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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30TechnologyA STUDY ON NUCLEAR ENERGY: SUSTAINABLE SOLUTION FOR ENSURING ENERGY SECURITY OR
EMERGING FUTURE THREAT
English0614Dewan Mowdudur RahmanEnglish Riasad AminEnglish Navid Bin SakhawatEnglish Md. Zubaer ChowdhuryEnglishSustainability is characterized by the environmental friendly process best fitted for eco-systems and the capacity to maintain a process smoothly indefinitely. Maintaining sustainability in every aspect is the key for continuing human race in the long run. Recent energy insecurity problem and global climate change has led the concerned to take a fresh look at the benefits and risks of nuclear power for better future and find out a sustainable solution. Risk from fatal accident and radioactive waste management for a long period of time surely diminish the benefits of nuclear power, such as no green house gas emission and significant amount of power supply with minimum infrastructural development. As nuclear power is all about balancing the benefit and the risk, therefore this paper summarizes the benefit and risk causing from nuclear power to find out a sustainable choice for future energy demand.
EnglishNuclear energy, climate change effects, radioactivity, energy demand, sustainable development.1. INTRODUCTION
Modern age is passing an energy deficient time and the coming days will definitely be starved for energy. About 1.4 billion people (20% of the global population) do not have access to electricity and 2.7 billion people (40% of global population) rely on traditional biomass for basic energy needs such as cooking and heating [1]. Increasing global energy demand combined with the need to minimize Green House Gas (GHG) emission will require the diversification of energy sources, while still ensuring that the bottom 2 billion people- those who live on less than USD 2.5 per day have access to modern energy services. Achieving the goal set in April, 2010 by the UN Advisory Group on Energy and Climate Change (AGECC) for universal access to modern energy by 2030 [2] is a daunting prospect, given the intertwined challenges to tackle natural resources security, energy insecurity and climate change impact. At present, nuclear power appears to be the best choice for many nations. However, integrating nuclear power into a country‘s energy infrastructure is not without challenges. It has a great prospect of supplying sufficient amount of energy with creating less impact to the environment but in the long run there still remains a doubt about its sustainability.
2. Sustainable Development Human beings are said to be at the centre of concerns for sustainable development. We are entitled to a healthy and productive life in harmony with nature. States are seen as having the right, within the principles of international law, to exploit our own resources and the responsibility to ensure that any activities within our jurisdiction do not cause damage to the environment or other States. In addition, the right to development must be fulfilled so as to equitably meet the developmental and environmental needs of present and future generations. Eradication of poverty is seen as a required element of sustainable development. Climate change is a pressing threat to the sustainability of life on earth [3]. It is a highly complex problem that is unpredictable, reflecting an intricate interaction of organizational production processes, government management and regulation, natural forces, and individual behaviour [4]. It is generally held that sustainable development requires attention to the following things:
Food availability and protection.
Water availability in adequate quantities.
Disease prevention and medical treatment.
Steady and abundant supply of energy specifically, electricity.
Sewage treatment. Infrastructure development such as schools, factories and transportation.
3. Global Climate Change Effects In recent years, dramatic environmental changes have caused extraordinary climate changes around the globe. This has made countries all over the world to focus on greenhouse effect issue and consider it seriously [5]. It is an important problem that can‘t be ignored because the greenhouse effect causes global warming [6, 7]. In the past century, research and literature has concluded that carbon dioxide (CO2) concentration increased by 28% following the industrial revolution [8]. The global average temperature has increased by 0.3?C to 0.6?C, and the sea level rose 10 to 15 cm in the past 100 years. If greenhouse gas (GHG) emissions continue to increase at the present rate, it is predicted that the average global temperature will increase by about 1?C by the year 2025 and by 3?C at the end of the century [9]. The increase of atmospheric GHG concentration results to a large extent from human activities [10, 11]. Scientists predict if no effective protection policies for the environment are put into place, the global temperature will increase by 1?C to 3.5?C, and the sea level will increase by 15 to 95 cm. This will make many countries uninhabitable by 2100 [12]. The second assessment report of Inter governmental Panel on Climate Change (IPCC) stated that the CO2 concentration in the atmosphere rose from 280 to 358 ppm in 1994 [13]. The World Meteorology Organization (WMO) also pointed out in greenhouse gas annual report in 2007 that the CO2 concentration had already raised to 383 ppm [14]. CO2 is the main GHG emitted from various sources and power sector is solely responsible for 30% emission of CO2 throughout the world [15].
4. Nuclear Energy: An Emerging Source The star, of which our sun is one, relies on nuclear fusion for their output of heat, light and other radiations. If one believes in the Big Bang Theory, then the Earth may be considered as a fragment of the Sun. Fusion reaction is exactly what is happening on the Sun. Energy from fission reaction is derived from a nuclear reaction involving uranium or plutonium as the fuel which originally comes from the fragment of the Sun. Nuclear reactors are either the slow thermal kind using moderators or the fast breeder type using purer fuels and able to generate or ?breed‘ new fuel form which is useful in the context of renewability. It is projected that world primary energy demand will increase by 45 percent between 2006 and 2030, an average annual rate of growth of 1.6 percent slower than the average growth of 1.9 percent per year from 1980 to 2006 [16]. The International Atomic Energy Agency (IAEA), the most authoritative international source of information on nuclear energy, predicted in August 2009 that global nuclear power capacity would be doubled by 2030, from the current 372 gigawats electric (GWe) to 807 GWe. Today, about thirty countries are harnessing nuclear energy in about 440 commercial reactors. Table I. shows the list of countries with their respective nuclear programme.
5. Problems With Nuclear Energy The disadvantages of nuclear energy include: the storage and management of dangerous high level radioactive waste, the possibility of proliferation of nuclear materials and potential terrorist applications, the high cost of building nuclear facilities and the possibility of accidents. Common people awareness is another issue that may also regard as a bar for nuclear energy programme. These disadvantages are listed below with respective description.
5.1 Radioactive Waste High-level radioactive waste is very dangerous. It lasts for tens of thousands of years before decaying to safe levels. It is highly radioactive and is a major barrier for the expansion of nuclear power. More than fifty years of commercial nuclear energy use has left the world with a legacy of tens of thousands of tons of highly radioactive waste that will last for tens of thousands of years [18]. On average, uranium ore contains only 0.1% uranium. Most nuclear reactors require one specific form of uranium, uranium-235 (U-235). This form represents only 0.7% of natural uranium. To increase the concentration of U-235, the uranium extracted from ore goes through an enrichment process, resulting in a small quantity of usable ?enriched‘ uranium and huge volumes of waste. If nuclear power production expands substantially in the coming decades, the amount of waste requiring safe and secure disposal will also significantly increase. High-level nuclear waste can last for thousands of years before being safe again, so this is a major hurdle which must be overcome before nuclear power can expand. Radioactivity can be turned out fatal for human body. Table II. shows major problems caused by radioactivity.
5.2 Proliferation Some forms of nuclear reactor, known as "breeder" reactors produce plutonium, which can, conceivably, be used to make nuclear weapons. This is a conventional explosive mixed with radioactive material with the intention of spreading the material across a wide area to do even more damage. As modern world politics is circling to grab more power and get share of energy of any rival country, therefore any nuclear power generating project could be turned into nuclear weaponry production project at any time.
5.3 Fuel Supply Nuclear fuels are, physically, even rarer than fossil fuels. Fossil fuels at least are made on Earth, albeit over millions of years. Heavy elements like Uranium are only made as stars die, in supernovas. Our solar system actually formed from the remains of another star, at which point heavier elements were made. Essentially, once they're gone, they are well and truly gone. Only in particle accelerators can heavier elements be made. Therefore the type of fuel required for nuclear power programme is not abundant at all.
5.4 Changing Perception of Common People Common people always posses a doubtful mind regarding nuclear energy. They feel free considering its capability to deliver huge power but become fearful when they consider its adverse effects. Table III. and IV. are showing the drastic change of the perception of common people and the reflection of doubtful mind setup about nuclear energy programme.
This changing mind setup of common people create dilemma among decision makers to take any major decision about launching nuclear power programme.
5.5 Accidents Happened So Far Nuclear power generating programme have been caused for some fatal accidents so far. To judge the severity of those accidents International Nuclear Events Scale (INES) has been introduced starting from 0 to 7. Table V. lists these accidents with respective INES scale and International Atomic Energy Agency (IAEA) description.
6. Nuclear Energy: Sustainable Solution or Future Threat Nuclear energy is clean and has a potential to guarantee the world to serve with an everlasting supply of fuel without affecting resources sorely needed for other applications. However, so far little has possibly been known about the damages associated with nuclear power generation. The valuation of damages is further complicated because they are likely to occur only after several decades. Therefore it is difficult to estimate the benefit of nuclear energy avoiding its risk. Nuclear power generation is seemingly profitable. However when real costs are taken into account, nuclear is often more expensive than fossil fuels. For instance, nuclear energy takes a long time to produce. The process of permitting, environmental impact studies and the length of time from planning to design and construction of the nuclear infrastructure typically last no less than several decades. Plus nuclear waste is still considered to be more controversial than fossil fuel emission, often requiring large underground storage facility. Despite these obvious hurdles, perhaps the most important challenge for this industry is about the risk of fatal accident and spreading radiation. Because casualty and fearful damage from such accident is not that so easy to handle by sending emergency rescue team and providing immediate shelter or medicine, the brutal effects of this type of damage pass from one generation to another through radioactivity and can be caused of an everlasting suffering for human race.
7. CONCLUSION
The authors of this paper evaluated one of the key debatable issues influencing the achievement of energy security both at present and in the foreseeable future. The facts have raised from neutral point of view considering their future impacts. The present trend of switching source of energy from classic fossil fuel to nuclear energy for countries is seemingly attractive for the long run of sustainability due to its reduction in global warming, climate change, and improvement in energy security. But energy security is such a issue that must be addressed considering an energy policy include: security of supply, environmental impact, national competitiveness and social concerns. Nuclear energy definitely has its potential to meet worldwide increasing energy demand but when security and safety issue comes into account then it becomes a tough situation to take it as a potential alternative of energy. Therefore it can not be said that nuclear energy is the only alternative and utmost solution for future. Continuous research and development programmes should carried out on this regard to make it best fitted for future and alternative options should put under microscope to find their feasibility for meeting the energy demand in a sustainable way.
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=1939http://ijcrr.com/article_html.php?did=19391. International Energy Agency, World Energy Outlook 2010. Available: http://www.worldenergyoutlook.org
2. The UN Secretary General‘s Advisory Group on Energy and Climate Change (AGECC), Summary report and recommendations 2010, New York. Available: www.unido.org/fleadmin/ user_media/Publications/download/AG ECCsummaryreport.pdf
3. R. Watson, M.C. Boudreau and A.J. Chen, ?Information Systems and Environmentally Sustainable Development: Energy Informatics and New Directions for the IS Community,? Management Information Systems Quarterly, Vol. 34, No. 1, 2010, pp. 23-38.
4. H. Hasan and C. Dwyer, ?Was the Copenhagen Summit Doomed from the Start? Some Insights from Green IS research,? Americas Conference on Information Systems 2010 Proceeding, Lima, 2010, p. 67.
5. H.J.D. Boeck, C.M.H. M. Lemmens, B. Gielen, H. Bossuyt, S. Malchair, M. Carnol, R. Merckx, R. Ceulemans and I. Nijs, ?Combined Effects of Climate Warming and Plant Diversity Loss on above and below Ground Grassland Productivity,? Environmental and Experimental Botany, Vol. 60, No. 1, 2007, pp. 95-104. doi:10.1016/j.envexpbot.2006.07.001
6. V.A. Frolkis, I.L. Karol and A.A. Kiselev, ?Global Warming Potential, Global Warming Commitment and Other Indexes as Characteristics of the Effects of Greenhouse Gases on Earth‘s Climate,? Ecological Indicators. Vol. 2, No. 1-2, 2002, pp. 109-121. doi:10.1016/S1470- 160X(02)00047-X
7. A. Smith, ?Global Warming Damage and the Benefits of Mitigation,? Fuel and Energy Abstracts. Vol. 37, No. 3, 1996, p. 221. doi:10.1016/0140- 6701(96)89126-0
8. Beier, B.A. Emmett, J. Peñuelas, I.K. Schmidt, A. Tietema, M. Estiarte, P. Gundersen, L. Llorens, T. RiisNielsen, A. Sowerby and A. Gorissen, ?Carbon and Nitrogen Cycles in European Ecosystems Respond Differently to Global Warming,? Science of the Total Environment, Vol. 407, No. 1, 2008, pp. 692-697. doi:10.1016/j.scitotenv.2008.10.001
9. Intergovernmental Panel on Climate Change (IPCC), ?Climate Change 2007: Synthesis Report Summary for Policymakers,? The 8th Session of Working Group II of the IPCC, Brussels, April 2007, pp. 2-3.
10. T. Beer, T. Grant, D. Williams and H. Watson, ?Fuel cycle Greenhouse Gas Emissions from alternative Fuels in Australian Heavy Vehicles,? Atmospheric Environment, Vol. 36, No. 4, 2002, pp. 753-763. doi:10.1016/S1352-2310(01)00514-3
11. H. Hayami and M. Nakamura, ?Greenhouse Gas Emissions in Canada and Japan: Sector-Specific Estimates and Managerial and Economic Implications,? Journal of Environmental Management. Vol. 85, No. 2, 2007, pp. 371-392. doi:10.1016/j.jenvman.2006.10.002
12. F. Georgios and C. Paul, ?Global Warming and Carbon Dioxide through Sciences,? Environment International, Vol. 35, No. 2, 2009, pp. 390-401. doi:10.1016/j.envint.2008.07.007
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14. World Meteorological Organization (WMO), ?WMO Greenhouse Gas Bulletin 2007: Atmospheric Carbon Dioxide Levels Reach New Highs,? Geneva, 2007.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30General SciencesISOLATION, OPTIMIZATION AND PRODUCTION OF PROTEASE FROM ASPERGILLUS SPECIES
THROUGH SOLID STATE FERMENTATION
English1518M. SaraswathiEnglish R. DakshayaniEnglish P. MuralikrishnaEnglishThe production of enzymes by bioprocesses is a good value added to agro industry residues. A comprehensive study was carried out on the production of protease using different agricultural wastes like paddy straw, sugarcane bagasse, peanut hull and rice bran by Aspergillus species. Among the all tested the maximum enzyme production was observed in paddy straw, while minimum protease production noticed in rice bran under solid state fermentation conditions. The optimal conditions for producing maximum yield of protease were incubated at 350C, 4 days, pH 6.The protease production from waste treatment could be commercially used in detergents and leather industry.
EnglishINTRODUCTION
Enzymes are delicate protein molecules necessary for life. Protease is the single class of enzymes which occupy pivotal position due to their wide applications in detergents, pharmaceuticals, photography, leather, food and agricultural industries and representing worldwide sale at about 60% of total enzyme market (Paranthaman et al., 2009; Rajmalwar and Dabholkar, 2009; Das and Prasad, 2010). Proteases of fungal origin have an advantage over bacterial protease as mycelium can be easily removed by filtration. Proteases produced by Aspergillus sp. is of greater importance due to its higher protease producing ability (Chakraborty et al., 1995; Nehra et al., 2002). Solid state fermentation (SSF) has many advantages including superior volumetric downstream processing, lower energy requirement and low wastewater output (Malathi and Chakraborty, 1990; Pandy et al., 1999). The present study was undertaken to produce protease under laboratory conditions by solid state fermentation of Aspergillus sp. using paddy straw, sugarcane bagasse, peanut hull and rice bran as substrate and to determine the effect of pH, temperature and incubation period on protease production.
MATERIALS AND METHODS Isolation of Aspergillus sp: For isolation of Aspergillus, rhizosphere soil samples were collected from paddy fields of Cherlopalli, near Tirupati area of Andhra Pradesh. The collected samples were subjected to serial dilution method by using potato dextrose agar medium. Then the isolate was screened for their proteolytic activity by using Skimmed Milk Agar (SMA) medium and maintained on PDA slants for further use.
Production of protease though solid state fermentation: Inoculum preparation: Three ml of 0.1% Tween 80 was added to release the spores and this spore suspension was used as inoculums for fermentation.
Substrate preparation and inoculation: Four substrates i.e., paddy straw, sugarcane bagasse, peanut hull and rice bran were used for protease production. 5 g of each substrate was taken into two separate was taken in separate 250 ml conical flasks and salt solution was added to maintain 70% moisture. Then the flasks were sterilized at 1210C for 15 min. The above flasks were inoculated with 1 ml of inoculum and incubated at room temperature for 5 days.
Extraction of crude enzyme: Seventy five ml of double distilled water was added to the conical flasks and kept on rotary shaker for about half hour to obtain uniform suspension. The suspension was filtered through Whatman No: 1 filter paper and the filtrate were collected separately and used as an enzyme extract.
Assay for neutral protease: To 200 µl of crude enzyme extract, 500 µl of 1% casein and 300 µl of 0.2 mol/l phosphate buffer (pH 7.0) were added. The reaction mixture was incubated at 600C for 10 min and arrested by the addition of 1 ml of 10 % Trichloroacetic acid (TCA). The reaction mixture was centrifuged at 8000 x g for 15 min and to the supernatant, 5 ml of 0.4 ml Na2CO3, 1 ml of 3 fold diluted Folin Ciocalteau‘s phenol reagent was added. The resulting solution was incubated at room temperature for 30 min and the absorbance of the blue colour developed was read at 660 nm using a tyrosine standard. One unit of enzyme activity was defined as the amount of enzyme that liberated 1 µg of tyrosine from substrate (casein) per minute under assay conditions and reported in terms of protease activity per gram dry fermented substrate.
Effect of pH: Different levels of pH i.e., 4.0, 5.0, 6.0 and 7.0 were evaluated for protease production of four substrates by using Aspergillus sp.
Effect of temperature: The inoculated substrates were incubated at different temperatures viz., 20, 30, 40, and 50 to find the effect of temperature on protease production. Effect of Incubation period: The effect of incubation period on protease production was determined by incubating the production medium for different incubation periods viz., 3, 4, 5 and 6 days, respectively.
RESULTS AND DISCUSSION The process parameters for the production of protease by Aspergillus sp. grown on different substrates (paddy straw, sugarcane bagasse, peanut hull and rice bran) was done under optimized condition (Sudto et al., 2008; Gitishree Das and Prasad., 2010; Vishalakshi et al., 2009). In the present study the maximum enzyme production was observed in paddy straw, while minimum protease production noticed in rice bran. As shown in Table 1, pH showed effect on protease production because microbial strains depends on extracellular pH which strongly influences the many enzymatic processes and transport of various components across the cell membrane which in turn support the cell growth and product production (Paranthaman et al., 2009).
The optimum pH for growth was recorded at pH 6 in all substrates. A notable decline in the enzyme productivity occurred at both high and lower pH values. Similar results were also reported by several works (Paranthaman et al., 2009; Teufel and Gotz., 1993; Vishalakshi et al., 2009). Temperature also showed maximum variation in the protease production (Tab 2).
The maximum activity was found at 300C in all the substrates. Results in the table 3 indicate that maximum enzyme production was observed at 5 days of incubation period in all the substrates (Rajmalwar, S. and Dabholkar, P.S., 2009). A gradual decrease in enzyme units was observed with increasing incubation period clearly suggests that enzymes role as a primary metabolite.
being produced in the log phase of the growth of the fungus for utilization of proteins present in the solid substrates (Sudto et al., 2008; Gitishree Das and Prasad., 2010; Vishalakshi et al., 2009). The subsequent decrease in the enzyme production could be probably due to inactivation of the enzyme by other constituent protease.
CONCLUSION
The pH, temperature and incubation periods showed much effect on production of protease by Aspergillus species.
Englishhttp://ijcrr.com/abstract.php?article_id=1940http://ijcrr.com/article_html.php?did=19401. Chakraborty, R. and Malathi, S.1990. Production of alkaline protease by a new Aspergillus flavus isolate under solid state fermentation conditions for use as a depilation agent. Appld. and Env. Micro.: 712-716
2. Ellaiah, P., Srinivasulu, K., Adinarayana, K. 2002. A review on microbial proteases. J.Sci. Ind.Res: 61:690-704.
3. Gitishree Das and Prasad, M.P. 2010. Isolation, purification and mass production of protease enzyme from Bacillus subtilis. Int. Res. J. Mic. Vol. 1(2): 26-31.
4. Lowry, O. H, Rosebrough, N.J., Farr, A.L. and Randall, R.J. 1951. Protein measurement with folin phenol reagent. J.Biol.Chem.193:265-275.
5. Nehra, K.S, Dhillon, S., Kamala, C. and Randir, S. 2002. Production of alkaline protease by Aspergillus sp. under submerged and solid substrate fermentation. Indian Microbiol. 42: 43-47.
6. Pandey, A., Selvakumar, P., Soccol, C.R. and Nigam, P. (1999). Solid state fermentation for the production of industrial enzymes. Curr. Sci 77: 149-162.
7. Paranthaman, R., Alagusundaram, K., and Indhumathi, J. 2009. Production of protease from rice mill wastes by Aspergillus niger in solid state fermentation. W.J.Agri.Res. 5 (3): 308- 312.
8. Rajmalwar,S. and Dabholkar, P.S. 2009. Production of protease by Aspergillus sp. using solid state fermentation. Afr. J.Biotech. Vol. 8 (17): 4197-4198.
9. Sudto, A., punyathiti, Y. and pongslip, N. 2008. The use of agricultural wastes as substrates for cell growth and carboxymethyl cellulose (CMCASE) production by Bacillus subtilis, Escherichia coli and Rhizobium sp. KMITL Sci. Tech. J. Vol.8 No.2:84-90.
10. Teufel, P. and Gotz, F.1993. Characterization of an extracellular metalloprotease with elastage activity from Staphylococcus epidermidis. J.Bacteriol. 175: 4218-4224.
11. Vishalakshi, N., Lingappa, K., Amena, S., Prabhakar, M. and Dayanand, A. 2009. Production of alkaline protease from Streptomyces gulbergensis and its application in removal of blood strains. Ind.J.Boitech. Vol 8: 280-285.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30General SciencesCROPPING AND LAND USE PATTERN IN HIMACHAL PRADESH: CASE OF DISTRICT SOLAN
English1925Kumar SanjayEnglish Barik KaustauvEnglish Prashar DeepakEnglishThe present research paper deals with the issues like land use and cropping pattern of district Solan of Himachal Pradesh. Change in these two factors determined the pace of agricultural diversification. The process of diversification of agriculture reduces the risk of perishment of crops and provides economical benefits to farm. Hence, it may prove helpful in alleviating rural poverty. To know about the changes in area under various crops, percentage method was used as a statistical tool. The result obtained in this study indicates that area under pulses shows decreased behavior pattern whereas in case of vegetables significantly increase was resulted.
EnglishAgriculture, Cropping pattern, Land use, Crops, Food grainsINTRODUCTION
The agriculture plays a vital role in shaping the Indian economy. In recent years though its contribution to the Gross Domestic Product is progressively declining approximately from 50% in 1950-51 to 14.6% in 2009-10 however a substantial proportion (64%) of population depends on this sector. Scarcity of cultivated land hampers the agricultural sector compare to secondary and tertiary sectors (industrial and service sector). Land use pattern has a great impact on the agricultural economy. The process of diversification within agriculture has now switched on to high value crops instead of low value crops which causes change in land utilization in agriculture. Change in cropping pattern is an essential part and common mode of diversification, which has great impacts on agricultural development and alleviation of rural poverty [1]. The rapid increase in human and livestock population has resulted in a change in cropping pattern and intensity of land use [2]. In this situation where the scope of bringing more land under cultivation is very limited, appropriate choice of cropping pattern can prove to be helpful in raising income from their limited land holdings. To generate and sustain the farm income for a long period it becomes necessary to use land optimally. This also affects the productivity of soil in a least hampered manner. Among the hill states prevailing in India, Himachal Pradesh is observed to be the most progressive state, which has made remarkable achievement in socio-economic development of its people [3]. Himachal Pradesh offers a model of hill farming in India [4]. The agro climatic conditions of the state ranging from sub tropical to humid temperature and cold deserts. Traditional field crop based farming is also done by majority of farmer for sustaining their rural economy. The growing interest of the farmers to run farming from business purpose has also encouraged them to reconstitute the cropping pattern and related activities. Consequently, there is wide difference in the system of cultivation, cropping pattern and cropping season between different regions and districts. A study conducted [5] resulted that food grains such as wheat, maize and paddy play a dominant role and occupy around 85 % of total area under food grains in Himachal Pradesh. Many researchers have carried out and utilize these cropping patterns along with diversification in different forms and in different geographical areas [6-10]. The present paper aims at the analysis of cropping pattern and land utilization in the Solan district of Himachal Pradesh .This district was specifically and purposively selected due to its increasing emergence as the most prominent and successful diversified agrarian pocket of the state. The farmers of the area have shown their increased interest towards the adoption of new crop enterprises. This district has total geographical area of around 1936 sq. km. and constitutes 3.49 % of the total area of the state. Following two objectives were selected as a criterion for the present research work.
To study the change in the use of land resources in the district Solan.
To examine the variations in cropping pattern of the district
METHODOLOGY
The present investigation is based on the secondary data. The data on different land use categories and cropping pattern of Solan were drawn from various published and reliable sources such as Annual Season and crop reports, Statistical Outlines of Himachal Pradesh etc. from 1993-94 to 2007-08. Annual Season and crop reports presented the data from 1993-94 onwards which is used as a platform for our present study. Simple tabular analysis and percentage method are used to fulfill the objectives of the study. The calculation of % area under land category, % area under crop and % change in area under crop was carried out utilising the formulas in equation 1, 2 and 3.
RESULTS AND DISCUSSION
Land Utilization Pattern in District Solan The percentage of different land categories to total geographical area was computed to evaluate the status of different categories of the land and net sown area in district Solan of Himachal Pradesh. This procedure was carried out for three different years i.e. 1993-94, 2000-01 and 2007-08 to examine the deviations over the different years. Area and percentage for each land category were given in Table 1.
The data indicated that the total geographical area of district Solan has increased from 180553 hectare during 1993-94 to 180923 hectare. This was due to increase in forest area of 370 hectare under forest land settlement of Tehsil Kandaghat of district Solan. Out of the total geographical area nearly 11 percent (20290 hectare) is covered by the forests. The net area available for cultivation was decreased from 22.35 % in 1993-94 to 20.62 % for the year 2007-08. Current fallow was increased from 2.40 % in 1993-94 to 2.62 % during 2007-08. There was decrease in cultivated area merely 668 hectare from the period 1993-94 to 2000-01. But there was significant decrease of 1970 hectare in the cultivated area from 2000-01 to 2007-08. This change is due to rapid urbanization and industrialization in the district. Solan district has recorded the highest population growth during the period 1991-2001.
Its total and urban population showed decadal growth of 30.64 percent and 92.84 percent, respectively. The main reasons for high growth in urban population were ideal location of Solan town in terms of accessibility to various facilities, moderate climate and nearest to state capital Shimla. Large number of industrial units has emerged at the industrial areas of Nalagarh, Barotiwala, Parwanoo and electronic complex at Chambaghat. Permanent pastures area was declined from 44.15 % in 1993-94 to 42.71% in the year 2007-08. Land available for non-agriculture uses was increased from 5.83 % in 1993-94 to 6.74 % in 2007-08. It is also clear from the table that over the time span forest, culturable waste, other fallow including barren land expressed increase in area whereas, reverse phenomenon was observed in case of land put under miscellaneous tree crops and groove . Area under Different Crops Cereals such as maize and wheat are the main cultivated crops. Even though, all the important crops are grown in the area, yet most of the demand of the cereals is meeting out from outside supplies. Among the income generating commercial crops like tomato, peas, capsicum and potato are important. Area and percentage area under different crops is given in Table 2. Study of area under various crops as a percentage of total cropped area indicated that percentage area under total cereals exhibits marginal increase from 83.04 in 1993-94 to 83.98 in 2007-08. Although the percentage change in area under total cereals looks insignificant but, actually there is significant decline of 2274 hectares between 1993-94 and 2007-08.
The percentage area under wheat and paddy expanded from 36.69 to 39.21 and 5.35 to 6.82, respectively during the period of 1993-94 and 2007-08. Area under maize creeps down from 38.32% to 35.49% while, barley and other cereals registered marginal decline. Among pulses, area under gram, black gram, peas and horse gram over the period (1997-98 to2007-08) had declined. Percentage area under total pulses decreased from 6.75 in 1993-94 to 3.90 in 2007-08.
The total cropped area under total food grains decreased from 60321 hectares in 1997-98 to 55986 hectares in 2007-08. Area under vegetables grew from 3.06 % in 1997-98 to 5.78 % in 2007-08. Tomato is most important crop under which area increased more than double from 1306 hectares in1997-98 to 2625 hectares in 2007-08. There is also minor increase in the percentage area under fruits and condiments and spices for the same period. The deviation of area under pulses during the period is compensated by the expansion of area under these crops as shown in Table 2. But, percentage area under oilseeds decreased from 2.63 to 1.73 during the study period. There is slight decline in percentage area under fodder crops and other crops during the present study period. This is mainly due to the expansion in the area under vegetables in the district Solan. The data of the year 2000-01 shows similarities and slight deviation as compare to 2007-08 and the continuation of this is carried till 2007-08 hence it is not used for comparison. The total cropped area registered decline of 3455 hectares between 1993-94 and 2007- 08. Percentage area under net sown area decreased from 60.08 to 58.57. Although there is an increase in percentage area sown twice in a year from 39.91 to 41.42 during the study period.
Trends in Area under Different crops The trend of increase or decrease in area under different crops is given in Table 3. It is revealed that during present investigation period, area under food grains has contracted. In 2000-01 there was decline in area under food grains by 7.15% in comparison to1993-94 and during the period 2000-01 to 2007-08 there was almost no change in area. Therefore, over the study period, the percentage fall in the area under food grains was almost constant by 7.16%. This contraction resulted due to expansion of area under vegetables and decline in area under maize, barley and pulses. Area under wheat showed mixed trends over the study period. Percentage area under wheat decline 5.71 in 2000-01 compared to 1993-94 and increase of 7.51 in 2007-08 in comparison to 2000-01. In case of barley, trends showed decline and percentage declination in area is 12.97 between the periods 1993-94 to 2007-08. There is also decreasing trends of maize cultivation, the total declination is 12.13% over the study period. The major reasons for this decline in these crops are: (1) The problem of wild animals (monkey, pigs and birds etc.) that mainly destroy the maize crop in this area. (2) Food habits of peoples also changed as a result of adaptation, they prefer wheat and rice in place of maize and barley. Table 3 shows that there is increase of 21.02% for crop paddy. High price of rice inspired the farmers to bring more area under cultivation of this crop. Area under pulses shows significant decline of 45.39% in 2007-08 in comparison to 1993-94. This was due to expansion of area under vegetables in the district Solan. Among the non food crops vegetables registered an increase of 79.06 % during the period 1993-94 to 2007-08. The decline in area under cultivation of pulses was compensated by the expansion of the area under vegetables. Oilseeds, fodder crops and others shows decline in area of about 37.66%, 20.79% and 39.31% respectively over the study period. Fruits, condiments and spices exhibit in area under these crops i.e. 14.03% and 70.94%. The attractive price of cash crops such as vegetables, fruits, condiments and spices inspired the farmer to increase production of these crops on more and more area but, also motivate them to shift the area from some of the food crops to cash crop cultivation. This may proves helpful to fulfill their requirements and to get better prices from the sale of their product. Table 3 reveals that net sown area, area sown more than once and total cropped area has decreased about 7.52%, 1.55% and 5.14% respectively over the period 1993-94 to 2007-08. The major reason for this decline in area under cultivation maybe the problems of wild animals (monkey, pigs and birds etc) that mainly destroys the maize and other crops. So the people restricts there cultivation and the far of land (not protected from wild animals) remains uncultivated during the last decade or so.
