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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareSYNTHESIS AND EVALUATION OF ANTIOXIDANT ACTIVITY (IN-VITRO) OF SOME N-PHTHALYL-[{(3-NITRO ANILINO)-4" ARYL SUBSTITUTED}]-1, 3, 4 THIADIAZOLES
English0106Pramilla SahEnglish Kuldeep SenEnglish1, 3, 4- thiadiazoles are potential bioactive agents having the toxophoric N=C–S linkage. There are several isomers of thiadiazole, i.e.1,2,3-thiadiazole, 1,2,4-thiadiazole, 1,2,5-thiadiazole, and 1,3,4-thiadiazole. However 1, 3, 4-Thiadiazole is the main isomer of the thiadiazole series which has versatile pharmacological activities. Hence in this study we have synthesized some new substituted 1, 3, 4 thiadiazoles i.e. N-phthalyl-[{(3-nitro anilino)-4’’ aryl Substituted}]-1, 3, 4 thiadiazoles. The title compounds were prepared from N-phthayl-3-nitro anilino thiosemicarbazide by treating N-phthayl-3-nitro aniline with carbon disulphide,
ammonium hydroxide and hydrazine hydrate. The synthesized compounds were then evaluated for their in- vitro antioxidant activity by determining the reducing power and hydrogen peroxide scavenging potential. The results show that one derivative V2 (N-Phthalyl-[{(3’-nitro anilino)-5-(4’’-chloro phenyl)}]-1, 3, 4-thiadiazole) had the best redusing ability while V4 (N-Phthalyl-[{(3’- nitro anilino)-5- (4’’-bromo phenyl)}]-1, 3, 4-thiadiazole) was the strongest oxidant. The chemical structures of the synthesized compounds have been characterized by IR, 1HNMR and mass spectra.
EnglishN-phthalyl, 1, 3, 4-thiadiazoles, Antioxidant activityINTRODUCTION
There is a vast variety of heterocyclic compounds which have medicinal importance. Recently, much attention has been focused on thiadiazole derivatives in view of their broad spectrum of activities as thiadiazoles have much importance in medicine, agriculture and technology. A large number of 1, 3, 4-thiadiazoles have been patented in the agricultural field as herbicides and bactericides. The N−C=S linkage is an essential structural feature which is responsible for organic sulphur containing pesticides such as dithiocarbamates, thioureas and thiosemicarbazides. Literature survey has shown this nucleus to exhibit diverse activities i.e. antimicrobial1-4, antifungal5 , anti-inflammatory 6-8, antileishmanial activity9 , anticancer activity, 10-11 anti-HIV activity12, antioxidant/radioprotective activity-13-14, anti-Helicobacter pylori activity15etc. Hence some new 1, 3, 4,-thiadiazole derivatives have been synthesized having this lead pharmacophore to investigate their antioxidant activity.
MATERIALS AND METHODS
Melting point of the synthesized compounds was taken in a ‘Neolab’ electrical apparatus. All the synthesized compounds were characterized by analytical and spectral techniques of IR, NMR and Mass spectroscopy (Table1-2). FTIR was carried out on Varian and Brucker models, 1H’NMR on Brucker 400 with DMSO as the solvent while Mass was recorded on JEOL-SX-102/DA6000 mass spectrophotometer instrument using Xenon (6KV,10MA) as the FAB gas. U.V. visible (U.V.-2601) of Rayleigh was used to evaluate the antioxidant activity (in- vitro).
Procedure
Synthesis of N - phthalyl-3-nitro aniline (III) Equimolar amount of phthalimide and 4-chloro-2-nitro aniline, in presence of (0.002 mol) of anhydrous potassium carbonate were refluxed in dry acetone (10mL) for 5-6 hrs. on a water bath. The residual potassium carbonate was filtered off. Filterate was concentrated, cooled and solid thus obtained was filtered, dried and recrystallized from ethanol. Synthesis of N-phthalyl-(3-nitro anilino)-thiosemicarbazide (IV) 16 0.02 mole of N-phthayl-3-nitro aniline was taken in a round bottom flask and 30mL absolute ethanol was added to it. In a separate beaker 0.02 mole of carbon disulphide was added to 20 mL ammonium hydroxide. This mixture was added slowly drop wise to the ethanolic solution with constant magnetic stirring for over half an hour. A clear solution was obtained. This was kept at room temperature for 1hr. Then 15mL hydrazine hydrate (10%) was added to the above reaction mixture again with constant stirring. A brown colored solution obtained was concentrated to half of its original volume and left overnight in a refrigerator. The solution was acidified using concentrated HCl and white precipitate obtained was washed with cold water filtered, dried and recrystallized with absolute ethanol.
Synthesis of N-phthalyl-[{(3’-nitro anilino)-5-aryl}]-1, 3, 4 thiadiazole (V1)
Equimolar ratio of N-phthayl-(3-nitro anilino) thiasemicarbazide intermediate synthesized in the previous step and benzoic acid was taken in a round bottom flask. The contents were then heated on a sand bath for approx. 4hr. without any solvent under moisture free condition. The fused material was then treated with 10% cold solution of NaHCO3 . A solid mass separated out was dried, recystallized from absolute ethanol after filtration. Other compounds (V2 -V6 ) were synthesized following the same procedure with different aryl substituted aromatic carboxylic acids namely p-chloro, p-hydroxy, p-bromo, ochloro and o-nitro respectively.
Antioxidant activity: Reducing power by FeCl3 17 Preparation of standard solution: 10mg of ascorbic acid was dissolved in 10 ml of water. Dilution of this solution was done with distilled water to give concentrations of 50 µg/mL, 100 µg/mL, 150 µg/mL, 200 µg/mL and 250 µg/mL respectively.
Phosphate buffer: 0.2M phosphate buffer of pH 6.6 was prepared according to IP. Preparation of test samples: Required quantities of the test sample were dissolved in minimum quantity of methanol and volume was made up to 10ml with phosphate buffer.
Procedure: 2.0mL of each sample and standard solution were mixed with 2.5mL of 1% potassium ferricyanide solution. The mixture was incubated at 50o C for 20 min. and after cooling aliquots of trichloroacetic acid 2.5mL were added to the mixture and the solution was left for 10 min. Then 2.5 ml of each sample was mixed with 2.5mL of distilled water, 2.5mL of freshly prepared ferric chloride solution. After 10min, absorbance was measured at 700 nm. A blank was prepared without adding the sample. Ascorbic acid at various concentrations was used as the standard. A test −A blank % Increase in Reducing Power = × 100 A blank Where; A test = Absorbance of test solution A blank = Absorbance of blank Standard = Ascorbic acid. The antioxidant activity of the sample compounds was compared with the standard i.e. ascorbic acid. Each experiment was carried out in triplicate.
Hydrogen Peroxide-scavenging activity18 0.1M Phosphate buffer (pH 7.4): 0.1M phosphate buffer of pH 7.4 was prepared according to IP. 40 mM solution of hydrogen peroxide: 4.535 mL of given 30%(w/v)H2 O2 was dissolved in 1000mL of distilled water to give 0.04M or 40mM solution of H2 O2 .
Preparation of test samples: Required sample 10mg was dissolved in minimum quantity of methanol and volume was made up to 10ml with phosphate buffer. Separately all the samples were diluted in 10mL volumetric flask with phosphate buffer and 1mL was made up to 10mL to give a concentration of 100µg /mL
Procedure: The hydrogen peroxide-scavenging activity of synthesis compound was determined by the method of Ruch et al.18 The compounds were dissolved in 3.4 mL of 0.1M phosphate buffer (pH 7.4) and mixed with 600 µL of 40 mM solution of hydrogen peroxide. The absorbance value at 230 nm of the reaction mixture was recorded at 10 min intervals between zero and 30 min. for each concentration. Separate blank sample was used for back ground substraction. The percentage of hydrogen peroxide scavenging activity was determined as follows: A blank − A test %Scavenging H2 O2 = ×100 A blank
RESULTS
Table 3 and 4 depict the reducing power of derivatives V1 -V6 by FeCl3 with ascorbic acid as the standard. Table 6 shows the oxidizing potential using H2 O2 while table 5 gives the IC50 values of the derivatives with respect to ascorbic acid.
DISCUSSION
Reducing power by FeCl3
At 250µg/mL, V1 has 44.2% increases in the reducing activity while V5 has 43.5%. The IC50 data also shows this similarity as values approx. 293 is obtained for V1 and 291 for V5 . However derivative V2 has 61.8% (Table 4) reducing ability at a concentration of 250µg/mL and is the most active among this series. Ascorbic acid also shows 60% reducing power though at a lower concentration of 100µg/mL(Table 3). Hence large dose of V2 will be required to produce the same effect. An IC50 value is also least in this compound. (Table 5) Derivatives V 1 and V5 also show similar behavior with 33.5% at 200µg/mL(V1 ) and 32%(V5 ) at the same concentration. Hence the above observations show V2 has the best reducing ability while derivative V4 is the least reductant. Structure activity relationship shows all these derivatives have an NH group linked to the phthalyl and thiadiazole ring which might be one factor for the reducing capability of these compounds.
Oxidizing Power
Maximum hydrogen peroxide scavenging activity is observed in V4 (89.4%) at 0 min. and 85.7% at 10min. comparable to ascorbic acid 91% (0min) and 87% after 10min. This is in agreement to the reducing power which is the least. Among V5 and V6 initially V5 has better activity 83% at 0 min. but with time the value falls to 23.6%. However in derivative V5 the oxidizing power shows a gradual decline from 74.7% to 51.4% in a span of 0 to 30 min. thus being better oxidant. Similar pattern is visible in derivative V3 with values between77.1% to 48.2% are obtained in the same time period. It can hence be concluded that V4 is the must active compound while V2 is the least. The behavior of V2 as the weakest oxidant matches with its reducing power ability which is the highest. (Table 6) Presence of substituents like nitro and hydroxyl group attached to the phthalyl substituted thiadiazole ring might be responsible for the oxidizing potential of these compounds.
CONCLUSION
Out of the six derivatives tested for in-vitro antioxidant activity maximum reducing power has been observed in compound V2 , while V4 has shown the highest oxidizing ponential. This is in agreement to the result observed as V2 has the least oxidizing power while V4 is the least reductant.
ACKNOWLEDGMENT
The authors are thankful to Head Department of Chemistry J.N.V. University, Jodhpur, for provided all the laboratory facilities. Thanks are also to the Director of (S.A.I.F.), Punjab University Chandigarh, for the spectral analysis.
Englishhttp://ijcrr.com/abstract.php?article_id=665http://ijcrr.com/article_html.php?did=6651. Mohan J, Rathee A. synthesis and antimicrobial activity of s-triazolo[3,4-b][1,3,4]thiadiazoles, s-triazolo[3,4-b] [1,3,4] thiadiazines and s-triazolo. Ind J Hetero Chem 2011; 21: 117-120.
2. Demirbas A, Sahin D, Demirbas N, and Karaoglu SA. Synthesis of some new 1,3,4-thiadiazol-2-ylmethyl-1,2,4-triazole derivatives and investigation of their antimicrobial activities. Euro J Med Chem 2009; 44(7): 2896–2903.
3. Hussain S, Sharma J, Amir, M. Synthesis and antimicrobial activities of 1,2,4-triazole and 1,3,4-thiadiazole derivatives of 5-amino-2-hydroxybenzoic acid. E-J. Chem 2008; 5(4):963–968.
4. Lamani RS, Shetty NS, Kambl RR, Khazi AM. Synthesis and antimicrobial studies of novel methylene bridged benzisoxazolyl imidazo[2,1-b][1,3,4]thiadiazole derivatives. Euro J Med Chem 2008; 44:2828–2833.
5. Chen CJ, Song BA, Yang S. et al., Synthesis and antifungal activities of 5-(3,4,5-trimethoxyphenyl)-2-sulfonyl-1,3,4- thiadiazole and 5-(3,4,5-trimethoxyphenyl)-2-sulfonyl1,3,4-oxadiazole derivatives. Bioorg Med Chem 2007;15: 3981–3989.
6. Jyothi C, Das AK, Pal P, Baidya M. synthesis and anti-inflammatory activities of some new substituted thiadiazolothieno- pyrimidinones. Indian J Hetero Chem 2007; 17: 191-192.
7. Karegoudar P, Prasad DJ, Ashok M, Mahalinga Poojary MB, Holla BS. Synthesis, antimicrobial and anti-inflammatory activities of some 1,2,4-triazolo[3,4-b][1,3,4] thiadiazoles and 1,2,4-triazolo[3,4-b][1,3,4]thiadiazines bearing trichlorophenyl moiety. Euro J Med Chem 2008; 43(4):808–815.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareA Study of attitude towards sex education of college going students in relation to their home environment
English0720Parveen KumarEnglish Archana MittalEnglishStudents are the future of a nation. The progress of any nation depends on the physical and mental well-being of the students. Positive attitude towards sex education may prevent the students from many diseases.
Objectives: 1) To study and compare the attitude towards sex education of college going students, 2) To compare the attitude of college going students towards sex education in relation to their home environment.
Methods: Normative survey method has been used in this study. 300 college going students were selected as sample through stratified random sampling technique from the rural and urban area of district Haridwar. Attitude Scale towards Sex Education developed by Dr, (Smt.) Usha Mishra and Home Environment Inventory developed by Dr. K.S. Misra were used to collect the data. The collected data was analyzed using Mean, S.D. and ‘t’ test.
Results and Conclusions: College going students have high attitude towards sex education. Urban female students have shown very high positive attitude towards sex education. Area has affected the attitude of college going students towards sex education as the urban students have been found to have more favorable attitude towards sex education. Sex had not affected the attitude of rural students towards sex education. Home environment and its dimensions have affected the attitude of students towards sex education. The study recommended provisions to formulate effective policies in favor of sex education in schools. It
provides complete and healthy information for necessary life skills to deal with the problems of future life.
EnglishAttitude, Sex education, Students, Home environmentINTRODUCTION
It is remarked that the destiny of any country shapes in its class rooms. But it is possible only, if the students studying in the class rooms are physically and mentally strong. Education should be imparted for both physical and mental well-being. In the present scenario, the Indian students are adapting western life style which is a blend of healthy and unhealthy entertainment and pleasure. They have easy access to modern technologies by which they are not only getting valuable knowledge but also they are under the dark influence of incomplete knowledge of intimate relationships. Due to this, they are inviting lots of physical, mental as well as sexual diseases like HIV/AIDS and STDs. These diseases are increasing day by day due to the lack of proper knowledge, awareness and modes of prevention. To protect our children, society, nation and humanity at large from this horrible situation, there is a dying need of sex education in India. Sex is a taboo in India and sex education is a big taboo to be talked about. Children are not allowed to have access to sexual health information because the society has the perception that such exposure will corrupt the child[1]. But Frimpong (2010) views that sex education is a systematic attempt to promote the healthy awareness in the individual on the matters of his or her sexual development, functioning, behavior and attitude through direct teaching [2].In the view of SIECUS (2004), “Sex education is a lifelong process of building a strong foundation for sexual health through acquiring information and forming attitudes, beliefs and values about identity, relationship and intimacy”[3]. Sex education focuses on all the aspects of life. The need and importance of sex education has been documented by many researchers. Toor, K.K. (2012) observed that in the absence of effective sex education, the immature adolescents make major decisions without ad equate knowledge. Sex education is required for children to provide them positive direction, right information which would avoid unnecessary worries and tensions [4]. Sex education will provide scientific knowledge and healthy attitude towards the issues related to sexuality. Majova, C.N. (2002) found that secondary school learners were favorably disposed towards Sex education [5]. Mahajan and Sharma (2005) observed that mothers were reluctant to talk about sex education to their daughters [6]. Ogunjimi, L.O. (2006) in his study found that majority of the students and parents were in support of the inclusion of sex education [7]. Sieswerda, L.E. and Blekkcenborst, P. (2006) found that parents believed that they should take lead role in teaching sexual health [8]. Students feel that sex education should be introduced in the senior high school curriculum and it is important for young people [9][10]. Parents and teachers have been found to have favorable attitude towards the importance of school sex education [11][12][13]. It can be concluded from the above discussion that sex education is the need of hour especially in India. Newspapers, Periodicals, journals and magazines often carry queries of the people regarding their sexual life and problems. To get rid of these problems the one and the only answer is that teaching of sex education should be institutionalized in schools and colleges only then their quires and problems will be solved honestly and scientifically. But there is a conflicting situation among parents, teachers and students regarding the inclusion of sex education. Many times people raise their arguments in the favor as well as in the opposition of the sex education. So it becomes mandatory that parents, teachers and students should have positive attitude towards sex education and they should be prepared to accept the sex education as a subject. Attitude of students towards sex education is influenced by their socio-cultural background, belief system, political system, religion and many other factors. But home environment is such a factor which affects the attitude of students towards sex education intensely. Considering all these factors, it was attempted to study the present status of attitude of college going students in relation to their home environment.
Statement of the Problem
“A study of attitude towards sex education of college going students in relation to their home environment”
Operational Definition of the Terms
Attitude towards Sex Education: Sex education is a broad term treated as a usual topic for health education. Attitude towards sex education means the views of the people regarding the introduction of sex education in the school curriculum. In the present study, attitude towards sex education means the scores obtained by the college going students on Attitude Scale towards Sex Education.
College going Students: In the present study college going students mean those students who have passed Intermediate and are studying in undergraduate courses. \
Home Environment: Home environment means the psycho-social climate of the home. In the present study home environment refers to those ten dimensions which are given by Dr. K.S. Misra in his Home Environment Inventory [14], which are as follows:
• Control: It indicates the autocratic atmosphere in which many restrictions are imposed by the parents.
• Protectiveness: It implies prevention of independent behavior and prolongation of infantile care.
• Punishment: It includes physical as well as affective punishment to avoid the undesirable behavior.
• Conformity: It refers to demands to work according to parents’ desires and expectations.
• Social Isolation: It indicates the isolation from beloved persons except family members for negative sanctions.
• Reward: It includes material as well as symbolic rewards to increase the probability of desirable behavior.
• Deprivation of Privileges: It implies controlling children’s behavior by depriving them or their rights to seek love, respect and child care from parents.
• Nurturance: It means existence of excessive unconditional physical and emotional attachment of parents with their child.
• Rejection: It implies that child has no right as a person and has no right to express his feelings.
• Permissiveness: It indicates provisions of opportunities to child to express his views freely and act according to his desires. In this way, the home environment means the sum of the above ten dimensions. In the present study, home environment means the scores obtained by college going students on Home Environment Inventory.
Aim
The broad aim of the study is to know the attitude towards sex education among college going students and to investigate the impact of home environment on their attitude towards sex education.
Objectives of the Study
Following objectives were framed to achieve the purpose of the study:
1. To study the attitude towards sex education of college going students.
2. To compare the attitude of college going students towards sex education. 3. To compare the attitude of college going rural students towards sex education in relation to their home environment.
4. To compare the attitude of college going urban students towards sex education in relation to their home environment
. 5. To compare the attitude of college going male students towards sex education in relation to their home environment.
6. To compare the attitude of college going female students towards sex education in relation to their home environment.
Hypotheses of the Study
Following hypotheses have been formulated in order to achieve the objectives of the study:
1. There is no significant difference in the attitude of college going students towards sex education.
2. There is no significant difference in the attitude of college going rural students towards sex education in relation to their home environment.
3. There is no significant difference in the attitude of college going urban students towards sex education in relation to their home environment.
4. There is no significant difference in the attitude of college going male students towards sex education in relation to their home environment.
5. There is no significant difference in the attitude of college going female students towards sex education in relation to their home environment.
Delimitations of the Study
The present study has been delimited as follows:
1. The study is delimited to the district Haridwar (Uttarakhand).
2. The study has included college going students only.
3. The present study is delimited to the students of science group only. The students of non-science background have not been included in this study.
4. The study included both male and female students.
5. The present study has involved rural as well as urban area of district Haridwar.
MATERIAL AND METHODS
Method Used Selection of the research method depends on the objectives and nature of the research problem. According to the nature of the present problem, the investigators have employed ‘Normative Survey’ method of research which is concerned with the situations and conditions of the present time. The present study deals with the attitude of college going students towards sex education in relation to their home environment along with their sex and area. Hence the present study is based on Normative Survey Method.
Population of the Study All the college going male and female students residing in the rural and urban area of district Haridwar, (Uttarakhand) is taken as the population of the present study. The college going students of science background only were the target population in the present study.
Sample and Sampling Procedure A representative sample of 300 college going students was selected by stratified random sampling technique. For the purpose of the study, all the college going students were divided into two strata: students of science background and students of non-science background. Only the students of science background were employed in the present study. The sample had equal numbers of male and female students from rural and urban area of district Haridwar. The sampling framework is present below:
In this way, a sample of 300 college going students was selected randomly.
Variables
The present study involves two kinds of variables, which are stated as under:
• Dependent Variable:In the present study, the dependent variable is attitude of college going students towards sex education which is measured by ‘Attitude Scale towards Sex Education’ [15] developed by Dr. (Smt.) Usha Mishra.
• Independent Variable: Home environment (control, protectiveness, punishment, conformity, social isolation, reward, deprivation of privileges, nurturance, rejection and permissiveness) is the independent variable in the study. It has been measured by Home Environment Inventory[16] developed by Dr. Karuna Shankar Misra.
Statistical Analysis
Mean, S.D. and t-test were used for the statistical analysis.
RESULTS
The above table shows that rural male and female college going students as well as urban male students have shown high attitude towards sex education while urban female students have exhibited very high attitude towards sex education. Rural female students have more favorable attitude towards sex education as compared to rural male students. In the case of urban students, similar results have been obtained as urban female students have higher attitude towards sex education in comparison to urban male students. Urban students have shown more favorable attitude towards sex education than rural students. Mean values show that rural male students have shown least attitude towards sex education. On the other hand, urban female students have exhibited the highest attitude towards sex education.
The above table shows the comparison of the attitude of college going students towards sex education. The first, third and fifth‘t’ values for the attitude of college going students towards sex education are 4.02 (df=298), 6.11 (df=148) and 5.59 (df=148) respectively, which are found significant at 0.01 level of significance. It means that there is a highly significant difference between college going rural and urban students, urban male and urban female students as well as rural female and urban female students on their attitude towards sex education. Mean values indicate that college going urban students and urban female students have more favorable attitude towards sex education than college going rural students and urban male students. Means values regarding the female students of rural and urban area indicate that urban female students have higher attitude towards sex education as compared to their rural counterparts. On the other hand, at df=148 the second and fourth ‘t’ values for the attitude towards sex education are 1.26 and 1.03 respectively, which are found insignificant. It means that rural male and rural female students as well as male students of rural and urban area do not differ significantly in their attitude towards sex education.
