Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareA STUDY ON POSTKERATOPLASTY ASTIGMATISM AND CO- RELATION
English0104Sohan LohiyaEnglish Ruchita LohiyaEnglishIntroduction: Post-operative visual status after successful penetrating keratoplasty depends mainly on the clarity of the graft and the refractive error, particularly the astigmatic component. Severe irregular astigmatism is often seen after keratoplasty which can delay visual rehabilitation, even with a clear graft.
Aim: The aim of this study was to co-relate post- keratoplasty astigmatism by using different number of sutures and different donor graft sizes.
Material and Method: In this prospective study, 80 eyes of patients underwent penetrating keratoplasty with interuppted suturing techniques with different numbers of sutures and by using different size of donor graft size.
Conclusion: Post operative corneal irregular astigmatism was noted to be more common with increased number of sutures and large donor graft size.
EnglishPenetrating keratoplasty, AstigmatismINTRODUCTION
Penetrating keratoplasty (PK) has emerged as a relatively safe means of restoring vision in corneal opacities and irregularities. Astigmatism is the most common cause of suboptimal vision after corneal transplantation despite a clear corneal graft [1, 2]. A clear corneal graft may be an optical failure if high astigmatism limits visual acuity. Intraoperative measures to reduce postkeratoplasty astigmatism include round and central trephination of cornea with an adequate size, appropriate sutures with evenly distributed tension, and perfect graft-host apposition. Suture manipulation has been described for minimising early postoperative astigmatism. In addition, we investigated the final astigmatic outcome after suture removal. Based on several studies, 15–31% of patients undergoing PK may develop postoperative astigmatism greater than 5 diopters (D) [3–5]. The astigmatism can be irregular with associated higher-order aberrations that can ultimately limit the vision obtained and add to patient’s inability to wear standard optical correction [6]. This explains why visual acuity in 10–20% of PK cases cannot be corrected satisfactorily by spectacles or contact lenses [7–9].
AIMS AND OBJECTIVES
We studied the cases with penetrating keratoplasty,
1. To compare the amount of astigmatism after the operation with different number of sutures using interrupted suture techniques
2. To compare the amount of astigmatism by using different donor graft sizes
3. To study the post-keratoplasty visual status
MATERIAL AND METHOD
This prospective study was performed on patients who underwent penetrating keratoplasty between January 2008 and Dec 2012 by one surgeon. Informed consent was obtained from the included subjects. During investigations, the subjects who showed delayed wound healing more than 3 weeks, graft rejection, newly developed intractable glaucoma, or with wound problems such as dehiscence and those with combined cataract or glaucoma surgery were excluded. The patients were followed up for at least18 months. In all cases, interrupted suturing with 10/0 nylon was done. Routine follow-up schedule every weekly for first month, biweekly for second month, monthly for 3 to 6 months, and every three months for one year was followed. Patients compliant with this schedule were called “Regular Follow Ups.” Selective suture removal was started from third month onward, after assessing tightness of sutures on slit lamp examination, and calculating astigmatism by Retinoscopy.
OBSERVATIONS AND RESULTS
In this study interrupted 10 O Nylon suture were used in all the cases undergoing penetrating keratoplasty, for securing donor graft in recipient’s eyes. Number of sutures was 16-24 in 52 (65%) eyes whereas 28-32 sutures were used in 28 (35%) eyes. (Table 1)
ASTIGMATISM AND NUMBER OF SUTURE
On post operative keratometry corneal astigmatism more than 3 D was noted to be more with increase in number of sutures used to secure donor graft. Irregular astigmatism was noted to be more common with increased number of sutures. (Table 2 ) ASTIGMATISM AND GRAFT SIZE Post operative corneal astigmatism on keratometry was noted to increase with increased size of donor graft. Irregular astigmatism was noted to be more common with large donor graft size. (Table 3 )
POST-OPERATIVE VISUAL STATUS
Out of 80 eyes included in this study in whom penetrating keratoplasty was performed post operative visual acuity in the operated eye was found to be >6/60 in 20 (25.0%) eyes and 20 (25.0%) eyes had visual acuity 6/60 in 20 (25.0%) eyes and 20(25.0%) eyes had visual acuity Englishhttp://ijcrr.com/abstract.php?article_id=521http://ijcrr.com/article_html.php?did=5211. K. A. Williams, N. B. Hornsby, C. M. Bartlett, et al., “Report from the Australian corneal graft registry,” Tech. Rep., Snap Printing, Adelaide, Australia, 2004.
2. N. C. Price and A. D. Steele, “The correction of post-keratoplasty astigmatism.,” Eye, vol. 1, part 5, pp. 562–566, 1987. View at Scopus
3. R. C. Troutman and M. A. Lawless, “Penetrating keratoplasty for keratoconus,” Cornea, vol. 6, no. 4, pp. 298–305, 1987. View at Scopus
4. K. A. Williams, D. Roder, A. Esterman, S. M. Muehlberg, and D. J. Coster, “Factors predictive of corneal graft survival: report from the Australian corneal graft registry,” Ophthalmology, vol. 99, no. 3, pp. 403–414, 1992. View at Scopus
5. R. J. Olson, M. Pingree, R. Ridges, M. L. Lundergan, C. Alldredge Jr., and T. E. Clinch, “Penetrating keratoplasty for keratoconus: a long-term review of results and complications,” Journal of Cataract and Refractive Surgery, vol. 26, no. 7, pp. 987–991, 2000. View at Publisher · View at Google Scholar · View at Scopus
6. M. S. Rajan, D. P. S. O’Brart, P. Patel, M. G. Falcon, and J. Marshall, “Topography-guided customized laser-assisted subepithelial keratectomy for the treatment of postkeratoplasty astigmatism,” Journal of Cataract and Refractive Surgery, vol. 32, no. 6, pp. 949–957, 2006. View at Publisher· View at Google Scholar · View at PubMed· View at Scopus
7. R. C. Troutman and C. Swinger, “Relaxing incision for control of postoperative astigmatism following keratoplasty,” Ophthalmic Surgery, vol. 11, no. 2, pp. 117–120, 1980. View at Scopus
8. J. H. Krachmer and R. E. Fenzl, “Surgical correction of high postkeratoplasty astigmatism. Relaxing incisions vs wedge resection,” Archives of Ophthalmology, vol. 98, no. 8, pp. 1400–1402, 1980. View at Scopus
9. G. W. Lavery, R. L. Lindstrom, L. A. Hofer, and D. J. Doughman, “The surgical management of corneal astigmatism after penetrating keratoplasty,” Ophthalmic Surgery, vol. 16, no. 3, pp. 165–169, 1985. View at Scopus
10. Vanathi et al. Indications and outcome of repeat penetrating keratoplasty in India, BMC, Ophthalmology,5:26,2005
11. Valery et al. The Profile of Repeated Corneal Transplantation, Ophthalmology 108:461-469, 2001.
12. Soong et al. Small, Overlapping Tectonic Keratoplasty Involving Graft-Host Junction of Penetraing Keratoplasty, American J Ophthalmol 129:465-467, 2000.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareRELATION AMONG AUDITORY REACTION TIME, AGE AND BMI: A STATISTICAL APPROACH
English0507Seema SinghEnglish Hom Nath DhunganaEnglishReaction time (RT) is defined as the elapsed time between the presentation of a sensory stimulus and its behavioral response.Simple reaction time is usually defined as the minimum time required for an observer or subject to detect the presence of a stimulus.There are many research works on the visual reaction time and auditory reaction time to study the influence of various factors associated with them and found highly correlated to each other. But a very few works are there regarding the developmentof mathematical relationship in functional form. Therefore, in this paper we try to find out the degree of relationship among study variables and develop a statistical model by using multiple regression technique. The high value of coefficient of determination (R2) supports our model favorably.
EnglishAuditory Reaction Time, Statistical Model, Correlation and Coefficient of determinationINTRODUCTION
Reaction time (RT) is defined as elapsed time between the presentation of a sensory stimulus and its behavioral response. Simple reaction time is usually defined as the time required for an observer to detect the presence of a stimulus. Reaction time is the time interval between the application of a stimulus and the appearance of appropriate voluntary response by a subject. It involves stimulus processing, decision making, and response programming .Reaction time has been widely studied as its practical implications may be of great consequence e.g., a slower than normal reaction time while driving can have grave results [1]. It is a measure of function of sensor motor association [2] and performance of an individual [3]. It involves stimulus processing, decision making, and response programming. Reaction time studies have been documented in both sexes for visual and auditory stimuli. It has physiological significance and is a simple and non-invasive test for peripheral as well as central neural structures [4]. Reaction time provides an indirect index of the processing capability of CNS and it is a simple means to determine sensory motor performance, therefore, it represents the level of neuromuscular coordination via different physical, chemical, and mechanical processes decodes visual or auditory stimuli which travel via afferent pathways and reach the brain as sensory stimuli [5, 6] .There are various factors that affect the reaction time to a stimulus. Factors like intensity and duration of the stimulus, age and gender of the participant, effect of practice can affect the reaction time of an individual to a particular stimulus. For example, there are relative differences between the reaction time to visual and auditory stimuli between genders [6]. In the present study we developed a mathematical model among age , BMI and average auditory reaction time (AART) which may be used to predict any variable if two of them are known. There are a very few models have been developed related to visual and auditory reaction time [7]
MATERIAL AND METHODS
The study subjects in the present study were assigned randomly from Techno Academic School and integral Institute of Medical Sciences and Research, Lucknow with a permission of director/principal. All disease free children’s and young adults aged between 6 and 21 years subjects had taken no medication included in the study and while we excluded those children’s who were any addiction such as smoking, tobacco or alcohol, any history of drug abuse and any past history of hereditary or chronic illness. The sample size was calculated by the help of statistician by using appropriate formula based on correlation between variables. The total number of subjects was 104. All the subjects were distributed in four age groups equally. The machine “IMCORP Ambala Reaction Time Instrument” was used to acquire the simple auditory reaction time data in children. The auditory reaction time was measured both for high and low pitch sound. Before collection of data all the study subjects were aware about the study. The data was collected for both high pitch and low pitch sound and then by averaging them we call it average auditory reaction time (AART).The data for variables gender, age and BMI were also obtained. The study was cleared by the Institutional Ethical Committee. After the collection of data it was analyzed by using SPSS of version 20, MS-Excel of version 7 and 3D function grapher of version 1.2. The descriptive statistics and correlation coefficient was calculated and multiple regression technique was used to develop a plane.
RESULTS
The table 1 represents the descriptive statistics of Average Auditory Reaction time of children’s. The mean age of subjects was 13.45 (±4.62) years, BMI was 17.16 (±2.75) kg/m2 and AART was 189.77 (±59.02) milliseconds. The table 2 illustrates the correlation matrix among age, BMI and ART. Table 2 shows the Pearson correlation coefficient among variable. The negative value shows the negative correlation while positive value shows the positive correlation. The correlation coefficients between variables associated with p-value Englishhttp://ijcrr.com/abstract.php?article_id=522http://ijcrr.com/article_html.php?did=5221. Gandhi P.H. et. al.,”A Comparative Study of Simple Auditory Reaction Time in Blind (Congenitally) and Sighted Subjects” Indian J Psychol Med. 2013 Jul-Sep; 35(3): 273–277.
2. Shenvi D, Balasubramanian P. A comparative study of visual and auditory reaction times in males and females. Indian J Physiol Pharmacol. 1994;38:229–31. [PubMed]
3. Das S, Gandhi A, Mondal S. Effect of premenstrual stress on audiovisual reaction time and audiogram. Indian J Physiol Pharmacol. 1997;41:67–70. [PubMed]
4. Mohan M, Thombre DP, Das AK, et al. Reaction time in clinical diabetes Mellitus. Ind J Physiol Pharmacol. 1984; 28: 311–4p.
5. Shalton J, Gippsland Physiotherapy Group, Malbourne, Australia, Comparison between auditory and visual simple reaction times. Neurosci Med. 2010; 1:30–2p.
6. Dhungana H. N.et al.,“Visual Reaction Time and its Relationship with Sex, Age and BMI in Northern Indian Children’s”. Research and Reviews: Journal of Medical Science and Technology, Volume 3, Issue 2.page 1-6, 2014.
7. Dhungana H.N. et. at. : Mathematical relationship among age, BMI and visual reaction time in northern Indian children’s, International Journal of current Reseach and Riview vol 6, issue 24.page 35-37, 2014.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareA STUDY ON ECONOMIC TREATMENT OF DISTILLERY EFFLUENT
English0812Nusrat AliEnglish Sohail AyubEnglish Juned AhmadEnglishThe present study was conducted to find out the economic pollution reduction technique of distillery effluent that possesses a serious environmental problem. The distillery effluent is generally highly acidic (pH 3.8 - 4.4) with high rates of BOD 45000- 60000 mg/l and COD 70000 – 98000 mg/l and also suspended solids (2000 -14000 mg/l). Currently different treatment techniques are used to treat distillery effluent which includes fungal treatment, adsorption techniques, Electrosorption, filtration, biological treatment, etc. but no treatment method alone give the desired goal to treat the distillery effluent effectively and efficiently therefore further research study in this area should be carried out to prevent surface and ground water pollution.
EnglishBOD, COD, Adsorption, Electrosorption, Filtration etc.INTRODUCTION
Water is one of the most important compounds required for every existing of life therefore adequate supply of fresh and clean water is a basic need for all human beings but According to the Natural Environmental Engineering and Research Institution (NEERI) Nagpur about 70% of all available water in India is polluted and therefore two third of all ailments in India such as Typhoid, Jaundice, Cholera, Diarrhea and Dysentery system is caused by contaminated water. These water borne diseases claims 1.5 million lives in India every year, which means three people die every 10 minutes due to contaminated water. [9] The fact behind this is rapid industrialization which is one of the major causes of water pollution. The discharges of untreated and partially treated wastewater from various industries like chemical, pesticides, fertilizer, pulp and paper and sugar, etc., have polluted the aquatic bodies such as a river, pond and ditches. [10] Alcohol production from sugarcane molasses is an important distillery industry posses a high load of water pollution. In India there are around 295 distilleries with a total installed capacity of 3198 million liters per annum and a current yearly production of 1587 million liters alcohols [1]. Liquid wastes from breweries and distilleries possess a characteristically high pollution load and have continued to pose a critical problem of environmental pollution. The high temperature of the waste waters may instantaneously kill fish and other aquatic organisms, thus destroying the flora and fauna of a river, when the wastewater is discharged into it. The spent wash gen- The spent wash generated is highly Acidic in nature (pH 4.0-4.3), Due to decomposition of soluble and suspended organic matters present in the wastewaters, high BOD (Biochemical Oxygen Demand) (45000-60000 ml/l) and COD (Chemical Oxygen Demand) (750000-98000 mg/l) (750000-98000 mg/l) of the waste- of the waste- of the wastewaters results, causing rapid depletion of the oxygen content of the water, thus creating a foul smell [2 and 9]. This required that the effluents of the distillery are either treated or utilized profitably.
SCHEMATIC OF ALCOHOL MANUFACTURING PROCESS [3].
IMPACT OF DISTILLERY EFFLUENT ON ENVIRONMENT [8]
1. Discharge of wastewater with high TDS would have an adverse impact on aquatic life and to make unsuitable water for drinking purposes, if used for irrigation reduce the crop yield, corrosion in the water system and pipeline.
2. Suspended solids in wastewater reduce the light penetration and plant production as a result, in receiving water by increasing turbidity it can also clog the fish gills.
3. High amount of BOD in the wastewater leads to the decomposition of organic matter under the anaerobic condition that produces highly objectionable products including Methane (CH4), Ammonia (NH3), and Hydrogen Sulphide (H2S) gas.
4. Low Dissolved Oxygen (DO) in water bodies affect the aquatic life as DO drops fish and other species are threatened and may get killed.
5. Fall in DO levels causes undesirable odors, tastes and reduce the acceptability of water for domestic purpose.
6. In steam generation, DO is one of the most important factors causing corrosion of the boiler material.
7. Generally, industrial wastewater changes pH level of the receiving water body. Such changes can affect the ecological aquatic system; excessive acidity particularly can result in the release of hydrogen sulphide (H2S) to air.
