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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31General SciencesA Novel Generalized Divergence Measure of Fuzzy Sets
English0103Anshu OhlanEnglishAim: The aim of the paper is to introduce a generalized measure of discrimination in fuzzy environment.
Methodology: To achieve the goal of this paper a parametric generalization of Hellinger’s fuzzy divergence measure is studied along with the proof of its validity.
Results: A particular case and some important properties are discussed in detail of the proposed generalized Hellinger’s fuzzy divergence measure.
Conclusion: Generalized Hellinger’s fuzzy divergence measure is valid measure of fuzzy divergence.
EnglishFuzzy sets, Fuzzy entropy, Fuzzy divergence measure, Generalized Fuzzy Divergence MeasuresINTRODUCTION
Shannon [1] was first to use the word “entropy” to measure an uncertain degree of the randomness in a probability distribution. The theory of fuzzy sets and fuzzy logic developed by Zadeh [2] has been used to form ambiguity, lack of information and uncertainty inherent in the human decision making process. It has achieved a great success in various areas such as multi-criteria decision making (MCDM), logical programming, pattern recognition, medical diagnosis and so on. Zadeh [3] introduced fuzzy entropy as an significant concept for measuring fuzzy information.
Thereafter, a number of researchers made study on the fuzzy theory and find their applications in different areas. For example, some new information and divergence measures and their applications in different areas have been proposed in literature [4-22].
Although many information measures between fuzzy sets has been emerging in the last decades. Still, there is a need to define quantitative information measures for imprecision, discrimination, distance, etc. over fuzzy sets with their practical applications. In literature the Hellinger’s measure of discrimination was firstly introduced by Hellinger [23]. Here we propose a new parametric generalized Hellinger’s divergence measure in fuzzy environment which provides a flexible approach to further leverage of choice to the user. It may be observed that the potential, strength and efficiency of this new generalized Hellinger’s fuzzy divergence measure exist in its properties.
Methodology section we recall and discuss some well-known concepts and the notions related to fuzzy set theory. In results section we introduce a generalized Hellinger’s fuzzy divergence measure with the proof of validity. Some interesting properties of the proposed measure between different fuzzy sets are studied drawn in discussion section. Final section concludes the paper.
METHODOLOGY
We now review a number of well-known concepts and definitions related with the theory of fuzzy sets. The uncertainty and vagueness in the environment can be easily handled by fuzzy sets.
Definition1. Fuzzy Set(FS) [2]: A fuzzy set (FS) on a universe of discourse on a universe of discourse having the membership function as follows:
The membership value describes the degree of the belongingness of When is valued in {0, 1}, it is the characteristic function of a crisp (i.e., non-fuzzy) set.
The fuzzy divergence measure can be defined as the difference between two fuzzy sets.
Bhandari and Pal [24] established the fuzzy divergence measure analogous to Kullback and Leibler [25] divergence measure, as
with the conditions:
RESULTS
We now propose a generalized measure of Hellinger’s divergence between two fuzzy sets A and B defined in a universe of discourse having membership values corresponding to Taneja [26] generalized Hellinger’s discrimination measure given by
Theorem 1 ht (X,Y) is the valid divergence measure of fuzzy sets.
Proof: It is clear from (2) that
(iii) We now check the convexity of ht (X,Y)
Thus ht (X,Y) is a convex function of fuzzy sets X and Y and hence in view of the definition of fuzzy divergence measure of Bhandari and Pal [2] provided in Section 2, ht (X,Y) is a valid measure of fuzzy divergence.
Particular Case: For 2h(X,Y), 2h(X,Y), reduces to 2h(X,Y), where h(X,Y), is fuzzy Hellinger’s divergence measure.
We now provide some more properties of the proposed generalized fuzzy divergence measure (2) in the following theorems. While proving these theorems we consider the distribution of U in to two parts U 1 and U 2 as
Proof: Proof of above theorems follows from (3) and (4).
CONCLUSION
In the present paper we have obtained generalized information measure of discrimination in fuzzy setting. For this we have proposed and validated the generalized Hellinger’s measure of fuzzy divergence. A particular case and a number of the interesting efficient properties of this generalized divergence measure are proven. Finally, we observe that the presence of the parameters in the proposed measure provides a greater flexibility in applications.
ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose article 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.
Conflict of interest: Nil
Source of Funding: Nil
Englishhttp://ijcrr.com/abstract.php?article_id=151http://ijcrr.com/article_html.php?did=151
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31General SciencesTWO NEW DEMATIACEOUS FUNGI FROM WEST BENGAL, INDIA
English0407D. HaldarEnglishThis communication deals with the description and illustrations of two undescribed species of Cercosporoid fungi viz.Cercospora krishnathii Haldar sp.nov. and Cladosporium dioscorae Haldar sp.nov., growing on the living leaves of Ricinus communis (Euphorbiaceae) and Dioscorea alata (Dioscoreaceae) collected from Murshidabad district, West Bengal, India
EnglishFoliicolous hyphomycetes, Morphotaxonomy, New species INTRODUCTION
The genus Cercospora was erected by Fresenius (1863), which is one of the largest genus of hyphomycetes producing vermicular fragmosporic conidia. This genus is globally distributed and represented by around 3000 species. In fact, it is a heterogeneous assemblage of hyphomycetes representing a “complex” (Cercospora complex), rather than a single generic entity. The taxonomic position of the genus Cercospora is almost accepted as being a member of the form family Mycosphaerallaceae, under the order Hyphomycetes of the form class Deuteromycetes. A large number of the species of Cercospora is pathogenic with diversified host range and most of them are known only from their morphotaxonomical characters in vivo. The reproductive structure of the fungi is the conidia, acropleurogenous, simple obclavate or subulate, colourless or pale, pleuriseptate, smooth. Conidiophores macronematous, mononematous, caespitose, straight or flexuous, sometimes geniculate, unbranched or rarely branched, olivaceous brown or brown, paler towards the apex, smooth.
The genus Cladosporium was established by Link in 1815. It has been named as “Klados” means a branch, hence branched spore chains and he cited Cladosporium herbarum (Pers: Fr.) Link ex S.F. Gray is the type species. The taxonomic position of the genus Cladosporium is almost accepted as being a member of the form family Cladosporiaceae under the order Hyphomycetes of the form class Deuteromycetes.
Conidiophores macronematous or semi macronematous and sometimes also micronematous, macronematous conidiophores straight or flexous, mostly unbranched or with branches, restricted to the apical region forming a stipe and head, olivaceous brown or brown, smooth or verrucose. Ramo-conidia often present. Conidiogenous cells polyblastic, usually integrated, terminal and intercalary but sometimes discrete, sympodial, more of less cylindrical, cicatrized, scars usually prominent. Conidia catenate as a rule but sometimes solitary especially in species with large conidia, often in branched chains, acropleurogenous, simple, cylindrical, doliiform, ellipsoidal, fusiform, ovoid, and spherical or sub spherical, often with a distinctly protuberant scar at each end or just at the base, pale to dark olivaceous brown, smooth, verruculose or echinulate, with 0-3 or occasionally more septa.” (Ellis, 1976).
Researchers’ from all over the world have made valuable contributions on the Cercosporoid fungi and the systematic of the taxons are given in accordance with Amanelah , and Zafari, D. 2015, Avasthi et al.2016, Begum 2009, Bensch, K. et al.2015,Braun, U. 2001,Braun, U., and Crous, P. W. 2007, Bligrami et al.1991, Bhat,J.2010,Cannon PF,Kirk PF.2007,Castaneda RF,Kendrick B. 1990, Chupp, C. 1954, Deighton, F.C.1990, HaldarandRay J.B.2011,Hesami et al. 2011,Groenewald,M.et al.2005,Huang, F.et al. 2015,Jang, Y.et al. 2013, Kamal 2010,Plakthongdee, S.et al. 2013,Ruiz, R. C., and Braun, U. 1989,Sandoval-Denis, M.et al. 2016,Schubert, K., and Braun, U. 2005,Seifert, K. A., and Gams, W. 2001,Seifert et al.2011,Souza, A. G. C.et al. 2011,Thaung, M. M. 1974 andYingLan, G. 2012.
During working on the foliicolous fungi of Murshidabad district of West Bengal the author had collected two members of Hyphomycetes growing on the living leaves of Ricinus communis (Euphorbiaceae) and Dioscorea alata (Dioscoreaceae), which on critical examination found to be two new species of the genus Cercospora and Cladosporium respectively. Hence, these two species Cercospora krishnathii Haldar sp.nov. and Cladosporium dioscoreae Haldar sp.nov. have been created as new taxa.
MATERIALS AND METHODS
The infected leaves of different ages were detached intact from the host plants and they were kept in polythene bags and processed by following standard techniques (Castaneda-Ruiz 2005). The infected leaves having distinct symptoms were collected and dried to make herbarium specimens. Photographs of the infected spots on the host leaves were captured by Sony DSC-HX200,camera and for the examination of fungal structure and spore morphology, the microscope slides were prepared in lacto-phenol cotton blue mixtures. Depending on the size of the leaf and the nature of infection the entire or a little part of the infected tissue was detached carefully with a sharp scalpel. It was then mounted on a glass slide in a drop of lacto phenol and covered with a cover glass and lukewarm on a flame so as to make the host tissue transparent. Morphotaxonomic study of the associated fungi was done through the low and high magnification 100x400 of the compound microscope, (Olympus-CX21i FS1 Research Microscope) by using USB INSTA CMOS camera. The microphotographs were stored in electronic format JPEG. Morphotaxonomic determinations of the new taxa were justified with the help of literature mentioned above. Holotypes being deposited at AMH, Agharkar Research Institute (ARI), Pune (MS), India and isotypes retained in the Departmental herbarium for future reference.
RESULTS AND OUTCOME
Cercospora krishnathii Haldar sp.nov.
Mycobank 819879
Etymology: in commemoration of Raja Krishnath Roy who intend to introduced modern education in Murshidabad district of West Bengal.
Incidence in winter, very virulent, older leaves more affected, spots distinct, spots formed amphigenous, more distinct on dorsal surface, scattered to coalescent, covering the major surface of the leaf area, angular to irregular, bounded by stronger or finer veins, cinnamon yellow to white, 2-12 mm in extent; caespituli amphigenous, better on dorsal surface, somewhat thickly and evenly distributed over the spots; Sexual morph: undetermined. Asexual morph: stroma well developed, globular, formed by some dark brown cells ,average length 387.34µm and breadth 247.42µm in diam; mycelium internal; conidiophores majority compactly fascicled, consisting of 2-18 divergent stalks, few solitary, light brown, hyaline and gradually slightly narrower towards the tip, straight to flexous, unbranched, continuous to septate, 2-8 transverse septa towards the base,1-8 geniculate, spore scar distinct (2-8 in number), apex blunt, average length 1014.94µm and breadth 44.41µm; conidia hyaline, oblcvate to linear, straight to curved, smooth walled, tip sub obtuse to acute, base truncate with a thickened and large hilum (18.11µm), 3 to many septate, average length 594.38µm and breadth 21.74µm.
Cladosporium dioscoreae Haldar sp. nov
Mycobank 819906
Etymology: the specific epithet dioscoreae in reference to the host genus.
Incidence in winter, spots formed on both surfaces of the lamina, distinct, numerous, angular to irregular, sometimes irregular, sometimes shooty appearance, spots greyish on dorsal surface and blackish on ventral surface, surrounded by raised yellow margin forming shot-hole, often coalescent,1.5-56.50mm in extent; Sexual morph: undetermined. Asexual morph: caespituli, epiphyllous, effuse, punctiform, brown to black, evenly distributed over the spots mycelium both immerse and superficial stroma thick-walled, composed of isodiametric type of cells, deep brown; conidiophores single to fasciculate, fascicles consisting of 1-6 divergent stalks, arising from epidermal hairs or rarely through stomata, straight to flexous sinuous, brown to pale brownish, paler towards the tip, simple to branched. smooth, sometimes nodose, thick-walled and smooth, pluriseptate up to12, occasionally geniculate, mature conidial scar present and conspicuous, situated at the tip or lying at the point of geniculation of the conidiophores often a single chain of conidia is attached at the tip of the conidiophores, tip sub acute to obtuse or sometimes swollen, average length 681.06µm and breadth 43.28 µm; conidia solitary or in catenate up to 8 in chain, straight, cylindric, thin-walled, smooth to verruculose, pleuriseptate up to 5 septa distinct, often with a distinct protuberant scars at each or both the end of the conidium, average length 212.31µm and breadth 51.59µm.
Material examined: On Dioscorea alata (Fam. Dioscoreaceae), Lalbagh, Murshidabad, West Bengal, India, Dinesh Haldar,25th December, 2015, AMH9772(Holotype),KNC0280(Isotype).
Material examined: On the living leaves of Ricinus communis L.(Fam. Euphorbiaceae).Goaljan ,Murshidabad,West Bengal, India. 24th December, 2015, Dinesh Haldar, AMH 9765(Holotype), KNC0258 (Isotype).
DISCUSSION
The fungi Cercospora krishnathii and Cladosporium dioscorae has been found to occur profusely during winter months to spring and early summer. The host plants Ricinus communis and Dioscorea alata both are economically important. The seed oil of Ricinus communis is used as purgative, lubricant and biodiesel. On the other hand the tuber of Dioscorea alata is edible and is the source of diosgenin- a contraceptive agent. The fungi attacks chiefly on the leaf lamina, the primary area of photosynthesis resulting of which the yield is severely damaged, causing great economic losses.
CONCLUSSION
The newly described taxa Cercospora krishnathii and Cladosporium dioscorae are the primary causes of leaf spot diseases of Ricinus communis and Dioscorea alata respectively. The present work will be helpful to a fungal taxonomist to arrange the fungi in different groups and easier to identify the diseases on the basis of which a plant pathologist can design the control measures of the diseases.
ACKNOWLEDGEMENTS
The author is thankful to the Principal, Krishnath College, Murshidabad, West Bengal for rendering help during the present work. The author is also grateful to the reviewers’ valuable remarks on the manuscript. Thanks are also due to the different authors, editors and publishers from where the literature of the present work have been cited and incorporated. The author expresses his sincere gratitude to the Curator of AMH-ARI, Pune for depositing holotype of the specimens and providing the accession numbers. I wish to acknowledge the extended help of Dr. S. Bandyopadhyay, Assistant Professor, Krishnath College, Murshidabad for the identification of host plants. The author is also grateful to the Director, UGC, for financial support.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31General SciencesBIODEGRADATION OF TANNERY EFFLUENT, ITS REUSE IN AGRICULTURE AND BIOCHEMICAL CHARACTERIZATION BY ELECTROPHORESIS
English0814C. M. NoorjahanEnglish Sheeba Ali SiddiquiEnglishAim: Tannery industry is one of the important industry that pose environmental pollution through the disposal of its effluent. Hence this study was carried out to analyze physico chemical parameters of the effluent already treated by the industry (industry treated effluent) to degrade the pollutants of the effluent using fungi and finally to reuse the biotreated sample for the agriculture purpose. (ie) growth of vegetable plant Lycopersicum esculentum and growth parameters were studied. Biochemical characterization (ie) proteins and DNA present in the roots of Lycopersicum esculentum were also studied using electrophoresis.