The above table presents the comparison of attitude of college going rural students towards sex education in relation to their home environment. At df 148, the t-values to compare the attitude of college going rural students towards sex education having low and high level of control (t=2.91), rejection (t=2.59) and nurturance (t=2.18) have been found significant at 0.01 and 0.05 level of significance respectively. It indicates that there is a statistical significant difference in the attitude of college going rural students towards sex education having low and high control, rejection and nurturance. Mean values clearly show that rural students who have high control, rejection and nurturance have shown more favorable attitude towards sex education as compared to those students who have low control, rejection and nurturance. On the other hand, the t-values for the comparison of attitude of rural students towards sex education having low and high protectiveness (t=0.586), punishment (t=1.04), conformity (t=0.351), social isolation (t=0.016), reward (t=0.253), deprivation of privileges (t=1.55), permissiveness (t=0.349) as well as total home environment (t=1.54) have been found insignificant. It suggests that rural students having low and high protectiveness, punishment, conformity, social isolation, reward, deprivation of privileges, permissiveness as well as total home environment do not differ significantly in their attitude towards sex education.
he above table shows the comparison of attitude of college going rural male students towards sex education in relation to their home environment. At df 73, the t-values for the comparison of the attitude of college going rural male students towards sex education having low and high level of control (t=3.67), nurturance (t=3.21) and rejection (t=2.76) have been found significant at 0.01 level of significance. It indicates that there is a highly statistical significant difference in the attitude of college going rural male students towards sex education having low and high control, nurturance and rejection. Mean values indicate that rural male students having high control, nurturance and rejection have shown more positive attitude towards sex education in comparison to those male students who have low control, nurturance and rejection. On the other hand, the t-values to compare the attitude of rural male students towards sex education having low and high protectiveness (t=0.22), punishment (t=1.43), conformity (t=1.01), social isolation (t=1.49), reward (t=1.08), deprivation of privileges (t=1.87), permissiveness (t=0.738) as well as total home environment (t=1.90) have been found insignificant. It reveals that rural male students having low and high protectiveness, punishment, conformity, social isolation, reward, deprivation of privileges, permissiveness as well as total home environment do not differ significantly in their attitude towards sex education.
The above table shows the comparison of attitude of college going rural female students towards sex education in relation to their home environment. At df 73, the tvalues for the comparison of the attitude of college going rural female students towards sex education having low and high level of conformity (t=2.09) and social isolation (t=2.22) have been found significant at 0.05 level of significance. It indicates that college going rural female students having low and high conformity and social isolation differ statistically and significantly in their attitude towards sex education. Mean values indicate that rural female students having low conformity and social isolation have shown more positive attitude towards sex education in comparison to those female students who have high conformity and social isolation. But the t-values to compare the attitude of rural female students towards sex education having low and high control (t=0.336), protectiveness (t=0.346), punishment (t=0.978), reward (t=1.58), deprivation of privileges (t=0.518), nurturance (t=0.835), rejection (t=0.366), permissiveness (t=1.06) as well as total home environment (t=0.670) have not been found significant. It reveals that rural female students having low and high control, protectiveness, punishment, reward, deprivation of privileges, nurturance, rejection, permissiveness as well as total home environment do not differ significantly in their attitude towards sex education.
The above table shows the comparison of attitude of college going urban students towards sex education in relation to their home environment. At df 148, the t-values for the comparison of the attitude of college going urban students towards sex education having low and high level of conformity (t=2.68), permissiveness (t=3.11) and social isolation (t=1.96) have been found significant at 0.01 and 0.05 level of significance respectively. It indicates that college going urban students having low and high conformity; permissiveness and social isolation differ statistically and significantly in their attitude towards sex education. Mean values indicate that urban students having low conformity and social isolation and high permissiveness have shown more favorable attitude towards sex education in comparison to those students who have high conformity, social isolation and low permissiveness. But on the other hand the t-values to compare the attitude of urban students towards sex education having low and high control (t=0.302), protectiveness (t=0.324), punishment (t=1.37), reward (t=1.01), deprivation of privileges (t=1.42), nurturance (t=0.083), rejection (t=0.915) as well as total home environment (t=0.083) have not been found significant. It exhibits that urban students having low and high control, protectiveness, punishment, reward, deprivation of privileges, nurturance, rejection as well as total home environment do not differ significantly in their attitude towards sex education.
The above table shows the comparison of attitude of college going urban male students towards sex education in relation to their home environment. At df 73, the t-values for the comparison of the attitude of college going urban male students towards sex education having low and high level of control (t=2.76), conformity (t=3.33), social isolation (t=2.94), deprivation of privileges (t=3.39), nurturance (t=3.40), rejection (t=3.71) have been found significant at 0.01 level of significance. But, the t-values for the comparison of the attitude of urban male students towards sex education having low and high level of protectiveness (t=2.38), reward (t=2.19) and total home environment (t=2.50) have been found significant at 0.05 level of significance. It indicates that college going urban male students having low and high control, protectiveness, conformity, social isolation, reward, deprivation of privileges; nurturance, rejection and total home environment differ statistically and significantly in their attitude towards sex education. Mean values indicate that urban male students having low control, protectiveness, conformity, social isolation, reward, deprivation of privileges; nurturance, rejection and total home environment have shown more favorable attitude towards sex education. On the other hand, the t-values to compare the attitude of urban male students towards sex education having low and high punishment (t=1.68) and permissiveness (t=0.802) have been found insignificant. It means that urban male students having low and high punishment and permissiveness do not differ significantly in their attitude towards sex education.
The above table shows the comparison of attitude of college going urban female students towards sex education in relation to their home environment. At df 73, the tvalues for the comparison of the attitude of college going urban female students towards sex education having low and high level of control (t=3.23), punishment (t=4.68), reward (t=3.62), nurturance (t=4.61), permissiveness (t=4.70) and total home environment (t=3.23) have been found significant at 0.01 level of significance. But, the t-value for the comparison of the attitude of urban female students towards sex education having low and high level of rejection (t=2.14) has been found significant at 0.05 level of significance. It indicates that there is a significant difference in the attitude of college going urban female students towards sex education having low and high control, punishment, reward, nurturance, permissiveness, rejection and total home environment. Mean values indicate that urban female students having high control, reward, nurturance, rejection and total home environment have shown more favorable attitude towards sex education. On the other hand, the t-value to compare the attitude of urban female students towards sex education having low and high protectiveness (t=1.13), conformity (t=0.297), social isolation (t=0.858) and deprivation of privilege (t=1.35) have been found insignificant. It means that urban female students having low and high protectiveness, conformity, social isolation and deprivation of privilege do not differ significantly in their attitude towards sex education.
The above table shows the comparison of attitude of college going male students towards sex education in relation to their home environment. At df 148, the t-values for the comparison of the attitude of college going male students towards sex education having low and high level of control (t=0.994), protectiveness (t=0.675), punishment (t=0.470), conformity (t=0.332), social isolation (t=0.592), reward (t=0.163), deprivation of privileges (t=0.405), nurturance (t=1.32), rejection (t=0.423), permissiveness (t=1.43) and total home environment (t=1.10) have been found insignificant. It indicates that there is an insignificant difference in the attitude of college going male students towards sex education having low and high control, protectiveness, punishment, conformity, social isolation, reward, deprivation of privileges, nurturance, rejection, permissiveness and total home environment.
The above table shows the comparison of attitude of college going female students towards sex education in relation to their home environment. At df 148, the t-values for the comparison of the attitude of college going female students towards sex education having low and high level of control (t=1.98) and permissiveness (t=2.40) have been found significant at 0.05 level of significance. It reveals a significant difference in the attitude of college going female students towards sex education having low and high control and permissiveness. Mean values indicate that female students having high control and permissiveness have shown more positive attitude towards sex education. On the other hand, the t-values for the comparison of the attitude of female students towards sex education having low and high level of protectiveness (t=0.425), punishment (t=1.32), conformity (t=1.39), social isolation (t=1.73), reward (t=1.99), deprivation of privileges (t=0.771), nurturance (t=1.74), rejection (t=1.57) and total home environment (t=1.84) have been found insignificant. It indicates that there is no significant difference in the attitude of female students towards sex education having low and high protectiveness, punishment, conformity, social isolation, reward, deprivation of privileges, nurturance, rejection and total home environment.
Discussion
Inclusion of sex education has always been issue of controversy and same has been found in the present study. Rural and urban students have shown different views about sex education. Rural students’ attitude towards sex education has been found comparatively low. Some of the rural students are of the view that sex education invites sexual crime and it has nothing to do with family planning. They also think that there is no need of sex education because it will reduce the interest of the students in the studies. Rural students assert that imparting sex education is against the Indian culture. On the other hand, urban students, specifically female students, have shown positive attitude towards sex education. It was felt that urban students are open minded and have scientific attitude that’s why they have shown more favorable attitude towards the inclusion of sex education. They think that giving sex education means giving scientific knowledge to the students from the prevention of the fatal diseases. Urban students feel that sex education may help them to solve the sex related problems. Female students assert that sex education can save them from sexual assault and can be helpful to eradicate the social evils and crime. They feel that it may be helpful to make good citizens and is appropriate for the needs of the present times.
Conclusions
On the basis of the interpretation of the data, following conclusions are presented as below:
1. College going students except urban female students have been found to have high attitude towards sex education. Urban female students have shown very high positive attitude towards sex education.
2. Area has affected the attitude of college going students towards sex education as the urban students have been found to have more favorable attitude towards sex education.
3. Sex had not affected the attitude of rural students towards sex education but it has put a significant influence on the attitude of urban students towards sex education. Urban female students have exhibited more positive attitude towards sex education.
4. Control has affected the attitude of rural students, rural male students, urban male and female students as well as total female students towards sex education. Highly controlled rural students, rural male students, urban male and female students as well as total female students have shown more positive attitude towards sex education.
5. Protectiveness has affected the attitude of urban male students towards sex education. Urban male students who are less protected have been found to have more favorable attitude towards sex education.
6. Urban female students who fall in the category of high punishment have been found to have more positive attitude towards sex education. But it has not been found to affect the attitude of other students towards sex education.
7. Conformity has affected the attitude of rural female students, urban students and urban male students towards sex education. These students having low conformity have more favorable attitude towards sex education.
8. Social isolation has affected the attitude of rural female students, urban students and urban male students towards sex education. Less isolated rural female students, urban students and urban male students have exhibited more favorable attitude towards sex education.
9. Reward has affected the attitude of urban male and female students towards sex education. Male students who are less rewarded and female students who are highly rewarded have shown more positive attitude towards sex education.
10. Deprivation of privilege has affected the attitude of urban male students towards sex education. Urban male students who are less deprived have shown more favorable attitude towards sex edu-cation.
11. Nurturance has affected the attitude of rural students, rural and urban male students and urban female students towards sex education. Highly nurtured rural students, rural male students and urban female students but less nurtured urban male students have exhibited more favorable attitude towards sex education.
12. Rejection has affected the attitude of rural students, rural and urban male students and urban female students towards sex education. Rural students, rural male students and urban female students having high level of rejection have shown more favorable attitude towards sex education but urban male students having low rejection have shown more positive attitude towards sex education.
13. Permissiveness has affected the attitude of urban students and urban female students as well as total female students towards sex education. Urban students, urban female students as well as total female students who have high permissiveness have exhibited more favorable attitude towards sex education.
14. Home environment has affected the attitude of urban male and female students towards sex education. Urban male students having low home environment have shown more positive attitude towards sex education while urban female students having high home environment have shown more favorable attitude towards sex education.
IMPLICATIONS OF THE PRESENT STUDY
The present study may guide teachers, educators, administrators, planners, policy makers, counselors, parents and students in formulating effective policies in favor of sex education in schools. This study is of enormous importance for the adolescents as it will aid them to have access to complete and healthy information that will guarantee them a reputable future and necessary life skills to deal with the problems of future life. This study may be beneficial for the teachers as well as parents as it would debunk the myths and misconceptions regarding the sex education in schools. The findings of this study may attract those policy makers who are interested to save the future generation and they may be able to determine their role also. It may also be useful for guidance workers and counselors in many ways to solve the problems of students.
Acknowledgement
The authors are firstly thankful to Smt. Murti Devi and Smt. Sunita Mittal (Active Reformer and social worker) for their motivation. We are also thankful to the college principals and students for their cooperation in data collection.
Englishhttp://ijcrr.com/abstract.php?article_id=666http://ijcrr.com/article_html.php?did=6661. Jimmy, E.; Abeshi, S.E.; Osonwa, K.O.; Uwaneda, C.C. and Offlong, D.A. Perception of students’, teachers’ and parents’ towards sexuality education in colabar south local government area of Cross River State, Nigeria. Journal of Sociological Research 2013; 4(2):225-40.
2. Frimpong, S. O. Adolescents’ attitudes towards sex education: a study of senior high schools in Kumasi metropolis. lfe Psychologia 2010; 18(1)https://www.questia.com/trial
3. Sexuality Information and Education Council of the US. Guidelines for comprehensive sexuality education: kindergarten-12th grade. 2004; Third Edition, Retrieved on March 22 from http/www.siecus.org
4. Toor, K. K. A study of the attitudes of teachers, parents and adolescents towards sex education. MIER Journal of Educational Studies Trends and Practices 2012; 2 (2): 177-89.
5. Majova, C.N. Secondary school learners’ attitudes towards sex education. Dissertation, Master of Education (Educational Psychology), University of Zululand, South Africa 2002.
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8. Sieswerda, L.E. and Blekkenhorst, P. Parental attitudes towards sex education in home: results of a 2003 parent survey conducted in Thunder Bay, Ontario. Thunder Bay District Health Unit, Thunder Bay, Ontario 2006.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareEFFECTIVENESS OF END-RANGE MOBILIZATION AND INTERFERENTIAL CURRENT OR STRETCHING EXERCISE AND MOIST HEAT IN TREATMENT OF FROZEN SHOULDER- A RANDOMIZED CLINICAL TRIAL
English2126Dhara N. PanchalEnglish Charu EapenEnglishBackground: Frozen shoulder, one of the leading causes of shoulder pain with incidence of 2% in India is frequently treated by physiotherapist. Very few studies have emphasized combination of modalities or comparison of combined treatments for frozen shoulder till date. Thus, there is a need to evaluate the effectiveness of combined treatments for better implications in clinical practice. This study was aimed at comparing the efficacy of end range mobilization (ERM) and interferential current therapy (IFT) with moist heat and stretching on pain, range of motions and disability of shoulder in acute stage of frozen shoulder.
Methodology: This clinical trial includes 43 subjects in the acute stage of frozen shoulder with SPADI score > 30. Group 1 (n=22) received treatment including moist heat application and shoulder stretching exercises whereas group 2 (n=21) received end range mobilisation with interferential current therapy. Follow up was taken at 6th day of treatment using SPADI, ROM and VAS for pain.
Results: Between Group comparison showed no statistically significant improvement (p=0.41) on VAS Score. However, Abduction (p=0.006), Flexion (p=0.03), and Internal Rotation (p=0.03) were statistically and clinically significant in group 2. Improvement was not observed for external rotation (p=0.8) and SPADI scale (p=0.57).
Conclusion: The results demonstrated that the end range mobilization can be used for better improvement in ROM in acute stage of frozen shoulder. Both the treatment strategies can be equally useful for pain management.
EnglishFrozen shoulder, Rehabilitation, Mobilisation, End range stretch, IFT, Moist heat.INTRODUCTION
Among different causes of musculoskeletal conditions, Shoulder pain is the third most commonly experienced condition exceeded only by low back and neck pain. 1-3 Shoulder pain is associated with significant impairment and disability which leads to the loss of mobility of this joint and significant morbidity.4,5 A number of causes for shoulder pain exist. Among them, frozen shoulder is the significant one with incidence of 2% in general population in India.6-8 Clinically, it progresses through four phases, acute-painful phase, freezing phase, frozen phase and thawing phase.9,10 The duration of acute phase comprises from 0 to 3 months along with pain and stiffness in more than two directions.9 Treatment of frozen shoulder in this stage can prevent the further progression to more disabling stage.10 The management with respect to physiotherapy consists of various methods to addresses pain and stiffness. For pain the different strategies used are heat11 or ice applications12, ultrasound13, interferential therapy14,15, transcutaneous electrical nerve stimulation16, and pulsed electromagnetic field therapy5 .To correct the stiffness active and passive range of motion exercises17, mobilization and manipulation techniques18-23 are used A recent systematic review concluded that interferential therapy is beneficial in reducing pain in musculoskeletal condition when used as an adjunct to other treatments.14Moist heat has been proven beneficial in the treatment of shoulder impingement and frozen shoulder.11,12 Studies regarding early implication of stretching exercises showed significant improvement in patients’ functional status.17,22Studies comparing the effects of various joint mobilization techniques for frozen shoulder suggested that end range mobilization and movement with mobilization are better for improving pain and function.18-23Thus modalities such as interferential therapy and manual therapy have been shown to be effective when used as an adjunct, the efficacy of other modalities has not been proven. Few studies on combination of modalities or comparison of combined treatments showed beneficial short-term effects.11, 16, 18,24Thus, there is a need to evaluate the effectiveness of combined treatments in better implications for clinical practice. There is a lack of randomized trials for strong evidence of treatment because of heterogeneity in inclusion criteria; inadequate treatment follow-up and variable methodology for specific clinical conditions like frozen shoulder. Therefore, there is a need recommended by Cochrane review to evaluate effectiveness of physiotherapy modalities used in combination. Hence, the aim of the study was to compare the efficacy of end range mobilization (ERM) and interferential current therapy (IFT) with moist heat and stretching on pain, range of motion and disability of shoulder in the acute stage of frozen shoulder.
MATERIAL AND METHODOLOGY
This study was a randomized clinical trial to compare efficacy of two different physiotherapy intervention strategies for frozen shoulder. The study was conducted at the Physiotherapy department, in a Tertiary care hospital. Total duration of the study was of nine months and each subject was treated for 6 daily sessions. The inclusion criteria was subjects between 40 to 65 years of age , with insidious onset of symptoms between last one to three months, significant night pain, significant limitations of shoulder motion in more than one plane with end ranges painful.9 and SPADI scores ≥30 points.25,26 Subjects who had pain due to acute severe trauma such as fractures, dislocation; cervical radiculopathy; subjects suffering from myocardial infarction, hyper and hypothyroidism; and subjects with hypermobility and instability were excluded.23 The study protocol was approved by the Scientific Committee and Time Bound Research Ethics Committee of the KMC, Manipal University. Subjects who were diagnosed for frozen shoulder referred by consultant to the physiotherapy were taken for the study. The total numbers of subject assessed were 59. Among them who fulfilled the inclusion criteria were taken for the study (N=43).The purpose of the study was explained to the subjects and an informed consent was obtained. The demographic information of the included subjects was taken. During the initial evaluation session, the patient was interviewed and an upper quarter screening examination was conducted to rule out cervical and elbow pathology. The baseline data of ROM with goniometer, VAS for pain and SPADI (shoulder pain and disability index) were taken by an observer who was blinded to the study. The same observer recorded the outcome measure after the completion of treatment session. After that, they were randomized into 2 groups, with block randomization.
In-Group 1, the intervention was given as follow.
1) Moist heat
Moist pack was wrapped in towel with three to four folds over the affected shoulder for 10 to 15 minutes. [Moist Heat Therapy Unit –MNE, India]
2) Stretching exercises
Shoulder stretching exercises include; Forward flexion, External rotation, Horizontal adduction, internal rotation.
In-Group 2, the intervention was given as follows,
1) End range Mobilization.-
At the start of each intervention session, the physical therapist examined the patient’s ROM in all directions to obtain information about the end-range position and the end-feel of the glenohumeral joint. Then, 10- 15 repetitions of intensive mobilization were given for flexion, abduction, internal rotation and external rotation Figures 1 and 2).18, 19
2) Interferential therapy
Interferential current therapy was given. [Current applied at 4000 Hz carrier frequency, Amplitude Modulated Frequency will be 0 to 250 Hz. Treatment time was 10 to 15 minutes].27 Patients were re-examined after 6 days of treatment for evaluation of outcomes, i.e. ROM, SPADI and VAS for pain.
'
RESULTS
Table1 shows baseline value of variables in both the groups. Both the groups had similar baseline values of characteristics for pain and disability and no significant difference was seen between groups. Table 2 shows the comparison of improvements in outcome measures between group 1 and group 2.Pain on visual analogue scale was not statistically significant (p=0.41) between the two groups. Both the group showed similar improvement on VAS. There were significant changes seen in ROMs between the groups. Abduction was statistically highly significant (p=0.006), while flexion (p=0.03) and internal rotation (p=0.03) range were also significant for group 2. However no statistically significant difference was seen in external rotation (p=0.8) between the groups. There was also no significant difference in SPADI scale between groups (p=0.57), which indicates improvement in disability was similar for both the groups.
DISCUSSION
Present study compared two different treatment strategies in patients with acute stage of frozen shoulder. The result of the study was in agreement with hypothesis that combination of End range mobilization and IFT will produce better improvement. The reasons could be attributable to: end-range mobilization and its specific mechanical effects on connective tissue which might have increased ROM.22 This difference in therapeutic responses measured through changes of joint mobility compared to pain and disability were noted previously in other studies.15-18
Range of Motion
The between-group mean difference for ROM of flexion (group 1-14.59, group 2-23.04), and abduction (group1- 11.27, group 2-21.38) was greater than the MCID reported 7 degree for flexion and 16 degree for abduction. The between –group mean difference for ROM for internal rotation (group1-6.27.group2-10.61) and external rotation (group 1- 9.22, group 2- 9.76) was lesser than the MCID reported 11 degree for internal rotation and 14 degree for external rotation.28 The possible mechanism for increase in ROM as suggested by Kelley M et al9 that, specific joint mobilization techniques are believed to selectively stress certain parts of the joint capsule. Yang et al22 said that, this mobilization performed in specific plane close to end range improve the extensibility of periarticular structure. However, the results of the previous studies 18, 19, 29 also showed significant improvement in shoulder external range of motion, which was not statistically significant in the present study. The probable reason of this could be capsular pattern of shoulder joint described by Cyrix in which external rotation was the most limited and hence, difficult to treat and in order to improve external rotation of shoulder long time treatment protocol is mandatory. In-group 1with conventional therapy, the stretching exercises prescribed also did not address specific to rotator cuff interval. Therefore, in both the groups it was lacking .Few studies with follow-up of 12 and 15 years in frozen shoulder patients showed deficiency in external rotation range even after successful treatment.30,31 So, this is in agreement that it is difficult to gain improvement in external rotation in a short period of time.
Pain on VAS score: The MCID value of VAS score is 3 mm.5 In the present study, group 1 showed mean improvement of 2.61mm and group 2 showed 2.92mm. Therefore, none of group has reached at MCID, which give inferences that either IFT or moist heat can be used for pain relief.