8. The alkaline nature of wastewater causes declination in plant growth and crop growth.
9. Color and odor of the effluent of the distillery were red brown in color with the unpleasant odor of Indol, Sketol and other sulphur compounds.
10. Spent wash is a complex, multi component stream that is known to cause considerable fouling.
Physico-chemical characteristics: The distillery spent wash is hot, highly colored and acidic with strong and objectionable odors that presents a significant disposal or treatment problem. Physicochemical characteristics are given in Table 1. [4]
Literature Review
The current distillery wastewater treatment includes methods to remove recalcitrant compounds by physicochemical processes (Pandey et al., 2003). In one case example, the physicochemical treatment of biologically-treated wastewater using conventional coagulant iron pickling wastewater supplemented with coagulant aid generated an effluent with COD in the range 940 to 1780 mg/L and a BOD of 25 to 30 mg/L. During this study, the colour of the treated wastewater was in the range of 580 to 1100 platinum cobalt units. It was recommended that the waste sludge from this industry be utilized as a substitute for conventional coagulants. Wastewater generated after chemical coagulation could be further treated efficiently by using 8 g/L of activated carbon with a contact time of 45 min to reduce residual COD to < 250 mg/L to meet discharge limits (Pandey et al., 2003). Anodized graphite anodes were found to be suitable for the treatment of wine distillery wastewater, especially in the presence of supporting electrolytes such as sodium halide, or sodium chloride, which was found to be the most effective in the degradation of polyphenols (Manisankar et al., 2004). Nataraj et al. (2006) investigated the treatment of distillery spent wash by removing the colour and the contaminants using a combination of NF and RO processes. Due to the high fluxes obtained, significant rejection rates of total dissolved solids (TDS), COD, potassium and chloride concentrations were achieved. Water reclaimed by NF and RO is suitable for use in both municipal and industrial applications. Chemical oxygen demand was considerably reduced in distillery wastewaters in India in order to reduce the cost of wastewater disposal. This process emphasized the recovery and recycling of valuable chemicals contained in the wastewaters (Nataraj et al., 2006). As with the generation of fertilizer for direct land application, the economics of any treatment method heavily depends on the financial value that can be assigned to the resultant product. The pre-treatment of wine distillery waste water with ozone improves its kinetic behavior during anaerobic digestion, but at the same time decreases COD removal efficiencies (Benitez et al., 1999a; Martin et al., 2002). Vinasse is known to be chemically very complex because of the high content of polyphenols, which delay biological processes such as anaerobic digestion. As a result, ozonation is seen as a desirable chemical pre-treatment prior to biological treatment because it is capable of converting the inhibitory and refractory compounds into simpler, low molecular weight compounds that are more readily degradable by microorganisms. In such cases, an alternative chemical oxidant has been used, and the treatment of wine distillery wastewater in a continuous reactor using a combination of ozonation and aerobic degradation in activated sludge systems has also been investigated (Benitez et al., 2000). In this combined system, oxidation by ozone achieved a reduction in the organic substrate concentration of 4.4 to 18%, while removal of the content of phenol compounds in the range of 50 to 60% was achieved. Aerobic degradation of these vinasses by activated sludge in experiments using varying hydraulic retention time (HRT) and substrate concentration provided organic substrate removal in the range of 12 to 60% (Benitez et al., 2000). Ozonation of this aerobically pre-treated vinasse led to an increase in COD removal efficiency from 16 to 21.5%, as well as higher rate constants (Benitez et al., 2000). Schafer et al. (2001) later applied membrane filtration with chemical treatment in the management of wastewaters containing natural organic problems. COD removal efficiencies were improved in aerobically pretreated and then ozonated wastewaters (Benitez et al., 1999a).
OTHER TREATMENT AND DISPOSAL OPTIONS OF DISTILLERY WASTE WATER
During the 1970s, land disposal was practiced one of the main treatment options, since it was founded to enhance yield of certain crops. However, for the high strength molasses based spent wash, the odor, putrefaction and unpleasant landscape due to unsystematic disposal are concerns in land application. More recent investigations have indicated that land disposal of distillery effluent can lead to groundwater contamination. Deep well disposal is another option but limited underground storage and specific geological location limits this alternative. Other disposal methods like evaporation of spent wash to produce animal feed and incineration of spent wash for potash recovery have also been practiced. [5]
Fungal treatment: In recent years, fungi have been used in the decolourization of natural and synthetic melanoidin in connection with colour reduction of waste waters from distilleries. The fungus has the capability to purify the effluent by consumption of organic substances, thus, reducing its COD and BOD, and at the same time to obtain any valuable product, such as fungal biomass for protein-rich animal feed or some specific fungal metabolite. In comparison to bacteria filamentous fungi have lower sensitivity to variations in temperature, pH, nutrients and aeration and have lower nucleic acid content in the biomass. [6]
Adsorption techniques to treat wastewater: Adsorption is a natural process by which molecules of a dissolved compound collect on and adhere to the surface of an adsorbent solid. Adsorption occurs when the attractive forces at the carbon surface overcome the attractive forces of the liquid. Granular activated carbon is a particularly good adsorbent medium due to its high surface area to volume ratio. One gram of a typical commercial activated carbon will have a surface area equivalent to 1,000 square meters. Application of above-mentioned methods becomes economically unviable for the removal of heavy metals at lower concentrations. Adsorptive treatment using non-conventional adsorbents. A number of other materials have also been used to remove heavy metals from wastewater, such as peat, wool and silk. Many papers have appeared on preparation of activated carbon from cheaper and readily available materials.[7]
Electrosorption: Electrosorption is generally defined as potential polarization induced adsorption on the surface of electrodes, and is a non-Faraday process. After the polarization of the electrodes, the polar molecules or ions can be removed from the electrolyte solution by the imposed electric field and adsorbed onto the surface of the electrode. Because of its low energy consumption and environmentally friendly advantage, electrosorption has attracted a wide interest in the adsorption processes for treatment of wastewater. Although electrosorption has been shown as a promising treatment process, it has been limited by the performance of electrode material. Activated carbon fiber cloth with high specific surface area and high conductivity is one of the commonly used electrode materials. The surface chemistry of activated carbon fiber has been recognized as a key parameter in the control of the adsorption process. To increase the adsorption capacity, a number of modification methods have been employed. [7]
Biological treatment: In the wastewater treatment sector, biological processes deal primarily with organic impurities. Microbial-based technologies have been used over the last century for the treatment of liquid waste domestic stream. The development of these technologies has provided an excellent process for the destruction of waste constituents that are readily biodegradable under aerobic conditions. Therefore, processes similar to those used for conventional domestic wastewater treatment have applied successfully for the treatment of many industrial wastewaters. Aerobic degradation in the presence of oxygen is considered to be a relatively simple, inexpensive and environmentally sound way to degrade wastes. Factors that are critical in the optimal degradation of the selected substrate include the temperature, moisture, pH, nutrients and aeration rate that the bacte-rial culture is exposed.[7]
Membrane technology [7]: Membrane processes such as microfiltration (MF), Ultrafiltration (UF), Nanofiltration (NF) and reverse osmosis (RO) are increasingly being applied for treating oily wastewater. Membranes have several advantages, among them:
(1) The technology is more widely applicable across a wide range of industries.
(2) The membrane is a positive barrier to reject components. Thus, the quality of the treated water (the permeate) is more uniform regardless of influent variations. These variations may decrease flux, but generally does not affect the quality of its output.
(3) No extraneous chemicals are needed, making subsequent oil recovery easier.
(4) Membranes can be used in-process to allow recycling of selected waste streams within a plant.
(5) Energy costs are lower compared to thermal treatments. \
(6) The plant can be highly automated and does not require highly skilled operators.
Membrane processes have some limitations:
(i) Scale-up is almost linear above a certain size. Thus capital costs for very large effluent Volumes can be high.
(ii) Polymeric membranes suffer from fouling and degradation during use. Thus, they may have to be replaced frequently, which can increase operating costs significantly
DISCUSSION
Distillery wastewater is highly concentrated and cause various problems and therefore distillery industries face dengerious environmental challenges in treating their effluents. Therefore, this review put the task of passing in revue the different technologies issued to treat distillery wastewaters. Several physicochemical options and biological wastewater treatment processes are widely utilised in the successful treatment of distillery effluent but no treatment technology alone is effective in treating the distillery effluent however combined treatment methods may be use to achive the desired goal.
CONCLUSION
In Distillery Industry the spent wash generated is highly Acidic in nature (pH 4.0-4.3), high BOD (Biochemical Oxygen Demand) (45000-60000ml/l)and COD (Chemical Oxygen Demand) (750000-98000 mg/l) of the wastewaters causing rapid depletion of the oxygen content of the water, thus creating a foul smell. Current treatment includes methods to remove recalcitrant compounds by physicochemical processes. The high rate of mass transfer generated by RO showed that a large amount of clean water could be permeated economically instead of being vaporized by energy-intensive evaporation Processes or steam distillation using tall towers. The findings of the present study are encouraging and suggest that application of UF and RO processes can be successfully used for the removal of colour and other contaminants from the distillery effluents. Biological treatment is considered to be a relatively simple, inexpensive and environmentally sound way to degrade wastes, but factors such as temperature, moisture, pH, nutrients and aeration rate that the bacterial culture is exposed are critical in the optimal removal from the spent wash. The application of sand and soil in the filtration bed would always be more effective than sand and soil alone. Activated charcoal has been observed best absorbent than fly ash and wood ash to remove the pollutants from distillery spent wash, but no treatment method alone gives the desired goal to treat the distillery effluent effectively and efficiently therefore an intensive research in this area would not only help to solve the liquid waste management problem but would be effective in preventing surface and ground water pollution.
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=523http://ijcrr.com/article_html.php?did=5231. Sohail Ayub, Nusrat Ali, Hassan Haleem, Impact of Distillery Effluent on ground water: A review. International Conference “Emerging trends in Engineering and Technology” held at TMU, Muradabad, April 6-7 2012.
2. Z.V.P. Murthy ,L.B. Chaudhari, Treatment of distillery spent wash by combined UF and RO processes. Global NEST Journal, Vol 11, No 2, pp 235-240, 2009.
3. N.K. Saha, M. Balakrishnan, V.S. Batra, Improving industrial water use: case study for an Indian distillery. Resources, Conservation and Recycling 43 (2005) 163–174.
4. Goyal SK, Seth R, Handa BK. Diphasic fixed-film biomethanation of distillery spentwash. Bioresource Technol 1996;56:239–44.
\5. Pawar Avinash Shivajirao International Journal of Advanced Engineering Research and Studies (E-ISSN2249–8974)
.6. Removal of melanoidin present in distillery effluent as a major colorant: A Review. Radhika Agarwal, Sneh Lata, Meera Gupta and Pratibha Singh, July 2010, 31, 521-528 (2010).
7. Mohamed Osman Awaleh and Youssouf Djibril Soubaneh Waste Water Treatment in Chemical Industries: The Concept and Current Technologies Res 5: 164. doi:10.4172/2157- 7587.1000164.
8. Sohail Ayub, Shoebuddin Usmani, TREATMENT OF DISTILLERIES AND BREWERIES SPENT WASH WASTEWATER International Journal of Research in Engineering and Technology eISSN: 2319-1163 | pISSN: 2321-7308.
9. Sohail Ayub and Nusrat Ali Impact of wave distillery effluent on ground water : A case study of Atrauli district, Uttar Pradesh, India, ICER/642/PS/O/14.
10. Avnish Chauhan and Namita, Tewari Effect of Lysimetric Treated Effluent on Seed Germination, Radicle Length and Plumule Length of Wheat Plants. New York Science Journal, 2010;3(1)
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareMolecular detection and discrimination of three poultry Eimeria species in Kerbala and Babylon provinces, Iraq
English1319Dhamiaa Make HamzaEnglish Hadi Rasol Hasan Al-MassodiEnglish Zuhair Muhammad Ali JeddoaEnglishCoccidiosis is an intestinal disease of chickens in which the Causes include a various species of protozoan parasites that located within the genus Eimeria. Diagnosis and genetic characterization of different species of Eimeria are central dogma to the preventative, resistance, and control of coccidiosis. The aim of the present study was to identified different avian Eimeria species that considered the causal agents of avian coccidiosis in each of the Kerbala and Babylon provinces, Iraq. The present study observations were revealed increasing and decreasing the percentages of infection with coccidiosis during different months of a year and that due to the large change in temperature and humidity in Iraq, so the results showed that the highest percentage of infection in both of Kerbala and Babylon provinces were in December (23.12%) and the lowest percentage in July (1.87%). A total of 200 samples of feces and intestines were collected from chickens that suspected to infection with Eimeria during the period from August 2013 to July 2014 and the results revealed that 160 samples were positive depending on the macroscopic and microscopic examination which in turn have undergone the second stage of the examination for the purpose of qualitative accurate diagnosis of the species of Eimeria that causing coccidia in chickens using of molecular methods for the target region ITS1 nucleic acid DNA encoded ribosomal RNA , these techniques depend on qRT- PCR technique ,Which diagnosed three species of Eimeria includes E. tenella which formed the largest proportion of the total positive samples (66.8%) then the species E. necatrix which accounted for (30%) and finally the species E. maxima which form (3.13%).Therefore , Using of the molecular methods such as REAL-TIME PCR which characterized by highly accuracy, but these methods expensive economically compared
to routine methods.
EnglishAvian Coccidiosis, Eimeria, Oocysts, RT-PCR, IraqINTRODUCTION
Avian coccidiosis is one of the most important diseases affecting the intensive poultry industry worldwide. Coccidia are almost usually found wherever chickens are raised and it is exceedingly rare to find a commercial chicken flock not affected. The infection causes tissue damage in the intestinal tract leading to interruption in digestive processes, blood loss, and increased susceptibility to other diseases, subclinical enteric infection, and sub acute mortality, the disease is treated by used of anticoccidial drugs that added in the feed or vaccination (1, 2, 3, 4). There are nine commonly recognized species of chicken coccidia; Eimeria acervulina, E. brunetti, E. maxima , E. mitis, E. necatrix, E. praecox , E.mevati , E. hagani and E. tenella, each Eimeria species develops in a particular location within the chicken digestive tract with some interfere seen between these species(5). The specific identification of Eimeria species and strains is important for diagnosis and domination, as well as for epidemiology and biological studies of the population (6).Depended on the routine tests, the Eimeria species have been identified by morphology and/or morphometry of their sporocysts and oocysts as well as their modes of development, and assessing the site and extent of the pathological lesions in the intestine of chicken (7, 8). However, these ways are costly, time-consuming, require skilled personnel and can be unreliable under the circumstances of mixed field infections, particularly when the overlap in biological and morphological characteristics makes the unambiguously identification and differentiation of Eimeria species impossible (9, 10). Molecular techniques have some advantages over traditional methods in that they rely only on the genomic sequence of the Eimeria species, several techniques based on the polymerase chain reaction using primers that specifically targeting different regions of the Eimeria genome have been described (5, 11, 12, 13, 14, 15). For molecular detection of Eimeria species in chickens, the DNA sequence of the first and second internal transcribed spacers (ITS-1 and ITS-2) of the nuclear DNA, which separate the ribosomal genes, is used most frequently, besides its heterogeneity in both sequence length and base composition of the ITS sequence, the rDNA is a member of a multiple copy gene family and provides large numbers of potential PCR targets (16, 17, 18, 19, 20). Nevertheless, the practical implementation of these techniques in tradition diagnosis and epidemiological studies has been limited (21). The number of studies related to the presence of chicken Eimeria species in Iraq are limited. These studies have been conducted in few locations and species identification was depended on the oocysts morphology, necropsy and/or histopathological findings. And as a result, nine Eimeria species (E.acervulina, E. brunetti, E. hagani, E. maxima, E. mitis, E. mivati, E. necatrix, E. praecox and E. tenella) have been reported to diagnosed in chickens (22, 23). In this study, we aimed to identify the Eimeria species causing coccidiosis in broilers using a molecular technique based on the Quantitative Real-Time PCR and determine the prevalence of coccidial infections in commercial broiler flocks in chickens.