Methodology: 5 litres of industry treated tannery effluent was collected in polythene containers from the tannery treatment plant situated in Chennai, Tamil Nadu India. The samples were collected for a period of 3 months from July 2015 to September 2015. The physico-chemical parameters were determined. Biotreatment of industry treated tannery effluent was carried out using native fungi Aspergillus niger and Rhizopus sp. Biotreated tannery effluent was used for growth of vegetable-tomato plant Lycopersicum esculentum for a period of 60 days and biochemical characterization such as protein and DNA of plant were studied by using electrophoresis.
Result: The results of physico-chemical characteristics of the industry treated tannery effluent has revealed that the effluent was brownish in colour with offensive odour, pH was alkaline in nature and has higher concentration of EC, BOD, COD, TSS and TDS though the effluent was treated by the industry which surpassed the permissible limits prescribed by CPCB (1995). The results of microbial analysis of the effluent revealed the occurence of 4 species of fungi in the industry treated tannery effluent namely, Aspergillus niger, Mucor sp, Pencilluim sp and Rhizopus sp. The results of analysis of degradation of the effluent showed that colour and odour of 100% treated sample has changed to colourless nature and odorless condition and also other pollutants were reduced using native fungi, Aspergillus niger and Rhizopus sp. The results of the plant growth showed that Lycopersicum esculentum was increased in bio-treated and control compared to industry treated sample.
Conclusion: The study revealed that native fungi, Aspergillus niger and Rhizopus sp plays a key role in the degradation of industry treated tannery effluent and the treated water can be utilized for agricultural purposes.
EnglishTannery effluent, Degradation, Aspergillus niger, Rhizopus sp, Lycopersicum esculentum, Molecular characterizationINTRODUCTION
Environmental pollution is the biggest menace to the human race on this planet today. The water of river and seas are being constantly polluted all over the world by various dangerous chemical and biological wastes. Mills and factories discharge very harmful waste water into rivers and seas. (Goyal, 2003).Tannery is one of the important industries causing water pollution. There are about 2,165 tannery industries in India. In Tamil Nadu alone, there are about 1,120 tanneries located in Vellore, Ranipet, Trichy, Dindigul, Erode and Pallavaram in Chennai. (Raniperumal and Singaram, 1996).Tannery effluent is the collection of water which was formed during various stages of processing of leather is collectively called as composite effluent. The tannery effluent is ranked as high pollutant among all other industrial wastes. (Eye and Lawrence, 1971).Tannery effluent induces health hazards to human and other aquatic organisms. It also makes the soil infertile, the ground and surface water turns to be unfit for irrigation and drinking. (Aruna U. Kakade, 2012). Disposal of such tannery waste with high pollution load into water courses or onto land, with or without prior treatment creates a great problem in the environment in the vicinity. So, it has become essential to treat the waste prior to its disposal. Thus the preliminary study was undertaken to analyse physico-chemical parameters of industry treated tannery effluent and to isolate and identify microbes of the effluent, native fungi Aspergillus niger and Rhizopus sp were used for the biotreatment of tannery effluent. Biotreated effluent was reused for agriculture (i.e) growth of vegetable plant Lycopersicum esculentum, growth parameters and biochemical characterization (i.e) proteins and DNA present in the roots of Lycopersicum esculentum were also studied using electrophoresis.
MATERIALS AND METHODS
Industry treated tannery effluent was used as the material in this study. The sample was collected in polythene containers (5 litres capacity) from the tannery treatment plant situated in Chennai, Tamil Nadu, India. Samples were brought to the laboratory and maintained at 25°C for further analysis. The samples were collected for a period of 3 months from July 2015 to September 2015. The physico-chemical parameters such as Colour, Odour, pH, Electrical Conductivity (EC), Total Suspended Solids (TSS), Total Dissolved Solids (TDS), Biochemical Oxygen Demand (BOD) and Chemical Oxygen Demand (COD), of industry treated tannery effluent were determined by following the Standard Methods outlined by APHA (1995).
Tannery effluent of about 1 litre was collected in sterile bottles and brought to the laboratory for the analysis of microbes (fungi) on the same day. Industry treated tannery effluent was diluted to 10-1 using sterile distilled water. 1 ml of diluted sample was cultured on Malt Extract Agar Medium (MEA) following pour plate method for fungal identification. Fungal species developed on the medium was observed. The fungal colonies grown on Malt Extract Agar Medium were sub-cultured on Potato Dextrose Agar (PDA) slants. Lactophenol cotton blue stain was used to identify the fungi by following the procedure of Onions et.al. (1981).
The seeds of vegetable - Tomato plant Lycopersicum esculentum were procured from a local nursery located in Chennai for the germination and growth in industry treated and biotreated tannery effluent.
Mycelial mats of native fungi, Aspergillus niger and Rhizopus sp. grown separately in liquid culture were recovered, washed with sterile distilled water and approximately 10 gms (fresh weight) mycelia of fungi were transferred to 100% industry treated tannery effluent in a conical flask separately. Conical flask with effluent and fungi both native Aspergillus niger and Rhizopus sp were incubated separately at 30 0.5oC for 96 hours on rotary shaker at 2000 rpm. After incubation the samples were centrifuged at 5000 rpm for 20 minutes. Control (conical flask with industry treated tannery effluent without fungus) was also run simultaneously. The procedure for degradation process was carried out by following the procedure of Krishna priya (2010). The supernatant were analysed for physico chemical parameters like pH, EC, Total Suspended Solids, Total Dissolved Solids, Biological Oxygen Demand, Chemical Oxygen Demand and heavy metals - chromium. Physico chemical parameters of the effluent were analysed before biotreatment (control) and after biotreatment by following the Standard procedure of APHA (1995).
After degrading the industry treated tannery effluent using native fungi Aspergillus niger and Rhizopus sp for 96 hrs, the degraded water were reutilized for growth of vegetable-tomato plant Lycopersicum esculentum for a period of 60 days by following the procedure of Jerin (2011).
The seeds of Lycopersicum esculentum were washed with mercuric chloride solution for 2 minutes and then thoroughly washed in distilled water. Each earthen pot filled with farm yard manure was sown with 10 seeds allowed to germinate by irrigating with equal volume of industry treated tannery effluent and biotreated water. One set was irrigated with water as control. Five replicates were maintained for each sample (100%). Three trials (20th, 40th& 60thday) were made with an interval of 20thdays for each. For each trial, the vegetative features (i.e) root length, shoot length, no. of subroots, and number of leaves of the above plant were recorded.
After the growth of Lycopersicum esculentum (tomato) for 60 days in industry treated and biotreated samples, biochemical characterization such as protein and DNA were studied by using electrophoresis by following the procedure of Choi et.al.(2004).
RESULTS
Result of the analysis of physico-chemical parameters of industry treated tannery effluent collected for a period of 3 months (July 2015 to September 2015) are depicted in Table 1.
Colour of the industry treated tannery effluent is brownish in colour. Odour of industry treated tannery effluent is offensive. The pH of industry treated tannery effluent has a minimum range of 6.71 (August 2015) and a maximum range of 8.96 (July 2015). The conductivity of the industry treated tannery effluent range between 6,342 µmhos/cm (August 2015) and 10,372 µmhos/cm (July 2015). The values of EC are higher than the permissible limits (400 µmhos/cm) of CPCB (1995). TSS level of Industry treated tannery effluent range from 156 mg/l (July 2015) to 172 mg/l August (2015) indicating that the TSS levels was higher than the permissible limits (100 mg/l) perscribed by CPCB (1995). TDS of Industry treated tannery effluent range between 4,440 mg/l (August 2015) and 7,273 mg/l (July 2015) the values of TDS found to be higher than the permissible limits (2,100 mg/l) of CPCB (1995). BOD levels of Industry treated tannery effluent has a maximum value of 750 mg/l (July 2015) and the minimum range of 320 mg/l (September 2015) which are higher than the permissible limits (30 mg/l) of CPCB (1995).COD levels of Industry treated tannery effluent ranges between 1005 mg/l (September 2015) and 2,261 mg/l (August 2015), the values are higher than the permissible limits (250 mg/l) of CPCB (1995). Chromium levels of effluent was within the permissible limits of CPCB (1995).
The result of isolation and identification of fungi present in the Industry treated tannery effluent are presented in Table 2. The results of the study revealed that 4 fungal species were isolated and identified from industry treated tannery effluent which include Aspergillus niger, Mucor sp, Pencillium sp and Rhizopus sp.
Result of analysis of degradation of Industry treated tannery effluent using native fungi (Aspergillus niger and Rhizopus sp.) are presented in Table 3.The results of the biodegradation study showed that Industry treated sample is brownish in colour before degradation but after degradation for 96 hrs using native fungi, Aspergillus niger and Rhizopus sp there is a change in colour from brownish to almost colourless nature of the sample. pH of industry treated tannery effluent was changed to almost neutral pH after biodegradation using fungi. TSS of Industry treated tannery effluent was reduced to a maximum percentage (67.85%) using Rhizopus sp and (64.28%) using Aspergillus niger. Maximum reduction of TDS (72.83%) was recorded using Rhizopus sp and Aspergillus niger (72.17%) after biodegradation. BOD level was reduced using Rhizopus sp (85.33%) and Aspergillus niger (82.66%) and COD level was reduced using native fungus, Rhizopus sp (83.62%) compared to other native fungus Aspergillus niger (80.92%). The level of heavy metal chromium was reduced after biodegradation for 96 hrs using native fungus, Aspergillus niger (63.15%) compared to that of native fungus, Rhizopus sp (59.89%).
From the present study, Aspergillus niger and Rhizopus sp, showed efficient degrading capabilities by degrading the contaminants of the effluent as they use it for their growth and reproduction. Hence after degradation of 100% industry treated tannery effluent, the treated water were reused for germination and growth of Tomato Plant Lycopersicum esculentum for a period of 60 days using 100% Industry treated and biotreated (native fungi, Aspergillus niger and Rhizopus sp) tannery samples.
The results of the study (Table 4) showed that maximum germination and growth of plants were recorded when exposed to 100% biotreaed sample and control. The germination and growth of vegetable, Tomato plant Lycopersicum esculentum on 20th, 40th and 60th day were recorded their vegetative features such as shoot length, root length, number of sub-roots and number of leaves were measured and recorded.
Bio Chemical Characterization
The study was further extended to carry out the biochemical characterization of vegetable tomato plant Lycopersicum esculentum. The results of characterization of the biochemical components (i.e) Proteins and DNA present in the roots of Tomato plant. Lycopersicum esculentum are presented in plate 1a & 1b.
Protein Characterization
The result of the study (Plate 1a) showed the formation of low, medium and high mobility bands indicating the presence of proteins of different molecular weight in the roots of Lycopersicum esculentum on 20th and 60th day when exposed to control (tap water), industry treated and biotreated tannery samples.
DNA Characterization
The results of the study (Plate - 1b) showed relative band intensities indicating the presence of damaged DNA in the roots of Lycopersicum esculentum exposed to industry treated sample, while band intensity in the roots of Lycopersicum esculentum exposed to biotreated sample resembles the bands of roots of control (tap water).
Seeds of Lycopersicum esculentum when treated with 100% industry treated and biotreated water showed interesting results. Germination and growth of seeds - no of leaves, root length, shoot length and no of subroots of Lycopersium esculentum in 100% industry treated sample on 20th, 40th and 60th days were decreased. Whereas maximum germination and growth of plants were recorded that exposed to 100% biotreated sample like control.
The biochemical characterization of protein and DNA were studied in the roots of Lycopersicum esculentum after 20th and 60th days of exposure to tannery samples. The results showed that the low, medium and high mobility bands were observed in all the samples indicating the presence of proteins of different molecular weight which is due to the effect of heavy metals and hazardous materials present in the industry treated effluent. The presence and absence of protein separation varied in different samples. (Choi et.al., 2004).
DNA isolated from roots of Lycopersicum esculentum on 20th and 60th day of growth showed relative band intensities results in the presence of damaged DNA on exposure to heavy metals and other toxic substances in the case of industry treated tannery effluent, while in the biotreated sample, band intensity resembles the control (tap water) which may be due to absence or less amount of toxic substances present in the treated samples. (Choi et.al., 2004).
DISCUSSION
This colour and odour could be due to decomposition of organic or inorganic matter (Singh et.al.,1998). Coloured effluent when discarded to land surface negatively affects the soil fertile capacity (Chhonkar et.al., 2000). pH of the effluent was alkaline in nature which affects the physico chemical properties of receiving water which in turn adversely affects the aquatic life and human beings. This also changes soil permeability which results in polluting underground resources of water. (Krishna Priya 2010). Industry treated effluent has high level of Electrical conductivity which gives the measure of water conductivity as well as the indication of the level of inorganic constituents in water. (Ramamurthy et.al., 2011). High amount of TSS found in the effluent may have adverse effects on aquatic flora and fauna and reduce the diversity of life in aquatic system and promote depletion of oxygen and sliting in ponds during rainy season (Goel, 1997). High levels of Total Dissolved Solids (TDS) of the industry treated effluent are one of the major sources of sediments which reduce the light penetration into water and ultimately decrease the photosynthesis process of aquatic flora. (Ramamurthy et.al., 2011). The present study has revealed high levels of BOD in the industry treated tannery effluent indicating high organic load. Further high COD may be due to high amount of inorganic compounds which are affected by the bacterial decomposition (Kulkarni 1992).