SPADI score In the present study, we have used shoulder Pain and Disability Questionnaire in order to document the level of disability with frozen shoulder patient. This scale has been used in previous studies with various shoulder pathology.32, 33 The improvement noted in-group 1 was (14.99±9.03) and group 2 was (16.44±7.09) which was greater than the MCID of this scale. Here, both the group showed similar improvement. Tvieta et al26 had reported the responsiveness of SPADI scale in-patient with frozen shoulder. Point estimates (1.45) for between group changes in disability not exceeded the reported MCIDs. In addition, using MCID of 13 point for SPADI scale, NNT was calculated. The NNT (Number needed to treat) is 5. This means that 5 patients are required in order to say our intervention is effective.
CONCLUSION
The results of present study demonstrated that patients treated with end range mobilization showed greater improvement in range of motion when compared with the group treated with moist heat and stretching exercises. Improvement in pain severity and disability was similar with both the treatments. Therefore, end range mobilization can be used for better improvement in range of motion particularly in acute stage of frozen shoulder. Both the treatment strategies were equally effective for pain management.
ACKNOWLEDGEMENTS
The authors thank Dr Vivek Ramanandi for support in making manuscript. Special gratefulness are extended to Dr P. Senthil Kumar (PT) and Dr Prem Kotian (MS, Ortho) for their support and guidance throughout this study. Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors /publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=667http://ijcrr.com/article_html.php?did=6671. Bhargav D, Murrell G A. Stiffness of shoulder: diagnosis. Aust Fam Physician. 2004; 33:143-47.
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3. Evidence based management of acute musculoskeletal pain. 2003.p.119-130.
4. Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskeletal Med. 2008;1:180-9.
5. Thompson J, O’Brien T, Richardson C, Davison D, Watson H, Wragg M et al. (2011) Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder v.1.2, ‘standard’ physiotherapy. Endorsed by the Chartered Society of Physiotherapy.
6. Gupta S, Raja K, Manikanandan N. Impact of adhesive capsulitis on quality of life in elderly with diabetic. Int J Diabetes Dev Ctries. 2008;28:125-9.
7. Mathew AJ, Nair JB, PillaiS. Rheumatic musculoskeletal manifestation in type 2 diabetes mellitus patients in south India.Int J Rheum Dis. 2011;14:55-60.
8. Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. N Am J Sports Phys Ther. 2010;5:266- 73.
9. Kelley MJ, Mcclure PW, Leggin BG. Frozen shoulder: evidence and a proposed model guiding rehabilitation. J Orhtop Sports Phys Ther. 2009;39:135-48.
10. Donatelli R A. Physical therapy of the shoulder. 5thed. Elsevier; 2011.p.231-44.
11. Leung MS, Cheing GL. Effect of deep and superficial heating in the management of frozen shoulder. J Rehabil Med. 2008;40:145-50.
12. Calis HT, Berberoglu N, Calis M. Are ultrasound, laser and exercise superior to each other in the treatment of shoulder impingement syndrome? A randomized clinical trial. Eur J PhysRehabil Med. 2011;47:375-80.
13. Kurtais Y, Ulus Y, Bilgic A, Dincer G, Heijden VD. Adding ultrasound in the management of soft tissue disorders of the shoulder: a randomized placebo-controlled trial. Phys Ther. 2004;84:336- 43.
14. Fuentes J, Olivo S, Magee DJ, Gross D. Effectiveness of interferential current therapy in the management of musculoskeletal pain: systematic review and meta-analysis. Phys Ther. 2010;9:1219-38.
15. Cheing G L,So EM, Chao CY. Effectiveness of electroacupuncure and interferential electrotherapy in the management of frozen shoulder. J Rehabil Med. 2008;40:166-70.
16. Uysal F G, Kozanoglu E. Comparison of the early response to two methods of rehabilitation in adhesive capsulitis. Swiss Med Wkly. 2004;134:353-8.
17. Celik D. Comparisons of the outcomes of two different exercise programs on frozen shoulder. Acta Orthop TraumatolTurc. 2010;44:285-292.
18. Yang J, Chang C, Chen S, Wang S, Jenq J. Mobilization techniques in subjects with frozen shoulder syndrome: randomized multiple-treatment trial. PhysTher. 2007;87:1307-15.
19. Vermeulen HM, Obermann WR, Burger BJ, Kok GJ, Rozing PM, Ende CH. End-range mobilization techniques in adhesive capsulitis of the shoulder joint: a multiple-subject case report. PhysTher. 2000;80:1204-13.
20. Yang J L, Jan M H, Chang C W, Lin J J. Effectiveness of the end range mobilization and scapular mobilization approach in a subgroup of subjects with frozen shoulder syndrome: a randomizedcontrol trial. Man ther. 2012;17: 47-52.
21. Vermeulen HM, Rozing PM, Obermann WR, Cessie SL, Vlieland TP. Comparison of high grade and low grade mobilization techniques in the management of adhesive capsulitis of the shoulder: randomized controlled trial. PhysTher. 2006;86:355- 68.
22. Brudvig TJ, Kulkarni H, Shah S. The effect of the therapeutic exercises and mobilization on patients with shoulder dysfunction: A systematic review with meta-analysis. J orthop sport physther. 2011;41:734-48.
23. Chen JF, Ginn KA, Herbert RD. Passive mobilization of shoulder region joints plus advice and exercise does not reduce pain and disability more than advice and exercise alone: a randomized trial. Aust J Physiother. 2009;55:17-23.
24. .Jurgel J, Rannama L, Helena G, Ereline J, Kolts I, Paasuke M. Shoulder function in patients with frozen shoulder before and after 4-week rehabilitation. Medicina 2005;41:30-6.
25. Carette S, Helene M, Tardif J, Bessette L, Morin F, Fremont P et al. Intra articular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder. Arthritis Rheum. 2003;48:829-38.
26. Tveita E K, Ekeberg O M, Juel N G, Holter E B. Responsiveness of the Shoulder Pain and Disability Index in patients with adhesive capsulitis. BMC Musculoskeletal Disord. 2008;9:161-65.
27. Kitchen S. Electrotherapy- Evidence based Practiced 11thedition. Melbourne. Harcourt Publishers Ltd; 2002.p.297-309.
28. Muir SW, Corea CL, Beaupre L. Evaluating changes in clinical status: reliability and measures of agreement for the assessment of glenohumeral range of motion.2010;5:98-111.
29. Johnson AJ, Godges JJ, Zimmerman GJ, Ounanian LL. The effect of anterior versus posterior glide joint mobilization on external rotation range of motion in patients with shoulder adhesive capsulitis. J Orthop Sports PhysTher. 2007;37:88-99.
30. Farrell C M, Sperling J W, Cofield R H. Manipulation for frozen shoulder: long- term results. J shoulder Elbow Surg. 2005;14:480-484.
31. Shaffer B, Tibone J E, Kerlan R K. Frozen shoulder: A long-term follow-up. J Bone Joint Surg Am. 1992;74:738-46.
32. Bennell K, Wee E, Coburn S, Green S, Staples M, Forbes A et al. Efficacy of standardized manual therapy and home exercise programme for chronic rotator cuff disease: randomized placebo controlled trial. BMJ. 2010;340:2756-65.
33. Dogan SK, Ay S, Evcik D. The effectiveness of low laser therapy in subacromial impingement syndrome: a randomized placebo controlled double-blind prospective study. Clinics.2010;65:1019-22.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareEFFECT OF HEALTH EDUCATION ONMENSTRUAL HYGIENE AND HEALTHSEEKING BEHAVIOUR AMONG RURAL AND URBAN ADOLESCENTS
English2734Ibanga EkongEnglishIntroduction: Health promotion programmes presume that providing knowledge about causes of ill health will go a long way towards promoting a change in individual behaviour, towards more beneficial health-seeking behaviour. However, there is growing recognition that providing education and knowledge is not sufficient in itself to promote a change in behaviour. Hence, this study sought to determine how health education could change the menstrual hygiene practices and health seeking behaviour of rural and urban school-going adolescent girls in South-south Nigeria.
Materials and Methods: This was a comparative-interventional study conducted among 601 girls using a structured questionnaire and focus group discussion. Sample selection was by multi-stage techniques of stratification and simple random sampling. Intervention was done using health education.
Results: More use was made of tissue paper among both groups of respondents after health education (rural 34.1% from 29.3%, urban 16.4% from 14.7%, the observed differences were statistically significant pre- and post intervention{X2= 17.485; 23.132. p= 0.000; 0.000 respectively}).
Discussion/Conclusion: This corroborates other study findings that Nigerian girls prefer the use of tissue paper perhaps due to economic realities. The implication of the use of tissue paper is that it could act as culture medium for microbes with its sequelae.
EnglishMenstrual hygiene, Adolescent girlsINTRODUCTION
Health information seeking is defined by Tardy and Hale as the search for and receipt of messages that help ‘‘to reduce uncertainty regarding health status’’ and ‘‘construct a social and personal (cognitive) sense of health’’.1 Lambert et al regard seeking information about one’s health as being increasingly documented as a key coping strategy in healthpromotion activities and psychosocial adjustment to illness.2 Health promotion programmes worldwide have long been premised on the idea that providing knowledge about causes of ill health and choices available will go a long way towards promoting a change in individual behaviour, towards more beneficial health-seeking behaviour. However, there is growing recognition, in both developed and developing countries, that providing education and knowledge at the individual level is not sufficient in itself to promote a change in behaviour, as was observed by MacKian.3 Aniebue, Aniebue and Nwankwo, Singh et al and Durge et al, in their studies agree to the importance of educating adolescent girls about their reproductive health which they also perceive as gaining momentum in India during the past few years.4,5,6 Lee et al, Adinma and Adinma, Poureslami and Osati-Ashtiani, and Severino and Moline, have each observed that teachers and formal education in general have little roles to play as source of information on reproductive health7,8,9,10 a situation considered worrisome in view of the important position of teachers as formal instructors in the teaching process of the growing adolescent. Furthermore, as reported by Drakshayani et al, Fakeye and Egade, Beek, Johnson, and Klein and Litt11,12,13-15 education is the single most effective method that will lead to a decrease in the severity of menstrual pain and a reduction in the rate of absence from school. On the other hand, Levisohn expresses his doubt thus: ‘...little is known about the effect of health education intervention on how adolescent girls manage their menstrual hygiene’.16 In an Eastern Nigerian study by Adinma and Adinma,8 it was noted that of the 401 respondents who claimed to have discussed their medical problems associated with menstruation, the most common person with whom this was done was the mother who accounted for 47.1%. A similar observation was made by Lee et al7 who reported that mothers constituted the source of information on menstrual disorders in as high as 80%, in their study population, other studies by Drakshayani et al, Koff et al and Tiwari et al11,17,18 report the mother as the most common source of information on menstruation generally. They go on to comment that the observation was not surprising since mothers are often the closest informant and “teacher” of the growing adolescent girl, and this was probably responsible for the glaring similarity in menstrual attitudes between mothers and their daughters following studies on the “generational differences in perception of menstruation and attitudes to menstruation” conducted by Strauss et al.19 Dongre et al in their study noted that after a health education intervention among currently menstruating girls, ready-made pad users increased significantly, from 5.2% to 24.9%.20 Conversely, cloth users declined from 94.8% to 72.7%; the practice of taking a bath during menstruation was almost universal. The percentage of adolescent girls observing dietary restriction during menstruation showed marginal decline (20.7% to 16.6%). Reusing cloth declined from 84.8% to 57.1%. Notably, among the re-users of cloth, the practices of washing it with soap and water and sun drying increased from 86.2% to 94.2% and 78.4% to 90.05 respectively. Similarly, the results of recent studies by Drakshayani et al, Fakeye and Egade, Dagwood, Nafstad et al, and Westhoff and Davis 11,12,21-23 showed the effectiveness of educating female students about menstrual health topics in both urban and rural schools. Swasthya, a Delhi based NGO reported some improvement in menstrual hygiene behaviour through health education messages disseminated by community-based health workers in rural Delhi.24 Chiou et al in an urban study in Taiwan after introducing self-care pamphlets on dysmenorrhoea and assessing the participants, revealed an increased knowledge and self-care behaviour among them.25 This is consistent with a study by Dongre et al who reported a significant improvement in both the hygiene management of menstruation and health-seeking behaviour of their study participants in rural India after a health education intervention.20 Rankin and Stallings from their study observed that knowledge is a factor that increases patients’ participation and the ability to make informed decisions about health;26 and Carson impresses that making informed decisions is an ongoing and changing process.27 Ahmed has stated that learning about hygiene during menstruation is a vital aspect of health education for adolescent girls.28Educational programmes can increase awareness about reproductive health, but in the absence of appropriate health services, this awareness may not always translate into appropriate help-seeking by adolescents.29 Banister and Schreiber have imposed the responsibility of providing comprehensive and practical information on essential issues of pubertal development on parents, to be assisted by schools and other social institutions.30 The phrase ‘spiral of decision making’ which refers to the process of self-assessment, help-seeking behaviour and new self-assessment is improved with health education.26 A needs framework has been identified in four steps by an Indian study by Barua and Kurz, thus: it begins with a symptom being identified by the girl, creating a felt need for treatment; telling a family member about the need; agreement on the part of family member(s) that it is worth seeking treatment; and action taken by the family and health providers to seek and provide treatment.31 The ability to recognize a symptom, and positive family support could be enhanced by health education. This study sought to determine how health education could change the menstrual hygiene practices and health seeking behaviour of adolescent girls.
MATERIALS AND METHODS
This was a comparative interventional study design among adolescent secondary school girls in rural and urban areas. This study was conducted in Akwa Ibom State comprising thirty one (31) local government areas, 24 rural and 7 urban.32 With a population of 3,920,051,33 the population of adolescents, who make up about 23% of the population, is estimated to be 901,612. Using a male/female ratio of 1.09:1, the estimated population of adolescent girls is 431,393 which is the study population. There are about 243 public post-primary institutions in Akwa Ibom State34 and the study subjects were in-school adolescent girls who had attained menarche. Adolescent girls from secondary schools in the selected rural and urban local government areas of Akwa Ibom State took part in this study. A minimum sample size of 546 was calculated. To allow for 10% (i.e. 55) invalid, incomplete and non-responses, the to-tal sample was 546+55= 601 for the four locations giving an average of 150 students per location. This study used both quantitative and qualitative research methods. It consisted of a baseline survey to determine the menstrual hygiene and health-seeking behaviour for menstrual problems of adolescents in the rural and urban areas of this study. The sampling frame consisted of adolescent girls attending the 237 co-educational and girls’ school from the list of rural and urban secondary schools in Akwa Ibom State. Health education intervention on menstrual hygiene and health-seeking behaviour was given to the participants at the end of the baseline survey and another survey was conducted three months post intervention on all the sites. They were compared thereafter to assess the impact of the intervention on menstrual hygiene and health-seeking behaviour between either group (rural and urban) of adolescent girls. The study sought to determine if the intervention had any effect and whether there were rural-urban differences in the observed effect. A multi-stage sampling technique was used to select the study sample. The first stage involved the stratification of local government areas into rural and urban (seven out of the thirty one local government areas in Akwa Ibom State are classified as urban, the other twenty four are rural).32 Two local government areas were selected from each stratum using the simple random sampling technique, by use of table of random numbers. In the second stage, among the thirty eight secondary schools (co-educational and girls’) that were listed in the four local government areas, one school each was selected per local government area (total of 4) using the simple random sampling technique, by use of table of random numbers, after stratification had been done. In the third stage, each school was stratified into lower (31) and upper (42) senior secondary classes to represent junior and senior adolescents. Selection of the classes was by stratified and then simple random sampling, using the table of random numbers, within each strata. The fourth stage involved selection of eligible students (2,867) that met the inclusion criteria (in-school girls aged between 10-19 years who had attained menarche) distributed over the selected streams of each class by the simple random sampling technique by use of table of random numbers. In the use of table of random numbers, every list was itemized. Six hundred and one adolescent girls were selected. A forty eight item questionnaire was designed in line with the specific objectives, with a few aspects adapted from literature review. 35 Pre-test was carried out in a rural girls’ school and an urban girls’ school after the study sites had been selected. At each site, Junior Secondary class 3 (10) and Senior Secondary class 1 (10) female adolescents were involved at this stage. The outcome led to the re-phrasing of certain terms in the questionnaire, and in the derivation of topics for the intervention workshop. Data collection was carried out at the school site during school hours, during the break period, with informed consent from the respective school principals. Pre-tested self-administered questionnaires, following an anonymous respondent approach were shared to the selected students (who had gathered at the assembly hall) without the presence of teachers and male students. The questionnaire sought for information about demographic variables, perception of menstrual problems, types of menstrual problems, coping strategies, sources of help for menstrual problems, and motivation and barriers to health-seeking behaviour. Three female registrars were trained to assist with the conduct of the survey, confidentiality, procedures for responding to students’ questions and focus group discussions. Two Focus Group Discussions (FGDs) were conducted to generate qualitative data, regarding the perception, attitude and practices of adolescent secondary school girls as it concerns menstruation. These were conducted by the researcher’s female colleagues. Six girls (including those who had been noted by teachers to be absent from school at various times due to menstrual problems) each from one rural, and from one urban site were engaged in the FGD. The intervention was by Information, Education and Communication (IEC) in which teaching and learning were approached through creative and involving methods. The researcher appropriately educated the girls on what normal menstruation is, in adolescents. They were also educated about proper menstrual hygiene. They were shown pictograms on the types of padding for menstrual flow and either a correct sign or a wrong sign beside a particular item. Proper health-seeking behaviour was taught them, emphasising the benefits of seeking healthcare early and through the right channel, providing the information in a way that was acceptable to them by using cardboards to illustrate the available and suitable avenues. This would empower them to take decisions, modify behaviour and change their social conditions. It took the form of a workshop. A twenty-minute presentation was made followed by a question and answer session. Three student health teams were formed to brainstorm on given topics (derived from the pre-test) and come out with resolutions which each team leader presented to all participants. After the presentation, the researcher made the necessary corrections. The entire session did not exceed one hour. Finally, hand-bills on menstrual problems and health-seeking behaviour were distributed to all the participants, and they were encouraged to share them with other peers. Quantitative data generated from the survey was entered into the Statistical Package for Social Sciences (SPSS) software, Version 17 for Windows, and analyzed. Percentages were calculated to draw out differences in variables between urban and rural adolescent girls. Cross tabulation and Chisquare tests were used to determine any association between selected socio-demographic variables, and perception and health-seeking behaviour variables. Odds ratio, Chi square and t test were used to compare possible differences between urban and rural variables and significance was 0.05 at the 95% confidence level. Tables were used to highlight the results obtained. Qualitative data gathered through Focus Group Discussions, and the interview following the mystery-client approach were transcribed verbatim from the audio record and analyzed manually. The check-list was also analyzed manually. Ethical clearance was received from Ethical Committee of the University of Uyo Teaching Hospital, while approval was obtained from the Ministry of Education and the respective school authorities. Informed consent was obtained from parents/guardians of participating students for minors; and from students that had attained the age of 18. Audio records were made with due verbal consent from the participants. Anonymity and confidentiality of the respondents were maintained in all phases of the study. Due to the sensitive nature of the study, female assistants were used at all times in administering the quantitative and qualitative surveys. Informed consent was sought from participants with respect to voluntary participation and freedom to discontinue the interview/discussion at any stage. There were anticipated benefits of improved behaviour and social conditions derived from the intervention in the short term. Free consultation was given to those with menstrual problems. There were no risks to the participants in the study. Out-of-school adolescent girls may have different perceptions and practices about menstruation; hence the study findings may only be generalizable for in-school adolescents in similar socio-demographic contexts. Increased knowledge is not necessarily a sufficient cause for behaviour change; other factors (e.g. culture, beliefs, inhibition) may affect the possible benefits derived from the intervention in the long term.
RESULTS
Table 1 displays the state of menstrual hygiene before and after health education among rural and urban respondents. There were some noted improvements in menstrual hygiene after health education was given: 33.3% rural and 10.1% urban respondents used old cloth as sanitary pad as against the previous 33.7% rural and 11.2% urban respondents respectively (the observed differences pre- and post-intervention were statistically significant {X2 = 41.003; 44.568. p= 0.000; 0.000} respectively), however the proportion of rural respondents that used sanitary pad was observed to reduce (74.4% to 73.6%) after health education as against the increased proportion (94.4% from 94.1%) of urban respondents (observed differences pre- and post-intervention were also statistically significant {X2 = 41.236; 45.467. p= 0.000; 0.000} respectively); more use was made of tissue paper among both groups of respondents after health education (rural 34.1% from 29.3%, urban 16.4% from 14.7%, the observed differences were also statistically significant pre- and post intervention{X2 = 17.485; 23.132. p= 0.000; 0.000 respectively}); also, there was a reduction in the proportion of both group of respondents who washed and reused cloth used as pad (rural 24.9% to 23.1%, urban 7.7% to 5.2%, again the observed differences were also statistically significant pre- and post intervention{X2 = 32.183; 38.524. p= 0.000; 0.000 respectively}). With regards to the frequency of change of pad among respondents, there was a general improvement to 3-4 times daily change after health education was given (the observed rural-urban differences was statistically not significant post intervention{X2 = 10.496, p= 0.062}). There was an increased proportion of respondents among both groups who stepped up their frequency of bath to three times (rural 49.1% from 46.5%; urban 61.5% from 59.8%). The observed rural-urban differences were statistically significant pre- and post intervention{X2 = 15.104; 15.625. p= 0.001; 0.000 respectively}. Table 2 displays the significance of association, using odds ratio (OR) at 95% Confidence Interval (CI), between some variables (health-seeking behaviour & hygiene) and exposure to health education. The association between health education and belief in the urban area that health-seeking behaviour is a weakness showed that the effect was statistically significant in the urban areas (OR=0.242, CI: 0.089-0.663). No association of statistical importance was observed in the health-seeking behaviour and menstrual hygiene variables. Table 3 displays the effect of health education on menstrual hygiene within rural, and then urban respondents. Although there were some marginal improvements in some menstrual hygiene variables, no statistically significant association was however observed in this study.