CONCLUSION
To evaluate the sequential variations of land under different uses in district Solan of Himachal Pradesh from 1993-94 to 2007-08 revealed that, there were some notable variations under area in case of permanent pastures and net sown area. Moreover, other land categories had not shown significant change under their area. The study on the cropping pattern in district Solan over the study period suggest that among food crops area under wheat and paddy has increased whereas, in case of barley and maize it had declined considerably. Area under non food crops has shown increased trend for cash crops. The result indicates that total cropped, net sown area, and area sown more than once decreased in period (1993-94 to 2007-08). The trend of cropping pattern in Solan district from 1993-94 to2007-08 disclosed the fact that shifting of area from food grains towards vegetables, fruits, condiments and spices is considerably high. It is clear from the above results and suggestions that farmers of the area are shifting towards commercial cropping.
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=1941http://ijcrr.com/article_html.php?did=19411. Ram S. Cropping Pattern Diversification in Orissa. Agricultural Situation in India 1999; 4: 15-18.
2. Gupta S, Sharma RK. Land Utilization Pattern in Himachal Pradesh: A District-wise Analysis. Agricultural Situation in India 2009; 4: 31-35.
3. Khoshla PK, Raina KK. Himalayan Farming Systems –RandD Support for sustainable Agro Economy. Centre for Integrated Mountain Development 1996: 12-13.
4. Kanwar PC. Diversification of Agriculture in Himachal Pradesh: A Spatio- Temporal Analysis. Agricultural Situation in India. 1986; 9: 451-454.
5. Oberoi RC, Raina KK. Growth and Diversification of Foodgrains in Himachal Pradesh. Economic Affairs 1991; 36(3): 155-160.
6. Chand R. Diversification through high values crops in western Himalayan region: Evidence from Himachal Pradesh. Indian Journal of Agriculture Economics 1996; 51(4): 652-663.
7. Narayanamoorthy A. Crop Diversification and Yield Response to Fertilizer. Productivity 1997; 38(1): 118-125.
8. Kumar U. Diversification of Crops in West Bengal: A Spatio- Temporal Analysis. Artha Vijnana 2000; 42(2); 170-182.
9. Vyas VS. Diversification in Agriculture: Concept, Rationale and Approaches. Indian Journal of Agriculture Economics 1996; 51(4): 636-643.
10 Kumar U. Changing Cropping System in Theory and Practice: An Economic Insight into the Agrarian West Bengal. Indian Journal of Agriculture Economics 2003; 58(1): 64-83
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareARE LIFESTYLE DISORDERS A RISK FOR PERIODONTAL DISEASE?
English2631Manoj RajaEnglishThe main objective of this study was to identify certain lifestyle disorders like diabetes mellitus and other medical conditions like hypertension and hyperlipidemia in an older adult population and to verify their relationship with the periodontal health status in the same group of individuals. A total number of 600 patients between 35-75 years were selected for this study. Their lifestyle habits were obtained through a questionnaire. It was followed by a periodontal examination, blood pressure re cording and a biochemical analysis of the blood samples taken from them. Results of MLRA showed that diabetes mellitus, was clearly associated with attachment loss. Hypertension was not associated with attachment loss, and elevated blood cholesterol levels (hyperlipedemia) were associated only in univariate models. It could be concluded that in the selected group of subjects aged 35-75 years, only diabetes mellitus was associated with attachment loss in this cross-sectional study.
EnglishDiabetes, Attachment loss, Hypertension, HyperlipedemiaINTRODUCTION Diabetes mellitus is a bonafied risk factor in periodontal disease. Type 2 is the form of diabetes present in 90-95% of patients with the disease and the risk of developing this form of diabetes, increases with age, obesity, previous history of gestational diabetes and lack of physical activity. (Brian L. Mealey and Gloria L.Ocampo) 1 The association between diabetes and periodontal disease has been reported for more than forty years. ?Chronic Periodontitis? is now considered the sixth complication of diabetes mellitus.2 Other general disorders like hypertension and elevated blood cholesterol levels (hyper lipedemia) often go hand in hand with diabetes mellitus. They are proving to be health epidemic in middle age populations causing many reasons to panic. This cross sectional survey aims to correlate elevated blood sugar levels, hypertension and elevated blood cholesterol levels with Gingival and Periodontal disease. It also helps to include patient education and motivation in the treatment plan, thus keeping a check on these life style disorders in the long run.
MATERIALS AND METHODS The present study was using a stratified randomly selected sample of 600 persons, aged 35 to 75 years from the patients in a private Dental College and Hospital. A William‘s probe and a Shepherd‘s Crook explorer were used for the examination of the periodontal parameters in the study namely Gingival Index (GI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL). The blood pressure reading (both systolic and diastolic blood pressure) was recorded for all the subjects, using a conventional sphygmomanometer with the help of a general physician. The blood pressure was recorded in the morning time. Each subject was then taken to the biochemical laboratory of the hospital for the assessment of Fasting blood sugar and Total blood cholesterol levels. The biochemical analysis was done in the morning time. The subjects who were included in the study were instructed to come on an empty stomach (i.e) they should not have consumed food for the past 12 hours. 3 ml of venous blood was drawn, from the Median-cubital vein of each subject using a 20- gauge needle connected to a 10 ml syringe.
Statistical Methods The association of the three periodontal parameters namely Gingival Index (GI), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) with three variables namely hypertension, diabetes and total cholesterol levels was estimated using ?Chi-square test? to calculate the p - value.
RESULTS
348 subjects who did not have hypertension showed a gingival index score less than or equal to 2, where as 24 subjects who did not have hypertension showed a gingival index score greater than 2.216 subjects who had hypertension showed a gingival index score less than or equal to 2, where as 12 subjects who had hypertension showed a gingival index score greater than 2. The difference was not statistically significant in both the subjects who did not have hypertension and the subjects who had hypertension (p = 0.68). 514 subjects who did not have diabetes showed a gingival index score less than or equal to 2, where as 26 subjects who did not have diabetes showed a gingival index score greater than 2. 50 subjects who diabetes had showed a gingival index score more than 2, where as 10 subjects who had diabetes showed a gingival index score greater than 2. The difference was found to be statistically significant in both diabetics and non diabetics (p 200mg/dl (p 4mm as against 36 diabetics, with CAL < 4mm. Similarly 12 subjects with diabetics had PPD > 5mm and 10 diabetic subjects had a GI score 2. These values were highly significant.
The results of ULRA for CAL showed an odds ratio of 5.33, in diabetic‘s subjects while the results of MLRA for CAL had the highest odds ratio of 4.33. Considering the above results, diabetes mellitus, was found to be most significantly association with periodontal disease progression, in our present study. The mean FBS level, in subjects with PPD > 5mm was found to be greater than 213mg/dl. This was in accordance with a study by Richard C Oliver et al10, wherein an increased prevalence and extent of periodontal pockets was a consistent finding of diabetics versus non-diabetics. The Oulu study, reported more gingival bleeding, as metabolic control worsened in diabetics, despite similar plaque and calculus scores in the diabetic subgroup. Other studies also reported extensive gingival inflammation in diabetics 8. These results were similar to the one in our present study. Hyperlipidemia is essentially not a well acknowledged risk factor for periodontal disease11. It plays a larger role in cardiovascular disease and stroke12.The results in ULRA for CAL in our present study showed an odds ratio of 3.1 for subjects with a Total Blood Cholesterol level >200mg/dl (42 subjects). However, 38 subjects in the group had an FBS level > 126mg/dl. So, the independent role of high Total Blood Cholesterol level (>200mg/dl), in periodontal disease could not be established in our present study, as the results of MLRA for CAL did not include subjects with Total Blood Cholesterol levels >200mg/dl as significant variables. The role of hypertension in periodontal disease progression was clearly negative, from our present study. The results clearly indicated that hypertension was a non significant parameter in our present study in periodontitis.These results in our study, was in accordance to a similar study done by Mattout C et al13, who included arterial hypertension as a parameter, on a population of 2144 adults, in France. The results from the study yielded similar nonsignificant values for hypertension.
Thus we can infer that certain risk elements like Diabetes Mellitus play a major role in increasing the probability for chronic periodontal disease among older adults. One possible bias which could have occurred in our study is the relatively small sample size of subjects, belonging to a highly similar geographic area, and all of them being subjects, seeking some form of dental therapy, as they were selected from a patient pool, at a dental hospital.
ACKNOWLEDGMENTS
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references to 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. I also wish to thank my professors T.Ramakrishnan, N.Ambalavanan, Pamela Emmadi and D.Deepalakshmi for their able guidance provided for my study. The study was conducted on a self financing basis by the author Dr. Manoj Raja.
Englishhttp://ijcrr.com/abstract.php?article_id=1942http://ijcrr.com/article_html.php?did=19421. Brian L. Mealey and Gloria L.Ocampo: Diabetes mellitus and periodontal disease, Periodontology 2000: 127-153, 2007.
2. Loe H: Periodontal disease: the sixth complication of diabetes mellitus, Diabetes Care 16 (suppl 1):329, 1993.
3. Flemmig TF: Periodontitis, Ann Periodontal 4:32, 1999
4. Page RC, Beck JD; Risk assessment for periodontal diseases, Int Dent J 47:61, 1997.
5. Michalowicz BS, Diehl SR, Gunsolley JC. Evidence of a substantial genetic basis for risk of adult periodontitis. J Clin Periodontol. 2000;71:1699–1707
6. Robert J Genco: Current view of risk factors for periodontal diseases. J Periodontol 1996; 67:1041 -1049
7. Tervonen T, and Knuuttila M: Relation of diabetes control to periodontal pocketing and alveolar bone level Oral Surgery, Oral Medicine, Oral Pathology 1986:61,346 -349
8. Taylor GW. Bidirectional interrelationships. between diabetes, and periodontal diseases: an epidemiologic perspective. Annals of Periodontology2001;6:99–112.
9. Soskolne W A and Klinger A: The relationship between periodontal diseases and diabetes an overview. Annals of Periodontology 2001:6,91 - 98.
10. Richard C Oliver and Tellervo Tervonen: Diabetes – A risk factor for periodontitis in adults? J Periodontol 1994;65:530 -538.
11. Moeintaghavi A, Haerian-Ardakani A, Talebi-Ardakani M, Tabatabaie I. Hyperlipidemia in patients with periodontitis. J Contemp Dent Pract. 2005 Aug 15; 6(3):78-85.
12. Moise Desvarueyx, Christial Schwahn and Thomas Kocher. Gender differences in relationship between periodontal disease, tooth loss, and atherosclerosis. Stroke, 2004; 35, 2029.
13. Mattout C, Bourgeois D, Bouchard P. Type 2 diabetes and periodontal indicators: epidemiology in France 2002-2003. J Periodontal Res. 2006 Aug;41(4):253-8.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareBLOOD GLUCOSE CONCENTRATION - A KEY TO FIX THE EFFECTIVE DOSE FOR HERBAL ANTIDIABETIC DRUGS USING RAT MODEL
English3245R.KannadhasanEnglish S.VenkataramanEnglishSedimental Extract of Tinospora cordifolia (SETc), with no mortality rate at the maximum of 2000mg/kg/p.o., acute dose was found to show maximum number of deaths on chronic treatment in the mid of 28 days repeated oral toxicity study. A trial made on SETc at incremental doses starts from the minimum of 250 - 1000 mg/kg/p.o., were then subjected to modified IDF procedure, to study their safer therapeutic margin. Sprague dawley rats were made diabetic with streptozotocin (45mg/kg/i.p.) and the OGTT procedure was performed on those diabetic rats, fasted around 16 hours prior to the commencement of IDF study. Starting from the 30th min after glucose load (1g/kg/p.o.), the incremental doses of SETc, from the minimum of 250mg/kg/p.o., to the maximum of 1000 mg/kg/p.o., were administered to each group. The reduced blood glucose levels from each group were analyzed and derived by means of AUC and thereby safer therapeutic and effective dose of the test drug was fixed. The onset of action of all the doses of the SETc originates
from the 60th min of the drug administration and showed the biological responses in a concentration dependant manner. Based on the IDF, AUC and EDF data‘s, it was found to be very clear that the dose of 1000 mg/kg/p.o., of SETc was found to underlie the safer therapeutic margin than the other doses. This evidences that the application of this modified method would be a valuable tool for finding safer therapeutic marginal dose using BGC as a key factor.
EnglishSedimental Extract of Tinospora cordifolia (SETc), Oral Glucose Tolerance Test (OGTT), Blood Glucose Concentration (BGC), Incremental dose finding (IDF), Area under the Curve (AUC), Effective dose finding (EDF), Streptozotocin (STZ) induced diabetic rats.INTRODUCTION
The major hindrance to the use of the herbal preparation in clinical practice is due to the lack of preclinical data for understanding the safety and efficacy of the drugs. For the evaluation of various forms of oral herbal preparations, instead of their treatment profile there must be a need of strong evidence, for its safer therapeutic index. Uncertainty, of dose fixation during preclinical toxicity studies also rules a part. Since it‘s in need and in deed to fix the effective therapeutic dose of those herbal preparation which would be safer enough with good therapeutic outcome, for long term therapy likely from fluctuating blood glucose levels in diabetics. So it necessitates a modified protocol along with statistical approach, the dose response effect of oral antidiabetic agents in animals could be studied.
AUC has a number of important uses in pharmacology, biopharmaceutics and pharmacokinetics. Through biochemical and hematological parameters, the bio equivalency or bioavailability studies of a compound could be analyzed by comparing its AUC values [1]. But here, the measurement of AUC after administration of an herbal product plays an important role in fixing safer therapeutic dose. Since its diabetic case, the study of alterations in the blood glucose concentration levels were found to be quite worthy to give enough surveillance to analyze the AUC which necessitates its role over preclinical evaluation of a drug dose. The incremental dose finding [2] method adopted to study the dose response relationship with AUC of the herbal antidiabetic agent using linear regression analysis. Based on the priority of work done in diabetes and ease of availability, a random selection of a large, glabrous, succulent, climbing shrub belonging to the family Menispermaceae, namely Tinospora cordifolia, which was used as a folklore medicine in diabetes [3] were made. In accordance to the work being carried out, its planned to make a trial on raw portion of the plant by means of sedimental extraction from the plant stalk which would be supportive than other solvents with particular components. Some of the antidiabetic works in various extracts of Tinospora cordifolia reported as below Aqueous, alcoholic and chloroform extracts of the leaves of T. cordifolia showed hypoglycaemic activity in both alloxan diabetic and normal rabbits at 250 mg/kg of the dose administered [4]. Daily oral administration of an aqueous root extract of T. cordifolia to alloxan diabetic rats for 6 weeks significantly reduced blood glucose levels at 2.5 and 5.0 g/kg, but not 7.5 g/kg. T. cordifolia was more effective than glibenclamide, but less effective than insulin (which restored parameters to near normal values) at lowering blood glucose levels. Instead of their biological action, the rationality for the regression of hypoglycaemic effect at these varying doses was not provided [5, 6, 7and 8]. The current study focused on the dose selectivity, that shows maximum therapeutic efficacy of Sedimental Extract of Tinospora cordifolia (SETc), an oral herbal preparation through incremental dose finding and area under the curve determinations on the OGTT in diabetic rats.
MATERIAL AND METHODS Plant Collection
Tinospora cordifolia collected from Irulars Tribal Women Welfare Society (ITWWS), Thandarai, Thirukazhukundram, a southern forest region of Tamil nadu, India. The stem portions were cut, dried and collected in the month of January 2007 and shade dried for further processessing and studies. The pharmacognositcal identity and authentication was done by Plant Anatomy research Centre, Chennai. A specimen of the plant was kept in the Department of Pharmacology, C.L.Baid Metha college of Pharmacy, Chennai (Specimen No. CLBMCP/102/2005).
Preparation of Plant Extract The dried stem of Tinospora cordifolia, 2 kg was grounded to a coarse powder and soaked in 1000ml of distilled water for a period of 24 hrs, until the active portion to settle down. The top layer was drained in a separate vessel (leaving the debris to filter off) and evaporated in a hot water bath at 100o C, and this portion is considered as water soluble portion. The sedimented portion after removing the water soluble portion was washed for 2-3 times with fresh distilled water. The sedimented extract was admixed with water soluble extract in the ratio of 3:1 to get the final sedimental extract of Tinospora cordifolia (SETc) for screening.
Physico chemical properties Slightly soluble in Ethanol < DMSO and not in other solvents. A fine suspension of the extract was obtained in 0.5 % Sodium Carboxy Methyl Cellulose (Na.CMC). Hence 0.5% Na.CMC suspension of this drug is used for animal experiment. Buff white powder. Bitter taste; Bitterness might be due to admixture of water soluble portion at the final preparation.
Chemicals and equipments Streptozotocin, 97% pure dextrose and Ready-to-use biochemical kits were purchased from Sigma-Aldrich Pvt.ltd, Mumbai. Ascensia One Touch glucometer and strips (Code. No: 3110; 3112) was used to measure the blood glucose concentration.
Animals Male Sprague dawley rats 200-250 gm were purchased from King‘s Institute, Guindy, Chennai. Requirement of animals for this study was authorized by Dr.C.L.Baid Metha College of Pharmacy, CLBMCP/131/IAEC/41 under CPSCEA guidelines. All rats were randomly selected, segregated and acclimatized for a period of 1 week with 12hr day light and 12 hours dark cycle, with food and water ad libitum.
Toxicity studies Acute Oral Toxicity Study
Acute oral toxicity studies were performed following by OECD 423 Guidelines. Maximum dose of 2000mg/kg was selected and administered orally to a group of 3 animals in each step as shown in flow chart of Annex 2d [9]. Animals (n=6) were fasted for a period of 12 hrs and weighed just prior to drug administration. The test substance was administered in a single dose using a suitable intubation canula. After drug administration, food was withheld for a period of 3-4 hours. The animals were observed closely for 3 hrs and observation were continued for 24 hours. Any mortality or toxic signs produced were noted.
Repeated Oral Toxicity Study Repeated dose 28 day oral toxicity study was carried out according to OECD guidelines 407 [10]. Animals were divided into four groups of 6 each. Group I – received 0.5% CMC orally and served as vehicle control and groups II, III and IV – were received a daily dose of SETc 500, 1000 and 2000 mg/kg/p.o., respectively for a period of 28 days. Adjustments were made as necessary to maintain constant dose level in term of animal body weight. Animals were observed at least twice a week for 28 days, for any mortality and morbidity. The doses at which animals don‘t show any mortality or morbidity were chosen for the dose finding study. Animals that survived after 28 days treatment were euthanized with excess ether on 29th day and blood samples were collected through cardiac puncture for hematological and biochemical studies. Liver, kidney and Pancreas were dissected out for histopathological studies.
Histopathological Studies Various tissues like liver, kidney and pancreas were dissected out from each group of normal control and normal animals treated with SETc (500 and 1000 mg/kg/p.o., respectively). The collected tissues of respective groups were dipped in 10% formalin solution and stained with hemotoxylin and eosin for preparation of section by using of microtome. Histopathological observations were studied in Vaishnave Clinic, Chennai – 17. The histopathological studies carried out by using the method described by Kanai Mukherjee [11].
Effective dose finding-Experimental design Fasting of Animals and Induction of Experimental Diabetes
Animals were fasted for 16 hours before the induction of diabetes with Streptozotocin [2]. Animals made diabetic by an intraperitoneal injection of freshly prepared solution of STZ (45mg/ml in 0.01 m citrate buffer, pH 4.5). The diabetic state assessed in STZ - treated rats by measuring the non-fasting blood glucose concentration 48 hours post STZ injection using one touch glucometer. Only rats with blood glucose levels ≤ 200mg/dl were selected and used for experimental studies.
Incremental dose finding experiment: Modified method* With a slight modification of the method of Soon and Tan [2], the fasting glucose along with oral glucose loading after the administration of the incremental doses of the test drug were used. Animals were divided into 6 groups of 6 animals each. A normal and a diabetic control both receiving 0.5% of Carboxyl methyl cellulose suspension and test groups with diabetes receives Incremental Doses (ID) of ID I, II and III (250, 500 and 1000mg/kg/p.o., respectively). Finally a diabetic treated with Standard drug, Glibenclamide - 600µg/kg (as calculated from the human dose) kept studied for the comparison of the test drug treated groups. Blood glucose concentration was examined at a regular interval for a period of 4 hrs starting from 0 hr and at 1st, 2nd, 3rd, 4th hr after drug treatment using One Touch Glucometer. Concentration response curve and area under curve were studied.
Statistical analysisStatistical analyses were done using Graphpad prism software, Version 4. Dose response effect were studied using Curves and regression followed by Area under Curve (AUC) and other biochemical, hematological parameters were assessed through One way anova using Tukey‘s multiple comparison method, were values are expressed as mean ± SEM (n=6).
RESULTS
Toxicity Studies Prior to the clinical application of experimental data, it is pertinent to establish the safety of herbal preparation through toxicological assessments. In the current study therefore, the acute toxicity and the liver and kidney function parameters of animals treated with subchronic doses of the crude sedimental preparation of T.cordifolia were assessed. In addition the microanatomical changes, if any of the test drug in majors organs viz., liver, kidney and pancreas were also studied. Acute Toxicity study Acute toxicity study under OECD 423 guidelines a maximum tolerable dose of SETc (2000 mg/kg/p.o.,) was used to assess the mortality or morbidity rate and also toxic signs and symptoms of animals were studied. The result showed neither mortality nor signs of toxicity at this dose (2000mg/kg/p.o.,) as shown in table no.1. Repeated Oral Toxicity Study The maximum tolerable dose assessed from the acute toxicity study, i.e., 2000mg/kg/p.o., along with its 1/2 and 1/4 portion of the corresponding doses, 1000 and 500 mg/kg/p.o., respectively, were studied for 28 days repeated oral toxicity under OECD 407 guidelines. The mortality rate with 2000mg/kg found to show maximum number of deaths within 15 days from the start of the study. Animals treated with 500mg/kg and 1000mg/kg/p.o., of SETC respectively, didn‘t show any mortality or morbidity throughout the treatment period and there were no significant changes in the biochemical and hematological parameters when compared to control animals. The results are depicted in table nos.2 - 6. There was no significant change in the biochemical parameters including total triglycerides, cholesterol, HDL-C, LDL-C and VLDL-C in test animals treated with SETc (500 and 1000mg/kg/p.o.,) compared to control (Table No.2). There was no significant alteration in the serum protein level and the A: G ratio was found near to the normal control (p=ns) as shown in Table. 3. It was observed that the test drug I and II do not showed any alterations in the serum urea, uric acid, creatinine and BUN level as compared with that of the normal control (p=ns). Sub chronic treatment of SETc did not affect the AST and ALT levels in comparison to normal animals (p=ns) as shown (Table No.5). The RBCs and Hb contents of SETc treated rats were found to show no significant difference (p=ns) as compared with that of the normal group (Table No.6). The number of WBCs were found to show a slight increase in test group treated with 1000mg/kg/p.o., as compared with that of the normal (pEnglishhttp://ijcrr.com/abstract.php?article_id=1943http://ijcrr.com/article_html.php?did=19431. Goodman and Gilman's. Pharmacokinetics and Pharmacodynamics. In: Laurence L. Brunton, Keith L. Parker, Donald K. Blumenthal, Iain L.O. Buxton, editors. Manual of Pharmacology and Therapeutics. 11th ed. New York: McGraw-Hill; 2008, pp.6-12.
2. Soon YY, Tan BKH. Evaluation of Hypoglycemic and Antioxidant activities of Morinda officinalis in STZ-induced diabetic rats. Singapore Med J 2002; 43(2): 077-085.
3. Singh SS, Pandey SC, Srivastava S, Gupta VS, Patro B, Ghosh AC. Chemistry and medicinal properties of Tinospora cordifolia (guduchi). Indian Journal of Pharmacology 2003; 35: pp.83-91.
4. Wadood N, Wadood A, Shah SAW. Effect of Tinospora cordifolia on blood glucose and total lipid levels of normal and alloxan-diabetic rabbits. Planta Med. 1992; 58: 131-136.
5. Prince PSM, Menon VP, Gunasekaran G. Hypolipidaemic action of Tinospora cordifolia roots in alloxan diabetic rats. Journal of Ethnopharmacology 1999; 64: 53-57.
6. Prince PSM, Menon VP. Short communication: Antioxidant action of Tinospora cordifolia roots in experimental diabetes. Journal of Ethnopharmacology 1999; 65: 277- 281.
7. Prince PSM, Menon VP. Hypoglycemic and other related actions of Tinospora cordifolia roots in alloxan-induced diabetic rats. Journal of Ethnopharmacology 2000; 70: 9-15.
8. Prince PSM, Menon VP. Antioxidant action of Tinospora cordifolia root extract in alloxan diabetic rats. Phytotherapy Research 2001; 15: 213- 218.
9. OECD/OCDE 423. Test procedure with a starting dose of 2000 mg/kg/bw. Annex 2d 2001; p.13.
10. OECD/OCDE 407. Repeated Dose 28-day Oral Toxicity Study in Rodents 1995; pp. 1-8.
11. Mukherjee KI. Medical Laboratory Technology. 1st Edition. New Delhi: Tata McGraw Hill Publications 1989: p.124.
12. Geidam MA, Pakman I, Laminu H. Effects of aqueous stem bark of Momordica balsamin. Linn on serum electrolytes and some haematological parameters in normal and alcohol fed rats. Pak. J. Biol. Sci. 2004; 7: pp.1430-1432.
13. Abdollahi M, Farzamfar B, Salari P, Khorram Khorshid HR, Larijani B, Farhadi M, et al. Evaluation of acute and sub-chronic toxicity of Semelil (ANGIPARS™), a new phytotherapeutic drug for wound healing in rodents. DARU 2008: 16(1); 7-14.
14. Tilkian SM, Conover MB and Tilkian AG. Clinical implications of laboratory tests. London. C.V. Mosby Company 1979: pp.3-44; 117-132; 154-159.
15. Whitby LG, Smith AF, Becket GJ. Lecture notes on Clinical chemistry. 4 th Ed. Oxford, London, Edinburgh, Boston, Melbourne; Blackwell Scientific Publications 1989; pp.38- 178.
16. Williams M.H. Nutrition for health, fitness and sport. Boston; McGraw-Hill 1999; pp.178-203.
17. Thatte UM, Dahanukar SA. Comparative study of immunomodulating activity of Indian Medicinal plants, lithium carbonate and glucan. Methods and findings in experimental and clinical pharmacology 1988; 10(10): 639-644.
18. Thatte UM, Dahanukar SA. Immunotherapeutic modification of experimental infection by Indian Medicinal Plants. Phytotherapy Research 1989; 3: 43-49.
19. Mathew S, Kuttan G. Antioxidant activity of Tinospora cordifolia and its usefulness in the amelioration of cyclophosphamide induced toxicity. Journal of Experimental and Clinical Cancer Research 1997; 16(4): 407- 411.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareBILATERAL VARIATION IN THE VASCULAR PATTERN OF PALM- A CASE REPORT
English4652A.HimabinduEnglish B.Narasing RaoEnglishA bilateral variation in the pattern of arterial supply of the palm was observed during routine dissection of a 65 years old male cadaver. The right hand received blood supply by ulnar, radial and median arteries, with an arch of communication between radial and median arteries. In the left hand superficial palmar arch was formed mainly by ulnar artery and completed by first dorsal metacarpal branch of radial artery. In both hands deep branch of radial artery and a branch from ulnar proper digital branch of little finger formed the deep palmar arch. Knowledge of arterial variations provides an important source of information for vascular surgeons for safe surgical procedures in the hand.
Englishsuperficial palmar arch, deep palmar arch, ulnar artery, radial artery, median artery.INTRODUCTION
Arterial supply to the human hand is derived from two main anastomotic channels, superficial and deep palmar arches. They are formed by radial and ulnar arteries, which account for high vascularity of the palm. So wounds of the palm bleed profusely but heal rapidly because of this rich anastomosis. Superficial palmar arch is mainly fed by ulnar artery alone or completed by superficial branch of radial artery, by the arteria radialis indicis, a branch of arteria princeps pollicis or by the persistent median artery1 . Very rarely it is formed by anastomosis of median artery with radial artery. This type of arch was described as median –radial type of superficial palmar arch2 . SPA shows a number of variations that it is difficult to establish a type3 . Deep palmar arch is formed by anastomosis of the deep palmar branch of the radial artery with the deep palmar branch of the ulnar artery. Jaschtschinski4 and Coleman and Anson1 described its variations. Variations of deep palmar arch are less common compared to superficial palmar arch1,5. So an injury to the ulnar artery or the superficial palmar arch may compromise the arterial supply of the fingers, particularly if there is an insufficient anastomosis between the superficial and deep palmar arches6 . Thus familiarity of the possible variations in arterial pattern of hand is especially important for the vascular surgeons while performing reconstructive hand surgeries for restoration of the normal function of the hand.
