Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareCOMPARATIVE EFFECTS OF POULTRY MANURE, PIGGERY MANURE AND NPK FERTILIZER ON THE GROWTH, YIELD AND NUTRIENT CONTENT OF OKRA (abelmoschus esculentus)
English0106Akinmutimi A.L. and Amaechi C.EnglishField and laboratory experiments were conducted to evaluate the comparative effects of poultry manure, piggery manure and NPK fertilizer on the growth, yield and nutrient content of Okra (Abelmoschus esculentus) in Umudike southeastern Nigeria. The treatments were: Control (A), 10 tons/ha Piggery manure (B), 10 tons/ha poultry manure (C), 10 tons/ha poultry manure + 100 kg/ha NPK (15:15:15) fertilizer (D), 10 tons/ha Piggery manure + 100 kg/ha NPK (15:15:15) fertilizer (E) and 400 kg/ha NPK (15:15:15) fertilizer (F). The treatments were replicated three times. The experiment was laid out in a randomized complete block design. The test soil was strongly acidic, having a pH (5.0) and low in % total nitrogen, % OC and the exchangeable bases. The okra variety Ivra v 21 was used for the study. From the results obtained from the study, plant height, stem girth and the number of leaves of Okra were significantly (PEnglishAbelmoschus esculentus, Inorganic fertilizer, Andomized complete block designINTRODUCTION
Nigerian soils are being degraded at an alarming rate through continuous cultivation, deforestation and inappropriate farming practices (Oshunsanya, 2011). This practice results in low organic matter content that makes the fragile soils collapse under the impact of rain drops leaving the soil more prone to compaction and erosion (Aiyelari and Oshunsanya, 2008). Consequently, the potential capacity of the soil to support healthy and nutrition yield of crop to meet the demand of the ever increasing human population is hindered. Continuous cultivation of crops on the same piece of land is practiced in Africa due to rapid growth in population coupled urbanization and industrialization (Isokrari, 1995). Vegetables play a vital role in the improvement of the diet of mankind (Schippers, 2000). Okra (Abelmoschus esculentus) is a vegetable of national importance in Nigeria. It is produced and consumed all over the country for the mucilaginous or “draw” property of the fruit that aid easy consumption of the staple food products such as ‘eba’, amala, akpu, pounded yam, etc. (Denton and Olufolaji, 2000). It is a good source of vitamins, minerals, calories, and amino acid found in its seeds compare favourably with those in poultry, eggs and soybean (Schippers, 2000). Tropical soils are adversely affected by sub-optimal soil fertility are erosion causing deterioration the nutrients status and changes in soil organism population (Economic Commission for Africa, 2001)
Fertilizer is a very essential input in crop production. The application of fertilizer is necessary for enhancing the soil nutrient status and increasing crop yield (Olaniyi et al., 2010). Use of inorganic fertilizers can improve crop yields and total nutrient content and nutrient availability but its use is limited due to scarcity, high cost, nutrient imbalance and soil acidity (Olaniyi et al., 2010). Therefore use of organic manures as a means of increasing and maintaining soil fertility has been advocated (Smil, 2000). Organic manures improve soil fertility by increasing the activity soil microbial biomass (Ayuso et al., 1996) thereby improving the physical and biological properties of the soil (El-Magd et al., 2006). It has being reported that combing organic and inorganic fertilizers has a greater beneficial residual effect than can be derived from use of either organic or inorganic fertilizers alone (Akande et al., 2010, Akande et al., 2003, Akanbi et al., 2005). Many researchers have carried out some work on the combined use of organic and inorganic fertilizers on the growth of some crops including okra in the southwestern part of Nigeria (Giwa and Ojeniyi, 2004, Olaniyi et al., 2010, Akande et al., 2010). However, research on the combined use of organic and inorganic fertilizers on the growth, and yield of okra in the ultisol of southeastern Nigeria has not been carried out in the recent past. This is the reason for this study.
OBJECTIVES
1. To compare the effects of organic manure, inorganic fertilizer (NPK 15.15:15) and their combination on the growth and yield of okra (Abelmoschus esculentus) in an ultisol of Southeastern Nigeria.
2. To find out the effects of the above treatments on the nutrient content of okra (Abelmoschus esculentus)
MATERIALS AND METHODS
DESCRIPTION OF THE EXPERIMENTAL SITE
Site Location
The experiments were conducted at Michael Okpara University of Agriculture, Umudike. Umudike lies within latitude 05° 29’N and longitude 07° 33’E within an elevation of 122mm above the sea level.
SOIL SAMPLING/SAMPLES PREPARATION
Pre-planting sampling was carried out on the experimental field to determine the inherent soil characteristics before treatment incorporation. Soil samples were collected at the depth of 0-15cm at various point of the field and bulked together for laboratory analysis.
Sample preparation
Samples were air-dried, gently crushed with a wooden roller and passed through sieves of 0.5mm and 2mm sizes for Total Nitrogen and Organic Carbon and other determinations respectively
LABORATORY STUDIES
General physical and chemical analysis of the soil
Standard methods of physical and chemical analyses for soils were used to analyze these parameters.
Particle size analysis
The particle size analysis was carried out using the Bouyoucos hydrometer method (Jackson, 1964).
Soil Reaction (ph)
Soil pH was determined using the glass electrode pH meter in a soil to water ratio of 1:2.5
Exchangeable acidity (Al3+ and H+)
Soil exchangeable acidity (Al3+ and H+) was determined by titration method (Mclean, 1982).
Organic carbon
Soil organic carbon was determined by Walkley and Black (1934) method.
Total Nitrogen
Soil total nitrogen was determined using the micro-kjeldahl digestion and distillation method (Jackson, 1964).
Available phosphorus
The available phosphorus was determined using Bray and Kurtz (1945) No. 2 method.
The exchangeable bases
The soils were leached with 1N NH4 OAc (Ammonium acetate) at pH 7. Calcium and Magnesium were determined using the EDTA titration method while potassium and sodium were determined by flame photometry.
Effective Cation Exchange Capacity Effective Cation Exchange Capacity was calculated as the sum of exchangeable bases (Ca²+, Mg²+, K+, Na+) and exchangeable acidity.
Base Saturation
The base saturation was determined using the equation.
Treatments The treatments consist of Poultry manure (P M), Piggery manure (PD) and N P K (15: 15:15) fertilizer combined thus: A- Control B- .10 tons/ha PD C- 10 tons/ha PM D- 10 tons/ha PM + 100 kg/ha NPK fertilizer E- 10 tons/ha PD + 100 kg/ha NPK fertilizer F- 400 kg/ha NPK fertilizer The treatments were replicated three times in a randomized complete block design
FIELD EXPERIMENT
The field was slashed, ploughed and made into beds 2m by 2m. The experiment was laid out in a randomized complete block design (R C B D) with three replications. The organic manures were applied on the necessary plots two weeks before planting. Okra seeds (variety, Ivra v 21) was planted 3 seeds per hole at a distance of 50 cm x 50 cm and thinned to one seedling per stand at 3 weeks after planting.
Records of agronomic measurement
- Random samples of five plants per plot were selected and tagged for data collection
. - Data on growth parameters (plant height, stem girth and number of leaves) were taken at two weeks interval on the tagged plants form 3 weeks after planting (WAP) - At harvest, numbers and fresh weights of fruits were recorded.
NUTRIENT CONTENT OF OKRA
The dried fruits okra was grinded and milled to pass through 1mm sieve. The grinded samples were subjected to kjeldahl digestion at 3600 C for 4 hours with concentrated H2 SO4 . Total Nitrogen was determined form the digest by steam distillation with excess NaOH. Phosphorus and potassium contents were determined by ashing 0.2g plant sample in a muffle furnace at 6000 C for 2 hours. The ash was cooled and dissolved in 1N HCl and from the solution, phosphorus was determined by the vanadomolybdate yellow calorimetry method using spectrophotometer. Potassium was determined using flame photometer
STATISTICAL ANALYSIS
Data generated from field experiment and laboratory analyses were subjected to analysis of variance (ANOVA) using the SAS software and the treatment means was separated using Fischer’s Least Significance Difference (FLSD) at 5% probability level.
RESULTS AND DISCUSSION
Physico-chemical properties of the soil under study The physico-chemical properties of the soil used for this study are presented in Table 1. The soil pH was low, signifying very strong acidity (Hazelton and Murphy, 2011). Organic carbon and total nitrogen were low, and available phosphorus was moderate (Akinrinde and Obigbesan, 2000). This result shows the need of the soil under study for organic amendment
CHEMICAL PROPERTIES OF ORGANIC AMENDMENTS USED FOR THE STUDY
The chemical properties of the organic materials used in this study are shown in Table 2. Both manures contain nutrient elements that will be useful to the growth of the okro plant. The piggery manure had higher percentage of mineral nutrients all through. This is an indication that the piggery manure would enhance the growth of the crop under study
EFFECTS OF POULTRY MANURE, PIGGERY MANURE AND NPK (15:15:15) FERTILIZER ON PLANT HEIGHT IN OKRA
(Abelmoschus esculentus) Table 3 shows the effects of Poultry manure, piggery manure and NPK fertilizer on plant height in Okra (Abelmoschus esculentus). 10 tons/ha piggery manure applied singly gave the highest values for plant height throughout the period of measurement, followed by 10 tons/ ha piggery manure + 100 kg/ha NPK fertilizer, then 10 tons/ha poultry manure + 100 kg/ha NPK fertilizer, 10 tons/ha poultry manure, then the 400 kg/ha NPK fertilizer and then the control gave the least values. The results were significantly different (P control> 10 tons/ha piggery manure> 10 tons/ha piggery manure + 100 kg /ha NPK (15:15:15) fertilizer > 400 kg /ha NPK (15:15:15) fertilizer. The fresh fruit number also followed almost the same pattern although the results obtained were not significantly different among the treatments (P> 0.05). The results were not consistent with what was obtained in the growth period of the okra. This could be because the poultry manure did not quickly begin the process of mineralization when compared with the other treatments, so at harvest it produced the highest result. The Piggery manure used in this study contains more % nitrogen than the poultry manure (Table 2). As a result, the vegetative growth of the okra was more favoured by the piggery manure than the fruit yield. Nitrogen is known to facilitate vegetative growth of crops (Agbede, 2009). The control having better yield than some of the treatments could be as a result of the rains washing some of the nutrients from the treated plots which was not pronounced until the time of harvest.
EFFECTS OF POULTRY MANURE, PIGGERY MANURE AND NPK (15:15:15) FERTILIZER ON THE NUTRIENT CONTENT OF OKRA
(Abelmoschus esculentus) The nitrogen, phosphorus and potassium contents of the okra plant (Abelmoschus esculentus) are as presented in Table 7. The result obtained could not be attributed to the effect of treatments applied. The nitrogen content of the okra was highest in the control, followed by the 10 tons/ha piggery manure + 100 kg/ha of NPK fertilizer, then the combinations of Poultry and piggery manures with NPK (15:15:15) fertilizer respectively, then the 400kg/ha NPK (15:15:15) and the least value was obtained with 10 tons/ha piggery manure. However, % phosphorus content was significantly (PEnglishhttp://ijcrr.com/abstract.php?article_id=509http://ijcrr.com/article_html.php?did=5091. Aiyelari, E.A and Oshunsanya, S.O. 2008. Preliminary studies of soil erosion in a valley bottom in Ibadan under some tillage practices. Global Journal of Agricultural Science. Vol.7 (II) 221-228.
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5. Akinrinde, E.A. and Obigbesan, G.O. 2000. Evaluation of fertility status of selected soil for crop production in five ecological zones of western Nigeria. Proceedings of the 26th Annual Conference of Soil Science Society of Nigeria. University of Ibadan. Pp. 279-288
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9. Economic Commission of Africa, 2001. State of the Environment in Africa. Economic Commission of Africa, P.O. Box 3001, Addis Ababa, Ethiopia, ECA/FSSDD/01/06. http://www.uneca.org/water/State_Environ_Afri.pdf
10. El-Magd, M.A. El-Bassiony, M. and Fawzy, Z.F. 2006. Effect of organic manure with or without chemical fertilizer on growth, yield and quality of some varieties of Broccoli plants. J. of Applied Science Res., 2 (10):791-798.
11. Eneje, R.C. and Uzoukwu, I. 2012. Effects of rice mill waste and poultry manure on some soil chemical properties and growth and yield of maize. Nigerian Journal of Soil Science. 22 (1). 59-64.
12. Giwa, D.D, and Ojeniyi, S.O. 2004. Effect of integrated application of pig manure and NPK on soil nutrient content and yield of tomato proceedings 29th annual conference of soil science society of Nigeria, UNAAB. pp 164-169.
13. Hazelton, P. and Murphy, B. 2011. Interpreting soil test results. Australian Society of Soil Science Inc. Publications Committee. CSIRO Publishing. Pp.152
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15. Jackson, M.L. 1964.Soil Chemical Analysis. Advanced course. Prentices Hall, New York, U.S.A.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareDEMOGRAPHIC FACTORS INFLUENCING CONSUMERS' LIFE STYLE ON MOBILE PHONE USAGE: A CASE OF DILLA CITY, ETHIOPIA
English0714Genet Gebre TirfeEnglish Rajyalakshmi NittalaEnglishMobile phones enable people to keep in touch with their families and friends. It makes easy the day to day activity of peoples around the world. The aim of this research is to investigate demographic factors influencing consumers’ life style on mobile phone usage in Dilla City, Ethiopia. This study evaluates the effect of demographic factors specifically consumers’ age, education, income, and occupation on mobile phone usage. The research methodology used in this study is both qualitative and quantitative approaches. 381 customers were surveyed by using purposive sampling technique. The target population of the study included businessmen, employees in government offices, teachers, and students. Primary data was collected through structured questionnaire. Secondary data were gathered from books, research studies, various governmental and nongovernmental organizations reports, and on line resources. Descriptive statistics and One-Way Analysis of Variance was employed to
analyze the data. The results of the study revealed that significant difference exist between life style on mobile phone usage and consumers’ occupational status and monthly income. On the other hand, the research found out that life style on mobile phone usage was not varied by age group and educational level of respondents. The research concluded that consumers’ make their purchase decisions by evaluating their life style and demographic factors in mobile phone usage. Hence, the findings of the study provided that companies and manufacturers need to consider demographic factors that affect mobile phone usage in order to meet the current demand of consumers in Dilla.
EnglishDemographic factors, Mobile phone, Life style, Consumer behavior, Dilla cityINTRODUCTION
The cell phone’s popularity revolves around convenience, business, recreation, and safety (Patel and Singh, 2011). The various information services of the cell phone have created an environment of immediate communication which has produced economic benefit to business and society. This makes the device very important in day to day activity (Moklis and Yaakop, 2012). Many of the phones have several applications such as calling, texting, and listening to music (Das, 2012). Patel and Singh (2011) further studied that mobile phone usage pattern varies from one group to another. Recreationally, cell phones have become entertaining devices for not only communication, but also for music and video activities, color screen, camera, and games (Safik and Azizul, 2012). Besides, (Wiliska, 2003) stated that young people relationship with their mobile phone is consistent with their life style in terms of technology enthusiasm. Mobile phone service applications are enormous attraction especially to young consumers who are constantly changing their interests with new innovative features. On the other hand, Chaubay, Zafar, Hassen (2011) described in their study that cell-phone connection is considered as an important mechanism for connecting family and friends. Coogan and Kangas (2001) also explained that a cell phone is also a symbol of belonging to a group and a part of one’s identity. Young people need cell-phone technology to establish and maintain social networks which help in their social interactions and other new dimensions in their lives (Downs and Aoki, 2003). Jaysingh and Eze (2009) highlighted that in their study that the universal availability of wireless telephony provides new business opportunities. Thus, it can be inferred that mobile phone usage varies considerably between the socioeconomic variables explained above. Moreover, Engel et al. (1995) suggested that an important part of lifestyle marketing is to identify the set of products and services that consumers associate with a specific lifestyle. Marketers need to understand the activities, interests, and opinions that influence life style of consumers, since they often attempt to influence consumer purchasing behavior through life style marketing. Marketers also need to relate a product to everyday experience of the target consumers by depicting how a specific product can be used by different age, income, occupation, and educational groups. Dilla’s importance as a market center grew especially for its coffee market after the mid-1920s. It is the administrative center of the Gedeo Zone in the Southern Nations and Nationalities, and Peoples Region. The city is located on the main road from Addis Ababa the capital city of Ethiopia to Nairobi. The city is the major transfer and marketing point for coffee grown farther south, particularly of the much-prized Yirga-Cheffe varietal1 . Central statistical agency of Ethiopia (2014) estimated that the total population of Dilla city is 125,599 out of which male account 63,360 and female constitute 62,239. Infrastructure problems slow down the socio-economic development of the town. According to Dilla structure plan project draft (2012) the most important means of transport is road transport. The existing road network in Dilla is insignificant in relation to the size and area of the city. This has been one of a great challenge in the development of communication technology. Besides, mobile phones’ marketing is low as compared to the development of commercial activities of the city. The growing need for modern communication technology devices in each sector of the economy calls for more research in Dilla as well as in Ethiopia. Hence, considering mobile phone as one of the telecommunication services, the current study explores demographic factors influencing consumers’ life Style on mobile phone usage in Dilla city.
Objectives of the study
To identify demographic factors influencing consumers’ life style on mobile phone usage
To examine life style factors that affect consumers’ mobile phone usage.
LITERATURE REVIEW
Ling and Yittri (2002) study revealed that adolescents used the mobile phone for emotional and social communications specifically in building and sustaining relationship with friends. Furthermore, their study found that adolescents viewed mobile phone as an outstanding, prominent, and liberating personal tool that allows them to have a better social position in life. Their further investigation disclosed that individuals with high self esteem understood to use less of the mobile phone for communication compared to those with low self esteem. Low self-esteem users were assumed to use mobile phone for reassurance and not mainly for social purposes. Chaubey, Zafar, and Hasan (2011) in their research also observed that different factors affecting customers’ decision of mobile service providers are associated with their level of education and income. Karjaluoto et al. (2005) added that students are buying low-priced phones. Some groups regarded new technological features such as multimedia messaging service (MMS) handy but too expensive to use at present. College students’ use of mobile phone for a variety of purposes was studied by Aoki and Downes (2003). The study found out that mobile phone helps them to feel safe, financial benefits or to manage time efficiently, keep in touch with friends, and family members. Moreover, the Brtish education communication technology agency (2008) highlighted that the multi-tasking capabilities by young people who are exceptional mobile game players. Juwaheer, Pudaruth,, Vencatachellum, Ramasawmy, and Ponnusami (2013) also found that mobile phone features and young consumers’ lifestyle impacted mobile phone selection. In another study, Wilska (2003) found that mobile phone choice and especially usage is consistent with respondents’ general consumption styles among Finnish young people aged 16-20. The research showed that addictive use was common among females and was related to trendy and impulsive consumption styles. On the other hand, males were found to have more technology enthusiasm and trendy-consciousness. These attributes were then linked to impulsive consumption. The study concluded that genders are becoming more alike in mobile phone choice. Similarly, Kumjonmenukul (2011) found out that factors that determine the selection of mobile phone by young people include touch screens, built-in cameras, and mp- 3capabilities. Style of ringtones on offer with the phone, the colors of mobile phone model available, chat or mobile internet application considered as important factors that affect mobile choice of young consumers. Ozcan and Koçak(2003)studies showed that income, previous experience with cellular phones, brand of handset, and use at the workplace and in car are found to be important in determining the level of usage. On the other hand, Patel and Rathod (2011) conducted a study on mobile phone usage habits of students in the rural areas of Visnagar by emphasizing on different influential factors affecting mobile purchase. The result of the study revealed that mobile phone has been largely accepted by students pursuing their graduation.