Materials and Methods
1- Stool Sample collection From August 2013 to July 2014 a total of 200 samples of fresh fecal droppings and intestines were collected from suspected infected chickens with coccidiosis attending to the veterinary hospital and veterinary clinics were spread in Kerbala and Babylon provinces , Iraq for the examination and treatment . The oocysts were isolated from intestines and stool of infected chickens and collected in Eppendrof tubes and stored in freezing until used in DNA extraction . (12)
2- Direct examination method (microscopic examination): The first step in the present study is identified the positive samples from whole samples that collected from suspected chickens with coccidiosis and examined microscopically to determined the oocysts either by direct methods in cases of acute diarrhea in which the samples examined either freshly or used of a natural formalin buffer solution which concentrated 10% or by staining the samples with Iodin or Giemsa stain to made the internal components more clear.
3-Stool DNA Extraction Genomic DNA was extracted from stool samples of chicken by using AccuPrep® Stool DNA Extraction Kit (Bioneer, Korea)
4-DNA profile For detection of DNA that extract from stool samples through the use of a Nanodrop spectrophotometer (THERMO. USA) for detection and measurement the concentration of nuclear acids (DNA and RNA) ,Where is detected DNA concentration (ng / μl) and measuring the purity of the DNA by reading the absorbance at a wavelength of between (280-260 nm) ( 21).
5-qRT-PCR protocols Real-Time PCR was preformed for detection of poultry Eimeria species by using the primers and TaqMan probe specific for ITS1 region In the DNA that code for Ribosomal RNA, technique was carried out according to method described by(13).
Real-Time PCR master mix preparation Real-Time PCR master mix was prepared by one step Reverse Transcription and Real-Time PCR detection kit (AccuPower RocketScript RT-qPCR PreMix, Bioneer. Korea), and done according to company instructions as following Table (1):
Primers: The primers were designed in this study by using the complete sequence of ITS1 region in the rDNA using NCBI Gene-Bank and Primer3 plus online and provided by (Bioneer company, Korea) as showed in Table (2):
The qRT-PCR master mix reaction components that mentioned in (table 2 ) were added into standard qPCR tube containing (8 wells strips tubes which containing Rocket Script reverse transcriptase and TaqMan probe premix). Then all strips tubes vortexing for mixed the components and centrifuge for 3000 rpm for 3 minutes in Exispin centrifuge, after that transferred into Exicycler RealTime PCR thermocycler.
6-Real-Time PCR Thermocycler conditions Real-Time PCR thermocycler conditions was set up according to primer annealing temperature and RT-qPCR TaqMan kit instructions as following Table (3):
Thermal cycles were applied to inspect the Real-Time PCR and relying on instructions AccuPower® 2X GreenStarTM qPCR Master Mix as well as by calculating the degree Tm prefixes using the device MiniOpticon RealTime PCR system BioRad / USA as in Figure (1) below:
7-Real-Time PCR Data analysis qRT-PCR data analysis was performed by calculation the threshold cycle number (CT value) that presented the positive amplification of gene in Real-time cycle number.
Statistical analysis The results of present study analyzed statistically by Program The Statistical Analysis (SAS) by using of the Lest Significant Difference (LSD) test and Duncan test depending on the level of probability P Englishhttp://ijcrr.com/abstract.php?article_id=524http://ijcrr.com/article_html.php?did=5241. McDougald ,LR. (2003): Protozoal infections. 973-1023. In: YM Saif, HJ .Barnes; JR. Glisson; AM. Fadly, LR. McDougald, DE Swayne. (Eds), Diseases of Poultry. Iowa State Press, Ames 973- 990Pp.
2. Schwarz, RS.; Jenkins, MC.; Klopp ,S.; Miska, KB. (2009): Genomic analysis of Eimeria spp. populations in relation to performance levels of broiler chicken farms in Arkansas and North Carolina .J. Parasitol, 95, 871-880.
3. Thebo, P.; Lunden, A.; Uggla, A.; Hooshmand-Rad ,P. (1998): Identification of seven Eimeria species in Swedish domestic fowl Avian Pathol, 27, 613-617.
4. Woods, WG ; Whithear, KG; Richards, DG.; Anderson, GR.; Jorgensen, WK., Gasser, RB. (2000): Single- strand restriction fragment length polymorphism analysis of the second internal transcribed spacer (ribosomal DNA) for species of Eimeria from chickens in Australia. Int JParasitol, 30, 1019-1023.
5. Gasser, RB.; Skinner, R.; Fadavi, R.; Richards ,G.; Morris, G. (2005): High- throughput capillary electrophoresis for the identification and differentiation of seven species of Eimeria from chickens. Electrophoresis, 26, 3479-3485.
6. Morris, GM.; Gasser, RB. (2006): Biotechnological advances in the diagnosis of avian coccidiosis and theanalysis of genetic variation in Eimeria. Biotechnol Adv,24, 590-603.
7. Aarthi, S.; Dhinakar, Raj. G.; Raman, M.; Gomathinay agam, S.; Kumanan, K . (2010): Molecular prevalence and preponderance of Eimeria spp. Among chickens in Tamil Nadu, India. Parasitol Res, 107, 1013- 1017.
8. Long, PL.; Reid, WM. (1982): A guide for the diagnosis of coccidiosis in chickens. The University of Georgia, College of Agriculture Experiment Stations, Research Report 404,1–17.
9. Carvalho, FS.; Wenceslau, AA.; Teixeira, M.; Matos, Carneiro JA.; Melo, AD.; Albuquerque, GR. (2011):Diagnosis of Eimeria species using traditional and molecular methods in field studies. Vet Parasitol, 176, 95-100.
10. Suhair, R. Al-Idreesi , Mahmoud, Kweider and Mahmad, M. Katranji .(2013).Efficacy of Eimeria tenella (Oocyst and Sporozoite) Proteins as a Vaccine in Broilers Against cocidiosis. International Journal of Poultry Science 12 (3): 157- 163.
11. Haug, A.; Thebo, P.; Mattsson, JG. (2007): A simplified protocol for molecular identification of Eimeria species infield samples. Vet Parasitol, 146, 35-45.
12. Mushattat,Sukayna J.(2013).Parasitology and Immunology study of Gastrointestinal parasites in Chickens.Athesis Submitted to the council of college of edu.for pure Sciences of Karbala in partial fulfillment of the Requirements for degree of Doctor of Philosophy in Biolgy /parasitology.
13. Ogedengbe, JD.; Hunter, DB.; Barta, JR. (2011): Molecular identification of Eimeria species infecting market-age meat chickens in commercial flocks in Ontario. Vet Parasitol,178, 350-354.
14. Qvarnstrom, Y.; James, C.; Xayavong, M.; Holloway, BP.; Visvesvara, GS.; Sriram, R.; da Silva, AJ. (2005).Comparison of real-time PCR protocols for differential laboratory diagnosis of Amebiasis.J. Microbiol Clin. 43:5491-5497.
15. Williams, RB. (1998): Epidemiological aspects of the use of live anticoccidial vaccines for chickens. Int J. Parasitol, 28 , 1089-1098.
16. AMAM, Z. S. ;Sohana,A. M. ; Md. Anayet H.; MohammedT. Akbar Rashel, A.; Md. Ashraful ; Islam , Israt Z. I. ; Bibi A. (2014). Molecular characterization of Eimeria spp. from chicken by Polymerase Chain Reaction based on speciesspecific SCAR markers . IOSR Journal of Agriculture and Veterinary Science (IOSR-JAVS)e-ISSN: 2319- 2380.
17. Lew, AE.; Anderson ,GR.; Minchin, CM.; Jeston, PJ.;Jorgensen, WK. (2003): Inter - and intra- strain variation and PCR detection of the internal transcribed spacer 1(ITS-1) sequences of Australian isolates of Eimeria speciesfrom chickens. Vet Parasitol, 112, 33- 50.
18. Lien, YY.; Sheu, SC.; Liu ,HJ.; Chen, SC.; Tsai, MY.; Luo , SC.; Wu, KC.; Liu, SS.; Su, HY. (2007): Cloning and nucleotide sequencing of the second internal transcribed spacer of ribosomal DNA for three species of Eimeria from chickens in Taiwan. Vet . J, 173, 186-191.
19. Patra ,G.; Ali, MA.; Chanu, KV.; Jonathan ,J.; Joy, LK,Prava, M., Ravindran R, Das G, Devi LI. (2010): PCR based diagnosis of Eimeria tenella infection in broiler chicken. Int J Poultry Sci, 9, 813-818.
20. Shirley , MW.; Smith , AL.; Tomley, FM .(2005): The biology of avian Eimeria with an emphasis on their control by vccination. Adv .Parasitol, 60, 285–330.
21. Haug, A.; Thebo, P.; Mattsson, JG. (2007): A simplified protocol for molecular identification of Eimeria species infield samples. Vet. parasitol, 146, 35-45.
22. Demir ,S. (1992): Bursa bölgesi tavuklar?nda coccidiose etkenleri ve bunlar?n yay?l???. Uluda? Univ Vet Fak Derg,122,45-49.
23. Kara? GD (2004): Etlik piliçlerde canl? a?? uygulamalar?n?n koksidiyozdan korunmadaki etkisinin ara?t?r?lmas?. Unpublished doctoral dissertation. University of Ankara,Turkey.2, 143- 51.
24. Cantacessi, C.; Riddell, S.; Morris, GM.; Doran , T.; Woods, WG.; Otranto, D.; Gasser, RB. (2008): Genetic characterization of three unique operational taxonomicunits of Eimeria from chickens in Australia based on nuclear spacer ribosomal DNA. Vet Parasitol, 152, 226-34.
25. Damer , P. Blake ; Zonghua, Qin.; Jianping, Cai . and Adrian, L. Smith.(2008).Enteric Immunology Group , Institute for Animal Health , ComptonBerkshire, RG20 7NN, UK .Development and validation of real- time polymerase chain reaction assays specific to four species of Eimeria. Avian Pathology . 37(1), 89_94.
26. Kirs, M. and Smith, D.C. (2007). Multiplex quantitative real - time reverse transcriptase PCR for F_-specific RNA coliphages: a method for use in microbial source tracking. Applied and Environmental Microbiology, 73, 808_814.
27. Johnston, W., Shirley, M., Smith, A. and Gravenor, M. (2001). Modelling host cell availability and the crowding effect in Eimeria infections. International Journal for Parasitology, 31, 1070_1081.
28. Amer, M.M;Awaad, M.H.H;Rabab, M .El-Khateeb,Nadia M.T.N. and Sherein ,said .(2014).Isolation and identification of Eimeria from field coccidiosis in chickens. American science J.6 (10).
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareAntifungal Susceptibility of Candida against Six Antifungal Drugs by Disk Diffusion Method Isolated From Vulvovaginal Candidiasis
English2025Twinkle N. GandhiEnglish Manish G. PatelEnglish Mannu R. JainEnglishIntroduction: Vulvovaginal candidiasis is the second most common cause of vaginitis after bacterial vaginosis and is diagnosed in 40 % women with vaginal discharge. Incidence of fungal infections has increased dramatically over the past few decades. Epidemiologic data from the past decade reveal a paradigm shift in candida species from albicans to non -albicans candida species. The aim of this study was to determine incidence of vulvovaginal candidiasis, identify the species and test their in vitro susceptibility
profile against six antifungal agents – Fluconazole, Itraconazole, Ketoconazole, Clotrimazole, Amphotericin B and Nystatin. Material and Methods: Two high vaginal swabs were collected from patient with complain of vaginal discharge. One sample is processed for direct microscopic examination and other sample is used for culture on Sabourad’s dextrose agar and Blood agar. Isolates identified by battery of test and antifungal susceptibility testing of Candida species done by Disk Diffusion method. Results: A total of 122 isolates of candida species were obtained. Candida albicans was found to be the most frequently isolated species 81(66.39%) of the total isolates, followed by C. glabrata 19 (15.65%),C. tropicalis 12(33.61%), C. parapsilosis 6(4.91%), C. krusei 3(2.4%) and C. gullermondii 1(0.8%).Non-albicans candida constituted 41(33.61%).Antifungal susceptibility pattern showed that candida isolates were more sensitive to Nystatin and Amphotericin –B, compared to that of Clotrimazole, Fluconazole and Ketoconazole. 78% C. albicans were sensitive to Fluconazole, 5% were dose dependent susceptible, and 17% were resistant. C. krusei had shown 33% resistance against fluconazole and67% resistance against Clotrimazole. Conclusion: The majority of C. albicans isolates were susceptible to Fluconazole. C. krusei had shown maximum resistance among all the isolates. Identification of Candida to species level and their antifungal susceptibility testing should be done to achieve better clinical results.
EnglishVulvovaginal candidiasis (VVC), Antifungal susceptibility testing, Disk diffusion methodINTRODUCTION
Vulvovaginal candidiasis (VVC) is a common fungalinfection that affects healthy women of all ages.1 At least75% of women will develop one or more infections once during their lifetime, with 5 to 8% of those individuals developing recurrent infections.1,11Symptoms generally include itching, burning, soreness and abnormal vaginal discharge.4 The principal agent of VVC is Candida albicans, but other species known generally as C. non-albicans (C. glabrata, C. tropicalis, C. krusei, C. parapsilosis, C.gullermondii) are also isolated.19C. glabrata is the second most common yeast, and its treatment is considered a serious clinical challenge. 2 Candida albicans and non-albicans species are closely related but differ from each other with respect to epidemiology, virulence characteristics, and fungal susceptibility, therefore Candida species identification is important for successful management.3 Prolonged therapy and increased use of antifungal for recurrent candidiasis are the most common risk factors for azoles resistance among Candida isolates from vulvovaginitis candidiasis patients.11Azoles have the advantage of being taken orally, which increase their potency. 5 The emergence of drug resistant strains, both chromosomal and plasmid borne, reinforce the need for the study of these pathogens and the surveillance of its susceptibility to drugs commonly used for therapy.2,9Close monitoring of the antimicrobial susceptibility and its resistance mechanism is essential in an environment of rapidly changing resistance patterns.4 Methods for evaluating the susceptibility of yeasts to antifungal agents have been the subject of numerous studies during the last decade.15,16A standard reference procedure has been described by the National Committee for Clinical Laboratory Standards (NCCLS).13 The reference procedure is a macrotube dilution technique which is too cumbersome for use in most clinical laboratories.2,15 A broth microdilution adaptation of that procedure has been found to be acceptable.13,16Although microdilution tests can usually be read after 24 h, 48-h readings are specified for the NCCLS macrotube test.14,15The E test is a proprietary test that has also been found to be capable of giving reliable results that can often be read after 24 h of incubation.2,16 For use in a clinical laboratory, a simplified disk diffusion test has some important advantages.6,8,18For practical reasons, that disk technique should be similar to the disk procedure that is being used to test antibacterial agents.8,12,10 Objectives of this study were to isolate Candida from VVC patients, characterization and in vitro antifungal susceptibility against six antifungal drugs by the Disk Diffusion method.
MATERIAL AND METHODS
This study was conducted during July 2010 to October 2011 in the Department of Microbiology, SMIMER medical college Surat, Gujarat, India.A total number of 410 OPD patients with complains of vaginal discharge attending department of Obstetrics and Gynaecology are included in the study.Two swabs were collected from each patient with the help of sterile cotton swabs. Specimen was collected from the vagina or cervix avoiding the contamination of other organism. Out of two swabs, one was subjected to direct smear examination, and the other was inoculated on Sabouraud’s dextrose agar (SDA) and Blood agar and incubated at 37?C aerobically. The growth of Candidaon SDA was confirmed based on colony morphology and gram stain examination. After growth species of Candida were identified. Species identification- Species identification of Candida isolates was done following standard mycological protocol including germ tube test, fermentation and assimilation of various sugars, chlamydospores production on Corn meal agar and colony color on Hi Chrome Candida agar. Antifungal susceptibility testing- Antifungal susceptibility testing of the isolates was performed by six antifungal drugs disk Fluconazole (25 mcg), Ketoconazole (10 mcg), Itraconazole (10 mcg), Clotrimazole (10 mcg), Nystatin(100 U) and Amphotericin-B (100 U). Antifungal susceptibility testing was performed by disk diffusion method using Mueller-Hinton Agar + 2% Glucose and 0.5 μg/ml Methylene Blue Dye (GMB) Medium as per CLSI guidelines (C.L.S.I. document M44-A2, 2009.). 0.5 McFarland standard was used to standardize the inoculums density. C.albicans ATCC 90028 and C. parapsilosis ATCC 22019 were used as quality control. All the culture media, Antifungal disk, and control strains were obtained from Himedia Laboratories, India. The antifungal susceptibility of the isolates was interpreted as sensitive (S), dose dependent-susceptible (DDS) and resistant (R). The results were interpreted as per the Clinical and Laboratory Standards Institute (CLSI) guidelines.