Case report During regular dissection for undergraduate medical students, bilateral variations of superficial palmar arch and deep palmar arch were identified in a 65-year-old male cadaver. In the right hand, beneath the palmar aponeurosis there were three vessels. From medial to lateral side they were ulnar, median and radial arteries respectively. Ulnar artery gave one proper and two common digital arteries, which supplied the medial 2½ fingers. Arteria nervi mediana, a branch of ulnar artery, accompanied by the median nerve passing deep to flexor retinaculum was found to be giving a common digital branch that supplied radial side of the middle finger and ulnar side of the index finger. Superficial palmar branch of the radial artery gave a common digital branch that supplied the radial side of index finger and the ulnar side of the thumb. A loop of communication existed between the radial artery and the arteria nervi mediana(median artery) but not with the ulnar artery.(Fig:1) In the left hand, one proper and four common digital arteries were branched out from the ulnar artery. Through these branches, the ulnar artery supplied entire palm except radial side of thumb, which got its nutrition from the radial artery. The superficial palmar arch was completed by the first dorsal metacarpal artery in the first digital web space. First dorsal metacarpal artery was a branch of radial artery, before it pierced 1st dorsal interossei muscle. These variant types of arterial anastamosis should be kept in mind while performing hand surgeries. (Fig.1),(Fig.2) Deep palmar arch in both the upper limbs was formed between deep branch of radial artery, which entered the palm through 1st dorsal metacarpal space piercing the 1st dorsal interosseus muscle and inferior deep branch arising from ulnar proper palmar digital artery of little finger. Deep branch of ulnar nerve accompanied the arch and supplied interossei and adductor pollices muscles. (Fig.3)
DISCUSSION The arterial supply to the hand and its variations were being reported since a long time. Jaschtschinski4 in his study on 200 subjects, classified superficial palmar arch into complete and incomplete types based on the anastomosis between the vessels. Complete SPA was ulnar type (38%), radioulnar type (27%) and mediano ulnar type (3%) and radio-mediano-ulnar (0.5%). He also mentioned the absence of superficial palmar arch. A very rare type of superficial palmar arch termed median –radial type existed between median artery and radial artery2 . Superficial palmar arch was classified into Group I (Complete arch) and Group II (Incomplete arch)1 Group I was further divided into five types: Type A: The classical radio ulnar arch formed by superficial branch of radial artery with large superficial branch of ulnar artery. Type B: This arch is formed entirely by ulnar artery supplying thumb and index finger. Type C: Mediano ulnar arch formed between ulnar artery and median artery. Type D: Radio-mediano-ulnar arch, in which three vessels enter into the formation of arch. Type E: It consists of a well-formed arch initiated by ulnar artery and completed by a large vessel derived from deep arch. Group II: An incomplete arch exists when the arteries forming superficial arch do not anastomose or when the ulnar artery fails to reach the thumb and index finger. It was subdivided into Type A: No anastomosis between superficial palmar branch of radial artery and ulnar artery Type B: Only the ulnar artery forms superficial palmar arch. Type C: Superficial vessels receive contributions from both median and ulnar arteries but without anastomosis. Type D: Radial, median and ulnar artery all give origin to superficial vessels but do not anastomose. The median artery forming superficial palmar arch may arise from ulnar, anterior interosseous, common interosseous and from radial arteries7 . This persistent median artery has an embryological correlation. The ante brachial pattern of median artery ends at the level of forearm and the palmar pattern where the artery accompanying the median nerve in the forearm and extending down to the palm supplying the digits8 . A dorsally arising small radial artery branch, coined as dorsalis pollicis artery by Agur and Lee9 might complete superficial palmar arch. McCormack et al. 10 also reported a small vessel arising dorsally from the radial artery passing into the palm to join the ulnar artery in 51% of the hands studied. First dorsal metacarpal artery often had a fascial course on the dorsal surface of the index head of first interosseus muscle, this artery can be easily injured in an intervention over the carpometacarpal joint of the thumb, when approached from the dorsum of this joint11 . In the present case, right hand showed a complete radio-median type of superficial palmar arch as described by Keen2 .Along with this rare arch, ulnar artery was also present in the hand without any communication with the other two vessels. In the left hand, an ulnar-radial type of complete arch existed between ulnar artery and first dorsal metacarpal artery of radial artery coming from the dorsum. An arch was seen in the first digital web space. Eventhough it was not falling in any of the major classifications of superficial palmar arch, a dorsal artery completing the arch was described by Agur and Lee9 McCormack et al10 Deep palmar arch: Coleman and Anson1 had classified deep palmar arch as follows: Group I: Complete arch, further divided into 4 types. Type A: The deep palmar arch is formed by the deep palmar branch of the radial artery, which anastomoses with superior deep palmar branch of ulna artery. The latter follows the deep branch of ulnar nerve into the palm. Type B: The commonest pattern of deep palmar arch that existed between deep palmar branch of radial artery with the inferior deep palmar branch of ulnar artery. Type C: Both (superior andinferior) deep palmar branches of ulnar artery join the deep palmar branch of radial artery to complete the arch. Type D: It is formed by superior deep palmar branch of the ulnar artery, which anastomoses with an enlarged superior perforating artery of the 2nd inter metacarpal space. Group II: Incomplete arch, further divided into: Type A: The inferior deep branch of ulnar artery anastomoses with the perforating artery of the 2nd interspace without any communication with deep palmar branch of radial artery. Type B: The deep branch of ulnar artery ends in an anastomosis with perforating artery of 3rd interspace as deep palmar branch of radial artery anastomoses with the perforating artery of the 2nd interspace. Mezzogiorno12 identified the deep palmar arch patterns as radioulnar (66.7%),) radialanastomotic (21.67%), radial (8.33%), and ulnar (3.33%). Olave13 explained two groups of deep palmar arches. In group I the radial artery passed through the first interosseous space anastomosing with one or two deep palmar branches. These deep palmar branches originated from the ulnar artery, ulnar proper palmar digital artery of the little finger or the common palmar digital artery of the fourth interosseous space. In group II, the artery passed through the second interosseous space, anastomosing with one deep palmar branch, rarely with two deep palmar branches. In the present case both limbs showed the commonest variety of complete deep palmar arch (type B). This complete radioulnar type of deep palmar arch existed between deep palmar branch of radial artery, which passed through the first dorsal interosseous muscle anastomosing with deep palmar branch of ulnar artery. This deep palmar branch of ulnar artery was arising from proper digital branch of little finger as explained by Olave.13
Embryology Shin Matsumoto14 explained the arterial supply of the early upper limb bud as subclavian-axillary-brachial trunk. The main arterial supply to the developing hand consisted of the brachial and interosseous arteries that terminated in a capillary plexus. A branch of the trunk- median artery, temporarily replaced interosseous artery in supplying the hand. The connection between superficial brachial artery and median artery became the main route of blood supply for the finger arteries up to the adult stage. Subsequently ulnar and then radial arteries are formed from the axis artery at the end of arterial development and median artery regresses. Ulnar artery joined the ulnar end of the superficial palmar arch, radial artery with deep palmar arch. Persistence of any of these vessels leads to variations.
Conclusion: The detailed knowledge of arterial arches of the human hand, a prehensile organ, is important to vascular surgeons while correcting any traumatic events in the hand. Success of surgical procedures depends on the healthy function of the arterial arch that exists between radial and ulnar arteries in order to maintain normal blood flow to the hand and digits. Otherwise it leads to ischemia of soft tissues of the hand which is the earn tool of mankind.
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=1944http://ijcrr.com/article_html.php?did=19441. Coleman,s.andAnson,j.(1961):Arterial pattern in hand–based upon a studyon650specimens.surgery.gynaec ology.obstetrics.,(113(4))pp409-24.
2. Keen JA. Study of the arterial variations in the limbs with special reference to symmetry of vascular pattern. Am J Anat. 1961; 108: 245- 61.
3. Poirier,P:Traite d‘Anatomie Humaine L. BattlleandCo.Paris:pp 833 (1886)
4. Jaschtscinski SN(Morphologie und Topographie des Arcus volaris sublimes und profundus desMenschen)Anat.Hefte 1897;7: 161-88
5. Karlsson,S.andNiechajev ,I.A.(1982): Arterial anatomy of the upper extremity.Acta Radiologica Diagnosis.23: 115-121
6. Calenoff,L.Angiography of the hand:guidelines for interpretation.Radiology,102(2):331- 5,1972
7. Sujatha D‘costa,kilarkaje Narayana,Prasanthi Narayana,Jiji,Soubhagya R.Nayak,SJ Madhan Occurance and fate of palmar type of medaian artery.ANZ J SURG 2006;76,484-487
8. Rodriguez- NiedenfuhrM; Sando,J.R; Vazquez,T;Nearn,L;Logan,BandParkin, I. Median artery revisited.J.Anat., 195(1):57-63,1999
9. Agur AMR, Lee MJ. Grant‘s Atlas of Anatomy. 9th Ed., Baltimore, Williams and Wilkins. 1991; 434
10. McCormack LJ, Cauldwell EW, Anson BJ. Brachial and antebrachial arterial patterns: a study of 750 extremities. Surg Gynecol Obstet. 1953; 96: 43–54.
11. Wilgis EFS, Kaplan EB. The blood and the nerve supply of the hand. In: Morton Spinner, ed. Kaplan‘s Functional and Surgical Anatomy of the Hand. 3rd Ed., Philadelphia, J.B. Lippincott Company. 1984; 206.
12. Mezzogiorno A.Passiatore C. Mezzogiorno v. Anatomic variations of deep palmar arteries in man. Acta Anat,1994,149(3):221-4
13. Olave E.Prates JC. Deep palmar arch patterns in Brazilian individuals. Surg Radiol.Anat.1999:(21)267-71
14. Shin Matsumoto1 , Hans-Jürg Kuhn2 ,Hermann Vogt3 , Michael Gerke3 Embryological development of the arterial system of the forelimb in Tupaia,Article first published online: 26 JAN 2005DOI: 10.1002/ar.1092400314
ABBREVIATIONS
ANM- ARTERIA NERVI MEDIANA
FR- FLEXOR RETINACULUM
FDMA- FIRST DORSAL METACARPAL ARTERY
DPA- DEEP PALMAR ARCH
IDP.Br- INFERIOR DEEP PALMAR BRANCH OF ULNAR
ARTERY RA- RADIAL ARTERY SPA- SUPERFICIAL PALMAR ARCH
UA- ULNAR ARTERY
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30TechnologyA REVIEW ON M-HEALTH SYSTEM AND TECHNOLOGIES
English5358Arvind RehaliaEnglish Rajat KumarEnglishRapid advances and developments in information technology and telecommunication have brought in picture a promising technology, called mhealth, for delivery of health-care facilities via mobile communication technologies. For accelerating the potential of mhealth, it is important to carefully study the barriers and gaps in policies and collaboration between governments and health-care institutions. This paper presents a detailed analysis of current and emerging trends in mobile health, with particular emphasis on case studies.
EnglishChild-Count, Colecta-Palm, Mobile Midwife, mhealth.INTRODUCTION
In 1983, the DynaTAC 8000X was the first mobile phone to be commercially available. From then onwards, mobile technologies have grown many-folds with an initial start from telephony systems to the modern systems that support a large array of services like text messaging, email, gaming, photography, internet access, short range wireless communication etc. Mobile phones have successfully bridged the the digital divide among different sections of developing economies and have reached the bottom of the economic pyramid. No other innovation has ever provided such parallel and distinct opportunities for instant communication and thus the utilization of potential of such a technology for health-care facilities has become important and obvious. Mhealth refers to the delivery of health care facilities supported by mobile devices using cellular, blue-tooth or wireless networks. The field of mhealth has emerged in the last decade or so and has put in place various applications of health-care service delivery for remote monitoring, emergency telemedicine, telematics, tele-radiology, education, awareness and other direct provisions of care. In recent years, several mhealth technologies have been implemented all across the globe under various research and health-care projects. The objective of the current paper is to present a review on mhealth systems and technologies. This paper has been divided into different independent sections and provides analysis of the concerned section accordingly. Next section presents a brief overview of current mobile communication technologies and their future design and considerations. After that a section on overview of related work done through published conference and journal papers has been placed. Next, a section on case studies has been presented and finally the paper wraps up with concluding remarks.
CURRENT MOBILE TECHNOLOGIES
This section describes the main wireless technologies used in mhealth systems and their future designs and considerations. SMS functions and real-time voice communication collectively forms the backbone of cellular communication. However with the development of technologies like that of smart phones and PDAs, the scope of mhealth is not just limited to cellular network integration. GSM is the current technology in use and was developed by European Telecommunications Standards Institute under the secondgeneration (2G) technologies. GSM operates under a carrier frequency range of 900 MHz to 1800 MHz with a limited data transfer rate of 9.6 Kbit/s. However, in recent years 2.5G (iDEN, GPRS, EDGE) and 3G ( TD-CDMA, W-CDMA, CDMA) technologies have evolved having higher data transfer rates as compared to GSM. Apart from GSM and 3G systems, Wireless Local Area Network (WLAN) and satellite systems also provide a means for data transfer for mhealth systems. The satellite systems provide global coverage and can operate under various frequencies and data transfer rates. WLAN links two or more devices using speed spectrum or OFDM radio methodology and provide data connectivity with user mobility (roaming unit). After a detailed analysis, the following limitations were observed in the current mobile communication technologies:
1. High cost of Communication Links and Infrastructure.
2. Limited bandwidth and data transfer rate.
3. Lack of network reliability of cellular networks.
4. Security challenges during data transfer.
5. Absence of guidelines for cellular phones to be used as imaging device.
The next generation mobile technologies must eliminate the limitations of the current system and on the other hand it should seamlessly integrate the current technologies for a better and advanced design. It is expected that the 4G technology will incorporate the fundamentals that will ensure costeffectiveness and high data transfer rates. The LTE Advanced technology (4G) promises to provide download speeds up-to 1Gbit/s and 100Mbit/s to mobile users. Further, the 4G will be based on iPv6. Considering the continuous improvements, it is almost certain that the ability of mhealth will grow many times as with larger bandwidths and faster data transfer rates, good imaging will become possible.
RELATED WORK
This section reports the related work done by research community all across the globe for development of an effective system for implementation of mhealth for health-care service delivery. Different databases like IEEE, INSPEC etc. were searched and finally a total of ten research papers published in various journals and conference proceedings were selected on the basis of the technologies involved and the area of application. The work listed table 1 provides a snapshot of implementation and integration of different technologies for health-care service delivery by mhealth concept. It was found that the current topic of focus among biomedical researchers is about development of systems for remote patient monitoring and wireless BODY AREA NETWORK. Further, there has been a continuous work going on for improving and integrating ambulatory emergency services and mhealth for better care of patient. Table 1, clearly suggests that mhealth is now not just confined to cellular network technologies and other technologies like ZigBee, Blue-tooth, satellite etc. have also stepped in as other communication network technologies for the development of mhealth systems.
CASE STUDIES A total of five case studies based on different areas of application of mhealth along with results, findings and other necessary details are presented here in this section. They are as under:
1. REAL TIME BIOSURVEILLANCE PROGRAM [11]:
AREA OF APPLICATION : Disease and Epidemic Outbreak Surveillance. Description : This program was started in India and Sri-Lanka with an objective to study and analyze mhealth systems for improving early detection and notification system for disease and epidemic outbreak. Under this program, 29 front line health workers in India and 16 in Sri-Lanka were chosen for digitizing the current paper based system of forms and patient health records by using mobile phones. The mobile phones were equipped with a customized application, called mhealthSurvey, developed jointly by IIT Madras and Rural Technology and Business Incubator. 4 primary health centres and 25 health sub-centres located in Tamil Nadu in India and 17 hospitals and clinics all across the country in Sri-Lanka were selected for implementation. Front line health workers digitized the patient's data at health centres and transferred them to central server. A statistical data analysis software developed by AUSTON LAB at Carnegie Mellon University was used for analysis at central server and results were sent to regional and local health officials through mobile and other communication technologies for issue of notification, if required.
RESULTS AND FINDINGS 1. It was observed that in India about 86% of the data was submitted in other-time and only 14% data in real-time. This suggests that the health workers faced difficulty in real-time submissions, mainly, due to high frequency of visiting patients. On the other hand, in SriLanka around 70% of the data was submitted in real-time. 2. Indian health workers were almost accurate in data submissions and 100% accurate in the last four weeks of the program. However, there was very large amount of errors in submissions made by SriLankan health workers. 3. It was observed that in Sri-Lanka front line health workers were aged 18-35 and were able to complete the whole process easily. However, in India front line health workers aging 30-50, even many of them with experience of 10 years or more were unable to complete the process without guidance. This suggests that younger generation is more adaptive to newer technologies than the older ones.
2. COLECTA-PALM [12]: AREA OF APPLICATION : Patient Monitoring and Support. Description : This project was started in Peru under the initiative of University of Washington and Universidad Peruana Cayetano Heredia Lima. Collecta-Palm is a web based application delivered on PDAs to HIV/AIDS patients for antiretroviral treatment and reducing transmission by safer sex behavior. This application uses intranet based secure connection for transfer of web surveys to HIV/AIDS patients. A research analysis on 15 people with HIV/AIDS (PWLHA) in two clinics in LIMA was carried out. RESULTS AND FINDINGS : Nine out of fifteen patients were satisfied with this technology and rated 3.7/5. They found this system easy-to-use, private and innovative.
3. CHILD-COUNT [13]: AREA OF APPLICATION : Point-of-care Support and Diagnosis. Description : This program was started in July 2009 in Sauri, Kenya under the partnership of Millennium Villages Project, The Earth Institute at Columbia University, UNICEF Innovation Group, Sony Ericsson and Zain. Under this project, more than 9500 children under five years of age were monitored for community based management of acute malnutrition by measuring a child's mid upper arm circumference, home based testing of malaria and home based treatment of children with diarrheal illness using ORS and Zinc supplements. The implementation was done by using a mobile application based on RapidSMS ( a free open-source framework for data collection, logistics and communication using SMS technology ) by 100 community health workers. They used SMS messages to register a patient with all the necessary details and demographics.
RESULTS AND FINDINGS 1. Initially duplicate child registrations made problems, however, changes made to the registration algorithm later solved out this issue. 2. It was found that community health workers required additional training for efficient use of the system. 3. It was found that about 10% of the total registration messages sent by the community health workers were rejected due to improper formatting by them. 4. Many of the phones went missing or needed replacement, thus adding to the overall cost of the project.
4. m-MONEY FOR WOMEN WITH FISTULA [14] : AREA OF APPLICATION : Health Financing Description : This project was started in Kenya as a combination of mobile banking, public information and free treatment. In Kenya, money transfers through mobile phones (Safaricom), constitute about 11% of GDP. Also, in a statistical survey, called msurvey, about 42% of the respondents didn't have access to formal bank accounts but use their mobile phone for financial transactions. Considering the potential of mobile banking in Kenya, this project was started to address the problems faced by poor rural women in fistula repair services. The cost of transportation to a fistula unit and lack of information about treatment options are the main problems of the concern. Under this project, a women can call a free hot-line to aquire information about fistula repair and if money is needed by women for transportation to a fistula unit, financial transfers are made via M-PESA ( a mobile banking product of Vodafone).
5. MOBILE MIDWIFE [15] : AREA OF APPLICATION : Health Education and Awareness. Description : This project was started in east Ghana, under the program, called, Mobile Technology For Community Health (MOTECH). This initiative is a result of partnership among Ghana Health Service, Grameen Foundation and Columbia University's Mailman School Of Public Health and is funded by Bill and Melinda Gates Foundation. The objective of this project is to improve the antenatal and neonatal care of rural women. In this community health workers, register the patient using MOTECH forms on mobile phones and issue a particular patient ID number. The patient then receives voice or text messages regularly regarding health information and information on essential vaccination and childhood diseases after the birth. In case a patient has a query, then she can clarify that by making a call citing reference to her patient ID.
CONCLUSION The current paper provided a brief overview of mhealth systems and technologies. The case studies clearly suggest the need for development of low cost ,secure and effective solutions for successful implementation of mhealth. Education and awareness about new technologies among community health workers is important and organizational changes should be incorporated for a better future of the telemedicine industry. While much research and development still needs to be done, the mhealth technology has already started making its impact and the future will definitely witness a revolutionized health system that will benefit the citizen and the society as a whole.
ACKNOWLEDGEMENT Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of the manuscript. Authors are also grateful to author/editor/publisher 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=1945http://ijcrr.com/article_html.php?did=19451. Hernandez A.I, Mora F, Villegas G, Passariello G, Carrault G. Real-time ECG Transmission via Internet for nonclinical applications. Proceedings of IEEE Transactions on Information Technology in Biomedicine. 2011 Sept; p. 253-57.
2. Aart Van Halteren, Richard Bults, Katarzyna Wac, Dimitri Konstantas, Ing Widya, Nicolay Dokovsky et al. Mobile Patient Monitoring: The Mobihealth System. The Journal of Information Technology in Health Care. 2004; 2(5): 365-73.
3. Yoshiko Yamada, Usui S, Kohn M, Mukai M. A vision of Ambulance Telemedicine Services using the Quasi-Zenith Satellite. Proceedings of 6 th International Workshop on Enterprise, Networking and Computing in Health-care Industry, HealthCom 2004. 2004 June 28-29; p. 161-65.
4. Eduardo A. Viruete Navarro, Jose Ruiz Mas, Julian Fernanadez Navajas, Cristina Pena Alcega. Enhanced 3G- Based mhealth System. Proceedings of the International Conference on Computer as a Tool, Eurocon 2005. 2005 Nov. 21-24; p. 1332- 35.
5. Pandian P.S, Safeer K.P, Shakunthala D.J, Parvati Gopal , Padkai V.C. Interent Protocol based store and forward wireless telemedicine system for VSAT and WLAN. Proceedings of International Conference on Signal Processing, Communication and Networking. 2007 Feb. 22-24; p. 54-8.
6. Zuehlke P, Li J, Talaei-Khoei A, Ray P. A Functional Specification for mobile ehealth (mhealth) Systems. Proceedings of 11th International Conference on e-health Networking, Application and Service. Dec. 16-18; p. 74-8.
7. Christian Sax, Elaine Lawrence. Point-oftreatment: Touchable E-nursing user Interface for Medical Emergencies. Proceedings of Third International Conference on Mobile Ubiquitous Computing, Systems, Services and Technologies. 2009; p. 89-95.
8. Rifat Shahriyar, Md. Faizal Bauri, Gaurab Kundu, Sheikh Iqbal Ahamed, Md. Mostafa Akbar. Intelligent Mobile Health Monitoring System (IMHMS). International Journal of Control and Automation. 2009 Sept; 2(3): 13-28.
9. Minutolo A, Sannino G, Esposito M, Depietro G. A rule-Based mhealth System for Cardiac Monitoring. Proceedings of IEEE EMBS conference on Biomedical Engineering and Sciences. 2010 Nov. 30- Dec 2; p. 144-49.
10. Blumrosen G, Avisdris N, Kupfer R, Rubinsky B. C-SMART: Efficient Seamless Cellular Phone Based Patient Monitoring System. Proceedings of IEEE IREHSS 2011: Third International Workshop on Interdisciplinary Research on E-health Services and Systems. 2011 June 22-25.
11. Gordon A. Gow, Nuwan Waidyanathan. Using Mobile Phones in Real-time Biosurveillance Program: Lessons from the front lines in Sri-Lanka and India. Proceedings of International Symposium on Technology and Society (IEEE). 2010 June 7-9; p. 366-74.
12. Walter H. Curioso, Ann E. Kurth, Robinson Cabello, Patricia Segura, Donna L. Berry. Usability Evaluation Of Personal Digital Assistants (PDAs) to support HIV Treatment Adherence and Safer Sex Behavior in Peru. Proceedings of AIMA 2008 Symposium. 2008; p. 918.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareTREATMENT SEEKING BEHAVIOR OF MARRIED WOMEN OF REPRODUCTIVE AGE BELONGING TO A
RURAL COMMUNITY OF INDIA
English5969Mohammad Shakil AhmadEnglish Shaikh MohsinEnglish Ritu Kumar AhmadEnglishBackground: India is a country of villages where 72.2% of the people live in the rural area and women of reproductive age group (15-49 years) constitutes 21% of the total population. Majority of the women suffer from morbidity due to obstetric and gynecological problems. Objectives:To know the health seeking behavior of a married women of reproductive age and to know the types of health services utilized by them. Methodology:It is one year community based cross sectional study. The study was conducted at Handignur PHC area in Belgaum district (India) from January 2007- December 2007, with a sample size of 732 (total number of all women in reproductive age group of selected villages under Handignur PHC area). All married women of reproductive age group were included in the study, and data was collected by administering pre designed and pre tested structured proforma. Data were analyzed using SPSS software. Results:The present study revealed that, 22.03% of the women were in the age group of 35-39 years. The literacy rate of the women was found to be 74.4%. The literacy rate of their husbands was found to be 82.4%. Joint family was the commonest being 81.28%. 71.3% of the women belonged to the category V of modified Prasad‘s group of socio economic status classification. All married women of reproductive age had the knowledge of the facilities available near their homes. 79.09% of the women preferred to go the PHC/ sub center for general health problems. 99.59% said it was easy accessibility. 92.49% said that they were satisfied by the treatment. In case of 75.18% of the study participants their husband‘s made decisions for them regarding their general health problems. For obstetrics care all 732 women preferred going to the PHC/ sub center. 39.34% said they made 1-2 visit for their ANC check up‘s. And to be noted that 21.03% of the women did not make a single visit as there was no PHC‘s/ sub center during the time of their pregnancy. 78.96% said they received iron and folic acid tablets during the time of their pregnancy. 54.78% women said the doctor provided it to them. 78.96% said they received injection tetanus toxoid injection during the time of their pregnancy. 66.12% said that they preferred the PHC/ sub center for the choice of place for getting delivered. 47.00% preferred the doctors conducting the deliveries. The choice of health facility opted for the gynecological problems; 81.42% said that they preferred the PHC/ sub center. 81.42% women said because it was near to thehouse, all necessary and emergency drugs were available and all facilities were provided. 46.17% of the women said it was their own decision. 91.25% women said they were practicing either temporary or the permanent methods or their husbands were using temporary methods of family planning. 61.07% women were using copper T as the methods of family planning. 61.07% women said the doctors at the PHC/ sub center helped them in providing them the family planning methods. 48.35% women said it was their husband‘s decisions in case of family planning. Conclusion: The participants had a fair knowledge regarding treatment seeking, the availability of health care services and the types of services offered. TREATMENT SEEKING BEHAVIOR OF MARRIED
WOMEN OF REPRODUCTIVE AGE BELONGING TO A RURAL COMMUNITY OF INDIA
Mohammad Shakil Ahmad1, Shaikh Mohsin1, Ritu Kumar Ahmad2
1College of Applied Medical Sciences, Qassim University, Saudi Arabia
2Chettinad Hospital and Research Institute, Kelambakkam, Chennai
E-mail of Corresponding Author: doc_shakmd@live.com
60 International Journal of Current Research and Review www.ijcrr.com
Vol. 04 issue 03 February 2012
The key decision maker for general health problems, obstetric health problems and for family planning
was the husbands, where as for the gynecological problems the majority of women made her own
decisions.
EnglishTreatment seeking behavior, married women, reproductive age group, rural communityINTRODUCTION
Health seeking behaviour is a topic which has received considerable attention in recent years. The ?quest for therapy?, all over the world is an important research issue since it reveals essential elements of people‘s social behavior and provides insight into their perceived needs for different kinds of health services. The community diagnosis is the starting point for local health planning - at least in theory- and the study of how people use health care facilities is an important component of it.1 Health care delivery in developing countries have been typically described in terms of insufficient medical and paramedical staff, unequal access to services, emigration of qualified personnel to jobs in other countries, and the concentration of manpower in the cities, leaving the under-served rural areas, has caused more than 80% of the population without access to appropriate medical care.2 The rural areas of developing countries are not ?health care deserts?, but they have their own systems of beliefs and customs and their own kinds of indigenous health practitioners. As their adaptation to the impact of western medicine has become better understood, their potential contribution to the primary health care has been reconsidered.2 Health seeking behavior refers to those activities undertaken by individuals in response to symptoms experienced. It is a dynamic process in the house-hold, which combines knowledge, resources, decision making power and the availability of health facilities. It requires some basic knowledge for seeking treatment such as few repeated episodes of any disease in household or any prior experience which helps in making a decision.3 Situation in India: India is a country of villages where 72.2% of people live in rural areas.4 Because of ignorance, illiteracy, cultural and religious factors, rural people are at higher risk of illness. Many factors play an important role such as socio-economic status, cultural acceptability, decision making power, the availability of health care services, or the treatment seeking behavior of the people. Health seeking behavior is influenced by large number of factors apart from knowledge and awareness like bio-social profile, their past experiences with health services, influences at community level, availability of alternate health care providers and their perceptions regarding efficiency and quality of services.4 In India, women of reproductive age group (15-49 years) constitute 21% of the total population, apart from the morbidity experienced by general population; women of reproductive age group also suffer from morbidity due to obstetric and gynecological problems. 5 Around 70% of the deliveries are conducted by untrained personnel, which will have an impact on maternal and infant mortality as well as morbidity. As women of reproductive age come under vulnerable group, it is important to know their treatment seeking behaviour, their decision making power, and utilization of health care services that are available. This study focuses how efficient is the present woman, in making decisions for availing the health care facilities, while the country is talking of women empowerment. The present study is an attempt in this direction.
Objectives
1. To know the treatment seeking behaviour of married women of reproductive age (15-49 years).
2. To know the types of health services utilized by them
METHODOLOGY
This community based cross sectional study includes all married women (732) of reproductive age (15-49 years) living under the sub center Handignur for a period of one year. Questionnaires was prepared which includes information on socio demographic variables, treatment seeking behavior for general health problems, obstetric care gynecological problems, and family planning the types of health services that are used by them and who actually takes the decision for seeking treatment. Study includes all married women of reproductive age group (15-49 years), residing at their home since one year. Research was conducted during January-2007 to December-2007. Place of study: Handignur village is situated 12 kilometers North East of Belgaum city. Handignur Primary Health Center has four sub-centers; with a total population of 24,160.Out of four one of the sub-centers was randomly selected. All villages under this sub-center were included (total no. of household were 762) and from these villages all married women (732) of reproductive age were included in the study. The required information was collected through door to door personal interview after informed, verbal and written consent. The services utilized for some of the problems like abortion and sexually transmitted diseases were not included in the study. Socio economic status: Per capita income in Rupees per month was classified using the modified BG Prasad classification.6.
