorski, U. Wo Ynicka, ”Correlation between Measurements and Monte-Carlo Calculations for the NNTE Logging-Tool,” The Henryk Niewodnicza?ski Institute of Nuclear Physics, Report No 1926/AP, 2003
8. D. D. Hua, R. J. Donahue, C. M. Celata, E. Greenspan, “Monte Carlo Simulation of Neutron Well-Logging in Granite and Sand to Detect Water and Trichloroethane (TCA),” Ernesst Orlando Lawrence Berkeley National Laboratory (LBNL-40866), January 1998
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524145EnglishN-0001November30TechnologyIMPLEMENTATION OF KANBAN SYSTEM TO IMPROVE THE PRODUCTION EFFICIENCY IN SMALL
SCALE INDUSTRIES
English139147Chethan Kumar C SEnglish N V R NaiduEnglishMany industries in India, including the garment industries, believe in holding huge amount of inventories [1]. Many of the garment manufacturers are practicing the „push? system of production [2]. This results in high stocking in the stores, large work-in process and large volumes of finished goods in the warehouse. Consequently, substantial amount of capital is tied up, resulting in perennial financial pressures. [4]. According to Taiichi Ohno, the person credited with developing Just-in-time concept (JIT), Kanban is one means through which JIT is achieved[10]. Kanban is not an inventory control system. Rather, it is a scheduling system that pin points what to produce, when to produce it, and how much to produce[7]. The flow of parts throughout the product line is controlled by Kanban Cards as proposed by [5]. Kanban system is known to tackle and solve the situation of inventory control too. [6]. The international market expects quality and responsive services from India. Most of the Garment Industries in India are in the small and medium sector. Apparel manufacturers are forced to deliver high quality garments at low costs in order to survive in the competitive world [9]. Hence an attempt was made to introduce and implement the Kanban system at Messrs Sun Garment Industry (located near Bangalore) where this assignment was taken up. This research work was carried out with the objective of designing the Kanban method for controlling the production and material flow in the above industry.
EnglishPush system, Kanban, Waste, garment industries, Production, Inventory.INTRODUCTION
Kanban in Japanese means signal or card. Kanban authorizes the upstream process to produce only when there is a requirement for production, and is an effective system to eliminate losses occurring due to overproduction. According to Kimura and Terade [70], Kanban uses cards or other visual signals to trigger the flow of materials from one part of the production process to the next. By utilizing a Kanban system, smaller lot sizes and huge inventory reductions can be achieved. This enables to keep inventories of raw material, subassemblies and finished product to a minimum and to adopt lean manufacturing principles to eliminate inventory as a source of waste. Typically there are two main kinds of Kanban:
1. Production Kanban . 2. Withdrawal Kanban
Aim and Objective
To reduce the work-in process at all stages of the fabric flow through the implementation of Kanban and the design of Kanban cards for production and withdrawal process. (A typical example of the mass production of „Formal Shirts? in the factory was chosen for this exercise).
Analysis of the existing system
The fabric rolls move from the stores department and undergo various operations as indicated in Figure 1.1
Data Collection
Product: Formal Shirt.
Lot size (Customer order): 2000 shirts.
From 1 fabric roll (dimensions 20 x 1.5 meters), 10 shirts are produced 200 fabric rolls are required for 2000 shirts.
Weight of each Fabric Roll: 3 Kg
Each of the departments shown in Fig.5.6 needs 5 days to complete the respective individual step of the production for 2000 shirts.
Each department completes its operations for 2000 shirts and then sends the material to the next department.
In the existing practice, the company (which follows the „push? system) purchases raw material (fabrics) as per the customer requirement meant for 2000 shirts i.e., 200 fabric rolls and holds it in the stores. Then, the cutting department collects all the 200 fabric rolls for cutting the main body of the fabric as well as all the other components of the shirt such as the collar, pocket, left panel, right panel, back panel, cuff, button strip and sleeves. It takes nearly 5 days to cut all the components for 2000 shirts. These cut portions are then given to the product line. Here, each component is processed for further operations and it takes 5 days to complete. Next, assembly department collects all the components and the assembly is completed in 5 days. Finally, the completed shirts are sent for inspection. Inspection department takes on the job of inspecting all the 2000 shirts for possible defects. Inspection takes another 5 days, and then the shirts are sent to the pressing and packaging department for final packing and dispatching. Pressing and packaging too consume around 5 days. As per the above work plan, it takes nearly 25days to complete production and dispatch 2000 shirts.This method of push system mandates holding of huge amount of work-in process at every stage of the material flow. The inventory piled up at every stage is indicated in the Figure.1.2
From the stores, 600 Kg of fabric (200 Rolls) is sent to the cutting department. After cutting the fabric, 500 Kg of material is sent to product line and the left over pieces (100 Kg) are scrapped.In the assembly, the inventory becomes 510 Kg (after adding other bought out components) and moves thereafter. The work-in process at every department is indicated in Table.1.1
The existing work-in process and the material flow were discussed in detail with the managers and supervisors of the garment industry. It was suggested to implement the pull system (in lieu of the push system) by designing new Kanban cards. The number of Kanban cards required was calculated using the formula of the Toyota production system (TPS), with necessary modifications needed for the garment industry.