RESULTS AND ANALYSIS
During the study period a total of 122 Candida spp. were isolated from 410 high vaginal swab processed for isolation and identification of Candida. Out of 122 isolates, 81(66.39%) were C. albicans, 19(15.65%) were C. glabrata, 12(9.85%) C. tropicalis, 6(4.91%) C. parapsilosis, 3(2.4%) C. krusei and 1(0.8%) were C. gullermondii. In our study All the Candida spp. had shown 100% sensitivity against Nystatin and almost 100% sensitivity against Amphotericin-B (Except C. tropicalis which showed 83.4% sensitivity to Amphotericin-B). (Table-1, 2) C. albicans had shown maximum sensitivity of 79% and 78% against Clotrimazole and Fluconazole respectively. It had shown 17% resistance against Fluconazole. C. glabrata had shown 95% sensitivity against Clotrimazole and 15.78%, 15.70% resistance against Itraconazole and Fluconazole respectively. C. tropicalis had shown maximum 83% sensitivity against Fluconazole. It had shown 17% resistance against Fluconazole, Ketoconazole and Clotrimazole and 16.60% resistance against Amphotericin-B. C. parapsilosis had shown 100% sensitivity against Ketoconazole and Amphotericin-B, followed by 83% sensitivity against Clotrimazole and Fluconazole. It had shown 16.60% resistance against Itraconazole. C.krusei had shown 67% sensitivity against Fluconazole and 67% resistance against Clotrimazole. C. gullermondii had shown 100% sensitivity against all the six antifungal drugs used in the study. In our study overall sensitivity of Candida species against Fluconazole was 79%, Ketoconazole76%, Itraconazole 52%, Clotrimazole 79.5%, Nystatin 100% and Amphotericin-B was 98.36 %.(Table-7)
DISCUSSION
Vulvovaginal candidiasis is one of the most common fungal infections among adult women during their lifetime.3,20Clotrimazole and Fluconazole are the two antifungal drugs that are widely used in the treatment of vulvovaginal candidiasis.5 The main agent of vulvovaginal candidiasis is C. albicans; however, it seems nonalbicans species (C. glabrata and C. tropicalis) of Candida appear to be increasing.5,7 C. glabratais the second commonest agent in vaginal infections in most regions.5 The sensitivity patterns of Candida isolates varies among studies in different countries.2 In our study Fluconazole had shown 78% sensitivity against C. albicans, which is quite comparable with study of Babin et al17(76%),while study done by Ajitha et al3 and Emam et al8 showed higher sensitivity rate of 93.3% and 96.7% respectively. Fluconazole was 33% resistant against C. kruseiin this study while in study conducted by Sachin et al7 it was 18.8% resistance and in study by Adesji et al1 it was 100% resistance. (Table 3) Clotrimazole had highest sensitivity 100 % against C. gullermondii followed by C. glabrata 95%in our study, while 66.67% sensitivity was found in study of Ajitha et al3 against C. glabrata. (Table 4) Ketoconazole had shown maximum resistant 33.5% against C.krusei in our study,while it was 25% in study of Sachin et al7 .(Table 5) Itraconazole was 13.5% resistant among C. albicans in our study which is 13.95% in Babin et al17and15.09% resistance in Salehei Z et al.5 (Table 6) Nystatin was 100% sensitive in all Candida spp. in our study which is quite comparable with Emam et al8 (100%). Amphotericin –B was almost 100% sensitive in all Candida spp., except C.tropicalis83.4% sensitive in our study. Data in Ajitha et al 3 was 81.8% and in Lata et al 9 75.6%. Overall, Fluconazole was 79% sensitive, while in study of Kelen Dota et al2 Fluconazole showed 35.5% and in Dharmik et al4 97.2% sensitivity.(Table 7) In this study the overall sensitivity of Clotrimazole and Itraconazole were 79.5% and 52% respectively, which were comparable to study of Dharmik et al4 80% and 57% respectively. (Table 7)
CONCLUSION
This study provides information on species pattern and antifungal susceptibility of Candida species isolated from VVC cases attending Obstetrics and Gynecology OPD of SMIMER Hospital, Gujarat, India. In the present study, though C. albicans was the commonest spp. isolated, there was a slight increase in the prevalence of non-albicans Candida spp. Among the non-albicans Candida, C. glabrata was the commonest species. Majority of C. albicans isolates were susceptible to Fluconazole. Antifungal susceptibility pattern showed that Candida isolates were more sensitive to Amphotericin –B and Nystatin, compared to that of Clotrimazole and Azoles. C. krusei had shown maximum resistance among all the Candida species. In vitro susceptibility testing of the yeast to antifungal agents will play a vital role in appropriate selection of antifungal agents for the treatment of fungal infections.
ABBREVIATIONS
VVC-Vulvovaginal Candidiasis
SDA-Sabourad’s Dextrose agar
NCCLS-National Committee for Clinical Laboratory Standards
ACKNOWLEDGEMENT
Authors would like to thank Dean and Medical Superintendent, SMIMER Medical College and hospital for allowing us to carry out this study and for providing the facilities and help. They are also thankful to the Head of Department Obstetrics and Gynecology, SMIMER Medical College and hospital for allowing us to collect the specimens of their patients. Authors would also like to extend their gratitude to authors whose articles are cited and included in the references of the present study. They are also grateful to authors/editors/publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed
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19. E. E. Akortha, V. O. Nwaugo and N. O. Chikwe. Antifungal resistance among Candida species from patients with genitourinary tract infection isolated in Benin City, Edo state, Nigeria African Journal of Microbiology Research Vol. 3(11) pp. 694-699, November, 2009.
20. Parisa Badiee , Abdolvahab Alborzi , Mohammad Ali Davarpanahb et al. Distributions and Antifungal Susceptibility of Candida Species from Mucosal Sites in HIV Positive Patients Archives of Iranian Medicine, Volume 13, Number 4, July 2010.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareDECLINING CHILD SEX RATIO IN INDIA AND ITS MAJOR CORRELATES
English2632Kalosona PaulEnglish Shrestha SahaEnglishOver all sex ratio (OSR) in India has enlarged from the last census (2001) by seven points from 933 to 940, the situation is worse for the child sex ratio (CSR). According to the decadal Indian census, the sex ratio in the 0-6 age group went down from 962 girls per 1000 boys in 1981, to 914 girls per 1000 boys in 2011. 2011 census showed that in 26 States/UTs rural child sex ratio are higher than urban areas. The paper intends to explain variability of CSR across the country through superimposed socio cultural frame. The analysis is based on CSR provided by Census of India for various decades. The study has focussed on various factors
covering wide range of socio-economic and demographic dimension that can be associated with contemporary sex discrimination and clarified their relative explanatory power. A total 230 districts has been analyzed from 7 states which have their CSR below national average(914). The spatial dimension of discrimination obtainable above leads to conclusions that sex ratio is more skewed in the most urbanized and economically well off states of north and western region.
EnglishChild sex ratio (CSR), Sex discrimination, Socio cultural frameINTRODUCTION
India has witnessed declining overall sex ratio since the last century. Females always have some biological advantage to survive longer than male in the absence of gender discrimination. Although the overall sex ratio (OSR) in India has increased from the last census (2001) by seven percentage points from 933 to 940, the situation is worse for the child sex ratio (defined as the ratio of girls to boys in the 0-6 year’s category). According to the decennial Indian census, the sex ratio in the 0-6 age group in India went from 962 girls per 1000 boys in 1981, to 914 girls per 1000 boys in 2011. 2011 census showed that in 26 States/UTs rural child sex ratio are higher than urban areas .9 States/UTs CSRs are higher in urban areas compared to rural areas. They are NCT Delhi, Chandigarh, Pondicherry Punjab, Maharashtra, Andhra Pradesh and Tamil Nadu, Mizoram and Manipur. Three fourth districts (461) in India have shown declining CSR in 2001- 2011. There have been has been more than 50 points decline in 38 districts and 51 districts increase has been 20 points. South Asian countries and India are societies with extreme demographic diversities and characterised by strong patriarchal norms which leads to the gender discrimination and strong son preferences. The issues pertaining to skewed child sex ratios are complex and multi-various. Declining child sex ratio in India is a long back issue and has been approached through various literatures. A major literature has emphasized on the unconventionality with prevailing culture demands as a pre requisite in devaluing girl child despite of the fact that such valuation has hooked up with other qualities like educational level, occupation, survival status and nutrition. Daughter discrimination in India is majorly found by depriving daughters mainly from food, medication and parental affection. Negligence towards girl child are much higher for those who born in higher parity and having elder sisters. Prevalence of infanticide in certain part of India and among certain communities definitely proclaims the unmet need for sex detection. Major studies have focussed on the cultural commonalities and contrast across regions and traditional north south division indicating differential position of women in society, which leads to the differential behaviour towards girl child and excess girl child mortality as a consequence of it (Sen 1990). The traditional excess girl child mortality displays a consistent connection with patriarchal social norms forming a core aspect of regional inequalities. The child sex ratio (0-6 years) is declining steadily during the last five decades and more steeply in northern states of India. In this context, this study aims to examine district wise child sex ratio and sex ratio at birth and study socio economic variations in child sex ratio focusing on Uttar Pradesh, Punjab, Haryana, Rajasthan and Himachal Pradesh, Maharashtra and Rajasthan the states with child sex ratios lower than the national average (914).
REVIEW OF LITERATURE
The major components of imbalances in overall and child sex ratio include (a) sex ratio at birth (b) sex differentials in mortality, (c) sex differential in migration and (d) under enumeration of women and girls. Sex ratio varies by region, by social group, age group and level of prosperity. The latest census in 2011 has recorded a significant decrease in the sex ratio of children age 0-6 while registering a marginal rise in the overall female-male ratio at from the earlier census in 1991. Many researchers attributed the decline in the child sex ratio to a possible rise in the sex ratio at birth owing to the increasing incidence of sex selective abortion (e.g. as Gupta and Bhat, 1997, Sudha and Rajan, 1999). The decline child sex ratio is both due to discrimination of female child at the age of 1-4 and sex selective abortion practices which is widely prevalent in Punjab, Haryana and Himachal Pradesh. Sex differentials in child mortality in ages 1-5 indicate a huge excess mortality for girls as the result of discriminations against female children in terms of food, nutrition and health care. Historically low sex ratio in India is mainly attributed to excess female child mortality (Visaria, 1971). However, the accelerated fall in the child sex ratio after 1981 is largely due to the diffusion of parental sex selection techniques in regions with well-entrenched gender bias (Bhat, 2002). Arnold, Kishore and Roy (2002), using NFHS- II data, found evidence of sex selective abortion based on data on use of ultrasound or amniocentesis in India. Biologically sex ratio at birth is always in favour of males, with about 105 boys per 100 girls. A statistical study of registered births in 75 territories with a relatively complete vital registration has confirmed the widely held belief that the masculinity ratio at birth varies generally between 104 and 107 (Male and Female). Sex ratio at birth greater than 107 may suggest evidence of sex selective abortion. Previous studies also indicated that in India sex-selective abortion is higher among urban women, middle and higher educated women and women living in households with high standard of living (Retherford and Roy, 2003 and Arokiasamy, 2004). In this context, although this study is inspired from the worrying facts of continuously strengthening tendency towards discrimination against women through integration of prevailing traditional gender biased norms and modern technology.
Objectives
• To study the pattern of district level child sex ratio (0-6 year age).
• To show the association of Child Sex Ratio (CSR) with various socio cultural and demographic variables
. • To study the effect of socio economic factors on the pattern of child sex ratio.
Data and methodology
• The district level data on child sex ratio (0-6 years)and socio economic indicators has been taken from 2001 and 2011 census
• The infant mortality rate and child mortality rate at district level has been taken from the report of ‘ Infant and child mortality in India district level estimates” population foundation of India 2008
• District level TFR and sex ratio at birth (SRB) has been taken from the published paper “District Level Fertility Estimates for Hindus and Muslims” by S irudaya Rajan, Economic and Political Weekly January 29, 2005 and
• “District-Level Estimates of Fertility and Implied Sex Ratio at Birth in India” by Sanjay Kumar, K M Sathyanarayana, Economic and Political Weekly august 18, 2012 vol xlviI no 33.
• The child sex ratio was calculated at the district level as the number of females per 1000 males of 0-6 age group following the definition of Indian census
• Socio cultural variables like has been taken and they have been correlated with CSR to show the association. the variables are
Female Literacy Rate (FLR):
Matrix Correlation:
Correlation Matrix is one kind of diagonal matrix which has provide the association between entire pairs of dependent and independent variables.
RESULT AND DISCUSSION
On the basis of the Child sex ratio the highest sex ratio is found in 2011 is Lahul and spiti district in Himachal Pradesh. It shows a very sharp distinction from other district in terms of child sex ratio although the overall CSR in Himachal Pradesh is below national average but the district having highest CSR located in that very state. Tawang district in Arunachal has the second highest child sex ratio of 1005 the district namely Dakshin baster dantewada also in Chhattisgarh also has as high CSR as Tawang. Kamrup Metropolitan in Assam has CSR of 994 State of nabarangapur in Orissa has CSR of 988 followed by Kolasib in Mizoram 987, Nawda in Bihar 985 Aizwal 984 Malkangiri in Orissa has the CSR of 979 (Table 1). District having lowest Child sex raio is found in Jhajjar of Haryana 774, Mahendragarh of same state having CSR of 778 and Rewari 784, Sonipat 790 of same state. In the district of Jammu CSR is 795 followed by Ambla in Haryana. Among15 lowest CSR districts in India 10 belong from Haryana (Table 2). The difference has been calculated to show the changes in child sex ratio between 1991 and 2011. The above table has been made on the basis of the 10 district who have the highest positive changes in improving CSR in twenty years of time period. Positive change in child se ratio is highest in Salem in Tamil Nadu which is 87 point change from 1991 to 2011 followed by Lahul Spiti in Himachal Pradesh by 62 points, Theni in Tamil Nadu and Tawang in Arunachal Pradesh have change of 41 points followed by Balarampr (33) in Uttar Pradesh, chandauli (32) champali (30 ) in Mizoram (Table 3). There also negative changes in many districts highest negative changes in 2011 CSR is found by 85 points since 1991 of district Jhajjar in Haryana, followed by Rewari 83 points, Mahendranagar 74 points of same state (Fig 1and 2). Ahmdanagar in Maharashtra has decreased by 65 points in CSR since 1991 Pithoragarh by 62 points (Table 4). The correlation has been done for each selected state with their various socio-cultural and demographic variables of those states which have the child sex ratio over national average (914). All total 230 district has been taken of states Uttar Pradesh, Madhya Pradesh, Maharashtra, Rajasthan, Punjab, Haryana, Himachal Pradesh The result shows that the influence of independent variables on dependent variable are not similar one independent variable for a particular state may act positively on the dependent and for other state it may act negatively or may show no strong relationship. No independent variable for all selected states has influenced as strongly as sex ratio at birth. Sex ratio at birth (SRB) for each state has influenced CSR very strongly. It makes the point clear that excess female child mortality starts in pre natal stage of life rather than post natal stages. Thus study of sex ratio at birth has became inescapable while studying child sex ratio specially for those states which are economically well off urbanised and have strong history of patriarchy. Where the SRB is greater than CSR post natal child mortality seems to be higher and vice versa. Literacy and urbanisation are negatively correlated with child sex ratio. Means on increasing literacy and accessibility of innovative technology of urban females the sex ratio is decreasing, which is a very shocking situation. Although with increase of literacy and urbanisation over all TFR and infant child mortality is negatively correlated thus one can assume that improvement with literacy and urbanisation there will be social progress and the child sex ratio will improve but the case is just reverse in India (Table 5). Multiple linear regression analysis has shown the influence of socio economic variable on child sex ratio. The result shows that sex ratio at birth are statistically significant and has positive effect on child sex ratio. Total fertility rate and infant mortality rate shows negative and positive influence on child sex ratio respectively .statistical evidences suggests percentage of urban population influence negatively on child sex ratio (CSR). Schedule caste population influence negatively on child sex ratio (Table 6).