Results
Demographic profile of study participants: The observation stated below are the findings of the present study conducted upon 732 study participants, married women of reproductive age of Handignur sub centre, Belgaum district, Karnataka state. Among the total 732 married women studied majority of them were between the age group of 35-39 years (22.03%). Mean age of patients studied was 35.6 ± 8.87 years. It was observed that out of 732 husbands of study participants, 129 (17.6%) were illiterate and out of 732 study participants (female), 187 (25.5%) were illiterate. While, 135 (18.44%) belonged to nuclear family, 595 (81.28%) study participants were from joint family, and 2 (0.27%) were from broken family. Out of total, 352 (48.08%) were from village Handignur where PHC and sub-center are situated and rest were from other villages under the same PHC. While evaluating modified Prasad‘s classification, out of all study participants, 11 (1.5%) women belonged to category I, 40 (5.5%) women belonged to category II, 60 (8.2%) belonged to category III, 99 (13.5%) belonged to category IV and 522 (71.3%) belonged to category V. When asked about any health facility located near the residence, all of 732 (100%) study participants were aware about PHC/ sub-centre and 352 (48.08%) had knowledge about private clinic. General health problems : This study reveals that, 579 (79.09%) study participants availed the PHC/ Sub centre for general health problems, 29 (3.96%) of the study participants visited a private doctor for general health problems. Out of 732 study participants, 677 (92.48%) women were satisfied with the treatment given at the PHC/sub-centre. 153 (20.90%) women said it would be their own decision for a health facility while 555 (75.18%) women said it would be their husbands decision and rest would depend on others decision to choose a health facility for general health problems. Obstetrics care: In this study out of 732 study participants all women said they were using the PHC/ Sub-centre for their obstetrics. 288 (39.34%) study participants had visited the PHC/sub-centre once during ANC (Antenatal Checkup), 290 (39.01%) women had visited more than once while 154 (21.03%) did not make any visit during ANC as there was no health facility available in and around during their pregnancy. In this study the 578 (78.96%) study participants received iron and folic acid tablets during ANC, and 154 (21.03%) did not receive any iron and folic acid tablets during ANC. 578 (78.96%) participants received injection tetanus toxoid and 154 (21.03%) women did not receive any injection of tetanus toxoid. It was observed that 154 (21.03%) study participants preferred home for conducting delivery as there was no health facility available during pregnancy, 484 (66.12%) preferred PHC / sub-centre for conducting delivery, 24 (3.27%) preferred district hospital, 43 (5.87%) preferred tertiary care center, and 27 (3.68%) women preferred private nursing homes for conducting delivery. The decision makers for using the health facilities for obstetric care were, 153 (20.90%) women made their own decisions, 555 (75.82%) women‘s husbands made the decision, 23 (3.14%) women‘s in laws made the decision, and for one woman (.14%) others who made decision to use the facilities for obstetrics care. Gynecological health problems: Out of 732 study participants who complained of gynecological problems, there were 110 (15.02%) women who complained of menorrhagia, 226 (30.87%) women complained of white discharge, 321 (43.85%) women complained of dysmenorrhoea, and 75 (10.24%) women had other problems. The choice of health facility for gynecological problems given as, 596 (81.42%) women preferred PHC / sub centre, 32 (4.37%) women preferred tertiary care center, 71 (9.69%) preferred the district hospital, 18 (2.45%) women preferred the private hospitals and 15 (2.04%) women preferred other places for gynecological problems. The reasons given for using this health facility for gynecological problems were, 34 (4.64%) women said that it was near to their house, 30 (4.09%) women said it was because all drugs were available, 72 (9.83%) women said because all facilities were provided their, and 596 (81.42%) females said all the reasons were true and that was the reason for using the facility. 338 (46.17%) women made their own decision for using the particular health facility for gynecological problems while others 394 (53.81 %) depended on others decision (Table -1). Family Planning: Out of all participants, 668 (91.25%) women practiced family planning and 64 (8.74%) women did not opt for family planning. In this study out of 732 study participants, 668 women were using any method of family planning, 57 (8.53%) women were using oral contraceptive pills as contraceptive methods, 79 (67.06%) women had got copper T inserted, 31 (23.80%) women had undergone tubectomy, 6 (0.59%) women said their husbands were using condoms. Total 668 couples were using family planning methods. Out of 668 participants, 261 (39.07%) women made their own decision for using for using contraceptive methods and 323 (48.35%) women had taken the advice of their husbands for using contraceptive methods. Impact of literacy status of the women on utilization of general health problems (Table – 2): The decision making with respect to education was as follows, in illiterates 27.80% women made their own decision, 66.31% women consulted their husbands, 5.88% women consulted their in laws, and no women consulted others. In primary school educated group, 20.62% women made their own decision, 77.18% women consulted their husbands, and 2.18% women consulted their in laws, In high school educated group, 16.41% women made their own decision, 81.59% women consulted their husbands, and 1.99% women consulted their in laws, In higher secondary educated group, 9.37% women made their own decision 82.60% women consulted their husbands, 4.34% women consulted their in laws for decision to take treatment for general health problems. Impact of literacy status of the women on utilization of Obstetrics problems: It was observed that decision making with respect to education was as follows, in illiterate group, 91.97% women made their own decision, 1.77% women consulted their husbands, 0.53%women consulted their in laws, and 0.53% women consulted others. In primary school educated group, 39.06% women made their own decision, 50.62% women consulted their husbands, 6.25% women consulted their in laws and 4.06% women consulted others. In high school educated group, 35.32% women made their own decision, 62.18% women consulted their husbands, 0.99% women consulted their in laws and 1.49% women consulted others. In higher secondary educated group, 49.96% women made their own decision, 56.52% women consulted their husbands, and nobody consulted their in laws or others for decision to take treatment for obstetric care. Impact of literacy status of the women on utilization of gynecological problems: It stated that decision making with respect to education was as follows; in illiterate group, 91.97% women made their own decision, 0.53% woman consulted their husbands, 6.95% women consulted their in laws, and 0.53% woman consulted others. In primary school educated group, 30.93% women made their own decision, 16.56% women consulted their husbands, and 45.93% women consulted their in laws, and 6.56% women consulted others. In high school educated group, 29.35% women made their own decision, 9.45% women consulted their husbands, 60.19% women consulted their in laws, and 0.99% women consulted others. In higher secondary educated group, 34.78% women made their own decision, 13.04% women consulted their husbands, and 52.17% women consulted their in laws. In graduate women, all women made their own decision for treatment of gynecological problems.
Impact of literacy status of the women on utilization of family planning methods: In this study decision making with respect to education was as follows; in illiterate group, 45.69% women made their own decision, 53.22% woman consulted their husbands, 0.53% women consulted their in laws, and 0.53% woman consulted others. In primary school educated group, 38% women made their own decision, 42.80% women consulted their husbands, 8.11% women consulted their in laws and 11.07% women consulted others. In high school educated group, 34.73% women made their own decisions, 50% women consulted their husbands, 2.63% women consulted their in laws, and 12.63% women consulted others. In higher secondary school educated group, 35% women made their own decision, 60% women consulted their husband, and 5% woman consulted others while all graduate women consulted their husband for family planning methods. Decision making with respect to socio economic status of family for general health problems (Table – 3): It was as follows; in category I, 9.09% woman made their own decision, 81.81% women consulted their husbands, 9.09% woman consulted their in laws. In category II group, 12.5% women made their own decision, 82.5% women consulted their husbands and 5% women consulted their in laws. In Category III group, 23.33% women made their own decision while 76.66% women consulted their husbands. In Category IV group, 20.20% women made their own decision 76.76% women consulted their husbands and 3.03% women consulted their in laws. In Category V group, 21.83% woman made their own decision, 74.90% consulted their husbands, 3.25% women consulted their in laws and none consulted others for treatment of general health problems. Decision making with respect to socio economic status of the family for obstetrics care(Graph-1); in category I, 36.36% women made their own decision, 45.45% women consulted their husbands and18.18% women consulted their in laws. In category II group women 35% women made their own decision, 25% women consulted their husbands, 25% women consulted their in laws, and 15% women consulted others. In Category III group, 40% women made their own decision, 20% women consulted their husbands, 35% women consulted their in laws, and 5% women consulted others. In Category IV group, 32.32% women made their own decision 18.18% women consulted their husbands, 44.44% women consulted their in laws, and 5.05% women consulted others. In Category V group, 27.96% woman made their own decision, 18.19% consulted their husbands, 48.85% women consulted their in laws and 4.98% women consulted others for obstetric care. Decision making with respect to socio economic status of family for gynecological health problems (Table -4); in category I, 9.09% woman made their own decision while rest consulted their husbands. In category II group, 12.55% women made their own decision, 82.5% women consulted their husbands, and 5% women consulted their in laws. In Category III group, 23.33% women made their own decision and 76.66% women consulted their husbands. In Category IV group, 22.22% women made their own decision, 74.74% women consulted their husbands, and 3.03% women consulted their in laws. In Category V group, 21.83% woman made their own decision, 74.90% consulted their husbands, and 3.25% women consulted their in laws for treatment of gynecological health problems. Decision making with respect to socio economic status of family for family planning (Table -5); In category I group, 9.09% woman made their own decision while 90.90% women consulted their husbands. In category II group, 12.5% women made their own decision, 82.5% women consulted their husbands, and 5% women consulted their in laws. In Category III group, 23.33% women made their own decision, 76.66% women consulted their husbands, and no women consulted their in laws. In Category IV group, 22.22% women made their own decision 74.74% women consulted their husbands, and 3.03% women consulted their in laws. In Category V group, 21.83% woman made their own decision, 74.90% consulted their husbands, and 3.25% women consulted their in laws for family planning methods. Decision making with respect to the type of family for general problems; 16.93% women who belonged to the nuclear family made their own decision, 79.83% women consulted their husbands, and 3.22% women consulted their in laws. In women belonging to joint family, 21.94% women made their own decision, 74.91% women consulted their husbands, and 3.13% women consulted their in laws. And in broken family 100% women took their own decision for taking treatment for general health problems. Decision making with respect to the type of family for obstetrics problems; 45.16% women who belonged to the nuclear family made their own decision, 19.35% women consulted their husbands, 33.87% women consulted their in laws and 1.61% women consulted others. In joint family women, 26.73% women made their own decision, 19.14% women consulted their husbands, 47.85% women consulted their in laws and 6.27% women consulted others, while in broken family all women took their own decision for obstetric care. Decision making with respect to the type of family for gynecological problems; 34.67% women who belonged to the nuclear family made their own decision, 12.09% women consulted their husbands and 53.22% women consulted their in laws. In joint family women, 48.67% women made their own decision, 10.06% women consulted their husbands, 37.29% women consulted their in laws and 3.96% women consulted others. Decision making with respect to type of family for family planning (Table -6); 35.96% women who belonged to the nuclear family made their own decision, 55.26% women consulted their husbands, 0.87% women consulted their in laws and 6.14% women consulted others. In joint family women, 39.49% women made their own decision, 47.10% women consulted their husbands, 4.25% women consulted their in laws and 8.87% women consulted others.
DISCUSSION
The present study revealed that, 22.03% of the women were in the age group of 35-39 years. The literacy rate of the women was found to be 74.4%. The literacy rate of their husbands was found to be 82.4%. Joint family was the commonest being 81.28%. According to the census data the literacy of females is 52% so being significant.7 Three-forth of the women belonged to the category V of modified B G Prasad‘s classification of socio-economic status. All married women of reproductive age had the knowledge of the health facilities available near their homes. Door steps services were provided to all married women, 88.93% of the study participants said ANM‘s provided them these services. And all study participants said that services provided were curative, diagnostic, health education, natal services, family planning and immunization. Out of the 732 women for general health problems, 79.09% of the women preferred to go the PHC/ sub-center. The reason that they gave was easy accessibility, as agreed by 99.59%.of women. 92.49% were satisfied by the treatment given. 75.18% of women said their husband‘s were the decision makers for their general health problems. For obstetrics care all 732 women preferred going to the PHC/ sub center. 39.34% said they made 1-2 visits for their ANC checkups, and it was also noticed that 21.03% of the women did not make a single visit during the time of their pregnancy. 78.96% of women had received iron and folic acid tablets during the time of their pregnancy. More than half of study participants told doctor providing it to them. 78.96% had received injection tetanus toxoid during the time of their pregnancy. 66.12% of women preferred the PHC / sub center as a convenient place for getting delivered. 47% preferred the doctors to conduct their deliveries.
Three forth of women said their husbands took the decisions concerned to obstetrics care. The choice of health facility opted by 80% of women for their gynecological problems was either PHC / sub center. 81.42% women went there because it was near to the house and all necessary and emergency drugs were available and also all facilities were provided. More than 90% women said they were practicing either temporary or permanent methods or their husbands were using temporary methods of family planning. 61.07% women were using copper T as the method of family planning. 61.07% women said the doctors at the PHC/ sub center helped them in providing family planning services. Around 50% women said their husband‘s decided about the family planning.
CONCLUSION
In the present study, the women of reproductive age group residing in PHC/sub center Handignur had a fair knowledge regarding treatment seeking, the availability of health care services and the types of services offered by them. Most of the women preferred the PHC/ sub center for mostly obstetric care as the new generation was more aware of the health care system. However it was observed that they utilized much of the services offered by the PHC/ sub center for preventive services as it was adequate and free of cost. For obstetric care they did not hesitate in deciding the choice of place to deliver as Handignur PHC/ sub center is providing all modern facilities, including a baby warmer and a neo natal resuscitation kit. Door steps services were provided by the health workers uniformly at all the three villages that come under the PHC/ sub center. The frequency of the health visitor to the area was also there for health education. Antenatal care was provided by health workers and utilized by the women of the PHC/ sub center. Younger women availed the facility more compared to the older generation, who did not have the privilege women of a health facility near their house at the time of their pregnancy. Women‘s awareness towards treatment seeking for obstetric care was also found, as compared to the older generation. The importance of attending the ANC clinics, intake of iron and folic acid tablets, and the two doses of tetanus toxoid injections was also seen. This was due to the regular health education conducted by the doctor, health visitors, ANM‘s and the anganwadi workers. The decision maker for general health problems, obstetric care and for family planning was still dependent on their husbands where as for the gynecological problems the majority of women made her own decisions.
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=1946http://ijcrr.com/article_html.php?did=19461. Pamela A Hunter and Farhat Sultana, ?Health Seeking Behaviour and the meaning of Medications in Bolochisthan, Pakisthan?; Soc. Sci. Med. Vol. 34, No. 12, pp. 1385 – 1397, 1992.
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4. K Park, Text book of Community Medicine, 18th Edition M/ s Banarasidas Bhanot Publishers; 353- 383, 2005.
5. M Jain, D Nanda, S K Misra, ?Quality assessment of Health Seeking Behaviour and Perception regarding Quality of Health Care Services among rural community of District Agra?, Indian Journal of community medicine Vol. 31, No. 3, July – September, 2006.
6. Kulkarni A P, Barde. J. P. Text book of Community Medicine, Ist edi. Mumbai: Vora Medical Publications: 1998.
7. Governments of India, Ministry of Statistics and Program Implementations, file no. M- 12011/ 2/ 2005- PCL.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30TechnologyTREND ANALYSIS OF NORTHEAST MONSOON RAINFALL OF TAMIL NADU
English7073Tamil Selvi .S English Samuel Selvaraj .REnglishRainfall forecasting has been one of the most scientifically and technologically challenging problems around the world in the last century. Statistical analysis of rainfall records for long periods is essential to provide information about rainfall variability and to better manage the rainfed agricultural activities such that the impact of climate change as well as changes in land use can be realistically assessed. This paper analyse the northeast monsoon rainfall of Tamil Nadu from 1902 -2009 using linear regression technique. The chi-square test was performed to test the hypothesis. This analysis revealed that the trend
of northeast monsoon rainfall of Tamil Nadu is decreasing and they are not statistically significant.
Englishchi-square test , forecasting, hypothesis, linear regression, statistical analysis.INTRODUCTION
The northeast (NE) monsoon season (October, November and December) is the major period of rainfall activity over south peninsular India. This season is also known as the winter monsoon [1] and post-monsoon season[2]. The NE monsoon season contributes to about 50% of annual rainfall in the east coast of Indian peninsular [3] . Tamil Nadu is the only sub-division of the Indian union which receives more rainfall in the Northeast monsoon season than in the Southwest monsoon. India is basically an agricultural country and the success or failure of the harvest and water scarcity in any year is always considered with the greatest concern [4]. The term monsoon seems to have been derived either from the Arabic mausin or from the Malayan monsin. The availability of adequate freshwater of appropriate quality has become a limiting factor for the development worldwide [5] . Understanding rainfall variability is essential to optimally manage the scarce water resources that are under continuous stress due to the increasing water demands, increase in population and the economic development [6] . Accurate and timely weather forecasting is a major challenge for the scientific community. Rainfall prediction modeling involves a combination of computer models, observation and knowledge of trends and patterns.
METHODOLOGY
We have used the Northeast monsoon rainfall data of Tamil Nadu from the period 1902- 2009. The data are obtained from the Regional Meteorological centre, Chennai. A wide range of rainfall forecast methods are employed in weather forecasting at regional and national levels. Fundamentally, there are two approaches to predict rainfall. They are Empirical method and dynamical methods. Using these methods, reasonably accurate forecasts can be made up. Several recent research studies have developed rainfall prediction using different weather and climate forecasting methods. Regression is a statistical empirical technique and is widely used in business, the social and behavioral sciences, the biological sciences, climate prediction, and many other areas. The most widely use empirical approaches used for climate prediction are regression, artificial neural network, fuzzy logic and group method of data handling. This paper describes empirical method technique belongs to the regression approach which try to make a short-term forecast of rainfalls in our state. Generally, the study of the weather and climatic elements of a region is vital for sustainable development of agriculture and planning. A declining and/or rising trend etc may be quite instructive for different segments of the human and natural systems [7] . The time series is made up of four components known as seasonal, trend, cyclical and irregular [8]. Trend is defined as the general movement of a series over an extended period of time or it is the long term change in the dependent variable over a long period of time [9]. Trend is determined by the relationship between the two variables rainfall and time. Trend analysis was accomplished with the line graphs as well as the least square regression technique for hypotheses testing and modelling. The chi-square test of association is used to find whether there is significantly a variation in the data having similar background. A trend is the general pattern of fluctuation of data over time [10]. Many methods are available for calculating trend but the most common ones are the least square regression techniques [11] . For reasons of hypothesis testing, generalization and projection, the study adopted the least square regression method. The linear regression line was fitted using the most common method of least squares. This method calculates the best fitting line for the observed data by minimizing the sum of the squares of the vertical deviations from each data point to the line. If a point lies exactly on the straight line then the algebraic sum of the residuals is zero. Residuals are defined as the difference between an observation at a point in time and the value read from the trend line at that point in time. A point that lies far from the line has a large residual value and is known as an outlier or, an extreme value. Though time – series data are not bivariate data, a linear trend line can be obtained by using the simple regression analysis technique [12],[10]. In the study therefore, time in years is one independent variable (x) while North east monsoon rainfall amount for 108 years (1902- 2009) is considered the dependent variable (y). The equation of a linear regression line is given as [13] , Y = a + bx + e
where; Y = Dependent variable ( rainfall in mm) X = Independent variable (time in years). a = A constant and y – intercept b = Regression coefficient e = Error random term In order to fit regression line the north east monsoon rainfall (dependent variable) against time (independent variable) in years were plotted. Linear regression lines were then fitted to determine the trends of rainfall. The contingency test, k – sample chi-square test of homogeneity is employed to associate the rainfall data. The problem can be solved as a contingency problem utilizing the rather normal chi-square test formula. The use of the conventional χ 2 formula involves the calculation of the expected frequencies is calculated.
The following research hypothesis are formulated a prior for testing at 99% level of confidence. Hi: Northeast monsoon rainfall of Tamil Nadu has varied insignificantly over time in the study area Decision Rule Reject null hypothesis (Ho) and accept the alternative research hypothesis (Hi) if critical χ2 value is lower than the calculated value at 99% confidence interval.
RESULTS AND DISCUSSION
As shown in Fig. 1, the north east monsoon rainfall of Tamil Nadu is statistically defined by the function y = -0.0498x + 492.01 +e It is significant at 99% confidence level with a coefficient of determination figure of 0.0001 or 0.01 %. In our study, the calculated value is much higher than the critical value so null hypothesis is rejected and alternative research hypothesis is accepted. i.e. Northeast monsoon rainfall of Tamil Nadu has varied insignificantly over time in the study area. The trend though negative is statistically not significant at 99% confidence; percentage explanation is equally very low at 0.01%
CONCLUSION
Rainfall time series may be unfounded. The topic of monsoon-rainfall data series is highly complex; the role that linear regressions might play in this topic is one for future research—it appears, from the evidence here, not to be useful as a predictive model. Whether it might be useful for offering an approximate value of future monsoon rainfall remains to be seen. Rainfall is most essential for our life. So, we predict that rainfall in the certain period. Therefore, we avoid flood, cyclone, forest fire detection, global warming etc. In future we predict the rainfall forecasting and other applications done by using the artificial intelligence, neural network and fuzzy sets etc. We do the research on public sectors and save the world.
Englishhttp://ijcrr.com/abstract.php?article_id=1947http://ijcrr.com/article_html.php?did=19471. Nageswara Rao G. Variations of the SO relationship with summer and winter monsoon rainfall over India: 1872–1993. J. Climate 1999; 12 : pp. 3486–3495.
2. Singh N and Sontakke N A . On the variability and prediction of the rainfall in the post-monsoon season over India. Int. J. Climatol. 1999; 19: pp. 300–309.
3. Kumar P, Rupa Kumar K, Rajeevan M and Sahai A K . On the recent strengthening of the relationship between ENSO and northeast monsoon rainfall over south Asia. Climate Dynamics 2007; 28: pp. 649–660.
4. Rajeevan M . Prediction of Indian summer monsoon: Status, problems and prospects. Current Science. 2001; 81: pp. 1451-1457 .
5. Gat J.R . Planning and Management of a Sustainable and Equitable Water Supply under Stress of Water Scarcity and Quality Deterioration and the Constraints of Societal and Political Divisions: The Case for a Regional Holistic Approach. Department of Environmental Science and Energy Research. The Weizmann Institute of Science, 2004. 76100 Rehovot, Israel.
6. Herath, S. and Ratnayake, U. Monitoring rainfall trends to predict adverse impactsacase study from Sri Lanka (1964-1993). Global Environmental Change, 2004; 14: pp. 71-79.
7. Afangideh, A. I., Francis, E. Okpiliya, Eja, E. I. A Preliminary Investigation into the Annual Rainfall Trend and Patterns for Selected Towns in Parts of South-Eastern Nigeria Journal of Sustainable Development September 2010; 3: pp. 275-282.
8. Patterson, P. E. 1987, Statistical Methods, Richard D. Irwin INC, Homewood, IL
9. Webber, J. and Hawkins. C. 1980, Statistical Analysis Applications to Business and Economics, Harper and Row, New York.
10. Okoko, E. 2001, Quantitative techniques in urban analysis. Ibadan, Krafy Books
11. Box, GEP and Jenkins, G. M. 1976, Time series Analysis Forecasting and control. San Francisco, Holder Day Publishers.
12. Udofia, E. P. 2008. Fundamentals of social science statistics, Enugu, Immaculate. Books.
13. Hays, W. E. 1981, Statistics. CBS College publishing, Tokyo.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30TechnologyMICROBIAL, SENSORY AND NUTRITIONAL PROPERTIES OF CAULIFLOWER, PRESERVED BY
HURDLE TECHNOLOGY
English7480Jyoti SinhaEnglish Ramesh ChandraEnglishObjective: Develop suitable Hurdle treatment for preservation of cauliflower till 180 days of storage period. Methods: Fresh cauliflower were preserved by combinations of hurdles i.e. blanching (100°C for 60 sec.), steeped into different concentrations & combinations of preservatives – P0 (Control sample- fresh without treatment), P1( 8% Salt + 500 ppm Potassium metabisulphite + 100 ppm Sodium benzoate), P2 (10% Salt + 400 ppm Potassium metabisulphite + 200 ppm Sodium benzoate), P3( 12% Salt + 300 ppm Potassium metabisulphite + 300 ppm Sodium benzoate), P4 ( 8% Salt +0.3% Citric acid + 300 ppm Potassium metabisulphite + 300 ppm Sodium benzoate), P5 ( 10% Salt + 0.2% Citric acid + 400 ppm Potassium metabisulphite + 200 ppm Sodium benzoate) and P6 (12% Salt + 0.1% Citric acid + 500 ppm Potassium metabisulphite + 100 ppm Sodium benzoate), aseptically temperatures T1 (ambient- 30-37 °C) & T2 (refrigeration- 5-7 °C) for different time intervals i.e. 0, 30, 60, 90, 120, 150 & 180 days respectively. This preserved cauliflower were studied for their microbial, sensory & nutritional properties. Results: The treatments which remained microbial safe till 180 days of storage period were P4/T1 (YMC- 23.14count/gm), P5/T2(YMC- 17.71count/gm) & P4/packed into food grade polyethylene pouches and then stored at two different T2 (YMC - 8.43count/gm). Among these three, P4/T2 was scored highest in sensory, lowest in physical and highest in nutritional evaluation. Conclusion: Best hurdle treatment for preservation of cauliflower till 180 days of storage period was P4/T2.
EnglishHurdle , YMC, ppmINTRODUCTION
India is a leading vegetable producing country in the world with the production of 113.5 million tons. The country is blessed with the unique gift of nature of diverse climates and distinct seasons, which makes it possible to grow a variety of vegetables. The overall productivity of vegetables is 14.4 tons per hectare. The production of vegetables has taken a big jump due to advent of many hybrid varieties. But our market strategy is not equipped with the handling of large quantity of vegetables as a result quantities of vegetables get spoil. Post harvest losses of horticulture crops are immense. It varies between 5-39% of the total production. The shelf life of perishable vegetables is very low. In brinjal, cauliflower and chilly post harvest losses were found to be high (9 Jayanthi 2005). Preservation involves action taken to maintain foods with desired properties or nature for as long as possible. It lies at the heart of Food Science and Technology and it is the main purpose of Food Processing (3Barnettand and Blanchfield, 1995). The Hurdle concept was first introduced by Prof. 10Lothar Leistner of Germany and his colleagues in 1978. The hurdle governs many preservation processes. Intense heat (F) preserves canned foods, low water activity prevents microbial growth in dried products, low pH is responsible for prolonged shelf life of fermented foods. This preservation technique is also called combination techniques or barrier technology or metodascombinados in Spanish, technologia degli ostacoli in Italian, Hurdle Technology in German. Potential hurdles for food preservation are – Temperature (High or Low), pH (High or Low), Water activity (High or Low), Modified atmosphere (Co2, N2 etc), Packaging (Vacuum packaging, aseptic packaging, edible coating etc.), Radiation (UV, microwave, irradiation etc), Preservatives (Class I and II). Hurdle Technology is a technology by which 2 or more hurdles are employed in a suitable combination and every hurdle is used at an optimum level so that damage to the overall quality of food is kept to the minimum. Hurdle Technology foods are defined as ?Products whose shelf-life and the microbial safety are extended by use of several factors none of which individually would be totally lethal towards spoilage or pathogenic microbes? (5Berwal, 1994).
Justification for research objective –
1) Through hurdle technology it become easy to preserve cauliflower at house hold level.
2) Make available the cauliflower at house hold level in off season.
3) Cauliflower preserved through hurdle technology are free from hazardous chemical which are used in cold storage to keep it like a fresh commodity.
Purpose – To preserve cauliflower through hurdle technology till 180 days.
MATERIAL AND METHODS
Cauliflower curds : The cords of cauliflower were procured from local market of Naini.
Chemicals used in preservation : Food grade (potassium metabisulphate, sodium benzoate and citric acid) chemicals were used.
Polyethylene pouches : Food grade pouches
Reagents used in analysis : Analytical grade reagents were used.
Method of preservation : First cauliflower head (white curds) after sorting, were cut into 5×3×3 cm. pieces with sharp edged stainless steel knife, then thoroughly washed in tap water and distilled water. After washing blanched at 100°C for 60sec. then steeped into different concentrations and combinations of preservatives – P0 (Control sample- fresh without treatment), P1( 8% Salt + 500 ppm Potassium metabisulphite + 100 ppm Sodium benzoate), P2 (10% Salt + 400 ppm Potassium metabisulphite + 200 ppm Sodium benzoate), P3( 12% Salt + 300 ppm Potassium metabisulphite + 300 ppm Sodium benzoate), P4 ( 8% Salt + 0.3% Citric acid + 300 ppm Potassium metabisulphite + 300 ppm Sodium benzoate), P5 ( 10% Salt + 0.2% Citric acid + 400 ppm Potassium metabisulphite + 200 ppm Sodium benzoate) and P6 (12% Salt + 0.1% Citric acid + 500 ppm Potassium metabisulphite + 100 ppm Sodium benzoate). Then aseptically packed into food grade polyethylene pouches and stored at two different level of temperatures- T1 (ambient temperature – 30 to 37 °C) and T2 (refrigeration temperatures – 5 to 7 °C) for different time intervals i.e. 0, 30, 60, 90, 120, 150 and 180 days respectively. This preserved cauliflower were studied for their microbial , sensory, physical and nutritional properties and data obtained after analysis were statistically analyzed.
Microbial properties: Yeast and mold was determined by Conventional method, ( 14Ranganna 2005).
Sensoryproperties : Sensory properties (color, flavor, texture and overall acceptability) were determined by 9 Point Hedonic Scale method ( 17Ranganna 2005).
Physical properties: Water activity was determined by using Water Activity Meter ( 2Aqua Lab Series 4TE- 2007). pH was determined by using pH meter (Electronic Corporation of India, Model 5652) as per procedure described in 12Ministry of Health and Family Welfare, Manual of methods of analysis of foods- Fruit and Vegetable Products , (2005).
Nutritional properties : Protein determined by Micro-Kjeldahl / Kjeltec method (16Ranganna, 2005), Vitamin A determined by method mentioned in (18Ranganna 2005), Vitamin C determined by 2, 6-dichlorophenol-indophenol visual titration method, ( 19Ranganna 2005) and potassium determined by Flame photometric method, ( 15Ranganna 2005).
Statistical analysis : Obtained data were analyzed for ANOVA ( 3 Way Classification) and critical difference (C.D.) technique, described by 8 Imran and Coover (1983). In statistical analysis, data used were average of replicates, total no. of treatments combinations were 14 – P0/T1, P0/T2, P1/T1, P1/T2, P2/T1, P2/T2, P3/T1, P3/T2, P4/T1, P4/T2, P5/T1, P5/T2, P6/T1, P6/T2 (where P0, P1, P2, P3, P4, P5 and P6 are different combination of preservatives and T1 and T2 are different level of temperatures, all are explained in Method of preservation). Level of significance was checked at 5% probability level.
RESULTS
Microbial properties of preserved cauliflower : Yeast and mold count of preserved cauliflower are given in Table 1. Treatments in which Yeast and mold count were found lowest with a storage period of 180 days are P4/T1, P4/T2 and P5/T2. There were significant difference between yeast and mold count of treated samples due to combination of preservatives and storage temperatures while there was not significant difference due to days of storage at 5% probability levels.
Sensory properties of preserved cauliflower : In sensory properties, results of only overall acceptability parameter was presented in Table 1. Treatment P4/T2 scored highest in overall acceptability with a storage period of 180 days. There were significant difference between overall acceptability scores of treated samples due to combination of preservatives and days of storage while there was not significant difference due to storage temperatures at 5% probability levels.
Physical properties of preserved cauliflower : From Table 1 - lowest water activity and from Table 2 - lowest pH were found in P4/T2 in a storage period of 180 days. There were significant difference between water activity and pH scores of treated samples due to combination of preservatives and storage temperatures while there was not significant difference due to days of storage at 5% probability levels.
Nutritional properties of preserved cauliflower : From Table 2 - highest retention of protein and vitamin A and from Table 3 - highest retention of vitamin C and potassium were found in treatment P4/T2 in a storage period of 180 days. There were significant difference between protein, vitamin A, vitamin C and potassium scores of treated samples due to combination of preservatives , storage temperatures and days of storage at 5% probability levels..
DISCUSSION
In microbial analysis, the increase in yeast and mold count was observed in all treatments at both the temperatures. In most of the treatments yeast and mold count were found above from the standard (as per 6 Food Safety and Standard Authority of India, 2006-Yeast/Mold not more than 100 count/gm) with increase in storage period, which may be attributed during addition of preservatives or during packaging which could have been a carrier of microbes. While in some treatments counts remained under control as per above mentioned standard till 180 days of storage, it might be due to better handling procedure or different concentration and combinations of class I and II preservatives and low temperature of storage. The results are in agreement of previous finding of 7Gould (1995), observed that the food preservation through hurdle technology cause interference with the homeostasis of yeast and mold. 1Alzamora et al. (1989), also noticed that yeast and mould counts remained below 100 cfu/gm.
during 4 months of storage of pineapple slices preserved through hurdle technology at 5°C. 11Lopez- Malo et al. (1994), preserved papaya through hurdles technology, found yeast and smold counts < 10 CFU/g during 5 months storage at 25°C. In sensory evaluation, the difference and decrease in overall acceptability scores was observed which may be attributed due to increase in microbial count with increase in storage period. But at the same time, treatments which remained microbial safe till 180 days of storage period were best rated in sensory evaluation. The results are in agreement of previous finding of 13Pruthi (1990), the vegetables like potatoes, carrot, cauliflower, cabbage, bitter guard, peas, mushroom and animals foods (meat, fish and poultry) preserved in an acidified sulphited brine solution through steeping can be used for pickling or home cooking after leaching out the salt and acid. 4Barwal et al. (2005) standardized the low cost and low energy processing technology for preservation of cauliflower involving different concentration and combination of salt (5-10%), potassium metabisulphite (0.2%) and citric acid (1%) after blanching. The preserved cauliflower was accepted in sensory evaluation after 90 and 180 days of storage by reconstituted in running water for half an hour and evaluated for the preparation of pickle and pakora. In physical test, the reduction in water activity and pH of preserved sample were found as compare to initial or fresh commodity. Reduced water activity and pH were found effective for long time storage. The results are in agreement of previous finding of 21Vibhakara et al.(2005), maintenance of pH< 4.5 helped in controlling multiplication and survival of spores and also helpful in achieving shelf stability. Low pH and water activity solutions are used as antimicrobial agent or as antioxidant to prevent browning, to reduce discoloration of pigments, and to protect against loss of flavor, changes in texture (23Wiley, 1994).