Conceptual frame work
The various studies discussed above identified important points in understanding demographic factors that are involved in consumers’ life style of mobile phone usage. The detail discussion above also suggested that companies to consider demographic factors of consumers in production and mobile phones marketing. A conceptual frame work for this research (see figure1) is developed based on the research work of Juwaheer, Pudaruth, Vencatachellum, Ramasawmy, and Ponnusami, ( 2013) to show the effect of demographic factors on life style of mobile phone usage.
RESEARCH METHODOLOGY
This section describes the research plan for this study and the way in which the research was conducted. The research sample, research methods, research instruments used to collect the data, and the method of distribution of questionnaire. Techniques of data analysis including methods used to maintain validity and reliability of the instrument are also explained. The research employed a descriptive research design for this study. Descriptive research describes behavior, attitudes, values, and characteristics (Kothari, 2004). It was found to be appropriate for this study because the purpose of the study was to investigate demographic factors that influence consumers’ life style on mobile phone usage. The target population included business men, teachers, employees in government office, and students. Effort was made to collect data from 400 consumers by using purposeful sampling technique. However, 381 qualified questionnaires were returned. The instrument used for data collection in the form of a structured questionnaire was designed to obtain information on demographic factors and life style of consumers in usage of mobile phone. The questionnaire had a mix of close-ended and open-ended questions in it. The first part was related to the demographic factors of consumers while the rest included factors related to life style of mobile phone usage such as keep in touch with family and friends, entertain with multimedia, connect people with social net works, update with current technology, and internet operation anywhere. This section contains some subsections on relevant aspects. The subsection is supported by some statements. Respondents’ responses were taken in the form of 5-point Likert scale as 1 for strongly disagree, 2 disagree, 3 neutral, 4 agree, and 5, strongly agree respectively. The open ended questions also assist the study in understanding the demographic factors that affect consumers in mobile phone usage. Consumers’ life style factors for usage of mobile phone were selected from the study conducted by Juwaheer, Pudaruth, Vencatachellum, Ramasawmy, and Ponnusami (2013) keeping in view of their importance to mobile phone usage in Dilla city. In order to achieve the objective of this research, One-Way Analysis of variance was used for data analysis. This method was selected to identify the demographic factors that affect consumers’ life style on mobile phone usage. Table 1 below illustrates the demographic characteristics of respondents.
Table 1 above indicates that sample customers in all age groups are users of mobile phones. However, age group 20-35 consists of the highest percentage (51.4%) of users compared to others. On the other hand, the table shows that the least number of respondents above 50 years are (6.6%). The majority of the respondents are females (69.3 %); and unmarried respondents represent (52%). Besides, sample respondents who posses’ bachelors’ degree level are (40.4%). The least number of respondents (4.5%) and (3.4%) are in certificate and primary level of education. The table also shows that according to occupational status, the number of respondents in each group is similar. Besides, (49.3%) samples respondents are within income group of below2000ETH birr. While, (9.4%) of respondents earn monthly income of above 4,000ETHbirr.
Hypothesis
We use mobile phones in our everyday life and for entertainment regardless of our age, occupation, income, or education. Consumers’ behavior is influenced by demographic factors, which include buyers’ age, occupation, income, and education. Products and brands are also perceived by consumers as having symbolic meaning (Loudon and Della Bitta, 1993). The profession or the occupation a person is in again has also an impact on the products they consume. Thus the following hypothesis was developed.
H1: Consumers’ life style in usage of mobile phone is different by consumers’ age, income, occupation, and educational level.
DATA ANALYSIS AND DISCUSSION OF RESULT
Reliability and validity of data
This section describes the reliability of instruments used in the research. Item total correlation applied in this study to investigate the validity of instruments. Item total correlation has been employed in this study to evaluate whether the factors under life style measure the same construct. Factors which have correlation coefficient of below.3 have been omitted (Pallant, 2005). Table 2 below illustrates the reliability analyses related to consumers’ life style factors in mobile phone usage.
The content validity of the questionnaire was assessed through examination by experts in the area. Initial changes were made to clarify or delete some statements according to recommendations or comments of the experts. A pilot survey was also conducted with 24 customers from each occupation i.e., business men, teachers, employees in government office, and students prior to the data collection in terms of vague questions and wordings. Few modifications were made to avoid misunderstanding among respondents
Table 2 depicted that life style factors in usage of mobile phone such as helping to keep in touch with family and friends, entertain with multi-media, connect customers with social net works, keep up to date with current technology, and enables internet operation anywhere. Thus, the results in the table revealed that items stated under life style are acceptable.
Table 3 above indicated that 96.4 percent of respondents agreed or strongly agreed that mobile phone helps them keep in touch with family and friends (M=4.62 and S.D=.57); Similarly, 93.7 percent of respondents agreed or strongly agreed that advanced functions in mobile phones makes them to cope up with current technology (M=4.24 and S.D=.57). Likewise, 84.2 percent of respondents agreed or strongly agreed that mobile phone helps them to entertain with music, games, and video (M=4.02 and S.D=.75). Moreover, 72.7 percent of the sample respondents agreed or strongly agreed that mobile phone helps them to be socially connected on social networking sites (M=3.82 and S.D=1.02). On the other hand, 40.6 percent of respondents agreed or strongly agreed that mobile phone enables them internet operation anywhere (M=3.02 and S.D=1.42). Therefore, the results of the study above shows that consumers life style factors such as use of mobile phone for keeping in touch with family and friends (96.4%), advanced functions (93.7%), entertainment with multimedia and photos (84.2%), and getting socially connected on social networking sites (72.7%) significantly affected consumers behavior toward mobile phone usage. On the contrary, for the factor mobile phone enables internet operation anywhere (40.6%) does not significantly affect consumers’ behavior toward mobile phone usage as compared to other factors.
Table (4-7) below is constructed to investigate consumers’ life style differences on mobile phone usage for various purposes by ages, occupation, income, and educational level of respondents. In order to investigate life style differences in usage of mobile phone by these factors One-Way-ANOVA analysis was used.
One-Way-ANOVA in table 4 shows that sample respondents’ occupational status, mean, standard deviation, and results of life style differences on mobile phone usage. The sample respondents’ occupational status is business men, teachers, employee in government office, and students. The mean and standard deviation in usage of mobile phone for business men is (M=3.42, S.D=.61); Teachers (M=3.94, S.D=.57); Employee in government office (M=4.05, S.D=.60); Students (M=4.11, S.D=.65). The results of ANOVA table in table 4 above shows that there is significant life style differences in usage of mobile phone in the mean scores across the four occupational status groups at pEnglishhttp://ijcrr.com/abstract.php?article_id=510http://ijcrr.com/article_html.php?did=5101. Aoki, K., and Downes, E. (2003). An analysis of young people’s use of and attitudes toward cell phones. Telematics and Informatics, 20(4), 349-364.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareSOCIO-DEMOGRAPHIC PROFILE OF CEREBRAL PALSY AFFECTED PATIENTS: AN INDIAN SCENARIO
English1518Varidmala JainEnglish Gyanendra SinghEnglish Jitendra Kumar JainEnglish Arvind DayalEnglish Neena GuptaEnglish Tapas PalEnglishObjective: This study was conducted with the aim of describing existing demographic profile of patients and their families coming to the rehab center for treatment.
Method: Parents of total 307 patients were respondents.
Result: Out of total 307 children only 30% (92) were females. Most common age of presentation was 2-9 years. 64.2% (197) patients belonged to joint families and maximum 58 % (178) belonged to upper middle class. Only 85% (261) families had toilets inside their houses. It was found that consanguineous marriages was found in both Muslims 47.1% (8) and Hindus 7.8% (22). 10.4% (32) fathers were professionals. Maximum mothers 89.6% (275) were housewives despite of high level of education (graduation or above) in 61% (187).
Conclusion: Social issues like gender biasness, family support system and socioeconomic profile affect to a great extent the treatment seeking of these families.
EnglishCerebral palsy, Socioeconomic status, Consanguinity, Housing conditionINTRODUCTION
Bax1 (1964) has defined cerebral palsy as a ‘disorder of movement and posture due to a defect or lesion of the immature brain.’ According to another study2 ,‘cerebral palsy is an Umbrella term covering a group of non progressive but often changing motor impairment syndromes secondary to lesions or anomalies of brain arising in the early stages of development.’ According to Stanley3 (2000) Cerebral palsy (CP) is the most common congenital neurological disorder. The world wide prevalence of cerebral palsy is 2-2.5/1000 live births. Although in developed world lot of literature on various aspects of cerebral palsy are available, in developing world specially Asia and India literature is scarce. This study was done to describe the socio-demographic profile of families belonging to cerebral palsy affected patients.
METHOD
A descriptive study was done on 307 patients, who came for treatment at Samvedna Trust, Allahabad, India during one year duration. Study was conducted to describe the socio-demographic profile of cases with cerebral palsy and their families. Parents of cases or any guardian, mostly mothers were the respondents. Ethical approval was obtained from Institutional Ethics Committee, Sam Higginbottom Institute of Agriculture Technology and Sciences, Allahabad, India before collection of data. Informed consent was obtained from the respondents.
RESULT
Out of total 307 children only 30% (92) were females. Most common age of presentation was 2-9 years because that is the time when the developmental anomalies and delay in milestones become very obvious. Although trend of Nuclear families is on increase but in the present study it was found that 64.2% (197) patients belonged to joint families and maximum 58 % (178) belonged to upper middle class. In spite of this only 85% (261) families had toilets inside their houses and other 15% were forced to go outside for this daily biological need. Although 47.1% (8) Muslims had history of consanguinity. Contrary to normal belief 7.8% (22) Hindus out of 282 also had consanguineous marriages. Maximum fathers 63.5% (195) were having clerical or other kinds of jobs; business or some of them were also farmers. 10.4% (32) fathers were also professionals. Maximum mothers 89.6% (275) were housewives despite of high level of education (graduation or above) in 61% (187).
DISCUSSION
Gender difference was apparent in our study, since ratio of males was more as compared to females 7:3. This difference is much more significant compared to other studies from most parts of the world. The prevalence in United States was found slightly higher in boys than in girls (male/female ratio, 1.4:1)4. Many studies analyze reason for it. According to a study5 it was stated that sex may have some influence on pathogenesis of developmental brain injuries. It was stated in the study that sex differences in the immature brain appeared to be strongly influenced by intrinsic differences between male and female cells due to their distinct chromosomal complements. In our study the difference is much higher than this which may be because of some gender biasness in health seeking for female child in developing countries. Locality, family type and socioeconomic class may be independent factor but in this study these all seems to have an effect on accessibility of treatment as it was seen that more people from urban and semi urban area approached for treatment and also more from middle socioeconomic status, none of the families belonged to lowest socioeconomic class. Solaski M.6 included twelve studies in the systematic review. Of these, eight found low SES to be a risk factor for increased CP prevalence. The probable reason of discrepancy in this study was that in the far rural and lower income families’ awareness regarding availability of treatment and affordability for seeking long term treatment are very low. In spite of an increasing trend in nuclear family system, majority of patients belonged to joint families because joint family persons could manage to stay out of their families for long duration of treatment because they had a support back at their homes who could look after other siblings of the child and also other parent mostly fathers. Consanguinity is considered as one of the risk factors for cerebral palsy. According to a Turkish study, conducted by Erkin G et.al,7 23.8 % parents had consanguineous marriages. In our study it was observed that 7.8% Hindu parents were also having consanguineous marriage which is not considered a common practice among north Indian Hindus. If we analyze the housing condition, not having toilets inside their houses put affected child and their caregiver to an extremely difficult situation who are already very much compromised for their ambulation. Also many families did not have walking space for the mobility aid. These circumstances put a very serious threat for functioning ability of these children in future also. In an era when we are looking for facilities at the community level for their uninterrupted mobility, children in developing country are still struggling at the basic level for these. Education level of both the parents was quite good; majority of them having education graduation or above. This was the reason why they were sensitive and aware enough to find appropriate treatment for their children to the best of their capability. Maximum mothers were housewives in spite of good education. Many of them had compromised their jobs and carriers to take care of their child leaving their husbands as the sole earners. Same time their education helped them to understand and deal the problem of their child in a better way
CONCLUSION
Social issues like gender biasness, family support system and socioeconomic profile etc affect to a great extent to treatment seeking specially in case of long term treatment. Considering large number of cerebral palsy affected children in our society there is need to increase awareness for this condition and removal of the myth that nothing can be done for them. The families need constant motivation to help bring these children to mainstream of the society and also there is need to increase both quantity and quality of facilities providing treatment to them.
ACKNOWLEDGEMENTS
We acknowledge physiotherapists of Samvedna Trust for helping in data collection. The study was self financed by the corresponding author. 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=511http://ijcrr.com/article_html.php?did=5111. Bax MCO. Terminology and classification of cerebral palsy Dev Med Child Neuro. 1964; 6:295–307.
2. Mutch L, Alberman E, Hagberg B, Kodama K, Perat MV. Cerebral palsy epidemiology: where are we now and where are we going? Dev Med Child Neurol. 1992; 34: 547–551
3. Stanley F, Blair E, Alberman, E. Cerebral Palsies: Epidemiology and Causal Pathways. Clinics in Dev Med. 2000; No. 151. London: Mac Keith Press. 19.
4. Arneson C, Durkin M, Benedict RE, Kirby RS, Yeargin -Allsopp M, Van Naarden Braun K, Doernberg N. Brief Report: Prevalence of Cerebral Palsy: Autism and Developmental Disabilities Monitoring Network, Three Sites, United States, 2004. Disability and Health 2008;2:45-48.
5. Johnston M V, Hagberg H. Sex and the pathogenesis of cerebral palsy. Dev Med Child Neurol. 2007, 49: 74–78
6. Solaski M, Majnemer A, Oskoui M. Contribution of socioeconomic status on the prevalence of cerebral palsy: a systematic search and review. Dev Med and Child Neurol. 2014; 56: 1043–1051
7. Erkin, G., Delialioglu, S. U., Ozel, S., Culha, C. and Sirzai, H. Risk factors and clinical profiles in Turkish children with cerebral palsy: Analysis of 635 cases. Int J Rehab Res. 2008; 31(1), 98-91.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareA CASE REPORT OF FACIAL NERVE SCHWANNOMA CO-EXISTING WITH AN EXTERNAL AUDITORY CANAL OSTEOMA: PRESENTATION OF UNILATERAL FACIAL ASYMMETRY WITH CONDUCTIVE HEARING LOSS
English1923Kriti BhujelEnglishAim: We present here a case of facial schwannoma co-existent with an external auditory canal osteoma which presented with a history of unilateral facial asymmetry with conductive hearing loss.
Case Report: A 50 year old female presented with progressive unilateral facial asymmetry of the left side since 5 years, with gradually progressive hearing loss in the left ear since 2 months. Examination revealed left-sided unilateral lower motor neuron facial palsy and a whitish bony hard mass in the left external auditory canal. CECT and CEMR scan of temporal bone showed a neoplasm arising from the vertical segment of left facial nerve. Modified radical mastoidectomy was done to trace the facial nerve lesion along the vertical segment of the facial nerve in the temporal bone and the exploration was extended along its extratemporal segment. The neoplasm was excised and histopathology examination revealed facial nerve schwannoma. The bony mass in the external auditory canal was excised and histopathological examination confirmed it to be an osteoma.
Conclusion: The gradually progressive unilateral facial asymmetry was due to the facial nerve schwannoma, while the unilateral conductive hearing loss was explained by the presence of the osteoma in the external auditory canal. The patient was cleared of the disease and physiotherapy was started. The asymmetry of the face improved from House-Brackmann grade 5 to 4 within a month. The hearing threshold improved to within the normal hearing range. The patient has been followed up for 6 months and there is no recurrence of symptoms.
EnglishFacial asymmetry, Conductive hearing loss, Facial nerve schwannoma, Osteoma, House-Brackmann stagingINTRODUCTION
A facial nerve schwannoma is a slow-growing tumor and may involve any part of the nerve. The posterior fossa and/or cerebellopontine angle is involved in about 50 percent of cases. Symptoms most often include dysfunction of the seventh or eighth cranial nerves. On CT and MRI, the mass appears identical to a vestibular schwannoma and the key to diagnosis is the neuroanatomic location of the tumour.1-4 Features include widening of the Fallopian canal in the temporal bone.3,4 For patients with mild or no facial dysfunction, a conservative attitude with observation and, if necessary, only debulking surgery is appropriate, sparing facial nerve function. The surgical approach depends upon tumor extension and location. Re-routing of the nerve is preferred when possible, but cable grafting is often necessary.1,3,4 Malignant tumors have been reported and may occur as part of the Neurofibromatosis type 2 (NF2) syndrome.4 Histologically, they are composed of cellular Antoni A areas with Verocay bodies and hypocellular myxoid Antoni B areas. Tumor cells are strongly and diffusely immunoreactive for S-100 protein. An osteoma of the external auditory canal is a benign growth of periosteal bone, which forms a solitary, dicrete, pedunculated, hemispherical swelling in the lateral part of the meatus, around the tympanomeatal junction, adjacent to the tympanic membrane. They are usually single. They are usually found as an incidental finding during the examination of an asymptomatic patient. No treatment is required in most asymptomatic cases. Canalplasty is indicated for refractory cases of recurrent otitis externa and frequent cerumen obstruction.
CASE REPORT
A 50 year old female presented with complaints of gradually progressive left sided facial asymmetry since 5 yrs and gradually progressive unilateral hearing loss in the left ear since 2 months. The patient noticed deviation of the angle of mouth towards the right side 5 years back, which started as a slight deviation which was noticed only when the patient smiled and slowly progressed to be present even at rest. (Fig.1) The facial asymmetry then progressed, with associated drooling of saliva and food and water from the left angle of the mouth and the patient was not able to close her left eye properly. She gave a history of watering and itching of the left eye as well. She also complained of reduced hearing in the left ear since 2 months, which was insidious in onset and gradually progressive. It was associated with intermittent fullness in the left ear. On examination of the ears after removal of cerumen, a whitish pedunculated growth was seen in the left external auditory canal, arising from the posterior wall, about 2 mm medial to the costochondral junction and encircling about 1/3 rd of the canal. On probing, it was hard in consistency, non-tender and did not bleed on touch. The tympanic membrane could not be visualized. Tuning fork tests revealed conductive hearing loss in the left ear. The right ear was grossly normal on examination. Facial nerve examination showed absence of wrinkling of the forehead on the left side (Fig. 2), left-sided Bell’s phenomenon was present (Fig. 3), deviation of the angle of mouth to the right when clenching teeth (Fig.4), and inability to blow out left cheek or to whistle (Fig.5). Taste over the anterior two-thirds of the tongue was normal and Schirmer’s test showed normal values bilaterally. CECT and CEMR scan of the temporal bones showed a heterogeneous iso-to-hypodense lesion noted in the left paraspinal component of the perivertebral space, extending into the stylomastoid foramen. A hyperdense lesion was also seen in the left external auditory canal, involving the bony posterior wall of the external auditory canal. The lesion was seen to cause scalloping of the anterior wall of the left external auditory canal. It was also seen to be pushing the left tympanic membrane medially. The segment of the left facial nerve 8mm proximal to the posterior genu was seen to be thickened. The facial nerve distal to the posterior genu was not seen separately from the above described lesion. The lesion was seen to abut the left styloid process. Ossicles and inner ear structures were found to be normal. These findings were suggestive of a neoplasm arising in the left facial nerve from the mastoid and extracranial segments and a separate bony neoplasm in the left external auditory canal. (Fig. 6, 7) The patient subsequently underwent Modified radical mastoidectomy under general anesthesia. Intraoperatively, a tumor involving the vertical segment and extratemporal segment of the left facial nerve was noted and the same was excised. Left canalplasty was done. The ossicles were found to be intact. Inlay greater auricular nerve grafting was done. The graft was placed in position and meatoplasty was done. (Fig. 8,9) Histopathological examination of the excised tumors revealed features suggestive of schwannoma of the facial nerve and a benign growth of bone from periosteum giving rise to the onion skin histologic appearance of lamellar bone suggestive of osteoma.