Tannery effluent is rich in organic and inorganic nutrients which would have supported the growth of fungal population, Sekar (2011) also reported the presence of various fungi in tannery effluent, which contains high organic load. Sukumaran et.al., (2008) identified 10 species of fungi in tannery effluent. Kaushik (2011) reported the presence of 2 fungal species in Direct Dye effluent. Ramamurthy et.al. (2011) reported the presence of 6 species of fungi in textile effluent. After biodegradation of sample using fungi following changes occurred color changed from brownish to almost colourless nature this may be due to the action of microbes - Aspergillus niger and Rhizopus sp, which decomposed the toxic pollutants present in the effluent and made the change in colour and odour of the effluent (Krishna priya, 2010). Shafiquzzaman Siddiquee et.al. (2015) removed heavy metal contaminants from wastewater using the potential filamentous fungi biomass. Ihsan flayyih Hassan et.al. (2015) studied efficiency of some filamentous fungi for treatment of refinery wastewaters and suggested that fungi helps in reduction of refinery contaminants from the effluent. pH levels decreased in biotreated samples which may be due to accumulation of organic acids and also indicating the efficiency of the microbes to biodegrade the effluent (Ramamurthy et.al.,2011). The reduction in TSS and TDS value may be due to the action of microbes – Rhizopus sp and Aspergillus niger, which decomposed the toxic pollutants present in the effluent and made the change in colour, odour, TSS and TDS of the effluent (Krishna priya 2010). BOD and COD levels were reduced after biotreatment thereby indicating the degrading efficiency of native fungi, Aspergillus niger and Rhizopus sp (Kulkarni 1992). Chromium levels were reduced in effluent Removal of chromium by Penicillium chrysogenum in tannery effluent was recorded to be high when compared to Aspergillus niger (Jayanthi et.al., 2014).
The presence of toxic substances present in waste water has decreased the growth of Lycopericum esculentum exposed to 100% industry treated samples. Whereas increased rate of germination and growth of Lycopersicum esculentum in 100% biotreated sample is due to the maximum removal of toxic substances by native Fungi, Aspergillus niger and Rhizopus sp. The untreated tannery effluent showed decrease in the seed germination percentage of Lycopericum esculentum with increasing the concentration in all treated samples as well as higher levels of effluent accumulation cause inhibition of seed germination and seedling growth at lower concentration. (Mandakini et.al., 2016).
CONCLUSION
Thus it may be concluded from the above study that industry tannery effluent with high pollutants can be reduced by using native fungi, Aspergillus niger and Rhizopus sp both the native fungi has the same degrading efficiency of the effluent and as evidenced in the present work this biotreated tannery effluent can be utilized for agricultural purpose.
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=153http://ijcrr.com/article_html.php?did=153
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Aruna U Kakade. Biodegradation of tannery effluent by using tannery effluent isolate. International Multiple disciplinary Reasearch Journal 2012; 2(3): 2231 – 6302.
Chhonkar PK, Datta SP, Joshi HC, Pathak H. Impact of industrial effluents on soil health and agriculture - Indian experience: Part II - Tannery and textile industrial effluents. J. Sci. Ind. Res 2000;59: 446 - 454.
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Jayanthi M, Kanchana D, Saranraj P, Sujitha D. Bioadsorption of Chromium by Penicillium chrysogenum and Aspergillus niger isolated from tannery effluent. Intl. J. Microbiol. Res 2014; 5 (1): 40-47.
Jerin S. Isolation of microbes treatment of flavour effluent using native fungus, Aspergillus sp and reuse of biotreated water for germination and growth of ornamental plant, chrysanthemum sp. B.Sc. Dissertation, University of Madras, Chennai 2011.
Kaushik CP, Sharma JK. Decolourisation studies in direct dyes effluent using fungi, Phanerochacte chrysosporium and Aspergillus niger, Indian Journal of environmental protection 2011;31: 129 - 132.
Krishna Priya E. Biodegradation of Tannery Effluent using native fungus, Penicillium sp. B.Sc. Dissertation, University of Madras, Chennai 2010.
Kulkarni TT. Source and characteristics of dairy wastes from a medium size effluent on microorganisms, plant growth and their microbial change. Life science of Advance 1992;3 : 26 - 28.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN-0001November30General SciencesA Heuristic Approach to Minimize Utilization Time in N * 2 Specially Structured Flow Shop Scheduling Problem Including Setup Time, Transportation Time and Jobs in a String of Disjoint Job Blocks
English1521Deepak GuptaEnglish Shashi BalaEnglish Pradeep BishnoiEnglishThe present paper is an attempt to obtain a sequence of jobs through heuristic method to optimize the utilization time of machines for specially structured n-job and 2-machine flow shop scheduling problem. Also, the jobs are to be processed in a string of disjoint job blocks having sequence independent setup times separated from processing times each associated with their respective probabilities including transportation time. In flow shop scheduling minimization of total elapsed time may not always result in minimization of utilization time of machines. To minimize the utilization time an algorithm is proposed and a numerical problem is solved to authenticate the algorithm.
EnglishElapsed time, Expected processing time, Expected setup time, Jobs in a StringINTRODUCTION
Scheduling models deals with determination of an optimal sequence to provide service to customers or to perform a set of jobs in order to minimize the total elapsed time or some other suitable performance measure. In today’s manufacturing and distribution systems, scheduling have significant role to meet customer requirements as quickly as possible while maximizing the profits. In flow shop scheduling problem n-jobs are processed on m-machines and the processing order i.e. the order in which various machines are required for completing the job is given. The common objectives in flow shop scheduling problems are to minimize some performance measures such as make span, mean flow time, mean tardiness, mean setup time, number of tardy jobs and mean number of setups. Johnson(1) developed an algorithm for two stage production schedule for minimizing the make span. Palmer DS(2) developed a heuristic algorithm for sequencing jobs to minimize the total elapsed time. Gupta JND(3) studied specially structured flow shop scheduling problem to obtain an optimal sequence of jobs. Gupta D, Sharma S and Bala S(4) investigated specially structured two stage flow shop scheduling problem under rental situation.
Corwin BD et al(5) studied two machine flow shop scheduling problems with sequence dependent setup time. Setup time includes the time to prepare the machines, obtaining, adjusting and returning tools for an operation, cleaning up the machines, setting the necessary jigs and fixtures and inspecting and positioning the process material. Setup time has an important part as reduction in setup time leads to increase in output, profitability and customer satisfaction in an organization. The setup times in scheduling problems can be classified into two categories viz. sequence-independent setup times and sequence-dependent setup times. Sequence-independent setup time depends solely on the current job to be processed regardless of previously processed job. Sequence dependent setup time depend both on the current job and previously processed job.
In most manufacturing and distribution systems, semi finished jobs are moved from one processing facility to another for further processing and finished jobs are delivered to customers or store houses by suitable modes. In job sequencing the time required in moving a job from one machine to another machine during the processing of jobs is known as transportation time. Maggu and Dass(6) considered a two machine flow shop problem including transportation time of jobs from first machine to the second machine. Langston(7) gave heuristic solution to minimize make span for a k-station flow shop problem where each station has a number of machines that can be used to process jobs and there is only one transporter with a capacity to transport one job with transportation times dependent on the physical locations of the starting and destination machines. Chung et al(8) studied machine scheduling problems with explicit transportation considerations. They considered scheduling models for transporting a semi-finished job from one machine to another for further processing and for delivering finished jobs to the customers or warehouses. Gupta D, Sharma S and Bala S(9) applied heuristic algorithm to minimize the utilization time and rental cost of machines for two stage specially structured flow shop scheduling problem involving transportation time.
Maggu and Das(10) established the basic concept of equivalent job for job block in scheduling theory. The string of disjoint job blocks consist of two disjoint job blocks such that in one job block the order of jobs is fixed and in second job block the order of jobs is arbitrary. Anup and Maggu(11) gave an optimal schedule for n × 2 flow shop problem with job blocks of jobs in which first job in each job block being the same. Heydari(12) studied flow shop scheduling problem with processing of jobs in a string of disjoint job blocks. Singh TP, Kumar V and Gupta D(13) studied n × 2 flow-shop scheduling problem in which processing time, set up time each associated with probabilities along with jobs in a string of disjoint job blocks. Gupta D, Sharma S and Gulati N(14) studied n×3 flow-shop scheduling problem in which processing time, set up time each associated with probabilities along with jobs in a string of disjoint job blocks. Gupta et al(15) considered specially structured two stage flow shop scheduling problem having jobs in a string of disjoint job blocks.
In this paper we investigate n-job and two machines specially structured flow shop scheduling problem with sequence independent setup times separated from processing times each associated with probabilities including transportation time and jobs to be processed as string of disjoint job blocks. The aim of the study is to obtain a sequence of jobs that optimizes the utilization time of machines. An algorithm is proposed to solve the problem and is validated with the help of a numerical example.
PRACTICAL SITUATION
The service centres and industrial units must utilize their resources in an optimal manner to increase their profits and productivity. For optimal utilization of available resources there must be a proper scheduling system and this makes scheduling a highly important aspect of industrial establishments and service sectors. Specially structured two machine flow shop scheduling problem has been considered as there are many realistic situations where the processing times of jobs on the two machines are related in specific manner. In many practical situations such as chemical, food processing, pharmaceutical, metal processing, printing etc. setup time is required while shifting from one operation to another.
The idea of job block has practical importance to deal with ordering of jobs so as to ensure priority in service to the preferred customers and/or jobs and hence maximize profits. Scheduling models with jobs in a string of disjoint job blocks are necessary in cases where certain orderings of jobs are prescribed either by technological constraints or by externally imposed policy(10).
During the processing of jobs in many production and distribution units, semi-finished tasks are transferred from one machine to another through various modes such as automated guided vehicles and conveyors, and finished jobs are delivered to consumers or storehouses by vehicles such as trains or trucks. Machine scheduling models that take into account the job transportation time are indeed more realistic than those scheduling models that do not take into consideration these parameters.
NOTATIONS
The following notations have been used throughout the paper:
σ : Sequence of n- jobs obtained by applying Johnson’s algorithm.
σ k: Sequence of jobs obtained by applying the proposed algorithm, k = 1, 2, 3, ------.
Mj: Machine j, j= 1, 2.
aij: Processing time of ith job on machine Mj.
sij: Set up time of ith job on machine Mj.
pij: Probability associated to the processing time aij.
qij: Probability associated to the set up time sij.
Aij: Expected processing time of ith job on machine Mj.
Sij: Expected set up time of ith job on machine Mj.
Ti,1→2 : Transportation time of ith job from first machine to second machine.
tij (σ k): Completion time of ith job of sequence σ k on machine Mj.
T (σ k): Total elapsed time for jobs 1, 2, --------, n for sequence σ k.
Uj (σ k): Utilization time for which machine Mj is required for sequence σ k.
Aij (σ k): Expected processing time of ith job on machine Mj for sequence σ k.
α : Fix order job block.
β : Job block with arbitrary order.
βk : Job block with jobs in an optimal order obtained by applying the proposed algorithm,
k = 1, 2, 3, ------.
S: String of job blocks α and β i.e. S = (α, β)
S?: Optimal string of job blocks α and βk.
ASSUMPTIONS
The assumptions for the proposed algorithm are stated below:
Jobs are independent to each other and are processed thorough two machines M1 and M2 in order M1 M2.
Pre-emption is not allowed. Once a job is started on a machine the process on that machine cannot be stopped unless the job is completed.
Processing times must satisfy the structural conditions mini{Gi} ≥ maxi{Hi} or maxi{Gi} ≤ mini{Hi} .
Each job has two operations and each job is processed through each of the machine once and only once.
The independency of processing times of jobs on the schedule is maintained.
Only one machine of each type is available.
Jobs i1, i2, ---------------, ih are to be processed as a job block (i1, i2, ----------------, ih) showing priority of job i1 over i2 etc. in that order in case of a fixed order job block.
DEFINITION
Completion time of ith job on machine Mj is given by,
tij = max (ti−1, j + S i−1, j, ti, j−1 + ti, 1→2 ) + Aij ; j ≥ 2,
where Aij = Expected processing time of ith job on machine Mj and Sij = Expected set up time of ith job on machine Mj.
THEOREM
If Ai1 ≥ Aj2 for each i and j, then K1, K2, ----------, Kn is a monotonically increasing sequence, where Kn = i=1nAi1 - i=1n-1Ai2 .
Proof: Let Kn = i=1nAi1 - i=1n-1Ai2
Englishhttp://ijcrr.com/abstract.php?article_id=154http://ijcrr.com/article_html.php?did=154Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31HealthcareA Rare Occurrence of Traumatic Fibroma with Secondary Ulceration in a Two Year Old Child: A Case Report
English2224Tanvi Sethi SahaniEnglish Umesh Chandra ChaudharyEnglish Nitin SinghEnglish Archana MalviyaEnglish Mobeen KhanEnglish Nazish AkhterEnglishReactive overgrowths are relatively common lesions that occur in response to irritation in the oral cavity but have been reported to be extremely rare in the first decade of life. Here we report an uncommon interesting case of Irritation fibroma occurring in a 2-year-old male child following a traumatic injury to maxillary anterior region.
EnglishIrritational fibroma, Traumatic irritants, Sessile growth, Surgical excisionINTRODUCTION
Inflammatory hyperplastic lesion may be defined as “an increase in the size of an organ or tissue due to an increase in the number of constituent cells, as a local response of tissue to injury”. The traumatic irritants include calculi, overhanging margins, restorations, foreign bodies, chronic biting, margins of caries, and sharp spicules of bones and overextended borders of appliances. Fibrous hyperplasia (Traumatic or Irritation fibroma) is the healed end product of the inflammatory hyperplastic lesion1. Clinically they appear either as pedunculated or sessile growth on any surface of the mucous membrane and smaller than 1.5 cm at its largest diameter, though there have been reports of a 4-6 cm injury. Its occurrence is reported to the anterior maxillary, more precisely in the interdental papilla. Other common sites are the buccal mucosa along the bite line, labial mucosa, tongue and gingiva. They do not have malignant potential and recurrences are mostly as a result of failure to eliminate the chronic irritation involved.2
There are relatively few reports in the literature regarding oral mucosal conditions in children.3 Short-term institutional studies by Mathew et al have shown no incidence of irritation fibroma in the age group of 2-20 years.4 It is extremely rare during the first decade of life.5
CASE REPORT
Herein, we report an uncommon interesting case of Fibroma occurrence in the Maxillary Anterior region associated with trauma to the same region in a 2 year old child. The patient had fallen down while playing about three weeks back and fractured his Deciduous maxillary anterior teeth. Subsequently a growth engulfing the left maxillary incisor developed which was painful and was interfering in the feeding of the child. On Intra oral examination a rounded, sessile, well-demarcated mass of diameter 1.5×1.5 cm completely enclosing fractured Maxillary Left Deciduous Incisor was found. Its surface was smooth and it had normal mucosa colour with secondary ulceration from recurring trauma (from the mandibular deciduous teeth) visible. It was tender on palpation. (Fig 1) The case was planned under general anaesthesia as the child was in pre-cooperative stage. The lesion was completely excised using scalpel. (Fig 2) Maxillary left Deciduous Incisor was extracted as fracture line extended subgingivally and the remaining tooth structure was not sufficient to support a coronal restoration. Also in the present case, the ragged margins of the fractured tooth was the probable causative irritant which enabled the lesion to grow.Suturing of the region was done with 3-0 black silk suture and Partial Pulpectomy was done for the Maxillary Right Central Incisor followed by composite build up. (Fig 3) The tissue was sent for histological examination, and was diagnosed as irritation fibroma. Histologically, Fibroblasts were scattered in a dense, collagenous matrix. A mild chronic, inflammatory infiltrate was present but this was not a consistent finding.(Fig 4) Follow up of the patient was done at regular intervals and at the end of one year the area present with fibroma had healed without any recurrences.