DISCUSSION
The rural discussants during the focus group interview had said they could use all sorts of items e.g. beret in emergen-cies while their urban counterparts admitted they used old cloth/parts of school uniform during emergencies. There were some noted improvements in menstrual hygiene after health education was given: where urban respondents using old cloth as sanitary pad reduced more than the rural respondents (observed rural-urban difference was statistically significant). This is in keeping with findings in an Indian study in which the use of old cloth reduced but ready-made sanitary pad use increased;20 however, the proportion of rural respondents that used sanitary pad was observed to reduce after health education (perhaps due to cost) as against the increased proportion by urban respondents; more use was made of tissue paper among both groups of respondents after health education also, this corroborates two Nigerian study findings that Nigerian girls prefer the use of tissue paper,36,8 perhaps due to economic realities. The implication of the use of tissue paper is that it could act as culture medium for microbes which may result in serious infection and its sequelae. Good enough, there was a reduction in the proportion of either group of respondents who washed and re-used cloth used as pad (observed rural-urban difference was statistically significant in favour of the urban girls), also in keeping with Dongre’s findings.20 With regards to the frequency of change of pad among respondents, there was a general improvement to 3-4 times daily change after health education was given, but the observed rural-urban difference was not statistically significant in this study. There was also an increased proportion of respondents among either group who stepped up their frequency of bath to three times daily (observed rural-urban difference was statistically significant in favour of the rural girls), though it has been stated to be a universal practice.20 The rural discussants during the focus group interview had said they could use all sorts of items e.g. beret in emergencies while their urban counterparts admitted they used old cloth/parts of school uniform during emergencies. Both groups often washed and re-used these items. The inadequacies of school toilet facilities for girls, and an improperly timed menstruation cycle were stated as some of the reasons for the use of any item that came handy. There was no statistically significant association between health education, and menstrual hygiene and health-seeking behaviour among the respondents. This means that there was no statistically significant difference among respondents pre-intervention and post intervention. Probably, the sample size may have been small or being that it was provided once it might not have been enough to make the desired impact. Also three months might not have been enough time for impact to be made. It implies that when planning an intervention of this nature for in-school adolescents in Akwa Ibom State, the researcher or other researchers would need more than a onetime intervention or the method used may need to be change.
CONCLUSIONS
• The effect of the intervention may not have been statistically significant with respect to menstrual hygiene and health-seeking behaviour. It however does not preclude real effect of public health importance as seen in the positive changes in frequency of noted variables
Recommendations
• Mothers and other female adults ought to imbibe the culture of educating younger girls on correct menstruation issues even before they attain menarche
• Barriers to health seeking should be delineated and corrected
• There is a need for the government to put policies in place for early health education to be taught in schools
ACKNOWLEDGEMENT
The Author acknowledges the immense help received from the scholars whose articles are cited and included in references of this manuscript. The author is also grateful to authors/ editors/ publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareHISTOLOGICAL AND ULTRA STRUCTURAL STUDIES OF THYMIC MYOID CELLS IN NANDANAM CHICKEN
English3539T.A. KannanEnglish Geetha RameshEnglish S. UshakumariEnglish Sabiha Hayath BashaEnglishLight and transmission electron microscopic studies of thymic myoid cells in Nandanam Chicken was done in various age groups ranging from day-old to forty weeks. Thymus is the central lymphoid organ in fowl, provides a complex environment essential for T-cell development and maturation. The thymic gland in chicken was covered by a thin connective tissue capsule. The connective tissue septa divided the gland into lobules. Thymic parenchyma consisted of an outer darker cortex and inner pale medulla. Under light microscope, numerous large cells with eosinophilic cytoplasm were observed in the medulla and also in the cortico-medullary junction, the myoid cells. Number of myoid cells increased as age advances. Under electron microscope, the cytoplasm of the myoid cell showed myofibrils as in skeletal muscle fibre. Cytoplasm also contained few mitochondria, free
ribosome and smooth endoplasmic reticulum. Small bundles of unmyelinated nerve fibres were observed in the thymic medulla
EnglishHistology, Ultrastructure, Thymus, Myoid cell, ChickenINTRODUCTION
Thymus is the central lymphoid organ occurs in all vertebrate species, situated on either side of the neck, close to the jugular vein (King, 1983). Bone marrow-derived T-cell precursors undergo differentiation, maturation eventually leading to migration of positively selected thymocytes to the peripheral lymphoid organs such as the spleen (Savino and Dardenne, 2000 and Varga et al., 2009) and GALT including the caecal tonsil and the lymph nodes (Ciriaco et al., 2003; Gail Pearse, 2006 and Karen Staines et al., 2013). Thymus is unique among the lymphoid organs in being an epithelial organ and well known for its cellular organization (Gail Pearse, 2006). Thymic epithelium shows subpopulation heterogenicity in both capsule and thymic parenchyma that form the three-dimensional framework of the thymus (Mohammad et al., 2007). Among these heterogenous cell population, there is an unique and interesting myoid cells of the thymus. Myoid cells are first described in Amphibians (Mayer, 1888) and they have been found to vary considerably due to cell turnover in the thymus in different vertebrates (Raviola and Raviola, 1967; Nakamura et al., 1986 and Geetha Ramesh and Vijayaragavan, 1997). In domestic fowl, they are identified as large cells in the thymic medulla and characterised by the presence of myofibrils in their cytoplasm similar to those found in skeletal muscle fibre (Gilmore and Bridges, 1974). Thymic myoid cells plays an important role of protecting thymocytes from apoptosis (Panse and Berrilh-Aknin, 2005). Although, fine structure of myoid cells has been described by Frazier (1973) in fowl, little details are available of their presence in Nandanam chicken of different age groups. Hence, an attempt has been made to study the histological and ultrastructural details of this unique cell type of thymic parenchyma of Nandanam chicken. It is a dual purpose, colored variety with good disease resistance and most popular among poultry farmers due to its adaptability to backyard farming. Nandanam strain was developed in Poultry Research Station, Tamil Nadu Veterinary and Animal Sciences University, Chennai.
MATERIALS AND METHODS
Over 36 specimens of thymic tissue were collected from six different age groups such as day-old, four, eight, twelve,twenty and forty weeks. Six birds were used in each age group. The thymus was removed immediately after high cervical dislocation and fixed for light and electron microscopy (Gilmore and Bridges, 1974). For light microscopy, tissue pieces were fixed in 10% neutral buffered formalin, dehydrated in alcohol, cleared in xylene and embedded in paraffin wax. Five micron thick sections were made and stained with Haematoxylin and Eosin (Bancroft and Stevens, 2007) and Masson’s trichrome for collagen and muscle fibres (Kiernan, 1981). For electron microscopy, small pieces of tissue were fixed for 2 hours in 3 % glutaraldehyde buffered to pH 7.4 with 0.1 M sodium cacodylate buffer at 40 C. The tissue was washed overnight in three changes of buffer at 40 C, post-fixed in 1 % osmium tetroxide in 0.1 M sodium cacodylate buffer at 40 C for 2 hours and washed overnight in buffer. Dehydration in ethanol and propylene oxide was followed by embedding in propylene oxide: epoxy resin mixture and embedded in Epon-araldite mixture after the method of Glauert (1967). Semi thin (1 micron) sections were stained by toluidine blue. Ultra thin sections (600 Ao to 900Ao ) were prepared on Leica ultracut microtome, mounted on uncoated copper grids and stained with saturated solution of uranyl acetate and lead citrate. Screening of ultra thin sections were made with transmission electron microscope (Phillips - Teknai-10) operated at 60-kilowatt ampere (KVA). The images were documented and processed in computer.
RESULTS
Light microscopy
In the present study, thymic gland was surrounded by a thin connective tissue capsule composed mainly of collagen and few elastic fibes. Fine trabeculae / septa extended from the capsule and divided the parenchyma into lobules. The parenchyma was observed to have a dark outer cortex and a pale inner medulla within the lobule in day-old, four weeks and ten weeks of age groups. The ratio of cortex to medulla of the thymus in day-old chick reversed in adult age groups. The cortex consisted of numerous small, medium and large lymphocytes lying within a meshwork of reticuloepithelial cells. Whereas the medulla contained predominantly retiucloepithelial cells with a fewer lymphocytes. In all the age groups, myoid cells were most numerous in the medulla, less in cortex. Also found in the cortico-medullary junction. The extramedullary location often found in young age groups rather than adult birds. The myoid cells were large and of varying shape in different age groups studied. From day-old to 20 weeks of age, they were seen as elongated, spindle shaped cells with striations (Fig. 1). In 40 weeks of age, the cells appeared ovoid or round. The nucleus was large and oval in shape with a single, discrete nucleolus. The cytoplasm appeared homogenous under light microscope and striations noticed in some cells. The cytoplasm was red in colour after Masson’s trichrome stain. The myoid cells were fewer in the thymic medulla on dayold and increased in number upto 40 weeks of age, in the present study
Electron microscopy
Under transmission electron microscope, the cytoplasm of the myoid cell contained myofibrils of skeletal muscle (Fig.2). However, the overall arrangement of those myofibrils were not as in skeletal muscle fibre. The cytoplasm contained few mitochondria and smooth endoplasmic retiuclum and also free ribosomes and glycogen granules. The nucleus contained dispersed chromatin. In younger age groups, the myofibrils were oriented along the long axis and changes in the orientation was noticed in 40 weeks of age. The myoid cells of the chicken thymus were found mainly in the medulla in all the age groups studied. The number of myoid cells increased as age advances in the present study. Small bundles of unmyelinated nerve fibres were observed in the thymic medulla in the present study (Fig.3). However, no nerve fibres were seen to terminate directly on the surface of the myoid cell, although some fibres lay in close association with them.
DISCUSSION
Light microscopy
Though there are literatures available on the histoarchitecture of avian thymus, the detailed study about the thymic myoid cell in Nandanam chicken is scanty. Hence, the present study was therefore designed to observe the light and electron microscopic details of myoid cells in Nandanam chicken. In chicken, thymic gland was surrounded by a connective tissue capsule and fine trabeculae / septa extended from the capsule and divided the parenchyma into lobules (Hodges, 1974; Firth, 1977; Bhattacharya and Binaykumar, 1983; Gail Pearse, 2006; Leena et al., 2008). These septa are considered as important structure for immigration and emigration of T-lymphocyte precursor cells and distribution of antigens within the thymus. They are also thought to guide the invasion of interdigitating reticular cells, macrophages and act as a pathway for blood vessels and nerves to and from the thymus (Seifert and Christ, 1990 and Ritter and Crispe, 1992). In all the age groups, the parenchyma was observed to have a dark outer cortex and a pale inner medulla and the cellular composition of the cortex was in agreement with the findings of Hodges (1974), Gilmore and Bridges, (1974) in fowl and King and Mc Lelland (1981) in birds. The extramedullary location of the myoid cells in the present study supports the ontogenic similarities between lower and higher vertebrates (Kendall, 1980; Saad and Zapata, 1992; Bowden et al., 2005 and Mohamed et al., 2007). A similar finding was observed by Gilmore and Bridges (1974) and Kendall (1980) in chicken and Geetha Ramesh and Vijayaragavan (1997) in buffalo calves. But Robert et al. (1978) described that myoid cells were rare in human thymus. The change in shape of the myoid cells between age groups in the present study was assumed to be change in cell morphology to be an expression of degeneration corresponding to the degeneration of the thymus as postulated by Raviola and Raviola (1967) and van de Velde and Friedman (1967). The presence of striations in the cytoplasm recognised the presence of muscular elements (Itoh, 1983 and Leena et al., 2008). Increase in number of myoid cells from day-old to forty weeks of age in the present study leads to a postulation that these myoid cells directly or indirectly related with the involution of the organ, which is functional synchronization with the amount of sex hormone present in the blood (Vijayaragavan, 1988). Whereas Bockman (1968) assumed that the myoid cells were involved in the mechanism of tolerance to muscle self-antigen in human, but Mandel (1968a and b) opined that the thymic striated muscles may act as a local source of antigen for the self recognition of skeletal muscle in guinea pig.
Electron microscopy
Under transmission electron microscope, changes noticed in the cell organelles and orientation of myofibrils indicted the degenerating changes in involuting thymus (Van de Velde and Friedman, 1970 and Leena et al., 2012). The presence of myoid mainly in the medulla in all the age groups studied was similar to thymic tissue from humans, amphibians, reptiles, birds and various mammals (van de Velde and Friedman, 1966, 1967; Strauss et al.,1966; Henry,1968; Toro et al., 1969 and Bridges et al., 1970). However, Morris (1971) and Sugimura (1972) have reported their presence in the medulla of the ten to twelve month old Ox, and they are present in the normal adult human thymus (Henry, 1968). The myoid cells seen in the present study are structurally similar to those described in the frog thymus (Toro et al., 1969). Two main theories have been put forward to explain the presence of myoid cells within the thymus: (1) that aberrant mesodermal elements from the branchial arches become incorporated accidentally into the thymus during its embryological development (van de Velde and Friedman, 1966 and Frazier, 1973) and (2) they develop within the thymus as an intrinsic part of the organ (Kapa et al. 1968; Bockman and Winborn, 1969 and Toro et al., 1969). These latter authors suggested that the myoid cells develop from the epithelial cells of the thymic cytoreticulum. Toro and Olah (1967) and Toro et al. (1968) have also observed this process in the development of myoid cells during the in vitro culture of embryonic rat thymus tissue. The number of myoid cells increased as age advances in the present study does not support the first theory that they represent the outcome of an embryological accident. Hence, the present study supports the second theory that the cells develop as an integral part of the normal thymus and as such it is reasonable to suggest that they play a physiological role therein. The function of the myoid cells is still unknown. However, Raviola and Raviola (1967) and Rimer (1980) found that myoid cells play no physiological role because myofilaments are organized in random directions and myoid cells have no anchoring apparatus. But in the present study, myofilaments were shown to arrange regularly, and cross striations were clear. Hence, we are inclined to think that myoid cells push lymphatic cells to circulation around hatching as Toro et a1. (1969) suggested, though anchoring apparatus was not found in this study.
CONCLUSIONS
Thymic parenchyma was made up of an outer darker cortex and inner pale medulla. The myoid cells were numerous in the medulla and were large cells with eosinophilic cytoplasm. They were also observed in the cortico-medullary junction. Under electron microscope, the cytoplasm of the myoid cell showed myofibrils as in skeletal muscle fibre. Cytoplasm also contained few mitochondria, free ribosome and smooth endoplasmic reticulum. Small bundles of unmyelinated nerve fibres were observed in the thymic medulla. Number of myoid cells increased as age advances.
Conflict of Interests
The authors declare that they have no competing interests among them.
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. The authors also acknowledge the Professor and Head, Department of Animal Biotechnology and Professor and Head, Centralised Instrumentation Laboratory, Madras Veterinary College for providing facilities to carry out this work.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareCONSEQUENCE OF FULLERENE NANOPARTICLE (C60) ON OXYGEN CONSUMPTION AND BEHAVIOURAL MODIFICATION IN ETROPLUS MACULATUS
English4044N. SumiEnglish K.C. ChitraEnglishBackground: Fullerenes are nanoparticles composed fully of carbon molecule that are widely used in industry, mostly cosmetics and also play an important role as antioxidants.
Aim: The present study was aimed to evaluate the consequence of fullerene toxicity on oxygen consumption and behavioural modification in cichlid fish, Etroplus maculatus.
Methods: Fishes were exposed at 100 μg/ L concentration of fullerene through fish feed for 96 h. Body weight of the animals, weights of gill, liver, brain and gonads along with mucous deposition was observed. Oxygen consumption of control and treatment groups was evaluated. Behavioural modification of fishes after exposure to fullerene was recorded throughout the study.
Result: Oxygen consumption was decreased at the end of treatment. Weights of fish were decreased and there was significant increase in mucous deposition throughout the body of treated animal. Weights of gill, liver, brain, ovary and testis decreased significantly than that of control fish. Alterations in behavioural patterns including erratic swimming and surfacing activity, slow opercular movements, reddening of skin and haemorrhage through surface of the body were well marked during the period of trial. However, no mortality was observed throughout the study.
Conclusion: The present study accordingly reveals that fullerene induced alteration on oxygen consumption and behaviour in fish.
EnglishFullerene, Behaviour, Etroplus maculatus, Oxygen consumption, Fish feedINTRODUCTION
Recently nanoscience concerns about carbon-based nanomaterials, among which fullerenes takes one of the first places. Fullerene molecules are composed entirely of carbon, in form of a hollow sphere, ellipsoid or tube. Among which spherical cage-like fullerenes also referred to as buckminsterfullerene or bucky balls are important as it contains 60 carbon atoms (C60) were chosen in the present study because most nanoscience particularly nanotoxicological assessment has focused on carbon-based nanoparticles. Fullerenes were discovered experimentally for the first time in September 1985. The Buckminsterfullerene, named after the American architect Buckminster Fuller, whose geodesic dome it resembles was observed by a group of scientists including Richard Smalley, Robert Curl and Harry Kroto at Rice University, Huston and they shared a Nobel Prize in 1996 for their novel discovery (1). Owing to the practical properties fullerenes have become an important molecules in science and technology, particularly on nanotechnology and industrial research. There is an insufficient toxicological data on nano-sized materials, therefore, it makes difficult to determine if there is a risk associated with nanomaterial exposure. Few studies have reported that fullerene possess radical scavenging property and proved as a powerful antioxidant (1), which have been widely used in the treatment of Parkinson’s disease, Alzheimer’s disease and amyotrophic lateral sclerosis (2). Fullerene in the range of 1 to 100 ppm is considered as therapeutically relevant concentration to function as antioxidant. On the contrary, some studies have reported that fullerene exposure has been shown to elicit oxidative stress response in embryonic zebrafish (3).
Researchers are widely using several biological models for toxicological assessments of nanoparticles. In the present study the cichlid fish, Etroplus maculatus is used as a piscine model for the rapid estimation of nanoparticle toxicity as it is very easy to rear, feed and are best to lodge in neutral to hard water. There is a growing concern that aquatic environmental pollutants have an impact on the direct behavioral responses on fish. Although numerous literatures have discussed the effect of environmental pollutants on aquatic ecosystem, there is a lack of data stating the outcome of nanoparticles on the behavior of aquatic animals, particularly fish. As behaviour serves as a link between physiological and ecological processes, it may be measured as an ultimate parameter for studying the effect of toxicant in the aquatic environment. In aquatic animals, respiration is an important process that plays a vital role in controlling the energy transformation. Therefore, the metabolic responses of organisms due to the changes in the surrounding environment are an indicator of the acclimatization of the organism, and alteration in the rate of oxygen consumption reflects changes in the internal metabolic activities of the animals. Thus the study was focused on the consequence of fullerene (C60) nanoparticle on the rate of oxygen consumption and behavioural modification in the cichlid fish, Etroplus maculatus.
MATERIALS AND METHODS
Etroplus maculatus weighing 8.5 ± 1.5 g and length 9 ± 1 cm were collected from a fish farm, Kaloos Aquarium, Kottakkal, Kerala. Fishes were then transported to the laboratory and were acclimatized to the laboratory conditions before the start of experiments. Constant supply of dechlorinated water and good lighting system (12: 12 h; light: dark) was maintained throughout the experiments. The physico-chemical features of the tap water were estimated as per APHA (4). Water temperature in the test ranged from 28 ± 2°C during the experiment, oxygen saturation of water ranged between 70 and 100 %, pH is 7.6 which were monitored using a standardized measures. Fullerene C60 (CAS No. 99685-96-8) of 99.9% purity was a generous gift obtained from Suzhou Dade Carbon Nanotechnology Co. Ltd., China. DMSO (1%) was used as a solvent to dissolve fullerene which was sonicated in SonicsVibracell VX-400 at 35 Hz for 30 min at 3 sec pulse interval to attempt uniform dispersion before adding to the exposure tanks to reach 100 µg/ L. It is also important to point out that the present study was specifically designed to evaluate interactions between the nanoparticle fullerene and the biological system as fish model, not to mimic, for example, an environmental exposure scenario. Therefore the above concentration was chosen for the present study. All other chemicals were of high purity and analytical grade. Experiments were carried out with 10 animals per group maintaining 3 groups of animals. In the present study the nanoparticle fullerene was exposed to animal through fish feed. For this initially total food consumption per fish per day was recorded and it was observed that 74.4 mg of feed (i.e. approximately 24 fish pellets) are required per fish (weighing 8.5 ± 1.5 g and length 9 ± 1 cm) per day. In our laboratory standard fish feed was used that was obtained from Grost and Bumpk Suppliers, Cherthala, Kerala, India. Then the nanoparticles fullerene (100 µg/ L concentration) was added to prior weighed fish feed, mixed, and dried in oven as per standard procedure and were used in the treatment group. Group I is non-treated group where fishes were fed without toxicant and maintained for 96 h. Group II is control group where fishes are exposed to feed prepared with vehicle only (1% DMSO) and maintained for 96 h. For this 350 µl solvent was used and previous findings in our laboratory have demonstrated that no adverse biological effects of DMSO (Dimethyl sulphoxide) at this concentration; however, use of a solvent will likely increase the uptake of material into the animal. Group III is fullerene-treated group where fishes were fed with fullerene dissolved in 1% DMSO at 100 µg concentration per litre and was also retained for 96 h. Every treatment tanks were covered with monofilament net to prevent the specimens from jumping out of test solutions. The mortality as well as the behaviour of fishes was recorded throughout the study. Oxygen consumption was determined by Winkler’s method (5). Before starting the experiment initial sample was collected immediately from each group without causing any damage to the animal. Then at every six hours sample was collected up to 96 h of exposure and the rate of oxygen consumption in each samples were calculated considering net weight of fish by using formula given by Winkler’s method. Briefly, the samples to be tested was collected in a 300 mL BOD (Biological Oxygen Demand) bottle taking special care to avoid adding air to the liquid being collected and it was stopper. Then bottle stopper was removed and 1 mL of the manganous sulfate solution was added at the surface of the liquid and followed by the addition of 1 mL of the alkaline-potassium iodide-sodium azide solution. The stopper was replaced avoiding trapping of air bubbles, shaken well by inverting the bottle several times. Concentrated sulfuric acid 1 mL was added to run down the neck of the bottle above the surface of the liquid and shaken well until the precipitate has dissolved. The volume of treated sample was titrated, which corresponds to 200 mL of the original sample as this corrects for the loss of some sample during the addition of reagents (4). The volume was calculated using the formula: mL of sample to titrate = 200 x [300/(300-2)] = 201 mL Then 201 ml of sample was poured from the BOD bottle into a flask and titrated against 0.0250 N sodium thio-sulfate to the first disappearance of the blue color and the total number of mL of sodium thiosulfate used was recorded and the dissolved oxygen was estimated by the formula mg/L oxygen consumption = (mL titrant x normality of titrant x 8000)/equivalent volume of sample titrated. The difference in dissolved oxygen content between initial and final water samples represents the amount of oxygen consumed by the fish. Thus the rate of oxygen consumption was expressed as ml of O2 / litre/ g/ h. However, in the present study the final results of oxygen consumption only at 96 h were given from the collected control and treated samples. Statistics were compiled using SPSS, version 19.0, where Students t-test was used to determine significant difference between control and treated groups (p < 0.05; p < 0.01). All exposure groups consisted of 10 animals (N = 10) and data are expressed in Mean ± Standard Deviation (SD).
RESULTS
Oxygen consumption was found to be decreased at the end of fullerene treatment when compared to the corresponding control groups; however, the data of vehicle control (DMSO) was not shown (Table 1). The weights of fish were decreased and there was mucous deposition throughout the body of treated animal (Table 2). Weights of gill, liver, brain, ovary and testis decreased significantly than that of the control fish (Table 2). DMSO treatment did not show any significant changes in the body weights or organ weights and the results were found similar to non-treated control group, therefore the data was not represented in the present study. Alterations in behavioural patterns including erratic swimming and surfacing activity, slow opercular movements, reddening of skin and haemorrhage on surface of the body through scales were well marked during the period of trial (Figure 1). However, no mortality was observed throughout the study.