In nutritional evaluation, loss of nutrients were found in each treatments but on other hand better retention of protein, vitamin A, vitamin C and potassium were also observed in treatments of 180 days of storage period. The results are in agreement of previous finding of 20Srivastava and Kumar (2002), sulphur dioxide is widely used throughout the world in the preservation as it acts as an antioxidant and bleaching agent. These properties help in the retention of vitamin C, vitamin A and other oxidizable compounds. Sulphur dioxide with potassium metabisulphite (if added in the solution) helps to retain vitamin C content of the preserved material (22Verma and Joshi, 2000). Low pH and water activity solutions were also effective towards nutrient retention ( 23Wiley, 1994).
CONCLUSION
All the treatments combination were not effective for preservation of cauliflower till 180 days of storage period. Only 3 treatments - P4/T1, P4/T2 and P5/T2 were microbial safe till 180 days and among these 3, only P4/T2 was found best in sensory as well in nutrient retention in 180 days of storage period. ACKNOWLEDGEMENT I express my deep sense of gratitude for my advisor (Prof.) Dr. Ramesh Chandra, (Dean) Warner School Of Food and Dairy Technology, to all member of advisory committee - Dr. D.B. Singh, Dean of Horticulture Department, (Prof.) Dr. Sarita Sheikh, Dean of Halina School of Home Science, (Prof.) Dr. Sangeeta Upadhayay, Assistant Professor (Microbiology),Warner School Of Food and Dairy Technology, (Prof.) Dr. Ram Lal, Dean of Department of Statistics, Sam Higginbottom Institute of Agriculture, Technology and Sciences, Allahabad, for there sincere guidance, suggestions, constructive work and encouragement during the entire research work. Sincere thanks to Honorable Vice-Chancellor, Sam Higginbottom Institute of Agriculture, Technology and Sciences, Allahabad, for providing me necessary technical and financial facilities. I want to acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. I 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=1948http://ijcrr.com/article_html.php?did=19481. Alzamora SM, Gerschenson LN, Cerrutti P, Rojas A M. Shelf-stable pineapples for long-term non refrigerated storage. J. Lebensm-Wiss. u. – Tech 1996; 22:233- 236
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4. Barwal VS, Sharma R, Singh R. Preservation of cauliflower by Hurdle Technology. Food Sci and Tech 2008; 42(1):26-31.
5. Berwal JS, Hurdle technology for shelf stable food products. Indian Food Industry 1996; 13:40-43.
6. Ministry of Health and Family Welfare (Food Safety and Standard Authority of India) Part 4th New Delhi. Microbiological Requirements of Food Products. Appendix B, Table-4. 2006; p.665.
7. Gould GW. Interference in homeostasis. In: Whitten bury R, Banks JG, editors. Homeostatic Mechanism in Microorganisms. 3rd ed.: Bath University Press; 1995. p. 220.
8. Imran RL, Cover WB. Statistical analysis. In: A modern approach to statistics. 2nd ed. New York; 1983: p. 120.
9. Jayanthi M. Innovative solution to extent the shelf life of fruits. Processed Food Industry 2008; 9(1): 37-38.
10. Luthar L. Hurdle effect and energy saving. In: Downey WK, editors. Food Quality and Nutrition. 2nd ed. London: Applied Science Publishers; 1990. p. 553-557.
11. Lopez-Milo A, Palou E, Welty J, Corte P, Arias A. Shelf-stable high moisture papaya minimally processed by combined methods. International J. of Food Research 1995; 27(6):545-553.
12. Ministry of Health and Family Welfare (India). Manual of methods of analysis of foods: Fruit and Vegetable Products. New Delhi: Government of India; 2005; 6.
13. Pruthi J S. Physiology, Chemistry and Technology of Passion Fruits. In: Advances in Food Research. Vol. 12. 2nd ed. New York: Academic Press; 2000. p. 203-274.
14. Ranganna S. General instruction for microbiological examination. In: Hand Book of Analysis and Quality Control for Fruit and Vegetable Products. 2nd ed. New Delhi: Tata McGraw Hill Education Private Ltd New York; 2005. p. 646-655.
15. Ranganna S. Minerals. In: Hand Book of Analysis and Quality Control for Fruit and Vegetable Products. 2nd ed. New Delhi: Tata McGraw Hill Education Private Ltd New York; 2005. p. 127-128.
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18. Ranganna S. Plant pigments. In: Hand Book of Analysis and Quality Control for Fruit and Vegetable Products. 2nd ed. New Delhi: Tata McGraw Hill Education Private Ltd New York; 2005. p. 84-86.
19. Ranganna S. Vitamins. In: Hand Book of Analysis and Quality Control for Fruit and Vegetable Products 2nd ed. New Delhi: Tata McGraw Hill Education Private Ltd New York; 2005. p. 105-106.
20. Srivastava RP, Kumar S. Principles and Methods of Preservation. In: Fruits and Vegetable Preservation: Principles And Practices. 3rd rev. ed. International Book Distributing Co; 2002. p. 93.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcarePLATFORM SWITCHING IN IMPLANT DENTISTRY - A REVIEW
English8188Gayathri NEnglish Lakshmi SEnglishThe success of dental implant is dependent upon the integration between the implant and the intraoral hard/soft tissue. Crestal bone loss is one of the factors that affect the long term prognosis of a dental implant. Platform switching is a concept recently introduced in implant dentistry. It is intended to reduce the crestal bone loss that is commonly found around implants exposed to the oral environment. The purpose of this review article is to discuss the mechanism, by which it contributes to preserve crestal bone loss, literature review, benefits, limitations and consequence of platform switching; in
order to assess its clinical success in implant dentistry
EnglishBiological width, crestal bone loss, platform switching, stress.INTRODUCTION
Dentistry is now focused mainly on the fixed replacement of lost teeth with priority given to aesthetic and function. Patient‘s desire for fixed restoration has increased over artificial substitutes. With new trends in dentistry, dental implants have taken the top position in fixed restoration and also have been accepted by the patient‘s widely. Implants have been used for various purposes such as single, multiple or full arch restoration. It could be a single or two piece implant system. Single implant system eliminates the junction between implant platform and abutment. Also have limitations of positioning, integration and aesthetics. Traditional twostage implants have enjoyed a long history of clinical success and have offered surgical and prosthetic versatility. They have been used in various situations with better emergence profile as well as bone integration at the implant abutment interface which gives rise to a new concept called ?Platform Switching?. For two piece implant system, there exists two potential pathways for bacterial penetration resulting in crestal bone loss. One route is through the inside of the abutment, along the screw threads eventually at the implant abutment interface or micro gap. Alternatively bacteria can migrate along the outer surface of the abutment. Ericsson et al, identified two important entities in the implant crestal region i.e. Plaque associated inflammatory cell infiltrate and Implant associated inflammatory cell infiltrate and he concluded that apical border of an inflammatory cell infiltrate is the aetiological factor for crestal bone loss which was always separated from the bone crest at 1 mm of healthy connective tissue1. However, early crestal bone loss has been commonly observed. Adell et al was the first to quantify and report marginal bone loss and indicated greater magnitude of bone loss during the first year of prosthesis loading. There are many elements that can accelerate the resorption of crestal bone, and they are discussed below2.
Factors accelerating crestal bone loss:
1) Biologic Width The crestal bone remodelling is an important phenomenon that occurs around natural teeth and implants called the biologic width – the natural seal that develops around any object protruding from the bone and through the tissue into the oral environment. This seal isolates the bone from the oral environment. Biological width forms within the first 2-4 weeks after the implant abutment junction has been exposed to the oral cavity. It is a barrier against bacterial invasion and food ingress implant-tissue interface. The ultimate location of epithelial attachment following phase 2 surgery in part, determines early post-surgical bone loss. Thus, implant bone loss is in part, a process of establishing the biological seal. When implants are initially placed within bone and then covered with an adequate layer of soft tissue (first-stage surgery), there is typically little or no crestal bone resorption. When the implant is uncovered (in second-stage surgery) and connected to an abutment, the body then reacts and in the process of creating the biologic width, the crestal bone may resorb3.
2) Micro gap In two stage implant systems, after abutment is connected, a microgap exists between the implant and the abutment at or below the alveolar crest. The countersinking below the crest is done to minimize the risk of implant interface movement during bone remodelling, to prevent implant exposure during healing and also to enhance the emergence profile. Countersinking places the implant micro gap below the crestal bone. The microgap crestal bone level relationship was studied radiographically by Hermann et al, who for the first time, demonstrated that the microgap between the implant/abutment has a direct effect on crestal bone loss, independent of surgical approaches. Epithelial proliferation to establish biological width could be responsible for crestal bone loss found about 2mm below the microgap3,4.
3) Surgical Trauma Heat generated during drilling, elevation of the periosteal flap and excessive pressure at the crestal region during implant placement may contribute to implant bone loss during the healing period. Signs of bone loss from surgical trauma and periosteal reflection are not commonly observed at the implant stage II surgery in successfully osseointegrated implants3. Wildermann et al, reported that bone loss due to periostium elevation was restricted to the area just adjacent to the implant, even though a larger surface area of the bone was exposed during surgery. Thus, surgical trauma is unlikely to cause early crestal bone loss5.
4) Stress Cortical bone is least resistant to shear force, which is significantly increased in bending overload. Excessive stress on the immature implant bone interface in the early stage of prosthesis in function is likely to cause crestal bone loss. However, bone loss from occlusal overload is considered to be progressive rather than limited to the first year of loading6.
The Need for Better Crestal Bone Preservation Emerges Crestal bone preservation should be thought during the treatment planning stage itself. There are various approaches described in the literature to prevent crestal bone loss. One of them is the Platform switching concept. Platform switching ?is the use of prosthetic components having an abutment diameter undersized when compared to the diameter of the implant platform?.7 Platform switching is a restorative protocol which has been reported by Dr. Richard Lazzara as a means of limiting crestal bone loss around dental implants. In this way, the prosthetic connection is displaced horizontally inwards from the perimeter of the implant platform, creating an angle or step between the abutment and implant; improving the distribution of forces. So this article reviews about the literature how platform switching has contributed to implant dentistry especially for crestal bone preservation7.
HISTORY OF PLS In 1991, the 3i wide diameter 5.0 and 6.0 mm implants were designed with a matching diameter seating surface to be used however, there were no matching diameter prosthetic components available, and as a result, they were restored with standard 4.1 mm diameter components, which created a 0.45mm or 0.95 mm circumferential horizontal difference in dimension. After the initial 5 year period, radiographical reviews stated that the amount of crestal remodelling was reduced and also exhibited no vertical crestal bone loss. These results have led many researchers to become interested to perform investigations. Various studies have been conducted in human beings, animals and Finite element analysis comparing the platform switched implants with regular two piece implants.
Human Studies: According to Lazzara and Porter, the deliberate creation of a space for the physiological barrier minimizes the space for repositioning of the fibers. By displacing the junction with the abutment to a more medial position with respect to the axis, an increased surface repositioning of the biological space occurs. This space is created in the horizontal plane 1 mm from the implant-abutment junction, supported over the external margin of the platform. Implant design also influences the morphology of the gingival margin – both the neck micro and macrostructure, and the macrostructure of the implant-abutment junction7. In turn, ensuring a minimum distance of 3 mm between implants allows sufficient margin to restore the biological space for restorations, as demonstrated by Tarnow a decade ago8. In implants involving an expanded platform integrated in their macrostructure, and ensuring the above mentioned distance between implants, bone crest preservation is seen to be 57% greater than with a traditional restoration design. Trammell et al, in a case-control study, measured the biological space with reduced and conventional platform abutments in the same individual. They concluded that bone loss was significantly smaller with the expanded platform9. Vela Nebot et al assessed interproximal bone resorption on the medial and distal of each implant using digital radiography at 1, 4, and 6 months after abutment attachment. Platform modification has been proposed to reduce the biologic and mechanical aggressions on the biologic width. The resulting peri-implant bone preservation leads to better aesthetics results10. Gardner presents a case study using platform switching implants dealing with the changes that occur when an implant is placed in bone. He states that its main advantage is that it is an effective way to control circumferential bone loss around dental implants11. Hurzeler M, showed that crestal bone height around dental implants could be influenced using a platform switch protocol and that the bone level would remain stable within 1 year after final prosthetic reconstruction. They concluded the concept of platform switching appears to limit crestal resorption and seems to preserve peri-implant bone levels12. Canullo L, Rasperini G, suggests that immediate loading with platform switching can provide peri-implant hard tissue stability with soft tissue and papilla preservation13. Degidi et al suggested that platform switching in combination with an absence of micro movement and micro gap may protect the periimplant soft and mineralized tissues, explaining the observed absence of bone resorption and also said that immediate loading did not interfere with bone formation and did not have adverse effects on osseointegration14. Qian Li et al evaluated the clinical results of dental implant treatment with platform switching technique in esthetic zone and to investigate its technical characteristics. He concluded that platform switching is a simple and reliable technique for dental implant treatment, helping to control marginal bone loss and ensure esthetic results in the esthetic zone15. Baumgarten et al describes that platform switching technique and its usefulness in situations where shorter implants must be used, where implants placed in aesthetic zones and where a larger implant is desirable but prosthetic space is limited. They concluded that sufficient tissue depth of approximately 3mm or more is necessary to accommodate an adequate biologic width and also, platform switching helps to prevent the anticipated bone loss and also preserves crestal bone16. Cappiello M observed vertical bone loss between 0.6mm and 1.2 mm in platform switched implants comparatively lesser than regular two piece implants17. Hermann et al reviewed platform switching, implant design in cervical region, nano roughness, biological width, fine threads, abutment designs and avoidance of micro lesions in the peri implant soft tissue as factors that determine the preservation of crestal bone levels. He concluded that these factors determine the aesthetic outcomes of implant restorations18. Vela Nebot et al concludes that platform switching improves aesthetic results and that when invasion of biologic width is reduced, bone loss is reduced10. Mangano et al evaluated 1920 Morse tapered connection implants clinically and radiographically at 12, 24, 36 and 48 months after implant insertion. They noted an overall cumulative implant survival rate of 97.56% (96.12% in maxilla and 98.91% in the mandible). The absence of an implant– abutment interface (micro-gap) is associated with minimal crestal bone loss19. Animal Studies: Becker et al in his histomorphometric study in dogs, concluded that twenty eight days after implant placement, both CAM (sand blasted and acid etched screw type implants with either matching) and CPS (smaller diameter healing abutments) revealed crestal bone level changes but they found no significant differences between them20. Sarment et al is found some changes in the width and height of bone when using platform switching implants21. Weiner et al connects the development of biologic width with the implant surface. They did not mention platform switching but focuses the study on the use of shift tissue engineered collars with micro grooving22.
Histological Studies: Luongo et al, examined biopsy specimens to helps explain the biologic processes occurring around a platform-switched implant. An inflammatory connective tissue infiltrate was localized over the entire surface of the implant platform and approximately 0.35 mm coronal to the implant-abutment junction, along the healing abutment. A possible reason for bone preservation around a platform switched implant may lie in the inward shift of the inflammatory connective tissue zone at the implant-abutment junction, which reduces its injurious effect on the alveolar bone23. Degidi M et al evaluated the histology and histomorphology of three morse cone connection implants in a real case report and he explains that when there is zero microgaps and no micro movement, platform switching shows no resorption. He also observes that this method provides better aesthetic results24. FEA Studies: Hsu et al analyzed the behaviour of reduced platform restorations in a 3 D FEA. Their results showed a 10% decrease in all the prosthetic loading forces transmitted to the bone-implant interface. Similar finite elements studies in two dimensions show great variability in the results obtained25. In effect, while some investigators report a decrease in force to the cortical bone of less than 10%, other authors such as Tabata et al have reported a decrease of 80%26. Rodriguez-Ciurana et al in a two-dimensional biomechanical study involving platform switching integrated into the implant design, failed to obtain peri-implant bone force attenuation values as high as those reported in earlier studies, when comparing platform expansion with a traditional restoration model. In addition, the authors concluded that force dissipation in the platform switching restoration is slightly more favourable in an internal than in an external junction, since it improves distribution of the loads applied to the occlusal surface of the prosthesis along the axis of the implant. On the other hand, this concentration of forces along the axis of the implant, transmitted through the retention screw, increases the possibility of abutment fracture, and thus may lead to failure of the restoration. All studies contrasting platform switching versus continuity of the platform with the body of the implant agree that force to bone diffusion is improved by expanding the platform27. However, Canay and Akça, in a three dimensional finite elements analysis involving different implant-free expanded platform dimensions and a range of abutment designs, claimed that the effect of platform expansion is not attributable to the distribution of loads to the peri-implant bone but rather simply to redistribution of the new biological space. Nevertheless, the authors pointed the need for further research on the behaviour of the marginal bone around the implants. The most appropriate reduced platform abutment design for securing lesser implant abutment material fatigue is represented by conical emergence abutments with a variable height of 1.5-2mm, freeing extension of the implant platform between 0.5-0.75mm. Such platform switching is not advisable in mandibular implant mucosal support prostheses, since reduction of the diameter of the junction lessens the abutment resistance in response to occlusal loading applied in the posterior area of the over dentures – fundamentally compromising the connecting abutment closest to the area where loading is applied28. Maeda Y et al, showed that the stress level in the cervical bone area at the implant was greatly reduced when the narrow diameter abutment was connected compared with the regular-sized one. They suggested that the platform switching configuration has the biomechanical advantage of shifting the stress concentration area away from the cervical bone-implant interface. It also has the disadvantage of increasing stress in the abutment or abutment screw29. Schrotenboer et al investigated the effects of implant microthreads on crestal bone stress compared to a standard smooth implant collar and to analyze how different abutment diameters influenced the crestal bone stress level. They concluded that microthreads increased crestal stress upon loading. Reduced abutment diameter resulted in less stress translated to the crestal bone in the microthread and smooth-neck groups30.
DISCUSSION
According to review literature, the technique of platform switching seems to have greatest potential to limit the crestal resorption. The inflammatory connective tissue infiltrate is located at the level of the collar, and doesn‘t migrate apically. Thereby resorption is avoided and the crestal bone is stabilized at the level of the implant collar. At the same time, the microgap is shifted away from the crestal bone, decreasing the probability of resorption by an increased distance of the peripheral bone and the base of the abutment. To maintain the long term implant stability, it is important to minimize crestal bone loss around implant. Stress is concentrated around the crestal region where 2 materials such as bone and implant with different modulus of elasticity interact. Peak bone stresses that appear in marginal bone are believed to cause bone micro fracture. So, decreased stresses may not be the only reason for the positive results shown by platform switching. Moreover, by decreasing the abutment diameter, more stresses are concentrated near the abutment, increasing the likelihood of abutment fracture. The other possible reason for the efficacy of the platform switching configuration is that the microorganisms are likely to move toward the high-energy area or by the mechanism such as interface micro movements that allow the microorganisms to move into that area, it is advantageous to have a large distance between the stress concentration area and bone surface. Hence implant abutment interface is a very important criterion for implant success. However, further studies utilizing modified 3D finite element models and animal experiments as well as longitudinal clinical observations are still necessary.
A critical analysis of how platform switching reduces crestal bone loss: The mechanism by which platform switching can contribute to maintain the crestal bone height could be due to four reasons: Shifting the inflammatory cell infiltrate inward and away from the adjacent crestal bone. Maintenance of biological width and increased distance of implant abutment junction from the crestal bone level. The possible influence of micro-gap on the crestal bone is diminished. Decreased stress levels in the peri-implant bone (According to FEA studies). Consequences of Horizontal Repositioning: Reduction in the amount of crestal bone resorption is necessary to expose a minimum amount of implant surface to which the soft tissue can attach. Horizontal Repositioning of abutment inflammatory cell infiltrate within less than 900 confined area of exposure decreases the resorptive effect on the crestal bone. Reduced diameter components beginning with healing abutment must be used from the moment the implant is exposed to the oral environment, since the process of biological width formation begins immediately. Limitations of platform switching If normal size abutments are to be used, larger size implants need to be placed. This is not possible every time clinically, especially if bone width is less. If normal sized implants are placed, smallerdiameter abutments are necessary, which may compromise the emergence profile, especially in anterior cases. Benefits of platform switching Improved aesthetics as crestal bone preservation helps to preserve papilla. Increased implant longevity. The effect of inter-implant distance is minimized. A minimum of 3 mm inter implant distance is needed to preserve marginal bone. Arthur et al, found that distances of 1, 2 and 3 mm between implants do not result in statistically significant differences in crestal bone loss around submerged or non-submerged implants with a Morse cone connection and platform switching31. The only requirement of platformswitched implant is that the implant should be placed crestally if sufficient soft tissue height and inter occlusal space are present, or sub crestally if insufficient soft tissue height and inter-occlusal space are present. So, soft tissue depth of approximately 3 mm should be present to place platform switched implants or else bone resorption is likely to occur, irrespective of implant geometry. Also, sufficient bone width should be present to accommodate the larger-diameter implant.
CONCLUSION
The ultimate objective of implant dentistry is to create optimal prosthetic restorations that are surrounded by stable bone and a natural gingival architecture that exists in harmony with the other teeth. All authors agree that the use of implants with platform switching improves bone crest preservation, excellent aesthetic outcomes and controlled biological space reposition. Requirement of platformswitched implant is that soft tissue depth of approximately 3 mm should be present to place platform-switched implants or else bone resorption is likely to occur, irrespective of implant geometry. Platform switching appears to be simple, functional, and predictable technique for preserving peri-implant crestal bone and can be clinically applied when clinical situation permits. Definitive clinical trials are currently underway and further clinical investigations are necessary to show long term results.
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=1949http://ijcrr.com/article_html.php?did=19491. Ericsson I, Persson LG, Berglundh T, Marinello CP, Lindhe J. Different types of inflammatory reactions in peri implant soft tissues. J clin Periodontol 1995;22:255- 261.
2. Adell R, Lekholm U, Rockler B, Branemark PI. A 5 year study of osseointegrated implants in the treatment of edentulous jaw. Int J Oral Surg 1981;10:387-416.
3. Misch CE. Stress treatment theorem for implant dentistry. Contemporary Implant Dentistry. Elsevier Mosby; 3rd edition. Page -75.
4. Hermann, J.S., Cochran, D.L., Nummikoski, P.V, Buser, D. Crestal bone changes around titanium implants. A radiographic evaluation of unloaded nonsubmerged and submerged implants in the canine mandible. Journal of Periodontology 1997; 68:1117–1130.
5. Cappiello M, Luongo R, Di Iorio D, Bugea C, Cocchetto R, Celletti R. Evaluation of periimplant bone loss around platformswitched implants. Int J Periodontics Restorative Dent. 2008 Aug; 28(4):347-55.
6. Misch CE. Bone density: A key determinant for clinical success. Contemporary Implant Dentistry. Elsevier Mosby; 3rd edition. Page -134.
7. Lazzara RJ, Porter SS. Platform switching: A new concept in implant dentistry for controlling post restorative crestal bone levels. Int J Periodontics Restorative Dent 2006 Feb;26(1):9-17.
8. Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol. 2000;71:546-9.
9. Trammell K, Geurs NC, O‘Neal SJ, Liu PR, Haigh SJ, McNeal S, et al. A prospective, randomized, controlled comparison of platform-switched and matched-abutment implants in short-span partial denture situations. Int J Periodontics Restorative Dent. 2009;29:599-605.
10. Vela-Nebot X, Rodríguez-Ciurana X, Rodado-Alonso C, Segalà-Torres M. Benefits of an implant platform modification technique to reduce crestal bone resorption. Implant Dent. 2006;15:313-20.
11. Gardner DM. Platform switching as a means to achieving implant esthetics. N Y State Dent J 2005;71:34-7.
12. Hürzeler M, Fickl S, Zuhr O, Wachtel HC. Peri-implant bone level around implants with platform switched abutments: preliminary data from a prospective study. J Oral Maxillofac Surg. 2007:Jul;65(7 Suppl1):33-9.
13. Canullo L, Rasperini G. Preservation of peri-implant soft and hard tissues using platform switching of implants placed in immediate extraction sockets: a proof-ofconcept study with 12- to 36-month followup. Int J Oral Maxillofac Implants. 2007;22:995-1000.
14. Degidi M, Iezzi G, Scarano A, Piattelli A. Immediately loaded titanium implant with a tissue-stabilizing/maintaining design ('beyond platform switch') retrieved from man after 4 weeks: a histological and histomorphometrical evaluation. A case report. Clin Oral Impl Res 2008 Mar;19(3):276-82. Epub 2007 Dec 13.
15. Qian Li, Ye Lin, Li-xin Qiu, Xiu-lian Hu, Jian-hui Li, Ping DI. Clinical study of application of platform switching to dental implant treatment in esthetic zone. Chinese journal of stomatology 2008; 43(9):537-41.
16. Baumgarten H, Cocchetto R, Testori T, Meltzer A, Porter S. A new implant design for crestal bone preservation: initial observations and case report. Pract Proced Aesthet Dent. 2005;17:735-40.
17. Cappiello M, Luongo R, Di Iorio D, Bugea C, Cocchetto R, Celletti R. Evaluation of periimplant bone loss around platformswitched implants. Int J Periodontics Restorative Dent. 2008 Aug; 28(4):347-55.
18. Hermann J, Buser D, Schenk RK, Schoolfield JD, Cochrane DL. Influence of the size of the microgap on crestal bone changes around titanium implants. A histometric evaluation of unloaded nonsubmerged implants in canine mandible. J Periodontol 2001; 72:1372-83.
19. Mangano C, Mangano F, Piattelli A, Iezzi G, Mangano A, La Colla L. Prospective clinical evaluation of 1920 Morse taper connection implants: Results after 4 years of functional loading. Clin Oral Impl Res 2009; 20:254-61.
20. Becker J, Ferrari D, Herten M, Kirsch A, Schaer A, Schwarz F. Influence of platform switching on crestal bone changes at nonsubmerged titanium implants: a histomorphometrical study in dogs. J Clin Periodontol 2007;34:1089-96.
21. Sarment DP, Meraw SJ. Biological space adaptation to implant dimensions. Int J Oral Maxillofac Implants 2008; 23:99-104.
22. Weiner S, Simon J, Ehrenberg DS, Zweig B, Ricci JL. The effects of laser micro textured collars upon crestal bone levels of dental implants. Implant Dent 2008; 17:217-28.
23. Luongo R, Traini T, Guidone PC, Bianco G, Cocchetto R, Celletti R. Hard and soft tissue responses to the platform switching technique. Int J Periodontics Restorative Dent 2008 Dec; 28(6):551-557.
24. Degidi M, Iezzi G, Scarano A, Piattelli A. Immediately loaded titanium implant with a tissue-stabilizing/maintaining design (?beyond platform switch‘) retrieved from man after 4 weeks: a histological and histomorphometrical evaluation. A case report. Clin Oral Implants Res 2008; 19:276-82.
25. Hsu JT, Fuh LJ, Lin DJ, Shen YW, Huang HL. Bone strain and interfacial sliding analyses of platform switching and implant diameter on an immediately loaded implant: Experimental and three-dimensional finite element analyses. J Periodontol 2009 Jul; 80(7):1125-32.
26. Tabata LF, Assunção WG, Adelino Ricardo Barão V, De Sousa EA, Gomes EA, Delben JA. Implant platform switching: biomechanical approach using two-dimensional finite element analysis. J Craniofac Surg 2010; 21(1):182-187.
27. Rodríguez-Ciurana X, Vela-Nebot X, Segalà- Torres M, Calvo-Guirado JL, Cambra J, Méndez-Blanco V, Tarnow DP. The effect of interimplant distance on the height of the interimplant bone crests when using platformswitched implants. Int J Periodontics Restorative Dent 2009; 29:141-51.
28. Canay S, Akca K. Biomechanical aspects of bone level diameter shifting at implantabutment interface. Implant Dent 2009; 18:239- 248.
29. Maeda Y, Miura J, Taki I, Sogo M. Biomechanical analysis on platform switching: Is there any biomechanical rationale. Clin Oral Implants Res. 2007 Oct; 18(5):581-4. Epub 2007 Jun 30.
30. Schrotenboer J, Tsao YP, Kinariwala V, Wang HL. Effect of microthreads and platform switching on crestal bone stress levels: A Finite element analysis. J Periodontol. 2008; 79(11):2166-72.
31. Novaes, Arthur B Jr de Oliveira, Rafael R Muglia, Valdir A Papalexiou, Vula Taba, Mário. The effects of interimplant distances on papilla formation and crestal resorption in implants with a morse cone connection and a platform switch: a histomorphometric study in dogs. Journal of periodontology 2006;77:1839- 1849
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareNEONATAL MORTALITY - AN EXPERIENCE BY VERBAL AUTOPSY
English8992Shaikh MohsinEnglish Pathan SameerEnglishObjective: To find out and understand the common causes of neonatal deaths using verbal autopsy as a tool. Method: Open ended verbal autopsy Questioner Method applied to a cross section of 47 neonatal deaths that occurred in previous 6 months (Nov. 05 – April 06). Study was carried out on purposively selected villages of four talukas of Vadodara district of Gujarat in India, during May 2006 to August 2006. Results: Out of 47 were neonatal deaths 36.2% died due to prematurity, 21.3% due to Birth Asphyxia and 10.6% of deaths were due to Septicemia. Deaths on the first day were 42.6%; of whom 40% died due to birth asphyxia and 45% due to prematurity. Conclusion: Using verbal autopsy tools, Common causes of neonatal deaths found, were prematurity, birth asphyxia and sepsis. More number of deaths occurred during first day of life.
Englishverbal autopsy, neonatal deaths, causesINTRODUCTION
Each year, 20 percent of the world‘s infants-an awesome 26 million-are born in this vast and diverse country. Of this number, 1.2 million die before completing the first four weeks of life, a figure amounting to 30 percent of the 3.9 million neonatal deaths worldwide. India is home to the highest number of both births and neonatal deaths of any country in the world. The current neonatal mortality rate (NMR) of 44 per 1,000 live births accounts for nearly two-thirds of all infant mortality and half of under-five child mortality. Over one-third of all neonatal deaths occur on the first day of life, almost half within three days, and nearly threefourths in the first week and same problem is faced by Gujarat with NMR of 42 per 1,000(SRS 2000) which share 4.5 percent of the total NMR burden in India.1 Reducing neonatal mortality will be necessary for achievement of the targets set for child mortality reduction under the United Nations millennium development goals (MDG) (Haines and Cassels, 2004)2 . More than two-thirds of the world's population lives in countries that lack a reliable system for issuing medical death certificates, leaving the true scale and distribution of disease in serious doubt. The main tactic for filling that gap is verbal autopsy, which assigns a probable cause of death based on interviews with families about the deceased's symptoms. ?Verbal Autopsy? is the collection of post-mortem information about a deceased individual through questionnaire or interview of household members, friends and others (including health care workers) who cared for the person at home or are familiar with the circumstances of the death3 . Verbal autopsy methods are most often used in locales where formal medical care is difficult to access. In such locales, deaths often occur at home and official records are inconsistently available.