DISCUSSION
The clinical features of Irritation Fibroma are not unique and the differentiation of these lesions should be made from Peripheral ossifying fibroma, Pyogenic granuloma or Peripheral giant cell granuloma. When treatment is required, the only option is surgical excision of the fibroma with narrow margins. Overall prognosis of Irritation Fibroma is usually good; they commonly do not recur when the source of irritation is removed. It is therefore important to manage the source of the irritation. These lesions although benign are usually excised to rule out the fear of malignancies in the patients.
CONCLUSION
Inflammatory hyperplastic lesion is an increase in the size of an organ or tissue. This is mainly due to an increase in the number of constituent cells. They mainly occur in the local response of tissue to injury. The common traumatic irritants are calculi, overhanging restorations, foreign bodies and chronic biting. They appear either as pedunculated or sessile growth. The main line of treatment is removal of irritants along with the surgical excision of the fibroma. Overall prognosis is good.
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=155http://ijcrr.com/article_html.php?did=155
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Delaney JE, Keels MA. Pediatric Oral Pathology: Soft Tissue and Periodontal Conditions. Paediatr Clin North Am 2000;47(5):1125-47.
Majorana A, Bardellini E, Flocchini P, Amadori F, Conti G, Campus G. Oral mucosal lesions in children from 0 to 12 years old: ten years’ experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2010;110:13-18.
Mathew AL, Pai KM, Sholapurkar AA, Vengal M. The prevalence of oral mucosal lesions in patients visiting a dental school in southern India. Indian J Dent Res 2008;19:99-103.
Barker DS, Lucas RB. Localized fibrous overgrowth of the oral mucosa. Br J Oral Surg 1967;5:86-92.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31HealthcareConsumption of GSH with the Increase in Oxidative Stress in Chronic Obstructive Pulmonary Disease (COPD) Patients
English2529Rupali S. PawarEnglishSubodhini A. AbhangEnglishIntroduction: Oxidant-antioxidant imbalance plays a major role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Recently, most of the studies are concentrated on the evaluation of oxidant-antioxidant balance in exhaled breath condensate and in other body fluids in COPD patients.
Aims and Objectives: In this study, we investigated oxidant-antioxidant balance in systemic circulation of patients with COPD. Serum malondiladehyde (MDA), protein carbonyl (PC) and whole blood reduced glutathione (GSH) levels were determined in 60 patients with stable COPD and it compared with 60 age and sex matched healthy controls.
Materials and Methods: The levels of serum MDA, protein carbonyl and whole blood reduced glutathione were determined according to Buge and Aust method, Levin et al and Beutler et al method.
Results: Serum MDA and PC levels were significantly increase in COPD patients as compared to healthy controls. We found significantly decreased levels of erythrocyte GSH in stable COPD patients as compared to healthy controls.
Conclusion: Tobacco smoking cause increase in oxidative stress and reduction in antioxidant level in COPD patients. From these findings we conclude that there is disturb oxidant – antioxidant balance in COPD patients and this imbalance is related to long term history of tobacco smoking.
EnglishCOPD, Reduced glutathione, Malondialdehyde, Protein carbonylIntroduction
COPD is a major public health problem and is projected to rank third leading cause of deaths globally by the year 2030 [1]. Chronic obstructive pulmonary disease is a disease state characterized by progressive and irreversible airflow limitation. This airflow limitation is associated with abnormal inflammatory response of the lungs to the noxious particles and gases [2]. Tobacco smoking is the major risk factor for the development of COPD in India. Tobacco smoke contains 1015 free radicals/ oxidants per puff and 4700 toxic chemicals. Tobacco smoke contains gas phase and tar phase. Gas phase of tobacco smoke contains free radicals superoxide and nitric oxide. Long-lived free radical semiquinone present in tar phase of tobacco smoke [3]. Activated neutrophils, macrophages due to smoking produces tremendous amounts of free radicals in alveoli and respiratory tract of COPD patients [4]. Lipid and proteins present on the membrane of airspace epithelium cells are highly susceptible to the free radical mediated damage which cause impair functioning of the cell [5]. Malondialdehyde is end product of lipid peroxidation. With the help of MDA we can indirectly measure free radical activity in body [6]. Protein carbonyl is the product of irreversible non-enzymatic oxidation of proteins. Protein carbonyl formation is a sign of protein dysfunction caused by disease [7,8]
To combat the deleterious effects of oxidants antioxidant system present in the body one of them is GSH. The reduced form of glutathione present in red blood cells. GSH is scavenger of H2O2. GSH inhibits lipid peroxidation reactions in lung tissue [9]. The presence of sulfhydryl group in GSH makes it function as an antioxidant, it protect the cells against free radicals and oxidants[10]. Intracellular GSH might decreases released of cytokines and chemokines from lung cells by decreasing NF-kB activation [11,12].
Therefore, the present study is undertaken to evaluate serum level of MDA, protein carbonyl and blood GSH in COPD patients and in healthy controls. In addition to this, we determined cut –off level of GSH, MDA and protein carbonyl in COPD patients by using ROC curve analysis.
Material and Methods:
This Case-Control study was carried out in Department of Biochemistry, B.J. Govt. Medical College and Sassoon General Hospital, Pune [Maharashtra]. The study period was in between 2012-2014. The study was approved by Institutional ethical committee [Ref. no. BJMC/IEC/Pharmac/D1210133-35]. Informed consent was obtained from each subject prior to the study. Healthy Controls and COPD cases were selected from Department of Pulmonary Medicine, B.J. Govt. Medical College and Sassoon General Hospital, Pune. Diagnosis of COPD patients were done with the help of spirometry test. The patients and controls were voluntarily participated in the study.
A total 120 subjects were participated in the study, of which 60 subjects were healthy controls and 60 subjects were of COPD disease. There were no difference in age among cases and controls.
Inclusion Criteria:
i) Group 1 (COPD patients): Group 1 consist of 60 clinically diagnosed COPD patients
ii) Group 2 (Healthy Controls): Group 2 consist of 60 normal healthy individuals without any history of smoking and chronic lung disease.
Exclusion Criteria:
Patients who were suffering from or who were known to have tuberculosis, pneumonia, asthma, bronchiectasis, lung cancer, interstitial lung diseases, respiratory failure, cardiac failure, diabetes mellitus, hepatic disease, renal disease and who had any recent surgical intervention and who were unable to performed lung function test were excluded from our COPD patients group. Healthy individual with any past history of lung/respiratory disease or with abnormal lung function test were excluded from Control group.
Collection of Blood Samples:
Under aseptic condition and with prior written consent of the subject, 5ml of blood was collected from large peripheral vein, after overnight fasting. Out of which 2ml was taken in an anticoagulant (EDTA) bulb for estimation of whole blood reduced glutathione (GSH) and 3ml in plain bulb for the estimation of serum malondialdehyde and protein carbonyl.
Estimation of Whole blood Reduced Glutathione:
Whole blood reduced glutathione was estimated by Ernst Beutler et al method [13]. It is based on the principle that all of the non-protein sulphydryl group of red blood cells are in the form of reduced glutathione (GSH). 5,51-dithiobis-2-nitrobenzoic acid (DTNB) is a disulphide compound, which is readily reduced by sulphydryl compounds, forming a highly colored yellow compound. Optical density measured at 412 nm and is directly proportional to GSH concentration[13]. It was expressed as mg/dl.
Estimation of Serum Malondialdehyde
Serum malondialdehyde was determined by Buege and Aust method (1978). It is based on the principle that serum sample is first treated with TCA (Trichloroacetic acid) for protein precipitation and then treated with thiobarbituric acid. The mixture is heated for 10 minutes in boiling water bath. One molecule of MDA (malondialdehyde) reacts with two molecules of thiobarbituric acid. The resulting chromogen is centrifuged and intensity of colour developed in supernatant is measured colourimetrically at 530nm. It was expressed as nmol/ml[14]
Estimation of Serum Protein Carbonyl:
Serum protein carbonyl was determined by Levin et al method (1990). The carbonyl groups in protein reacts with 2, 4- Dinitrophenyl hydrazine (DNPH) to form 2,4–Dinitrophenyl hydrazone which is estimated colorimetrically at 360-390nm. It was expressed as nmol/mg of proteins[15]. Protein concentration in mg/ml was determined by Bradfoed method (1976) [16].
Statistical Analysis:
Results are expressed as mean ± SD and range values. Unpaired ‘t’ test is used for comparing different biochemical parameters between cases and controls. P values of Englishhttp://ijcrr.com/abstract.php?article_id=156http://ijcrr.com/article_html.php?did=1561. WHO site http:// www.who.int world bank/ WHO global burden of disease study.
2. MacNee W. Pulmonary and systemic oxidant/antioxidant imbalance in chronic obstructive pulmonary disease. Proc Am Torac Soc. 2005; 2:50-60
3. Pryor WA, Prier DG, Church DF. Electrons spin resonance study of main-stream and side stream smoke: nature of free radicals in gas-phase smoke and in cigarette tar. Environ Health Perspect 1983; 47:345-55
4. Kumar V, Abbas A, Fausto N, Aster J. The Lung. In: Robbins and Cotran pathologic basis of disease. 8th edin, Elsevier, New Delhi 2010; 683-92
5. Devasagayam TPA, Boloor KK, Ramsarma T. Methods for estimatinf lipid peroxidation: Analysis of merits and demerits (minireview). Indian J Bioche Biophys 2003; 40: 300-308
6. Malondialdehyde from Wkipedia, the free encyclopaedia (serial online) cited 27th Aug. 2010. Available from :http//en.wikipedia.org/wiki/malondialdehyde
7. Lopaczynski W, Zeisel SH. Antioxidants, programmed cell death, and cancer. Nutr Res. 2001;21:295–307.
8. Dalle-Donne I, Rossi R, Giustarini D, Milzani A, Colombo R. Protein carbonyl group as biomarkers of oxidative stress. Clin Chim Acta 2003;329(1-2):23-38
9. Rai RR, Phadke MS. Plasma oxidant-antioxidant status in different respiratory disorders. Indian J Clin Biochem 2006; 21(2): 161-64
10. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4(8): 118-126
11. Antonicelli F, Parmentier M, Drost EM, Hirani N, Rahman I, Donaldson K, MacNee W. Nacystelyn inhibits hydrogen peroxide mediated interleukin-8 expression in human alveolar epithelial cells. Free Rad Biol Med. 2002;32:492–502.
12. Aoki T, Suzuki Y, Suzuki K, Miyata A, Oyamada Y, Takasugi T, Mori M, Fujita H, Yamaguchi K. Modulation of ICAM-1 expression by extra-cellular glutathione in hyperoxia-exposed human pulmonary artery endothelial cells. Am J Respir Cell Mol Biol. 1996;15: 319–327.
13. Beutler E, Duron O, Kelly BM. Improved method for the determination of blood glutathione. J.Lab.Clin. Med.1963; 61(5): 882-888.
14. Buege JA, Aust SD. Microsomal lipid peroxidation. Method Enzymol. 1978; 52:302-310.
15. Levin RL, Garland D, Oliver CN, Amici A, Climet I, Lenz AG. Determination of carbonyl content in oxidatively modified proteins. Meth. Enzymol. 1990;186: 464-78.
16. Bradfoed MM. A rapid and sensitive method for the quantitation of microgram of
protein utilizing the principle of protein dye binding. Analy. Bioch. 1976;72:248-54.
17. Pawar RS, Abhang SA, Borale P, Lokhande R. Study of correlation of pulmonary function test with the markers of oxidative stress and non-enzymatic antioxidants in chronic obstructive pulmonary disease (COPD) patients. British Journal of Medicine and Medical Research 2014; 4(28):4710-4722.
18. Parija M, Bobby Z, Kumar VS, Saradha B. Oxidative stress and protein glycation in patients with chronic obstructive pulmonary disease. Indian J Physiol Pharmacol. 2005; 49(1):95-98
19. Calikoglu M, Unlu A, Tamer L, Ercan B, Bugdayci R, Atik U. The levels of serum vitamin C, malondialdehyde and erythrocyte reduced glutathione in chronic obstructive pulmonary disease and in healthy smokers. Clin Chem Lab Med 2002;40(10): 1028-31
20. Toorn MV, Maria P, Varies S, Slebos D, Bruin HG, Abello N et al. Cigarette smoke irreversibly modifies glutathione in airway epithelial cells. Am J Physiol 2007; 293:1156-62
21. Ozbay B, Dulger H. Lipid peroxidation and antioxidant enzymes in Turkish population: Relation to age, gender, exercise and smoking. Tohoku J Exp Med 2002;197:119-24
22. Yessica DT, Maria LG, Ivonne MO, Hicks JJ. Correlation of plasma protein carbonyl and C-reactive protein with GOLD stage progression in COPD patients. Open Respir Med J 2009; 3: 61-66
23. Daga MK , Chhabra R, Sharma B, Mishra TK. Effects of exogenous vitamin E supplementation on the levels of oxidants and antioxidants in chronic obstructive pulmonary disease. J Biosci. 2003; 28(1): 7-11
24. Kirkil G, Muz MH, Seckin D, Sahin K, Kucuk O. Antioxidant effect of zinc picolinate in patients with chronic obstructive pulmonary disease. Respir Med 2008;102:840-44
25. Pryor WA, Prier DG, Church DF. Electron-spin resonance study of main-stream and sidestream cigarette smoke: nature of the free radicals in gas-phase smoke and in cigarette tar. Environ Health Prospect 1983;47:345-55
26. Henneke JH, Leo MAH, Geraedts MCP, Hafmans T, Josw RV, Richard D. et al. Oxidative and nitrosative stress in diaphragm of patients with COPD. Intr. J. COPD.2006;1(2):173-179.