DISCUSSION
Toxicity effects of fullerene C60 through fish feed was assessed in the cichlid fish, Etroplus maculatus as biological model. Present investigation clearly demonstrates that exposure to fullerene through fish feed efficiently target the model organism and it was proved through various parameters including rate of oxygen consumption and behavioural modification in the cichlid fish. In the present study the potential toxicity of fullerene was evaluated by observing the total body weight gain or loss of the animal for the exposed period. It was renowned that at acute exposure of fullerene for 96 h showed a decrease in the total body weight of the fish when compared to the control groups. The reduction in the body weight may be due to treatment related effect but it was observed that no animals are noticed with anorexia as the food consumption was not decreased throughout the study and no pellets were found left at the end of each day observations in both control and treatment groups. In addition, there was a significant increase in the deposition of mucous throughout the body of fullerene-treated animal than that of control groups. The present observation reveals that when fullerene was exposed through fish feed it enters into gut and as soon as it reaches other vital organs as gill, liver, brain (as nanoparticles can passes through the blood-brain barrier) and also the reproductive organs could have caused the animal to secrete mucous throughout the body as the first line of defensive mechanism to dispose the toxicant from the body. Our previous study on the exposure of one of the nanoparticles, silicon dioxide to Oreochromis mossambicus had shown a comparable observation (6). Moreover the presence of mucous is an indicator of existence of toxic substances in the water and this could lead to the functional alterations and intrusion in fundamental process such as osmoregulation (7). Fullerene treatment significantly decreased the weights of gill, liver, brain, ovary and testis than that of control groups and it was evidenced that fullerene through fish food could seriously affect the vital organs of the animal. A change in respiratory rate is common physiological responses of fish to any toxicants. It can be detected easily through changes in rate of oxygen consumption, which was frequently used to evaluate the changes in metabolism under environment deterioration. In the present study the decrease in the rate of oxygen consumption by Etroplus maculatus at 96 h of fullerene exposure through fish feed may be due to internal action of nanoparticle fullerene C60. Thus it was evident that fullerene exposure disrupts the osmotic regulation of fish and this may be possibly due to the adverse effect of nanoparticle on gills and could have caused disruption in the efficiency of oxygen uptake, which could induced respiratory stress and impaired oxidative metabolism, and also may be due to mucous secretion on body surface upset osmoregulation (8). Nanoparticles are known to cause biochemical changes in the brain of fish, which can lead to behavioural changes (9). Nanoparticles can be taken up through gut or gill and via blood are transferred to several organs, including the brain. Therefore, fishes in the present study when exposed to fullerene through fish feed are known to cause several behavioural changes. Immediately after the fullerene exposure fishes showed air engulping behaviour and vigorous swimming to tide over the stress. After few hours fishes fight among themselves and they tried to escape from the aquarium tank followed by sinking behaviour. At the end of the treatment period, hemorrhage was noticed on scales as well as on the pectoral fin. Red bulged eyes, shedding of scales, slow opercular movement was also noticed.
CONCLUSION
In the present study the exposure to fullerene C60 even at therapeutically proven concentration as antioxidant is measured as toxic to aquatic animals as fish. An emerging nanoscience have the market growth of fullerene through several applications, such as creams used on skin, or for drug delivery, but there is a widespread concerns about their adverse effects on human health. The present investigation clearly portraits that fullerene C60 at 100 µg/ L concentration through fish feed imbalance osmotic regulation as well as caused behavioural modifications in cichlid fish, Etroplus maculatus.
ACKNOWLEDGEMENT
The authors acknowledge the funding agency, University Grants Commission-Special Assistance Programme, Government of India for this study. Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=670http://ijcrr.com/article_html.php?did=6701. Tong J, Zimmerman MC, Li S, Yi X, Luxenhofer R, Jordan R, Kabanov AV. Neuronal uptake and intracellular superoxide scavenging of a fullerene (C60)-poly(2-oxazoline)s nanoformulation. Biomaterials 2011; 32: 3654-65.
2. Cai X, Jia H, Liu Z, Hou B, Luo C, Feng Z, et al. Polyhydroxylated fullerene derivative C60(OH)24 prevents mitochondrial dysfunction and oxidative damage in an MPP+ induced cellular model of Parkinson’s disease. J Neurosci Res 2008; 86: 3622- 34.
3. Usenko CY, Harper SL, Tanguay RL. Fullerene C60 exposure elicits an oxidative stress response in embryonic zebrafish. Toxicol Appl Pharmacol 2008; 229: 44-55.
4. APHA. Standard methods for the examination of water and waste water, 20th Edition, Washington, DC. 1998.
5. Welsh JH, Smith RI. Laboratory Exercise in Invertebrate Physiology. Burgess Publishing Co., Minneapolis. 1961.
6. Vidya PV, Chitra KC. Elevation of reactive oxygen species in hepatocytes of tilapian fish when exposed to silicon dioxide: A potential environmental impact of nanomaterial. Int J Recent Sci Res 2015; 6(3): 2990-5.
7. Bernet D, Schmidt H, Meier W, Burkhardt-Holm P, Wahli T. Histopathology in fish: proposal for a protocol to assess aquatic pollution. J Fish Diseases 1999; 22: 25-34
. 8. Mukadam M, Kulkarni A. Acute toxicity of cypermethrin, a synthetic pyrethroid to estuarine clam Katelysia opima (Gmelin) and its effect on oxygen consumption. J Agri Chem Environ 2014; 3: 139-43.
9. Smith CJ, Shaw BJ, Handy RD. Toxicity of single walled carbon nanotubes to rainbow trout, (Oncorhynchus mykiss): Respiratory toxicity, organ pathologies, and other physiological effects. Aquatic Toxicol 2007; 82: 94-100.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareTHE PREVALENCE OF PALMARIS LONGUS ABSENCE IN THE CITY OF KERMAN IN IRAN AND THE RELEVANCE OF AGE, GENDER AND BODY SIDE
English4548Babaee AbdolrezaEnglish Dehghani Soltani SamereEnglish Ansari Javad MohajerEnglish Eftekhar Vaghefi Seyed HasanEnglish Ezzatabadipour MassoodEnglishBackground: Phylogenetic agenesis, comparative anatomy and clinical importance of palmaris longus (PL) as a vestigial muscle have been considered by anthropometric studies.
Objectives: Determination of the prevalence of absence of this muscle in the city of Kerman in Iran and possible relevance of sex and the left or right sides were the main goals of present study.
Methods: In total, 900 individuals, 14–50 years old, from the city of Kerman in Iran whocould take advantage of the standard Schaeffer’s test were studied.
Results: The overall PL absence in both sexes was 33.7%. The frequency of bilateral absence of PL was not significant in both genders. Our findings showed a markedly higher right-sided PL agenesis in females (9.8%) than in males (5.8%). Additionally, this data demonstrated a higher left-sided absence of PL in the young group than in the middle-aged group which was statically significant (p=0.001).
Conclusion: The total prevalence of PL agenesis was higher in comparison with reported data in literature and textbooks. Findings of the present study indicated that the prevalence of PL absence is significantly different to other regions and findings in textbooks. These results are important as phylogenetic and clinical issues.
EnglishHuman, Palmaris iongus muscle, Agenesis, Phylogenetic, AnthropometryINTRODUCTION
The palmaris longus (PL) is one of the superficial flexor muscles of the forearm. It has a short fusiform bellyand long cord-like tendon. Its tendon is a useful indicator ofthe anatomical position of the median nerve in surface anatomy. Although variability in the muscles is low, PL variation is relatively high, such as in double muscles, anomalous attachments and the existence of a distal belly. The latter instance can produce symptoms of carpal tunnel syndrome by compressing the median nerve.1, 2 However, the most common variation of this muscle is PL agenesis.3 The attention of anthropometric and clinical studies has been attracted to phylogenetic agenesis of PL for the following reasons: one of them is PL’s weakened performance in human bipedal locomotion in comparison with quadrupedal mammals and the other is its tendon usage in reconstructive surgery such as cruciate ligament replacement in the knee, upper eyelid ptosis correction and chin reconstruction.4 Absence of PL was reported for the first time by Columbus in 1559.5 PL absence in the entire population is about 13– 15% 6, 7 but significant differently data has been reported in different regions and for different racial groups: from 1.5% for Zimbabwean to 63.9% for the Turkish population.8, 9 The relationship between PL absence and factors like region, race and sex maybe the reason forthe different data presented.10 Is unilateral absence of PL (left or right sided) related to these factors? Therefore, determination of prevalence of unilateral or bilateral PL absence and its relation with gender, age and right or left side of the body in the city of Kerman of Iran were the aims of this study.
MATERIALS AND METHODS
To accomplish this research, 900 individuals who lived in the city of Kerman in Iran were randomly selected and their upper limb extremities were examined. The sample population included 450 healthy males and 450 females (age: 14 to 50; mean±standard deviation: 23.66±6.80). Existence or absence (unilateral and bilateral) of the PL tendon was assessed by taking advantage of a standard test (Schaeffer’s test). On the basis of this test, the opposition of the thumb and little finger and then flexion of wrist (about 20 degrees) distinguishedthe tendon of the PL on the front of the distal part of the forearm.3 If the tendon of the PL was not satisfactorily palpable by standard test, three additional tests (Thompson’s fist test, Mishra test and Pushpakumar’s “two-finger sign”method) were carried out to determine PL absence.5 In addition, the age and sex of each person were recorded. The subjects of this study were divided into two groups: (1) young (aged 14–28) and (2) middle-aged (aged 29–50). Statistical analysis was done by SPSS software (version 16). The prevalence of agenesis of PL was presented with a 95% confidence interval and the association between PL agenesis and age groups and gender analyzed using the chi-square test. Differences were considered significant at p Englishhttp://ijcrr.com/abstract.php?article_id=671http://ijcrr.com/article_html.php?did=6711. Jashni HK, Rahmanian K, and Jahromi AS.Relation of Palmaris Longus agenesis with hand dominance.Life Sci J 2014;11(2).
2. Backhouse K and Churchill-Davidson D.Anomalous palmaris longus muscle producing carpal tunnel-like compression. The Hand 1975;7(1): p. 22-24
. 3. Kose O, et al. The prevalence of absence of the palmaris longus: a study in Turkish population. Arch Orthop Trauma Surg 2009;129(5): p. 609-611
. 4. Foucher G, et al. Primary palmaris longus transfer as an opponensplasty in carpal tunnel release. The J Hand Surg: British and European Volume 1991;16(1): p. 56-60
. 5. Sebastin SJ, Lim AY and H. Wong, Clinical assessment of absence of the palmaris longus and its association with other anatomical anomalies-a Chinese population study.Ann Acad Med, Singapore 2006;35(4): p. 249.
6. Kapoor SK, et al. Clinical relevance of palmaris longus agenesis: common anatomical aberration.Anat Sci Int 2008;83(1): p. 45-48.
7. Sinnatamby CS, ed. Last`s Anatomy (regional and Applied). Tenth ed. 1999; Timothy Horne (for Churcill Livingstone). 63.
8. Ceyhan CAM, Distribution of agenesis of palmaris longus muscle in 12 to 18 years old age groups. Indian J Med Sci 1997;51(5): p. 156-160.
9. Gangata H. The clinical surface anatomy anomalies of the palmaris longus muscle in the Black African population of Zimbabwe and a proposed new testing technique.Clin Anat 2009;22(2): p. 230-235.
10. Thompson N, Mockford B, and Cran G.Absence of the palmaris longus muscle: a population study.Ulster MedJ 2001;70(1): p. 22.
11. Aversi-Ferreira RA, et al. Morphometric and Statistical Analysis of the Palmaris Longus Muscle in Human and NonHuman Primates. BioMed Res Int.2014; URL: http: // dx.doi. org/10.1115/2014/178906 (accessed, September, 2014).
12. Kyung DS, et al. Different frequency of the absence of the palmaris longus according to assessment methods in a Korean population.Anat Cell Biol 2012;45(1): p. 53-56.
13. Kigera JW and Mukwaya S.Frequency of Agenesis Palmaris Longus through Clinical Examination-An East African Study. PloS one 2011;6(12): p. e28997.
14. Sadeu JC, et al. Alcohol, drugs, caffeine, tobacco, and environmental contaminant exposure: Reproductive health consequences and clinical implications.Crit Rev Toxicol 2010;40(7): p. 633- 652.
15. Tejaswi HLSYD. Clinical Assessment of Agenesis of Palmaris Longus and Flexor Digitorum Superficial is in Indian Population. Int JRecent Trends in Sci Technol 2014;10(3): p. 492-494.
16. Mbaka GO, and Ejiwunmi AB.Prevalence of palmaris longus absence–a study in the Yoruba population. Ulster Med J 2009;78(2): p. 90.
17. Enye L, Saalu L, and Osinubi A, The prevalence of agenesis of Palmaris longus muscle amongst students in two Lagos-Based Medical schools. Int. J. Morphol 2010;28(3): p. 849-54.
18. Eri? M, et al. Prevalence of the palmaris longus through clinical evaluation. Surg Radiol Anat 2010;32(4): p. 357-361.
19. Sater MS, Dharap AS, and Abu-Hijleh MF.The prevalence of absence of the palmaris longus muscle in the Bahraini population. Clin Anat 2010;23(8): p. 956-961.
20. Karimi-Jashni HKR, and Jahromi AS, AGENESIS OF PALMARIS LONGUS IN SOUTHERN OF IRAN: A POPULATION BASED STUDY. OnLine J Biol Sci 2013;14(1): p. 8.
21. Keyghobad Ashoori M, and Dahmardehei M.Prevalence of Palmaris Longus Agenesis in a Hospital in Iran. Arch Iranian Med 2013;16(3): p. 187.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareIL-3 AND GM-CSF INDUCES INCREASED RECRUITMENT OF LYMPHOCYTES IN PERIPHERAL BLOOD IN ENU INDUCED LEUKEMIA MOUSE MODEL
English4953Ashish Kumar SinghaEnglish Bhaskar BhattacharjeeEnglish Debasish MaitiEnglishAim: The enrolment of blood progenitor cells from the bone marrow into peripheral blood or mobilization is required in leukemia following treatment with chemotherapy and/or cytokines. In this experiment, we examined the mobilization of lymphocytes from bone marrow to peripheral blood using interleukin-3 (IL-3) and granulocyte monocyte-colony stimulating factor (GM-CSF) in experimentally induced leukemia model.
Methods: In our Laboratory, leukemia is induced in Balb/C mice by challenging with N’-N’ Ethylnitrosourea (ENU) at the dose of 80mg/kg body twice in one week interval and confirmed by staining of peripheral blood and bone marrow smear. After confirmation of leukemia induction, animals were received rmIL-3 and rmGM-CSF in combination for consecutive four days. Leishman’s staining of peripheral blood smear and isolation of lymphocytes by percoll gradient method used in this study to determine the cell count.
Results: Total leukocyte count exhibits 6 folds higher in number in leukemia group compared to control group. After combination of treatment the total leukocyte count was same as leukemic control group until the sacrifice of animals. But the lymphocyte count increased around 2.6 fold after combination of IL-3 and GM-CSF treatment to leukemic mice.
Conclusion: This data suggests the mobilization of lymphocytes from bone marrow to peripheral blood may be immunologically beneficial to combat against tumor cells
EnglishMobilization, Leukemia, ENU, interleukin-3, Granulocyte monocyte colony, Stimulating factorINTRODUCTION Conventional cancer treatment strategies include chemotherapy and radiotherapy. The rationale for administration of high-dose chemotherapy and/or radiation to patients with therapy-sensitive tumours is to reduce tumour burden (Kapustay PM. 1997). Carriage of these therapies with respect to higher drug doses and intensified schedule are resulted by organ toxicities (e.g., bone marrow, heart, and lung) and pancytopenia (Walker F et al., 1994). Hematopoietic stem/progenitor cells (HSC) were formed from the bone marrow and transported generally as mature hematopoietic cells into peripheral blood. The alterations of cells transportation in following treatment with chemotherapy and/or cytokines is termed as mobilization (Lemoli RM et al., 2008). Numerous factors affect HSC mobilization: age, type and dose of cytokines used, in the autologous setting, the patient‘s diagnosis, mobilizing chemotherapy regimen, number and type of previous chemotherapy cycles or radiation, and interval from last chemotherapy cycle (SuarezAlvarez B et al., 2012). Leukemia is a type of cancer of the blood or bone marrow featured by an abnormal increase of immature leukocytes and clinically it is called blast cells. Generally, it starts in the bone marrow, the soft tissue inside most bones. All of the primary elements of the blood are derived from multipotent stem cells found primarily in the bone marrow. During the diseased condition, impair the ability of the bone marrow to produce red blood cells and platelets (Mackaness GB. 1964). Lymphocyte which are derived from the bone marrow and become matured in spleen or thymus, participates in immune system. It is to be believed that; different subpopulation of T cells performs different function in cancer. CD8+ T cells mainly provide antitumor activity (Yusuf Net al., 2008; Kmieciak M et. al., 2011). However, in leukemic condition most of the lymphocytes are in defected condition. CD4+ T cells are not involved directly in antitumor activity whereas pure CD8+ T cells alone can have the antitumor activity as well as can help to survive in marrow transplant condition (Palathumpat V et al., 1995). The number of normal CD8+ T cells present in the blood is important and if the number is not sufficient to fight against the cancer cells in leukemia, the condition of the patient will deteriorate. In diseased condition, as many normal activated CD8+ T cells will present in the blood, immune system can protect the disease progression and so mobilization of lymphocytes by some cytokines and growth factors (Fu P et al., 2006) are helpful. IL-3 stimulates the differentiation of multipotent hematopoietic stem cell into lymphoid lineage; IL-3 stimulates proliferation of all cells in the myeloid lineage, in conjunction with other cytokines like GM-CSF). GM-CSF stimulates stem cells to produce granulocytes and monocytes. Monocytes exit the circulation and migrate into tissue, whereupon they mature into macrophages and dendritic cells to fight against infection through inflammatory cascade. The function of IL-3 is quite similar to GM-CSF. Reports suggest that, combination dose of GM-CSF and IL-3 enhances megakaryocyte maturation and platelet count in primates (Stalh CP et al., 1992). It was also suggested that, treatment of G-CSF or GM-CSF with IL-3 exhibits increased rate of neutrophil and monocyte release in peripheral blood from bone marrow (Lord B et al., 1991). Treatment of IL-3 in patient with bone marrow failure, observes significant increase in leukocyte count (Ganser A et. al., 1990). It was reported that, GM-CSF were used as immunotherapeutic agent in alone or in combination with other factors and cytokines (Arellano M et al., 2008) to treat different type of solid cancer. IL-3 alone also can induce the lymphocyte differentiation and proliferation (Leite-de-Moraes MC et al., 2002; Dilloo D et al., 1996).
MATERIALS AND METHODS
Chemicals required: N-ethyl-N’-nitrosourea (ENU) obtained from Sigma Aldrich, USA. RPMI-1640, Hank’s balanced salt solution (HBSS), Antibiotic solution from Himedia, India. Percoll from GE Healthcare, USA. rmIL-3, mrGM-CSF from ImmunoTools GmBH, Germany. Leishman’s stain from LOBA Chemicals. PBS and the other chemicals were obtained from SRL, India.
Maintenance of animals
Male Balb/C mice, 3-4 weeks old, were obtained from National Institute of Nutrition, Hyderabad, India. Mice were housed in a virus-free animal facility for the duration of the experiments as per guidelines of Institutional Animal Ethics Committee, Tripura University (Ethical Clearance Ref. No.: TU/IAEC/2014/VIII/3-2; Dated: 12-09-2014). These mice were kept and maintained specific pathogen free condition with proper humid (60-65%), and temperature 25-28o C in Tripura University Animal House. Food, dietary supplements and water were provided ad libitum.
Numbers of animal used
Four groups (two groups as control and two groups of leukemic mice) were used for entire experiment having six animals in each group. Group I: Normal control introduced with PBS only. Group II: Challenged with ENU for leukemia induction. Group III: Normal mice received only PBS and treated with rmGM-CSF and rmIL-3 in combination starting at 5days before sacrifice at 24 hr. of interval. Group IV: Mice challenged with ENU and after five months confirmed leukemia and treated with rmGM-CSF and rmIL3 in combination starting at 5 days before sacrifice at 24 hr. of interval.
Treatment of animals
Leukemia control mice are produced by treating with Nethyl-N’-nitrosourea (ENU) at 80 mg/Kg body weight at 3-4 weeks old condition twice in one week interval (Chatterjee R et al., 2015; Law S et al., 2001).
Cytokine supplementation
After confirmation of leukemia induction, all the mice from group III and IV were received rmIL-3 and rmGM-CSF in combination for 4 consecutive days(ImmunoTools GmBH, Germany) (Stalh CP et al., 1992, Lord BI et al., 1991).
Sample collection
All the mice were sacrificed as per guidelines of Institutional Animal Ethics Committee. Mice were dissected and peripheral blood was collected using a sterile syringe into a 2 ml micro centrifuge tube containing heparin solution. The spleen was collected in 1X PBS for T cell isolation. The bones from upper and lower legs were dissected and kept it into 1X PBS for bone marrow smear.
Blood smear and bone marrow smear preparation
After five months of first injection of ENU, a drop of peripheral blood were drawn in a clear, fresh and grease free slide for blood film smear. The blood and bone marrow smear were stained with Leishman’s stain for differential analysis of blood cells. Appearance of blast cells confirmed the leukemia induction in animal and was again confirmed by taking bone marrow smear after sacrificing the animal.
Total count
Small amount of blood were used for total count using Neubeur’s hemocytometer chamber. Remaining blood sample were used for analysis using Blood Analyzer (Cellenium 19, Trivitron)
Isolation of splenic lymphocytes
Non-adherent cells from the splenic suspension removed after macrophage isolation was layered at the top of the percoll layer. Percoll gradient were made using 0.25M sucrose solution and iso-osmolar percoll solution, according to the instruction of manufacturer (GE Healthcare USA). After centrifugation of percoll gradients with cell suspension the layer at upper phase contains lymphocyte cell population taken in separate fresh tube (Depamede NS 2010). After isolation small amount of cells were taken in 1.5 ml microfuge tube to check the purity and was confirmed by using anti CD8 primary antibody (SC-18860 FITC, Santacruz Biotech Inc.) followed by FITC conjugated goat antimouse secondary antibody. The isolated cells were 95% pure CD-8+ cell. In brief, cells were fixed with 4% paraformaldehyde and kept in 1% gelatin coated slide. Cells were washed twice with PBST and blocked with 3% BSA. The cells were incubated with anti CD8 antibody conjugated FITC followed by washing twice and count the cells under the fluorescence microscope
Statistical analysis
All the readings were taken 3-5 times repeats of same experiments. Data were expressed as means ± SEM. Data were analyzed Student’s t test for test of significant using GraphPad Prism software. All statistical test were considered as (***p < 0.001, **p < 0.01, *p < 0.05).