CONCLUSION
The spatial dimension of discrimination presented above leads to conclusions that sex ratio is more skewed in the most urbanized and economically well off states of north and western region. Conversely, the relative under developed and less urbanized population of central and eastern region have higher child sex ratio. Many of the factors associated with gender bias in India discussed previously more in the context of north south cultural contrast (Dyson and Moore 1983). The maps show obvious regional contrast but it also indicates a strong level of geographical continuity. Thus geography of CSR variations remain as an issue of discussion through the superimposed socio cultural frames that really deserves attention. The district level CSR from census 2011 has been analyzed. Historically Indian CSR has always been skewed in North western India. Literature on CSR pointed out a clear division between North West and South east pattern of female survival disadvantage. The reasons of child masculinity in north western states have been explained by the cultural practice and kinship structure which attaches lesser utility to female children than male children and produces social norms hostile for the survival of a girl child.
Englishhttp://ijcrr.com/abstract.php?article_id=526http://ijcrr.com/article_html.php?did=5261. Agnihotri, S.B., 2000, “Sex Ratio Patterns in the Indian Population: A Fresh Exploration.” New Delhi: Sage Publications.
2. Arokiasamy, P. 2004, “Regional patterns of sex bias and excess female child mortality in India”. Population Studies, 59 (6), pp 833-864.
3. Arnold, F., Kishor, S. and Roy, T. K. (2002) Sex-Selective Abortions in India, Population and Development Review. 28(4). p. 759-785 .
4. Bhatt. Mari P.N., 2002, “On the Trail of “Missing” Indian Females (I).” Economic and Political Weekly, 37(51 and 52), 5108-118.
5. Dyson, T. and Moore,M. 1983, “On Kinship Structure, Female Autonomy, and Demographic Behavior in India”. Population and Development Review Vol. 9, No. 1 pp. 35-60.
6. Das Gupta, M., 1987, ‘Selective Discrimination Against Female Children in Punjab, India’, Population and Development Review, Vol. 13, No.1, pp.77-100.
7. Das Gupta, Monica and Bhat, P.N. Mari 1997, “Fertility decline and increased manifestation of sex bias in India.” Population studies, 51(3). 307-315.
8. Guilmoto, C.Z. and S.Irudaya Rajan 2002, “District level Estimates of fertility from India’s 2001 census” Economic and political weekly, feb.2002 (672).
9. Gulliot, Michel. 2002, “The dynamics of population sex ratio in India, 1971-96” Population studies, 56(2002), 51-63, printed in Great Britain.
10. Krishnaji, N.1987. “Poverty and Sex Ratio: Some Data and Speculations.” Economic and Political Weekly, Vol. XXII, No 23, 892- 897.
11. Sanjay Kumar, K M Sathyanarayana 2012, District-Level Estimates of Fertility and Implied Sex Ratio at Birth in India, Economic and Political Weekly august 18, 2012, vol xlviI no 33. ‘Infant and child mortality in India district level estimates” population foundation of India 2012.
12. Sekher, T.V. and Neelambar Hatti., 2006, “Vulnerable Daughters in a Modernizing Society.” Lund papers in Economic History. No.104, Lund, Sweden: Lund University.
13. Sen, Amartya, 1990, ‘More than 100 Million Women are Missing,’ New York Review of Books, 20 December, 61-66
14. Visaria, Praveen M. 1967, “Sex Ratio at Birth in Territories with a relatively complete Registration.” Eugenics Quarterly, Vol. 14, No. 2(pp. 132-142).
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareDownsizing as a Strategic Tool for Corporate Performance and Economic Growth of Nigeria: An Exploratory
Analysis
English3338EZEANYEJI CLEMENT I.English Ugochukwu F. EjefobihiEnglishCorporate downsizing has been the biggest fallout of the troubled times the world is witnessing. Companies have to make meaningful contributions to make inroads into a wide range of business endeavours in the new global competitive world. This is being done through the instrumentality of downsizing which is a proactive strategy defined as a process which results in layoffs and the streaming of functions as well as the redesigning of systems. It refers to a process where a company or a firm simply reduces its workforce in order to cut the operating costs and improve efficiency and thus economic growth. Downsizing has
become a legitimate option for business growth strategies especially after the 1980s. In Nigeria, downsizing is, in fact, the most preferred option of companies to sustain operating costs and comply with the existing scope of the business. Downsizing, if properly conceived and implemented, has a tremendous potential for organizational survival and futurity and boast for economic growth especially for a developing economy like Nigeria. The study adopts a simple literature survey method and concludes that downsizing strategies are highly necessary for organizational competitiveness and efficiency in the new world order. It further
stresses inter alia that downsizing be tailored as both a defensive and offensive strategy in the best interest for any organization in the troubled times that the Nigerian economy is witnessing in the recent past.
EnglishDownsizing, Corporate performance, Strategy, Organization and economic growthINTRODUCTION
Downsizing refers to the permanent reduction of a company’s workforce and is generally associated with corporate reorganization, or creating a “leaner, meaner” company. Downsizing is undertaken in an effort to trim expenses and anticipated revenue shortfalls. Downsizing such as these are also commonly called reorganizing, reengineering, restructuring, or rightsizing. Regardless of the label applied, however, downsizing essentially refers to layoffs that may or may not be accompanied by systematic restructuring programs, such as staff reductions, departmental consolidations, plant or office closing, or other forms of reducing payroll expenses. Corporate downsizing results from both poor economic conditions and company decisions to eliminate jobs in order to cut costs and maintain or achieve specific levels of profitability. Companies may lay off a certain percentage of their employees in response to certain endogenous or exogenous changes in the economy, such as a slowed economy, merging with or acquiring other companies, the cutting of product or service lines, competitors grabbing a higher proportion of market share, distribution forcing price concessions from supplies, or a multitude of other events that have a negative impact on specific organizations or entire industries. In addition, downsizing may stem from restructuring efforts to minimise efficiency, to cut corporate bureaucracy and hierarchy and thereby reduce costs, to focus on core business functions, and to use part-time and temporary workers to complete tasks previously performed by full-time workers in order to trim payroll costs. Downsizing generally accompanies some kind of restructuring and reorganizing, either as part of the downsizing plan or as a consequence of downsizing. Since companies frequently lose a large number of employees when downsizing, they usually must reallocate tasks and responsibilities in an effort to increase the amount of work output relative to the amount of work input. Conse quently, downsizing often accompanies corporate calls for concentration on “core capabilities” or “core businesses”, which refers to the interest in focusing on the primary revenue-generating aspects of a business. The jobs and responsibilities that are not considered part of the primary revenue-generating functions are the ones that are frequently downsized. These jobs might then be outsourced or handled by outside consultants and workers on a contract basis. Another aspect of downsizing in business may include the reduction of bureaucracy and the number of corporate layers. Since dense bureaucracy frequently causes delays in communication and decision-making, the reduction of bureaucracy may help bring about a more efficient and responsive corporate structure that can implement new ideas more quickly. Apart from laying off workers, restructuring efforts may involve closing plants, selling non-core operations, acquiring or merging with related companies, and overhauling the internal structure of a company. Therefore, we characterize restructuring as the “fundamental rethinking and radical redesign of business processes to achieve dramatic improvement in critical, contemporary measures of performance such as costs, quality, service, and speed.” In Nigeria, the pervasiveness of restructuring is gaining in popularity. Many Nigerian companies both in the manufacturing and service sectors are looking for ways to streamline their operations and become lean and efficient. Many managers and Chief Executive Officers (CEO’s) have embraced downsizing and restructuring as there are increases in quality and productivity in those organizations that have embraces downsizing. Equally noteworthy is the fact that competitive pressures are forcing many organizations to react to these changes with improved quality services. It is important to stress that corporate downsizing have been the biggest fallout of the troubled times the world is witnessing (Taylor, 1998). Competitive pressures around the world are now prompting organizations to cut costs restructure and reduce their labour force. Akinola (2011) observed too that global economic recession has affected company’s structures and practices while global management has brought companies face-to-face with complex cross cultural issues and competition. To survive this unprecedented period of global economic recession, many Nigerian companies have embarked on corporate downsizing and restructuring to remain relevance in today’s competitive pressures. Accordingly, this study tries to focus on the need for restructuring the Nigerian economy through downsizing. The main trust of this paper is to investigate the downsizing strategies and techniques adopted by Nigerian organizations and the adverse effect of downsizing on economic growth of Nigeria.
REVIEW OF RELATED LITERATURE
Downsizing is one of the modern key concepts of manpower planning. It is generally associated with corporate re-organization to create a more efficient and leaner company. Downsizing is the systematic reduction of a workforce through an internationally instituted set of activities by which organizations aim to improve efficiency and performance (Cameron, 1994a; Cascio, 1993). De Meuse (1994), defined downsizing as “a large permanent, reactive layoffs, a streamlining of functions, a redesign of systems, a redefinition of policies aimed at cutting costs and a proactive strategy.” On their part, Band and Tustin (1995) posited that downsizing is one tactic within a corporate strategy for shifting the organizational structure from what it is now to what it has to be in order to sustain competitive edge and satisfy customer’s needs. They contended that, downsizing should be referred to as “downsizing” particularly when it is not done as a part of a company’s strategy but strictly as a cost saving measure with little thought devoted to long-term implications. The phenomenon of downsizing has lately become a recurrent issue in the public sector (Lloyds and Weissman, 2001). Over the past decades, the public services had been dramatically transformed through downsizing at a great human cost (Frederickson and Perry, 1998). In the opinion of Mhone, (2003), the governments modernization initiatives were processes used to reduce cost through workforce reduction and organizational restructuring. Downsizing is certainly not limited to the advanced countries of Europe and America but is a worldwide phenomenon that began in the 1980s and continued through the 1990s and even through the twenty-first century. During industrial development, recessions increased operational costs and economic changes involve risks such that no organization can unconditionally guarantee security of employment of its workers. Employees are constantly advised of their continued relevance and usefulness in the organizations (Obinatus, 2002). Regrettably, in the last few years, business organizations have learned to strategise how they can be more successful by growing their market share, sales and earnings, but not their organizations or staffing strength. They have reshaped their companies for future success by downsizing their corporate bureaucracies (Tomasko, 2002). According to Appelbaum (1991), the issue of corporate downsizing has assumed a central position in the recent times. Companies are attempting to reposition themselves so as to gain a competitive advantage in an uncertain market place. To do this, corporations are undergoing organizational change. In Nigeria, the environment in which business organizations operate today is changing rapidly. As a result of this, companies have been more or less forced to cut out wasteful and unproductive activities and concentrate resources in the areas of core competence in order to achieve sustainable competitive advantage. The reason advanced for downsizing, according to Bureau of Public Service Reform (2006) is to improve service delivery and promote good governance. (the method is involuntary workforce reduction, early retirement, termination of appointment on the basis of the officers considered as medically unfit, without entry qualifications and officers whose line of duties had been outsourced and redundant etc), and the outcome is several thousands of workers losing their jobs while others remain as survivors. The spate of mass retrenchment that accorded the civil service reforms of 1975 and 1984 in Nigeria, coupled with cases of staff dismissal in different states of the federation that followed minimum wage increment in 1999/2000 can attest to this fact. At the federal government level, organizational restructuring is the first on the list under operation and system, which is the fourth cardinal point of the public service reforms in Nigeria (Adegoroye, 2006). The other three are privatization, liberalization, and restructuring of government spending. The reforms were targeted at improving service delivery and promoting good governance.
STRATEGIES AND TECHNIQUES FOR DOWNSIZING
Downsizing has caught the imagination of the government, trade unions and the private sector the world over. In Nigeria, virtually every sector of the economy has engaged in one form of downsizing or the other. In the face of this downsizing environment and mandate, the need to investigate the best way to downsize organization becomes crucial because the success of organizations that have downsized in the past has not been particularly laudable (Henkoff, 1990). Most organizations didn’t consider their downsizing efforts to have been effective. One explanation is that downsizing has not been managed effectively in many firms, and therefore, the intended cost reduction and efficiencies have not been achieved (Huber and Glick, 1993). According to them firms adopt three common strategies for downsizing which are as follows; 1.Workforce Reduction Strategy: This includes transfers, outplacements, retirement incentives, buyout packages, layoffs and attrition (Cameron, 1994a; Casci, 1993; De Meuse et al, 1994). These constitute the different ways of implementing workforce reduction. 2.Work Redesign Strategy: This approach aims at reducing work instead of workforce reduction. It is a mid-term strategy implemented by phasing out functions, hierarchical levels, departments or divisions, redesigning tasks, combining units and adopting a shorter work week (Cameron, 1994a). 3.Systemic Strategy: This is a long term strategy which relates downsizing with the simplification of all the areas of the firm, including supplies, design processes, marketing, sales support and production methods. The main objective of a systemic strategy is to ensure that continuous and respective workforce reduction will not have to be carried out in future.
TRENDS IN CORPORATE DOWNSIZING
Corporate downsizing trend grew out of the economic conditions of the late 1970s, when direct international competitions began to increase and many companies or organizations have to face still competition from opponents in terms of price and durability of their products. To overcome these problems, many companies implemented a couple of key changes including forming partnerships. In Nigeria, the story is not different. Downsizing began in the 1980s and continued through the 1990s largely unabated. During this time, many of Nigeria’s largest corporations and organizations participated in the exercise including the National Bureau of Statistics, the ministry of solid minerals development, Power Holding Corporation of Nigeria, Nigerian Ports Authority, Federal Character Commission and many others. In the twenty-first century, downsizing continued after a sharp decline in the stock market early in the century which was followed by the century pressure on corporate earnings following the global economic meltdown. In Nigeria, the environment in which business organizations operate today is changing rapidly. As a result of this, companies have been more or less forced to cut out wasteful and unproductive activities and concentrate resources in the areas of core competence in order to achieve sustainable competitive advantages. Akinola (2011) observed too that global economic recession has affected company’s structures and practices while global management has brought companies face-to-face with complex cross cultural issues and competition. To survive this unprecedented period, many Nigerian financial institutions and corporations have embarked on corporate downsizing.
EMPLOYEES’ PERCEPTIONS OF DOWNSIZING
Few empirical investigations had analyzed employees’ perceptions of downsizing, in relation to employees’ commitment to work in the public sector. While all the factors examined by earlier researchers, Anderson-Connelly and Greenbery, (2000); Turnlay and Feldman, (1998), on perception of downsizing are more in the private establishments and aimed at determining the acceptability status of downsizing to the employees, Downsizing as a term in organizational structural/ change has been found to have a great influence on the organizational commitment (Bennett and Durkin, 2000) Worrall, Cooper and Campbell- Jamison (2000), state that one of the most devastating effects of a structural change could occur when the nature of the relationship between the employee and the employer is damaged, other notable effects include reduced job satisfaction and distrust (Bateman and Strasser, 1984), absenteeism (Mowdey,Peter and Steers, 1982), job insecurity (Worral, Cooper and Cambell, 2000), and a decline in motivation (Bennett and Durkin, 2000). All these effects, whether acting independently or collectively, have an enormous influence on organizational commitment (Muchinsky, 2000). Several other studies have confirmed that organizational downsizing adversely influences organizational commitment of survivors. Appelbaum, Delage, Labib and Gault (1997), find that organizational commitment to survivors reduced after downsizing. Noer (1993) concludes that most downsizing effort end up in low productivity due to the way in which the exercise is carried out. The report says that the morale, skills and job satisfaction of the surviving employees are greatly reduced. Productivity also is reduced and when this is done, the economic growth of the nation in general will be adversely affected.