DISCUSSION
Facial schwannomas are benign, slow-growing tumors that arise from Schwann cells within the nerve sheath, and are often diagnosed late. Two types of tissue are distinguishable; the compact interwoven bundles of Antoni A, and the looser, more disordered cellular arrangement of Antoni B. The histological appearance cannot differentiate facial schwannomas from vestibular schwannomas and have no clinical, surgical or prognostic significance.5 Facial schwannomas are encapsulated tumors attached to the nerve. They are usually intimately adherent to the nerve trunk, often compressing the nerve against other structures. The tumor is usually slow-growing and can involve multiple segments of the nerve. A proportion of schwannomas are found within the body of the nerve, the nerve fibers either running through the tumor or splayed around its capsule.6 The geniculate ganglion (68.2 %) and labyrinthine portion (52.3 %) are the most commonly affected segments. Multiple segment tumors are almost twice as common (63.6 %) as single segment tumors (36.4 %).7 Facial nerve schwannomas grow in the direction of least resistance.8 Facial nerve schwannomas may be asymptomatic or can present with a wide variety of symptoms. There can be progressive or acute facial nerve palsy. Associated otological symptoms such as conductive and/or sensorineural hearing loss can occur. Mass effect on adjacent nerves may well cause sensorineural hearing loss (SNHL) or even conductive hearing loss if growth into the middle ear impairs the normal function of the ossicles. In a minority of cases (~10%) the tumor is extra-cranial, where it presents as an asymptomatic parotid mass.9 Surgery is the only treatment for facial nerve schwannoma and therefore patients are left with permanent facial dysfunction after treatment because tumor removal almost always requires total nerve resection. Osteomas of the external auditory canal are discrete, pedunculated bone lesions arising along the tympanosquamous suture. The most common location of osteomas in the temporal bone is the external auditory meatus, followed by the mastoid and temporal squame with other sites being exceptional. 10,11 They can present with recurrent otitis externa because the self cleansing mechanism of external canal has been compromised. When the external auditory canal aperture becomes reduced to 3 mm, high frequency hearing loss occurs, and further reduction in size could lead to lower frequency losses.12 It is managed surgically only when the patient suffers from recurrent episodes of otitis externa or conductive hearing loss, and surgery is usually done via the transmeatal route.
CONCLUSION
The patient presented with symptoms of gradual unilateral facial palsy and conductive hearing loss. After clinical and diagnostic investigations it was concluded that the patient had left facial nerve schwannoma along with a co-existing external auditory osteoma. At postoperative 1 year follow up, there is no recurrence of the schwannoma or osteoma. The facial palsy has improved from House- Brackmann 5 to 4. The patient’s hearing is in the normal range at present.
ACKNOWLEDGEMENT
The author acknowledges the immense help received from the scholars whose articles are cited and included in the references of this manuscript. The author is also grateful to the authors, editors and publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed. The author wishes to thank the Head of the department of ENT, Central Referral Hospital, Sikkim Manipal Institute of Medical Sciences, Dr. Suvamoy Chakraborty for his constant support and expert guidance. The author would also like to thank her fellow colleagues and post graduate students for their help, and the departments of Radiology and Pathology for their expert inference on the case. A special thanks to my dear friend Dr. Davis Thomas for always being there to help me.
Englishhttp://ijcrr.com/abstract.php?article_id=512http://ijcrr.com/article_html.php?did=5121. Moffat DA, Ballagh RH. Rare tumors of the cerebellopontine angle. Clinical Oncology (Royal College of Radiologists (Great Britain). 1995; 7: 28-41.
2. Bonneville F, Sarrazin JL, Marsot-Dupuch K, Iffenecker C, Cordoliani YS, Doyon W et al. Unusual lesions of the cerebellopontine angle: A segmental approach. Radiographics. 2001; 21: 419-38.
3. Lalwani AK. Meningiomas, epidermoids, and other nonacoustic tumors of the cerebellopontine angle. Otolaryngologic Clinics of North America. 1992; 25: 707-28.
4. Bartels U, Arrington JR. Rare Tumors of the cerebellopontine angle. In: Jackler RK, Brackmann D (eds). Neurotology. St Louis: Mosby, 1994: 835-61.
5. Maran AGD. Benign diseases of the neck. In: Kerr AG (ed.). Scott-Brown’s otolaryngology, 6th edn. London: Butterworth Heinemann, 1997: 5/16/8-10.
6. Hajjaj M, Linthicum FH. Facial nerve schwannoma: Nerve fibre dissemination. Journal of Laryngology and Otology. 1996; 110: 632-3.
7. Kertesz TR, Shelton C, Wiggins RH, Salzman KL,Glastonbury CM, Harnsberger R. Intratemporal facial nerve neuroma: Anatomical location and radiological features. Laryngoscope. 2001; 111: 1250-6.
8. King TI, Morrison AW. Primary facial nerve tumors within the skull. Journal of Neurosurgery. 1990; 72: 1-8.
9. Marzo, Sam J; Zender, Chad A; Leonetti, John P. Facial nerve schwannoma. Current opinion in otolaryngology and Head and Neck Surgery.2009 ;17: 5:346-50
10. Denia A, Perez F, Canalis RR, Graham MD. Extracanalicular osteomas of the temporal bone. Arch Otolaryngol Head Neck Surg 1979; 105: 706-9.
11. Camacho RR, Vicente J, Cajal SR. Imaging quiz case 2. Arch Otolaryngol Head Neck Surg 1999: 125: 349, 351-52.
12. Sheehy JL. Diffuse exostoses and osteomata of the external auditory canal: A report of 100 operations. Otolaryngology, Head and Neck Surgery. 1982; 90: 337-42.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareHAEMORHEOLOGY AND RED CELL INDICES IN HIV POSITIVE INDIVIDUALS ON ANTIRETROVIRAL
THERAPY IN DELTA STATE, NIGERIA
English2430Ifeanyichukwu Martin Ositadinma*English Osakue Stanley IkponmwosaEnglish Okeke Chizoba OkechukwuEnglishObjective: This work was designed to study the impact of HIV and anti-retroviral therapy on some haematological and haemorheological parameters.
Method: Two hundred and fifty three subjects aged 18 – 60 years; comprising; 85 HIV patients on ART, 90 not on ART and 78 age-matched apparently healthy HIV negative controls were recruited. CD4+ count, Haematocrit, Mean corpuscular volume (MCV), Mean corpuscular haemoglobin (MCH), Mean corpuscular haemoglobin concentration (MCHC), red cell distribution width (RDW), Whole blood viscosity (WBV), plasma viscosity (PV) and plasma fibrinogen were assayed.
Result: WBV, PV, plasma fibrinogen, RDW and MCV were significantly higher in HIV-positive subjects on ART and those not on ART compared to the controls (pEnglishHaemorrheology, Red cell indices, Antiretroviral therapy, HIVINTRODUCTION
Since its identification in 1981, Human immunodeficiency virus (HIV) infection and associated Acquired immune deficiency syndrome (AIDS) remain a major burden globally [1]. Nigeria has the second highest number of people living with Human immunodeficiency virus (3.1 million) next to South Africa (5.6 million). It accounts for 10% of the global Human immunodeficiency virus burden. In patients infected with Human immunodefi- In patients infected with Human immunodeficiency virus, the prevalence of cardiovascular risk factors is greater than in the general population. Both the Human immunodeficiency virus infection itself and the anti-retroviral treatment play a role in the development of cardiovascular event [2]. Haemorheology is the study of the flow properties of blood and its elements. There is increasing evidence that flow properties of blood are among the main determinants of proper tissue perfusion, and alteration in these properties play significant role in disease processes. Whole blood viscosity is the property of the fluidity and internal friction of blood. Increased viscosity may be one mechanism by which all major risk markers may promote cardiovascular disease [3]. Generally, changes in whole blood viscosity have been reported in several human cardiovascular diseases indicating that blood viscosity may be a major cardiovascular risk factor. Men have been shown to have higher blood viscosity than women, largely because of their higher hematocrit. Plasma viscosity is the intrinsic flow resistance of plasma. Increased plasma viscosity and whole-blood viscosity are observed in primary hyperlipoproteinemias as well as in secondary hyperlipoproteinemias such as diabetes mellitus and the nephrotic syndrome [3]. Plasma viscosity is primarily dependent on the concentration of plasma proteins, especially fibrinogen and it is not affected by anaemia [4]. According to [5], elevated plasma fibrinogen levels may be regarded as an independent cardiovascular risk factor. Cardiovascular disease is associated with high fibrinogen and lipid fractions leading to an increase of both plasma and whole blood viscosity as well as raised aggregability of blood cells [6]. The Haematologic manifestations of Human immunodeficiency virus infection are well-recognized as major complication of the disease and may be clinically important in many patients. The physiopathology of Human immunodeficiency virus-associated anaemia may involve three basic mechanisms: decreased Red Blood Cell production, increased Red Blood Cell destruction, and ineffective Red Blood Cell production. Red cell distribution width is an automated measure of the heterogeneity of red blood cell sizes (e.g. anisocytosis) and routinely performed as part of a complete blood cell counts. Red cell distribution width is used in the differential diagnosis of anemia. Red cell distribution width which also indicates the degree of anisocytosis is currently considered a new marker of inflammatory activity. A high level of red blood cell distribution width is a novel prognostic marker that may reflect an underlying inflammatory state. Recently, a series of studies have demonstrated that red blood cell distribution width can serve as a novel, independent predictor of prognosis in patients with cardiovascular diseases [7]. This study was therefore aimed at studying the impact of Human immunodeficiency virus infection and anti-retroviral therapy on some haematological and haemorheological parameters of Human immunodeficiency virus patients.
MATERIALS AND METHOD
SUBJECTS SELECTION
A total of one hundred and seventy-five (175) HIV-positive subjects (60 males and115 females) between the ages of 18-60yrs were recruited for this study from the Voluntary Counselling and Testing (VCT) centre in Delta State Government Hospital and Sage Clinic both in Warri, Delta State. Eighty five (85) were on Anti-retroviral drugs and Ninety (90) were not on anti-retroviral therapy. Seventy-eight (78) apparently healthy age-matched HIV sero-negative participants were also recruited as controls (30 males and 48 females). Ethical approval was obtained from the Ethics committee of Delta State Hospital Management board and informed consent was obtained from all participants that were involved in this study. Inclusion criteria were HIV positive patients on antiretroviral therapy (ART) at the duration of three months to thirty-eight months, HIV positive patient not on ART and HIV negative patients as control subjects. Exclusion criteria were Pregnant women, subjects with known bleeding or clotting disorders, including history of deep vein thrombosis, Concurrent malignancy requiring cytotoxic chemotherapy or radiation therapy, Patient less than 18years or above 60 years of age and subjects that declined from participating in the study.
SAMPLE COLLECTION
Six (6) millilitres of blood was collected from the antecubital fossa of each subject, 4ml was dispensed into EDTA container for CD4 count, haematological and haemorheological parameters, the remaining 2ml into plain containers (chemically clean plastic tube), which was allowed to clot and serum used for serum viscosity and HIV screening.
METHODS
HIV 1/2 RAPID TEST KIT BY IMMUNOCHROMATOGRAPHY
Determine HIV ½ test strips (Alere medical company Ltd, Japan, 2013, lot No: 53427K100) Fifty microliter (50µL) of plasma sample was dispensed into the specimen pad of the test strip. The reaction was allowed for 15 minutes. The appearance of distinct red lines on the test and control regions of the kit suggests a positive HIV test. While only one distinct red line in the control region suggested a negative result. Appearance of the distinct red line on the control region will validates the result without which the kit was assumed non-functional.
STAT PAK HIV ½ test kit (CHEMBIO DIAGNOSTIC SYSTEMS INC., USA 2012, lot No: HIV070612)
The test kit was placed on a flat surface; 5µL sample loop provided for the specimen was used to touch the sample allowing the opening of the loop to fill with plasma which was then placed into the sample pad. Three (3) drops of the buffer drop-wise was added to the sample in the sample well. Result was read after 10 minutes of adding the buffer.
UNI-GOLD HIV ½ test kit (TRINITY BIOTECH PLC, Ireland 2013, lot HIV3100204)
The test device was removed from the protective wrapper. Over the sample port 60µL of serum was added. Also two drops of wash buffer reagent was added to the sample on its port. Result was read after 10 minutes. CD 4+ T CELL COUNT (Partec, Germany) Twenty microlitre (20µL) sequestrated blood was collected into a partec test tube (Rohren tube). Then 20µL of CD4+ T cell antibody will be added into same tube. The content was mixed and incubated in the dark for 15 minutes at room temperature. 800µL of CD4 buffer was then added to the mixture in the tube and mixed gently. The partec tube was then plunged on the Cyflow counter and the CD4+ T cell count displayed as peak and interpreted as figures.
RED CELL INDICES (using DIRUI BCC-3000B
Auto Haematology Analyser) Haematocrit (HCT), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC) and Red Cell Distribution Width (RDW) was analysed using DIRUI BCC-3000B Auto Haematology Analyser. The procedure was according to manufacturers’ instruction.
WHOLE BLOOD VISCOCITY AND PLASMA VISCOSITY
Whole Blood Viscosity (WBV) and Plasma Viscosity (PV) were carried out by a modification of the method of Reid and Ugwu [8].
PLASMA FIBRINOGEN ESTIMATION
Fibrinogen was estimated using the method of miller et al [9].
STATISTICAL ANALYSIS
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7. Puerta S, Gallego M, Palacios R, Ruiz J, Nuño E, Márquez M, Santos J. Higher red blood cell distribution width is associated with a worse virologic and clinical situation in HIV-infected patients. Biomed Central 2010; 13: 69
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10. Tagoe DN, Asantewaa E. Profiling Haematological Changes in HIV Patients Attending Fevers Clinic at the Central Regional Hospital in Cape Coast, Ghana: A Case-Control Study. Archives of Applied Science Research 2011; 3: 326- 331.
11. Obirikorang C, Yeboah FA. Blood haemoglobin measurement as a predictive indicator for the progression of HIV/ AIDS in resource-limited setting. Journal of Biomedical Science 2009; 16: 102-109.
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13. Tripathi AK, Misra R, Kalra P, Gupta N, Ahmad R. Bone Marrow Abnormalities in HIV Disease. Journal of the Association of Physicians of India 2005; 53: 705-711.
14. Alem M, Kena T, Baye N, Ahmed R, Tilahun S. Prevalence of Anaemia and Associated Risk Factors among Adult HIV Patients at the Anti-Retroviral Therapy Clinic at the University of Gondar Hospital, Gondar, Northwest Ethiopia. Open Access Scientific Reports 2013; 2: 6-11.
15. Ferede G, Wondimeneh Y. Prevalence and related factors of anaemia in HAART-naive HIV positive patients at Gondar University Hospital, Northwest Ethiopia. BMC Haematology 2013; 13:8-16
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20. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJV, Pfeffer MA, Swedberg K, Yusuf S, Michelson EL, Granger CB. Red cell distribution width as a novel prognostic marker in heart failure: data from CHARM program and Duke data bank. Journal of American College of Cardiology 2007; 50: 40–47
21. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. For the Cholesterol and Recurrent Events (CARE) Trial Investigators. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008; 117:163–168.
22. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Archive of Pathology and Laboratory Medicine 2009; 133: 628–632.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareCARTILAGE GROWTH DISORDERS: A REVIEW
English3135G. RamkumarEnglish Navin BalasubramanianEnglish Vivek NarayanEnglishThe normal development and growth of various structures in human body gives distinct appearance to the body with proper functions. Growth of individuals mainly depends upon the growth of long bones. Cartilage in epiphyseal end of long bones proliferates to form matrix which gets converted into bone by ossification and calcification. Continuous formation of matrix, conversion of bone helps the longitudinal growth of bone. Various factors disturb the endochondral ossification in various places including the long bones and the growth of bone is disturbed causing stunted growth with deformities in the individual. Thorough study of
the facts and truths of disturbances of cartilage growth of long bones and other parts of bone would help in research to find out the possible remedies to solve the problem in cartilage dysfunction. Hence the present article is prepared to review the various aspects of cartilage, cartilage growth disturbances in endochondral ossification, stunted growth and deformities.
EnglishCartilage, Basicranium, Mandibular condyle, Epiphyseal cartilageINTRODUCTION
Skeletal growth and growth in longitudinal direction of an individual depends upon proper cartilage function as cartilage plays a vital role in multiple growth centers of the body. 10Mesenchyme of embryonic germinal layer gives rise to formation of cartilage by producing cartilaginous matrix in which fibers are embedded to form homogenous cartilage. 10Depending upon the amount and type of fibers, the cartilage is called as hyaline cartilage, elastic cartilage and fibroelastic cartilage. Cartilage exists in pinna of the ear, nose, nasal septum, respiratory tract, ribs and articular surfaces of joints. In cartilage growth center cartilage proliferates and elaborates a matrix which is slowly replaced by ossification and calcification to form bone through endochondral ossification9 . This normal physiological function of cartilage turning into bone is affected by known and unknown causes. The development and growth of bone particularly the long bones are affected causing stunted growth and deformities. These disorders are being described and discussed in this article.
CARTILAGE GROWTH CENTERS
Cartilage growth centers exist in many places of the body but the following places are important for the growth of structure6, 7, 12.
1. Basicranium
2. Condyle of mandible
3. Epiphyseal end of long bones
CARTILAGE IN BASICRANIUM
Cartilage growth center exist in the base of the skull in the form of synchondrosis12. Cartilage synchondrosis is bipolar cartilage cells on either side with a central zone of persistent cartilage cells8,12. Spheno-occipital synchondrosis, 12 mid-sphenoidal synchondrosis and sphenoethmoidal synchondrosis are present in the base of skull. Persistent cartilage cells proliferate on either side and elaborate a matrix. This matrix further undergoes ossification and calcification to form bone through endochondral ossification12. Spheno-occipital synchondrosis exists in basicranium12. In the anterior part of spheno-occipital synchondrosis, cartilage cells proliferate to form a matrix which gets ossified and calcified to form sphenoid bone. The posterior part of cartilage cells proliferates to form matrix which gets ossified and calcified to form occipital bone. Thus the spheno-occipital synchondrosis is converted into spheno-occipital bone of the skull12. The sphenoid bone in the anterior part is attached with pterygoid plates which in turn join the maxillary bone. Growth of sphenoid bone in basicranium pushes the petrygoid plates which in turn push to maxilla to form mid dle part of face. Any disturbances in the development of sphenoid bone in the anterior part of spheno-occipital synchondrosis causes arrested growth of sphenoid bone. Failure of forward growth of maxilla occurs due to the arrested growth in the base of the sphenoid bone [figure 1] and this causes the deformity of retruded maxilla in the midface.