RESULTS
Leukemia induction
After 5 months of the ENU challenge, mice showed some secondary infection including hair fall, foot and mouth infection, red colour of lower portion of nose. Two mice out of twelve treated mice were dead within five days of ENU introduction. Peripheral blood smear from tail vein showed appearance of blast cells with Leishman’s stain in ENU chal lenged mice which were absent in control group is confirmedfor leukemia induction. Further it is supported by bone marrow smear of ENU challenged group showed presence of blast cells which is one of the conventional diagnosis processes for the leukemia patient.
Total Count
The other conventional diagnostic process of leukemia is to count the total leukocyte number. In ENU challenged mice the total count increased around six fold compared to control mice (Figure 1). After treatment with IL-3 and GM-CSF in combination for 4 days, the total count of leukocyte taken every 24 hrs after treatment was not changed significantly.
Induction of lymphocyte count in peripheral blood after cytokine treatment:
After complete treatment of IL-3 and GM-CSF in ENU challenged group, number of lymphocyte (Figure 2) per 100 leukocytes were increased. Splenic lymphocytes (Figure 3) were isolated in percoll gradient method from all the groups of animals after the experiment was over. The total splenic lymphocyte count was almost four fold decreased in ENU induced leukemia animal which was restored again after treatment with IL-3 and GM-CSF in combination for consecutive four days.
DISCUSSION
Leukemia model is developed in our laboratory with ENU treatment according to the protocol published earlier (Chatterjee R et al., 2015). Blast cell appearance in peripheral blood as well as bone marrow smears confirmed the leukemia disease. The total cell count was increased, which are the symptoms, reminiscent of leukemia disease. But, after treatment of IL-3 and GM-CSF the total count remained same. Facilitating the normal and active cell count in peripheral blood may combat better way against the leukemic cells and after treatment with IL-3 and GM-CSF lymphocytes count was significantly increase compared to untreated leukemia . This might indicates the mobilization of lymphocytes from bone marrow to peripheral blood supported by lymphocyte count in peripheral blood. Cytotoxic T lymphocytes (CTLs) are the antigen specific effector cells of the immune system with the ability to lyse the virus infected cells, abnormal cells or parasites in a contact-dependent manner (Groscurth P et al., 1998). Numerous studies revealed that in solid tumor, the cytotoxic activity of CTL is decreased (Aerts J G et al., 2013, Hariharan K et al., 1995). During the disease condition, the number of functional normal cytotoxic T lymphocytes are (CTL) decreased in lung cancer (Aerts J G et al., 2013). These results also support our data that in diseased condition, the decreased number of CTL might be due to the killing activity of tumor cells and/or due to a hostile environment created by blast cells. It may happen that these cytokines may not activate CTL activity directly. Rather through antigen presenting cells these cytokines activate CTL activity. All of the CTL cells present in peripheral blood in leukemia condition may not function normally due to the hostile environment. Some tropic factors including cytokines like IL-3 and GM-CSF may responsible for differentiation and proliferation of normal hematopoietic stem cells of lymphoid lineage (Hoggatt J et al., 2011). CONCLUSION In animal leukemia model induced by carcinogen ENU, the number of cytotoxic T lymphocytes (CTL) was significantly reduced without affecting the total leukocyte count in the peripheral blood. The number of lymphocyte was again induced significantly towards normal with the treatment of IL-3 and GM-CSF in combination for consecutive 4 days. These experimental results may possibly suggest an immune-therapeutic approach for leukemia treatment.
ACKNOWLEDGEMENT
We are thankful to DBT, Govt. of India for funding as State Biotech Hub for this study. We also gratefully acknowledge to Dr. Manashi Saha (Roy), Dept of Pathology, Agartala Government College and Hospital for confirming the leukaemia. Authors acknowledge the immense help received from the scholars whose articles are cited and included in reference of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature has been received and discussed.
Ethical permission
All the animal experiments were done with proper permission and according to the guidelines of Institutional Animal Ethics Committee (IAEC) of Tripura University.
Conflict of interest
The authors declare that there is no conflict of interest for this study
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20. Stahl CP, Winton EF, Monroe MC, Hoff E, Holman RC, Myers L, et al. Differential effects of sequential, simultaneous, and single agent interleukin-3 and granulocyte-macrophage colonystimulating factor on megakaryocyte maturation and platelet response in primates. Blood 1992; 80: 2479-2485.
21. Suárez-Álvarez B, López-Vázquez A, López-Larrea C. Mobilization And Homing Of Hematopoietic Stem Cells. Stem Cell Transplantation, edited by Carlos López-Larrea, Antonio LópezVázquez and Beatriz Suárez-Álvarez. Landes Bioscience / Springer Science+Business Media, LLC dual imprint / Springer series: Advances in Experimental Medicine and Biology 2012; 741.
22. Walker F, Roethke SK, Martin G. An overview of the rationale, process, and nursing implications of peripheral blood stem cell transplantation. Cancer Nurs. 1994; 17(2):141-148.
23. Yusuf N, Nasti TH, Katiyar SK, Jacobs MK, Seibert MD, Ginsburg AC, et al. Antagonistic roles of CD4+ and CD8+ T-cells in 7,12-dimethylbenz(a)anthracene cutaneous carcinogenesis. Cancer Res 2008; 68(10): 3924-30
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareSOLUTION OF 3-DIMENSIONAL WAVE EQUATION BY METHOD OF SEPARATION OF VARIABLES
English5456Rajan SinghEnglish Mukesh ChandraEnglish B.K. SinghEnglishWe study solutions of the 3-Dimensional wave equation with boundary Conditions on Cartesian co-ordinates, and we also study the analogous problem on a certain axis. This gives an alternative method of obtaining solutions of a corresponding problem in 3-Dimensional wave equation further, In this paper, we find the solution of 3-D wave equation .Three dimensional wave occur in earth quake, tsunami and many physical states. In this paper we discussed the 3-D wave equation in XYZ axis and using partial differential equation.
English3-D wave equation, Partial differential Equation, Fourier series.INTRODUCTION
Solutions of the wave equation with boundary conditions have many practical applications in engineering and physics. The paradigm of such textbook problems is that describing vibrations of a circular membrane (the shape of a drum) requiring solutions of the wave equation in a 3- dimensional. These solutions must vanish on the rectangular boundary of the membrane [8]. A theoretical application of much current interest, requiring such solutions, is the computation of sound energies for spherical boundary conditions. We show here that it is just as easy to set up such problems in a certain co-ordinate plane [3]
RESEARCH METHODOLOGY
The following Research Methodology is adopted for the proposed Research paper: • Identification of the problem
• Collection and study of related literature
• Mathematical formulation of the problem
• Analysis and numerical solution of the mathematical model
• Interpretation of results
• Conclusion
Mathematical formulation of the problem
The physical setting for our problem is as follows. We consider the three dimensional wave equations with the normal axis. Three dimensional wave equation is
CONCLUSION
In this paper, for a general solution of three dimensional of wave equations is fond and with the help of this solution, we have to find varies kind of solution wave equations for example radio waves, telephonic wave etc.
ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in the manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. Authors are grateful to IJCRR editorial board members and reviewers for their useful comments that lead the improvement of the manuscript.
Englishhttp://ijcrr.com/abstract.php?article_id=673http://ijcrr.com/article_html.php?did=6731. Adomian, G. (1994)., Solving Frontier problems of Physics: The decomposition method. Kluwer Academic Publishers.
2. Courant, R. and Hilbert, D. (1962), Methods of Mathematical Physics II, New York: Wiley-Interscience.
3. Evans, L. C. (1998), Partial Differential Equations, Providence: American Mathematical Society, ISBN 0-8218-0772-2.
4. Ibragimov, Nail H (1993), CRC Handbook of Lie Group Analysis of Differential Equations Vol. 1-3, Providence: CRCPress, ISBN 0-8493-4488-3.
5. John, F. (1982), Partial Differential Equations (4th ed.), New York: Springer-Verlag, ISBN 0-387-90609-6.
6. Jost, J. (2002), Partial Differential Equations, New York: Springer-Verlag, ISBN 0-387-95428-7.
7. Lewy, Hans (1957), “An example of a smooth linear partial differential equation without solution”, Annals of Mathematics. Second Series 66 (1): 155–158.
8. Polyanin, A. D. (2002), Handbook of Linear Partial Differential Equations for Engineers and Scientists, Boca Raton: Chapman and Hall/CRC Press, ISBN 1-58488-299-9.
9. Wazwaz, Abdul-Majid (2009). Partial Differential Equations and Solitary Waves Theory. Higher Education Press. ISBN 90- 5809-369-7.
10. Zwillinger, D. (1997), Handbook of Differential Equatio
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareABLATION OF SULCUS SPERMATICUS FOR BIRTH CONTROL SURGERY IN MUGGER CROCODILES(CROCODYLUS PALUSTRIS)
English5760Justin William B.English G. Dhananjaya RaoEnglish M. BharathidasanEnglish R. ThirumuruganEnglish S. SimonEnglish R. JayaprakashEnglishRavi Sundar GeorgeEnglishObjectives: Mugger crocodiles breed twice in a year under captivity resulting in over population; requiring birth control measures. As the testis and vas deferens are intra-abdominal, the efficacy of surgical ablation of sulcus spermaticus that transport the
sperm during copulation, on the dorsal surface of the phallus was assessed.
Methods: Twelve male crocodiles weighing between 140 to 230 kg were immobilized and anaesthetized with a combination of xylazine-ketamine at the dose rate of 1.5 and 20 mg/kg body weight respectively. Under aseptic precautions the phallus was retracted through cloacal slit as the animal was positioned on dorsal recumbency. The mucous membrane guarding the groove and floor were resected to ablate the sulcus spermaticus and the mucous membrane on either side was sutured. After 6 to 8 months randomly 6 crocodiles were immobilized and the phallus was examined, which revealed no signs of regeneration of the groove.
Conclusion: The study revealed that ablation of sulcus spermaticus could be followed as a birth control surgery in male mugger crocodiles without affecting the welfare and breeding behavior.
EnglishBirth control surgery, Crocodiles, Male, Mugger, Phallus, Sulcus spermaticus, Surgical ablationINTRODUCTION
The mugger crocodile is a medium-sized crocodile which is restricted to the Indian sub-continent and has a broad snout, belonging to the genus Crocodyus(Silva da and Lenin, 2010). The mugger crocodiles are a hole-nesting species and the egg-laying takes place during annual dry season. Females become sexually matured when they reach approximately 1.8 to 2.0 meters and they lay 25 to 30 eggs in each clutch and the incubation period is 55 to 75 days (Whitaker, and Whitaker, 1979). In captivity they are known to lay two clutches in a single year (Whitaker and Whitaker, 1984). Often the population goes beyond the desired level which can be managed in captivity. Captive breeding and rearing programs in India have met with success. Excess numbers of captive-bred animals now reside in captivity, due to lack of suitable release sites in recent years. In reorganization of zoo rules 1992 (Wild Life-Protection-Act 1972) it is recommended to safeguard against uncontrolled growth in the population of prolifically breeding animals and every zoo shall implement appropriate population control measures like separation of sexes, sterilization, vasectomy, tubectomy and implanting of pallets etc. . The common procedures adopted in male to prevent deposition of sperm in female genitalia are either occlusion or resection of vas deferens and deviation or hiding the penis from being introduced. In crocodiles the testis and vas deferens are intra-abdominal and the vas deferens opens at the base of the penis. The measures adopted to control breeding in these species are segregation of male and female which make them more aggressive and stealing and destroying the eggs which are of welfare concern. Literature and careful anatomical study of male crocodile penis – the phallus, revealed that the presence of a sulcus spermaticus; located on the dorsal aspect of penis and is similar to urethra in depositing the sperm in female genitalia during mating (Ziegler and Olbort, 2007).The study was carried out to assess the efficacy of the surgical removal or ablation of the groove; sulcus spermaticus under anaesthesia as a birth control measure in male mugger crocodiles without affecting their breeding behaviour.
MATERIALS AND METHODS
The study was conducted on twelve male mugger crocodiles belonging to Arignar Anna Zoological Park, whose weights ranged from 140 to 230 kg, through a project on Health cover to captive Wild Animals (Prolifically Breeding Wild animals) in reorganization of zoo rules 1992, Government of India. The crocodiles were physically restrained with snares and chemically immobilized and anaesthetized with a combination of xylazine at the rate of 1.5 mg/kg body weight and ketamine at the rate of 20 mg/kg body weight administered intramuscularly (Shiju et al., 2012).
Exteriorization of phallus and examination
Under dorsal recumbency the ventral abdomen around the cloacal slit was cleaned and a gloved hand was introduced into the cloacal slit and the anterior aspect was explored for the presence of the phallus. The phallus in male is differentiated from female rudimentary phallus or clitoris in relation to age and length of the crocodile. The phallus was gently grasped at the crura, retracted back and exteriorized through the cloacal slit(Figure 1) to expose the shaft of the penis. The sulcus spermaticus was examined and the organ and cloaca was cleaned with one per cent povidone iodine solution.
Ablation of sulcus spermaticus
The mucus membrane folds on either side of the grove were infiltrated with 2 per cent lignocaine (Figure 2) and resected over the entire length upto glans penis using an electrocautery. The mucus membrane in the grove was excised to expose the underlying collagenous shaft with Bard-parker blade No. 10 (Figure 3). Haemorrhage was controlled and the mucous membrane on either side was opposed with polyglycolic acid suture material No. 1 without involving crura of penis (Figure 4). Povidone iodine ointment was applied on the wound edges and the phallus was repositioned in-situ.
Post-operative care
The operated mugger crocodiles were housed separately and observed for 7 days. Enrofloxacin was administered intramuscularly at the rate of 5 mg/kg body weight for three days post-operatively. The sulcus spermaticus ablated male crocodiles were left in their regular tank after 7 days along with their mates.
Examination of phallus after 6 months
After an interval between 6 and 8 months, 6 crocodiles were immobilized and the phallus was exteriorized and examined for the regeneration of the groove (Figure-5) under xylazineketamine immobilization. Further they were allowed to mate where only the sulcus spermaticus ablated males were retained in the tank along with the female.
RESULTS
Xylazine at the rate of 1.5 mg/kg and ketamine at the rate of 20 mg/kg when administered intramuscularly induced chemical immobilization and anaesthesia for a period of 45±3.26 minutes and the animals recovered in 2.45±0.91 hours.
Phallus anatomy
The phallus was hidden inside the longish cloacal slit. The retracted phallus was an unpaired laterally compressed organ located on the ventral wall of cloaca. The phallus could be divided into three regions; proximally a pair of crura located dorsal to the ischia, a fused penile shaft and distal glans. The penile shaft was curved and a V-shaped groove; the sulcus spermaticus, formed by a pair of mucous membrane folds that acted as wall on either sides of the groove. The groove extended the full length of the penile shaft and glans on the dorsal side when the phallus was in-situ. The groove was deep around one centimetre in adult mugger and it became shallow as it reached the glans penis. The glans penis was lappet-shaped and the tip was irregular with mucous membrane folds to which the sulcus spermaticus extended in the form of small branches (Figure-1,2). The mucous membrane cover over the shaft and gland penis was loosely adherent to the underlying tissue.
Ablation of sulcus spermaticus
Resection and excision of the mucous membrane folds on either side of the sulcus spermaticus resulted in total ablation of the groove. After opposing the mucous membrane the conical shape of the phallus was maintained. Bleeding was effectively controlled by the use of thermocautery. During the post-operative period the animals did not show any signs of discomfort.
Examination of phallus after 6 months
Examination of phallus in 4 crocodiles after 6 to 8 months of surgery revealed no signs of regeneration of the groove (Figure-5). Mating resulted in unfertilized without hatchlings following natural incubation.
DISCUSSION
Phallus anatomy and ablation of sulcus spermaticus
In mugger crocodiles a pair of testes (testis), are situated in the abdominal cavity on either sides of the spinal column. Vas deferens arising from testis, passes from the dorsal side of the cloaca to the ventral side, not accompanied by the ureter and opens into the blind sac which forms the basal continuation of the deep groove on the dorsal side of the phallus. As the testis and vas deferens are intra-abdominal, vasectomy could be performed only through laparotomy which was not attempted because it could be a major surgery with expected post-operative complications and the position of anterior abdominal vein. In certain lizards the vas deferens and ureter unite and form a short canal which opens beneath or upon a small papilla(Das and Purkayastha, 2012). Hence attempt was not made to close the blind sac as it could interfere with excretion from the urinary system and if the anatomical nature was similar to lizards in muggers. The copulatory organ in crocodiles is unpaired and called a phallus. It is formed of cavernous tissue and is erected when engorged with blood. The penis consists of two parallel bands of cancellous tissue, the corpora cavernosa (corpora cavernosa penis) at the ventral wall of the cloaca. Between them lies a groove, the sulcus spermaticus, which transports sperm from the vasa deferens. There is a glans (glans penis) of cavernous tissue at the extremity of the phallus. When engorged with blood, the corpora cavernosa enlarge and shape the sulcus spermaticus into a duct through which sperm flows and protrude the glans from the cloacal vent enabling its insertion into the cloaca of the female (Kelly, 2013). Amputation of penis was performed in a Nile crocodile for recurrent paraphimosis and bleeding (Lankester and Hernandez, 2005). When the animal was on dorsal recumbency; retraction of crura and exteriorization of phallus gave good visualization of the groove on the ventral aspect of the animal making it convenient for the surgery. The haemorrhage was controlled by electrocautery and suturing.
Examination of phallus after 6 months
Occasional cases of tail regeneration have been observed in crocodilians (Alibardi, 2010). In the present study regeneration could not be observed upto 8 months. Allowing the crocodiles with ablated sulcus did not produced fertilized eggs as no hatchlings could be located.
CONCLUSION
Ablation of sulcus spermaticus on the phallus of mugger crocodiles resulted prevented deposition of sperm into the female genitalia during mating without affecting the breeding behaviour and upto 8 months follow-up; the sulcus spermaticus did not regenerated.
ACKNOWLEDGEMENTS
The authors acknowledge the help rendered by the Director of Clinics, TANUVAS, Dean, Madras Veterinary College and Director of Arignar Anna Zoological Park, Chennai for the support and financial help for the purchase of drugs and surgical disposable. 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.
Competing Interests The authors declare that they have no competing interests.
Englishhttp://ijcrr.com/abstract.php?article_id=674http://ijcrr.com/article_html.php?did=6741. Alibardi, L., 2010. Regeneration of reptiles and its position among vertebrates. In. Morphological and cellular aspects of tail and limb regeneration in Lizards. A model system with implications for tissue regeneration in mammals. Springer, p1-49.
2. Das, M and Purkayastha, J., 2012. Insight into hemipenial morphology of five species of Hemidactylus Oken, 1817 (Reptilia: Gekkonidae) of Guwahati, Assam, India, Hamadryad. 36(1): 32 – 37.
3. Kelly, D.A., 2013. Penile anatomy and hypotheses of erectile function in the American Alligator (Alligator mississippiensis): Muscular eversion and elastic retraction. The Anat. Rec., 296: 488-494.
4. Lankester, F. and Hernandez, DSJ., 2005. Paraphimosis and amputation in a Nile crocodile (Crocodylus niloticus).J. Zoo Wildl. Med., 36(4):698-701.
5. Shiju, S, William, BJ., Jayaprakash, R.; Kumar, RS. and Thejomoorthy, P, 2012. Evaluation of xylazine-ketamine and xylazine - acepromazine -ketamine for surgical intervention in mugger crocodiles (Crocodylus palustris). Indian J. Field Vet. 7(4): 41- 44.
6. Silva da, A.and Lenin, J., 2010. Mugger crocodile Crocodylus palustris. In: Crocodiles. Manolis, S.C. and C. Stevenson (Eds), 3rd Edn., Staus Survey and Conservation Action Plan, India. P94-98.
7. Whitaker, R. and Whitaker, Z., 1979. Preliminary crocodile survey – Sri Lanka, J. Bombay Nat. Hist. Soc. 76 (1) 66-85. 8. Whitaker, R. and Whitaker, Z., 1984. Reproductive biology of mugger. J. Bombay Nat. Hist. Soc. 81(2) 119-127.
9. Wild Life (Protection) Act 1972, Recognition of Zoo Rules, 1992. Government of India.
10. Ziegler, T., and Olbort, S., 2007. Genital structures and sex identification in Crocodiles. Crocodile Specialist Group Newsletter, 26(3): 16-17.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareA FRAMEWORK FOR A HEURISTIC APPROACH TO EVALUATING AND ASSESSING ADAPTIVE HYPERMEDIA LEARNING SYSTEMS
English6168Jean-Pierre Kabeya LukusaEnglishThis article provides a holistic view of e-Learning as a by-product of Adaptive Hypermedia Learning Systems (i.e. AHLS). It aims at proposing a generic framework for evaluating and assessing AHLS. While many of the existing assessment and evaluation instruments yield useful findings (1), most of them seem to be revolving around one key problem – with so many variables that can potentially be considered of impact to the quality of these instruments, how do we re-adapt the assessment and evaluation instruments to produce results that are relevant to our learners’ ethnographic background1, pedagogical paradigm2, and the actual AHLS. It was also found that many authors choose to disregard (i.e. consciously or otherwise) some variables (2). This practice needs to be discouraged as it not only results in constraining findings but also distorts analysis of the flaws (and strengths) in current AHLS deployments. The proposed framework is designed on a premise that considers a number of studies namely; the E-VAL project models - considering factors from ethnographic, pedagogical, and applicable AHLS; and the Learning Object Review Instrument (LORI) – considering the nine dimensions of quality (3).
EnglishAdaptive hypermedia learning system (i.e. AHLS), Ethnographic research methods, Pedagogical paradigm, Heuristic approach, e-Learning assessment, Evaluation frameworkINTRODUCTION
This paper is aimed at proposing a heuristic framework tailored with the sole intent of improving existing evaluation and assessment methodologies used in determining the level of effectiveness of Adaptive Hypermedia Learning Systems (AHLS). AHLS or also known as Adaptive Educational Hypermedia Systems (AEHS) are reusable learning resources specifically designed to customize educational contents to an individual learner’s preferences (1). In order to better model the proposed framework, the author adopts a learner-centric (4) approach geared at viewing elearning ventures as by-products of AHLS. In light of this, care has been taken to generalize the proposed framework and present it in a universal format in order to ease adaptability to e-Learning Assessment or Evaluation studies.