27. Warren JS, Johnson KJ, Ward PA. Consequence of oxidant injury. In: Crystal RG, Weibel ER, Barnes PJ eds. The Lung: Scientific foundation. New York N.Y. Raves Press Ltd. 1997; 2279-2288
28. Mesia-Vela S, Yeh CC, Austin JHM, Dounel M, Powell CA, Reeves A, Santella RM, Stevenson L, Yankelevitz D, Barr GR. Plasma carbonyls do not correlate with lung function or computed tomography measures of lung density in older smokers. Biomarkers 2008; 13(4): 422-434
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31HealthcareCorrelation between Serum Ferritin and Glycated Hemoglobin Level in Patients of Type 2 Diabetes Mellitus
English3033Poonam AroraEnglishIntroduction: The complications of diabetes mellitus are influenced not only by the duration of the diabetes mellitus but also by the average level of blood glucose along with glycated haemoglobin. Raised serum ferritin may possibly be related to the occurrence of long term complications of diabetes, both microvascular and macrovascular.
Objective: The aim of this study is to establish a correlation between serum ferritin, fasting plasma glucose and glycated hemoglobinin type 2 diabetes mellitus patients.
Materials and Methods: This was a cross-sectional study of 100 cases, visiting medical outpatient department of SGT Medical College and Hospital, Budhera, Gurugram, Haryana. Sample were analysed for the measurement of FPG, HbA1c and Serum Ferritin (by ELISA).
Results: The mean FPG, HbA1c and serum ferritin levels were significantly higher with PEnglishSerum Ferritin, Glycated Hemoglobin, Type 2 Diabetes MellitusIntroduction:
Diabetes is a metabolic disorder characterized by hyperglycemia from defects in insulin secretion, insulin action, or both1. People with type 2 diabetes mellitus develop characteristic microvascular complications such as retinopathy, nephropathy and neuropathy. There is also increased risk of macrovascular complications such as cardiovascular, cerebrovascular and peripheral vascular disease2.
Complications due to diabetes are a major cause of disability, reduced quality of life and death. Approximately 5.1 million people aged between 20 and 79 years died from diabetes accounting for 8.4% of global all cause mortality in this age group3. In India 65.1 million in the age group of 20 to 79 have diabetes (8.56%) and expected to rise to 109 million by the year 20354.
The pathogenesis of type 2 diabetes mellitus (T2DM) is complex and involves the interaction of genetic and environmental factors. Individuals with (T2DM) show both insulin resistance and beta cell defects5. The complications of diabetes mellitus are influenced not only by the duration of the diabetes mellitus but also by the average level of blood glucose along with glycated haemoglobin2.
Serum ferritin is an acute phase reactant, and is a marker of iron stores in the body6. Iron is a transitional metal that can easily become oxidized and thus act as an oxidant7. Elevated iron stores may induce diabetes through a variety of mechanisms, including oxidative damage to pancreatic beta cells, impairment of hepatic insulin extraction by liver, and interference with insulin’s ability to suppress hepatic glucose production 8.
Raised serum ferritin may possibly be related to the occurrence of long term complications of diabetes, both microvascular and macrovascular 9,10.
Recent studies have shown that serum ferritin was proportional to serum glucose concentration, diastolic blood pressure, HDL cholesterol, and insulin resistance. In fact, the higher the ferritin levels, the higher the incidence of type 2 diabetes mellitus11,12. Amongst the various markers of glycemic control, glycated hemoglobin has now been established as the most reliable. However, ferritin’s role as a marker of iron overload in pancreatic damage and peripheral insulin resistance or its role as an inflammatory marker is not clear13.
Hence this study was carried out to examine the association between serum ferritin and glycated hemoglobin levels in T2DM and to establish a correlation between serum ferritin, Fasting Plasma Glucose (FPG) and Glycated Hemoglobin (HbA1c).
Materials and Methods:
This was a cross-sectional study of 100 cases, visiting medical outpatient department of SGT Medical College and Hospital, Budhera, Gurugram, Haryana. The study was approved by institutional ethical committee. 50 diabetic patients were compared with 50 age and sex matched normal healthy controls. A written informed consent was also taken from the cases with detailed history.
Inclusion Criteria: Clinically diagnosed type 2 diabetes mellitus patients on treatment in the age group of 35-70 years.
Controls: Healthy controls in the age group of 35-70 years.
Exclusion Criteria:
Chronic Infections
Chronic Liver Disease
Chronic Renal Disease
Overt Thyroid Dysfunction
Patients on Corticosteroids Therapy
Anemia (HbEnglishhttp://ijcrr.com/abstract.php?article_id=157http://ijcrr.com/article_html.php?did=157
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Thilip Kumar G, Saravanan A, Ramachandran C and John Nitin Ashok. Mean blood glucose level and glycated haemoglobin level in patients of non-insulin dependent diabetes mellitus and its correlation with serum ferritin level. Int J Med Sci 2011; 4 (1and 2): 13-17.
Roglic G, Unwin N. Mortality attributable to diabetes: estimates for the year 2010. Diabetes Res Clin Pract 2010; 87(1): 15-19.
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Koorts AM, Viljoen M. Acute phase proteins: Ferritin and ferritin isoforms. University of Petoria, South Africa 2011; 154-84.
Herbert V, Spencer S, Jayatilleke E, Kasadan T. Most free radical injury is iron-related: Itis promoted by iron, heme, holoferritin and vitamin C and inhibited by desferoxamine and apoferritin. Stem Cells 1994; 12: 289-303.
Gallou G, Guilhem I, Poirier JY, Ruelland A, Legras B, Cloarec L. Increased serum ferritin in insulin-dependent diabetes mellitus: relation to glycemic control. Clin Chem 1994; 40: 947-8.
Kim NH. Serum ferritin in healthy subjects and type 2 diabetes mellitus. Med Korea 2000; 41: 387-92.
Eshed I, Elis A, Lishner M. Plasma ferritin and type 2 diabetes mellitus. Endocr Res 2001; 27: 91-7.
Forouhi NG, Harding AH, Allison M, Sandhu MS, Welch A, Luben Re et al. Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study. Diabetologia 2007; 50: 949-56.
Wrede CE, Buettner R, Bollheimer LC, Scho lmeirch J, PalitzschK-D and Hellerbrand C. Association between serum ferritin and the insulin resistance syndrome in a representative population. Eur J Endocr 2006; 154: 333-40.
Sharifi F and Sazandeh Sh. Serum ferritin in type2 diabetes mellitus and its relationship with HbA1c. Acta Med Iranica 2004; 42(2): 142-45.
Padmaja P, Shabana S and Shariq Mas. Serum ferritin and HbA1c in type 2 diabetes mellitus. Int J Clin and Biomed Res 2015; 1(3): 30-37.
Radoi V, Lixandru D, Mohara M, Virgolici B. Advanced glycation end products in diabetes mellitus: Mechanism of action and focused treatment. Proc Rom Acad Series B 2012; 1: 9-19.
Halliwell B, Gutteridge JMC. Role of free radicals and catalytic metal ions in human disease: an overview. Meth Enzymol 1990; 186: 1-85.
Herbert V. Everyone should be tested for iron disorders. J Am Diet Assoc 1992; 92: 1509-76.
Swaminathan S, Fonseca VA, Alam MG, Shah SV. The role of iron in diabetes and its complications. Diabetes Care 2007; 30 (7): 1926-33.
Balla J, Jacob HS, Balla G, Nath K, Vercellotti GM. Endothelial cell hemeoxygenase and ferritin induction by heme proteins: a possible mechanism limiting shock damage. Trans Assoc Am Phys 1993; 105: (in press).
Balla G, Jacob HS, Balla J, Rosenberg M, Apple F, Eaton JW, Vercellotti GM. Ferritin: a cytoprotective antioxidant stratagem of endothelium. J Biol Chem 1992; 267: 18148-53.
Qian M, Liu M, Eaton JW. Transition metals bind to glycated proteins forming redox active “glycochelates”: implications for the pathogenesis of certain diabetic complications. Biochem Biophys Res Comm 1998; 250: 385-89.
Fernandez-Real JM, Richard- Engel W, Arroyo E, Balanca R, Casamitjana-Abella R. Serum ferritin as a component of the insulin resistance syndrome. Diabetes Care 1998; 21(1): 62-68.
Ford ES, Cogswell ME. Diabetes and serum ferritin concentration among U.S. adults. Diabetes Care 1999; 22: 1978-83.
Tuomainen TP, Nyyssonen K, Salonen R, Tervahuta A, Korpela H, Lakka T et al. Body iron stores are associated with serum insulin and blood glucose concentration: Population study in 1,013 eastern Finnish Men. Diabetes Care 1997; 20(3): 426-28.
Thanna RC, Nigosker S. Level of serum ferritin and glycated haemoglobin in type 2 diabetes mellitus. Int J Med and Health Sci 2016; 2(2): 49-51.
Momeni A, Behradmanesh MS, Khieri S, Abasi F. Serum ferritin has correlation with HbA1c in type 2 diabetic patients. Adv Biomed Res 2015; 4: 74.
Rawat N, Mathur N, Harikrishnan R, Choudhary J, Rawat K, Mathur M. A study of correlation of serum ferritin with glycated haemoglobin in diabetes mellitus type 2 patients: a case control study. Asian Pac J Health Sci 2016; 3(4): 83-88.
Pramiladevi R, Boke U, Kora S. Serum ferritin levels in type II diabetes mellitus. Sch J App Med Sci 2013; 1(5): 472-75.
Raj S, Rajan GV. Correlation between elevated serum ferritin and HbA1c in type 2 diabetes mellitus. Int J Res Med Sci 2013; 1(1): 12-15.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31HealthcareA Prospective Study to Analyse Safety of Low Flow Anesthesia for Laparoscopic Procedures
English3439Annu ChoudharyEnglish Vaishali C. ShelgaonkarEnglishBackground: Anesthesia for laparoscopic surgery has developed and advanced significantly, resulting in a technique that is safe and provides better outcome than before. Low flow anesthesia is newer technique which is more economic, ecofriendly and effective. But there is reluctance in combining these two techniques due to risk of hypoxia and hypercapnia. So, this study was conducted to prove that low flow anesthesia is safe in laparoscopic surgeries.
Method: A prospective observational study including 70 patients (ASA I/II, 18-65 years) undergoing various laparoscopic procedures was conducted with the permission of institutional ethical committee and patient’s consent. Selected patients were assigned into two groups with fresh gas flow 3L and 0.5L in high and low flow group respectively. The inspiratory and expiratory concentrations of various gases were compared. Also, the increase in soda lime temperature and change in liver/kidney functions were studied.
Result: Demographic data in both the groups were comparable. Inspiratory and expiratory concentration of oxygen, carbon dioxide and sevoflurane were comparable at all intervals of time without any complication. Temperature of sodalime increased in both the groups, but was comparable. Also, there was no significant change in postoperative liver/kidney function tests.
Conclusion: Low flow technique is a safe, efficient technique of general anesthesia for laparoscopic surgery.
EnglishLow flow anesthesia, Laparoscopy, SevofluraneINTRODUCTION
Laparoscopic procedure is a principle technique for minimally invasive procedure and has been currently employed in multiple surgical disciplines. This technique has improved greatly during the past few years towards more patient comfort and safety. The advantages of laparoscopy in comparison to open abdominal surgery include reduced surgical trauma, less pain, fewer post-operative pulmonary complications, and shorter recovery time and a lower incidence of postoperative wound infection1,2. The disadvantages include longer surgical duration and higher equipment cost.1 So, the field of anesthesia must also grow and evolve in order to provide safe anesthesia for these kind of procedures. The anesthesiologist should have an understanding of the pathophysiological consequences from the pneumoperitoneum, to be prepared to prevent, detect and manage the possible alterations that can occur during the intervention.
Pneumoperitoneum causes an increase in systemic vascular resistance, pulmonary vascular resistance, while causing a decrease in cardiac output. However, mean arterial pressure is increased overall because increase in SVR exceeds decrease in cardiac output.3 These effects are proportional to the increase in IAP and can be exacerbated by the reverse trendelenberg position or if patient is hypovolumic. Bradycardia, cardiovascular collapse and asystole in healthy patients have been described, which are attributed to deep vagal reflexes due to sudden insufflations. Pneumoperitoneum transmits upward pressure to thorax and elevates the diaphragm, compresses the lungs and impedes expansion of the lungs and chest cavity (i.e. decreases thoracopulmonary compliance) leading to reduced functional residual capacity and basal atelectasis4. Furthermore, the pulmonary complications like subcutaneous emphysema, pneumothorax, endobronchial intubation, gas embolism can also occur.
In upper abdomen procedures, positioning in different anti trendelenburg degrees causes a reduction in the venous return and therefore in the cardiac output that can reach upto 50% of baseline. In lower abdomen procedures (pelvic, gynecology) trendelenburg position is used, sometimes in an exaggerated degree which makes ventilatory condition worse, but improves venous return and increases cardiac output in healthy patients. Because of venous stagnation, cyanosis and edema in the face and neck may be expected and if this position is maintained for an extended duration, cerebral edema and retinal detachment may occur. Lithotomic position is associated with much higher rise in venous return. All these physiological changes and potential complications makes anesthesia risky. But laparoscopy demands a safer technique of anesthesia to justify its usefulness over open procedures.
Low-flow anesthesia technique provides conservation of the heat and humidity of the respiratory system, while minimizing cost and preventing air pollution. The physiology of the tracheobronchial environment is protected as mucociliary clearance is better maintained in this technique than in high-flow anesthesia6-9. As the waste gases are reduced- atmospheric pollution is lowered, occupational hazard to operating room staff is decreased and ecological balance is maintained. A number of studies have been conducted evaluating the use of low flow anesthesia in open surgeries, but hardly a few studies conducted including all types of laparoscopic procedures. Potential reasons can be increased incidence of hypoxia, hypercarbia that can make the case difficult. This study was designed to test all those reasons which made anesthesiologist to hesitate in accepting low flow anesthesia technique for laparoscopic procedures of limited duration.
The aim of study was to assess whether low flow technique is compatible with laparoscopic surgery. Primary objectives were to compare the inspiratory and expiratory concentration of various gases at different time interval, to observe the rise in temperature of sodalime canister and compare the preoperative and postoperative kidney/liver function tests to confirm the safety of this technique.