CLINICAL CHANGES DUE TO DISTURBANCE OF SPHENOID BONE FORMATION IN THE CRANIAL BASE
In the craniofacial development, midface hypoplasia in cleidocranial dysostosis occurs and this is due to inadequate ossification of the cranial base12. As a result of the disturbance in formation of sphenoid bone in cranial base the forward movement of maxilla is not possible. In Crouzon5, 9, 12 syndrome [figures 4, 5 and 6] due to genetic disturbance, early closure of spheno-occipital synchondrosis occur due to failure in the development of the anterior part of sphenoid bone and posterior part of occipital bone. This results in short base of skull and midface hypoplasia[figures 4, 5 and 6]. 12Midface malformation due to cranial base disturbances also occurs in Apert syndrome5 and Turner’s syndrome12. Midface hypoplasia occurs in achondroplasia due to the disturbances of cartilage growth in spheno-occipital synchondrosis3 .
CARTILAGE IN CONDYLE OF MANDIBLE
The head of mandibular condyle articulates within the glenoid fossa to form temporomandibular joint6 . Mandible on either side develops separately and joins in the midline. During development, the anterior part of mandible develops from differentiation of fibrous tissue around the Meckel’s cartilage through intramembranous ossification. The posterior part of mandible is formed by endochondral ossification of condyle of mandible [figure 2]. Condyle of the mandible is a growth center and consists of hyaline cartilage. Cartilage cells in condyle proliferate and elaborate a matrix downwards. The matrix gets calcified and bone is formed. Further proliferation of cartilage cells and further matrix formation pushes the bone downwards. 11Formation of cartilage matrix, conversion of matrix into bone continuously help to form the bone which helps in the forward growth of mandible. While the anteroposterior growth of mandible is formed by endochondral ossification of condyle, the horizontal growth of mandibular body is formed by surface apposition of bone in the preformed intramembranous ossification. Any disturbances to condylar cartilage growth center affect the development and growth of posterior part of mandible resulting in arrested growth of mandible. The following conditions are due to the disturbance of condylar growth center.
1. Agenesis of condyle
Agenesis of condyle is congenital absence of condyle due to failure of formation of condyle on one side. It is associated with hemifacial microsomia, where unilateral absence of condyle occurs. Clinically the individual has depression in the preauricular region with absence of auricle and external auditory meatus. The mandible in the affected side has arrested growth with deviation of mandible from unaffected side causing a shift in the midline. Palpation will reveal total absence of condyle and condylar movement in the affected side. Facial deformity with microstomia is a characteristic feature. Prenatal growth disturbance of condyle is the cause of agenesis of condyle.
2. Aplasia of condyle
Aplasia of condyle is an attempted formation of miniature condyle where the growth of condyle and endochondral ossification is affected. It may be unilateral or bilateral. In unilateral aplasia of condyle, the mandible will be small due to arrested growth in that side. On palpation the condyle will be small in size but the movement is not affected. On the unaffected side the growth of mandible is normal causing deviation of mandible and shift of midline towards the affected side. Bilateral aplasia of condyle causes arrested growth of mandible on both sides causing mandibular micrognathism.
3. Hypoplasia of condyle
Hypoplasia of condyle [figures 7, 8 and 9] is reduced size of condyle due to developmental disturbance6 . This may occur unilaterally or bilaterally. As the condyle is hypoplastic and there is disturbance in endochondral ossification on one side, it causes arrested growth of mandible on one side and results in facial deformity [figures 7, 8 and 9]. The unaffected side of mandible grows normally but is deviated to affected side shifting the midline. If hypoplasia occurs on both sides, arrested growth occurs resulting in micrognathism. Due to arrested growth of mandible there is a depression at the junction of ramus and body called antegonial notch. Thus when cartilage growth center in condyle of mandible is affected, arrested growth of mandible occurs causing deformity. The exact cause of prenatal disturbance of cartilage growth center is not fully understood but may be due to certain developmental disturbances.
4. Unilateral condylar hyperplasia
Disturbances in cartilage growth in many places occur as a deficiency or absence of growth of cartilage. But in condylar growth centers, cartilage overgrowth occurs resulting in condylar hyperplasia4 where cartilage produce excessive matrix and bone resulting in a large mandible with excessive anteroposterior growth. In unilateral condylar hyperplasia there is bending of the lower border of mandible with deranged occlusion of teeth. The unaffected side is normal.
CARTILAGE IN EPIPHYSEAL END OF LONG BONES
The growth of long bone in vertical direction is purely due to the presence of cartilage in the epiphyseal end of long bones7 [figure 3]. The cartilage proliferates and forms a matrix which gets calcified to form bone. Continuous proliferation of cartilage to form matrix and the matrix ossifying into bone causes growth in the length of bone. The growth of diaphysis in horizontal direction is by intramembranous ossification. If the endochondral ossification in epiphyseal end is disturbed, different deformities occurs with a common sign of stunted growth/dwarfism9 . Achondroplasia is a condition in which absence of cartilage growth occurs. Absence of cartilage growth in spheno-occipital synchondrosis causes midface hypoplasia and shortening of base of skull. Absence of cartilage growth in epiphyseal end in achondroplasia results in stunted growth of long bones in extremities with short stature of the individual [figures 10, 11 and 12]. Deficient ossification of cartilage matrix in epiphyseal end causes stunted growth with flattened vertebral body in Morquio Brailsford disease. Abnormal ossification of epiphyses causes stunted growth in dysplasia epiphyseal multiplex10. Osteopetrosis is a genetic disorder in which failure of bone resorption causes excess bone formation which obliterates the blood vessels and the viability of bone in that area is lost1 . Osteomyelitis can develop in the affected bone due to a compromised blood supply. In osteopetrosis continuous bone formation occurs and failure of bone resorption causes unresorbed cartilage. This causes widening of bone with club shaped appearance of metaphysis of long bones. Thus the persistent cartilage causes defects in bone10. The cartilage matrix formed in the epiphyseal end fails to calcify and more amount of cartilage accumulates in the metaphysis affecting the longitudinal growth of long bone in Ollier’s disease10. Shortness of affected extremities due to chondrodystrophic calcification congenita and stippled epiphyses is a rare congenital disease with discrete spots of calcification affecting cartilaginous structure. A single limb may be affected10. Cartilage growth disturbances occurs in epiphyseal end of long bones due to genetic disturbances resulting in stunted growth of extremities with a clinical appearance of a long trunk and short extremities, polydactyly with cardiac changes in Ellis-van Creveld syndrome2 . Growth of any organ depends upon the metabolic activities of growth hormones, pituitary hormone and thyroid hormone. Epiphyseal cartilage growth is also suppressed when there is a deficiency of these hormones and cause stunted growth in hypopituitarism and hypothyroidism9 . Stunted growth occurs in Gargoylism due to chondroosteodystrophy10 and is associated with mental retardation, cloudy cornea and enlargement of liver and spleen.
DISCUSSION
It is true that proper growth of an individual depends upon the proper growth of cartilage in the cartilage growth centers, since midface deformity is due to the disturbance in growth of spheno-occipital synchondrosis12. Arrested growth of mandible is due to defective condylar growth and stunted growth is due to failure of cartilage growth center in epiphyseal end of long bones11. Craniofacial deformities are due to disturbances in growth centers of cranial base. Cartilage growth disturbance in spheno-occipital synchondrosis may be only a local disturbance without involving other growth centers as we find that in Crouzon’s disease only face is affected. But in achondroplasia, cartilage growth disturbances occur both in spheno-occipital synchondrosis and in the epiphyseal cartilage growth center resulting in midface deformity and stunted growth of long bones. Anterior cranial base is affected more than posterior cranial base and the skull base is shortened in the cartilage growth disturbances of the cranial base. Since cranial base growth disturbance is due to mutation of genes, a thorough research study may be helpful to solve this problem. Arrested growth of mandible due to disturbances in cartilage growth center of condyle appears to be an independent disorder without involving other cartilage growth centers. Arrested growth of mandible is not associated with other skeletal deformities like midface hypoplasia or stunted growth. This appears to be more of prenatal disturbances rather than genetic involvement. Cartilage growth disturbances in condyle cause aplasia and hypoplasia of condyle resulting in arrested growth of mandible. But condylar hyperplasia also occurs with the formation of large body of mandible for which the reason in not known. The major cause of individual stunted growth/dwarfism is mainly due to disturbed growth of epiphyseal cartilage of long bones. This may be a physiological alteration due to pituitary and thyroid deficiency or due to genetic disturbances. There is no absence of cartilage in epiphyseal growth center but the existing cartilage does not grow or grows abnormally. In the abnormal cartilage, there is failure of ossification and calcification. The reason behind failure of growth, ossification and calcification of cartilage is not fully understood but genetic changes have been proposed. Cartilage growth in the epiphyseal end without ossification and calcification may occur as masses in the long bone. Single long bone may also be affected. In certain conditions, epiphyseal cartilage growth is affected in association with ectodermal dysplasia and cardiac manifestations in Ellis-van Creveld syndrome and mental retardation, cloudy cornea, spleen and liver enlargement are seen in Gargoylism. The systemic symptoms do not have any relevance in the failure of cartilage growth. Disturbances in epiphyseal cartilage growth are not associated with condylar cartilage growth but is seen in cranial base disorders as in achondroplasia.
CONCLUSION
Disturbances in cartilage growth centers causing stunted growth and deformity have been explained. Stunted growth of long bones, arrested growth of mandible and sphenoid bone are the features of cartilage growth disturbances. Disturbances are not uniform and may vary for every growth center. Continuous and constant research in genetics and prenatal disturbances pertaining to the cartilage growth disturbances may be carried out and this research may reveal some newer concepts which may help to prevent the cartilage growth disorders. This review article would act as a basis for further evaluation and research of cartilage growth disturbances.
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.
Figure 12: Stunted growth of lower extremities
Englishhttp://ijcrr.com/abstract.php?article_id=514http://ijcrr.com/article_html.php?did=5141. Bollerslev J. (1987) Osteopetrosis: a genetic and epidemiological study. Clin Genet 31:86–90.
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3. Baujat Geneviève et al.AchondroplasiaBest Practice and Research Clinical Rheumatology, March 2008 Volume 22, Issue 1, 3–18.
4. Jonck LM. Facial asymmetry and condylar hyperplasia. Oral Surg Oral Med Oral Pathol 1975;40:567-573.
5. Kreiborg S,Cohen M.M, et al. Is craniofacial morphology in Apert and Crouzon syndromes the same? – Acta odonto scand. 1998 vol 56, no 6: 339–341.
6. Kreutziger, KL, Mahan, PE. Temporomandibular degenerative joint disease. Part I. Anatomy, pathophysiology, and clinical description. Oral Surg Oral Med Oral Pathol. 1975; 40:165–182.
7. Karlen AG, Cameron JA. Dysplasia epiphysialis punctata; report of a case with discussion. J Bone Joint Surg Br. 1957 May; 39-B (2):293–301.
8. Mølsted K, Kjaer I, Dahl ESpheno-occipital synchondrosis in three-month-old children with clefts of the lip and palate: a radiographic study. Cleft Palate–Craniofacial Journal 1993; 30:569–573.
9. Robert B Duthie, George Bentley, Mercer’s orthopedic surgery volume I ninth edition.
10. Samuel.L.Turek, Orthopedics: principles their application 4th edition.
11. Sicher, H. Functional Anatomy of the Temporomandibular Joint. in: B. Sarnat (Ed.) The Temporomandibular Joint. Charles C Thomas, Publisher, Springfield, Ill; 1951.
12. Nie X. Cranial base in craniofacial development: developmentalfeatures, influence on facial growth, anomaly, and molecular basis.Acta Odonto Scand 2005; 63: 127–35.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareDELAYED DIABETIC WOUND HEALING: A FOCUS ON BACTERIAL PROTEASES IN CHRONIC WOUND AND FOOT ULCER
English3643Saumya Mary MathewEnglish Varshaniyah RavisankerEnglish Tanvi PotluriEnglish Suchithra T.V.EnglishBackground: The infectious bacteria produce proteolytic enzymes which help them to invade, establish infection and to survive the host defence mechanism delaying the wound healing.
Objectives: Protease secreting potential of bacterial flora; specifically the bacterial isolates of diabetic ulcer foot patients are studied here.
Methods: The predominant bacteria in foot ulcer were identified and bacterial enzymes caseinase, gelatinase, alkaline protease, hyaluronidase, proteinase K and collagenase were analysed.
Results: Out of the 78 strains isolated S.aureus was the most predominant organism. Among the bacterial isolates, the presence of different types of proteolytic activities was observed as follows: proteinase K (87.2%), collagenase (80.8%), hyaluronidase (78.2%), caseinase (60.3%), alkaline protease (53.8%) and gelatinase (25.6%).
Conclusions: Bacterial wound flora were found capable to produce and secrete proteolytic enzymes and it can be worsen the proper wound healing
EnglishCaseinase, Alkaline protease, Hyaluronidase, Proteinase K, CollagenaseNTRODUCTION
Diabetic foot ulceration is one among the foremost complications of diabetes and 85% of amputation cases are reported because of diabetic foot ulcers. Increased incidence of infections in the wound further adds to the complications. Diabetes slows down the conventional functioning of wound healing processes resulting in vascular and neuropathic disorders . The peripheral neuropathy associated with diabetes cause the degradation of cell epithelium , serving the microbes to overcome the cell barrier of the host. Bacterial infection, along with local tissue hypoxia, ischemia, continued trauma and altered cellular and systemic stress response causes wounds to heal slowly; reworking them into chronic wounds. The colonisation of bacteria in wounds hinders the wound healing process. These pathogenic bacteria cause disease by mechanism of establishment, production of invasins and bypassing host defence mechanisms. Bacteria produce proteolytic enzymes like hyaluronidase , collagenase, gelatinase, caseinase, alkaline proteaseetcwhich damages host cells and help in spread of the pathogen. These enzymes have a very important role in worsening of wound. Bacterial protease hydrolyses the protein and peptide thus causing degradation of cell membranes and disrupting numerous biological functions. The number of diabetic people in the world is estimated to leap to 592 million in 2035 in comparison to 382 million in 2013 . Hence present study focuses on the prevalence of tissue damaging enzymes of bacterial isolates from diabetic ulcer foot and its role in delayed wound healing.
MATERIALS AND METHODS
Study population
The pus samples were collected from the wounds of 55 diabetic foot ulcer patients of Medical Trust Hospital and Diabetes Care Center, Pandalam, Kerala, with their informed consent and institutional ethical committee’s permission. All the specimens were handled and transported and aseptically to the microbiology laboratory for further testing.
Identification of organisms
The bacteria were isolated by streaking on nutrient agar plates and incubating at 37 C for 24 hr. The individual bacterial colonies were isolated and the identification was done based on standard medical microbiology laboratory procedures.
Qualitative tests for tissue degrading bacterial enzymes
The tissue degrading enzymatic potentials of bacteria like proteinase K, collagenase, hyaluronidase, caseinase, alkaline protease and gelatinase were analysed qualitatively. A collagen containing media (collagen + tyrode solution) was prepared and wells in the medium were inoculated with the test sample for collagenase test. For caseinase test casein agar plates were streaked with the each bacterial isolates and were checked for the presence of clearancezones. Bacterial cultures were inoculated into nutrient gelatin broth and incubated for 48hrs for gelatinase test. The tests for proteinase K, hyaluronidase and alkaline protease were done along with the quantitative tests.
Quantitative tests for tissue degrading bacterial enzymes
The bacterial isolates were quantitatively analysed for the enzymes such as proteinase K, collagenase, hyaluronidase, caseinase, alkaline protease and gelatinase. Isolated organisms were inoculated separately in 10 ml of broth at 37C for 24 hrs. The culture was then centrifuged and the pellet and supernatant were collected separately. The supernatant was directly assayed for secretory enzyme activity. The pellet was suspended in 1 ml phosphate buffer, sonicated and centrifuged and then used for intracellular enzyme assay. One unit of proteinase K was defined as 1 µM of tyrosine liberated at culture conditions using hemoglobin as substrate. Collagenase and caseinase assay was done according to the procedure of Mandal . One unit of enzyme activity was defined as µM of leucine liberated in 5 hrs under the culture conditions. Hyaluronidase was assayed by the method of Tolksdrof and Kass and Seastone. The alkaline protease activity was measured by the method of Meyers and Ahearn . Unit activity was defined as amount of enzyme that released 1 µmol of tyrosine/ml/minute. Gelatinase activity was done according to the method Tran and Nagano and was defined as µM of leucine liberated/ml/minute.
RESULTS
For the present study, 55 diabetic foot patients were selected those who have chronic infections of Wagner grade 2 to 5. A total of 78 strains of organisms were isolated from wound and identified biochemically. The gram positive isolates were sp., sp., and sp. The gram negative isolates were and (figure 1).
Qualitative analysis of tissue degrading proteases
The proteolyticenzymes such asproteinase K, collagenase, hyaluronidase, caseinase, alkaline protease and gelatinase were studied here to screen the proteolyticaction of bacterial flora from ulcer foot. From the qualitative analysis, it was observed that 100% of total isolates were positive for at least 2 different proteases under consideration (Figure 2), but secretory capability varies with different genus and species.
Quantitative analysis of tissue degrading proteases
Both production and secretion of proteases were analysedby screening intracellular and extracellular enzymes respectively. Table 1 and 2 depict the level of extracellular and intracellular level of each enzyme considered in this study.
DISCUSSION
Increased infection susceptibility is seen in patients with diabetes mellitus, than non-diabetic person .The increased hyperglycemic condition leads to advanced glycation of proteins and lipids and gets deposited in the blood capillaries. This leads to the diminished blood flow and oxygen perfusion to the site of wound.The decreased oxygen condition in wound also deliver very good environment for the anaerobic organisms. Even though diabetic ulcer foot is multifactorial condition, one amongst the important reasons for non-healing wound is the tissue destruction .This tissue destruction is caused by the increased activity of the bacterial proteases. For the present study, 55 diabetic foot patients were selected those who have chronic infections. They were suffering from different grades of foot ulcer and coming under Wagner grade 2 to 5. A total of 78 strains of bacteria were isolated from wound and identified biochemically. The most predominant organisms isolated were and it accounted for 24% of the total bacterial isolates. Our previous study of bacterial isolates form diabetic foot ulcer patients admitted in hospital of Malabar region also gave a similar result of as the most predominant isolate from the wound. The predominance of in the wound isolates were reported in many other studies. This indicates the predominance of is irrespective of the locality. The degree of occurrence of other gram positive isolates other than was > sp. sp. > > sp. The order of occurrence of other gram negative isolates was > > > > > (figure 1). Hena and Growther also reported the presence of and in septic complications of infected diabetic foot patients from Coimbatore .
The wound micro-flora are capable to grow on the surface of the wound with the help of their proteolytic enzymes and other invasins like exotoxins and endotoxins . These invasins help in the spreading of the pathogen and cause considerable tissue damage. In this study, only some important invasins such as collagenase, caseinase, gelatinase, hyaluronidase, alkaline protease and proteinase K were considered. These protease enzymes can cause the destruction of extracellular matrix in chronic wounds and act as virulence factor of the infecting bacteria . Out of the total isolates, 8.97% of isolates showed activity for all the 6 enzymes taken under consideration. About 82.05% of isolates gave good activity for 50% of enzymes in our study. Among the bacterial isolates, the presence of different types of proteolytic activities was observed as follows: proteinase K (87.2%), collagenase (80.8%), hyaluronidase (78.2%), caseinase (60.3%), alkaline protease (53.8%) and gelatinase (25.6%). Both production and secretion of proteases were estimated here by screening the intracellular and extracellular enzymes respectively. The extracellular (secretory) proteases can cause extensive tissue damage , blood stream diffusion and coagulation of blood . They also help bacteria in degradation of proteins producing small peptides and amino acids which are further transported and utilized by the organism for the growth and development. Intracellular proteases help in the cellular and metabolic processes and helps in the cell to cell interaction of the organism. Depending upon the secretory potential of isolates, they showed the presence of extracellular or intracellular proteolytic activity. A group of proteolytic isolates having only extracellular activity exhibited high enzyme secretion. Another set of isolates exhibited lower extracellular activity while a third group exhibited only intracellular activity. The reason for lower or no extracellular activity can be attributed to the lack of specific substrate stimulation in condition. Regardless of the site of activity all isolates were found to be potential protease producers.