Verbal autopsies may provide important public health information about factors related to deaths and actions taken to address the medical problems and prevent the death. Investigators must adhere to cultural norms and sensitivities when approaching and asking for information from family members and other informal caregivers of the deceased person. Study teams, especially research interviewers who will conduct these interactions, require training in local customs about these issues, particularly regarding awareness of the pressures on respondents to portray situations in a particular manner, sensitivity to the distress respondents may feel related to the interview/questionnaire, and approaches for handling high levels of distress. Cause-of-death data derived from verbal autopsy (VA) are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribution of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. The exact cause of death can be known by postmortem autopsy. However, this is not feasible on a large scale, particularly in developing countries like India. In this difficult situation, a post death analysis by verbal autopsy is used as a proxy to determine the possible causes of death. In this research we used VA as a research tools to investigate the neonatal deaths.
MATERIAL AND METHODS
The present study was undertaken on selected four talukas of Vadodara district (e.g. Chota Udepur, Pavi- Jetpur, Kawant and Naswadi), where a partnership was initiated between the Health Department of Government of Gujarat and a local NGO- Deepak Charitable Trust. The study area covered 25 villages (out of approximately 200 total villages of each talukas) each in the selected four talukas, spread over 29 PHCs and 4 CHCs which have been designated First Referral Units (FRUs) under RCH. Each of the taluka had one taluka coordinator (TC) and 14 outreach worker (ORWs), initial survey was carried out by ORWs who identified the infant deaths and finally TC and a team of doctors (Resident Doctors of PSM dept. and Pediatric Dept. of Medical College Baroda) went out there and carried out verbal autopsy of neonatal deaths that occurred in previous 6 months (Nov. 05 – April 06). Study period consists of 4 months of data collection from May ‘06 to August ‘06. Final confirmation of verbal autopsy was verified by associate professors of PSM dept. and Pediatric dept. of Medical College Baroda). Prior consent was taken for verbal autopsy procedure. The standard verbal autopsy questionnaire suggested by WHO3 was used for the same. Questionnaire was administered to the care giver (usually the mother) of the child. The questions were explained by the interviewer to the caregiver in local language. Sufficient time was given to recall the events during illness. It usually took 60 minutes to complete an interview. Diagnosis was made on the basis of the answer given by the caregiver to the questions asked in the questionnaire. Open-ended questions were freely probed to follow up particular aspects as required. This descriptive account also was taken into consideration while arriving at the diagnosis. Total no. deliveries (whether home delivery or institutional delivery) occurred in Pavi jetpur(2535), Chota Udepur(2692), Naswadi (796) and Kawant(1053) during april 2004 to march 2005 were reported by district health office of baroda and with that information in background we carried out this verbal autopsy.
RESULTS
Out of the 47 neonatal deaths reported (42.6 % - Pavi jetpur, 23.4 % - Chota Udepur, 17 % - Naswadi and 17 % Kawant), 36.2 %( 17) died due to prematurity, 21.3 %( 10) due to Birth Asphyxia and 10.6 % (5) of deaths were due to Septicemia. Deaths on the first day were 42.6 % (20); of whom 40 %( 8) died due to birth asphyxia and 45 %( 9) due to prematurity.
In 72.4% cases death occurred in early neonatal period. 59.6 % patients were male and 40.4 % were female. 80.9% mothers had not received ANC during antenatal period, although TT coverage was 68.1%. 80.9% deaths occurred in cases where deliveries were conducted at home, of which 48.9% deliveries were conducted by untrained Dais. Treatment was not received in case of 78.7% neonatal deaths. 29.8% deaths occurred in case of fifth birth rank or more and in 66% we found family size of >5 member. 63.8% of the deaths reported were in case of illiterate mother. No neonates had received any vaccine.
DISCUSSION
Majority of patients died during first seven days of whom the majority died in first 24 hours Singhal et al reported 42% of total neonatal deaths during the first seven days of life.4 In majority of the cases mothers were illiterate and received ANC rarely. At the same time, more number of mothers delivered at home by untrained die while in over three forth of the neonatal deaths no treatment was received. More number of mothers who lost neonates had a big family size.
CONCLUSION
Common causes of neonatal deaths, as per the Verbal Autopsy, were Prematurity, Birth Asphyxia and Sepsis and more number of deaths occurred during first day of life. Similar observations have been made in earlier studies of Singh V and Dutta N et al.5,6 Majority of deaths occurred where mother had not received any ANC visit. Birth rank makes a difference along with the size of the family. The fact that many babies (42.6%) died within 24 hours of delivery, sometimes with no recognized symptoms, indicates the need for early intervention for those most a risk. The study identified risk factors that could be identified during delivery (complications, premature/ small babies, and multiple births). Attendants at delivery could have a key role if trained in resuscitation and through notifying paramedics about high risk babies to be given an immediate post-natal check-up in the home. This may be feasible in areas served by NGOs, where efforts can be augmented. Increasing the number of institutional deliveries would be a relevant strategy for the same.
ACKNOWLEDGEMENT
Author acknowledges with thanks the support of Government of Gujarat and Deepak charitable trust. Author acknowledges the immense help received from the scholars whose articles are cited and included in references of this manuscript. The author is also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=1950http://ijcrr.com/article_html.php?did=19501. Dadhich JP, Paul VK, State of India‘s Newborns, National Neonatology Forum and Save the Children. Available from URL:http://www.savethechildren.org/publi cations/technicalresources/saving-newbornlives. Accessed on February 1, 2007.
2. Haines A and Cassels A. Can the millennium development goals be attained? BMJ. 2004, 329: 394-397.
3. Martha et al., A Standard Verbal Autopsy Method for Investigating Causes of Death in Infants and Children, Department of Communicable Disease Surveillance and Response, WHO/CDS/CSR/ISR/99.
4, Accessed at http://www.who.int/csr/resources/publicati ons/surveillance/whocdscsrisr994.pdf on January 1 2006. 4. Singhal PK, Mathur GP, Mathur S, Singh YD, Neonatal Morbidity and Mortality in ICDS urban slums. Indian pediatrics, 1990, 27: 485-488.
5. Singh V, Sachdev HPS, Mittal O, Sethi GR, Choudhury P, Ramji S, et al., Causes of under five mortality in Delhi slums _ An evaluation by Verbal Autopsy technique: in: 8th Asian Congress of Pediatrics Scientific Abstracts. Eds. Chaudhary P, Sachdev HPS, Puri RK, Verma I.C. Jaypee Brother, New Delhi, 1994. p 135.
6. Dutta N, Mand M, Kumar V. Validation of causes of infant death in the community by autopsy. Indian J Pediatrics 1988; 55; 599- 604.
Illustration: PSM – Preventive and Social Medicine PHC – primary health care CHC – community health center SC - sub center ANC – antenatal care TT – tetanus toxoid VA – verbal autopsy NGO – Non Government Organization
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareESTHETIC AND FUNCTIONAL REHABILITATION OF THE PATIENT WITH SEVERELY WORN DENTITION
USING TWIN STAGE PROCEDURE: A CASE REPORT
English9399Naresh HG ShettyEnglish Manoj ShettyEnglish Krishna Prasad D.EnglishThe form function and pathofunction of the dynamic masticatory system comprises one of the most fascinating, basic and important areas of interest in dentistry. The explosion of technological and procedural advances coupled with improved materials herald a new age in dentistry. In this age of the ?esthetic revolution‘ and the ?extreme makeover‘ factors that control occlusal stability are usually overlooked. Even though a full-mouth reconstruction can be relatively complex, it does not have to be a long or complicated process in patient‘s perspectives. The severe wear of anterior teeth facilitates
the loss of anterior guidance, which protects the posterior teeth from wear during excursive movement. The collapse of posterior teeth also results in the loss of normal occlusal plane and the reduction of the vertical dimension. This case report describes prosthetic rehabilitation using the Hobo and Takayama twin-stage procedure for a patient with esthetically and functionally compromised dentition. The final prosthesis with this twin-stage procedure ensured a restoration with a predictable posterior disclusion and anterior guidance in harmony with the condylar path.
EnglishFull mouth rehabilitation, Hobo‘s twin stage, Effective cusp angle, Posterior disocclusion.INTRODUCTION
Though the full-mouth rehabilitation and its philosophies are often intrigue in nature, but the esthetic and functional accomplishment of rehabilitation is always satisfying. The gradual wear of the occlusal surfaces of teeth is a normal process during the lifetime of a patient. However, excessive occlusal wear can result in pulpal pathology, occlusal disharmony, impaired function, and esthetic disfigurement. Tooth wear can be classified as attrition, abrasion, and erosion depending on its cause. A differential diagnosis is not always possible because, in many situations, there exists a combination of these processes.Therefore, it is important to identify the factor that contribute to excessive wear and to evaluate alteration of the vertical dimension of occlusion (VDO) caused by the worn dentition. As teeth are worn, the alveolar bone undergoes an adaptive process and compensates for the loss of tooth structure to maintain the vertical dimension of occlusion. Therefore, vertical dimension of occlusion should be conservative and should not be changed without careful approach. Anterior guidance is crucial in human occlusion because it influences molar disclusion that controls horizontal forces. This case reports the satisfactory clinical outcome achieved by restoring the vertical dimension with an improvement in esthetics and function. In this case Hobo-Takayama method was incorporated for creating molar disclusion using a twin-stage procedure.
CASE REPORT
A healthy 44 year-old woman patient was reported to the department of prosthodontics, A B Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India, with a chief complaint of severely worn dentition, unpleasant smile, generalized sensitivity and difficulty in chewing(Fig 1) .The medical history was non-contributory. The patient‘s dental history indicated faulty tooth brushing habit, and extraction of 25,36 due to caries .The patient denied for any symptoms of temporomandibular joint disorder or myofacial pain dysfunction syndrome.
Clinical findings Extra oral findings; The patient had no gross facial asymmetry, muscle tenderness. The temporomandibular joints, muscles of mastication, and facial expressions were asymptomatic Intraoral findings; The maxillary and mandibular arch were partially dentate with tooth 25, 36, 38, missing. No gross abnormalities were noted in the overall soft tissues of the lips, cheeks, tongue, oral mucosa, and pharynx. Occlusion; Generalized severe attrition was noted. The patient presented with bilateral class I molar and the patient‘s lateral excursions showed canine guided occlusion. The patient was diagnosed with severe attrition with loss of vertical dimension. Treatment goals To restore the entire severely worn dentition to function and optimal esthetics Centric relation occlusion with maximum number of tooth contacts with no change in established vertical dimension To develop a canine guided occlusion Twin stage procedure to produce a definite amount of disocclusion during eccentric movements
Treatment procedure The patient received oral prophylaxis, and reinforcement of oral hygiene practises. Patient was advised for intentional root canal therapy for 31, 32, 41, and 42 due to decreased tooth structure. As there was clinical evaluation of reduced vertical dimension of occlusion, full mouth rehabilitation with increasing vertical dimension of occlusion was planned. Patient‘s informed consent was taken prior to treatment. Two sets of diagnostic impressions were made using irreversible hydrocolloid and diagnostic casts were obtained. Maxillary casts were mounted using an earpiece facebow (Hanau springbow no. 0103280) onto a Hanau arcon articulator (ALL 182/183 Wide –Vue series, Waterpik, USA) and mandibular cast was mounted using interocclusal aluwax (Aluwax dental products, Michigan, USA) record. Diagnostic wax up was prepared to proper size shape and contour (Fig 2). Mandibular posterior occlusal plane was analysed using occlusal plane analyser (Fig 3). On analysis all mandibular teeth followed the curve of spee. Maxillary left third molar was supraerrupted which required occlusal correction. Mandibular anterior teeth required intentional root canal treatment followed by post and core .Maxillary occlusal wax up was done to maximum intercuspation. Anterior wax up was checked for proper anterior guidance to achieve disocclusion in eccentric movements Meanwhile a maxillary occlusal splint was fabricated at an increased occlusal vertical dimension of 2 mm using heat cured acrylic resin. The occlusal splint was inserted and adjusted. Two weeks later the patient reported with no difficulties in adapting to the new position. Hence full mouth rehabilitation was planned at increased vertical dimension of 2mm. Tooth preparations for metal ceramic crowns were completed for the entire dentition (Fig 4). A final full arch impression for maxillary and mandibular teeth was made using poly vinyl siloxane (Express™ XT ,3M ESPE) impression material with double mix single impression technique (Fig 5). The casts were poured in die stone (Kalrock; Kalabhai Pvt.Ltd, Mumbai, India), which was later secured to a die lock tray. This assembly was mounted on a Hanau arcon articulator using face bow (Hanau springbow).Mandibular die lock tray was mounted using centric interocclusal record made in aluwax at previously determined vertical dimension. Provisional crowns were made (Protemp II, 3M ESPE dental products, St Paul, USA) from diagnostic wax up. Provisional restorations were cemented using zinc oxide non eugenol temporary cement (Temp bond cement, Kerr, USA). Articulator was programmed to condition I twin stage procedure (As in Table 1) maxillary and mandibular anterior segment was removed, and posterior teeth wax build up was completed to achieve balanced articulation, which helped in achieving standard effective cusp angle of 25‘ .(Fig 6)Then anterior wax build up was carried out after the values had been adjusted to condition II of twin stage procedure (Table 1) to achieve an incisal guidance of 40‘which produced a standard amount of disocclusion.(Fig 7) All wax patterns were cast and metal units were tried in and adjusted for proximal contacts and occlusion. Definite restorations with porcelain fused to metal crowns exhibiting vital and natural appearance with proper contour were designed. Completed porcelain fused metal crown showing posterior balanced articulation (Condition I)(Fig 8) and uniform disocclusion Condition II)(Fig 9),and intra orally showing the same(Fig10).Permanent cementation was done with glass ionomer Type 1 (GC Goldlabel, GC Group. Tokyo luting cement). Oral hygiene instructions were reviewed, emphasizing brushing habits and the use of floss for better maintenance of the prosthesis. Follow-up was carried out at regular intervals and the patient's post-operative condition was satisfactory (Fig 11, 12)
DISCUSSION
Aesthetic and functional restoration of the severely worn dentition represents a significant clinical challenge. The complications with severely attrited teeth demand a circumspect treatment plan and proper sequencing of therapy to ensure an optimal result for both the patient and the clinician. Proper treatment sequencing is critical when a patient requires multiple fixed restorations. The vertical dimension, centric relation, and occlusal plane must be determined first, followed by a diagnostic wax up which is essential for fixed prosthesis. An accurate diagnostic and interdisciplinary approach is necessary for obtaining improved, conservative and predictable results. Full mouth rehabilitation seeks to convert all unfavourable forces on the teeth which inevitably induce pathologic conditions, into favourable forces which permit normal function and therefore induce healthy conditions. A variety of techniques may be used in simultaneous constructions to obtain complete arch dies and mounted casts. When all of the prepared teeth are on a single articulator, there is flexibility in developing the occlusal plane, occlusal theme, embrasures, crown contour, and esthetics. The chairside disadvantages include 1 arduous, unpredictable patient visits, 2 full arch anaesthesia,3 full arch chairside treatment restorations,4 multiple occlusal records, and 5,6,7 possible loss of the vertical dimension of occlusion. An alternative approach to the full-mouth simultaneous reconstruction is to complete one quadrant before beginning another. The advantages of this approach are that it is primarily chairside and includes preparation and final impressions of select teeth, maintenance of vertical dimension, quadrant anaesthesia, and shorter, predictable appointments. The disadvantages of the quadrant reconstruction include restrictions for achieving ideal occlusion when altering the vertical dimension, occlusal plane, and embrasure development. The existing opposing dentition limits the reconstruction of an isolated quadrant. Esthetic consistency can be compromised because the porcelain restorations are made in stages. The advantages of the simultaneous and quadrant full-mouth reconstruction are combined in the present technique.8 The mechanism of anterior guidance was reviewed from recent mandibular movement studies to provide a basis for understanding the twin-stage technique, which is a practical method for establishing anterior guidance from the condylar path. 9,10 Hobo and Takayama studied the influence of condylar path, incisal path and the cusp angle on the amount of disocclusion. They concluded that cusp angle was the most reliable and was used as a new determinant of occlusion. Twin stage procedure proposed by Hobo and Takayama was adopted for wax build up because studies have proposed that it is possible to accurately control the amount of disocclusion on the restoration without measuring the condylar path. Anterior guidance and the condylar path previously were considered independent factors. It is an established fact that anterior guidance influences the working condylar path and even changes when the lateral incisal path deviates from the optimal orbit. This supports the hypothesis that anterior guidance and the condylar path are dependent factors. In setting anterior guidance, it is recommended to set the working condyle so that it moves straight outward along the transverse horizontal axis. The angle of hinge rotation produced by the angular difference between anterior guidance and the condylar path assists posterior disclusion but is not solely responsible. The anatomy of the cusps is created by establishing the appropriate form of the posterior cusps aligned to the condylar path; thus it also contributes to posterior disclusion. Posterior disclusion is crucial in controlling harmful lateral forces but the factors that determine the precise amount of disclusion have not been established.10 As followed in this case twin stage procedure helps in achieving a standard disocclusion of 1 mm on protrusion, 1mm on non working side, and 0.5 mm on working side in centric movements at 3mm protrusion from centric relation.
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 greatful 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=1951http://ijcrr.com/article_html.php?did=19511. Kazis H. Complete mouth rehabilitation through restoration of lost vertical dimension. J Am Dent Assoc 1948; 37:19- 39.
2. Hausman M, Hobo S. Occlusal reconstruction using transitional crowns. J Prosthet Dent 1961; 11:278-87.
3. Braly BV. A preliminary wax-up as a diagnostic aid in occlusal rehabilitation. J Prosthet Dent 1966; 16:728-30.
4. Hobo S. A kinematic investigation of mandibular border movement by means of an electronic measuring system: Part II: A study of the Bennett movement. J Prosthet Dent 1984; 51:642-6.
5. Hobo S. A kinematic investigation of mandibular border movement by means of an electronic measuring system: Part III: Rotation centre of lateral movement. J Prosthet Dent 1984; 52:66-72.
6. Hobo S. Formula for adjusting the horizontal condylar path of the semiadjustable articulator with interocclusal records: Part I: Correlation between the immediate side shift, the progressive side shift, and the Bennett angle. J Prosthet Dent 1986; 55:422-6
7. Hobo S. Formula for adjusting the horizontal condylar path of the semiadjustable articulator with interocclusal records: Part II: Practical evaluations. J Prosthet Dent 1986; 55:582- 8
8. Binkley TK, Binkley CJ. A practical approach to full mouth rehabilitation. J Prosthet Dent 1987; 57:261-6.
9. Hobo S, Takayama H. Effect of canine guidance on the working condylar path. Int J Prosthodont 1989; 2:73-9
10. Hobo S. Twin-tables technique for occlusal rehabilitation: Part I: Mechanism of anterior guidance. J Prosthet Dent 1991; 66:299-303
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareEVALUATION OF YOGA THERAPY FOR THE RISK FACTORS OF CARDIOVASCULAR DISORDERS-A
REVIEW
English100107Deepa.TEnglish N.ThirrunavukkarasuEnglishYoga and Meditation techniques are growing popular worldwide in preventing or reducing cardiovascular diseases. We reviewed the latest studies and recent literature concerning the use of yoga in the treatment of cardiovascular disorders. The studies of yoga therapy on acute and chronic hypertensive patients showed significant reduction in stress,stress related blood pressure, blood cholesterol level and body weight. The studies showed significant improvement in cardiovascular endurance and reduction in left ventricular mass. The purpose of this review is to evaluate the effect of yoga therapy on hypertension, obesity and coronary heart disease.
EnglishINTRODUCTION
Yoga is an ancient cultural heritage of India, designed to bring balance and health to the physical, mental, emotional, and spiritual dimensions of the individual. Yoga is often depicted as a tree comprised of eight limbs, such as yama (universal ethics), niyama (individual ethics),asana (physical postures), pranayama (breath control), pratyahara(control of the senses), dharana (concentration), dyana(meditation), and samadhi (bliss)1 .Yoga is described as comprising a rich treasure of physical and mental techniques that can be effectively used to create physical and mental well-being through down-regulation of the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS). As shown in fig 1,The HPA axis and SNS are triggered as response to stress, leading to a cascade of physiologic, behavioral, and psychologic effects, as a result of the release of cortisol and catecholamines. The repeated firing of the HPA axis and SNS due to stress can lead to dysregulation of the system and ultimately produce diseases such as diabetes, autoimmune disorders, depression, substance abuse, and cardiovascular disorders. Numerous studies have shown yoga to have an immediate downregulating effect on both the SNS and HPA axis response to stress2 .
Yoga has been extensively studied for its various effects in reducing salivary cortisol, blood glucose, as well as plasma renin levels and 24-hour urine norepinephrine and epinephrine levels3 . yoga reverses the negative impact of stress on the immune system by increasing levels of immunoglobulin A as well as natural killer cells .Yoga has been found to be useful on reducing BMR4,5, improvement in respiratory capacity 6 and shift of autonomic balance toward parasympathetic nervous system dominance, possibly via direct vagal stimulation7 . It is also found to be useful in treatment of diabetes8 , asthma9 , epileptic seizures10 and in anxiety disorders 11 .Yoga employs simple postures (asana), controlled breathing exercise(Pranayama)and meditation admixed in varying proportions.
History of yoga The origin of yoga is estimated to date back to the period between 200 BC and 300 AD, was written by a historically renowned yoga teacher and Hindu philosopher named Patanjali. The ancient Indian classic on the practice of yoga, Gherananda–Samhita, mentioned out of 840,000 asanas, only 84 are in contemporary common practice. Of these, only 32 are recommended by this ancient text as being useful for regular practice28 . Pranayama involves a slow deep inspiration and the breath is held momentarily in full inspiration, followed by slow and spontaneous exhalation.
Hypertension and its management
Hypertension is the most common cardiovascular disease affecting more than one billion people throughout the world. It is a major contributor of stroke, ischemic heart disease, heart failure, renal dysfunction and blindness43.The seventh Joint National Committee on Detection, Evaluation, and treatment of high blood pressure (JNC VII 2003) defined hypertension as a systolic blood pressure (SBP) of 140mmHg or greater and diastolic blood pressure (DBP) of 90mmHg or higher. Hypertension is further classified into two groups based on etiology as essential or primary hypertension and secondary hypertension. Essential hypertension is diagnosed when there is strong family history and no identifiable cause can be found42 . Hypertension is almost always easy to treat but difficult to keep under control as blood pressure is a continuous variable12. The goal of treatment is to lower the blood pressure as early as possible and maintain it, thereby preventing major complications of systemic hypertension. Drugs are prescribed as first line choice of treatment due to their significant, cost-effective, immediate action on reducing blood pressure. The utility of these agents is limited by the narrow range between therapeutic and toxic doses. These often produce dose dependent side effects, adverse reactions and rebound or overshoot hypertension when drug therapy is discontinued suddenly.13The side - effects, life long medical regimen, and cost of drugs have stimulated the search for a non-drug therapy as a primary treatment or as adjunctive therapy.Many non-pharmacological measures, such as 100mmol/day reduction in sodium intake, have been associated with a decline in blood pressure of about 5–7mmHg (systolic)/2.7mmHg (diastolic) in hypertensive subjects. Regular physical exercise such as walking is added along with drugs for its effect in managing hypertension. Many mindbody interventional methods like relaxation, biofeedback, stress management along with lifestyle modification have been shown as potential treatment for BP. Relaxation therapies alone doesn‘t show significant result in reducing BP. Hence progressive muscle relaxation techniques are not considered as an effective treatment method for high blood pressure . In contrast, Stress management therapies have some merits but are not widely available nor practiced. Studies on various non- drug modalities have shown more benefits from Yoga and Meditation in long term control of hypertension than any other modality.14,15 .
Yoga therapy on hypertension
It has been demonstrated in a randomised controlled Studies ,that even a short period of yoga intervention (3 months ) is as effective as drug therapy in reducing high blood pressure16 and heart rate31. The mechanism of yoga-induced blood pressure reduction may be attributed to its beneficial effects on the autonomic neurological function. Impaired baroreflex sensitivity has been increasingly postulated to be one of the major causative factors of essential hypertension. Regular practice of yoga increase the baroreflex sensitivity and decrease the sympathetic tone, thereby restoring blood pressure to normal level in hypertensive subjects17. Similarly, the decrease in sympathetic activity seen with slow breathing might be beneficial in hypertension, where sympathetic activation has been linked to disturbed breathing patterns and increased chemoreflex activity29 . Meditation by modifying the state of anxiety reduces stress induced sympathetic over activity , decreases the arterial tone and peripheral resistance, that lead to reduction in diastolic blood pressure and heart rate. This ensures better peripheral circulation and blood flow to the tissues18,19 . Meditation is associated with reduced sympathetic adrenergic receptor sensitivity,which might affect cardiovascular response during stress. During meditation appearance of frontal midline theta rhythm in electroencephalogram reflects mental concentration as well as meditative state of relief from anxiety and is correlated negatively with sympathetic activation. This suggests a close relationship between autonomic functions and activity of medial frontal neural circuitry and possibility of controlling CNS functions through yoga and meditation20. Transcendental meditation (TM) practice improves mood state, adrenocortical activity and kidney functions and believed to reduce stress and shows significant reduction in ambulatory diastolic BP21 . Yoga on chronic hypertension Yoga has proven its effect in modifying secondary complications produced by chronic hypertension. Left ventricular hypertrophy is a common consequence seen due to systemic hypertension.This may lead to many chronic cardiac complications, such as myocardial ischaemia, congestive cardiac failure and impairment of diastolic function. Left ventricular hypertrophy due to systemic hypertension is indicated by the height of ?R‘ wave in lead I, aVL, V5 and V6 in electrocardiogram. In one study The height of ?R‘ wave was taken prior to yoga practice and three months after continuation of yoga practice. The height of ?R‘ wave has come down appreciably in some patients indicating the reduction of left ventricular mass22 . Effect of yoga on body weight Weight also has the strongest independent correlation with the risk of hypertension. Yoga has been found to be particularly helpful in the management of obesity23. A randomized controlled study revealed that practising yoga for a year helped significant improvements in the ideal body weight and body density3 . A retrospective observational study showed that a regular practice of yoga for 4 years was significantly associated with weight loss by overweight participants24. After 4-day residential yoga practice followed by 14 weeks of 1 h daily home practice, one study found a significant loss in mean body weight from 72.26 to 70.48 kg among subjects with risk factors for coronary artery disease25 . Other studies confirmed that yoga was associated with significant weight loss by subjects with Coronary artery disease. After one year yoga practice coronary artery diseased patients showed a 7% loss of body weight26 and in a study by Schmidt and colleagues, healthy adults lost an average of 5.7 kg after 3 months of yoga practice27 . Effect of yoga on coronary artery disease Systemic hypertension is one of the risk factor for developing coronary artery disease. Participants with risk factors of coronary artery disease showed reduction in all parameters such as Blood pressure, LDL, total cholesterol, triglycerides except high density lipoprotein.In a randomized controlled study, patients with angiographically proven coronary artery disease who practiced yoga exercise for a period of one year showed a decrease in the number of anginal episodes per week, improved exercise capacity and decrease in body weight28. Thus yoga exercise increases regression and retards progression of atherosclerosis in patients with severe coronary artery disease26. Subjects who practiced pranayama or controlled yogic breathing could achieve higher work rates with reduced oxygen consumption per unit work and without an increase in blood lactate levels. one study reported the effects of yoga training on cardiovascular response to exercise and found yoga training improved the exercise tolerance to cardiovascular effects. Yoga on the management of coronary artery disease showed reduction in sympathetic tone, decreased peripheral vascular resistance, improved cardiac output, reduction in heart rate , blood pressure, and improvement in cardiovascular endurance3 . Effect of Yogic Practices in Prevention of Diabetes Yogic practices reduce body fat and increase lean body mass, thereby help in improving insulin sensitivity32 . The reduction in free fatty acid levels have a significant effect on beta cell function. hence yogasanas by preventing beta cell exhaustion may prevent diabetes. studies have confirmed the benefit of yoga in the control of diabetes mellitus. All the studies showed a significant fall in the fasting and post-prandial blood glucose values within 3 months and continued to have a smooth and good control of diabetes during the period of the study as evidence by a normal glycosylated hemoglobin and blood glucose levels33. The drug requirements were significantly reduced. CONCLUSION The beneficial effects of yoga to the heart ailments is outstanding. However, the role of yoga in the management of the hypertension should be complementary to the conventional modes of treatment. Regular yoga practice involving simple postures, relaxation exercise and respiratory exercise combined with drug therapy showed superior results compared to those who did not practice yoga. The reviews showed that yoga had beneficial effects on reducing BP , blood cholesterol level and body weight .It also improves left ventricular function and cardiovascular endurance. Considering the scientific evidence discussed so far, we can postulate that the practice of yoga triggers neurohormonal mechanisms that bring about health benefits by suppressing sympathetic activity. hence we conclude that yoga can be beneficial in preventing cardiovascular disease and can play a complementary role to drug therapy for hypertension.Any persistent benefits require a long-term adherence to yoga therapy and subjects who have continued their programs even at home showed better results30 . Additional studies are needed to distinguish between the different types of yoga and their various techniques. The optimal duration, the type of yoga program, and intensity of the yoga program need to be described clearly in many studies as they can affect the final outcome.. Additional studies are needed to find the effect of yoga on long term as only a few follow up studies are available. All of these studies need to use rigorous study methodologies, including the use of larger sample sizes, randomized samples, and blinding of researchers. 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.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30General SciencesCHARACTERIZATION OF FATTY ACIDS IN MELIA AZEDARACH L. SEED OIL
English108114R. K. BachhetiEnglish Himanshu DwivediEnglish Vikas RanaEnglish Indra Rai Archana JoshiEnglishPhysical and chemical characteristics of oil extracted from Melia azedarach L. seeds are presented in this work. The results indicate that Melia azedarach seeds constituted 39.6% crude oil. The specific gravity, refractive index, saponification value, and unsaponifiable matter content of Melia azedarachseed oil were found to be 0.80 g/cm3, 1.36 40 D n , 84.15 (mg KOH/g) and 0.71 (%w/w) respectively. Elemental analysis of oil by AAS and Titration method shows that it contains Ca (1230 mg/100g), Mg (990 mg/100g), K (121 mg/100 g), Zn (3.12 mg/100 g), Mn (3.4 mg/100g), Fe (19.52 mg/100g) and P (213 mg/100g). The extracted oil was methyl-esterified and analyzed by GC and GC-MS. The major fatty acids reported here, in Melia azedarach seed oil, are Palmitic acid (5.68%), Linoleic acid (74.57%), Oleic acid (16.39%), Stearic acid (3.33%). This work might be useful for developing applications for Melia azedarach L. seed oil.