MATERIALS and METHODOLOGY
This prospective observational study was conducted in a tertiary hospital in Maharashtra after approval from the hospital’s ethics committee on 70 patients, age in the range of 18 to 60 years undergoing elective laparoscopic surgeries under general anaesthesia of limited duration (upto 2 hours). Exclusion criteria were patients under ASA III /IV, patients with known hepatic, pulmonary, renal, or neuromuscular disorder, clinically significant laboratory abnormalities, unstable angina, history of myocardial infarction 8 were used to assess the recovery characteristics. Residual neuromuscular block was antagonized and patients were extubated after return of all reflexes. Total consumption of sevoflurane was recorded from the anesthesia machine software.There was no loss to follow up.
Data was presented as mean and standard deviation.All data were analyzed by specific statistical methods (Chi Square, t-Test, Z-test, Fisher's exact test and Yates' correction) applicable to the various sets of data.
RESULT
There was no significant difference between both groups in terms of demographic data. Patients posted for any type of laparoscopic surgery were selected for the study.
Time to achieve MAC 1.2 i.e. time required to achieve surgical plane of anesthesia was comparable in both the groups (2.92±0.64 in HFA and 3±0.86 in LFA). Intraoperatively, respiratory parameters were comparable. Inspiratory oxygen concentration decreased with time but never dropped below 44.4% in any group. Nitrous oxide was found to be increasing slowly. Also, concentration of sevoflurane was lower in LFA as compared to HFA group. There was no incidence of hypoxia, hypercapnia or arrhythmia in any of the group.
EtCO2, peak airway pressure and minute ventilation were within acceptable range in both the groups at all stages of surgery, although EtCO2 was found slightly higher in LFA group. Mean of EtCO2 in all conditions was less than 45. It is evident that the ventilator parameters remained in the normal range in both the groups with these two different anaesthesia techniques.
Haemodynamically, patients were stable in both the group at all intervals. Stress response of intubation was evident. But later on, gradually settled to near baseline Depth of anesthesia was maintained to overcome surgical stimuli at every point by BIS kept in 40-60.
CO2 absorption by sodalime is an exothermic reaction. This was evident by the observation of increase in temperature of sodalime canister. The temperature of canister was comparable preoperatively, but around 30 minutes intraoperative, there was a significant rise. The mean of temperature were comparable with p value >0.05.
Extubation was uneventful in all cases. Further on observation it was found that a few patient had postoperative complication in terms of nausea, vomiting and agitation, but were easily treated with drugs and counseling.
There was no major difference between two groups in preoperative and postoperative kidney function test or liver function test. Patients were also clinically stable and healthy.
DISCUSSION
Laparoscopic surgery is not without its own specific risks, either due to individual laparoscopic techniques or due to the physiological changes associated with the creation of a pneumoperitoneum. As a result, anesthetic techniques for laparoscopic surgery must be refined according to it.4 With the development of modern workstation, monitoring devices, lower solubility inhalational agent and other safe drugs, anesthesia has moved towards a more eco friendly, economic and safer technique. Actually to justify anesthesia of laparoscopy, it must parallel the advantages laparoscopy provides, simultaneously considering the problems it can give birth to. However, anesthesia practitioners, as well as pharmacy and therapeutic committees, are demanding proof that a new more costly drug or technique is superior to preexisting one in achieving the desired effect, enhances efficacy and reduces health care costs.10 In this study, we tried to test the reasons which made anesthesiologists to be reluctant for using low flow with laparoscopic procedures.
Traditionally, anesthesiologists participating in laparoscopic cholecystectomy have been quite cautious about adapting low flow anesthesia due to reason like-
potential for inducing hypoxia, hypercarbia
more increase in temperature of sodalime canister
accumulation of toxic degradation products such as compound A by sevoflurane due to exhaled carbon dioxide rebreathing and administration of small amount of oxygen less than 500ml/min11
EtCO2 helps in controlling the carbon dioxide absorption-elimination equilibrium. In healthy individuals it correlates with PaCO2 from 4-8 mm Hg. In our study inspiratory oxygen never fell below 40% and EtCO2 never rose above 45 mm Hg in LFA group. These findings suggest that clinically significant rebreathing does not occur with a limited period surgery. Similar findings were observed by Young Ho Jang et al11. Also, patients were haemodyanamically stable without any signs of distress. There was no tachycardia, desaturation or increase/decrease in blood pressure at any time interval.
The next concern used to be proportionately more increase in temperature of sodalime canister with lower fresh gas flow. This becomes more significant with sevoflurane, which degrades to compound A, a nephrotoxic substance. Compound A is found to be dose-related nephrotoxin in rats, but renal toxicity, as defined by an increase in serum creatinine or BUN, has not been reported in surgical patients. The literature indicates that for care of surgical patient, the change from preoperative levels in serum creatinine and BUN levels is the most practical predictor of postoperative renal dysfunction and they are widely available, inexpensive, and have been clinically validated as predictive of renal function .12-13 In present study, it was noted that there is increase in temperature of sodalime with time and it was a little more in LFA group because low flow technique preserves heat and humidity in the breathing circuit. But they were comparable as p value was insignificant. To confirm the patient safety pre/postoperative KFT and LFT were recorded. There was no significant change in laboratory investigations suggesting that low flow with sevoflurane is safe for limited hour surgery. For the small variation in a few cases, it can be antibiotics, surgical stress, preexisting renal disease, intraoperative blood pressure, site of surgery, and anesthetics have been implicated in the cause of renal and hepatic dysfunction /injury, but none have been controlled for in prospective studies. 14
Thus, this anesthetic technique offers a means of reducing expenditure without reducing patient care; indeed it could be argued that patient care is increased as a result of the increased monitoring which they receive.15
Conclusion
In conclusion, LFA with sevoflurane using fresh gas flow of 0.5 L with setting of 50% oxygen and nitrous oxide for laparoscopic procedures is safe without any significant likelihood of risks involved.
Acknowledgement
My immense gratitude to Dr. S.P. Manjrekar, Professor and Head of Department, IGGMC, Nagpur for her kind support and help to complete this research work.
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.
There is no conflict of interest.
Englishhttp://ijcrr.com/abstract.php?article_id=158http://ijcrr.com/article_html.php?did=158
Smith I. Anesthesia for laparoscopy with emphas is on outpatient laparoscopy. Anesthesiol Clin North Am. 2001;19:21-41.
Paul Hayden, Sarah Cowman. Anesthesia for laparoscopic surgery Continuing Education in Anesthesia, Critical Care and Pain.2011; vol 1,number 5
O’Malley C, Cunningham A. Physiology changes during laparoscopy. Anesthesiol Clin North Am. 2001;19:1-19
John H. Nguyen, Pedro P. Tanaka. Anesthesia for Laparoscopic Surgery
Barker L. Positioning on the operating table. Update Anaesth. 2002;15:1-6.
M. Bilgi, S. Goksu, A. Mizrak et al., “Comparison of the effects of low-flow and high-flow inhalational
anaesthesia with nitrous oxide and desflurane on mucociliary activity and pulmonary function tests,” European Journal of Anaesthesiology, vol. 28, no.4, pp. 279–283, 2011.
P. D. Stevanovic, G. Petrova, B. Miljkovic et al., “Low fresh gas flow balanced anesthesia versus target controlled intravenous infusion anesthesia in laparoscopic cholecystectomy: a cost minimization analysis,” Clinical Therapeutics, vol. 30, no. 9, pp.1714–1725, 2008.
M. Brattwall, M. Warr´en-Stomberg, F. Hesselvik, and J. Jakobsson,“Brief review: theory and practice of minimal fresh gas flow anesthesia,” Canadian Journal of Anesthesia, vol. 59, n o. 8,pp. 785–797, 2012.
J.M. Feldman, “Managing fresh gas flow to reduce environmental contamination,” Anesthesia and Analgesia, vol. 114, no. 5, pp.1093–1101, 2012.
White PF, Smith I. Impact of newer drugs and techniques on the quality of ambulatory anesthesia. J Clin Anesth.1993;5(Suppl 1):3-13
Young Ho Jang, Sue Rung Ho.Low-flow sevoflurane anesthesia in laproscopic cholecystectomy. Korean J Anaesthesiol.2005 Dec;49(5):1-5
Mazze RI, Callan CM, Galvez ST, Delgado-Herrera L, Mayer DB. The effects of sevoflurane on serum creatinine and blood urea nitrogen concentrations: a retrospective, twenty-two-center, comparative evaluation of renal function in adult surgical patients. Anesth Analg. 2000 Mar;90(3):683–8. 1.
Groudine SB, Fragen RJ, Kharasch ED, Eisenman TS, Frink EJ, McConnell S. Comparison of renal function following anesthesia with low-flow sevoflurane and isoflurane. J ClinAnesth. 1999 May;11(3):201–7.
Sahin SH, Cinar SO, Paksoy I, Sut N, Oba S. Comparison between low flow sevoflurane anesthesia and total intravenous anesthesia during intermediate-duration surgery: effects on renal and hepatic toxicity. Hippokratia. 2011 Jan;15(1):69–74.
Cotter SM, Petros AJ, Doré CJ, Barber ND, White DC. Low-flow anaesthesia. Practice, cost implications and acceptability. Anaesthesia. 1991 Dec;46(12):1009–12.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31HealthcareGait Cycle Duration: A Determining Factor of Gait Maturity in Children
English4043Ikram HussainEnglish Syed Anayat HussainEnglishAim: To explore one of the temporal characteristic of running gait (Gait Cycle Duration) in children and determine its relationship with the selected body characteristics
Methodology: Twenty school going children of 5 years age consisting of both genders were selected for the study. To obtain the required data, an experimental setup was designed consisting of caliberated running path and a cannon camcorder Legria SF10 operating at shutter speed of 1/2000 and frame rate of 50 Hz. The obtained video data was analyzed using Silicocoach7 motion analysis software. The statistical analysis was done by SPSSv 17.0 to determine the relationship of gait cycle duration with the selected body characteristics.
Results: No significant relationship was found between the gait cycle duration and body characteristics, however a striking feature got extracted that the gait cycle duration of 5 years old children was shorter than that of adults.
Conclusion: The results concluded from the study could be of great use to clinicians to assess the gait maturation or abnormality in the gait of children. Further, the changes in the gait cycle duration could reflect improvement in gait over time..
EnglishBody Characteristics, Gait Cycle Duration, Motion AnalysisINTRODUCTION
Gait is the manner in which we move our body across the environment. It is a complex phenomenon which consists of alternating rhythmical swinging forward of the leg and foot strike involving the coordination of almost all the joints and muscles of the body (Slaton, 1984). In case of children, immature control of posture and gait results in unsteadiness in locomotion and thereby having large stride-to-stride fluctuations and frequent falls (Breniere and Brill, 1988). By the time children grow in age (approx. above 3-years old), their gait tends to become relatively mature and a more stable walking/running pattern is observed (Sutherland, Olshen, Biden and Wyatt, 1998). Even after this age, development of neuromuscular control and locomotor function continues. With maturation, experience and motor learning, movements and postural adjustments in children tend to become automated to meet the new demands and situations (Scott, 1967). However, the criteria applied in determining the mature gait is rather controversial. Many factors like stride and step length, stride width, foot placement angle, cadence etc have been used to measure children’s gait. One such factor which has been taken into consideration in current study is “gait cycle duration”.
Statham and Murray suggest that gait cycle duration during free walking is shorter in pre-school children than in the adult and that cycle duration tends to lengthen as age increases (range; 0.68 sec at 1 years of age to 0.96 sec at 5 years of age). However, little information is available about the variability of gait characteristics (gait cycle duration) with growth and maturation and same has been tried to find out in this study, if the subject’s changing characteristics (age, sex, weight, height and leg length) is having significant influence on gait cycle duration. Thus, the present study will provide an insight into the development of neuromuscular control in children. Also, it will help in removing the size related variability in results of various studies where subjects of different body characteristics are taken into consideration through normalization of gait parameters.
MATERIALS AND METHODS:
Subjects
A group of 20 children (5 years old) containing both genders participated in this study. Before examining the subjects, the consent from their parents was received. Children who had any disorders likely to affect gait were excluded. The mean and standard deviation (SD) of their age (yrs), body height (cms) and body weight (kgs) were 5.28±0.21, 120.75±8.34 and 20.65±3.01 respectively.
Protocol
The required gait data was obtained using a Legria SF10 canon camcorder operating at shutter speed of 1/2000 and frame rate of 50 Hz, positioned perpendicular to sagittal plane on the left side of the subject at a distance of 8.5 meters from the mid of the calibrated running line/axis. The subjects ran on the provided calibrated running line/axis for about 10 meters at fast speeds. The subjects were given three trials to trace out the best which would be considered for analysis. The filming procedure took not more than 15 minutes. After filming, each child was asked to remove his or her shoes and socks. Then, measurement of height, weight and the distance from the right anterior iliac spine to the floor (leg length) was taken.
After obtaining the required video data, the recorded videos were carefully viewed and the best performance clips were extracted for analysis which was done by Siliconcoach7 motion analysis software. The “gait cycle duration” was assessed to determine its relationship with the selected body characteristics of a child. The gait cycle durations were recorded from heel strike to successive heel strike of the same foot.
Pearson product-moment correlation coefficients were calculated to determine the strength of relationship between gait cycle duration and sex, age, height, weight and leg length.
RESULTS
Table 1 presents individual characteristics and average cycle durations for each subject. The age ranged from 5 to 5.7 years, height from 106 to 135 cms, weight from 16 to 27 kgs and leg length varied from 50 to 69 cms. Individual mean cycle durations ranged from 0.44 to 0.62 sec with an overall sample mean cycle duration of 0.52 sec ± 0.05 sec
The subjective notations I made during filming procedure suggest that most of the children were feeling somewhat hesitating and uncomfortable and were showing extra cautious attitude. Also few subjects did not maintain the proper swing of their arms during running. Inspite of this, no relationship existed between postural attitudes or upper extremity position and the duration of corresponding gait cycles.
Table 2 represents the correlation of gait cycle duration and the selected individual characteristics. I found that no significant relationships between cycle duration and subject characteristics.
DISCUSSION
The mean gait cycle duration of 5 years old children as determined through the current study is 0.52 sec, which is shorter in comparison to adults (Statham and Murray, 1971). The reasons for this is however not clear, but Statham and Murray suggest that;
The shorter cycle duration or increased cadence could be an attempt by children to decrease the lateral displacement of their high centre of gravity. Murray had found that, faster gait speeds in adults decreased the lateral displacement of centre of gravity, and then as such as child grows older and centre of gravity gradually descends, the gait cycle duration also lengthens. Our results also seem to support this hypothesis.