Prevalence of secretory proteases in ulcer foot
a) Bacterial proteinase K
All of proteinase K positive bacteria were found capable to produce extracellular proteinase K except Among them, showed the highest secretory potential with mean activity of 25.208±0.410 unit/ml/min. As a predominant microflora of ulcer foot, their proteinase K activity can further worsen the impaired wound healing in the infected area. Even though the infection have the prevalence next to, the proteinase K extracellular activity was lesser, but their abundance in ulcer foot can affect the protease action on tissues. While the sp. possess 8.640±0.707 unit/ml/min of extracellular activity, they have comparatively higher intracellular activity of 5.464±0.701 unit/ml/min. gave the lowest extracellular activity of 0.400±0.190 unit/ ml/min. was found negative for intracellular production of the enzyme and thereby no extracellular secretion too. According to Wandersman’s findings, the secretion of this enzyme help the each bacteria to establish infections in wound by cleaving the internal peptide bonds of proteins in normal non-diabetic condition. It also have the capability to digest the native keratin. Hence the proteinase K secretory capabilities of almost all bacterial flora can worse the tissue damage in diabetic ulcer foot.
b) Bacterial collagenase
Generally, collagenase can breakdown the peptide bonds of the collagen protein, the fibrous protein of extracellular connective tissue.Unlike human collagenase, bacterial collagenases have a broader substrate specificity . For instance, they can hydrolyze the native collagen in its triple helical conformation HShibano, YMorihara, KFukushima, JInami, SKeil, BGilles, AMKawamoto, SPOkuda, KStructural gene and complete amino acid sequence of Vibrio alginolyticus collagenaseBiochem. JBiochem. J703-7082811992, both water-insoluble native collagens and watersoluble denatured collagens and also the gelatin along with collagen as a substrate sp., and were found devoid of this enzyme. sp. and sp. showed high secretory potential of this enzyme. Maximum extracellular collagenase activity of 0.675±0.191 unit/ml/min was shown by gave the least extracellular collagenase activity of 0.102±0.036 unit/ ml/min. Most of the collagenase produced was released to extracellular environment destroying the matrix leading to delayed wound healing process and causing tissue destruction. Intracellular collagenase activity was shown by and Maximum intracellular collagenase activity of 0.301±0.0143 unit/ml/min was shown by The high rate of collagenase secretion in majority of isolates of the study reveals its capability to cause uncontrolled proteolytic tissue destruction and act as a pathogenic factor in non-healing wounds.
c) Bacterial hyaluronidase
All the isolates gave extracellular hyaluronidase activity. Most of the bacteria were capable of releasing the enzyme into the extracellular environment. The highest mean extracellular activity of 0.180±0.012 unit was shown by. They gave no intracellular activity, this might be because, the organism is capable of releasing the enzyme produced to the outside environment and thus the hyaluronidase enzyme is completely released. Least extracellular hyaluronidase activity of 0.087±0.007 unit was given by. The intracellular enzyme activity was not given by the all organism under consideration. sp., and did not show any intracellular enzyme activity. gave the highest intra cellular activity of 0.146±0.024 unit and sp. gave the lowest intracellular activity of 0.086±0.009 unit. This enzyme increases the permeability of the extracellular matrix (ECM) by hydrolysing the ECM component, the hyaluronan. Starr and Engleberg also reported hyaluronidase positive and in cellulitis in patients of United States . Some streptococcal species produces a hyaluronic acid (HA) capsule preventing phagocytosis and facilitating the adherence to the mucosal surface .This enzyme can act as virulence factor, disrupting the polysaccharides in the cell membrane and thus increasing cell wall permeability so as to promote bacterial spread.
d) Bacterial caseinase
As an important factor for virulence of bacteria isolated from wound infection, caseinase activity was also studied here. Bacterial flora of ulcer foot except and showed the presence of both extracellular and intracellular caseinase. The highest caseinase activity of 0.173±0.108 unit/ml/min was seen in the cell free supernatant. and gave the highest extracellular caseinase activity thus they can impart high proteolytic activity . exhibited the highest intracellular caseinase activity of 0.097±0.010 unit/ml/min followed by . But showed lesser ability to release enzyme in contrast to other isolates. Similarly, the presence of caseinase was detected in many hospital clinical isolates like from respiratory tract secretions, in corneal ulceration during bacterial keratitis and also in some strains. This proteolytic activity was found to be related to the pathogenesis of the bacterium and the development of nosocomial infections. Besides this enzyme is essential for the activity of haemolysin too . Therefore, the prevalence of caseinase producers in diabetic ulcer foot might have influence in delayed ulcer foot management.
e) Bacterial Alkaline protease
Alkaline protease were shown to be secreted during infection and they affect the wound healing by increasing the pH at the wound site. Normally the wound healing occurs more readily in an acidic environment of pH of 4–6. This protease enzyme elevates the pH of the wound, thus affecting many factors like oxygen release angiogenesis, protease activity bacterial toxicity etc leading the wound to remain unhealed. Alkaline protease cleaves the peptide bonds of protein and are stable at a higher pH. They are found in all living organism and are needed for the normal cell growth and differentiation . Alkaline protease activity was not observed by all the organisms taken up for the study. Organisms like sp., and gave very less alkaline protease activity. Considerable alkaline protease activity was shown only by sp. and sp. gave a maximum intracellular enzyme activity of 1.44 unit/ml/min in the sonicated cell pellet. They were unable to release the enzyme to the environment. An extracellular activity of 0.859±0.521 unit/ml/min was given by Alkaline proteases also have proteolytic activity on proteins involved in host defence mechanisms like complement activation via the classical and lectin pathways and they penetrate the body barriers and damage the host cells . They also protect the organism from the immune system of the host . Hence, bacterial alkaline protease can cause impaired wound healing in diabetic ulcer foot but, alkaline protease positive organisms was found significantly less in our study. Though the enzyme activity was less, its impact can cause severe consequences on already debilitated condition of diabetic ulcer foot.
f) Bacterial gelatinase
Generally gelatinase is capable of hydrolyzing collagen, casein, hemoglobin and other peptides.in this study, bacterial gelatinase was detected both extracellularly and intracellularly. Even though they were positive for the enzyme production, the activities of secretory gelatinase were lower than that of intracellular enzyme. was the lowest gelatinase producer in this study. Although there were contradictory reports on the positive and negative influence of human gelatinase (MMP-2 and MMP-9) in normal wound healing process, the microbial gelatinase have a negative effect on the wound healing process. They degrade the gelatin in the connective tissue and help the microorganism to further spread its infection into the tissue . Unlike other study enzymes, only 25.66% of total isolates were found as gelatinase positive. However, isolates were potential to produce gelatinase. Hence they might have role in worsening of ulcer foot in diabetic patients.
CONCLUSION
We can conclude that the bacterial infection is very common in diabetic ulcer foot. This bacterial infection has increased the burden of foot ulceration. Bacterial infection in ulcer foot may further lead to septicaemia and can result in the death of the patient. The release of proteolytic enzymes by bacteria together with the matrix metalloproteases of the host tissue causes the tissue disruption in the wound and leads to delayed wound healing. The purpose of the study was to find out the influence of different proteolytic enzymes of bacteriological origin on tissue damage and impaired wound healing process. The results of the study reveal us that the bacterial proteolytic enzymes damage the cells and tissue of the host and increase the delay of the healing process. The knowledge of the organism and its biochemical parameters helps us to provide a better treatment for the diabetic ulcer foot problem and the other poorly healing wounds.
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.
Ethical Clearance and Informed Consent
The pus samples were collected from the wounds of diabetic foot ulcer patients of Medical Trust Hospital and Diabetes Care Center, Pandalam, Kerala, with their informed consent and institutional ethical committee’s permission.
Source of Funding
The authors acknowledge the Ministry of Human Resource Development, India, for funding of the project.
Conflict of interest
The authors have no conflict of interests.
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareA CLINICOPATHOLOGICAL STUDY OF PEDIATRIC LUPUS NEPHRITIS IN TERITARY HOSPITAL OF BANGALORE
English4447Seema H.S.EnglishBackground: To study the clinical behavior of lupus nephritis in children from Southern India, and to report the differences in disease pattern.
Objectives:
1. To study histopathological changes and outcome in paediatric lupus nephritis.
2. To study the clinical and immunological spectrum of lupus nephritis.
Methodology: Laboratory received renal biopsy specimens with a clinical diagnosis of SLE by ARA criteria over a period of 6 years were included in the study and were classified according to the 1982 WHO Classification and reclassified ISN classification.
Results: Of the 16 cases studied, 12 patients were females (75%). ANA was the most frequently positive parameter occurring in 91% of cases. ds- DNA was positive in 9 cases. Anaemia was present in 10 cases (63%). In our study WHO Class IV lupus nephritis was most the common 63% (n=63). Acute renal failure was seen in 18% of paediatric cases and doubling serum creatinine was noted in 20% of paediatric patients. Interpretation and conclusion: The incidence of disease was 3 times more common in females. WHO class IV was the commonest class, seen in 63% of cases. The percentage of patients having doubling serum creatinine was noted in 20% paediatric age group indicating poor renal outcome and prognosis in children.
EnglishPaediatric, Systemic lupus erythematosus, Clinical profile, Serum creatinine, Lupus nephritisINTRODUCTION
Systemic lupus erythematosus (SLE) is a prototype multi-system disease of autoimmune origin that accounts for significant mortality and morbidity Lupus nephritis is an important complication occurring in up to 60% of patients with systemic lupus erythematosus (SLE) 1. The clinical spectrum of lupus nephritis ranges from asymptomatic low grade proteinuria to rapidly progressive course with hypertension, oedema and leading to renal insufficiency within days2 . Unlike adults, the clinical picture of SLE is often less characteristic in paediatric patients and a significant proportion of children present with severe renal disease at onset, but lack a sufficient number of criteria to be clearly diagnosed as SLE3 . Nephritis in children may manifest with no symptoms, mild abnormalities, or may present with symptoms of diffuse proliferative disease4 . Patients with severe histological forms of nephritis have more severe renal manifestations. The World Health Organization (WHO) has defined five histological types of lupus nephritis. Patients with pure mesangial nephropathy generally have good prognosis, whereas proliferative glomerulopathy especially diffused variant require aggressive therapy2 . The factors affecting outcome are controversial and include male sex, black race, onset before puberty, persistent hypertension, impaired renal function, nephrotic syndrome, anaemia, class IV nephritis and increased histological index scores 5 . With this in the background, in this study we have emphasizes histopathological changes in paediatric lupus nephritis. We also studied clinical and immunological spectrum of paediatric lupus nephritis.
MATERIALS AND METHODS
In this study patients case records of children who were diagnosed to have SLE by American rheumatism association(ARA) criteria, and in whom renal biopsies was done in, St. John’s Medical College, Bangalore for six years were retrieved and classified according to WHO classification. The study was both retrospective (January 1999 to January 2003) and prospective (February 2003 to December 2004). The clinical data and laboratory parameters like haemoglobin, hematuria, hypertension, low complement, doubling of serum creatinine, Antinuclear antibody(ANA) and Anti (double stranded) dsDNA were retrieved from medical records department of St. John’s Medical College Hospital in all cases. For this study, all the slides for light microscopy were examined. The study complied with the guidelines of the local ethics committee. Exclusion Criteria: Renal biopsies with a clinical diagnosis of discoid lupus, neonatal lupus and drug-induced lupus nephritis.
Microscopic examination: The types of samples that were obtained were:
i. Formalin fixed renal core biopsies which were stained with 1. Haematoxylin and Eosin (H and E) 2. Periodic acid-Schiff (PAS) 3. Periodic acid methenamine silver stain (PAS-M)
ii. Data collected was analyzed based on following observations after classifying the renal biopsies according to the 1982 WHO classification, reclassified according to (International society of nephrology) ISN classification.
RESULTS
Our study comprised of 16 cases belonging to paediatric age group (Age less than 16years). In our study out of 16 paediatric patients, 12 were females and 4 male. ANA was positive in 13 of 14 cases tested. (See in Table 1). Anti ds-DNA was positive in 9 of the 11 patients tested. (See in Table 2). Anaemia was present in 10 cases of 13 patients whose data was available (See in Table 3). Hypertension was noted in 9 out 12 cases whose data was available. Low complement was noted in 4 cases. Hematuria was seen in 9 of the 15 children whose data was available. In our study out of 16 cases, 10(63%) cases belonged to class IV, 5 cases belonged to class III and one case belonged to class II (See table 4). We reclassified the biopsies according to ISN2003 classification and results are given in Table5. Nine cases had high urine proteinuria(3+) and 8 of these belonged to Class IV. Eight of the 9 children who had hematuria belonged to class IV. Out of 16 cases 6 cases had no follow up. In these 10 cases, 2 cases that are 20% of childhood lupus nephritis showed doubling of serum creatinine. Out of 16 cases 3 children developed acute renal failure, 2 of them belonged to class IV and one belonged to class III.
DISCUSSION
Demographic data
In our study 14% of cases belonged to the paediatric age group (Englishhttp://ijcrr.com/abstract.php?article_id=516http://ijcrr.com/article_html.php?did=5161. Dhir. V, Aggarwal A, Lawrence A, Agarwal V, Misra R.LongTerm Outcome of Lupus Nephritis in Asian Indians. Arthritis Care and Research.2012; 64:713-20.
2. Hafeez F, Tarar AM and Saleem R. Lupus Nephritis in Children. Journal of The College of Physicians and Surgeons Pakistan 2008; 18 (1): 17-21.
3. RuggieroB, Vivarelli M, Gianviti A, Benetti E , Peruzzi L, Barbano G, et al.Lupus nephritis in children and adolescents: results of the Italian Collaborative Study.Nephrol Dial Transplant; 2013: 1-8.
4. Baqi N,Moazami S, Singh A, Ahmad h, Balachandra S , Tejani A. Lupus Nephritis in Children: A Longitudinal Study of Prognostic Factors and Therapy. J. Am. Soc. Nephro.1996; 7:924-29
. 5. Agarwal I, Sathish Kumar T, Ranjini K, Kirubakaran C And Danda D. Clinical Features and Outcome of Systemic Lupus Erythematosus in Children. Indian paediatrics: 2009; 711- 15.
6. Gupta KL. Lupus nephritis in children. Indian J Pediatr 1999; 66:215-23.
7. Chandrasekaran AN, Rajendran CP, Ramakrishnan S, Madhavan R and Parthiban M. Childhood systemic lupus erythematosus in South India. Indian J Pediatr 1994; 61:223- 29.
8. Singh, Surjit, et al. Clinical and immunological profile of SLE: some unusual features. Indian pediatrics 34 (1997): 979-986.
9. Ali US, Dalvi RB, Merchant RH, Mehta KP, Chablani AT, Badakere SS, et al. Systemic lupus erythematosus in Indian children. Indian Pediatrics 1989; 26:868-73.
10. Hari, P, Bagga A,Mahajan P, Dinda A. Outcome of lupus nephritis in Indian children. Lupus 18.4 (2009): 348-354.
11. Yang LY, Chen WP, and Lin CY. Lupus nephritis in children-A review of 167 patients. Pediatrics 1994 Sep; 94(3): 335-40.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcarePHOTOGRAPHY AND PIXEL ISSUES IN UNDERGRADUATE SLIDES IN PATHOLOGY
English4851Jyothi B. LingegowdaEnglish Prakash H. MuddegowdaEnglish Ramkumar Kurpad R.English Prasanna G. KonapurEnglish Sathiyamurthy K.English Thamilselvi R.EnglishDigital images have become an important tool in pathology. Telepathology towards consultation is rapidly developing. Teaching through digital slides is growing fast due to easily availability of digital cameras, computer hardware and the internet.
Objective: Our purpose was to evaluate the resolution requirement for digital images. Size of data of these digital images and there upload speed was also evaluated.
Methods: Digital images of 29 selected slides showing characteristic lesions were produced in five different resolutions each, ranging from 640x480, 2048x1536, 2592x1944, 3264x2448 and 4000x3000---. They were compared individually by a group of two experienced pathologists regarding the diagnoses and level of confidence.
Results: Images at the resolution of 2048x1536 were perceived as equivalent to higher resolutions, Data upload and image loading was significantly better in 2048x1536 rather than 4000x3000 images
Conclusion: For digital images in dermatology a resolution of 768 x 512 x 24 is suitable to recognize the relevant details of the source image.
EnglishAdenocarcinoma stomach, Basal cell carcinoma, Fatty liver, Follicular adenomaINTRODUCTION
Instances of imaging in pathology can date back to 1968 in Boston, where live images were captured or to 1974, where data was transferred from a ship in Brazil to Washington DC. Pathology is the driving field for microscopic imaging. In microscopy, pictures are data. The need to maintain and record morphological findings is necessary both at macroscopic and microscopic level for diagnosis, consultation, documentation and education. Images document the true appearances and eliminate inaccuracies in the reporting process.(1-5) Previously, elaborate photography sets, black and white images were not conducive and cost effective. Now, with the advent of digital photography, low cost of digital cameras and the ability to view on mobile, tablets or computers without the need to print along with expanding internet use has made major inroads in documenting pathological changes at both macroscopic and microscopic levels. Digital microimaging consists of digital camera, computer, imaging software and an optical connector to the microscope. Images can also be captured with a cell phone camera with or without adapter. Digital image format is appropriate for computer analysis, as the images are already in digital format.(4,6,7) In the present study, undergraduate slides digital images were prepared and evaluated to identify the appropriate megapixel for teaching, storage and transfer purposes.
MATERIALS AND METHODS
This study was conducted in department of Pathology, VMKV medical college, Salem. Selected undergraduate slides images were taken at various resolutions like 640x480, 2048x1536, 2592x1944, 3264x2448 and 4000x3000 (VGA mode, 2 MP, 5 MP, 8 MP, 13 MP respectively) using a Sony DSC W220 aim and shoot camera.
Standard binocular microscope was used for capturing images, and all were taken at 10X magnification. The camera was hand held against the microscopic eye piece to take photographs. No zoom function or adapters were used. The images were viewed using a laptop and was evaluated by two pathologists. The pathologists were completely blinded regarding the image resolution. The images were evaluated for the ability to make diagnosis, upload speed and also speed of image processing during viewing. They were asked to evaluate the image within 60 seconds per image and viewer recorded the diagnosis and level of confidence. Images were jumbled up and the resolutions of images were only known to the author and were blinded to the reviewers to prevent conscious and unconscious bias. Slides were taken from routine undergraduate student slides. The slides selected were from actinomycosis, acute appendicitis, adenocarcinoma stomach, basal cell carcinoma, capillary hemangioma, cavernous hemangioma, chronic pyelonephritis, chronic venous congestion of lung, cirrhosis liver, colloid goiter, fatty liver, follicular adenoma, granulation tissue, leiomyoma, lobar pneumonia, maduramycosis, malignant melanoma, osteoclastoma, osteosarcoma, papillary carcinoma thyroid, pleomorphic adenoma, renal cell carcinoma, rhinosporidiosis, squamous cell carcinoma, squamous cell papilloma, seminoma, teratoma, hydatidiform mole and Tuberculous lymphadenitis. All the slides were stained using Hematoxylin and Eosin stain.