EnglishMelia azedarach, seed, oil.INTRODUCTION Melia azedarach L. (Sapindales: Meliaceae), know as Chinaberry or Persian lilac tree, is a deciduous tree native to northwestern India and has long been recognized for its medicinal and insecticidal properties but yet to be properly analyzed. This tree typically grows in the tropical and subtropical parts of Asia, but nowadays it is also cultivated in other warm regions of the world because of its considerable climatic tolerance1 . It has been cultivated since the sixteenth century, chiefly for ornamental purposes and has become naturalized in most tropical and subtropical countries2 . In Traditional Chinese Medicine, the plant is used as an antiparasitic and antifungal agent, but many of its constituent compounds have been found to exhibit a wide range of other biological properties3-10 . In addition, a number of potent pharmaceutical limonoids and triterpenoids have been isolated from fruits and bark11 . The cytotoxic property of limonoids is extensive and recent efforts are designed to investigate the cellular and molecular mechanisms by which such effects are exerted in the tumorigenic cell lines12 . Although the fruits are the poisonous part of the tree, they have been used traditionally for the treatment of a variety of diseases, specially dermatitis and rubella11 . The bark and rootbark mainly contain tetracyclic triterpenoids, as well as flavones and anthraquinones, etc. Pharmacological studies indicate that the bark, fruit, seed and leaf have the effects of expelling parasites, suppressing bacteria and anti-virus, etc13 . In some parts of Tamil Nadu, India the decoction of the leaves of the tree is used under traditional system of medicine to cure the problem of dysmenorrhoea (pain and discomfort during menstruation). They gave the suffering patients the decoction of the leaves of Persian Lilac tree, `Malaivembu' in Tamil, Melia azedarach and it is known to cure the conditions very fast. The object of this study was therefore to extract oil from Melia azedarach seeds and assessment of the physical and chemical characteristics of the oil as a prelude to an investigation into the scientific basis for its best end uses. MATERIALS AND METHODS Collection of plant materials The seeds of Melia azedarach L. are small (about 6-7 mm long) and enclosed in a thick hard bony endocarp commonly known as stone. The fruits of Melia azedarach were collected from Sahestra Dhara road, Dehradun in month of December 2010. The fruit were cleaned and stones were separated. The stones were broken manually to obtain seeds. The seeds were air dried in the shade for few days and kept in colour bottles until analyzed. Extraction of seed oil 100 gm of seeds were grounded into powder form with high speed blender and dried in an air circulating oven at 50oC for 1 h. Oil was extracted from the dried grounded seeds with petroleum ether (boiling point 60-80oC) using a Soxhlet extractor. The solvent was distilled off at 80oC. Oil content was calculated on the basis of dry seeds weight and expressed in g/100g. Analysis of seed oil Oil density was determined picnometrically, Refractive index was determined at 25°C with Abbey Refractometer, viscosity was determined by Ostwald method14. The oil extracted from the seeds was assessed for various chemical properties. Standard methods described by Association of Official Analytical Chemists15 were used for the determination of moisture, crude fibre and ash contents of the seed samples. Physical and chemical analyses of the extracted oil were carried out by using AOAC methods15. Iodine value was determined using Wij‘s method as reported in AOAC methods15. The procedures of Egan et al. 16 were adopted for the estimation of saponification values, unsaponifiable matter content and acid value of the oil sample. Protein content in seeds and oil sample was determined using microKjeldhal method as described by Allen and Quarmby17 . A factor of 6.25 was adopted for protein content estimation. Carbohydrate content was determined by colorimetric method17 . The metal composition Zinc, Iron, and Manganese of the seeds were determined by using an Atomic Absorption Spectrophotometer (Model Varian 240FS+GTA120), after acid digestion. Calcium and magnesium was determined by complexometric titration with 0.1M EDTA, by using Erichome black T indicator and calculated. Phosphorus was determined by the precipitation of phosphorus in the form of phospho molybdate by using the reagent ammonium molybdate. Precipitate was filtered from asbestos, then residue obtained was taken in Conical Flask and dissolved in 0.1 M NaOH and titrate with 0.1 M HCl by using indicator Phenolphthalein. Potassium was determined by flame photometer model No. ESICO 1381 by using the reference standard (Merck) and calculated on the basis of reading and dilution of the sample. GC and GC-MS analysis The Fatty acids were derivatized by using the boron trifluoride method as described by Hisil18. Samples were injected as 2 µl into a Nucon model 5700 equipped with 10% DEGS (Diethylene Glycol Succinate) + 1% H3PO4 constant phase, a flame ionization detector (FID) and chromosorb G (100/120 mesh) support matter, internal diameter (2mm) and stainless steel (190 cm) column. Column temperature was programmed from 70°C to 200°C with the increasing rate of temperature 6°C/Minute. Injector and detector temperatures were set at 225°C. Nitrogen (N2) (25 ml/min) was used as the carrier gas.
Hydrogen (40ml/min) and Air (60ml/min) were used as burnt and dry gas respectively. Fatty acid methyl esters were identified by comparison with fatty acid internal standards, Individual fatty acid concentration was expressed as percent RESULTS AND DISCUSSION The seeds of Melia azedarach were collected in the month of December, 2010 from Dehradun (Uttarakhand), India. The seeds were dark brown in colour and evaluated for physical properties. Analysis results of seeds are given in table-1. Seeds are rich in protein, oil and fibre. Oil extracted (yield; 39.6 %w/w) from Melia azedarach seeds is dark brown in colour and free from sediments. It is liquid at room temperature (27± 2OC). It contains 20.13% protein, 19.45% carbohydrates and 15.40% crude fibre. The physico-chemical properties of Melia azedarach seed oil is given in table-2. The results of GC (figure-1) and GCMS analysis of oil is listed in table-3 and showed that the oil contain both saturated (9.0226%) and unsaturated fatty acids (90.9774). The main acids present in the oil were Palmitic acid (5.68%), Linoleic acid (74.57%), Oleic acid (16.39%), Stearic acid (3.33%). Acid value is an indicator for edibility of oil and suitability for industrial use. Melia azedarach seed oil has an acid value 2.25. This falls within the recommended codex of 0.6 and 10 for virgin and non virgin edible fats and oil respectively19. The iodine value of Melia azedarach oil is 9.14 which indicate that it is drying oils. The low iodine value in this study indicate the oil contain low level of polysaturated fatty acids. The seed oil studied have a significant saponification value 84.15, the high saponification value recorded for the seed oil suggested that the oil contain high molecular weight fatty acid and low level of impurities. This is evidence that the oil could be used in soap making industry20, 21 . The main chemical component of the fatty acids in Melia azedarach is Linoleic acid. Linoleic acid is the essential amino acid, and be supplied to the human beings only by food sources. It helps low blood pressure in hypertensive patients, and also be useful to protect human cardiac system22, 23. It is used for manufacturing margarine, shortening, and salad and cooking oils as well as soaps, emulsifier, and quick drying oils24. The other main chemical component is Oleic acid, it reaches 16.39%. Oleic acid is the most abundant fatty acid in human adipose tissue25 . Oleic acid may hinder the progression of adrenoleukodystrophy (ALD), a fatal disease that affects the brain and adrenal glands26 . Oleic acid is also responsible for the hypotensive effects of olive oil27 . As an excipient in pharmaceuticals, oleic acid is used as an emulsifying or solubilizing agent in aerosol products28. In Melia seed oil the palmitic acid and stearic acid contributed 5.68 and 3.33% respectively. Palmitic acid is used in the manufacture of soaps, candle, cosmetic formulations, food grade additives, waterproofing agents, lube oils, and non drying oils (surface coatings). Whereas the presence of stearic acid in Melia seed oil indicates the potential use of oil for pharmaceutical preparations, dietary supplements, oil pastels, soaps, food packaging, deodorant sticks, toothpaste and softening rubber29, 30 . The mineral composition of Melia azedarch is summarized in table-4. It is rich in Calcium, Magnesium, Potassium and Iron which make it quite suitable as edible and commercial oil. Considering the results obtained in this preliminary study, it is noticeable that the seeds oil had a high content of linoleic acid and oleic acid and also has a healthy composition for nutrition. It turned out that Melia azedarach could be good source of natural oil rich in Linoleic acid and Oleic acid. This work might be useful for exploring the applications of Melia azedarach seeds and its oil. Further by cultivation and breeding of capers plants regularly, a more productive quality raw matter would be obtained.
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=1953http://ijcrr.com/article_html.php?did=19531. WAC, World Agroforestry Centre, Agroforestry Tree Database, A tree species reference and selection guide [http://www.worldagroforestry.org/sea/Pr oducts /AFDbases/af/asp /SpeciesInfo.asp?SpID=1141] (Accessed September 23, 2011).
2. Hadjiakhoondi A, Vatandoost H, Khanavi M, Sadeghipour-Roodsari R, Vosoughi M, Kazemi M, Abai M R., Fatty acid composition and toxicity of Melia azedarach L. fruits against malaria vector Anopheles stephensi. Iran. J. Pharma.Sci. 2006; 2(2): 97-102.
3. Isman M B. Botanical insecticides, deterrents, and repellents in modern agriculture and an increasingly regulated world. Annu. Rev. Entomol. 2006; 51: 45-66.
4. Akhtar Y, Yeoung Y R, Isman M B. Comparative bioactivity of selected extracts from Meliaceae and some commercial botanical insecticides against two noctuid caterpillars,Trichoplusia ni and Pseudaletia unipuncta. Phytochem. Rev. 2008; 7 (1): 77-88.
5. Carpinella M C, Ferrayoli C, Valladares G, Defago M, Palacios S. Potent limonoid insect antifeedant from Melia azedarach. Biosci. Biotechnol. Biochem. 2002; 66 (8): 1731-1736.
6. Carpinella M C, Ferrayoli C G, Palacios S M. Antifungal synergistic effect of scopoletin, a hydroxycoumarin isolated from Melia azedarach L. fruits. J. Agric. Food Chem. 2005; 53 (8): 2922-2927.
7. Carpinella M C, Giorda L M, Ferrayoli C G, Palacios S M. Antifungal effects of different organic extracts from Melia azedarach L. on phytopathogenic fungi and their isolated active components. J. Agric. Food Chem. 2003; 51 (9): 2506- 2511.
8. Coria C, Almiron W, Valladares G, Carpinella C, Ludueña F, Defago M, et al. Larvicide and oviposition deterrent effects of fruit and leaf extracts from Melia azedarach L. on Aedes aegypti (L.) (Diptera: Culicidae). Bioresource Technol. 2008; 99 (8): 3066-3070.
9. Kamaraj C, Rahuman A A, Bagavan A, Mohamed M J , Elango G , Rajakumar G, et al. Unit Ovicidal and larvicidal activity of crude extracts of Melia azedarach against Haemonchus contortus (Strongylida). Parasitol. Res. 2010; 106 (5): 1071-1077.
10. Ntalli N G, Menkisoglu-Spiroudi U, Giannakou I. Nematicidal activity of powder and extracts of Melia azedarach fruits against Meloidogyne incognita. Ann. Appl. Biol. 2010; 156 (2): 309-317.
11. Alché L E, Ferek G A, Meo M, Coto C E, Maier M S. An antiviral meliacarpin from leaves of Melia azedarach L. Z. Naturforsch. 2003; 58c (1/2): 215-219.
12. Ntalli N G, Cottiglia F, Bueno C A, Alché L E, Leonti M, Vargiu S, et al., Cytotoxic tirucallane triterpenoids from Melia azedarach fruits. Molecules. 2010; 15 (9): 5866-5877.
13. Anonymous. Hong Kong Jockey Club Institute of Chinese Medicines, Encyclopedia on Contemporary Medicinal Plants, Melia azedarach (Chinaberry-tree) [http://www.hkjcicm.org/cm_database/pl ants/detail_e.aspx?herb_id=35] (Accessed August, 25, 2011).
14. Boži? J S, Ogrin T. Viscosity. [http://www.standardbase.hu/tech/SITech Visc.pdf.] (Accessed July, 12, 2011). 15. A.O.A.C. Official Methods of Analysis 14th Edn. Association of Official Analytical Chemists. Washington D. C. 1990; 14th Edn.: pp. 801-805.
16. Egan H, Kirk R S, Sawyer R. Pearson‘s Chemical Analysis of Foods. 8th Edn. London: Churchill Livingstone Publishers; 1981: pp. 507-547.
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18. Hisil Y. Instrumental Analysis Technique. Izmir, Turkey: Ege Univ. Engineering Fac. Publ. Nu.55;1989.
19. Ibrahim T A, Dada I B O, Adejare R A. Comparative phytochemical properties of crude ethanolic extracts and physicochemical characteristics of essential oils of Myristical fragrans (Nutmeg) seeds and Zingiber officinate (ginger) roots. Electronic Journal of Enviornment, Agriculture and Food Chemistry. 2010; 9(6): 1110-6.
20. Kirsehenbauer H G. Fats and Oil: An Outline of their Chemistry and Technology. 2nd edn. New York: Reinhold Publ Corp. 1965; p. 160-161.
21. Akanni M S, A-dekunle S A, Oluyemi E A. Physio-Chemical properties of some non-conventional oil seed. J. Food Technol. 2005; 3:177-181.
22. Zhen L I, Yang De-po. Structure-effect relationship of conjugated linoleic acid and its molecular pharmacology research progress. J. Int. Pharmaceutical Res. 2007; 34(1): 26-30.
23. Whigham L D, Cook M E, Atkinson R L. Conjugated linoleic acid: implications for human health. Pharmacol Res. 2000; 42(6): 503-510.
24. Ukalina, O G, Ifechukwude N M. Characterization of the fatty acids of Gardenia jasminoide flower from port Harcourt, Nigerian. International Journal of Academic Research. 2011; 3 (3): 534- 538.
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26. Rizzo W B., Watkins P A, Phillips M W, Cranin D, Campbell B, Avigan J. Adrenoleukodystrophy: oleic acid lowers fibroblast saturated C22-26 fatty acids. Neurology. 1986; 36(3): 357-61.
27. Terés S, Barceló-Coblijn G, Benet M, Alvarez R, Bressani R, Halver Je, et al. Oleic acid content is responsible for the reduction in blood pressure induced by olive oil. Proc. Nat. Acad. Sci. U.S. A. 2008; 105 (37): 13811–6.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareKNOWLEDGE AND OPINION OF CAREGIVERS REGARDING CHILDHOOD ADDITIONAL VACCINES
IN AGARTALA, WEST TRIPURA
English115120Majumder NilratanEnglish Datta Shib SekharEnglish Boratne Abhijit VinodraoEnglish Majumder NilanjanEnglish Basu Majumder ChandrikaEnglishIntroduction:
Despite growing vaccine-preventable infections, immunization campaigns still suffer due to parental resistance. Knowledge and opinion of caregivers about childhood additional vaccines becomes imperative before we stress upon any such promotion under UIP. Objective: To assess knowledge and opinion of caregivers regarding childhood additional vaccines in Agartala, Tripura.
Methods: Present study was undertaken during Jul-Dec 2011 in a child clinic at Agartala. Data was collected using pre-designed and pre-tested proforma by interview technique. Information regarding background characteristics of parents, source of information, knowledge and opinion regarding childhood additional vaccines was collected after obtaining written consent. Data analysed using Microsoft Excel and Epi_Info version 6.04. Chi-square test was used and pEnglishCare givers, Childhood Additional vaccine, Immunization, ParentsINTRODUCTION
Immunizing children against vaccine preventable diseases responsible for child mortality and morbidity is not an easy task. In a resource poor developing country like India, the numbers of target population across geographically diverse regions and difficult areas make universal immunization a mammoth task.1 Immunization coverage in India are still lagging and current level of ?fully immunized‘ children undCONCLUSIONer the national immunization programme is quite low, as pointed by previous studies.2,3 Factors such as parents‘ knowledge about routine and additional vaccination and their attitudes towards them does influence vaccine coverage. Despite growing and emerging vaccine-preventable infections, reassurance from researchers on safety and efficacy of vaccines, and tremendous efforts by health care professionals, immunization campaigns still suffer on accounts of parental resistance.4,5 It is imperative to understand the current level of knowledge and opinion of caregivers about childhood additional vaccines before we put emphasis on any such promotion to be included under the national immunization schedule as suggested by Indian Academy of Paediatrics (IAP) 6 in India and especially in remote and difficult part of north-east India like Tripura state. Objective: The present study was conducted to assess knowledge and opinion of caregivers regarding childhood additional vaccines in Agartala, West Tripura.
MATERIALS AND METHODS
Study setting: The present facility based observational study was undertaken during July-December 2011. For this purpose, a specialist child clinic situated in the urban area of Agartala, Tripura served as study center. The child clinic has a regular OPD attendance of around 20-25 children (upto 12 years age) per day. The clinic is run by a senior child specialist and 2 trained medical assistants. Data collection: Data was collected by a predesigned and pre-tested proforma using interview technique by senior child specialist at the child speciality clinic. Each parent(s) of children aged 2-5 years attending the clinic were explained about need of the study and those who consented to participate in the study after proper description and rationale of the interview questionnaire, were included in the study. Information regarding background characteristics of parents, source of information, knowledge and opinion regarding childhood additional vaccines was collected. Additional vaccines: For study purpose, optional vaccines recommended by IAP6 such as H influenza B (HiB), Hepatitis A, Chicken Pox, Meningococcal Vaccine, Pneumococcal Vaccine, Influenza Vaccine and Rota Virus Vaccine were considered as childhood additional vaccines. Data analysis: The data were analysed using Microsoft Excel and Epi_Info software package version 6.04. To compare data sets Chi-square test was used and p < 0.05 was considered statistically significant (Yates‘ correction applied wherever applicable). Ethical consideration: Written consent was obtained from all the study participants before assessing their knowledge and opinion about childhood additional vaccines.
opinion regarding childhood additional vaccines were gathered from parents of total 180 children. Among them, 112 (62.22%) were parents of male and 68 (37.78%) parents of female children. Majority (96.67%) of the respondents were Hindu and 104 (57.78%) belonged to joint families. 131 (72.78%) mothers of children were graduate and 144 (80%) were housewives. 151 (83.89%) fathers were graduate and 107 (59.45%) were in service. (Table 1) Knowledge regarding additional vaccines Doctors (73.33%) were main source of information regarding childhood additional vaccines followed by television (18.89%) and friends (17.78%). 48 (26.67%) and 59 (32.78%) parents respectively knew the timing of these additional vaccines and against which diseases these vaccines are being used. 133 (73.89%) parents reported vaccination as best way to prevent these diseases. 86 (76.79%) parents of male children reported that vaccination is the best approach to prevent these diseases as compared to 47 (69.12%) parents of female children (p=0.033). Further, 101 (56.11%) parents correctly knew the routine immunization schedule. (Table 2) Opinion regarding additional vaccines 137 (76.11%) parents opined that additional vaccines should be available at govt. hospitals. 84 (46.67%) parents recognized polyvalent vaccines better than monovalent vaccine. Numbers of injections (89.29%), cost (21.43%), numbers of visits (16.67%) and less complications (15.48%) were cited for such preference. Financial constrain (46.11%), family disagreement (26.67%), time constrain (20%), fear of complication (18.89%) and non-availability (8.89%) were stated as barriers; and parents‘ education (69.44%) and economic status (41.11%) were stated as foremost family related reason for poor acceptance of childhood additional vaccines. (Table 3)
DISCUSSION
Study findings indicate that knowledge and opinion of parents regarding childhood additional vaccines pose as significant factor towards successful immunization campaign. Doctors remained important source of information (73.33%) for parents in regard to childhood additional vaccines. Majority of parents opined that vaccines are best method to prevent these diseases (73.89%) and those vaccines should be made available in govt. hospitals (76.11%). These results are similar to findings documented by previous researchers. 7,8 However, in the present study, only 26.67% and 32.78% parents respectively knew the timing and rationale of selected childhood additional vaccines. Previous researchers have mentioned that modusoperandi towards knowledge and concerns raised by parents regarding childhood immunization determines action taken by parents, and thus immunization coverage in particular area.9,10 It has been recommended that parents who resist immunization campaign because of background characteristics, traditional beliefs or situational perceptions; health care providers must assess the socio-cultural, economic and scientific basis for resistance before promoting such campaign.11 Financial constrain, parental knowledge, family disagreement, fear of complication and non-availability of additional vaccines were stated as main barriers for poor acceptance and coverage of childhood additional vaccines. Similar findings has already been compiled and documented in this respect through studies conducted in Africa and Asia.12 In general, parents‘ knowledge about childhood additional vaccines still remains poor in third world countries. However, it has been argued that public often accepts vaccination despite limited knowledge about it.13 It is recommended that parents‘ knowledge and concerns must be addressed to promote and maintain childhood additional vaccination campaign once we plan to start this campaign. Further, to improve vaccination coverage and child survival, a sense of urgency is must from national as well as community level.14 Measures which can lever promotion and popularization of childhood additional vaccination may include addressing knowledge gap among parents and their concerns, making these vaccines available at govt. hospitals, engaging private health providers/facilities and monitoring the progress to sustain the impact. Performance of MCH services still remains a matter of concern in India and it has been recommended to engage and monitor services rendered by anganwadis towards improvement of immunization services. 15 The strong association between parents‘ education and vaccination coverage has been recognized in NFHS-3 and UNICEF coverage surveys in India and other developing countries. 16, 17 This fact may also be may be utilized considering higher education level of parents in the study area to promote and sustain coverage of childhood additional vaccines in the study are as suggested by Indian Academy of Paediatrics.
Limitations: Debatable limitations of the present study may include urban setting of the study and already sensitized respondents otherwise clients of the same private health care facility. This arguably may have led to an inflated response and thus puts question on application of the study findings in other difficult, remote and rural India.
CONCLUSION
Parents‘ knowledge and opinion regarding childhood additional vaccines is a matter of concern. This knowledge-gap and other operational issues should be addressed before launching and promoting any such campaign.
ACKNOWLEDGEMENT
We acknowledge all study participants for valuable information towards improving vaccination coverage among children. 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. Source of financial support: Nil Conflict of interest: None declared
Englishhttp://ijcrr.com/abstract.php?article_id=1954http://ijcrr.com/article_html.php?did=19541. Sharma R, Bhasin SK. Routine immunization - Do people know about it? A study among caretakers of children attending pulse polio immunization in east Delhi. Indian Journal of Community Medicine 2008; 33(1):31-34.
2. Bhatia V, Swami HM, Rai SR, Gulati S, Verma A, Parashar A, et al. Immunization status in children. Indian J Pediatr 2004; 71:313-315.
3. Yadav RJ and Singh P. Immunization of children and mothers in northeastern states. Health and Population - Perspectives and Issues 2004; 27(3):185- 93.
4. Chen RT, DeStefano F, Pless R, Mootrey G, Kramarz P, Hibbs B. Challenges and controversies in immunization safety. Infect Dis Clin North Am. 2001; 15(8):21- 39.
5. Offit PA, Jew RK. Addressing parents‘ concerns: Do vaccines contain harmful preservatives, adjuvants, additives, or residuals? Pediatrics. 2003; 112:1394- 1397.
6. Singhal T. Recommendation: Consensus recommendations on immunization, 2008. Indian Academy of Pediatrics Committee on Immunization (IAPCOI). Indian Paediatrics 2008; 45(8):635-48.
7. Gellin BG, Maibach EW and Marcuse EK. Do parents understand immunizations? A national telephone survey. Pediatrics. 2000;106(5):1097-1102.
8. Manjunath U, Pareek RP. Maternal knowledge and perceptions about the routine immunization programme: A study in a semi-urban area in Rajasthan. Indian J Med Sci 2003;57:158-63.
9. Gust DA, Kennedy A, Shui I, Smith PJ, Nowak G and Pickering LK. Parent attitudes toward immunizations and healthcare providers: The role of information. Am J Prev Med. 2005;29:105-112.
10. Keane MT, Walter MV, Patel BI, et al. Confidence in vaccination: a parent model. Vaccine. 2005;23:2486-2493.
11. Dawson A. The determination of ?best interests? in relation to childhood vaccinations. Bioethics. 2005;19:188-205.
12. Jheeta M and Newell J. Childhood vaccination in Africa and Asia: the effects of parents‘ knowledge and attitudes. Bull World Health Organ 2008;86(6):419-420.
13. Nichter M. Vaccinations in the Third World: A consideration of community demand. Soc Sci Med 1995; 41: 617-632.
14. Kumar S. Indians can do better at improving child survival. Indian Journal of Community Medicine 2011; 36(3): 171-173.
15. Datta SS, Boratne AV, Cherian J, Joice YS, Vignesh JT and Singh Z. Performance of anganwadi centers in urban and rural area: A facility survey in coastal south India. Indian Journal of Maternal and Child Health 2010; 12(4): 1-9.
16. Luman ET, McCauley MM, Shefer A, Chu SY. Maternal characteristics associated with vaccination of young children. Pediatrics 2003; 111(5 Part 2): 1215-1218.
17. International Institute for Population Sciences (IIPS) and ORC Macro. National Family Health Survey (NFHS-3), 2005- 06. Mumbai, India: IIPS; 2007.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareEVALUATION AND COMPARISON OF REMINERALIZATION EFFICACY OF CPP-ACP AND FLUORIDE VARNISH USING DIAGNODENT - AN IN VITRO STUDY
English121129R.SenthilEnglish V. Rathna PrabhuEnglish J. Jeeva rathanEnglish A. VenkatachalapathyEnglishAim: To evaluate the remineralization efficacy of CPP-ACP and Fluoride Varnish using Diagnodent and to compare the remineralization efficacy of CPP-ACP and Fluoride Varnish.
Methodology: Sixty freshly extracted non carious premolars were selected and randomly divided into three groups of twenty samples each. Group A: (Control), Group B: Fluoride Varnish (Fluorprotector), Group C: CPP – ACP (Tooth mousse). The baseline values for all the samples were recorded using diagnodent (KaVo). After demineralizing the samples, values were again measured. Fluorprotector (Ivoclar Vivadent) and GC Tooth mousse (Recaldent) were applied on to the buccal surface of the samples in group B and group C respectively with group A as control. Twenty minutes later the readings for Group B and Group C were obtained. All the samples in the three groups were immersed in artificial saliva and the readings obtained were statistically analyzed.
Results: The mean value for group B was (5.6+/-0.9) and for group C was (7.2+/-1.6). This was statistically significant (PEnglishRemineralization, CCP-ACP, Fluoride varnish, Artificial saliva, Diagnodent.INTRODUCTION
The development of dental caries is a complex, multistage and a dynamic process which can be conceptualized as an imbalance between mineral loss called demineralization and mineral gain called remineralization. The cycle of remineralization and demineralization is a constant process in the normal oral environment, and only when the speed and the level of demineralization become dominant the actual surface cavitation becomes possible. This multifactorial infectious disease which is initiated and progressed by Mutans streptococci should be quickly detected for an effective treatment plan that reverses the progression from white spot lesion to cavitation. The ability to promote mineralization can be achieved using various remineralizing agents such as Fluoride varnish (Fluorprotector) and CPP-ACP (Casein Phosphopeptide Amorphous Calcium Phosphate). CPP-ACP a water based sugar free cream when applied to the tooth surface binds to biofilm, plaque, bacteria, hydroxyapatite and surrounding soft tissue, localizing bioavailable calcium and phosphate, there by buffering plaque pH and enhancing remineralization. In a human in situ demineralization study, 1.0%w/v CPP-ACP solution used twice daily produced a 51% reduction in enamel mineral loss caused by frequent sugar solution exposure1 . CPP-ACP solutions have shown to promote demineralization of the enamel sub surface lesions 2 . On the other hand, use of fluoride is the pivot of preventive dentistry which continues to be the cornerstone of caries prevention program. The decline of dental caries prevalence in recent decades has been explained by widespread use of fluoride. The ability of fluoride to facilitate remineralization process is presently believed to be more significant than its inhibition of demineralization3 . The absorption of calcium fluoride on the tooth surface and the release of ions during low plaque pH promotes remineralization. Among various topical fluorides, fluoride varnish plays an important role in preventing the enamel sub surface lesion because of high fluoride concentration and also the ability to adhere to the enamel thereby extending the exposure time to several hours forming a depot from which fluoride is released slowly 4 . The DIAGNOdent system is a part of an exciting new generation of dental equipment. This system employs laser light of a defined wave length to help detect and quantify broken down tooth substance without x-ray exposure. It is also a quick, easy and pain free diagnostic aid with 90% success rate in caries detection, pathological changes and initial demineralization. This laser-fluorescence device is suitable for monitoring small caries lesions as well as occlusal caries5 . In this study this investigation tool is used for assessing the demineralization as well as the subsequent remineralization by using two materials such as CPP-ACP (Tooth mousse) and Fluoride varnish (Fluorprotector) on the extracted human premolars.
MATERIAL AND METHOD Sixty freshly extracted non carious premolars were selected and cleaned thoroughly with ultrasonic scaler and polished with pumice slurry. The samples were then preserved in a beaker containing thymol. A 4x4mm sticker paper was cut and stuck on the buccal surface of all the samples to create a window. The remaining surfaces of the samples were coated with acid resistant nail varnish and then the sticker paper was removed. Each tooth was kept in a separate plastic tube with a rubber stopper and was numbered from 1 to 60 individually on the tubes and kept in a stand. The samples were then randomly divided into three groups of twenty samples each. Group A: Control Group B: Fluoride Varnish (Fluorprotector) Group C: CPP – ACP (Tooth mousse) The laser tip of DIAGNOdent was kept in free air and the calibrating button in the instrument was pressed for thirty seconds until the monitor displayed the indication ?CAL? on it. Then the tip was placed in a ceramic calibrating block given by the manufacturer and again the calibrating button was pressed till the indication ?CAL DONE? was displayed on the monitor. The calibrated tip was then kept in the window created on the buccal surface of the tooth and the peak value displayed in the diagnodent was recorded as the baseline value. Similarly the baseline values (V1) for all the samples were recorded after calibrating the tip between each sample readings. The samples were immersed in their respective tubes containing 2ml of demineralization solution and kept for 4 hours6 . Later they were taken from the tubes, washed with de-ionized water and dried with soft tissue paper. DIAGNOdent values were again measured (V2) with the same tip as before for all the samples on the same surface. Fluorprotector (Ivoclar Vivadent ) and GC Tooth mousse (Recaldent) were applied on the buccal surface of the samples in group B and group C according to manufacturer‘s instructions. The group A (control) was left without any application. Twenty minutes later the DIAGNOdent readings (V3) for Group B and Group C were again obtained after calibrating the equipment. All the samples in the three groups were kept undisturbed in individual tubes containing 2ml of artificial saliva for 24 hours7,8. The diagnodent readings (V4) of all the samples in the three groups were again obtained. Statistical analysis was done using paired?t‘ test and student‘s ?t‘ test appropriately (p Englishhttp://ijcrr.com/abstract.php?article_id=1955http://ijcrr.com/article_html.php?did=19551. Reynolds EC, Cai F, Shen P, Walker GD. Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. J Dent Res 2003; 82(3):206-11.
2. Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res 1997;76(9):1587-95.
3. Eujeno Fluoride Varnish; A review. J Am Dent Assoc 2000:131.
4. Castellano JB. Donly KJ. Potential remineralization of demineralized enamel after application of fluoride varnish. Am J Den. 2004; 17(6):462-4.
5. Alwas-Danowska HM, Plasschaert AJ, Suliborski S, Verdonschot EH. Reliability and validity issues of laser fluorescence measurements in occlusal caries diagnosis. J Dent 2002; 30 (4):129-34.
6. Corry DT, Millett SL. Effect of fluoride exposure on cariostatic potential of orthodontic bonding agents: an in vitro evaluation. Journal of Orthodontics 2003; 30 (4): 323-329.
7. Devlin H, Bassiouny MA, Boston D. Hardness of enamel exposed to Coca-Cola and artificial saliva. J Oral Rehabil 2006; 33(1):26-30.
8. Eisenburger M, Addy M, Hughes JA, Shellis RP. Effect of time on the remineralisation of enamel by synthetic saliva after citric acid erosion. Caries Res 2001; 35(3):211- 5.
9. John Hicks, Catherine F. Biological factors in dental caries: role of remineralization and fluoride in the dynamic process of demineralization and remineralization. J Clin Pediatr Dent 2004; 28: 203.
10. Bader J, Shugars DA. A systematic review of the performance of a laser fluorescence device for detecting caries. J Am Dent Assoc 2004; 135: 1413-1426.
11. Shinohara T, Takase Y, Amagai T, Haruyama C, Igarashi A, Kukidome N, Kato J, Hirai Y. Criteria for a diagnosis of caries through the DIAGNOdent. Photomed Laser Surg 2006; 24(1):50-8.