Another explanation for shorter gait cycle duration in children as compared to adults is reported by Saunders and his associates who suggest that;
The shorter cycle duration could be the lack of acquisition of six determinants of mature gait in children (pelvic tilt, pelvic rotation, knee flexion at mid-stance, foot and knee coordination at heel and toe-off and lateral displacement of pelvis). If this could be the reason, then cycle duration should lengthen to same extent as that of adult by the time a mature gait is achieved. Sutherland and his associates also suggest the same. From their data, it was reported that cycle duration rapidly increased during initial periods of walking/running until 3 years of age. Then after, this increase continues but at a slower rate. This suggests that cycle duration is directly related with acquisition of gait determinants.
Although no significant relationship was determined between gait cycle duration and body characteristics of children in our study, yet relationships may exist if some other age group is considered or a larger sample is studied. If the significant relationship is determined, it could be of use to clinicians to assess further maturity or abnormality in gait in childhood. Changes in gait cycle duration could reflect improvement in gait over time.
CONCLUSIONS
The mean running gait cycle duration in 5 year old children is shorter than adults; many reasons have been put forth as discussed in the content of discussions. The results as depicted by our study are consistent with the results of other studies showing a trend of increasing of gait cycle duration with age. However, further studies need to get completed in order to determine the feasibility of using gait cycle duration as a tool for measuring gait maturity or abnormality in clinical setting.
ACKNOWLEDGEMENT
The 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=159http://ijcrr.com/article_html.php?did=159
Breniere, Y., and Brill, B. (1988). Why do children walk when felling down, while adults fell down in walking? Computes Rendus Academie Sciencies III, 307: 617-662.
Sutherland, D. H., Olshen, R. A., Biden, E. N., and Wyatt, M. P. (1988). The development of mature walking. Oxford, UK: Mackieth.
Scott, L. (1967). Child development: An individual longitudinal approach, New York, NY, HoH, Rinehart and Winston General Book, 20-144.
Statham, L., and Murray, M. P. (1971). Early walking patterns of normal children. Clinical Orthopedics and Related Research, 79: 8-24.
Slaton, D. S. (1984). Gait cycle duration in 3-year-old children. Physical Therapy, 65: 1, 17-22.
Saunders, J. B., Inam, V. T., and Eberhart, H. D. (1953). The major determinants of normal and pathological gait. Journal of Bone and Joint Surgery (Am), 35: 543-558.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31HealthcareEvaluation of Microscopic Screening Methods for Detection of Urinary Tract Infection
English4449Akeela FatimaEnglish Abiroo JanEnglish Nighat AkhterEnglish Bashir A. FomdaEnglish Mohd Suhail LoneEnglish Junaid AhmedEnglish Lubna SamadEnglish Shugufta RoohiEnglishObjective: The study was conducted to evaluate the accuracy, cost and turnaround time of wet mount, gram stain and acridine orange stain microscopy of quantitative unspun urine for screening of urine samples. The combination of wet mount and gram stain and wet mount and acridine orange stain was also evaluated.
Materials and Methods: A total of 618 urine samples, which comprised of first ten consecutive samples that were received in the microbiology laboratory daily from patients with suspected urinary tract infection, were included in the study. All uncentrifuged urine specimens were subjected to wet mount, gram’s stain, and acridine orange stain microscopy and semi quantitative urine culture tests. Time taken and expenditure for each test per sample was calculated and compared.
Result: Sensitivity, specificity, PPV and NPV of all the screening tests were compared singly and in combination. Acridine orange and gram stain had the highest sensitivity while wet mount, wet mount+gram stain and wet mount+acridine orange stain showed similar sensitivities. Specificity was highest for wet mount+acridine orange followed by acridine orange, wet mount+gram stain, gram stain and wet mount. PPV was highest for wet mount+acridine orange followed by acridine orange, gram stain, wet mount+gram stain and wet mount. NPV was highest for acridine orange followed by wet mount+acridine orange, gram stain, wet mount+gram stain and wet mount. All the microscopic tests were significantly rapid and cost effective as compared to culture test.
Conclusion: Acridine orange stain is recommended as a single screening test as it is an accurate, rapid and inexpensive method to rule out UTI.
EnglishWet mount, Urine microscopy, Acridine orange stain, Urine cultureINTRODUCTION
The term urinary tract infection encompasses a variety of clinical entities, including asymptomatic bacteriuria (ASB), cystitis, prostatitis, and pyelonephritis. Both symptomatic UTI and ASB connote the presence of bacteria in the urinary tract, usually accompanied by white blood cells and inflammatory cytokines in the urine. However, ASB occurs in the absence of symptoms attributable to the bacteria in the urinary tract and does not usually require treatment, while UTI has more typically been assumed to imply symptomatic disease that warrants antimicrobial therapy. Symptomatic UTI can be complicated or uncomplicated. Uncomplicated UTI refers to acute cystitis or pyelonephritis in nonpregnant outpatient women without anatomic abnormalities or instrumentation of the urinary tract and complicated UTI encompasses all other types of UTI.1 UTIs are the second most frequently occurring infections in the general population after upper respiratory tract infections.2 UTIs are the leading cause of gram negative sepsis in hospitalized patients and are the origin for about half of all nosocomial infections caused by urinary catheters.3 UTI is associated with considerable cost in terms of morbidity and economic and research expenditure.4
The most frequent cause of uncomplicated community acquired UTIs is Escherichia coli (E. coli) followed by Klebsiella spp., other Enterobacteriaceae, Staphylococcus saprophyticus, and enterococci. In complicated UTIs, the relative frequency of infection caused by Proteus, Pseudomonas, Klebsiella, and Enterobacter spp, increases. Hospitalized patients are most likely to be infected by E.coli, Klebsiella spp., Proteus spp., staphylococci, other Enterobacteriaceae, Pseudomonas aeruginosa, enterococci, and Candida spp.3 Since the last two to three decades UTIs due to multidrug resistant uropathogens have caused a growing concern worldwide. 5
Evaluation of suspected UTI includes history, physical examination and laboratory investigations. Urine culture and urine analysis for presence of pus cells and bacteria are important in the adequate management of UTI.6 Gold standard for diagnosis of UTI is quantitative urine culture for specific bacteria. However, this procedure is costly, and takes at least 24 hours; whereas an ideal test should be cheap, quick and should require only limited technical skill.7 Several rapid screening tests are used commonly to make a presumptive diagnosis of UTI, like dipstick biochemical analysis of urine for nitrites or leukocyte esterase (LE), catalase test, glucose oxidase test, automated assays and microscopic examination of urine for white blood cells by wet mount or for bacteria by Gram’s stain.8
Rapid diagnostic tests can rule out negative samples, are economical, save valuable time and thus are useful in high-end laboratories. Screening is also required in special circumstances where it is difficult to identify UTI on the basis of clinical criteria alone but where early diagnosis and prevention of complications affords significant benefit (e.g. children, and post renal transplant patients).9 As one diagnostic test is not reliable for confirmation of UTI, so researchers consider a combination of tests as the best choice for clinical decision making.7
The advantages to urine microscopy are that leukocytes, leukocyte casts, and other cellular elements are observed directly.10 Gram’s stain has added advantage of guiding the antibiotic therapy by observing the morphology and staining properties of the organisms. However, clinician should consider local sensitivity patterns of the possible pathogen.11 Acridine orange staining has also been evaluated as a microscopic bacteriuria screen as it is more sensitive and rapid method than Gram’s staining. 12
In the present study, we evaluated the accuracy, cost and turnaround time of wet mount, gram stain and acridine orange stain microscopy of quantitative unspun urine for screening of urine samples keeping semiquantitive urine culture as the gold standard for diagnosis of UTI. We further compared combination of wet mount and Gram’s stain and wet mount and acridine orange stain with culture for the same parameters.
MATERIALS AND METHODS
This prospective study was carried out in a tertiary care hospital from December 2015 to March 2016. The first ten consecutive urine samples that were received in the microbiology laboratory daily from patients with suspected urinary tract infection were included in the study. These comprised clean catch mid-stream, catheterized and suprapubic urine samples received in sterile containers.
A total of 618 samples were included in the study. All patient details were recorded along with urine sample collection methods. The samples were processed within one hour. All uncentrifuged urine specimens were subjected to wet mount, Gram’s stain, and acridine orange stain microscopy and semi quantitative urine culture tests.
Direct microscopy or wet film preparation:
Fifty microlitre of well mixed uncentrifuged urine sample was placed on a clean, grease free, glass slide and covered with a 20 mm X 20 mm coverslip. The wet mount preparation was then examined under a high power magnification (40X) of a microscope for presence of pus cells. The presence of > 1 pus cell / 7 high power fields was considered significant pyuria.9
Gram’s staining:
Fifty microlitre of well mixed uncentrifuged urine was smeared on a slide, air dried, heat fixed and Gram stained. At least 20 fields of the smear were scanned using oil immersion objective (100X). Presence of ≥1 bacterial cell per oil immersion field, which corresponds to 100,000 organisms/ml of urine, was considered significant.12, 13
Acridine orange staining:
Hundred microlitre of well mixed uncentrifuged urine was smeared on a slide, air dried, fixed in 96% methanol for 2 minutes, flooded with acridine orange for 2 minutes, washed with distilled water, dried and examined under a fluorescent microscope. Presence of ≥ 1 morphologically similar orange coloured organism / 12 high power fields (40X) was considered significant. Presence of ≥ 2 morphologically different organisms indicated presence of mixed flora.12
Urine culture and antimicrobial susceptibility testing:
Urine culture was routinely put up in the laboratory and identification of the organisms was done as per the standard procedure.
Turnaround time and cost analysis
Time taken by each test for one sample was calculated and compared. The cost of chemical constituents, consumables and other overhead charges was calculated for each of the screening tests and for culture and then compared.
Statistical Analysis
Diagnostic data were analyzed using 2 × 2 contingency tables. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each of the methods separately and in combination.
RESULTS
During the study period, a total of 2880 urine samples were submitted to the bacteriology laboratory for urine culture among which only 1400 showed significant microbial growth. As first ten consecutive urine samples daily were included in the study, only 618 samples from same number of patients were tested by microscopy.
Among the 618 urine samples analyzed, 266 (43.04%) were from male patients and 352 (56.95%) from female patients. Out of 618 samples, 382 (61.81%) were midstream clean-catch samples, 210 (33.98%) were catheter samples and 26 (4.07%) were suprapubic aspirates. The samples from OPD (out patient department) were 230 (37.21%) and from wards were 388 (62.78%). Out of 618 patients, 317 were having significant medical history, commonest being Type 2 Diabetes mellitus (16.82%) followed by sepsis (9.70%), hypertension (7.28%), recurrent UTI (4.85%), acute pancreatitis (3.72%), chronic kidney disease (2.58%), pregnancy (1.29%) and others (5.05%). Out of 342 patients, who were on antibiotics at the time of collection, 102 were culture positive.
Out of 618 samples, 332 (53.7%) were sterile, 198 (32%) showed significant microbial growth on culture, 22 (3.6%) yielded mixed growth and 66 (10.7%) showed growth of no significance. The results of 88 samples which showed mixed growth and growth of no significance were excluded from the study. Among the cultures with significant microbial growth, 68.68% (136/198) were from females and 31.31 % (62/198) were from males. Escherichia coli (48.48%) was the commonest isolate, followed by Candida spp. (18.18%), Enterococcus spp. (16.16%), Klebsiella pneumonia (9.09%), Acinetobacter baumanni (2.02%), Pseudomonas spp. (2.02%), Citrobacter spp. (1.01%), methicillin-resistant Staphylococcus aureus (1.01%) and combination of two organisms was present in 3.03%.
Among 198 culture positive urine samples, wet mount (Fig. 1) was positive in 170 samples, Gram’s stain (Fig. 2) was positive in 192 samples, acridine orange stain (Fig. 3) in 192 samples, wet mount + gram’s stain combination was positive in 188 samples and wet mount + acridine orange stain in 188 samples.
Sensitivity, specificity, PPV and NPV of all the screening tests were compared singly and in combination (Table 1). Acridine orange and Gram’s stain had the highest sensitivity while wet mount, wet mount+Gram’s stain and wet mount+acridine orange stain showed similar sensitivities. Specificity was highest for wet mount+acridine orange followed by acridine orange, wet mount+Gram’s stain, Gram’s stain and wet mount. PPV was highest for wet mount+acridine orange followed by acridine orange, Gram’s stain, wet mount+Gram’s stain and wet mount. NPV was highest for acridine orange followed by wet mount+acridine orange, Gram’s stain, wet mount+Gram’s stain and wet mount.
Comparison of turnaround time
Time taken by each test for processing of one sample was calculated and compared (Table 2). All the microscopic tests were significantly rapid as compared to culture test.
Cost analysis
The cost benefit was estimated as the difference between cost of culture and the rapid tests (Table 3). Cost of wet mount microscopy, Gram’s staining and acridine orange staining singly or in combination was more or less comparable to each other but when compared to urine culture was 15-40 times less.
DISCUSSION
In our study of 618 urine samples, 43.04% were from males and 56.95% from females. Among the urine cultures with significant microbial growth, 68.68% were from females and 31.31 % from males. This is in concordance to the increased prevalence of UTI in women; the main reason being anatomical and physiological differences between the two sexes.7
Out of 618 urine samples, 61.81% were midstream clean-catch samples, 33.98% were catheter samples and 4.07% were suprapubic aspirates. The ward: OPD ratio of submitted samples was 1.68: 1. Out of 618 patients, 317 were having significant medical history. The reason for such sample diversity and association with significant diseases was that all the patients were from a tertiary care hospital and were selected randomly.
In our study, Escherichia coli was the commonest organism isolated (48.48%), followed by Candida spp. (18.18%), Enterococcus spp. (16.16%), Klebsiella pneumonia (9.09%), Acinetobacter baumanni (2.02%), Pseudomonas spp. (2.02%), Citrobacter spp. (1.01%), methicillin-resistant Staphylococcus aureus (1.01%). Arslan S et al., in his study showed the growth of organisms on urine culture as; 47% Escherichia coli, 18.5% Klebsiella pneumonia, 10% Proteus mirabilis, and 8.5% staphylococci.14 Shobha KL et al., showed the isolation of organisms from culture in the sequence of E.coli 38%, Klebsiella spp. 8%, Enterobacter spp. 3%, Candida spp. 4%, Enterococcus spp. 22%, Citrobacter spp.1%, Acinetobacter spp.1%.15 Ali M et al., showed that organisms isolated from culture were in the order of; E.coli (65%) followed by Proteus spp.(16.3%), Pseudomonas spp.(7.6%), Enterococcus spp.(6.8%) and Klebsiella spp.(4.3%). 16 The higher prevalence of Candida in our isolates could be because more than 50% patients (342 out of 618) were on antibiotics.