DOWNSIZING AND ECONOMIC GROWTH IN NIGERIA
An evaluation of employee’s commitment to work in the aftermath of downsizing becomes important in view of the fact that when downsizing occurs, employees who are laid off as well as those who remain in their jobs could be adversely affected. When this happens, the pace of economic growth becomes adversely affected. This should be of concerns to organizations, given that those who survived downsizing may have just had their world turned upside down. As a result, they may experience a change in their commitments after downsizing. It appears that employees who survived downsizing constitute majority of workers in many of the establishments after restructuring. The implication is that employees who do stay are not necessarily loyal by choice and they are not sometimes committed employees, but employees who are trapped in their jobs (Kaye, 1998). Organizational health depends on the continued commitment of those individuals remaining with the organization after downsizing has occurred (Kaye, 1998). If this group of workers have their morale dampened, it may well have bad analysis on the organization and on the economic growth of the country in general. In the same way, downsizing in the public service of Nigeria may have dealth, a great blow to the morale of an average civil servant who survived the exercise. It may affect their commitment to work in the long-run thereby impacting economic growth negatively. In view of the peculiar nature of the public service in Nigeria, downsizing exercise is likely to pose a special problem, given that an average Nigerian civil servant has a different conception of job, unlike their counterparts in corporate environment (Adegoroye, 2006). A worker in the public service feels secured, believing that his or her job is tied to retirement and is ‘pensionable’. But with the recent government public service reforms, this may not be guaranteed. The problem of over manning is widely prevalent in Nigerian industries- ranging from Power Holding Corporation of Nigeria (PHCN) to water boards etc, so companies in these industries are ripe for manpower reductions. As a result, many government establishments have disengaged substantial number of workers from services; while many are still in the process of doing the same. Thus, negative trend in employees’ commitment may ensure the aftermath of downsizing exercise. Moreso, Nigerian public institutions need employees who will be committed to work on their volition. That is, employees who ‘want to’ work and not those who ‘have to’ work in the wake of downsizing exercise.
FACTORS MILITATING AGAINST DOWNSIZING
Several factors have been accounted for the non-realization of the expected benefits of downsizing such as:
1. Poor execution and management of downsizing projects (Cameron 1994a; and Freeman, 1994).
2. Inability of firms to look beyond the traditional 3-C’s approach to organization design and management that is, principles of command, control and compartmentalization (Cascio, 1993).
3. The extent of resentment and resistance to changes within the firm resulting in the loss of productivity, efficiency and competitiveness (Cameron, 1994a)
. 4. Inability of firms to determine the reasons for undergoing change as well as their failure to determine their organization contact (Appelbaum, Simpson and Shepiro, 1997).
5. Inadequate preparation for the types of problems that arise due to downsizing, (employee resentment and concern, loss of morale, lack of innovation and creation) (Casio,1993; Freeman, 1994), and
6. Downsizing is driven by social instead of finding motivation in predicated financial benefits (Mckinley et al 1995).
CONCLUSIONS
Manpower reductions, if well planned, can help a company put itself on the path of recovery. But, in practice, it has been misused betraying a lack of vision, a short-term focus and wrongheaded thinking about costs, capabilities and people. In Nigeria, downsizing has primarily taken the form of reduction of workforce through the Voluntary Retirement Scheme (VRS). The indiscriminate use of VRS in the public sector in Nigeria has not only led to organizations losing their best employees but has pushed profitable companies into red on account of massive cash outflows. Whenever VR Schemes were operated, it inevitably was workers skilled enough to get other jobs that will be willing to leave the company. Such companies ended up losing their best and brightest people and were left with precisely the workers they wanted out (Aand Ram, 1995). This inevitably will affect the pace of economic growth adversely. Moreover, as the goal of revamping the economy is unfolding in Nigeria, the government downsizing policy and the likely psychological trauma that may accompany the exercise may have begun to take its hold on the people. the retrenched workers as well as those who were left behind; may have started to witness carrier destruction as a result of changes in work environment and job design created by downsizing exercise. While the laid off workers may quickly accept their fate and, to a greater extent, pose no problem to their immediate past organizations, the changes in work environment created by the exercise may affect the retained workers’ commitment to work negatively, and as such, its overall effect on Nigeria’s economic growth cannot be underestimated. Further, downsizing has created resentment and resistance in firms, so it has hindered more than helped economic growth.
Englishhttp://ijcrr.com/abstract.php?article_id=527http://ijcrr.com/article_html.php?did=5271. Aand Ram, V. (1995). Evolving Performing Organisation Through People: A Global Agenda. New Age International Publishers, New Delhi 2. Adegoroye, G. (2006). ‘Public Service Reform for Sustainable Development; The Nigeria Experience’. Keynote address at the Commonwealth Advanced Seminar, Wellington, New Zealand, 20th Feb-3rd march, 2006. 3. Akinola, E.O. (2011). An Appraisal of the Practice of Corporate Downsizing in Nigeria Banks: a study of Intercontinental Bank Plc. A research project at the Department of Business Management, Benue state university. 4. Anderson, C.R; and Greenberg, E.S. (2000). Surviving Layoffs; the Effect on Organizational / Commitment and Job Performance, Journal of Work and Occupation, 27 (1) 7-31. 5. Appelbaum, S.H; (1991). “How to slim successfully and ethically. Two case studies of downsizing” Leadership and Organization Development Journal 12(2):11- 16. 6. Appelbaum, S.H, Delage, C, Labib, N and, Andgault, G. (1997); ‘The Survivors Syndrome aftermath of Downsizing Career Development International, 2: 278-286. 7. Bateman, T.S., and Strasser, S. (1984); ‘Longitudinal analysis of the antecedents of Organizational Commitment’. Academy of Management Journal, 27 (1), 95-112.doi: 10.2307/255959 http://dx.doi.org/10.2307/255959. 8. Bennett, H. and Durkin, M. (2000). ‘The Effects of Organizational Change on Employee Psychological Attachment: An Exploratory study’. Journal of Managerial Psychology, 15(2), 126-147. 9. Bank, D.C and Justin (1995). “Strategic Downsizing” Management Decision” 33(8):36-45 10. Cameron, Kim S. (1994a), “Investigating Organizational Downsizing” Human Resource Management Executive, 7, (1), 95-104. 11. Cascio, W. (1993), “Downsizing: What Do We Know? What Have We Learned”. Academy of Management Executive. 7,(1), 95-104. 12. De Meuse, K.P; Vanderheiden P.A; and Bergmann J.J. (1994). “Announced Layoffs 13. Their Effects on Corporate Performance,” Human Resource Management, 331(4): 509-530. 14. Freeman, S.J. (1994). “Organizational Downsizing as Convergence or Reorientation: Implications for Human Resource Management”. Human Resource Management, 33(2): 213-238. 15. Henkoff, R. (1990). Costing Cutting: How to do it right. Fortune, 9 April, 17-19. 16. Huber, G.P. and Glick,W. (1993). Sources and Forms of Organizational Change in
17. Huber.G.P; and Glick, W (Eds), Organizational Change and Redesign, Oxford Press, New York: pp.3-15.
18. Kaye, B.L. (1998). ‘The kept on workforce’ Training and Development, 52, 32-36.
19. Lloyds, v. and Weissman, W. (2001). “Against the Workers; How IMF and World Bank Policies Undermine Labour Power and Rights”. The Multinational Monitor, 22:9, September.
20. Mckinley, William, Mark A. Mone, and Vincent L. Barker, III (1995). “The Protestant ethic, the Post-modern Ethic, and the Ideological Spirit of Downsizing”, Paper Presented at the Annual Academy of Management Meetings, Vancouver, B.C.
21. Mhone, G.C.Z. (2003). “The Challenges of Governance, Public Sector Reform and Public Administration in Africa: Some Research Issues” DPMN Bulletin: Volume X, Number 3, May.
22. Mowday, R.T; Porter; L.W., and Steers, R.M. (1982). ‘Employee-Organisation Linkages: The Psychology of Commitment, Absenteeeism and Turnovers’ Academic Press, New York. NY.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareUnderstanding the burden of caring people for patients with a stroke in the subacute and chronic phase in
Nepal
English3943Inosha BimaliEnglishPurpose: To determine the prevalence of caregiving burden among stroke caregivers in the subacute and chronic phase of stroke in Nepal. Methods: Fifty caregivers of subacute and chronic stroke were included in the study. Participants were asked to complete a caregiver strain index form. Results: Stata /MP 13.0 data analysis and statistical software was used to analyze the data. One sample t-test, two sample ttest and Pearson correlation test were used for the analysis. Level of significance EnglishSubacute stroke, Chronic stroke, Caregivers, Caregiver strain indexINTRODUCTION
Stroke is one of the most disabling disorder with the majority of survivors having persistent functional deficits and requiring assistance from professional and informal caregivers.1 The primary caregivers may experience high levels of burden, emotional distress and adverse effects on family relationships.1 Caring for stroke survivors has been burdensome for their informal caregivers.1 A Caregiver is defined as “a person who lives with the patient and is most closely involved in taking care of him/her at home”.2 Caregiving can also be defined as “an unpaid person who helps with the physical care or coping with the disease”.3 The Caregiver is vulnerable to stress and strain as a result of nursing/attending to a patient over a prolonged period of time. Caregiver burden described by Zarit et al “the state resulting from necessary caring tasks or restrictions that cause discomfort for the Caregivers”.4 Caregivers can experience the burden in terms of sleep disturbance, physical strain, financial strain, emotional and behavior instability, etc. In a study of ischemic stroke survivors aged 65 and older, approximately 50% had hemiparesis, 30% needed assistance with walking, 20% were dependent in their ADLs, one-third had depressive symptoms and 26% were placed in nursing homes.5 The degree to which the caregiver’s work is perceived as a burden may differ among societies and cultures. It also depends on various characteristics of the patient as well as the caregiver.2,3 Although there is extensive literature evaluating caregiver burden and benefit in stroke patients in developed countries, there have been few studies conducted in developing countries and none in Nepal. All the studies showed a high level of caregiver strain. A similar situa tion is expected in Nepal because of limited professional and social support. As we cannot rely on assumptions, a study to document caregiver burden in Nepal is needed to estimate the size of the burden and compare it to developed nations and also it could be useful to design prevention strategies in reducing the level of Strain among stroke caregivers in Nepal.
Materials and Methods
The subjects were randomly selected from different hospitals in Kathmandu and Dhulikhel, Nepal from 2013- 2014. Subjects were also included through outpatient’s clinic home visits. Among the 65 participated for screening, 50 fulfilled the inclusion criteria and were included in the study. A written informed consent was obtained from the participants after explaining the study procedure. Ethical approval was obtained from institutional review committee of Kathmandu university school of medical sciences (KUSMS) with the approval number 55/12. The subjects were recruited in the study based on following inclusion and exclusion criteria:
Flow diagram: Subject’s selection and Study methodology
Twenty-five carers who care for patients with a stroke in subacute stage (~6-12 weeks of caregiving) and twenty-five carers who care for patient with a stroke in the chronic stage (~24 weeks of caregiving) were included in the study. The following measures were then obtained: Demographic data like age and gender of the patient and caregivers, relation (patient-caregiver), duration of caregiving. A Self-administered Caregivers Strain Index was then given to the caregivers .14 Caregivers Strain Index is a brief and easily administered screening instrument for the identification of strain. The 13-item Caregivers Strain Index measures common stressors experienced by caregivers. Items are scored yes (1) or no (0) and are summed, with higher scores indicating greater strain. A Caregivers Strain Index score ≥ 7 was considered an indicator of considerable strain.
Data analysis
Stata/MP 13.0 data analysis and statistical software was used to analyze the data. The level of significance Englishhttp://ijcrr.com/abstract.php?article_id=528http://ijcrr.com/article_html.php?did=5281. Reimer WJM, Haan RJ, Rijnders, Limburg M, Bos GAM. The Burden of Caregiving in Partners of Long-Term Stroke Survivors. Stroke 1998; 29:1605-11.
2. Bhattacharjee M, Vairale J, Gawali K, Dalal PM. Factors affecting burden on caregivers of stroke survivors: Population-based study in Mumbai (India). Ann Indian AcadNeurol 2012;15:113-9.
3. Hileman JW, Lackey NR, Hassanein RS. Identifying the needs of home caregivers of patients with cancer. OncolNurs Forum 1992;19:771-7.
4. Zarit SH, Reever KE, Bach -Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist 1980;20:649-55.
5. Kelly-Hayes M, Beiser A, Kase CS, Scaramucci A, D’Agostino RB, Wolf PA. The influence of gender and age on disability following ischemic stroke: the Framingham study. J Stroke Cerebrovasc Dis. 2003;12:119-26.
6. Wilkinson PR, Wolfe CD, Warburton FG, Rudd AG, Howard RS, Ross-Russell RW, Beech R. Longer term quality of life and outcome in stroke patients: is the Barthel index alone an adequate measure of outcome? Qual Health Care. 1997;6:125-30.
7. Dennis M, O’Rourke S, Lewis S, Sharpe M, Warlow C. A quantitative study of the emotional outcome of people caring for stroke survivors. Stroke 1998;29:1867-72.
8. Thommessen B, Wyller TB, Bautz-Holter E, Laake K. Acute phase predictors of subsequent psychosocial burden incarers of elderly stroke patients. Cerebrovasc Dis. 2001;11:201-6.
9. Blake H, Lincoln NB, Clarke DD. Caregiver strain in spouses of stroke patients. ClinRehabil 2003;17:312-17.
10. Bugge CRN, Alexander H, Hagen S. Stroke patients’ informal caregivers: patient, caregiver, and service factors that affect caregiver strain. Stroke 1999;30:1517-23.
11. Wilkinson PR, Charles DA, Wolfe, Fiona G. Warburton, Anthony G, et al. A long-term follow-up of stroke patients. Stroke 1997;28:507-12.
12. Visser-Meily A, Post M, van de Port I. Psychosocial functioning of spouses in the chronic phase after stroke:Improvement or deterioration between 1 and 3 years after stroke? Patient Education and Counseling 2008;73:153-8.
13. Das S, Hazra A, Ray BK, Ghosal M, Banerjee TK, Roy T, et al. Burden among stroke caregivers-results of a community based study from Kolkata, India. Stroke 2010;41:2965-8.
14. Robinson BC. Validation of a Caregiver Strain Index. J Gerontol 1983;38:344-8.
15. Dozois, David JA, Dobson, Keith S, Jamie L. A psychometric evaluation of the Beck Depression Inventory–II. Psychological Assessment 1998;10:83-9.
16. Wade DT, and Collin C. The Barthel ADL Index: A standard measure of physical disability? Disability and Rehabilitation. 1988;10:64-7. 17. Rigby H, Gubitz G, Phillips S. A systematic review of caregiver burden following stroke.Int J Stroke. 2009;4:285- 92.
18. Poulshock SW, Deimling GT. Families caring for elders in residence: issues in the measurement of burden. J Gerontol. 1984;39:230–239.
19. Seltzer MM, Wailing Li L. The transitions of caregiving: subjective and objective definitions. Gerontologist. 1996;36:614–626.