RESULTS
29 histopathology slides were selected and images were taken at various resolutions like 640x480, 2048x1536, 2592x1944, 3264x2448 and 4000x3000 (VGA mode, 2 MP, 5 MP, 8 MP, 13 MP respectively)
The average size of images in each megapixel is as shown in table 1
All the images were evaluated by two experienced pathologists and each one applied the image based on the appropriate for diagnosis. The collective decision regarding resolution is as shown in table 2. Images from conditions like actinomycosis, maduramycosis, osteoclastoma and colloid goiter were easily identified at the lowest resolution. Higher resolution was required for fatty liver and Tuberculous lymphadenitis. The processing of images varied with each resolution. The average duration is as shown in table 2. Both examiners agreed about larger resolutions taking upto 2 seconds at times and as the resolution increased, so did the image processing and loading time.
.
DISCUSSION
Telepathology is defined as the acquisition of histological or microscopic images for transmission along telecommunication pathways for diagnosis, consultation or continuing medical education. It may be for primary opinion, frozen section consultation or second opinion. It is especially useful for supplying the remote areas with specialist medical advise. Images are also used for proficiency testing, web pages like blogs, facebook, image analysis, web based learning/ teaching, etc. (1,5,8,9,10) Various methods to take microphotography has been discussed previously. Digital zooms should be avoided, as it blurs the image, while optical zoom can help in a closer look. The images can be used for various purposes, in-cluding teaching and clinical meetings, conference presentations, diagnosis, image analysis, archiving, etc. In the present study, images no zoom was used and images were used for teaching purposes.(3,4) Telepathology can be simple store and forward or dynamic real-time telepathology. In few countries, immunohistology laboratories have employed the internet to post images of stains to avoid delay. Here, we used simple, store and forward method for evaluation purpose.(4) With the professionals using their education, experience and intuition, selection bias or sampling error, where an area is chosen for selecting for a closer look, leaving out other areas is of particular concern. To thwart this, image scanners are commonly used, which includes all images. Here pathologists with more than 5 years undergraduate teaching experience were involved in selecting areas. The evaluators agreed the chosen field was important and adequate for diagnosis for undergraduates.(2,4) There is a long list of manufacturers who have produced slide scanners for pathology. The setup includes preparation of microscopic images through computer controlled image capture, focus stacking, and image mosaic stitching. However, this has not been widely accepted due to high cost of specialized equipment, difficulty in capturing and stitching single images and also difficulty in manipulating and viewing smaller images. Here, we used hand held camera without any adapter. Images were found to be good enough for diagnosis.(2) With image storage, the size of physical storage and methods of transfer becomes important. Hard disks are large, bulky but can store plenty of data. While smaller data storages like pendrive, cannot carry multiple larger images and require much data storage. CD and DVD can also be used for permanent storage. Compressed images for storage are not advisable as poorly compressed images bring out poor quality photographs. Publishers always seek uncompressed files. For transfer of images, compression would be necessary to reduce use of bandwidth and faster transfer speeds. In our study, smaller uncompressed images were better appreciated. A resolution of 2048x1536 was found to be adequate mostly. However, some images, which were not classical, required larger resolutions for zoom and more depth evaluation. Transfer with 3G network was way better than 2G. The difference was astounding. Even though better, took a bit longer for larger images and in future could be use for transfer of uncompressed large data image files. With the advent of 4G in the country, larger data, if necessary especially stitched images, can be transferred easily. We also noticed, larger resolution images, occupied larger spaces and were cumbersome to transfer. (3,4,5) Traditional glass side teaching can never be replaced. However, interesting case slides, as it ages, is prone to fade, difficult to transport or share and is fragile, easily damaged and cannot be replaced. Digitalization of these slides can provide a solution to many of these drawbacks. (1,4) Problems faced include naming, storage of data and differences in identifying the magnification. Any model cameras can be used. Now a days, mobile phone with excellent cameras are available and immediate sharing through whatsapp and if necessary online is also being done. Problems of scientific fraud have been put forward by few critics; however, fraud existed before too due to falsification of data. Also problems like poor slide preparation can affect focus plane, which would make it difficult to work with relevant data. (4,5) Whole slide educational sets similar to what we have done can be made available on internet or intranet. Studies have shown, computer based teaching to be effective and could be an additional attractive way for medical students to self educate. Students need not own a microscope, but can examine virtual slides and learn the techniques. This helps in the improvement of efficiency and distribution of available resources.(5,10) In India, the potential is high for using digital images for teaching and consultation purposes. Given the growth of mobile use and its penetration, and reduced transmission costs, this could be very useful for both service providers and patients.
CONCLUSION
Even though digital imaging in microphotography is relatively developing, it has made rapid development because of low cost, rapidity and convenience of usage. Application of the same in teaching undergraduates could go a long way in better teaching. The usage of mobile cameras can be used for instant teaching along with immediate uploading and better management of this virtual scenario. The students will be benefitted with immediate help and interest in learning pathology at its microscopic level could go a long way in furthering the knowledge.
ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars, whose articles are cited and included in references of this manuscript. The authors are also grateful to authors/ editors/ publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=517http://ijcrr.com/article_html.php?did=5171. Leong FJW-M, Graham AK, Gahm T, McGee JO’D. Telepathology: clinical utility and methodology. In: Lowe D. Underwood JCE, eds. Recent advances in histopathology 19, Edinburgh: Churchill Livingstone; 1999;217-39.
2. Longson J, Cooper G, Gibson R, Gibson M, Rawlins J, Sargent R (2010). Adapting Traditional Macro and Micro photography for scientific gigapixel imaging. Proceedings of the fine internatioanal conference on gigapixel imaging for Science, November 11-13, 2010. Available from: http:// repository.cmu.edu/cgi/viewcontent.cgi?article=1001andco ntext=gigapixel
3. Bagnell CR Jr. Photomicrography [Internet]. 2013.[cited 2014 April 13]. Available from : https://www.med.unc. edu/microscopy/files/courses/spring-2013-lm/path-464- class-notes/lm-ch-14-photomicrography
4. Leong FJW-M, Leong ASY. Digital photography in anatomic pathology. J Postgrad Med. 2004;50(1):62-9.
5. Schmitz J, Bollmann O, Vogel C, Bollmann R. Virtual microscopy (remote patchwork) as a new technique for teleconsultation and tele-education. Electronic J Pathol Histol 2003;9.2:32-0005.
6. Ying X, Monticello TM. Modern imaging technologies in toxicologic pathology: An overview. Toxicologic pathology 2006;34:815-26.
7. Bellina L, Missoni E. Mobile Cell-phones (M-phones) in telemicroscopy: increasing connectivity of isolated laboratories. Diagnostic Pathology 2009;4:19.
8. Khalbuss WE, Pantanowitz L, Parwani AV. Digital imaging in Cytopathology. Pathology Res Int. 2011;2011:264683.
9. Marcano F, De Armas N, Diaz-Cardama, Ferrer-Roca O. Collaborative systems for pathology applications. The Open Pathology Journal 2007;1:1-4.
10. Rozman P. The impact of telemedicine on the organization of blood transfusion services. Bilt Transfuziol. 2006;52(2- 3):22-6.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareLOGISTICAL FACTORS INFLUENCING PORT PERFORMANCE A CASE OF KENYA PORTS AUTHORITY (KPA)
English5259William K. RutoEnglish Everlyn DatcheEnglishThe port of Mombasa is run and managed by Kenya ports Authority, over the recent years the global maritime trade has been evolving rapidly. The surge in shipping traffic and cargo volumes especially on container traffic has placed the port with a huge responsibility to provide effective, efficient and reliable maritime service. The primary objective of this study aims to find out the logistical factors influencing port performance at the port of Mombasa. The study gave recommendations which can make the Port of Mombasa become more efficient and effective as Port of choice for East and Central Africa region. A primary data analysis which uses data gathered through interviews and secondary data analysis which involves the utilization of existing data collected from the existing documents, questionnaires and interviews shall be conducted within sampled and selected organizations which according to the researcher are likely to give a clear picture of the current logistical factors influencing
port performance in the port of Mombasa. The target population under study was 600 Port Stakeholders including at least 10 experts from the 6 different background or expertise in the transport sector including Kenya Revenue Authority, Container Freight Stations officials, Kenya Association of Manufacturers and shipping officials with a certain level of knowledge of the Port of Mombasa and comparative ports in the Maritime Industry such as Singapore Port, Port of Dar es Salaam etc. The study use both quantitative and qualitative data, tables, charts and graphs are be used to illustrate findings. A conclusion on port performance at the port Mombasa today and its future development is provided as recommendations.
EnglishLogistical, Stakeholders, CargoINTRODUCTION
Kenya Ports Authority is the only mandated Government Agency authorized to operate all sea ports in Kenya. The port of Mombasa is the largest port in East Africa and is the gateway to East and Central Africa and plays a very important role in facilitating trade and development of the region. The port has strategic importance far beyond the borders of Kenya. As the largest port in East Africa, it is the main gateway for the import and export of goods not only for Kenya but also to countries of the East African Community, the Democratic Republic of Congo, southern Sudan and southern Ethiopia (KPA Container Freight Station Policy, 2014). The Port handles approximately 90% of Kenya external trade in terms of tonnage. Mombasa port has 17 deep water berths. Cargo traffic through Mombasa port is about 24 million tonnes in year 2014 including over a 1 million TEUs of container traffic. Kenya Ports Authority also operates two inland container depots in Nairobi and Kisumu, currently the port has employees about 7200 workers working in various department with nearly 60% working in operations departments who execute the core functions of the port in cargo handling, marine services and stevedoring. Kenya Ports Authority s strategy is to introduce private sector management and financing so as to improve the port’s performance, starting with the new container terminal under construction, conventional berths, oil terminals and marine craft, currently the port employs approximately 7200 Employees. (KPA Annual Bulletin of Statistic 2013) The port of Mombasa is currently among the fast growing ports in the world in terms of container handling trends following the recent infrastructure development undertaken by the government to expand the current container terminal. Global Maritime Transport has considerably changed in the last decade. Maritime Transport is growing at a high pace. Container traffic is the fastest growing segment of maritime transport. Shipping lines have invested in ever growing containerships in order to benefit fromeconomies of scale: the threshold of 10,000 TEUs per vessel was surpassed whereas, ten yearsago, the largest vessels had capacity of 4,400 TEUs (Panamax). As a result of increased competition, mergers and takeovers have taken place in the recent years to establish “mega-carriers”. This trend of larger ships will increase pressure for better port facilities and for significant improvement in port performance to achieve high productivity. In the last decade, after a period of liberalization, concentration has grown in the maritime transport industry as well as for port operators. The barrier at entry is becoming increasingly high in maritime transport since shipping lines have to invest in mega-container vessels, which may now cost more than 100 million US dollars. Containerization rate continues to grow at a high pace. (Pálsson. G, Alan H, and Raballand G (2007) As ports would be increasingly challenged by intensified traffic, greater ship size and transhipment growth, ports capacity may have to be expanded in the future. Larger ships are more demanding in terms of port installations. The ship to shore gantry cranes need to be sufficiently large to reach all the containers and sufficiently fast in operation for an acceptable ship turnaround time. (Drewry, 2006) The Port of Mombasa also has four container berths with a total length of 840 meters with additional combi berths 13 and 14 being converted to handle container operations whose total length is 355metres. Containerized cargo represents about 70% of the Port of Mombasa’s total cargo volume, and that volume is growing at around 12% per year. The Port of Mombasa Container Terminal began operating in 1979. (Master Plan Study of the Port of Mombasa, 2009).
The goal-setting theory
Goal-setting theory had been proposed by Edwin Locke in the year 1968. This theory suggests that the individual goals established by an employee play an important role in motivating him for superior performance. This is because the employees keep following their goals. If these goals are not achieved, they either improve their performance or modify the goals and make them more realistic. In case the performance improves it will result in achievement of the performance management system aims (Salaman et al, 2005). Expectancy theory had been proposed by Victor Vroom in 1964. This theory is based on the hypothesis that individuals adjust their behavior in the organization on the basis of anticipated satisfaction of valued goals set by them. The individuals modify their behavior in such a way which is most likely to lead them to attain these goals. This theory underlies the concept of performance management as it is believed that performance is influenced by the expectations concerning future events (Salaman et al, 2005). Banfield and Kay (2008) describe performance management as a framework in which performance by individuals can be directed, monitored and refined. They also view performance management as the process of creating a work environment or setting in which employees are enabled to perform to the best of their abilities. Despite the fact that the number of studies measuring ports performance is flourishing, several deficiencies still exist. The vast majority of the studies have a specific focus towards the assessment of operations productivity, in order to conclude on port efficiency. According to Mangan and Cunningham, it has been argued that improved performance is partly due to revised handling procedures and focused management strategies as a result of private participation. The Port of Rotterdam follows Singapore in port performance and efficiency ranking, with over six private container terminals within its boundaries, all of which compete openly - thereby placing emphasis on service and ship turnaround times. Again the argument holds true that those ports where private participation is encouraged in areas of cargo handling and port administration, enjoy greater service enhancements and ultimately draw long-term sustainable business opportunities (Mangan and Cunningham 2001: 54)
The Port Performance
Ports have traditionally evaluated their performance by comparing their actual and optimum throughputs (measured in tonnage or number of containers handled). If a port’s actual throughput approaches its optimum throughput over time, the conclusion is that its performance has improved over time. On the other hand when the port registers poor performance such as high container dwell time, threat of Vessel delay surcharge and worst still is the big ships avoiding the port. In the long run this renders transport from the port un-competitive by factual analysis. Crane productivity which is calculated per crane and can be expressed in gross and net values; Port Productivity, there are seven different productivity measures which terminal operators need to compute, although they may wish to include others for monitoring their productivity. These core productivity measures are: Ship productivity which is the broadest measures of shipproductivity relate container handling rates for a ship’s call to the time taken to service the vessel; Quay productivity which defines the relation between production and quay resources, the latter can be measured by defining, for a given unit time. Terminal area productivity which is similar to the quay productivity indicator is the measure of ‘terminal area productivity’ which applies to the entire terminal and expresses the ratio between terminal production and total terminal area for a given unit time; Equipment productivity is the value that is of interest is the number of container moves made per working hour, either for an individual machine or for the stock of a particular type of machine. The number of moves can be deduced from data collected; Labour productivity even with a high level of mechanization, labour costs still form a large part of total terminal costs and it is important to monitor labour well and know what the productivity per man-hour is over a measured period; Cost effectiveness this brings the all- important element of cost into the equation. Perhaps the simplest and most revealing measure of a terminal’s efficiency is the cost of handling its container traffic or throughput over a specified period, Port dwell time which refers to the time cargo spends within the port or its extension. To separate the components of cargo delays, Dwell time figures have become a major commercial instrument to attract cargo and generate revenues. Port authorities and container terminal operators have increasingly strong incentives to lower the real figure. The average or mean dwell time has usually been the main target indicator in the best performing ports worldwide. (Raballand et al, 2005).
Drivers of Port Performance
Productivity at the East African ports is affected by several factors, among them are: Equipment Utilization and Labor productivity; For Mombasa, labour productivity still remains low despite heavy investment in equipment modernization and infrastructure development over the past five years. For instance, ship to shore gantry cranes recorded an average 18 mph in Mombasa and 14 mph in Dar – es – Salaam against an internationally acceptable standard of 25 – 30 mph. It is evident that dock workers are not making the best use of the recently acquired modern and more efficient equipment. In order to improve berth productivity at Mombasa, some shipping lines have been forced to implement an independent bonus scheme for dock workers in order to improve vessel turnaround time. (Kenya Shipping Council, 2008) Optimal use of available Infrastructure; Recent infrastructure developments at Mombasa such as the new container terminal and a new berth have not necessarily resulted in improved productivity at the container terminal. There still exists poor yard planning and it is not easy for importers of bulk containers to trace their cargo easily. Poor traffic flow within the port area occasioned by poor gate operations has resulted in an increase in truck turnaround within the port area. Entry and exit is now taking as much as 6 hours. (Kenya Transport Association, 2008) Loading Point in efficiencies; when it comes to loading within the port, trucks are spending up to 6 hours to load for containerized cargo and 2 days for bulk and conventional cargo. For instance, most of the loading at the grain bulk handling facility happens at night when the customs department is closed and transporters have to wait until the following day to load. Traffic Congestion within Port Cities and Cities along the Transport Corridor; both the cities of Dar es salaam and Mombasa are heavily congested with huge volumes of truck traffic entering and leaving the ports. In Mombasa, the heavy traffic between the port exit gates and Mariakani means that trucks are spending as much as 6 hours to navigate through a 30KMs stretch, which ordinarily would take 30 minutes. The situation is compounded by narrow roads and single lane roads between Changamwe and Miritini. As for cities along the corridor, Nairobi and Eldoret and Kampala are the most notorious in terms of traffics congestion. Lack of bypass roads in these cities, coupled with single lane roads passing through Eldoret town mean that trucks are spending an average 5 hours to transit through these cities at peak hours. Such infrastructure constraints within the port area and major cities along the transport corridor are responsible for the long truck turnaround times recorded in this survey Delays related to delivery at destination points; it is taking up to two days for trucks to off load cargo at destination points. This is common for local and other transit cargo that is destined for bonded warehouses where importers have failed to fulfill their tax and regulatory obligations when cargo crosses borders and thus trucks experience unnecessary delays as they await customs clearance. (East Africa Logistics Performance Survey 2012)
Port Infrastructure
Container terminals are essential inter-modal transportation network which work under multiple operational objectives. The main one is to minimize ships turnaround time and subsequently maximize the terminal throughput. They can be achieved by efficient loading and discharging of ships. Therefore, accurate ship assignment is usually taken as the key performance measure for the operational efficiency of a terminal. Other effective parameters in efficiency of container ports that is the quay length of which leads to economies of scale on the ability to handle more containers per one ship within one quay.
Recognizing that the shipping industry is shifting towards large vessels that cannot come to the Port of Mombasa due to draught restrictions, Kenya Ports Authority embarked on capital dredging of the navigational channel and anchorage basins, maintenance dredging of areas in front of the existing berths, the same have resulted in bigger ships calling at the port of Mombasa from the previous 1500 TEUs to the current 4000 TEUS per ship. A fully integrated ICT Strategy has embraced an Enterprise Resource Planning (ERP) system, a Kilindini Water Front system and a Community Based System, all web enabled. The Enterprise Resource Programme system integrates all functions at the Port to provide on-line and real-time information hence assisting in making timely decisions. Benefits of the waterfront system include: Reduced Human intervention due to system controls that are based on authorization, Reduced cargo documentation processing duration, Reduced cargo dwell time from an average of 8 days to 5 days, Reduced port clearance time from 5.5 days to 3 days, Enhanced planning process both in the yard and on board ship, Easy access of statistical data for planning and decision making, Enhanced audit trails, hence minimized cargo pilferage at the port (Bandari Magazine, 2012). The Community Based System, commonly known as the National Single Window System currently on trial and sensitization to stakeholder is due for full implementation soon (2015). Funded by the World Bank, the system is a flexible automated information sharing resource that will eventually link the port community users via electronic means to allow secure exchange of authorized data between partners. The port of Mombasa has been facing major challenges with Kenya Revenue Authority’s Cammis System and Kenya Ports Authority’s Kwatos System. Kenya’s rail corridor is of strategic importance to the region. It is a common knowledge that Standard Gauge Railway (proposed) and launched recently by President Uhuru will handle over 22 Million tonnage of Cargo against the current Single Gauge handling only 1.2 Million tonnes (Kamau. M, 2014). Linking the port of Mombasa to Nairobi and continuing onward into Uganda, it is a key conduit for bulk freight, easing pressure and providing additional capacity along the northern corridor. Currently the cargo is mostly transported using the road (97%) and the rail (3%). The gate expansion by KPA has enable trucks hauling export/imports/empty containers within Mombasa depots/CFS’s faster turnaround than previous. Currently the trucks are able to make 6 trips per day unlike 1trip per day before the gate expansion. This enables the fluid movement of containers from the port and creation of more space for incoming containers.