As more than half of the urine samples routinely received in the laboratory during the study period (1400 out of 2880) showed no significant growth on culture, this results in unnecessary expenditure and delay in patient care. This can be overcome by screening tests which rule out negative samples, are economical, save valuable time and labor and thus are useful in high-end laboratories.
In the present study, three easily available and rapid tests were evaluated singly and in combination for their efficacy as screening tests. Wet mount examination of uncentrifuged urine was used to detect pyuria as it has been reported that wet mount of well mixed uncentrifuged urine is more reliable than that of centrifuged urine. 12 Significant pyuria, in the absence of significant bacteriuria in a symptomatic patient (e.g. acute urethral syndrome) is an indication for treatment and hence the importance of wet film examination.12 In this study, we evaluated this test taking ≥ 1 WBC / 7hpf 9,12 as cut off and found sensitivity of 85.85%, specificity of 72.89%, PPV of 64.88% and NPV of 89.55%. Taneja N et al, reported sensitivity of 68.4 %, specificity of 60.8 %, PPV of 32.7% and NPV of 87.3 % for this test.9 A study by Mohamed Ali et al. showed that this test has the sensitivity of 95.7%, specificity of 99.2%, PPV of 99.1% and NPV of 96.2%.16 A study by Cemal P et al showed that wet mount is 92% sensitive, 26% specific with 52% PPV and 78% NPV.2 Certain other previous studies have shown this test to have sensitivity ranging between 25-95% and specificity of 41-97 % but the PPV as low as 33 %.12 As most of the studies reported PPV of this test as low, this test, when used singly, cannot be relied upon as a screening test.
In the present study, Gram’s staining of urine samples showed sensitivity of 96.96%, specificity of 91.56%, PPV of 87.27% and NPV of 96.96 %. These values were in concordance with most of the previous studies. A study by Satish SP et al., reported sensitivity of 89.1%, specificity of 86%, PPV of 85.4% and NPV of 89.6% with this test.11 A study by Matias L et al., found that this test had sensitivity of 92.7%, specificity of 88.7, PPV of 68.5% and NPV of 97.9%.17 In a study by Amalia UP et al., this test had sensitivity of 88%, specificity of 100%, PPV of 100% and NPV of 90%.18 Thus, urine Gram’s stain is very reliable for screening of urine samples. In addition, Gram’s stain can guide the empirical treatment of patients with UTI.
Acridine orange stain as a urinary screening test has not been evaluated as much as Gram’s stain. Various studies have reported sensitivity from 92 to 98% and specificity from 59 to 87%.12 In the present study, we found that this test had sensitivity same as that of Gram’s stain i.e. 96.96% but a better PPV (89.71%), specificity (93.37%) and NPV (98.10%). Our results were in concordance with a study by Taneja N et al. who reported this test with a sensitivity of 90% and NPV of 98.8% but he reported lower specificity of 76.6%.12 Hoff et al. reported that this test had NPV of 99%.19 Based on the results of above studies and ours, it is inferred that when counts of >104 cfu/ml are taken as significant on culture, this test will eliminate the need for cultures in majority of the specimens. Thus, this technique can be recommended as a routine negative screening test especially in large laboratories.
In this study, combination of two tests, wet mount and Gram’s staining was also evaluated and we found sensitivity was 85.85%, specificity 92.16%, PPV 86.73% and NPV 91.61%. A study by Taneja N et al. showed that these two tests in combination had the sensitivity of 80%, specificity of 78.4%, PPV of 25% and NPV of 97.7%.12 A study by Matias L et al. showed that the combination of these two tests increased the sensitivity to 87.4%, specificity to 94 %, PPV 81.7%, and NPV 96.6%.17 A study by Sukru A et al., revealed that these two tests in combination had the sensitivity was 42%, specificity 90%, PPV 90% and NPV 40%.14 This combination had no advantage over gram stain as a screening test as sensitivity and PPV both decreased.
We also evaluated the combination of wet mount and acridine orange stain which to the best of our knowledge has not been done previously. When compared to culture, combination of two tests had sensitivity, specificity, PPV and NPV of 85.85%, 94.57%, 90.42% and 97.51% respectively. This combination had no advantage over acridine orange alone as a screening test. Thus, this study proved acridine orange stain to be the best screening test for diagnosis of UTI followed by Gram’s stain. Hence, absence of bacteriuria has reliable diagnostic value for ruling out UTI but positive results need to be confirmed by culture.
Negative predictive value is the probability that subjects with a negative test truly don’t have the disease. Our study indicated that acridine orange stain had NPV of 98%; that is strong for a screening test, and brings up property of this test to rule out UTI. This is important for a tertiary health care where a large number (more than 50% in our study) of cultures ordered routinely are negative. This could be attributed to prior use of antibiotics. In our patient population, 342 patients were on antibiotics at the time of collection of sample and out of these only 102 were culture positive.
Time taken by each test for processing of one sample was calculated and compared (Table 2), and all the microscopic tests were found to be significantly rapid than the culture test. Out of the microscopic tests, wet mount microscopy was the most rapid (0.17 h) followed by acridine orange stain (0.25 h) and Gram’s stain (0.33 h). As urine culture takes a minimum of 24 h to show any significant growth, microscopic tests serve as quite good screening tests for UTIs because of their rapidity; particularly in laboratories where a large percentage of urine cultures prove to be negative.
The cost benefit was estimated as the difference in expenditure on rapid tests and the culture (Table 3). The average cost of the screening tests was INR 1 as against INR 20 for the urine culture, amounting to a cost saving of 97.5%. Thus, the financial benefits of screening cannot be overemphasized. This cost factor makes these screening tests a viable and attractive option in peripheral centers where facilities of culture are not available and also in hospitals where majority of urine cultures prove to be negative.
Conclusion
Acridine orange stain is recommended as a single screening test as it is an accurate, rapid and inexpensive method to rule out UTI. As the need of a fluorescent microscope is a limitation to this test, Gram’s stain can be used as an alternative in laboratories where fluorescent microscope is not available.
Acknowledgements
We would like to thank the personnel of the bacteriology laboratory of the Sher-i-Kashmir institute of medical sciences, Soura, Srinagar, Kashmir. 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.
Ethical Clearance
The study has received ethical approval from Institutional ethical committee.
Source of funding
None.
Conflict of interest
None.
Englishhttp://ijcrr.com/abstract.php?article_id=160http://ijcrr.com/article_html.php?did=160
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-524196EnglishN2017March31TechnologyEnhanced Energy Efficient Virtual Machine Placement Policy for Load Balancing in Cloud Environment
English5053Ankita MevadaEnglish Hiren PatelEnglish Nimisha PatelEnglishCloud computing is an emerging computing technology that uses the Internet and central remote services to maintain data and application which are provisioned on-demand and on pay-as-you-go basis. Wide adaptation of Cloud concepts has increased number of data centers worldwide resulting into significant amounts of power consumption by datacenters which affects environment and economical aspects. Through virtualization, multiple virtual machines (VM) can be deployed onto one physical machine (PM). These VMs hold and execute the Cloud workload. Efficient allocation of VMs on PM may lead to better resource utilization and result into saving in energy. In this research, we aim to provide enhanced energy efficient VM placement policy for load balancing in Cloud environment which places the VMs in such as way that hosts’ overload and underload situation is addressed and maintain Service Level Agreement (SLA) between the Cloud provider and the user. In addition, we propose power aware algorithm to reduce energy consumption and achieve better load balancing.
EnglishCloud computing, VM Placement, Energy consumptionINTRODUCTION
Cloud computing is based on Internet that provides shared computational resources and access data on demand [1]. Cloud computing provide storage, application and services, which are available to customer on acceptance basis between provider and user. User use cloud services on pay per use. Cloud computing has three types of services such as Infrastructure as a Service (IaaS), Platform as a Service (PaaS) and Software as a Service (SaaS). There are numerous advantage of Cloud’s deployment model such as QoS, reliability, ease of utilization, robustness etc [2].
Virtualization technology is a backbone for working of Cloud environment [3]. In virtualization, resources are requested by user in terms of virtual machine and then provisioned on different host based on the requirement of storage, memory, bandwidth etc. [4]. Virtualization helps to increase resource utilization and decrease energy consumption. Through virtualization multiple VM can be deployed onto one physical machine [5]. Virtualization uses file abstraction to provide mapping between virtual resources and physical resources. Virtualization and abstraction applied to disk storage [6]. VM placed in different hosts based on specific criteria, such as Service Level Agreement (SLA) between Cloud provider and users [7]. The placement goal can either be increase the usage of available resources or it can be saving of power by being able to suspend some servers [8]. Allocating virtual machine to physical is NP hard problem and this problem can be solved by first-fit or best-fit method [9].
In this paper, we propose VM placement algorithm for better load balancing and reduce power consumption using power aware placement algorithm. Load balancing is the optimization technique that should be improve the performance of the system by shifting of workload among the virtual resources. So, improve the performance and increase the availability of the physical machine and maintain SLA between Cloud provider and user.
The rest of the paper is organized as follows. Section 2 discusses about related work that has been carried out in the domain over recent years. Section 3 illustrates introduction of various existing scheduling techniques. Section 4 discusses about our proposal based on VM placement. in section 5 we conclude our work subsequently listing the references.
RELATED WORK
With increase usage of Cloud computing, the issue of energy consumed by Cloud datacenter has attracted attention of research community. Proper usage of available computing resources may assist in addressing the issue. In this section, we discuss various mechanisms which claim to reduce power consumption by various means such as efficient resource allocation, better VM placement, proper load balancing techniques etc. The virtual machine placement problem is being well advised as one of the most research issues in the direction of achieving energy efficiency in Cloud computing. There are two types of placement algorithm. First
one is power based approach in which energy conservation is reduced by shutting down some servers. Second one is application QoS based approach which is based on maximizing the resource utilization.
Fu at el[7] claim that which VMs should be migrated from high utilized host and migrated VM should be directly effect on the VM migration time and it raise energy consumption for the datacenter. Authors propose VM selection policy that prefers placing a migratable VM on a host that has the minimum host utilization. For host lower utilization indicates lower performance reduction for other VM on the host due to the migration.
Ranjana at el[8] define problem of mapping of VM to physical machine and problem is solved at two stages viz. Initial placement of VMs and dynamic VM placement. Resource aware energy efficient VM placement algorithm classify the physical machine into classes based on their physical configuration and check for the appropriate class of host for the VM to be placed and select a host with minimum resource usage.
Okada at el[11] identify VM placement problem as a bin packing problem[8] and it is solved by First Fit Decreasing and Best Fit Decreasing algorithms. Authors have used PABFD (power aware best fit decreasing) algorithm based on best fit decreasing algorithm. In PABFD algorithm, authors assume that initially each host is suspended hence, every host needs to wakeup first before allocating virtual resources on it and calculate power that host had the lowest increase in power consumption.
In the proposal given by Kaur at el[12], VM is placed one by one on physical machine and the PM is checked for host stability factor. VM check threshold violation when PM has required resources for VM and if PM is below lower threshold then VM is allocated that PM.
Zheng at el[13] claim that the recent VM placement approaches are not effective for live migrations with dynamic characters. In dynamic VM placement scheme map VM on PM dynamically by calculating probability of VM on PM. Using probability calculate normalized matrix and author decide which VM should be migrated on PM . Probability matrix is build by considering physical machine characteristics such as storage, virtualization, bandwidth.
OUR PROPOSAL
As mentioned earlier, due to the issue of heavily power consumption and CO2 emission in Cloud datacenters, in this research, we propose a modified version of power aware best
fit decreasing algorithm. The proposed approach enhances energy efficiency by minimizing number of active hosts.
In our algorithm, total number of hosts in a datacenter is bifurcated among two categories (a) Active hosts (b) Inactive hosts. Active hosts are the host which are currently being in use (host utilization is greater than zero) whereas inactive host are the host which are in sleep mode or switched off (host utilization is zero). For any VM to be placed on host, first the policy searches for suitable host from (with required resources) the list of active host having following criterion
(i) Does the host have enough resource to serve the incoming VM? (ii) Does the resultant utilization exceed the preset upper threshold value after placing the VM on the host and (iii)
for all found hosts, calculate the power consumption by the host after the VM placement, and select the host with least increase in power consumption. In case, the result of exploring
suitable host for a VM is empty, we go for an option of making one of the inactive hosts live and add it to the list of active hosts. Above process is repeated till all the requests in
terms of VMs are served on active hosts are full and there is not a single inactive host left, which can be turned off. Followingalgorithm illustrates the process mentioned above.
Algorithm: Modified Power Aware Best Fit Decreasing algorithm for VM placement
Input:ActiveHost List,
1. InactiveHostList, vmList
2. Output: VMPlacementMap
3. sort all vm in decreasing utilization
4. for each vm in vmList do
5. minPower Englishhttp://ijcrr.com/abstract.php?article_id=161http://ijcrr.com/article_html.php?did=1611. P. Mell and T. Grance, “The NIST Definition of Cloud Computing,” National Institute of Standard and Technology, Information Technology Laboratory 800-145, September 2011
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7. Xiong FU and Chen ZHOU, ” Virtual machine selection and placement for dynamic consolidation in Cloud computing environment” 2015-Springer
8. R. Ranjana, S. Radha , J. Raja, ” Performance study of resource aware energy efficient VM Placement Algorithm ” 2016-IEEE
9. A. Beloglazov and R. Buyya, “Optimal online deterministic algorithms and adaptive heuristics for energy and performance efficient dynamic consolidation of virtual machines in Cloud data centres,” Concurrency and Computation: Practice and Experience, vol. 24, no. 13, pp. 1397–1420, 2012.
10. R. Panigrahy, K. Talwar, L. Uyeda, and U. Wieder, “Heuristics for Vector Bin Packing” Technical report, Microsoft Research, 2011
11. Thiago Kenji Okada, Albert De La Fuente Vigliotti, Daniel Macˆedo Batista, Alfredo Goldman vel Lejbman, ”Consolidation of VMs to improve energy efficiency in Cloud computing
environments”2015-IEEE
12. Amandeep Kaur and Mala Karla, “Energy Optimized VM Placement in Cloud Environment ” 2016-IEEE
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14. R. N. Calheiros, R. Ranjan, A. Beloglazov, C. A. F. D. Rose, and R. Buyya, “CloudSim: A toolkit for modeling and simulation of Cloud computing environments and evaluation of resource provisioning algorithms,” Software: Practice and Experience, vol. 41, no. 1, pp. 23–50, 2011.
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