BACKGROUND TO THE STUDY
AHLS are designed with the single intent of providing an educational content tailored to an individual learner (5). This is done by employing a ‘user model’ built on the basis of parameters derived from human factors (1). These human factors play an important role in the conception and development of AHLS thereby ensuring that their educational context range from gender differences (6) through prior knowledge to cognitive styles (7). Therefore the approach in AHLS is that just as people differ in many aspects, so do ways in which they learn (8). The argument raised is that of individual learners in need of personalized learning styles. Adaptive Hypermedia Learning Systems (AHLS) are specifically designed to provide this personalized service. AHLS closes this functional gap in Learning Management Systems (LMS) by providing a deployment approach that tailors a given learning experience (i.e. content and class activities) to an individual learner’s needs (9).
PROBLEM STATEMENT
A review of the existing literature has been conducted leading to the conclusion that most instruments developed for the Evaluation and Assessment of AHLS are justified through ethnographic research methods (i.e. handing questionnaires to participants) (2)(10). While many of these tools bore useful findings, most seem to revolve around one key question how do we re-adapt the assessment and evaluation instruments to produce results that are relevant to our learners’ ever changing ethnographic background, pedagogical paradigm, and the actual adaptive hypermedia learning system. The usual practice of disregarding some variables(11) is one to be discouraged as it not only results in constraining findings but also distorts analysis of the flaws (and strengths) in current e-Learning venture.
MOTIVATION
In addition to bringing a number of benefits such as low cost, ease of access, and user convenience; the primary concern of e-learning ventures is to improve existing learning processes and provide means for an easy integration of new teaching strategies(10). One key challenge faced by many researchers in this regard is to come up with the right approach of evaluating and assessing the entire e-learning venture. Another major problem is to decide on the inclusion of variables(12) that may potentially have an impact in the study design (2) and determine what constitutes dependent, independent, and irrelevant variables in the study(13). Depending on the scale of the study, this inherent problem, may bias the conclusions and prevent the study from accurately gauging the significance of the selected variables or missing them altogether (2). To derive the pool of variables of interest, a review of numerous studies including the E-VAL project and the LORI project was conducted. To avoid discarding important variables, cluster analysis (14) was used to rather converge them into homogeneous groups. The proposed framework is therefore presented as a heuristic approach for an assessment and evaluation methodology; offering a framework that is both generic and adaptable to e-learning systems as by-products of AHLS.
CONCEPTUAL FRAMEWORK
In order to establish a baseline to the study, the proposed framework will be referred to as the e-Val Framework in which ‘e’ stands for e-Learning and ‘Val’ for the valuation process that one goes through to determine the actual benefits of an e-Learning venture. The following diagram is used to demonstrate how the e-Val Framework would work in a given e-Learning scenario.
It is therefore hoped that the e-Val Framework may provide both a means for conducting an assessment aimed at increasing the level of quality and/or performing an evaluation with the intent of judging the level of quality of the e-Learning venture (15).
THE E-VAL FRAMEWORK: A TOOL FOR PARAMETRIC DEDUCTIONS
Derived e-Learning Ventures Characteristics and Factors The related studies reviewed revealed the list of generic factors presented in table 1 and that of characteristics presented
CLUSTER ANALYSIS: MEASURING HOMOGENEITY
Guiding Assumptions
Representativeness of the Sample For the initial run of the model, our pilot study group consisted of 32 randomly selected3 volunteers. The volunteers’ ranking of each of the 32 key characteristics against factors was considered and an average measure was drawn for each of the characteristics for processing. To determine the factorspecific groups of homogeneous objects, the K-Means Cluster Algorithm (12) was used. We refer to these factor-specific groups as clusters.
As illustrated in figure 3, each of the coded characteristics was ranked on a factor-specific scale (i.e. counts not recurring within characteristics). To tie the characteristics to factors, a Likert scale of 1 to 6 was used and the collected data was processed using SPSS.
Reduced Impact of Multicollinearity
Multicollinearity occurs when two or more predictor variables in a multiple regression model are highly correlated; allowing one variable to linearly predict the other(s) with a non-trivial degree of accuracy (18). Multicollinearity is an important assumption for researchers who wish to introduce new variables within the identified characteristics or introduce new characteristics altogether to improve the model factors. As a recommendation to future studies; to avoid any effect (19) due to Multicollinearity on the predictor variables one should:
• Reduce the variables to equal numbers in each set of correlated measures, or
• Use a distance measure that compensates for the correlation, such as Mahalanobis(12) distance
Deriving Clusters
In order to ensure that the identified characteristics (i.e. LC, LH, LA, etc…) in table 2 are properly classified according to identified generic factors in table 1, cluster analysis techniques are employed to guarantee that the resulting factorbased grouping (18) of the characteristics exhibit high internal (within cluster) homogeneity and high external (between cluster) heterogeneity (19).
Defining the Identified Clusters
To facilitate adaptation to multiple studies, a common language by means of First Order Logic (FOL)(17)(16) to present the resultant clusters (i.e. the independent variables) will be adopted. Cluster 01: Learner’s Aptitude
Cluster 02: Learning Context Suitability
Cluster 03: Technological Appropriateness???????
Cluster 04: Pedagogical Alignment???????
Cluster 05: Quality Alignment
Cluster 06: Learning Environment’s Appropriateness???????
THREATS TO VALIDITY OF THE E-VAL FRAMEWORK REGRESSION MODELS
In order to avoid a biased estimator of the causal effect due to the identified regressors5 , one needs to ensure that the statistical inferences about causal effects are valid for the population being studied (i.e. Internal validity) and that they can be generalized from the population and setting studied to other populations and settings (i.e. external ) (19). In this context the term “settings” refers to the legal, policy, physical environment and other related salient features.
MODEL VALIDITY
This section is used to demonstrate how the multiple regression models described in the e-Val Framework can be used to conduct assessment and/or evaluation in an actual study. For the sake of brevity, the regression model for learner’s aptitude will be used. Adapting the e-Val Framework entirely depends on how a given researcher presents his/her research objectives. To demonstrate this, let us suppose that our aim is to run an experiment where: An individual learner’s characteristic is described using the following variables:
• LC described in terms of age: LCA, sex: LCS, and visual impairment: LCV of the respondent.
• LH described in terms of experience rating: LHE, level of attainment: LHL, and enrolment Program duration: LHD.
• LA described in terms of attitude of learner towards learning experience: LAE
• LM described in terms of learner’s motivation towards a given learning style: LMS
• LF described in terms of learner’s familiarity with the technology: LFT
Therefore for the tuple L:
It can be deduced from table 6 that the F-ratio is not statistically significant. Hence the conclusion that the assumption of equal variances is tenable (i.e. there is homogeneity of variance).
Therefore, on the basis of the data provided, there is insufficient evidence to conclude that the learner’s attitude towards a given learning experience has a significant effect on his/her level of aptitude for significance level of 1% and, thus of 5% and 10%.
QUESTION 2: Does the learner’s visual impairment have a negative effect on his/her level of aptitude?
Therefore, on the basis of the data provided, there is insufficient evidence to conclude that the learner’s visual impairment has a significantly negative effect on his/her level of aptitude for significance level of 1%.
CONCLUSION AND FUTURE WORK
This paper is a step in the right direction in the development of robust and generic research methodologies for measuring the effectiveness of e-learning ventures through evaluation and assessment. Consented effort has been made to ensure that the proposed e-Val Framework is not only grounded on solid theoretical precepts but also presented in a format that is comprehensive, generic, and adaptable enough for an easy integration as a measuring tool to numerous studies. A deliberate measure had been taken to enable researchers to have more flexibility in to use the e-Val Framework with the assumption that they would adapt it to their specific needs. Moreover, one might instead of sticking to a purely multiple regression approach adopt a multivariate approach by combining the individual regressor equations to derive a more unified measure of effectiveness centered on the user, e-learning resource, quality of learning style, etc…
ACKNOWLEDGEMENTS
I would like to thank the Office of Research and Quality Management at Botho University for sponsoring the presentation costs of this paper. I would also like to thank colleagues, and friends who have taken time to review and provide much needed feedback. Their objective comments have truly made this paper a possible. I would also like to take the opportunity in acknowledging the immense help received from the scholars whose articles are cited and included in references of this manuscript and am grateful to authors/editors/publishers of all those articles, journals and books from which the literature for this article has been reviewed and discussed.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareAUDITORY BRAINSTEM PROCESSING OF COMPLEX SPEECH SOUNDS IN YOUNGER AND OLDER ADULTS USING SEABR - A REVIEW
English6973Muhammed AyasEnglish Rajashekhar B.EnglishThe ability of the human auditory system to process the acoustic information from peripheral auditory centres to the auditory centres in the brain is integral for understanding speech and non speech sounds. Age is a critical factor that most often impairs the temporal processing in human population. Due to the decline in temporal precision in the aging auditory system, difficulty in speech understanding was expressed by many older individuals.Difficulty in discriminating speech was perhaps one of the most critical forms that hearing loss can have in person’s life. There were various techniques and procedures used to assess the auditory processing in this group of individuals. In recent times, the focus lies on using Speech Evoked Auditory Brainstem Responses (SEABR) to unravel complex speech processing at the brainstem level in children and adults. This article reviews the various studies done using SEABR to understand the brainstem timing changes in various age groups.
EnglishSpeech evoked auditory brainstem response (SEABR), Temporal processing, Onset responses, Frequency following responseINTRODUCTION
Hearing is considered as one of the most important senses in humans. The ability of the auditory system to process the acoustic information from the peripheral auditory centres to the auditory centres in the brain is integral for understanding speech and non speech sounds. The auditory system is primarily divided into peripheral and central auditory system. The levels in the central auditory pathway are completely interlinked and any disturbance in any of the areas at any point will lead to the difficulty in auditory and speech perception in humans. Due to the impaired temporal precision in the auditory system associated with aging, there were difficulties in speech understanding expressed by many older individuals. Age is a critical factor that is most often associated with acquired hearing loss in the adult population. There were various techniques and procedures used to assess the auditory processing in this group of individuals.The recent developments in auditory evoked potentials and neuro imaging techniques allows one to probe auditory processing in a more comprehensive manner .This was done by focussing primarily on the rate at which the signals were processed. This information was critical in understanding the complex mode of auditory processing in humans. The review was focused largely on the existing studies on auditory processing in humans and the use of SEABR in understanding the complex speech processing at the auditory brainstem level in various age groups.
Auditory processing in aging auditory system
The human auditory systems ability to process acoustic signals such as speech and non-speech sounds are integral in understanding speech in humans. This ultimately helps in effective communication. The speed at which this process occurs makes a huge impact on the auditory system to refine and precisely encode all the signals for the better understanding and was termed temporal processing or timing aspects of the signal processing at the central auditory system.
There is plethora of research that has been done to study the temporal aspects in human auditory system majorly using psycho acoustical and psychophysical tests.
Gordon-salant, et al (1999), examined the age related effect on various temporal manipulation of acoustic signals in the presence of background noise as well as in the quiet. They found a strong effect of aging on non-speech measures in the old age group compared to other younger groups. Schnided and Hamstra(1999)conducted a similar line of study and reported that the gap detection measures were severely hampered in older age groups than that of younger groups. Pichora-fuller (2003) did a series of research on the effect of timing in auditory processing in older population by using various psychoacoustic methods. The outcome from various measures reached a conclusion that there were significant effects causing temporal processing decline in older adults even though there were primary interactions with cognitive function of the person. These research findings opened up a whole lot of new research areas, which allowed professions like psychology, and other related areas to start probing the effect of aging in cognitive aspects as well as temporal aspects.
Peelle, et al (2011), studied the effect of aging on the neural system for supporting the speech comprehension. They reported that even a moderate decline in the peripheral auditory acuity would remarkably down regulate the central auditory processing for speech sounds. This was evident from the measures used for the older population in their study.Jafari,et al (2013),studied the effect of aging on various temporal processing measures such as time compressed speech test and temporal resolution for words in quiet as well as in the presence of noise. The results supported the existing literature that the older adults performed poorly for time-compressed tests than that of the younger groups. They concluded that the aging had a remarkable effect on the speech processing and temporal resolving ability .This eventually affected the speech perception in older adults. Humes(2015) reported an interesting study done on cognitive and sensory processing in middle aged adults by using various psychophysical measures. The study was compared with that of younger and older adults and reported that there were significant effects seen in cognitive function and sensory processing in middle-aged adults. This study gives an additional input to the researchers regarding the importance of involving the middle-aged groups whenever any such experiments were conducted with older adults and younger adults.
Speech Evoked Auditory Brainstem ResponseSEABR
Since its advent in early 70s by Jewett and Williston, ABR has undergone series of research both clinically as well technically in order to refine its utility in clinical research. However, early 90s saw a paradigm shift in ABR research due to the application of advanced computer technology .This further boosted the confidence of the researchers to use more complex stimulus in ABR recording. It replaced the traditional clicks and tone burst stimulus. This has led to the use of various other stimuli such as speech and music. Various studies have demonstrated that click and speech stimuli processes and create a slightly different encoding at the brainstem level. Mainly children with learning disabilities show an abnormal neural processing of speech sounds even when a normal click ABR was present. (Cunningham et al,2001; Wible, et al, 2005; Song, et al, 2006, Johnson et al 2008).
The main interest was the peak latency difference seen for the Speech stimuli that occurs within the first 10msec. This particular portion of the neural response was thought to be generated within the upper brainstem areas. Therefore, these evidences emphasises the important neural encoding differences between the traditional click and the speech stimuli, though they are believed to be generated from the similar sites. Furthermore, the frequency-following response (FFR), which was an important component of the SEABR, was recorded in adults by using various complex stimuli ( Krishnan, 1999, 2002). The FFR is thought to reflect the encoding of the fundamental frequency and harmonic structure of the complex speech stimuli; it also has midbrain origins as reported by Galbraith, (1994). However, it is not sure how the developmental time course of FFR takes place in humans. Although the waveform that emerges for the initial response to a speech stimuli was similar to that of click stimulus, a complete analysis would reveal much more complex auditory processing information such as phase locking responses. This can be studied in detail with remarkable fidelity by using this speech signal (Kraus and Nicol, 2005; Johnson, et al, 2005,).As as result, SEABR came across as one of the widely used tool in understanding the complex speech processing at the brainstem level in various populations.
DISCUSSION
In early 2000, the SEABR picked its momentum in clinical research labs across the globe. In 2001, Cunningham et al, studied the cortical and brainstem processing in children with learning difficulties to underline the subconscious speechprocessing deficit in these children. They reported that there is a considerable amount of evidence to prove that there is a clear disassociation of the signal processing especially for complex speech sounds such as voiced stop consonant/da/ at the brainstem level and partially in the cortical level for the children. It was believed that these findings have paved the entry of complex speech signals into ABRs clinical research more often than not compared to the early 1990s research activities in ABR related areas.
SEABR is a complex waveform that includes a transient response and sustained responses which includes the FFR. The response for the transient portion of the speech stimulus / da/ includes a positive peak that is recorded after 7 ms post stimulus onset named wave V. This is followed by a negative deflection, which is named wave A and then wave C. Following the onset responses are the peaks named D, E and F and were termed as the FFR. It is predominantly the neural phase locked response of the speech stimulus, fundamental frequency and the spectral harmonics less than 2 kHz. The offset of the stimulus is termed wave O (Johnson et al 2005). The FFR reflects the encoding of the fundamental frequency of the stimulus and also harmonic structure of the stimulus. Thus, the advantages of the SEABR was that it can extract both transient and sustained portions of the stimulus which can be measured in any age group at the level of the brainstem. However, many questioned the test retest reliability of the SEABR recording with /da/ stimulus. Song, et al,(2011) reported that SEABR measures of transient and sustained components can be reliably recorded with high test-retest stability and with minimal variability across the subjects. The authors concluded that the SEABR faithfully records most of the acoustic components of the desired speech signal.
To establish SEABR as a reliable procedure in research and clinical practice, Russo et al (2004) established a reliable testing procedure and normative value to quantify brainstem encoding of speech syllables/da/. They measured the SEABR in quiet and background noise in nearly 38 normal children. They found that the responses to the transient and sustained components of the speech syllables were recorded reliably with good test–retest stability and with minimal variability among the participants. They reported that the brainstem response to speech sounds provides a tool to understand the complex neural processing at the auditory brainstem level. Eventually these responses can be used as a biological marker for auditory processing in human population. (Johnson et al 2005).
The advances in the technology led to the incorporation of these complex stimuli into various evoked potential equipment. This has led to the proliferation of clinical studies in various clinics and enormous data has been published in paediatric population using SEABR. The prime focus of the research was particularly concentrated on the auditory processing deficits in learning disabled children as well specific language impairment groups (Wibel et al 2005, Banai et al 2007, Chandrashekaran et al 2009). Khaladar, et al (2004) studied the perceptual deficits in sensorineural hearing loss patients using click evoked ABR and the burst portion of the syllable /t/. Speech burst evoked ABRs were more prolonged in latencies which is suggesting that by using speech sounds one can delineate the normal speech processing versus abnormal speech processing. They reiterated that the burst portion would not give us much information regarding the neural coding of the speech stimulus Thus, brainstem response to vowels as a measure of frequency following response (FFR) can be used to understand the complex signal processing in humans
There were studies reported in literature that specifically focussed on the FFR. Krishnan (1999) obtained FFRs in 10 normal hearing human adults and reported that phase locking plays a key role in the neural encoding of speech sounds. The analysis of the FFRs data revealed a various peaks for the frequencies equivalent to first and the second formants. These results are pointing towards phase-locked activity among two different groups of neurons in FFR. He also suggested that the FFR can be used to evaluate not only the neural encoding of speech sounds but also auditory processing associated with various non linear cochlear functions. In continuation with the FFR research, Krishnan and Parkinson (2000) investigated the FFR to a rising and a falling tone in eight normal hearing adults. Their results clearly demonstrated that the human FFR does follow pattern of the acoustical properties of the tones. Krishnan (2002), Krishnan et al(2004) further investigated the FFR by using English back vowels and reported that phase locked activity among two different populations of neurons is still preserved in FFR. All these findings suggest that the FFR can provide useful acoustic processing information and helps in evaluating the neural encoding of speech sounds at the brainstem level.
Werf and Burns (2010) studied the SEABR in younger and older adults to assess the neural precision timing. They reported that there was significant reduction in transient responses in older adults than that of FFR. Neupane et al. (2014) studied the effect of repetition rate on SEABR in younger and middle aged adults. They used three different repetition rates and found that the latency of wave V were prolonged in the middle age group than that of younger individuals. They also reported that encoding of fundamental frequency was affected with increase in repetition rates. Anderson, et al (2011) studied the speech perception in presence of background noise in older adults using SEABR. They recruited 28 older adults and behaviourally assessed them with Hearing in noise test (HINT) and objectively by using SEABR in quiet and background noise. They reported that in the quiet condition the older group had reduced neural representation of the speech stimulus and observed an overall reduction in response analysis. Whereas, in the background noise condition, older group demonstrated more deeper decline in neural encoding resulting in poor neural synchrony. Similar findings were reported by Chandrasekaran et al (2009), Wong et al (2010) in groups of learning disabled children and older adults.
Anderson, et al (2012) studied the SEABR in older adults and stated that older adults would show certain timing delays due to aging. They recorded SEABR in younger and older adults. Their results were consistent with the hypothesis that the older adults did show delayed SEABRs, especially in response to the rapidly changing formant transition with greater variability. In addition to that, they also found that the older adults had decreased phase locking and smaller response magnitudes than that of the younger adults. In conclusion, the study results supported the ongoing postulation that older adults will have disruption in temporal precision in the sub cortical encoding of speech sounds, which can be attributed for their difficulties in speech perception. Following year in 2013, Anderson, et al studied the interaction of auditory cognitive function in understanding speech in the presence of background noise in older adults. They found that there were strong interactions between the central processing and cognition, but not hearing. These factors in their structural equation modelling implies the need to formulate specific treatment plans for patients complaining of hearing-in-noise difficulties especially individuals with mild-to-moderate hearing loss. Anderson et al 2013 reported another study on the effect of auditory training on improving speech perception in noise in older adults. They used SEABR measure to assess the neural timing improvement after auditory training. They claim that with auditory training alone, one can help them to improve speech perception in older adults along with the amplification use.
Clinard and Tremblay (2013), reported that aging has its effect on the neural encoding of speech sounds in the brainstem level. They used consonant vowel /da/ and 1000Hz tone burst stimuli in 34 adults and recorded the responses. They reported that the neural representation of the speech sound stimuli decline as the age increases. FFR responses were prolonged in older adults; however the fundamental frequency responses are remained intact. They concluded that complex speech stimuli would give more information on how the speech sounds were represented in the older adults and it helps in understanding the decline in their performances, especially in challenging conditions
Anderson, et al, (2013), studied the effect of hearing loss in sub cortical representation of speech cues. They recorded SEABR in normal and hearing impaired older adults. They found that in the hearing impaired group, the envelope-tofine structure representation was affected in comparison with that of the normal hearing group. This disruption underlies the fact the older adults with hearing loss have difficulty when trying to understand speech in background noise. This study also shed lights into the understanding of the effects of hearing loss on central auditory processing in humans. Bidelman, et al (2014) studied the age related changes in sub cortical encoding and categorical perception of speech. They recorded SEABR and Speech evoked cortical auditory potential in younger and older adults. The results of the study indicate that older adults did show reduced amplitude for brainstem responses and delayed responses for cortical measures. They reported that due to the lower interdependence of the two levels such as brainstem and cortical areas in the central auditory system and the implied lesser neural flexibility in older adults, resulted in the distorted representation of speech at the brainstem level as well as reduced neural redundancy at the cortical level. Taken together, all these aspects constitute the primary reasons for the decline in speech perception in older adults. Once again, it illustrates the efficacy and importance of AEPs, especially SEABR in understanding the complex speech processing in older adults.
CONCLUSION
The above discussed review indicates the use of SEABR in understanding the neural encoding of speech at the level of brainstem in humans. Studies using SEABR have been focussed mainly on normal individuals, dyslexics and hearing-impaired population. The interest in SEABR research in older population has opened a window to the research community for better comprehension of complex interactions of various factors that lead to the decline in temporal processing in older adults. Majority of the studies focused on selecting only two age groups, which was not enough to understand the timing changes in older adults. Also, they failed to describe the reason as to why particular age groups were not included in their studies. This may warrant the need for future studies in specific age groups to understand the complex signal processing in adults. However, the existing work done by various authors in SEABR research was commendable and it would improve the clinical value of SEABR. Furthermore, prospectively SEABR could be employed as an important diagnostic tool in audiology clinical practice
ACKNOWLEDGEMENTS
Authors acknowledge the immense help received from the scholars whose articles are cited and included in the references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been gathered, reviewed and discussed.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareCROSS BORDERING STUDIES AMONG DECISION MAKING AND SPOUSAL VIOLENCE IN INDIA AND BANGLADESH
English7484Sk. KarimEnglish Kalosona PaulEnglishViolence at least 20% of the world’s women has been physically or sexually assaulted by a man (World Bank, 1993) and that between 16% and 52% of women have been physically assaulted by an intimate partner (WHO, 1997). Paper mainly focuses on cross country variation on spousal violence, help seeking behaviour and decision making of women and its determinants. Demographic health survey (DHS) data of India (2005-06) and Bangladesh (2007) is used for the analysis of spousal violence and decision making among women aged 15-49 years. Descriptive statistics, bivariate analysis and Multivariate analysis is carried out to examine the prevalence of spousal violence among married women aged 15-49 years, decision making the two selected countries and their help seeking behaviour in India. Decision making is significantly more among educated, wealthier women, yet it is markedly low among the Hindus in both India and Bangladesh. Experience of violence is significantly more among those with more decision making in India and it is having no relation in Bangladesh.