Cargo Handling
Equipment Cargo handling equipment includes equipment used to move cargo to and from marine vessels, on-road trucks and yards. The equipment typically operates at marine terminals or at rail yards and not on public roadways or lands. Kenya Ports Authority inventory on cargo handling equipment includes 7 Ship to Shore Cranes, 57 Terminal Tractor, 5 Mobile cranes, 23 Forklifts among others. Beside the availability of equipment there are other silent features which have direct correlation with performance, motivation is one among them, this is evidence by the various ships categories calling at the port of Mombasa, those with Incentives/motivations yield better results than those without incentive from the same operators. Records show that none motivating ships makes 15 moves per hours whereas those with incentives making as high as 40 moves per hour. Ships planning also play an important role in measuring Vessel performance and the features which drives the performance are cargo handling equipment allocation to a particular ships such as the number of SSG, TT etc, this will enable the ship have a well coordinate flow of cargo discharge as well as cargo loading. With regard to East African ports, it is important to note that the efficiency of these ports and the entire logistics chain is not wholly dependent on the management structure or ports authorities –There exist a number of public and private sector players who have a role to play in the goods clearance process and the efficiency with which they execute their obligations plays a critical role in the overall efficiency of ports. Clearing and forwarding agents, shipping lines, transporters, revenue authorities, standards bodies, the police and inspection agencies among other entities have in one way or another been an impediment to the smooth clearance of goods. Cargo owners are not spared either, as their readiness to effectively and efficiently engage in international trade transactions has also affected the efficiency of the goods clearance process (Langat. G, 2013)
Yard Capacity
The yard operation is perhaps the busiest of all the activities in the terminal. The operation involves discharging of containers from the vessels, loading of containers onto vessels, shuffling of containers that are out of sequence, in the yard block, redistribution of containers to other blocks for more efficient loading onto the second vessels and inter-terminal haulage where containers are moved to other yards in another terminal. A container Yard Operators must plan to satisfy prompt accommodation of ships with minimum waiting time in port, and with maximum use of berth facilities. Somewhere between these opposing objectives each container port must reach a compromise, the number of berths which will achieve the most economical transfer of cargo between ships and shore.
The crucial terminal management problem is to optimize the balance between the ship owners who request quick service of their ships and economic use of allocated resources. Since both the container ships and the container port facilities are very expensive, it is desirable to utilize them as intensively as possible. Simulation modelling techniques are being applied to a wide range of container terminal planning processes and operational analysis of container handling systems. These models have become extremely valuable as decision support tools during the planning and modelling of container terminal operations. Simulation of the logistics activities related to the arrival, loading/unloading and departure processes of ship-berth link can be carried out for different usages such as design of container yard, increase productivity and efficiency of terminal equipment on quay cranes, yard trucks and yard cranes. Analysis and planning of container terminal transfer operations from the quay to the container yard etc. These logistics activities are particularly complex and very costly since they require the combined use of expensive infrastructure capacities especially berths and container yard. Container terminal operations are required to serve containers as quickly as possible. There are operational characteristics of the container yards that play important role in evaluation of the container yards utilization. These are the wide of container yard, the storage time, and the capacity of the container yard.
The Port of Singapore Authority
The Port of Singapore Authority runs one of the most technologically advanced ports and information technology is the tool behind making it the most efficient port in the World (lee Partridge, Teo and lim).The Country is in severe lack of land hence, the efficient utilization of existing land is crucial for the port and this was achieved by the sophisticated technology used in the port. This is a good example of overcoming physical limitations by the proper utilization of information technologies. The information system in port of Singapore is separated into three levels (applagate, dustin, and macfarlan, 2003). The Singapore experience shows how IT can reduce the consequences of disadvantages; Singapore cannot dramatically increase its land area, but it can and has used IT to increase the capacity of its constrained physical resources to run a large Port. Singapore’s strategy of supplementing its location and harbor with manmade resources has overcome the limitations of the natural resources to create a Port whose location, harbor, infrastructure, and operations and information technology combined are rare, valuable, inimitable and no substitutable. While Operations and Information Technology has helped reduce labuor in some instances, reduce time and increase quality, its major contribution has been to create flexibility. This flexibility allows Port of Singapore Authority to enlarge the capacity of the Port to handle more ships and cargo. In this way, operations and information technology take on a role comparable to physical infrastructure; one can expand a Port physically to provide more capacity, or one can employ technology to increase the volume of cargo handled by an existing physical infrastructure. The combination of space restraints and Operations and Information Technology innovations increased productivity as well. Because the Port’s land area is small, yard cranes and prime movers have shorter distances to travel than in physically larger Ports, while Operations and Information Technology applications help make efficient use of stacked containers. The case points out an important characteristic of operations and information technology; it can be used to expand capacity without adding investment in plant and equipment or physical space. Technology helps the firm utilize assets more effectively. This same principle applies in other settings as well; a railroad can reduce the need for new locomotives through systems that monitor their mechanical condition, and systems that provide more efficient scheduling of trains. A manufacturing company can increase the capacity of its plants through better production control and scheduling systems. (John et al.)
Port of Dar es salaam and Mombasa port
The port of Dar es salaam which during the East Africa Community was being run together with Mombasa as one under East Africa Harbours and Railways before the breakdown in 1978 have been competing for cargo destined to the land locked countries in East and Central Africa have been experiencing nearly similar logistical factors that have been affecting their port performances. There is some similarity in the geography of the Ports of Dar es Salaam and Mombasa; both are located on sea inlets or creeks, with long, naturally–protected shorelines on the two sides of the creek. The main facilities of both ports are located on the city side of the creek, which limits their expansion possibilities. Moreover, there is no practical way of expanding these terminals’ areas since in both ports the marine port facilities are cordoned by the city or other private facilities. The small backup area provides for relatively small container yards. The resulting shortage in container yards currently is the main source of terminal congestion and poor port performance in both ports. A related and even more severe problem is traffic congestion inside and outside these terminals. The container yards in both ports seem to have difficulties in serving ship and gate traffic at the same time. The result is that the STS cranes often wait for yard tractors, a ma-jor factor for the low crane productivity and subsequently low berth productivity. Dar es Salaam Port Authority in trying to address these challenges of yard capacity introduced the Inland Container Depots Integration Program which was intended to increase berth productivity by relieving the traffic congestion while increasing the available container yard space. The level of efficiency of port operations and the volume of traffic Mombasa and Dar es Salam are able to handle directly affect the performances of road, rail, and inland navigation systems along the Northern and Central corridors. For example, increases in the volume of containers handled by the two ports also increase the number of trucks and railcars that operate along the corridors. In absence of adequate measures that increase the capacity of roads, railways, warehouses, dry ports, and Customs to handle the new traffic volumes, congestion and inefficiency follow as unintended effects of business success of the two ports. (Anna et al., 2014) The major factors affecting port dwell and performance time as revealed by the survey conducted by International Peace Information Service and TransArms-Research include the following: System reliability for ports and customs authorities which is affecting the passing of customs entries and issuance of release orders, rigidity of the clearance process means that any errors in declarations and manifests are heavily punished as shippers who complete a form for rectifying such errors have to content with an average 7 days to have their entries passed, at which point their cargo has already started to incur storage and demurrage charges, Complexity in fulfilling documentation for transit related cargo and Too many government agencies involved in the goods clearance process The port of Mombasa management by the very nature of its business attracts a lot of interest nationally, locally and regionally. The business also involves diverse players including government agencies and private players. The potential of this diversity has not been tapped for a coordinated and common approach to issues affecting the industry. Information dissemination, limited collaboration and partnerships continue to be a hindrance for stakeholder participation and involvement. Moreover negative publicity continues to taint the image of the Port. Mechanisms for collaboration and cooperation with stakeholders will be established to bring about synergy that will accelerate the achievements of Kenya Ports Authority goals (Bandari Magazine, 2010).
Target Population and Sample Size
A population refers to an entire group of persons or elements that have at least one thing in common (Kombo and Tromp 2006). The target population under study will be 600 Port Stakeholders with a certain level of knowledge of the Port of Mombasa and comparative ports in the Maritime Industry such as Singapore Port, Port of Dar es Salaam etc. The research sample put into consideration that there are few experts in Maritime industry especially in Kenya and hence the consideration of a conservative sample figure of 60 officials in maritime Sector, that will be 10% of the target population, the research will put into consideration old and new projects in the port of Mombasa as shown in table below;
DATA PRESENTATION, ANALYSIS AND INTERPRETATION
Data Analysis and Interpretation
The Analysis was derived from the conceptual framework dependant vs Independents on the following features Infrastructure in relation to Port Performance, Cargo Handling Equipment in relation to Port Performance and Yard Capacity in relation to Port Performance The respondent’s distribution by gender shows that 64% of the officers were female and 36% of the officers were male. It show that more women were more responsive to this research than Male counterpart and the reason attributed to this was most of the Planning Officer sampled were Female. a large group of the officers were aged 41 above and this shows a wealth of experience in the transport industry, this is main attributed to the fact that most of the policy makers are in the senior and middle management level. The research targeted the planners and engineers in this study considering that strategies and port Infrastructure requires a lot of technical input, the responses shows that 37% and 27% responses rates from Corporate Planning and Technical/Engineering Services respectively. Responses were as showed below:
Infrastructure in relation to Port Performance
The findings shows that the most common feature contributing to poor port performances in the port of Mombasa are poor road network contributing 80%, non performing railway with 64%, then restriction of navigational channel with 57% and least is the inadequate ICT infrastructure with 44%, details below:
A technical view on KPA and strategies to improve port performance shows positive responses affirming the fact that KPA have a strategic plan for infrastructural
Cargo Handling Equipment in relation to Port Performance
KPA has a multiple of equipment for Cargo Handling, with the listed option for rating, inadequate terminal tractors were rated as the highest contributing factor to poor performance with 83% even though most of the respondents attributed this to regular breakdown of terminal tractors or poor planned maintenance regime where mostly more than 30% are on continuous breakdown. The engineers however attribute this with poor supervision from the operations side where a driver is allocated a truck but returns it to workshop on flimsy excuses that the breaks either are not good, lighting and since nobody will question the engineers to confirm the driver will just walk away after dumping the truck in the workshop. This was followed by Inadequate SSG equipment with 57% since most of the respondents were KPA staff the majority or nearly all outside respondents especially shipping agents/lines representative do not agree with this as they consider the 7 SSG currently in the terminal if each ship is allocated two and perform to the minimum industry practise of 20 moves per hour per gantry the performance can greatly improve. The research found out that the training of staff handling equipment is adequate meaning that Bandari College is playing a major role accordingly in contributing to better performance in the port of Mombasa A rating based on the listed strategic activities as put in place by KPA with the aim of Improvement on Performance at the Port of Mombasa shows the rating as listed: Modernization of Civil Works (80%), Modernization of Operations Equipment (57%), Introduction of ICT in Port Management (67%), Capacity Building for KPA staff (41.7%), Dredging and Deepening of Navigational Channel (32.2%), Upgrading of Power lighting system in the port Area (71.3%) and Upgrading of Dockyard –Dry Dock facilities (17.4%). The main bottleneck appears to be inadequate yard capacity with 80.0% of the respondents affirming to it, Inadequate skills on yard management, and poor planning for yard area was also identified as greatly contributing factor with over 80%, followed by poor utilization of yard area with 72% and The summary shows that yard capacity and inadequate skills on yard management plays a major role and its planning, utilization and management is a key feature in port operation and management of port facility. A correlation between dwell time and port performance is directly proportionate as it is about the provision of space for incoming cargo and yard utilisation. The less the dwell time the more the space is avail for more containers. The finding from research shows that there is a direct relation to poor performance in the port of Mombasa and the long dwell of cargo in the port area with 64% strongly agree with it as compare with a small number of 9% which did not agree with it.
Challenges facing Mombasa container terminal
Based on the finding from the research, the main challenges faced by the current management which are contributing to poor performance appear to be Lack of funds for Infrastructure/capital works with 80.0%, Lack of Support from Central Government with 57.4%, Lack of adequate training for engineers with 57%, Unclear Strategies by Central Government with 44%. There are others which though are there a contributing factors but were given less weight by the research finding are Lack of commitment from Top KPA Management with 25% and Ineffective Management in the Port and others Support Service Challenges with 17%.
Recommended Area of improvement
The following are recommendation raised as the most likely to lead to improvement in port performance if put in place; terminal yard capacity expansion (80%), improvement in terminal equipment (57%), legal reforms (54.0%), rehabilitation of terminal facilities (43%), terminal quay length extension (32%), improvement in ICT infrastructure (25%) and institutional reforms (17%)
Main causes of Poor Performance at Mombasa port
The research summaries the causes of poor performance in the port of Mombasa according to the findings are: lengthy customs clearing procedures, rapid growth of container trade, frequent break down of Kenya Revenue Authority and Kenya Ports Authority, IT Systems, slow gate out process and slow container off-take to Container Freight Station, inadequate yard capacity and lengthy KRA clearing procedures, poor yard planning and in adequate usage of IT in yard planning, poor working corporate culture by the corporate staff and poor hinterland connectivity.
CONCLUSIONS
Some of the conclusion observed from this research show that port activities at the Port of Mombasa are more or less control by international linkage of business happening internationally, global business trend, competition in the Maritime industry and regional development contributes towards more activities on imports and exports. The research finding shows that factors which are leading to poor performance in the port of Mombasa are attributed to lack of funds for Infrastructure/capital works, lack of support from Central Government, lack of adequate training for engineers, unclear strategies by Central Government, lack of commitment from top KPA management, ineffective management in the port and others support service Challenges. The research reveal that multi sectorial linkage such as working relation between KPA, KRA, Shipping lines/agencies, KEBS, Police etc play a role is contributing to poor performance in the port of Mombasa as most of the stated institutions have different reporting structures.
Englishhttp://ijcrr.com/abstract.php?article_id=518http://ijcrr.com/article_html.php?did=5181. Anna B, Peter D, Sergio F, Ken M(2014) Supply Chains and Transport Corridors in East Africa IPIS/Trans Arms
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareCLINICAL PRESENTATION AND MANAGEMENT OF 100 CONSECUTIVE CASES OF THYROID
ASSOCIATED OPHTHALMOPATHY SEEN IN THE OUT- PATIENT DEPARTMENT OF A REGIONAL INSTITUTE OF OPHTHALMOLOGY
English6063Garima AgrawalEnglishIntroduction: Thyroid associated ophthalmopathy is an autoimmune disorder. It is a life -long disease with systemic and ocular manifestations. Early diagnosis and appropriate management of this disorder are essential.
Aim: Clinical presentation and management of 100 consecutive cases of Thyroid associated ophthalmopathy seen in the outpatient department of a regional institute of ophthalmology.
Material and Methods: All patients of Thyroid associated ophthalmopathyseen in our institute were subjected to a complete clinical work up, ultrasonography B scan, computed tomographic scan, triiodothronine, thyroxine and thyroid stimulating hormone assays. Treatment of thyroid dysfunction and thyroid ophthalmopathy were given as per protocol.
Observation and Results: Age of patients ranged from 17-63 years. The female:male ratio was 1.7:1. Distribution of thyroid dysfunction was hyperthyroidism (96%), hypothyroidism(3%) and euthyroid(1%). Majority of patients had mild (68%) and /or quiescent disease(77%). Eyelid retraction was the most common presentation (88%). Other presentations were exophthalmos( 63%), extraocular myopathy(37%), soft tissue inflammation (23%) and optic neuropathy (12%). Thyroid dysfunction was treated with anti thyroid drugs(100%), thyroidectomy(12%), radioactive iodine(1%). Thyroid ophthalmopathy was treated with
supportive therapy(100%), glucocorticoids(32%), ocular surgery(27%), orbital radiotherapy (1%), cyclosporine(1%).
Conclusion: We present the clinical manifestations and management of Thyroid associated ophthalmopathy patients at a regionalinstitute of ophthalmology. A larger percent of patients required glucocorticoids reflecting the referral of moderate-severe and/or active patients to our tertiary care centre.
EnglishThyroid associated ophthalmopathy, Clinical presentation, ManagementINTRODUCTION
Thyroid associated ophthalmopathy is an auto immune disorder involving the orbital muscles and orbital fat.1 It presents clinically as lid retraction, exophthalmos, extraocular muscle involvement, optic neuropathy and inflammation. Management includes serum levels of triiodothyronine, thyroxine, thyroid stimulating hormone and imaging in the form of computed tomography scan and B scan ultrasonography. Treatment includes treatment of thyroid dysfunction and treatment of ophthalmopathy. Treatment of ophthalmopathy includes supportive treatment, glucocorticoids, surgery, orbital radiotherapy and other immunosuppressive agents.2,3,4 We designed a study to document the clinical presentation and management of 100 consecutive cases of thyroid associated ophthalmopathy seen in the out-patient department of our regional institute of ophthalmology.
AIM
Clinical presentation and management of 100 consecutive cases of Thyroid associated ophthalmopathy seen in the out-patient department of a regional institute of ophthalmology.
MATERIAL AND METHODS
100 consecutive cases of thyroid associated ophthalmopathy were studied. The study was carried out at our Regional Institute of Ophthalmology. All patients were subjected to history taking, visual acuity examination, Intraocular pressure measurement, slit lamp examination, dilated fundus examination, ocular movements and colour vision. The patients were classified as mild and moderate-severe1 . Clinical activity score was used to classify disease as active or quiescent. Presence or absence of optic neuropathy was documented on basis of vision, colour vision, afferent pupillary defect and optic disc edema or pallor. Extraocular myopathy as evidenced by enlargement of muscle bellies was documented on ultrasonography B scan and non contrast computed tomographic scan. Apical crowding on computed tomographic scan provided an additional documentation of optic neuropathy. Thyroid dysfunction was documented by triiodothyronine, thyroxine and thyroid stimulating hormone assays. Informed consent was taken from all patients. Treatment included treatment of thyroid dysfunction using anti thyroid drugs, thyroidectomy, radio active iodine(single fixed dose of 370 Mbq). Treatment of thyroid ophthalmopathy was done. This included patient counselling, stopping smoking, lubrication, nocturnal head elevation, cool compresses, dark glasses, prisms(where required) and taping of lid at night as per patient presentation. Sight threatening optic neuropathy was treated with intravenous corticosteroids followed by oral steroids. Patients with moderate to severe and/or active ophthalmopathy were also treated with intravenous steroids followed by oral steroids. Intravenous steroids were given as a pulse therapy i.e. 4 cycles of 15 mg/kg followed by 4 cycles of 7.5 mg/kg. Oral steroids were given in a dose of 1mg/kg followed by tapering as per response. Surgery of orbital decompression was reserved for unresponsive patients (no response after 2 weeks of steroids in optic neuropathy).Cosmetic surgery was reserved for patients whose disease has been inactive for at least 6 months .Orbital radiotherapy was an option in patients with active Graves ophthalmopathy resistant to steroids. Retro orbital radiotherapy was used in a dose of 20Gy in 12 fractions over 2 weeks. Cyclosporine in an initial dose of 7.5 mg/kg body weight per day followed by tapering as per response was used in cases resistant to steroids.