12. Tanaka M. Comparative Reduction of Enamel Demineralization by Calcium and Phosphate in vitro. Caries Res 2000; 34:241-245.
13. De Bruyn H, Buskcs JA, Arends J. The inhibition of demineralization of human enamel after fluoride varnish application as a function of the fluoride content. An in vitro study under constant composition demineralising conditions. J Biol Buccale 1986; 14(12): 133-138.
14. Munshi AK, Reddy NN, Shetty V. A comparative evaluation of three fluoride varnishes: an in - vitro study. J Indian Soc Pedod Prev Dent 2001; 19:92-102
15. Reynolds EC, Cai F, Shen P, Walker GD. Retention in plaque and remineralization of enamel lesions by various forms of calcium in a mouthrinse or sugar-free chewing gum. J Dent Res 2003; 82(3):206-11.
16. Attin T, Buchalla W, Gollner M, Hellwig E. Use of variable remineralization periods to improve the abrasion resistance of previously eroded enamel. Caries Res 2000; 34(1):48-52.
17. Amaechi BT, Higham SM. In vitro remineralisation of eroded enamel lesions by saliva. J Dent 2001; 29(5): 371-6.
18. Silverstone Poole. Human saliva as potential remineralizing agent. Caries Res 1968; 2:87.
In Table 2, mean ± SD values between group B and C at V3 was about (5.6 ± 0.9) and (7.2 ± 1.6) which was statistically significant (pRadiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareMUTATIONAL ANALYSIS OF INTERFERON-GAMMA GENE IN INDIAN WOMEN WITH FEMALE GENITAL
TUBERCULOSIS
English130140Venkanna BhanothuEnglish Jane TheophilusEnglish Roya RozatiEnglishFGTB is usually a silent disease evidencing itself only when really looked for. It usually affects females of reproductive age group. Disruption of the IFN-gamma gene in mice infected with M. tuberculosis has resulted in exacerbation of disease, progressive and widespread tissue destruction and necrosis with numerous bacteria. We therefore proposed, to study the possible association of IFN-γ gene polymorphism in Indian women with female genital tuberculosis. It is a prospective case-control study. Screening of genomic DNA samples were carried out from clinically definite 106 FGTB
patients and 100 unaffected patients aged between 18 to 40 years. +874 (T?A) IFN-γ genotyping was carried out by using sequence specific primer polymerase chain reaction (SSP-PCR) method. Statistical tests were performed using pantaray software systems. According to our investigation, FGTB patients showed more or less similar TT (30.18% vs. 30.0%), higher AA (19.81% vs. 9.0%) genotypes compared to controls and the frequency of AT genotypes decreased significantly. Distribution of IFN- γ genotypes between patients and controls were have statistical disparity. This study suggests that IFN-γ +874 T to A polymorphism have an etiological association with susceptibility of female genital tuberculosis.
EnglishMycobacterium tuberculosis; Interferon-? gene polymorphism; Female Genital Tuberculosis (FGTB)INTRODUCTION
Female genital tuberculosis (FGTB) is usually a symptom-less disease diagnosed during investigations for infertility (Namavar Jahromi et al., 2001). It represents 15-20% of extra pulmonary tuberculosis (Rajamaheshwari, 2009). In 80-90% cases, FGTB affects women between 18-38 years of age with menstrual irregularities accounting for nearly 27% of manifestations of FGTB (Chakrabarti et al., 1998). Primary infection may occur when the male partner has active genitor-urinary TB and transmission takes place by sexual intercourse (Richards and Angus, 1998). It is usually a result of reactivation of a silent bacillemia, primarily from lungs and also thought to be from cervical TB infections (Richards and Angus, 1998; Sutherland et al., 1982). The seeding of bacilli usually occurs immediately after puberty as blood supply to the pelvic organs increases and as a result, more bacilli can reach genital organs and infect them (Crofton et al., 1992). Infection of vulva, vagina and cervix may result from direct inoculation and ascending spread to other genital organs may occur (Haas et al., 2002). The incidence of infertility in genital TB worldwide varies from 44-74%; in India it is reported to be 58% (Dam et al., 2006) and majority are in the same age group (Crofton et al., 1992). In western countries the incidence of FGTB is estimated to be 60% of cases), pelvic pain and scanty menstruation and amenorrhoea, and histopathological evidence in biopsy of premenstrual endometrial tissue or demonstration of tubercle bacilli in culture of menstrual blood or endometrial curetting. Exclusion criteria were as all the following: Women above 40 years of age, symptoms suggestive of pulmonary TB/Extra pulmonary TB except infertility, with normal abdomenal and vaginal examinations, other chronic disease, pregnancy or nursing, severe psychiatric dysfunction, multiple sclerosis or other autoimmune disorders, pulmonary infections, HIV co-infection, women with diabetes, malnutrition and other medical disorders like hypertension were excluded. Details of laparoscopy findings like unilateral or bilateral tubal block with hydrosalphinx, omental adhesions, frozen pelvics, tubo-ovarian masses, tubercular salphingitis and tubercles were noted in Table 1. Symptoms included pelvic pain, irregular menstrual bleeding, scanty menstruation, dysmenorrhoea oligomenorrhea, amenorrhea and infertility. A pelvic mass in variable combination aroused a suspicion. Constitutional symptoms such as sweating, increase in temperature and weight loss were not major complaints while local organ dysfunction manifested in amenorrhea, omental adhesions and bilateral tubal blockage seen on hysterosalpingographic study. The median age of the subjects was 29 (range 18- 40) years. All subjects were HIV negative and normal for pulmonary TB on the basis of complete history, physical examinations; chest X-ray, lung plain X-ray and by appropriate tests such as tuberculin test, sputum smears and sputum cultures (Raut et al., 2001; Saracoglu et al 1992). The study population is from the state of Andhra Pradesh, which is known for ethnic variations.
Study group: Tube ovarian biopsy was taken from 106 women during laparoscopy; from 45 women endometrium was obtained by curettage and 61 women with biopsy for smear microscopy, histopathology, culture and PCR for mycobacterium. All these women were infertile: primary infertility in 81 (76.4%) women and secondary infertility in 25 (23.58%) women with mean age of 29.16 ± 3.73 years, mean age at menarche of 12.53 ±1.01 years, mean duration of infertility of 3.97 ± 2.91 years. Other gynaecological pathology like dysmenorrhoea in 49 (46.2%) women, tubal block with hydrosalphinx in 57 (53.77%) women, omental adhesions in 41 (38.68%) and tubercular salphingitis in 51 (48.1%) were reported. Blood samples were collected in heparinised tubes. The specimens were received and preserved in 10% formalin, processed in routine manner and embedded in paraffin wax. Three-micron thick sections were cut and stained by haematoxylin and eosin (Namavar Jahromi et al., 2001). The diagnosis was undertaken on morphological grounds (Raut et al., 2001). Erythrocyte sedimentation rate (ESR) was performed on all the patients, which showed readings of between 57 and 123. Tissue specimens were examined by a pathologist for granulomatous reactions, fibrosis suggestive of mycobacterium disease.
Control group: Out of one hundred women who attend the same clinic for other gyaecological disorders and tubal sterilization, 92 (92%) women were proven fertile. Eight (8%) women were infertile: primary infertility in 7 (7%) women, secondary infertility in 1 (1%) women with other gynaecological pathology (3 polycystic ovaries, 1 idiopathic infertility, 4 pelvic inflammatory disease) and were laparoscopically confirmed to be without female genital tuberculosis. All the women in this group were asymptomatic with mean age of 26.11 ± 4.57 years, mean age at menarche of 12.03 ± 0.84 years and mean duration of infertility of 0.174 ± 0.184 years. The following symptoms were also present in the control group: abdominal pelvic pain was observed in 2 (2%) women, dysmenorrhoea in 25 (25 %), oligomenorrhoea in 3 (3%), there were 2 (2%) mild menorrhagia, and 1 (1%) general malaise cases. There were no severe cases as shown in the Table 1.
Culture
Homogenized samples were cultured on Lowenstein Jensen egg medium for acid-fast bacilli and incubated for 3 to 8 weeks. ZiehlNeilsen staining was used to identify the bacilli (Abebe et al., 2004).
DNA Preparation Five ml of whole blood from patients and controls were used for DNA extraction by a modified proteinase-K/salting-out method (Miller et al., 1988). Polymorphism at position +874 of IFN-γ gene was identified using sequence specific polymerase chain reaction (PCR-SSP) as described by Pravica with some modifications (Pravica et al., 2000). Briefly, red blood cells were lysed using cold Lysis buffer-I (0.3 M sucrose, 10mM Tris-HCl (pH: 7.4), 5 mM MgCl2, 1% Triton x-100). The pellet was washed with phosphate buffer saline (PBS) once. To the pellet 3 ml Lysis buffer-II (10mM Tris-HCl, 400mM NaCl, 2mM Na2- EDTA), 200μl of 10% SDS and 40μl proteinase-K were added and incubated in 37°C overnight. To remove proteins, 1 ml of 6M NaCl was added and centrifuged for 5 min at 1500g. For extraction of DNA, 2 volumes of absolute ethanol were added to the supernatant. The extracted DNA was washed twice in 70% ethanol, dried at 37°C, and recovered in sterile water. Extracted DNA was stored at -20°C until utilization.
PCR-SSP Amplification IFN-γ polymorphism at position +874 in the first intron (T versus A) was determined by sequence-specific primer-PCR (PCR-SSP) according to manufacturer‘s recommendations (QPS Bioserve India (P) Ltd, Hyderabad, India). Briefly, the PCR was performed in a final volume of 50μl with 100-200ng of isolated genomic DNA as template in reaction mixture containing 200μM (each) dNTPs and 0.5 U Taq DNA polymerase, 1X reaction buffer (Bangalore Genie, Bangalore, India), 3.5mM MgCl2 (GENETIX, New Delhi, India), 0.5μM each specific primers (antisense: TCA ACA AAG CTG ATA CTC CA; sense +874 T: TTC TTA CAA CAC AAA ATC AAA TCT; or sense +874A: TTC TTA CAA CAC AAA ATC AAA TCA), and 0.2 μM of each internal control primers (QPS Bioserve India (P) Ltd, Hyderabad, India). Internal control primers amplify a human β-globin sequence (forward primer: ACA CAA CTG TGT TCA CTA GC; reverse primer: CAA CTT CAT CCA CGT TCA CC). PCR amplification was performed using a touch down method that included initial denaturation at 95oC for 5 minutes followed by two loops; loop 1 which consisted of 10 cycles with the following program: 95oC for 30 seconds, 62oC for 50 seconds, and 72oC for 40 seconds and loop 2 included 20 cycles with the following program: 95oC for 30 seconds, 56oC for 50 seconds and 72oC for 40 seconds and a final extension step at 72oC for 5 minute. The amplified products were run on 1% agarose gel that was in a buffer containing 0.5 μg/ml ethidium bromide (Figure-1). Later it was visualized under UV light and photographs were documented.
Figure-I: PCR-SSP Amplified product of IFN-γ (+874 T→A) gene SNP from FGTB patients were electrophoreses on 1% agarose gel; 262 bp size bands correspond to IFN-γ A or T allele and the 100 bp size bands correspond to internal controls. 50bp DNA marker is loaded in first well; lanes 1 and 2 show homozygosity for T allele; lanes 3 and 4 show heterozygosity for A and T alleles; lanes 5 and 6 show homozygosity for A allele; lanes 7, 8, 9 and 10 show homozygosity for T allele; lanes 11 and 12 show homozygosity for A allele.
STATISTICAL ANALYSIS
Statistical analysis was performed using pantaray software systems (Uitenbroek and Daan, 1997). Comparison of age, menarche age, body mass index, duration of infertility in the study groups and control group was performed using the independent two-sample Student‘s t test and data are presented as mean ±SD. The odds ratio (OR) and p-values were used to measure the strength of the association between genotypes and female genital tuberculosis. Hardy– Weinberg equilibrium (HWE) analysis was performed to compare genotypes frequencies between patients and controls by using χ2 analysis (df=1). All odds ratios (OR) were calculated as estimates of the confidence intervals (CI) were calculated at the 95% level (95% CI). p -value Englishhttp://ijcrr.com/abstract.php?article_id=1956http://ijcrr.com/article_html.php?did=19561. Abebe M, Lakew M, Kidane D, Lakew Z, Kiros K and Harboe M. 2004. Female genital tuberculosis in Ethiopia. Int J Gynecol Obstet., 84:241-246.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareZIZIPHUS MAURITIANA : A REVIEW ON PHARMACOLOGICAL POTENTIAL OF THIS UNDERUTILIZED PLANT
English141144Sukirti UpadhyayEnglish Prashant UpadhyayEnglish A K GhoshEnglish Vijender SinghEnglishZiziphus mauritiana is one of the underutilized herbs having potential to heal various ailments. It is reported in the ancient literature that whole plant as fruits, leaves , seed and root posses pharmacological activity . So this article is focused on potential and reported pharmacological activities of the whole plant.
EnglishZiziphus mauritiana , root ,seed, fruitINTRODUCTION
Ziziphus mauritiana a tropical fruit tree species. It is a spiny, evergreen shrub or small tree up to 15 m high, with trunk 40 cm or more in diameter; spreading crown; stipular spines and many drooping branches. The fruit is of variable shape and size. It is oval, obovate, oblong or round, and it can be 1-2.5 in (2.5- 6.25 cm) long, depending on the variety. The flesh is white and crisp. When slightly unripe, this fruit is a bit juicy and has a pleasant aroma. The fruit's skin is smooth, glossy, thin but tight.It is the most commonly found in the tropical and sub-tropical regions. Originally native to India it is now widely naturalized in tropical region from Africa to Afghanistan and China, and also through Malaysia , Australia and in some pacific regions. It can form dense stands and become invasive in some areas, including Fiji and Australia and has become a serious environmental weed in Northern Australia. It is a fast growing tree with a medium life span that can quickly reach up to 10–40 ft (3 to 12 m) tall.
VERNACULAR NAMES:
English: Chinee apple, Chinese date, cottony jujube, Indian cherry, Indian jujube, Indian plum, jujube
Fijian: baer
French: jujubier, massonnier
Hindi: baher, bahir
Spanish: azufaifo africano
CHEMICAL CONSTITUENTS:
It is a rich source of cyclopeptide alkaloids lupane and triterpenes. cyclopeptidmacrocycles of Ziziphus species showed interesting biological properties, including sedative, analgesic, antibacterial , antifungal and, antiplasmodial activity etc .It have 14-membered ring cyclopeptides to be the largest subgroup of alkaloid obtained, whereas only one 13-membered macrocyclic alkaloid isolated from this plant. These included the 4(14)-membered ring class: mauritineC, amphibine F and frangufoline the 5(14)-membered ring type: mauritines A and B. It also contain protein ,carotene and vitamin C. The fruit is eaten raw or pickled or used in beverages. It is quite nutritious and rich in vitamin C. It is second only to guava and much higher than citrus or apples. In India, the ripe fruits are mostly consumed raw, but are sometimes stewed. Slightly unripe fruits are candied by a process of pricking, immersing in a salt solution. Ripe fruits are preserved by sun-drying and a powder is prepared for outof-season purposes. It contains 20 to 30% sugar, up to 2.5% protein and 12.8% carbohydrates. Fruits are also eaten in other forms, such as dried, candied, pickled, as juice, or as ber butter. In Ethiopia, the fruits are used to stupefy fish.The leaves are readily eaten by camels, cattle and goats and are considered nutritious.In India and Queensland, the flowers are rated as a minor source of nectar for honeybees. The honey is light and of fair flavor.1
MEDICINAL PROPERTIES
Plant pacifies vitiated pitta, kapha, obesity, fever, burning sensations, cough, wound, skin disease, ulcers, stomatitis, diarrhea, sexual weakness, and general debility. Useful part : Fruit, Seed, Leaves, Root, Bark. 2
PHARMACOLOGICAL REVIEW OF LITERATURE: The alcohol and aqueous extract of Z.mauritiana leaves stimulates cell-mediated immune system by increasing neutrophil function and phagocytic activity. 3 Free radical scavenging activity & inhibitory response of Ziziphus maurtiana seed extract exert on alcohol induced oxidative stress.4 Anticancer potential of aq. ethanolic extract of Ziziphus maurtiana was found against cancer cell liner by MTI assay. 5 Ziziphus maurtiana root exert antidiarrhoeal activity of in rodents . The antidiarrhoeal effect of the methanolic extract as evaluated exhibited a concentration dependent inhibition of the spontaneous pendular movement of the isolated rabbit jejunum and inhibited acetylcholine induced contraction of rat ileum. A dose dependent decrease of gastrointestinal transit was observed with extracts (25 and 50 mg/kg) which also protected mice against castor oil induced diarrhea and castor oil induced fluid accumulation, respectively.
The presence of some of the phytochemicals in the root extract may be responsible for the observed effects, and also the basis for its use in traditional medicine as antidiarrhoeal drug. 6 Chronic alcohol ingestion is known to increase the generation of reactive oxygen species (ROS), thereby leading to liver damage. Pretreatment of rats with 200, 400 mg/kg body weight of aqueous leaf extract of Z.mauritiana resulted reduced the morphological changes that are associated with chronic alcohol administration .Rat liver administered with only alcohol resulted in severe necrosis, mononuclear cell aggregation and fatty degeneration in the central and mid zonal areas which was a characteristic of a damaged liver. 7 Ziziphus maurtiana aqueous ethanol seed extract exert hypoglycemic activity in alloxan induced diabetic mice. 8 The aqueous extract of Ziziphus maurtiana leaf lowers cholesterol and triglycerides level in serum & liver of rats Aqueous extract of Ziziphus maurtiana leaf can be used for the prevention and treatment of fatty liver, atherosclerosis and other diseases associated with high levels of cholesterol and triglyceride. Pretreatment was found to confer more protection than co-treatment, hence pretreatment should be preferred. 9 The methanolic extract of Z.mauritianastem bark was evaluated for its antiulcer activity using two models. Models are ethanol induced gastric ulcers model and aspirin induced gastric ulcer model in mice. It was found that the methanolic extract of stem bark have significant antiulcer activity in dose dependent manner where 3 different oral doses prepared (100 mg/kg of body weight, 250 mg/kg of body weight and 500 mg/kg of body weight). Evaluation was done on both models comparing with reference standard ranitidine (80 mg/Kg/ p. o.). The above result shows that Z.mauritianastem bark probably contains some active ingredients that could be developed for above mentioned abnormal condition as have been claimed by traditional system of medicine. 10 The antimicrobial effects of ethanolic extracts of leaves of two species of genus Ziziphus were determined against Escherichia coli, Staphylococcus aureus, Streptococcus pyogenes, Aspergillus niger and Candida albicans. S. pyogenes was the most susceptible followed by E. coli while S. aureus was the least susceptible. 11 Investigation of the MeOH extract that alkaloids isolated exhibited potent antiplasmodial activity against the parasite Plasmodium falciparum with the inhibitory concentration (IC50) ranging from 3.7 to 10.3 μM. Compounds 2 and 3 also demonstrated antimycobacterial activity against Mycobacterium tuberculosis with the MIC of 72.8 and 4.5 μM, respectively. 12 The aqueous, methanolic and saponin extracts of Zizyphus mauritiana bark were screened for spermicidal activities against human spermatozoa.Saponin extract is found to be more active to cause immobilization then aqueous and methanolic extract.13.
CONCLUSION
Thus from traditional and reported activities of Z.mauritiana it may be concluded that this herb has great potential as antimicrobial , hepatoprotective , anticancer , contraceptive and antidiarrhoel agent other activities mentioned in the literature have to explore for further development of potential medicinal agent.
ACKNOWLEDGEMENT
I would like to acknowledge Prof R L Khosa conveyer of GBTU for encouragement in doing research work.
Englishhttp://ijcrr.com/abstract.php?article_id=1957http://ijcrr.com/article_html.php?did=19571. www.ayurvedicmedicinalplants.com
2. http://commons.wikimedia.org
3. Wadekar R.Effect of Ziziphus maurtiana lea.f extract on phagocytosis by human neutrophills. Journal of Pharmacy Research 2008;1 (1).
4. Bhatia A and Mishra T ,Free radical scavenging activity and inhibitory responces of ziziphus maurtiana seed extract on alcohol induced oxidative stress. An international forum for Evidence Based Practices 2009,;( 1): 8
5. Mishra T , Kullar N and Bhatia A.Anticancer potential of Aqueous ethanol seed extract of Ziziphus maurtiana against cancer cell lines and Ehrlich Ascites Carcinoma. Evidence Based Complementary And Aleternative medicines 2011;.2011:11.
6. Dahiru D, Sini J.M.and John Africa L Antidiarrhoeal activity of Ziziphus maurtiana root extract in rodents. African Journal of Biotechnology 2006; 5 ,10.
7. Dahiru D , Obidoa O. Evaluation of the Antioxidant Effects of Z.mauritianaLam. Leaf Extracts Against Chronic EthanolInduced Hepatotoxicity in Rat Liver Afr J Tradit Complement Altern Med 2007 ; 5(1): 39–45
8. Bhatia A and Mishra T ,Hypoglycemic activity of Ziziphus maurtiana aqueous ethanol seed extract in alloxan induced diabetic mice.Pharmaceutical biology 2010; 48,604.
9. Dahiru D, Obidoa O,Effect of aqueous extract of Ziziphus maurtiana leaf on cholesterol and triglycerides level in serum & liver of rats administered alcohol.2009, Pakistan j of nutrition , 2009:1884-1888.
10. Panchal S, Panchal K, Vyas N, Modi K, Patel V, Bharadia P, Pundarikakshudu K. Antiulcer Activity of Methanolic Extract of Z.mauritiana stem Bark International Journal of Pharmacognosy and Phytochemical Research,2010 2(3): 6-11.
11. M. E. Abalaka1, S. Y. Daniyan1 and A. Mann2 M. E. Abalaka1, S. Y. Daniyan1 and A. Mann Evaluation of the antimicrobial activities of two Ziziphus species (Z.mauritianaL. and Ziziphus spinachristi L.) on some microbial pathogens. African Journal of Pharmacy and Pharmacology 2010. 4(4): 135-139.
12. Panomwan P., Kanlaya L., Samran P., Palangpon K., Apichart S, Somsak R and Sunit S .Antiplasmodial and antimycobacterial cyclopeptide alkaloids from the root of Ziziphus mauritiana ,Phytochemistry 2011,72 : 909-915 .
13. Dubey R, Dubey K, Sridhar C, Jayaveera K N. Sperm immobilization activity of aqueous, methanolic and saponins extract of bark of Ziziphus Mauritiana.Pelagia Research Library.Der Pharmacia Sinica, 2010 , 1 (3): 151-156.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524143EnglishN-0001November30HealthcareROLE OF COMMUNITY BASED LEARNING IN CREATING SELF-DRIVEN LEARNING AND RURAL BIAS
AMONG MEDICAL UNDERGRADUATES
English145149Shib Sekhar DattaEnglish Abhijit V BoratneEnglishIntroduction:
Currently medical education is dominated by examination and product oriented didactic lecture sessions in most of the medical schools. Innovation in medical education is required to reorient current medical curricula. Objective: The present study aimed to explore the scope of community based learning at village set-up in creating self driven learning and rural bias among medical undergraduates.
Methods: Using a village posting, students were made aware of community needs through social mapping, transect walk and discussion on various issues pertaining to rural health. A triangulation of qualitative methods like free list, pile sort exercise and focus group discussion was undertaken to understand the perception of students regarding various teaching methods. Results: Student could notice existence of different teaching methods: classroom based didactic lecture, OHP/PPT guided session, group discussion, problem based learning, field visit based learning, port folio driven learning and community based learning. Community based learning, problem based learning and filed visit guided learning motivated students towards self-driven learning and created a sense of rural bias among them. However, competitive examination oriented lecture sessions were cited as poor teaching methods and fail to motivate them.
Conclusion: Community based learning has the potential of creating self-driven learning among medical undergraduates.
EnglishCommunity based learning, Medical education, Pile sort analysisINTRODUCTION
The role of innovation in medical education is becoming increasingly important and it will be vital for all nations to reorient their education systems.1Advances in the learning sciences have expanded our understanding of how student‘s learning and how the mind converts information into useful knowledge.2 Indian education system is based upon British colonial legacy: educational levels, curriculum frameworks, physical structure of colleges and classrooms, and timing of examinations.1 The education system is characterized by didactic teaching, individual work, a product oriented approach, absence of independent thinking, and presence of unquestioned obedience to authority.3 Skill building in research methods is increasingly being seen as integral component of medical education, and community based learning can be one of them.4-5 Garg6 and Narayanan7 have already described the role of community based teachings in creating rural bias among medical undergraduates and social revolution. The teaching model of Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram is based on Gandhian ideology. The institute aims at evolving a pattern of medical education suitable for developing countries. To orient the students and provide them with a personal experience of rural life, ?Social Service Camp‘ is held in a village adopted each year for the purpose for a period of 15 days. During this period, first year medical students are asked to stay in the village under the guidance of faculty of Community Medicine. They carry out health, sanitation and nutrition surveys.8 The theme for the 2008 batch medical undergraduates camp was ?Community Based Learning‘. The aim was to explore the scope of community based learning in creating self driven learning and rural bias among medical undergraduates.
MATERIALS AND METHODS
Study setting:The current study was undertaken during ?Social Service Camp‘ organized for 2008 batch of medical undergraduates at Pulai village of Wardha district, Maharashtra with a total population of 846 and 217 households. Students were oriented about socio-demographic profile of the village and community needs using different Participatory Rural Appraisal tools and techniques and utility of community based learning cum research in rural development. Preparation of self portfolio and discussion on topics ranging from rural health, gender bias, and leadership among doctors was undertaken. Students participated in social mapping, did transect walk to have better understanding of rural community. In addition, they did anthropometric measurements of 0-20 years age group population and dietary survey in one allotted families. They also participated in microbiological and pathological sample collection for the entire village which extended till management of positive cases in the village. Information collection: These were carried out at the end of the Social Service Camp. A triangulation of qualitative methods like free list, pile sort exercise9 and Focus Group Discussions (FGDs)10, which are useful to explore the perceptions of students regarding better teaching-learning methods was undertaken. Initially, students (n=64) were asked to individually enlist the various teaching methods they have observed during the camp posting. Later, 9 various types of teaching methods (Figure 1) with relatively high Smith‘s S value were pile sorted. In pile sort exercise, 12 purposively selected students, who were willing to participate and talk freely, were individually asked to form the groups of these 9 methods which they felt went together. This was followed by 4 FGDs, consisting of 6-8 students for each session (both boys and girls), to understand perception and attitude towards different teaching methods. These FGDs were facilitated by a faculty of Community Medicine using semi-structured guidelines and note taker (post graduate of Community Medicine) recorded all discussions. The numbers of FGDs were decided by saturation point i.e. where it stopped yielding any new information. The facilitator encouraged the participants to freely exchange their perception and experiences related to various teaching methods. The sampling technique adopted for the present study was purposive with maximum variance.
Data analysis: A two dimensional scaling and hierarchical cluster analysis was completed with pile sort data to get collective picture of their perceptions. The analysis of free list and pile sort data was undertaken using Anthropac 4.98.1/X software. 11
RESULTS
Various teaching methods which students could observe to be in practice during their initial six month career as medical undergraduates including current camp posting in decreasing order of frequency are: classroom based didactic lecture sessions, sessions using over head projectors (OHP)/power point presentations (PPT), and group discussion (GD); which are mostly examination oriented. To a lesser extent they could also observe the existence of problem based learning (PBL), field visit guided learning and learning through community based posting, especially during this camp. Community based learning as per their experience has triggered among them need for exploration of social issues related to health and disease, and has been able to create a sense of rural bias and better understanding of disease process. Portfolio aimed at self driven learning revealed ?what they want to learn?‘ ranging from personal hygiene, communication skills, geriatric care, nutrition, environment and sanitation to health care delivery at village level. Examination oriented study however, they feel has failed to motivate them to explore the core need of the community. Most of the classroom based lecture sessions they observe are curriculum guided and do not address the needs of the rural poor. Such competition oriented curriculums are often examination oriented and record book or theoretical knowledge aimed. Community based learning, portfolio guided study and PBL were recognized as better learning methods; whereas examination guided didactic lecture sessions, sessions using OHP/PPT were cited as poor teaching methods. However, they also mentioned that institutional credibility played an important role in establishing such teaching-learning setting at village level. In pile sort exercise, four major groups of teaching-learning methods were formed.
The first major group comprised of better ones comprising of community based learning, PBL and field visit guided learning. Students felt that, these should be encouraged in medical institutions to promote rural health and also they found them interesting and better methods to understand the Community Medicine subject. The second group of portfolio based learning and GD was considered to be better during initial days of the professional course to guide their future career. Remaining groups of classroom based didactic lecture sessions, and OHP/PPT guided sessions; and examination oriented study, they commented to be the inferior ones which do not serve the purpose of learning and rather demotivate the students and creates a picture of casualness on part of a teacher. (Figure 1)
DISCUSSION
In the present study, usefulness of various teaching methods has been re-invented. Need for innovative learning methods in medical institutions; like learning through community based posting, PBL and learning through filed visits has again been well established. On the other hand, lecture guided teaching sessions, which currently is being practiced in most of the medical schools has been viewed as one of the negative factor and demotivate students. Medical teaching in developing countries aims to impart skills to students to critically appraise evidence, promote, prevent, and manage health in the community.9 Community based learning has been shown to have the potential to motivate students to appreciate the learning process with greater community involvement. 12-13 In the present formative research, the ?Social Service Camp‘ approach and application of community based posting to learn social issues and appreciate self-motivated learning as an effective method has been well established. The attribute can be because of their continuous presence in the rural community for a descent period and better interaction with the community. Dongre et al14 has already well documented role of community based study in motivating students for self-driven learning. The teaching approach in such camps is an integration of task oriented assignments, integration of social sciences within medical domain and active involvement with the community. Notably, the student centered educational innovation is not quite evident in Asia as seen in other parts of the world.13 Students reported that examination oriented teaching are ineffective in guiding them towards self-driven learning. This has again reiterated that most of the medical schools in Asia have traditional, teacher centered and hospital based education which fail to produce complete doctors required for the rural poor.15,16 Few researchers also feel medical curricula should formulate flexible syllabus rather than a rigid one, but this has not been popular and on the contrary created lot of issues rather than solution.5 Research particularly at community set-up has also been used as a tool to teach epidemiology in some medical schools in India.17 Self-driven learning thus should be promoted to guide medical education in resource poor developing countries to cater for the rural masses in better way.18 Such selfdriven learning can be facilitated through community based learning.
CONCLUSION
Community-based learning is one important teaching method which has the potential of creating self-driven learning among medical undergraduates, and is better compared to classroom based lecture sessions or similar other examination oriented teaching methods. Community based learning at village set-up promotes rural bias among medical undergraduates and should be incorporated in current medical curricula.
ACKNOWLEDGEMENT
We thank staff of Dr. Sushila Nayar School of Public Health incorporating Department of Community Medicine, Sewagram for their support during the Social Service Camp. 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.
Source of financial support: Nil
Conflict of interest: None
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18. World Federation for Medical Education. The Edinburgh Declaration. Med Educ 1988;22:481-2.1-Community based learning 4-Port folio based learning 2-Problem based learning 5-Group discussion 3-Filed visit guided learning 6-OHP /PPT guided session 8-Competition based study 7-Didactic lecture session 9-Examination oriented study