Implementation of Kanban system
Product: Formal Shirt.
Lot size (Customer order): 2000 shirts.
From 1 fabric roll of dimensions 20 x 1.5 meters, 10 shirts are produced
200 fabric rolls are required for 2000 shirts.
Weight of each Fabric Roll: 3 Kg
Number of Kanbans suggested: 2 per day (1 each for the morning session and the afternoon session)
Number of shirts covered by each
Kanban calculation
As proposed by Toyota Production System [110], the number of Kanban can be calculated by using the following formula
Data collection for Kanban cards
The following data was accumulated based on the in-puts from the manager and the supervisors based on the lead time, customer delivery schedule and their past experience:
It is clear that the proposed system of pull production will have to make use of 10 Kanban cards to fulfill the customer requirement. Hence, five withdrawals and five production order Kanban were designed.
The proposed flow of the fabric using production order kanban and withdrawal kanban is indicated in figure 1.3. Figures.1.4 to 1.8 refers to Production order Kanban (POK) and Figures. 1.9 to 1.13 refer to withdrawal Kanban (WK).The colour of the kanban indicates that it belongs to specific department.
Production Process as per the New System Using the above Kanbans, pull production system was employed instead of the push production system. Fig.1.3 shows the Kanban flow. The stores department now negotiates with the supplier and sets the revised schedule to deliver 40 fabric rolls per day. After getting an order of 2000 shirts, withdrawal kanban- 1 is prepared by packaging department and is given to inspection department. Withdrawal Kanban (WK) is prepared for 200shirts per session i.e., 400 shirts per day. Inspection department organizes withdrawal kanban-2 for 200 shirts per session which is then passed on to the assembly department. Similarly, assembly department will send withdrawal kanban-3 for each component of shirt which is then transferred to the product line. Product line department sends withdrawal Kanban-4 to the cutting department. Finally cutting department will prepare withdrawal Kanban- 5 to stores. Stores section supplies the raw materials as mentioned in withdrawal Kanban- 5 to the cutting department. Cutting department will prepare production order Kanban (POK) to cut shirt components of quantity as mentioned in withdrawal Kanban-4 requested by the product line. All the shirt components will be sent to the product line along with the withdrawal Kanban-4 for verification. The product line will further process the components and will pass them on to assembly line along with withdrawal Kanban-3. Similarly, assembly department will assemble 200 shirts per session and sent them to inspection department along with withdrawal Kanban-2. Inspection department will inspect shirts and will forward the lot to the packaging department for pressing and packaging. 400 shirts will be prepared per day. There is no work in process inventory at any stage of production process. 2000 shirts will be prepared in 5 days.
After implementing the Kanban system in the entire flow of fabric - from stores to packaging - substantial amount of work-in process was saved, as indicated in Table.1.2.The comparison of the existing system without Kanban and the one after implementing Kanban is shown in Table.1.3. The reduction in work-in process is evident.
CONCLUSIONS
Feeling the need for an immediate action plan to reduce the enormous inventory in the medium size Garment Factory (Sun Garments), an extensive study was carried out to collect all the data pertaining to the existing mode of operation. This leads to the conclusion that there was an immediate need to introduce an effective system in lieu of the „push? system being adopted. Accordingly, a Kanban „pull? system was conceived and implemented across various stages of the garment flow. This resulted spontaneously in reduced inventory, minimum damage to the materials and higher clarity in the material flow. More than 450 Kg of inventory of fabric has been reduced at every section. This has resulted in enormous saving in inventory carrying cost. In addition, production is wellstream lined and the morale of the employees has been boosted up. Gross and net profits of the company are bound to escalate as a direct result of the appreciably reduced inventory costs. Such an effective implementation of Kanban is not confined to the medium size garment industry. Other industries in general, and all the garment industries in particular (ranging from tiny size to very large scale) will do well to go in for this valuable tool that is fast, inexpensive and potent.
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=1918http://ijcrr.com/article_html.php?did=19181. Chandra, P.,(2004) “Competitiveness of Indian Textiles & Garment Industry: Some Perspectives,” A presentation at Indian Institute of Management, Ahmadabad.
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