OBSERVATIONS AND RESULTS
Table 1 shows the case demographics. 46 out of 100 patients were 40 years of age. Range was 17-63 years. There were 63 females and 37 males with female: male ratio of 1.7:1.35(35%) patients were smokers. All of these patients were male. Hyperthyroidism was seen in 96% and hypothyroidism in 3%. 1 patient was euthyroid. The diagnosis of thyroid opthalmopathy followed or preceded the diagnosis of thyroid dysfunction by +/- 24 months. 22 % patients were diabetic, 24% patients had positive family history of Thyroid associated ophthalmopathy. 33% patients had hypertension. 26 patients gave a concurrent history of some associated stress as illness, pregnancy etc. Table 2 shows the distribution of cases as per severity/ activity/optic neuropathy. 68 out of 100 cases had mild Graves ophthalmopathy. 32 patients had moderate- severe disease. The ophthalmopathy was active in 23 patients while majority of patients (77) had quiescent disease. 12 cases had optic neuropathy. Table 3 shows the major clinical manifestations of Thyroid Ophthalmopathy. Eyelid retraction was the most common presentation seen in seen in 88 patients followed by exophthalmos in 63 patients. Extraocular myopathy as evidenced by restricted ocular movements and enlarged muscle bellies on ultrasonography B scan and computed tomography scan was seen in 37 patients. The most frequently enlarged muscles were medial rectus and inferior rectus. Optic neuropathy was uncommon and seen in 12 out of 100 patients. Soft tissue signs of active Graves ophthalmopathy were seen in 23 patients. All these five presentations together were seen infrequently in 7% patients. Table 4 shows the treatment of thyroid dysfunction. Anti -thyroid drugs were used in all cases. 12 cases required thyroidectomy. 1 patient was given radioactive iodine. Table 5 shows the treatment of Thyroid Ophthalmopathy. Supportive treatment was given in all cases. 32 patients received treatment with intravenous or oral glucocorticoids. These were patients with moderate-severe and/or active disease. Ocular surgery was required infrequently. Lid lengthening was done in 17 cases. Squint surgery was required in 9 cases. Orbital decompression surgery was done in one case for optic neuropathy. Orbital radiotherapy was given in one case. Cyclosporine was given in one case.
DISCUSSION
We report the clinical presentation and management of 100 consecutive cases of Thyroid associated Ophthalmopathy in a regional Institute of Ophthalmology. The disease was found in all age groups (17-63 years). Female:male ratio was 1.7:1. 96% patients had hyper-thyroidism, 3% had hypothyroidism and 1% were euthyroid. The diagnosis of thyroid ophthalmopathy followed or preceded the diagnosis of thyroid dysfunction by +/- 24 months. Majority of the patients had mild (68 patients) and/or quiescent disease (77 patients). Moderate- severe disease was observed in 32% and/or active disease in 23% cases. All active cases fitted into the moderate to severe category while not all moderate to severe patients had active inflammation. The most common clinical presentation was eyelid retraction (88%). The other presentations were exophthalmos(63%), extraocular myopathy (37%), soft tissue inflammation(23%) and optic neuropathy(12%). Only 7% patients had all five clinical presentations. Thyroid dysfunction was treated with anti thyroid drugs with 12 cases requiring thyroidectomy and one patient radioactive iodine. Thyroid ophthalmopathy was treated as per protocol. Supportive therapy was given in all cases.32% patients were treated with glucocorticoids (higher % as compared to other studies).Ocular surgery distribution was lids(17%), squint(9%) and orbital decompression (1%). Bartley GB et al reported that eyelid retraction is the most common clinical sign of Graves’ ophthalmopathy. The complete constellation of typical features (hyperthyroidism, eyelid retraction, exophthalmos, restrictive extraocular myopathy, and optic nerve dysfunction) occurs relatively infrequently.5 Bartley GB reported incident cases of Graves ophthalmopathy in Olmsted city, Minnesota. Female: Male ratio was 6:1. 90% had Graves hyperthyroidism, 1% had primary hypothyroidism, 3% Hashimoto’s thyroiditis and 5% were euthyroid. Clinical features seen were eyelid retraction (90%), exophthalmos(60%), restrictive extraocular myopathy (40%)and optic nerve dysfunction (6%). Only 5% patients had complete constellation of clinical findings.6 Bartley GB et al reported the chronology of Graves ophthalmopathy in an incident cohort. Median age at time of diagnosis of Graves ophthalmopathy was 43 years(8 – 88 years).There is a strong temporal relationship between thyroid and eye manifestations of Graves disease. The diagnosis of Graves ophththalmopathy tends to follow the diagnosis of hyperthyroidism (either concurrent with diagnosis of thyroid dysfunction or six months before or after the diagnosis of thyroid dysfunction).7 Jankauskiene J et al reported that in patients with active Graves ophthalmopathy there was increase of proptosis, periorbital edema, chemosis and injection of conjunctiva. On ultrsonography B scan there was a marked increase in the volume of medial rectus and inferior rectus eye muscles.8 Bartley GB et al reported the treatment of Graves ophthalmopathy in an incident cohort.74.2% required no therapy or only supportive measures. 5 % patients were treated with systemic steroids. One patient had orbital radiotherapy. 24 patients (20%) underwent one or more surgical procedures. The probability of surgical intervention was significantly related to patient age (older than 50 years) but it was not related to gender or smoking.9 Marcocci C et al reported the occurrence of ophthalmopathy in Graves disease. They reported that active Graves ophthalmopathy was associated with hyperthyroidism in 91.4% patients. It was not accompanied by thyroid dysfunction in 8.6% cases. Female:Male ratio was 2:1. Age distribution revealed a peak prevalence in the fifth decade of life. In 85% patients the first ocular manifestations occurred within +/- 18 months around the onset of hyperthyroidism, 10
CONCLUSION
We present the clinical manifestations and management of 100 consecutive cases of Thyroid associated ophthalmopathy in a regional institute of ophthalmology. The findings are concurrent with other studies on the topic though we report a higher percentage of use of glucocorticoids. This reflects the referral of difficult cases with active and/or moderate-severe disease to our tertiary care centre. We have also distributed patients as per activity and severity not seen in the studies cited in this article. Thyroid associated ophthalmopathy is a life long disease and appropriate diagnosis and treatment are crucial for the management of this auto immune disorder.
ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors/editors/publishers of all those articles journals and books from where the literature for this article has been reviewed and discussed.
Englishhttp://ijcrr.com/abstract.php?article_id=519http://ijcrr.com/article_html.php?did=5191. Bartalena Luigi, Tanda Maria Laura. Grave’s Ophthalmopathy. N Engl J Med 2009;360:994-1001.
2. Bartalena L, Baldeschi L,Dickinson A et al.Consensus statement of the European Group on Grave’s Orbitopathy (EUGOGO) on management of Graves orbitopathy. Eur J Endocrinol 2008;158:273-285.
3. Bartalena L, Baldeschi L, Dickinson A et al. Consensus statement of the European Group on Grave’s Orbitopathy(EUGOGO) on management of Graves orbitopathy. Thyroid 2008;18:333-346.
4. Zang S, Ponto KA, Kahaly GJ. Clinical review:I ntravenous glucocorticoids for Graves Orbitopathy:efficacy and morbidity. J ClinEndocrinol Metab 2011;96(2): 320-32.
5. Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, Gorman CA. Clinical features of Graves’ ophthalmopathy in an incidence cohort. Am J Ophthalmol 1996 Mar;121(3):284-90.
6. Bartley GB. The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc. 1994;92:477-588.
7. Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, Gorman CA. Chronology of Graves’ ophthalmopathy in an incidence cohort. Am J Ophthalmol. 1996 Apr;121(4):426-34.
8. Jankauskiene J, Imbrasiene D. Investigations of ocular changes, extraocular muscle thickness, and eye movements in Graves’ ophthalmopathy. JhnMedicina (Kaunas). 2006;42(11):900-3.
9. Bartley GB1, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, Gorman CA. The treatment of Graves’ ophthalmopathy in an incidence cohort. Am J Ophthalmol. 1996 Feb;121(2):200-6.
10. Marcocci C1, Bartalena L, Bogazzi F, Panicucci M, Pinchera A. Studies on the occurrence of ophthalmopathy in Graves’ disease. ActaEndocrinol (Copenh). 1989 Apr;120(4):473.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241712EnglishN-0001November30HealthcareSCREENING OF CLONES OF CASUARINA EQUISETIFOLIA FOR PULPING TRAITS USING
WOOD FIBRE CHARACTERISTICS
English6471Kannan C.S. WarrierEnglish E.V. AnoopEnglish B. Gurudev SinghEnglishCasuarina equisetifolia, a multipurpose tree species, is an important raw material for many major paper mills in India. Institute of Forest Genetics and Tree Breeding (IFGTB), Coimbatore, India is the focal point of Casuarina research in the country and has the largest germplasm assemblage in India. A study was undertaken at IFGTB to understand the wood fibre characteristics in select clones of this species as fibre characteristics like fibre length, fibre diameter, wall thickness and lumen diameter influence the quality of pulp and paper products. Wood samples collected from 43 clones and three seedling origin materials of C.
equisetifolia were subjected to various analyses. The maximum value for fibre length was registered by clone CE 268 (1986.23 μm). Clone CE 327 recorded the minimum value (1243.18 μm). Fibre diameter ranged from 21.14 (CH 2803) to 29.59 μm (CE 224). Lumen diameter exhibited a wide variation between 6.17 to 17.10 μm. Fibre cell wall thickness varied widely from 4.99 to 10.07 μm. The minimum and maximum values were shown by clones CE 268 and CE 224 respectively. Ray height varied from 380.25 (CE 281) to 564.00 μm (CE 2002/1). The values for ray width ranged between 23.56 to 43.23 μm. Clones TNVM 3 and
TNPV 4 registered the minimum and maximum values respectively. With reference to ray frequency, clone CH 2803 registered the minimum value (20.60 no. per mm.). Clone CE 276 recorded the maximum (56.56 no. per mm.). Various rations like Felting coefficient, Coefficient of fibre flexibility, Runkel’s ratio and Isenberg coefficient were also worked out. Clones with high Felting coefficient and Coefficient of fibre flexibility but low Runkel’s ratio and Isenberg coefficient are ideal for pulp. In the present study it was observed that clones CE 83, CE 100, CE 268, CE 2003/3, CE 2003/4, TCR 120203, APKKD 6 and JKCE 8 in general were suitable for quality pulp production
EnglishCasuarina, Pulping, Wood properties, Fibre charactersINTRODUCTION
Casuarina equisetifolia L. is a high value tree crop. It has a sustained market demand as scaffolding in building industry, cheap housing material, banana stakes and excellent fuelwood. It supports land reclamation and sand dune stabilization, and shelter belts along coastal tracts. This species is an important raw material for many major paper mills in India. These mills currently use more than 2 million tonnes of Casuarina wood per year. Pulp and Paper industries have undertaken various farm forestry programmes in which Casuarina is an important component. Realizing the potential of C. equisetifolia, systematic tree improvement programmes are being undertaken at the Institute of Forest Genetics and Tree Breeding (IFGTB), Coimbatore, Tamil Nadu for over two decades and is a focal point for Casuarina research in India. IFGTB has the largest germplasm of C. equisetifolia in the country. Apart from the growth characteristics, it is also equally important to understand the wood parameters. Fibre characteristics like fibre length, fibre diameter, wall thickness and lumen diameter influence the quality of pulp and paper products. These affect the bulk, burst, tear, fold and tensile strength of paper (Zobel, 1965). Therefore, a study was undertaken to understand the wood fibre characteristics in select clones of C. equisetifolia.
MATERIALS AND METHODS
Wood samples collected from 43 clones and three seedling origin materials of C. equisetifolia assembled by IFGTB were the experimental materials. Billets of 1 m length were cut from the basal position of one tree (ramet) each selected randomly from the clones. Transverse discs of 6 cm thickness were collected from the base, middle, and top positions of each billet. Wood shavings were taken from these discs and then maceration was carried out. Maceration of the wood samples was done using Jeffrey’s method (Sass, 1971). For maceration, Jeffrey’s solution was used and it was prepared by mixing equal volumes of 10% potassium dichromate and 10% nitric acid. Microscopic examination and quantification of macerated fibre were undertaken using an Image Analyser (Labomed-Digi 2). For vessel and ray morphology study, sections were taken from specimens of size less than 1 cm3 using microtomy. Sections were then stained with safranin for 5 minutes. Excess stain was removed by washing sections successively in 70, 90 and 95% ethanol solution. Thin sections were further dehydrated using acetone and then kept in xylene for two hours for getting rigidity. Sections taken out from xylene were permanently mounted on microscopic slides with cover slips using DPX.
RESULTS AND DISCUSSION
The primary results on wood analysis are presented in Tables 1 to 3. Table 4 shows the results on the various ratios worked out. The maximum value for fibre length was registered by clone CE 268 (1986.23 µm). Clone CE 327 recorded the minimum value (1243.18 µm). Out of the 46 tested materials, 19 measured a fibre length of more than 1500 µm. Good quality paper can be produced from long fibered woods. Fibre diameter ranged from 21.14 (CH 2803) to 29.59 µm (CE 224). Lumen diameter exhibited a wide variation between 6.17 to 17.10 µm. Fiber length, fibre diameter and lumen diameter are reported to be genetically controlled (Wheeler et al, 1965; Zhang and Jiang, 1998). Otegbeye and Kellison (1980) reported a heritability of 0.42 for fibre length, 0.82 for fibre diameter and 0.94 for wall thickness in Eucalyptus viminalis. Ratio of fibre length to fibre diameter is known as Felting coefficient. It affects the qualities of paper like ease of sheet formation, sheet smoothness and opacity. Higher the ratio, better the quality of paper. The maximum value was registered by clone CE 268 (73.70). Clone CE 219 recorded the minimum value of 43.36. Clones CE 83, TN 111, CE 398, CE 2003/4, CH 2602, TCR 120203, CE 276, APVSP 14, CE 332, TNPV 4, APKKD 6, JKCE 8 and CH 2803 registered higher values for this ratio. Fibre cell wall thickness varied widely from 4.99 to 10.07 µm. The minimum and maximum values were shown by clones CE 268 and CE 224. It showed a direct relationship with wood specific gravity. Though the quantity of pulp produced by the high dense wood would be high, the quality of the pulp would be poor due to the stiffness of fibres. Clones CE 100, TN 111, APSKLM 25, TNVM 2, CE 2003/3, CE 2003/4, CE 2002/1, APKKD 6, TNPV 4, JKCE 8, CE 83 and CE 268 showed lower values for fibre wall thickness (Table 1). The ratio of double wall thickness to lumen diameter is known as Runkel’s ratio. It also affects the quality of paper and pulp. Thick walled fibres are ausually stiff, resistant to beating and retain their rounded shape during sheet formation. This inhibits inter fiber bonding and the resulting fibers would be of low quality with poor printing surface. On the other hand, thin walled fibres bend easily and collapse upon pulping and provide a large area for inter fibre bonding (Kumar, 2001). Clones CE 268, CE 100, CE 2003/3, CE 83, JKCE 8, APKKD 6, TNPV 4, CE 2002/1, TNVM 2 and CE 2003/4 registered lower values for Runkel’s ratio. The values ranged from 0.59 (CE 268) to 2.94 (CE 276). The results could be obtained from Table 4. The ratio of double wall thickness to fibre diameter, known as Isenberg coefficient, influences the pulping qualities in several ways. It determines the degree of flexibility and collapse of fibers, both of which control the degree of conformability within the paper sheet and thus the numbers of inter fiber bonds. Generally lower the ratio, better the quality of paper (Kumar, 2001). In the present study, clones CE 268, CE 100, CE 2003/3, CE 83, JKCE 8, APKKD 6, TNPV 4, CE 2002/1, TNVM 2, CE 2003/4, TCR 120203 and APSKLM 25 exhibited lower values for this ratio (Table 4). Clone CE 268 registered the lowest value (0.37) while clone CE 276 estimated the highest (0.75). Coefficient of fibre flexibility is the ratio of lumen diameter to fiber diameter and it influences the flexibility of fibres. Generally, a higher ratio indicates better flexibility of fibres (Kumar, 2001). Clones APSKLM 25, TCR 120203, CE 2003/4, TNVM 2, CE 2002/1, TNPV 4, APKKD 6, JKCE 8, CE 83, CE 2003/3, CE 100 and CE 268 recorded higher values for coefficient of fibre flexibility. The values ranged between 0.25 (CE 276) and 0.63 (CE 268). The results could be obtained from Table 4. The inverse of fibre diameter is usually taken as a measure of wood density. It varied from 0.034 in clones CE 224, CE 9, CE 219 and CE 2003/5 to 0.047 in clone CH 2803. High dense wood is generally indicated by a lower value (Table 4). Higher values for the ray parameters are not ideal for pulp production. Ray height varied from 380.25 (CE 281) to 564.00 µm (CE 2002/1). The values for ray width ranged between 23.56 to 43.23 µm. Clones TNVM 3 and TNPV 4 registered the minimum and maximum values respectively. With reference to ray frequency, clone CH 2803 registered the minimum value (20.60 no. per mm.). Clone CE 276 recorded the maximum (56.56 no. per mm.). Clones CH 3001, TNVM 3, CE 276, CH 2803, CE 398, CE 332, CE 268, CE 100, CE 281, CE 243, TN 111, CE 80, CH 0905, CE 303, APKKD 6, CE 224, CE 2003/5, CE 83, CE 2003/3, TNRM 8 and TCR 120203 exhibited lower values for the ray characteristics. The results are summarised in Table 3.
CONCLUSION
Clones with high Felting coefficient and Coefficient of fibre flexibility but low Runkel’s ratio and Isenberg coefficient are ideal for pulp (Kumar, 2001). In the present study it was observed that clones CE 83, CE 100, CE 268, CE 2003/3, CE 2003/4, TCR 120203, APKKD 6 and JKCE 8 in general were suitable for quality pulp production based on the above mentioned ratios.
ACKNOWLEDGEMENT
Authors are grateful for the funding support from the Indian Council for Forestry Research and Education. 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=520http://ijcrr.com/article_html.php?did=5201. Kumar A. Clonal variability in Eucalyptus tereticornis Sm. [Dissertation] Forest Research Institute Deemed University, Dehra Dun, India; 2001.
2. Otegbeye GO, Kellison RC. Genetics of wood and bark characteristics of Eucalyptus viminalis. Silvae Genet. 1980 29: 27-31.
3. Sass JE. Botanical microtechnique. The IOWA State Univ. Press, Ames, IOWA, 1971: 12-54.
4. Wheeler EY, Zobel BJ, Weeks, DL. Tracheid length and diameter variation in the bole of loblolly pine. Tappi 1965 49: 484-490.
5. Zhang SY, Jiang ZH. Variability of selected wood characteristics in 40 half-sib families of black spruce (Picea mariana). Wood Sci. and Tech. 1998 32: 71-82.
6. Zobel BJ. Inheritance of fiber characteristics and specific gravity in hardwoods - A review IUFRO Section 41 Meet Melbourne, Australia, 1965:13.