20. Scholte WJ M et.al. The Burden of Caregiving in Partners of Long-Term Stroke Survivors. Stroke.1998; 29: 1605-11.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareSTUDY OF HYPERTENSION IN YOUTH AND ITS CONTRIBUTORY FACTORS - A CROSS
SECTIONAL STUDY OF 600 SUBJECTS
English4449Amrit M. NastaEnglish S. R. RaghuwanshiEnglish Jayati J. ChuriwalaEnglish=0Hypertension, a critical determinant of vascular disease and component of metabolic syndrome, remains scarcely studied in youth. Objectives:
1. To study the prevalence of hypertension in the age group 14-26years
2. To study its association with the variables- gender, stress, obesity, dietary habits, exercise, smoking, alcohol consumption, religion and family history of hypertension Methods: In this cross-sectional study, 600 individuals in the age group 14-26 years were enrolled from a metropolitan city. Prevalence of hypertension and its association with contributory variables was studied for 2 months. Hypertension was diagnosed
according to the Indian Academy of Pediatrics and Joint National Committee 7 guidelines. Data regarding contributory factors was collected on a pre-validated questionnaire. Statistical analysis was performed using Mann Whitney U test and Pearson’s Chi square test. Binary logistic regression was performed to eliminate confounding factors. Results: The prevalence of prehypertension and hypertension in the age groups 14-18 years, 19-22 years and 23-16years was 40.5%, 45.5% and 53% respectively. 42.2% hypertensives belonged to the age group 23-26years. Of the prehypertensives and hypertensives, 77% were males; 8.3% obese; 54.7% admitted that they took stress; 66.5% had a family history of hypertension and 23% were alcohol consumers. No significant association was noted with smoking (p=0.071), religion (p=0.102), exercise and dietary pattern (p=0.452). Conclusion: Prevalence of hypertension in age group 14 to 26 years is 10.67% and prehypertension is 35.67% showing an increasing trend with age and a higher prevalence in males, obese and alcohol consumers
EnglishHypertension, Prehypertension, Youth, ObesityINTRODUCTION
Background: Hypertension is an important modifiable risk factor for coronary heart disease, stroke, congestive heart failure, end-stage renal disease, and peripheral vascular disease. Earlier thought to be a disease affecting mainly the elderly, it now has a firm grip on youth in developing countries like India. Rising affluence has modified dietary pattern characterized by increased consumption of fats and salt. Increasing population and technological advancement have shrunken employment opportunities among youth leading to stress and hypertension in the younger generation, including students. Alcoholism and smoking have become a trend among the youth. Sports and physical activity have decreased with the advent of gaming devices and smartphones. Such factors have led to a rise in hypertension in the youth. Thus, it becomes imperative to carry out a study on the prevalence of hypertension in youth and work towards lowering its incidence.
Objectives:
1. To study the prevalence of hypertension in the age group 14-26years
2. To study the association of hypertension with the variables- gender, stress, obesity, dietary habits, exercise, smoking, alcohol consumption, religion and family history of hypertension
MATERIAL AND METHODS
This study is cross sectional in design. 600 individuals belonging to the age group 14 to 26years were recruited from the metropolitan city of Mumbai. 200 students belonged to each of the age groups- 14 to 18years, 19 to 22years and 23 to 26years. They were randomly selected from a secondary school and junior college, a medical college and a tertiary health care institute respectively.
Inclusion Criteria:
1. Individuals consenting to participate in the study
2. Individuals belonging to the age groups under study
Exclusion Criteria:
1. Individuals not consenting for the study
2. Pregnant females
3. Patients diagnosed with secondary hypertension
After obtaining informed consent, a physical examination was performed and findings of blood pressure, anthropometry and general examination recorded. Personal details regarding stress, dietary habits, exercise regime, smoking, alcohol consumption, religion and family history of hypertension and cardiovascular disease were collected from each subject through a pre-validated questionnaire administered by volunteers. The study duration was two months.
Diagnosis of Hypertension:
Blood pressure was measured using a standardized calibrated column type mercury sphygmomanometer with appropriately sized cuff, on the right arm in seated posture with the instrument at the level of the heart. In cases where blood pressure was more than 140/90 mm of Hg, it was measured again after 30 minutes of rest. For children aged 14-17 years, hypertension was classified on the basis of guidelines of the Indian Pediatric Nephrology Group, Indian Academy of Pediatrics. Prehypertension was defined as systolic or diastolic blood pressure between the 90th and 95th percentile for age, gender and height. When blood pressure exceeded120/80 mm Hg in adolescents, but was below the 95th percentile, they were included in this category. Systolic or diastolic blood pressure exceeding the 95th percentile for age, gender and height was diagnostic of hypertension.1 In adults, hypertension was diagnosed as per the guidelines laid by the Joint National Committee 7 (Table 1). Individuals on medication for hypertension were also classified as hypertensives irrespective of blood pressure.
Psychological Stress:
The participants were asked if they took too much stress or tension. If the answer was ‘YES’, they were grouped as stressed.
Obesity:
Weight was measured on a standard bathroom weighing scale with clothes and without shoes.Height was measured on a standard wall-mounted chart with subject standing straight and head held in Frankfurt’s plane. Error due to subject’s hair was eliminated with the help of a flat board. Children aged 14-17 years were classified into underweight, normal, overweight and obese on the basis of charts published in the study titled ‘Physical Growth Assessment in Adolescence’ by KN Agrawal, A. Saxena, AK Bansal and DK Agrawal in June, 2001.3 Adults were classified similarly on the basis of the WHO guidelines based on their Body Mass Index (B.M.I.).
Physical Activity:
Individuals were classified into three categories depending on the duration of physical exercise
i) Those who did not perform any exercise
ii) Light exercise- individuals who performed any form of physical exercise for upto 2 hours per week
iii) Heavy exercise- individuals performing more than 2 hours per week of any form of physical exercise.
Smoking: Any amount of smoking habit was considered positive in our study.
Alcohol consumption: Males consuming more than or equal to 80g alcohol per day and females consuming more than 40g alcohol per day were considered to have a positive history of alcohol consumption based on a study by U Keil et al.4
Family History: Family history of hypertension was noted as positive if any first degree relative of the participant was a known hypertensive. Other aspects of general examination were done by routine methods.
All measurements were taken late in the afternoon or in the evening between 3 p.m. and 7 p.m.
Statistical Analysis:
1. Quantitative data:
a) Kolmogorov Smirnov test was used to check normality of data. A ‘p’ value of less than 0.05 suggests that the underlying data distribution is not normal.
b) As the underlying data distribution is non normal, Mann Whitney U test was applied to test the relationship of group and age.
2. Qualitative data:
Pearson’s chi-square test is used to test the relationship of categorised independent and dependent variable. To examine the relationship of each independent variable with the dependent variable, Binary Logistic Regression was performed. This procedure examines the above relationship after accounting for interaction and confounding. A ‘p’ value of < 0.05 is deemed statistically significant.
RESULTS
The study sample consisted of 200 individuals in each of the age groups 14-18years, 19-22years and 23-26years. 64.7% of the sample comprised of males and the rest were non-pregnant females. The prevalence of prehypertension and hypertension in the age groups 14-18, 19-22 and 23-26years was 40.5%, 45.5% and 53% respectively. 35.67% of the sample was found to be prehypertensive and 10.67% hypertensive (Table 2). Age, gender, BMI, stress, family history of hypertension and alcohol consumption were found to be statistically significant independent risk factors of hypertension in youth. The prevalence of hypertension and prehypertension shows an increase with age- in the age group 14 to 18 years it is 29.1%, in the group of individuals 19 to 22 years old it is 32.7% and amongst the age group 23 to 26 years it is 38.1% of the total hypertension and prehypertension group. 77% of the individuals in the prehypertensive and hypertensive age group are males. Among the group with deranged blood pressure, 8.9% are obese and 25.2% are overweight, and 54.7% admitted leading a stressful life. Family history is found to be significantly associated with hypertension with 66.5% having a positive history. Alcohol consumption was noted in 23% prehypertensive and hypertensive individuals. Smoking, found to be a significant risk factor on univariate analysis, was proved to be insignificant on performing binary logistic regression (p=0.071). Exercise (p=0.221), dietary habits (p=0.452) and religion (p=0.102) were statistically insignificant associations (Table 3).
DISCUSSION
The prevalence of hypertension in youth was found to be 10.67%. An increasing trend is evident with age rising from 8.5% in 14-18 year old individuals to 11.8% in 19- 26year olds. Another study carried out by Soudarssanane MB et al showed an increasing prevalence of hypertension with age in an urban Indian setting.5 A study conducted in the urban setting by Kath A. Moser et al on 10,671 subjects showed a prevalence of 13% amongst 18-30year old participants. This study also supports our result of an increasing prevalence with age.6 A prevalence of 10.1% was reported by PA Dyson et al (2014) in the age group 12-18years in India.7 R. Gupta et al (2009) reported a lower prevalence of hypertension among young Asian Indians of 1.4% in the age group 15- 19 years and 3.1% in the age group 20-29 years.8 Similarly D. Narayanappa et al conducted a prevalence study in 2012 on a group of school children 10-16 years old and reported a prevalence of prehypertension and hypertension as 2.9% and 2.8% respectively demonstrating and increasing trend with time.9 In our study, the prevalence of prehypertensives and hypertensives was comparatively higher in the male sex. 77% of the prehypertensive and hypertensive population were males. Gender was a significant risk factor for hypertension (Odds ratio 0.352). Similarly, the Framingham Offspring Study by Garrison RJ et al. also showed that men below 40 years of age were twice as likely to be hypertensive as women. A hormonal role is believed to be responsible for this difference. Body Mass Index was found to be a very significant risk factor for hypertension. In our study, from the total hypertensives and prehypertensives, 3.6% were underweight, 62.9% were normal, 25.2% were overweight and 8.3% were obese.PA Dyson et al reported a 3.5-5.5 times likelihood of obese children developing hypertension and 1.7-2.3 times probability for overweight children.7 A threefold increase in the risk of hypertension in obese children as compared to the non-obese has been reported by M. Salvadori et al.10Stress was found to be a very highly significant risk factor in our study (p< 0.0001, Odds ratio 1.867). 54.7% subjects admitted to taking too much stress. According to a study by Karen Matthews et al., 13 years of follow-up in a sample of >4100 normotensive black and white men and women showed a very high co-relation of stress and hypertension (pEnglishhttp://ijcrr.com/abstract.php?article_id=529http://ijcrr.com/article_html.php?did=5291. National High Blood Pressure Education Programme Work- National High Blood Pressure Education Programme Working Group. The Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114:555-76
2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560– 2572
3. KN Agarwal, Saxena A, Bansal AK, S Agarwal DK. Physical Growth assessment in adolescence. Indian Pediatr 2001, 38: 1217-1235.
4. Keil U, Chambless L, Filipiak B, Härtel U. Alcohol and blood pressure and its interaction with smoking and other behavioural variables: results from the MONICA Augsburg Survey 1984-1985. J Hypertens. 1991 Jun;9(6):491-8.
5. Soudarssanane M, Mathanraj S, Sumanth M, Sahai A, Karthigeyan M. Tracking of Blood Pressure Among Adolescents and Young Adults in an Urban Slum of Puducherry. Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive and Social Medicine 2008;33(2):107-112. doi:10.4103/0970-0218.40879.
6. Moser KA, Agrawal S, Davey Smith G, Ebrahim S. SocioDemographic Inequalities in the Prevalence, Diagnosis and Management of Hypertension in India: Analysis of Nationally-Representative Survey Data. Guo Y, ed. PLoS ONE 2014;9(1):e86043. doi:10.1371/journal.pone.0086043.
7. Dyson PA, Anthony D, Fenton B, Matthews DR, Stevens DE. High rates of child hypertension associated with obesity: a community survey in China, India and Mexico. PaediatrInt Child Health.2014 Feb;34(1):43-9. doi: 10.1179/2046905513Y.0000000079
8. Gupta R, Misra A, Vikram NK, et al. Younger age of es- Gupta R, Misra A, Vikram NK, et al. Younger age of escalation of cardiovascular risk factors in Asian Indian subjects. BMC Cardiovascular Disorders 2009;9:28. doi:10.1186/1471-2261-9-28.
9. Narayanappa D, Rajani HS, Mahendrappa KB, Raviku- Narayanappa D, Rajani HS, Mahendrappa KB, Ravikumar VG. Prevalence of prehypertension and hypertension among urban and rural school going children. Indian Pediatr. 2012 Sep;49(9):755-6
10. Salvadori M, Sontrop JM, Garg AX, Truong J, Suri RS, Mahmud FH, et al. Elevated blood pressure in relation to overweight and obesity among children in a rural Canadian community. Pediatrics. 2008;122:e821–7.
11. Matthews KA, Katholi CR, McCreath H, Whooley MA, Wil- Matthews KA, Katholi CR, McCreath H, Whooley MA, Williams DR, Zhu S and Markovitz JH. Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA study. Circulation 2004 11074–78. doi:10.1161/01. CIR.0000133415.37578.E4.
12. Lijing L. Yan, Kiang Liu, Karen A. Matthews, Martha L. Daviglus, T. Freeman Ferguson, Catarina I. Kiefe. Psychosocial Factors and Risk of Hypertension -The Coronary Artery Risk Development in Young Adults (CARDIA) Study. JAMA 2003;290(16):2138-2148. doi:10.1001/ jama.290.16.2138
.13. Puddey, I. B. and Beilin, L. J., ALCOHOL IS BAD FOR BLOOD PRESSURE. Clinical and Experimental Pharmacology and Physiology, 2006 33: 847–852. doi: 10.1111/ j.1440-1681.2006.04452.
14. Carnethon MR, Evans NS, Church TS, et al. Joint Asso- Carnethon MR, Evans NS, Church TS, et al. Joint Associations of Physical Activity and Aerobic Fitness on the Development of Incident Hypertension: Coronary Artery Risk Development in Young Adults (CARDIA). Hypertension 2010;56(1):49-55. doi:10.1161/HYPERTENSIONAHA.109.147603.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareBONE MARROW STUDY IN PANCYTOPENIA
English5052GOVINDARAJ T.English RATHNA S.English VENKATRAMAN J.EnglishBackground: Pancytopenia is defined by reduction of all the three formed elements of blood below the normal reference. 1It represents wide variety of disorders affecting the marrow components. Materials and Methods: The present Bone marrow study was carried out over a period of eight months from June 2013 to Jan 2014. A total of fifty cases with a hematological diagnosis of pancytopenia on peripheral smear were included for the study. Results: Out of 50 cases, 34 were males and 16 were females. Most of the patients were in the age group of 41-60 years (54%). The commonest cause of pancytopenia was megaloblastic anaemia (44%) followed by mixed nutritional anemia(20%), hypersplenism(12%), aplastic anemia(10%), Acute Leukaemia(6%), myelodysplastic syndrome(2%) and uncommon causes like Dengue fever(4%) and Hemolytic anemia(2%). Conclusion: Pancyopenia is a commotn entity and it reflects the underlying pathology. Bone marrow study is an important tool in the diagnosis of cause of pancytopenia to implement appropriate management and therapy
EnglishBone marrow aspiration, Pancytopenia, Megaloblastic anemiaINTRODUCTION
Pancytopenia is defined by reduction of all the three formed elements of blood below the normal reference.1 It is a manifestation of wide variety of disorders, which primarily or secondarily affect the bone marrow. The presenting symptoms are often attributable to anemia or thrombocytopenia. Leucopenia is an uncommon initial presentation but poses serious threat to life.2 The mechanisms contributing to pancytopenia include, decrease in haematopoietic cell production, marrow replacement by abnormal cells, suppression of marrow growth and differentiation, ineffective hematopoiesis with cell death, defective cell formation, antibody mediated sequestration or destruction of cells in a hypertrophied and overactive reticuloendothelial system.3 Pancytopenia is a serious hematological problem, the underlying cause of which is diagnosed by bone marrow study. Bone marrow examination is extremely helpful in the evaluation of pancytopenia.4 Since the underlying pathology of pancytopenia determines the management and prognosis of the patient, there is a definite need to study about pancytopenia.
MATERIALS AND METHODS
The present study was carried out over a period of eight months from June 2013 to Jan 2014. During this period a total of fifty patients with pancytopenia were studied. A criterion for pancytopenia is : haemoglobin less than 10 gms/dl, total WBC count less than 4000/cumm, platelet count less than 100000/cumm. Bone marrow aspiration was performed using Salah and Jamshidi needle from the posterior iliac crest.