EnglishViolence, Decision making, Spousal violence, Help seeking behaviourINTRODUCTION
Violence is the look of brutal nature of mankind. Violence against women has been distinguished by the United Nations as a fundamental abuse of women’s constitutional rights. In the past, little attention gave to domestic violence as a broad social matter. But in attendance domestic violence is a major burden to patriarchy s ociety which has its existence in every bend of planet demarcation across the frontier of culture, custom, class, education, income, ethnicity, religion and age. Since early 1990s, there has drastically increased concern about domestic violence against married or unmarried women in both developed and developing countries. It is approximation that 20% of the world’s married or girls are physically or sexually assaulted by a man (World Bank, 1993) and that between 16% and 52% of women was physically beaten by an intimate partner (WHO, 1997).
In view of, women are facing other types of violence since her by birth. In a nutshell, female infanticide, genital mutilation, abduction, kidnapping, bride-burning, wife battering, rape, murder, molestation and honour killings are the ordinary forms of brutality against women. But, the worst happens when they are focus to beating, insult, harassment in their dweller by their relatives and husband. Violence against women is one of the vital social apparatus by which women’s are strained into an inferior position contrast with men. Domestic violence is habitually a cycle of abuse that patent itself in numerous ways throughout their life. Violence includes the constitutional acts of physical aggression, sexual coercion, psychological or emotional abuse and controlling behaviours by present or past husband or spouse. Spousal violence is one of the mainly forms of brutality often termed as domestic violence taking forms of slaps, kicks, punches or sometimes attack with a weapon or severe burns or injuries or fracture in the body. Few studies has been adopted an ecological model, which illustrates that violence is effect of personal, biological, marital, environment, community and societal factors (Heise et al., 1999). Violence against woman occurs in all socio-economic-cultural population; and in different cultural society, including India and Bangladesh, but women are socially believed, tolerate, and even though rationalize to remain silent about such practices.
Existing Studies on This Issue
Violence against women’s is a universal issue, cross-bordering culture, geographic, religious, social and economic boundaries. It has become distinguished major issue on the global ground and a lot of research work was taken this issue over the last few decades (Counts, Brown, and Campbell, 1999; Levinson, 1989; Straus and Gelles, 1999; Straus, Gelles, and Steinmetz, 1980). Research indicates that the most common type of violence against women is domestic violence (Koss et al., 1994; Naved, Azim, Bhuiya, and Persson, 2004). Among the most prevalent are those forms of violence perpetrated against women by intimate partners and ex-partners (Heise, Germain, and Pitanguy, 1994; Naved et al 2005).
Women who were more severely abused and those with higher education and younger age sought more help (Straus, 1990). Women who are both verbally and physically abused sought more help, but those with greater marital conflict sought less; and those women whose health was poor sought help less but those who reported being depressed sought more help (Gelles and Straus, 1988). World Report on Violence and Health (2002), Women are particularly vulnerable to abuse by their partners in societies where there are marked inequalities between men and women, rigid gender roles, cultural norms that support a man’s right to have sex regardless of a woman’s feelings and weak sanctions against such behaviour. South Asia is commonly thought of as a region where the domestic violence is very prominent. Many studies from South Asia report high rates of spousal physical abuse against women. In Indian sub-continent high domestic violence is associated with various demographic, socio-economic characteristics (Naved,2005; Khosla et al.,2005; Panda et al.,2005). WHO (2006) in collaboration with London School of Hygiene and Tropical Medicine (LSHTM) and PATH studied lifetime prevalence of physical and sexual violence in ten countries including Bangladesh. The role of patriarchy, power dominance of men is one of the prime aspects of causes of violence among women (Emery, 2011). A number of independent studies have been done in the area of domestic violence. But there is a dearth of attempts in India and Bangladesh to understand the spousal violence and to generate a connecting link between spousal violence with decision making also less emphasis is given on help-seeking aspect in India. This study intent to underpin, who seek help and from whom and whether there is any association of decision making and experience of violence.
Objectives
Based on this perspective the specific objectives of this study are as follows:
1. To study the cross country variation in decision making of women and its determinants. 2. To find out the link between spousal violence and decision making.
3. To understand the pattern of and help seeking behaviour among women in India.
Sources of Data
Demographic health survey (DHS) data of India (2005-06) and Bangladesh (2007) is used for the analysis of spousal violence and decision making among women aged 15-49 years. Demographic health survey is a large scale surveys which has collects, analyse and disseminate the information on health and numerous social issues relevant to society through more than 90 countries in the world. In the respective used datasets, a module of question on domestic violence was included as part of the Women’s Questionnaire. Information was collected on different forms of violence experienced by women and help-seeking behaviour. The module collects detailed information on physical, sexual, and emotional violence perpetrated by husbands against their wives. National family health survey (NFHS-III) is the India version of DHS. However DHS of Bangladesh does not give information on help-seeking behaviour.
In NFHS third round and BDHS, spousal physical and sexual violence is measured using the following set of questions. Decision making variables in both the survey are:
1. Final say on own health care.
2. Final say on to buy household purchases.
3. Final say on household daily needs.
4. Final say on to meet relatives or friends.
(Does/did) your (last) husband ever do any of the following things to you?
1. Slap you?
2. Twist your arm or pull your hair?
3. Push you, shake you, or throw something at you?
4. Punch you with his fist or with something that could hurt you?
5. Kick you, drag you or beat you up?
6. Try to choke you or burn you on purpose?
7. Threaten or attack you with a knife, gun, or any other weapon?
8. Physically force you to have sexual intercourse with him even when you did not want to? The sample consisted of 92,859 women from India and 10,981 women from Bangladesh.
Methodology
Descriptive statistics and bivariate analysis is carried out to examine the prevalence of spousal violence among married women aged 15-49 years, decision making the two selected countries and their help seeking behavior in India.
VARIABLES
Predictor: Place of residence, age group, age at marriage, religion, wealth quintile, number of household members and education level, regions are the independent variables. These variables were grouped into some categories to examine each unique contribution relative to the other variables.
Dependent: Dependent variables are decision making are health care, household purchases, daily needs and spatial mobility. These were categorized into three type: self, joint and others for bivariate tables and into two categories (self + joint) vs. (others) in logistic regression. In logistic regression of violence dependent variable is ever experienced violence or not.
RESULT AND DISCUSSION
A. Determinants of decision Making of women
Table 1: Comparing women across place of residence it is evident in Table 1 that in India, women from urban areas have more decision making power in household chores than their counterpart from rural India. In urban, more than one fifth (21 percent) of women, herself takes the decision on their health care. Similarly, more than half (52 percent) of women from urban area along with other members in the households can take decision on household purchases. Age and decision making power of women are positively related in the study. Women at later ages are more likely to involve in decision making process in the household than the young women. More than one fourth (29 percent) of women aged 35 and above as compared to only 9 percent of making process over the women who have married before 18 years of age. Women from affluent families have more decision making power than their counterpart poor women in the household. More than one third (36 percent) of women from affluent household as compared to less than 30 percent of poor women take decision on daily needs by their own in India. No of household member and decision making power of women are inversely related in this study. Women with below 5 households members are more empowered to involve in the decision making process than the women with above 5 household members in the family. This pattern is followed in all the household chores in India.
Table 2: The decision making power of women by different background characteristics in Bangladesh are presented in table 2. Comparing women across place of residence it is found that, urban women are more involved in all household chores than their counterpart from rural area. Age and selfdecision of women in household chores are positively related in this study. Women at later ages takes more self-decisions in household chores than the young women in Bangladesh. Muslim women are more empowered to take self-decision than their counterpart women from other religions in Bangladesh. More than one third (35 percent) and 17 percent of women from Muslim religion can take self-decision on daily needs and health care respectively.
Education and decision making power of women is inversely related in Bangladesh. Women with no or limited education are more likely to involve in decision making process than the women with higher education in the households chores in Bangladesh. More than one fifth of women with no education as compared to 16 percent of women with higher education can take self-decision on their health care in Bangladesh. An inverse relationship between age at marriage and decision making power of women is observed in Bangladesh. Women married below the age of 18 years are more likely to involve in self-decision making process than their counterpart women married after 18 years of age. Contrary to this, women married after 18 years of age are more involved in joint decision making process than the women married below the age of 18 years in Bangladesh. Women from affluent families are more involved in the decision making process in the household chores than the poor women in Bangladesh. Women with below 5 household members are more likely to involve in decision making process in household chores than their counterpart group with more than 5 household members in Bangladesh. Nearly one fifth of women with 5 household members as compared to 14 percent of women with more than 5 household members take self-decision on health care.
Table 3: In the logistic table it is shown that in India all type of decision making among rural women is significantly lower than decision making of urban women whereas in Bangladesh any type of decision making of rural women is not significantly different from urban women. Any type of decision making increases significantly as the age of the women increases, this result is same for both the countries. In both the countries, health care decision making is significantly lower in Hindu women than Muslim women whereas decision making for daily needs in Hindu women is not significantly different from Muslim women. In India share of women in all type of decision making increases significantly as the level of education increases, whereas in Bangladesh share of women in decision making for daily needs and spatial mobility is not significantly increases as the education level increases. In India share of women in decision making for healthcare and spatial mobility does not vary significantly if age at marriage of women is below eighteen years. In Bangladesh share of women in decision making for household purchases, daily needs and spatial mobility does not vary significantly if age at marriage of women is below eighteen years. In India, share of women in decision making for household purchase and daily needs increases as economic status increases, whereas in Bangladesh share of women for all type of decision making is high in rich families. In both the countries share of women in decision making is significantly high in households having more than four members in comparison to women of household with less than five members.
B. Linkages between spousal violence and decision making of Women
Table 4: The prevalence of domestic violence and involvement in decision making process is presented in Table 4. Comparing women across countries it is found that, women who take their own decision on health care face more violence in India than their counterpart group from Bangladesh. Similar pattern is followed in other household chores wherein women take her own decision in India. Women who can make household purchase by her own choice face more violence (67 percent) in India than their counterpart group from Bangladesh (22 percent).
Table 5: In the logistic table it is shown that in India domestic violence among rural women is significantly higher than urban women whereas in Bangladesh any type of violence of rural women is not significantly different from urban women. Violence increases significantly in the age of women especially in India. Both the countries Hindu women face more domestic violence than Muslim and other religious groups. In the both countries magnitude of domestic violence significantly decreases as the level of education level increases. In India poor and middle status women are facing more violence than the rich women but in Bangladesh middle status women of not significant. Rich women in Bangladesh face low violence. In both the countries violence are high in household with more than five members. In India, not all regions of women face same magnitude of violence. There is a difference from one region to another region. In India, East, North-east and Central regions of women face more violence than the West and South region. In Bangladesh do not have violence but Chittagong, and Sylhet are less violence prone area compared to Barishal. If a women takes decision alone or with partner in India they faces high magnitude of violence but in Bangladesh it is not significant because there women are more empowered than the Indian women.
C. Circumference of help seeking behaviour of Women
Table 6: The prevalence of domestic violence and help-seeking behavior of women in India is presented in Table 4. Comparing women across place of residence, it is observed that women from urban are more likely to seek help for the violence than the rural women. The only exception is the women having faced severe violence in rural seek more informal help than their counterpart group from urban area. Women from other religion background are more likely to seek both informal and formal help in their violation of rights than their counterpart from Hindu and Muslim women. Women with education are more likely to seek more formal help in violence than women without education in India. One tenth of women having faced severe violence seek formal help as compared to less than 4 percent of women with no education. Women married after 18 years of age seek more help in violence than their counterpart women having married before 18 years of age. Women from affluent households are more likely to seek help in their violation of rights as compared to poor women.
Table 7: Shows the coefficient of seeking help among women who experienced domestic violence in India with increase in age and education chance of seeking help increases markedly. While Hindus seek more help than the Muslim. But in bigger household (with more than 4 members) the probability is significantly lower. In East, North-East, West and Southern region the chance of women seeking for help is markedly more than Northern region. Decision making increases with age, while experience of spousal violence also increases with age.
CONCLUSION
Decision making is significantly more among educated, wealthier women, yet it is markedly low among the Hindus in both India and Bangladesh. Experience of violence is significantly more among those with more decision making in India and it is having no relation in Bangladesh. Help seeking is an important component in controlling violence, though less explored. In India, chance of seeking help has no significant relation with decision making. Seeking help increases with age, education among the Hindus and women of smaller households. Marked regional variation is observed in decision making, spousal violence in both countries (as well as help seeking behaviour in India). Northern region in India are more privilege in terms of decision making, spousal violence as compare to rest of the regions.
ACKNOWLEDGEMENTS
We are extremely grateful for the help and support from everyone including our friends, teachers and parents. Our immense thanks goes to all the authors and resource persons whose journal we used .We are grateful to all the member of “International Journal of Current Research and Review” for entertaining our paper. My special thanks goes to the reviewers for their valuable comments and suggestions.
Conflict of Interest
The authors declare that there is no conflict of interest regarding the publication of this article.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241714EnglishN-0001November30HealthcareSTUDY OF VARIATIONS IN THE ORIGIN AND COURSE OF VERTEBRAL ARTERY
English8590Preeti SonjeEnglish Vasanti AroleEnglish Rieshav AnandEnglishArterial variations are always very commonly seen in different arteries of the body and they are very important from surgical and
diagnostic point of view. Aim of this study is to find variations in the origin and course of vertebral artery. The vertebral arteries
are major arteries of the neck. The vertebral arteries and their major branches, i.e. vertebro-basilar system, essentially supply
blood to the upper spinal cord, the brain stem and cerebellum and variable parts of posterior cerebral hemispheres. Different
types of variations in the origin and course of vertebral artery were found .The operative indications for surgery in the cervical
region include spondylosis, a herniated inter-vertebral disc, tumour, infection and trauma. . So, apart from understanding the
clinical implications, the data which is derived from the gross anatomical dissections of cadavers can be a useful guideline to the
surgeons for careful pre-operative planning in cases with an unusual course of vertebral artery and can help them in avoiding
potentially life threatening complications1.
EnglishVertebral artery, Foramina transversaria, AortaINTRODUCTION
The vertebral arteries are major arteries of the neck. The vertebral arteries and their major branches, i.e. vertebro-basilar system, essentially supply blood to the upper spinal cord, the brain stem and cerebellum and variable parts of posterior cerebral hemispheres. The vertebral arteries are normally derived from the subclavian arteries. After taking origin from the subclavian arteries; the vertebral arteries ascend through the neck in the foramina transversaria from C6 upwards up to C1 vertebrae (i.e. C6- C1) and enter the cranial cavity through the foramen magnum, close to the anterolateral aspect of the medulla. They converge medially as they ascend the medulla and unite to form the midline basilar artery at approximately the level of the junction between the pons and medulla. The course of the vertebral artery is divided into four parts as follows:
First part-The first part extends from its origin from the subclavian artery to reach the transverse process of C6.
Second part-The second part runs upward through the foramen transversarium of the C6 to C1 vertebrae.
The third part lies in the suboccipital triangle. It emerges from the foramen transversarium of C1, winds around the posterior aspect of the lateral mass of atlas, runs medially lying on posterior arch of C1 and enters the vertebral canal. The fourth part extends from the posterior atlanto-occipital membrane to the lower border of pons. In our study we will be dealing with the first and second part of the vertebral artery.
Numerous variations are found in the origin of the vertebral artery as well as in its course i.e. its passage through the foramina transversaria of cervical vertebrae. Normally it enters into the foramen transversarium of C6 and passes upwards but sometimes it may enter into foramen transversarium of any other cervical vertebrae. Also, sometimes the vertebral artery takes its origin directly from the arch of aorta instead of subclavian artery. These type of variations, if present, are very important from the diagnostic as well as surgical point of view.
The operative indications for surgery in the cervical region include spondylosis, a herniated inter-vertebral disc, tumour, infection and trauma. The failure to recognize the anomalies during the preoperative planning can lead to surgical complications. The laceration of the vertebral artery is the most challenging surgical dilemma which is faced during anterior cervical spinal surgery. So, apart from understanding the clinical implications, the data which is derived from the gross anatomical dissections of cadavers can be a useful guideline to the surgeons for careful pre-operative planning in cases with an unusual course of vertebral artery and can help them in avoiding potentially life threatening complications1 .
MATERIAL AND METHODS
Cadavers embalmed in 10% formalin from Department of Anatomy, Dr. D.Y. Patil Medical College formed the armamentarium of the study. 40 cadavers were dissected to study the variations in the origin and course of the vertebral artery. Dissection was carried out in the scaleno-vertebral region (between the scalenus anterior and the longus colli muscles) on both the sides, so a total of 80 vertebral arteries were dissected. The prevertebral segment of the vertebral artery as well as the entrance and course of vertebral artery into foramina transversaria was studied in detail. Variations in the origin as well as course of vertebral artery were noted and photographs were taken.
Observations and Results Numerous variations were found in the origin and course of vertebral artery. These variations were noted down as follows.
Variations in the origin of vertebral artery
Variations in the origin of vertebral artery were found in four cases out of 40 cases dissected.
• Left vertebral artery was arising as a common stem with Subclavian artery from the arch of aorta in one case. The common stem was measuring about 1cm in length (Figure 1)
• Left Vertebral artery was arising directly from the arch of aorta instead of arising from Subclavian artery in three cases. In all the three cases the vertebral artery arose as a third branch of arch of aorta, between left common carotid artery and left subclavian artery. (Figure 2)
Variations in the course of the vertebral artery
Variation in the course of vertebral artery were found in four cases.
In two cases the variation in the course of vertebral artery was found to be unilateral.
• Left vertebral artery was entering into the foramen transversarium of C4 in two cases .In the same case the course of right Vertebral artery was normal. (Figure 3) Two cases showed the bilateral variation in the course of vertebral artery.
• Right sided vertebral artery was entering into the foramen transversarium of C5 while on the left side it was entering into the foramen transversarium of C7 in both the cases.(Figure 4)
DISCUSSION
Panicker HK (2002) reported the origin of vertebral artery from arch of aorta in 5 percent of cases, while . Gorey AR (2005) et al stated that the most frequent variant is the left vertebral artery arising directly from arch of aorta between left common carotid and left subclavian arteries which accounts to about 2.4-5.8 percent of cases. Nayak SR et al (2006) reported the classical branching pattern of the aortic arch i.e.the left vertebral artery arising from the arch of aorta in 1.6% of the cases. C Bhattarai et al (2010) had studied 85 cadavers in Nepalese to find out 6 (7%) cases left vertebral artery was arising from arch of aorta. In the present study the vertebral artery originated from the arch of aorta in 7.5% of cases. In this study it was also observed that there was a common stem for left subclavian artery and left vertebral artery, arising from arch of aorta. This type of variation was observed in 2.5% cases.
M. Bruneau et al (2006) studied 500 vertebral arteries, they observed an abnormal level of entrance into foramen transversarium in 7% specimens (35 cases), with a level of entrance into the C3, C4, C5, or C7 foramen transversarium respectively in 0.2%, 1.0%, 5.0% and 0.8% of all specimens. Seventeen abnormalities were right sided and 18 were left sided. Thirty-one out of 250 cases had a unilateral anomaly and two had a bilateral anomaly.
Kajimoto BHJ et al (2007) in his study described variations of vertebral artery entering the transverse foramen of seventh cervical vertebra (C7) to be 7.5%.
Aprajita Sikka and Anjali Jain (2012) found the origin of left vertebral artery from the arch of aorta between the left common carotid artery and the left subclavian artery and entered the foramen transversarium of the fourth cervical vertebra .The origin of the right vertebral artery was also variable in the same cadaver. It took origin from the right subclavian artery at the junction of its origin from the Brachiocephalic trunk. It then ascended to enter the foramen transversarium of the third cervical vertebra.
Rawal Jitendra D et al 2012 12 dissected 50 vertebral arteries, and found 46 vertebral arteries entering the transverse foramen of the sixth cervical vertebra (92 %) and 4 of them entering transverse process of seventh cervical vertebra (8%).
In this study also entrance of vertebral artery into different foramina transversaria other than normal i.e. C6 was found. Vertebral artery was entering into the foramen transversarium of C7 was found in 5% of cases. Vertebral artery entering into the foramen transversarium of C5 was observed in 5% of cases. Also we observed the entrance of vertebral artery into foramen transversarium of C4 in 5% cases.
Embryological explanation- At the end of the third week of development, small posterolateral sprouts arise from the dorsal aorta at the cervical through sacral level and grow into spaces between the developing somites. In the cervical region, the intersegmental sprouts form vertical anastomosis with each other, secondarily lose their intersegmental connections to form vertebral arteries.12
Also in the fourth week of development vertebrae are formed from the sclerotomes. Due to resegmentation of the sclerotomes, intersegmental arteries at first lying between the sclerotomes now pass midway over vertebral bodies .When the vertebral arch fuses with body, the vertebral artery, formed from intersegmental anastomosis is enclosed into foramina transversaria of cervical vertebrae. Alteration in this development leads into entry of vertebral artery into different foramina transversaria.13
CONCLUSION
Variations in the origin of left vertebral artery are necessary and beneficial for planning of aortic arch surgery or endovascular interventions, surgical procedures that would necessitate exposure of vertebral artery, include repair of aneurysms, excisions of cranio-cervical junction masses, vertebral endarterectomy, vertebral artery bypass surgery, and bony decompression of the vertebral artery. Also, an anatomical variations in vertebral artery, if missed, can lead to catastrophic sequelae in surgeries like atlanto-axial transarticular screw fixation, anterior cordectomy. Advances in technology have increased our knowledge regarding different variations in our body and an awareness regarding them can help avoid unwanted complications during various interventions 14.
SUMMARY
The vertebral arteries are major arteries of the neck. The vertebral arteries and their major branches, i.e. vertebro-basilar system, essentially supply blood to the upper spinal cord, the brain stem and cerebellum and variable parts of posterior cerebral hemispheres. Numerous variations are found in the origin of the vertebral artery as well as in its course. These are clinically and diagnostically important, were studied. Summary of findings is tabulated in Table no. 4 and Table no. 5
ACKNOWLEDGEMENT
I am very much thankful to Dr Vatsalaswamy, professor and head of Anatomy as well as Dr Neelesh Kanaskar for supporting help for this study.
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed
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