RESULTS
50 cases of pancytopenia were studied. Out of 50 cases, 34 were males and 16 were females. The male to female ratio was 2.1:1. Most of the patients were in the age group of 41-60 years (54%). Majority (50%) of the patients had hemoglobin ranging from 5.1-7 g%. The total leukocytic count was in the range of 500-4000 cells/ cumm. The range of platelet count varied from 4000- 1,50,000 cells/cumm. The reticulocyte count varied from 0.1-20%. Bone marrow aspirate in the present study of pancytopenia showed the following types of cellularity:
Hypocellularity – 10%, Hypercellularity – 76%, Normocellular – 14%. The commonest cause of pancytopenia was megaloblastic anaemia (44%) followed by combined nutritional anemia(20%), hypersplenism(12%), aplastic anemia(10%), Acute Leukaemia(6%), myelodysplastic syndrome(2%) and uncommon causes like Dengue fever(4%) and Hemolytic anemia(2%) were also encountered.
DISCUSSION
In the present study, megaloblastic anemia(44%) was the commonest cause of pancytopenia followed by combined nutritional deficiency anemia and hypersplenism, in sharp contrast to the present study Hossain MA et al3 observed aplastic anemia was the commonest followed by chronic malaria and kalaazar. Osama5 found megaloblastic anemia (39%) as the commonest cause of pancytopenia followed by hypersplenism (19%) in concurrence to the present study. Megaloblastic anemia is common in india.this seems to reflect the higher prevalence of nutritional anemia .In the study of pancytopenia by Jha et al6 , the age range was 10-79 years(31 years)There was a male preponderance and male to female ratio was 1.5:1.In the present study, age ranged from 18-70 years.There was a male preponderance and the male to female ratio was2.4:1. Aplastic anemia is another frequent cause of pancytopenia. In the study by Jha et al6 , age ranged from 1.5-70 years with male to female ratio of 1.3:1in contrast to the present study where the age ranged from 31-60 years with male to female ratio was 1.5:1. Hypersplenism is known cause of pancytopenia.Kumar et al7 study, age ranged from 41-70 years with male to female ratio being 2:1.In the present study age ranged from 41-70 years with male to female ratio being 2:1. Jha et al6 study revealed leukemia associated with pancytopenia accounted for 19.59% of total cases of pancytopenia and age ranged from 2-75 years with male to female ratio of 1.9:1.In the present study leukemia accounted for 6% of pancytopenia cases and age varied from 21-40 years with male to female ratio being 2:1. Pancytopenia is known to occur in MDS. In a study of 31 patients by Kini J et al8 the patients were in the age group of 4-7 years.In the present study, one case presented with pancytopenia in a female patient aged 55 years. Naeem Khan et al.9 studied 30 cases of pancytopenia and found 1 case of dengue fever. In the present study, 2 cases in 18 years (male) and 22 years (female) with dengue fever presented with pancytopenia. Osama et al.5 in their study found two cases of pancytopenia with hemolytic anemia. In the present study, one patient of hemolytic anemia presented with pancytopenia.
CONCLUSION
Pancytopenia is a common entity. However, it has received inadequate attention in the Indian subcontinent. A study of pancytopenia using easily available diagnostic techniques is therefore important. Age and sex distribution of patients with pancytopenia in this study was consistent with the findings in other studies. Megaloblastic anemia was the commonest cause of pancytopenia in the present study. Most other studies have reported aplastic anemia as the commonest cause. This seems to reflect higher prevalence of nutritional anaemia in the Indian subjects. Uncommon etiological factors like dengue fever and hemolytic anemia were identified in this study. A comprehensive clinical and bone marrow study usually helps in identification of the underlying cause. Pancytopenia poses a challenge for the haematologists in searching the accurate diagnosis. Bone marrow examination is extremely helpful in evaluation of pancytopenia.4 The spectrum of disorders primarily or secondarily affecting the bone marrow may manifest with peripheral pancytopenia.10,11,12 Underlying pathology determines the management and prognosis of patients. Hence there is a need to study.
ACKNOWLEDGEMENT
Authors sincerely thank Dr A L Hemalatha, Former Prof and Head, Dept of Pathology, Mysore Medical College, Mysore for her constant support. Authors also acknowledge the immense help received from the scholars who 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=530http://ijcrr.com/article_html.php?did=5301. Williams DM. Pancytopenia, Aplastic anemia and PureRed cell aplasia In: Wintrobe’s Clinical Hematology, 10th ed. Baltimore: William and Willkins; 1993.1449-1484.
2. Firkin F, Chesterman C, Penington D, Rush B. deGruchy’s Clinical haematology in Medical Practice.5th ed. London: Blackwell Scientific Publications; 1989.119-136, 346-358.
3. Hossain MA,Akond AK,Chowdhary MK.PancytopeniaA study of 50 cases. Bangladesh Journal of Pathology 1992;1:9-12.
4. Khodke K, Marwah S, Buxi G, Yadav RB, Chaturvedi NK. Bone Marrow Examination in Cases of Pancytopenia. JIACM 2001; 2:55-59.
5. Osama I, Baqai Hz, Anwar F, Hussain N. Patterns of pancytopenia in a general medical ward and a proposed diagnostic approach. JAMC 2002;16(1):8-13.
6. Jha A, Sayami G, Adhikari RC, Panta AD, Jha R. Bone Marrow Examination in Cases of Pancytopenia. JNMA 2008 Jan-Mar;47(169):12-7.
7. Kumar R, Kalra SP, Kumar H, Anand AC, Madan H. Pancytopenia – A six year Study. JAPI 2001;49:1078-81.
8. Kini J, Khandilkar UN, Dayal JP. A study of the haematologic spectrum of Myelodysplastic syndrome. India J Pathol Microbiol 2001;44 (1):9-12
9. Naeem Khan M, Ayyub M, Nawaz KH, Naeem Naqi, Hussain T, Shujaat H, et al. Pancytopenia: Clinico-pathological study of 30 cases at Military Hospital, Rawalpindi. Pak J Pathol 2001 Apr-Jun;12 (2):37-41. 1
0. Dodhy MA, Bokhari N, Hayat A. Aetiology of Pancytopenia, A five- year experience. Ann Pak Inst Med Sci 2005 AprJun;1 (2): 92-5.
11. Wintrobe MM Clinical Haematology. 8th ed. Philadiphia; Lea and Febiger 1981: 699-915.
12. Verma N, Dash. Repraissal of underlying pathology in adult patients presenting with pancytopenia. Trop Geog Med 1992; 44: 322-7.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareTO DETERMINE ASSOCIATION OF LIPID PROFILE, SERUM URIC ACID AND BODY MASS INDEX AS A MARKER FOR PREECLAMPSIA
English5357Shashikant G. SomaniEnglish Sonali Rathi SomaniEnglish Vrunda ChoudharyEnglish P. Sudhir BabuEnglish A. VijayalaxmiEnglishObjective: To detect association of serum lipid profile, uric acid and body mass index in preeclampsia and to measure their clinical significance. Methods: A prospective case-control study was conducted at Kamineni Institute of Medical Sciences, Narketpally. One hundered patients with pre-eclampsia were compared with age matched 100 normotensive pregnant woman. Body mass index was calculated. Blood pressure was measured. Their serum levels of triglycerides (TG), Cholesterol, low density lipoprotein (LDL), very low density lipoprotein (VLDL), high density lipoprotein (HDL) and serum uric acid were measured. Data was analysed by students t-test and Chi?square test. Results: Blood pressure, body mass index ,TG, VLDL, LDL, cholesterol and serum uric acid level were significantly higher in preeclamptic women (pEnglishBody mass index, High blood pressure, Lipid profile, Pre-eclampsia, Uric acidINTRODUCTION
Pregnancy is a physiological stress in which many changes occur in the milieu interior, to meet demands of the rapidly developing fetus including biochemical changes. These changes are exaggerated in complications of pregnancy like pre-eclampsia(1). Pre-eclampsia is a pregnancy specific disorder and is an important cause of fetal and maternal morbidity and mortality. Nearly 7-10% of pregnancies are complicated worldwide(2). While incidence of pre-eclampsia in India ranges between 11-13%. It is a multi-system disorder of unknown etiology and is mediated by placental products that reaches maternal circulation and trigger endothelial dysfunction, thereby evoking cardiovascular diseases, such as vasospasm, increased endothelial permeability and activation of thrombogenic mechanisms and leading to early events of atherosclerosis(3). Susceptibility to preeclampsia is also modulated by maternal factors like obesity, chronic hypertension, diabetes mellitus and hyperlipidemia which exhibits intense vascular reactivity. However, several theories like placental ischemia, genetics, immune maladaptation and oxidative stress have been proposed(4). Out of which oxidative stress theory is most widely accepted and has been linked with lipid abnormalities and vascular dysfunction. Predominantly atherogenic LDL are increased in association with hyperlipidemia in preeclampsia. Also, excessive cellular activity associated placental ischemia leads to overproduction of uric acid which serves as a marker of disease(5).So, simple measurement of serum lipid profile, serum uric acid and body mass index may be of good predictive value in preeclampsia. Therefore present study was conducted to find out any association between lipid profile, serum uric acid and body mass index in preeclampsia.
MATERIAL AND METHOD
Present prospective case-control study was conducted in Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, after taking approval from ethical committee, from June 2014 to March 2015 in 200 pregnant women
. Inclusion Criteria:
? Primigravida between 18- 35 years of age in third trimester
? Singleton live fetus
Exclusion Criteria:
? Refusal for participation in study
? Multiple pregnancies
? Patients with essential hypertension, diabetes mellitus, renal disease, liver disorder, and thyroid disorder
? History of treatment with drug influencing lipid profile
The patients were divided into two groups:
• Control Group - Normotensive pregnant women (n= 100)
• Study Group - Pregnant women with preeclampsia (n= 100)
All patients were explained in detail about aim, objectives of study and written consent was taken. A detailed obstetric history and examination was done. Height was measured, maintaining an accuracy of 0.5cm.Weight was measured, up to nearest 100gm. Prepregnancy body mass index (Quetelet index) was calculated as weight in kilograms/height in square meters. According to WHO, normal BMI ranges from 18.5 to 24.9 kg/m2 . BMI between 25-29.9 kg/m2 is overweight, while a BMI > 30 kg/m2 is considered obese. Blood pressure was measured by sphygmomanometer in right arm in left lateral position after 10 minutes of rest. Preeclampsia was diagnosed as blood pressure >140/90 mmHg on 2 separate occasions 4 hours apart in association with proteinuria ( >0.3gm in 24 hours or at least 1+ on dipstick examination(6). With fasting of 8 hours, under all aseptic precautions 8-10 ml of blood was collected and analysed for lipid profile and serum uric acid. Triglycerides were measured by Glycerol phosphate oxidase/ Peroxidase (GPO/POD) colorimetric endpoint method. Cholesterol and HDL were measured by cholesterol oxidase/ Peroxidase (CHOD/ POD) colorimetric endpoint method. LDL measured directly using semi-auto analyzer by enzymatic method. VLDL was calculated as 1/5th of triglycerides.Pregnant women were diagnosed as having dyslipidaemia according to American Association of Clinical Endocrinologists Guidelines(7). Uric acid was measured by uricase – POD enzymatic method . Abnormal serum uric acid was defined as values >5mg/dl.
Statistical Analysis:
The data collected was tabulated in microsoft excel sheet. They were analysed and compared using unpaired students t-test and Chi square test. ‘p’ value less than 0.05 was considered significant.
RESULTS
Mean body mass index in preeclamptic women was 29.4 ±2.8 Kg/m2 which was significantly higher then control group (p Englishhttp://ijcrr.com/abstract.php?article_id=531http://ijcrr.com/article_html.php?did=5311. Elisabeth B M, Lars J V, Tom LN et al. Pre pregnancy cardiovascular risk factors as predictors of pre-eclampsia: population based cohort study. British Medical Journal 2007;335: 978-981.
2. Anderson CM and Ren J. Leptin, leptine resistance and endothelial dysfunction in preeclampsia. Cell Mol Biol 2002;48:323-329.
3. Airoldi J, Weinstein L. Clinical significance of proteinuria in pregnancy. Obstet Gynecol Surv. 2007;62(2):117-124.
4. Gohil JT, Patel PK, Gupta P. Estimation of lipid profile in subjects of preeclampsia. J Obstet Gynaecol India 2011;61:399-403.
5. Enaruna NO, Idemudia JO, Aikoriogie PI. Serum lipid profile and uric acid levels in preeclampsia in University of Benin Teaching Hospital. Niger Med J 2014;55:423-427.
6. F.Gary Cummingham, Norman FG, Kenneth et al. Hypertensive disorders in pregnancy, Williams Obstetrics, 22 Edition, Me. Graw Hill 2005:761-764.
7. Atherosclerosis, American Association of Clinical Endocrinologists Task Force for Management of Dyslipidemia and Prevention of American Association of Clinical Endocrinologists. Guidelines for Management of Dyslipidemia and Prevention of Atherosclerosis. Endocrine Practise. 2012;18(Suppl.1).
8. Sharami SH, Tangestani A, Faraji R, Zahiri Z, Azam A. Role of dyslipidemia in pre-eclamptic overweight pregnant women. Iran J Reprod Med 2012;10:105-112.
9. Ephraim R, Doe PA, Amoah S, Antoh EO. Lipid profile and high maternal body mass index is associated with preeclampsia: A case-control study of the Cape Coast Metropolis. Ann Med Health Sci Res 2014;4:746-750.
10. NAF Islam, MAR Chowdhury, GM Kibria, S Akhter Faridpur. Study of serum lipid profile in pre-eclampsia and eclampsia. Med. Coll. J. 2010;5(2):56-59 .
11. Pradnya Phalak, Mona Tilak. Study of lipid profile in preeclampsia. Indian Journal of Basic and Applied Medical Research. 2012; 5, (2) : 405-409.
12. Ray JG, Vermeulen MJ, Schull MJ, Redelmeier DA. Cardiovascular health after maternal placental syndromes (CHAMPS): Population-based retrospective cohort study. Lancet 2005;366:1797-1803.
13. Swapan Das, Debasish Char, Sanjay Sarkar, Prakash Das,Tushar Kanti Saha, Sucheta Biswas. Comparison of lipid profiles in normal pregnancy and in pre-Eclampsia: A case control study. IOSR Journal of Dental and Medical Sciences. 2013; 11(4): 53-55.
14. Karl W, Birgit W, Michael M. H et al. Triglyceride rich lipoproteins are associated with hypertension in preeclampsia. The Journal of Clinical Endocrinology and Metabolism 2003;88(3):1162-1166.
15. Kashinakunti S. V. , Sunitha H , Gurupadappa K, Manjula R. Lipid Profile In Preeclampsia – A Case Control Study. Journal of Clinical and Diagnostic Research 2010 ; 4: 2748- 2751.
16. Cekmen MB. Erhagci AB, Balat A, Duman C, Maral H, Ergen K, et al. Plasma lipid and lipoprotein concentrations in pregnancy induced hypertension. Clin. Biochem. 2003; 36(7):575-578.
17. Pirzado ZA, Sangi SA, Malik R. High density lipoprotein cholesterol metabolism and its role in ischemic heart disease. Pak J Med Res 1999; 38: 38–41.
18. Hawkins TL, Roberts JM, Mangos GJ, Davis GK, Roberts LM, Brown MA. Plasma uric acid remains a marker of poor outcome in hypertensive pregnancy: A retrospective cohort study. BJOG 2012;119:484-492.
19. Wu Y, Xiong X, Fraser WD, Luo ZC. Association of uric acid with progression to preeclampsia and development of adverse conditions in gestational hypertensive pregnancies. Am J Hypertens 2012;25:711-717.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareCHARACTERIZATION AND OPTIMAL DESIGNS OF ADENINE LIGHT-EMITTING DIODES
English5864Han Seong LeeEnglish Sang Mok JungEnglish Seul Gi KangEnglish Han Joo LeeEnglish Ji Su SonEnglish Jae Hyuk JeonEnglish Hyun Woung ShinEnglishWe discuss the design of bilayer organic light emitting diodes (OLEDs) formed using adenine sandwiched between indium tin oxide (ITO) and Al, which were fabricated into four types of device structure. The electroluminescence intensities were characterized as a function of the current and voltage. The efficiency was significantly greater in bilayer devices in which adenine were used. The performance of green light emission with adenine-based devices was significantly greater than that reported to date (we find a luminance of -4227cd/m2 at a voltage of -8 V). The multi-layer OLED devices were formed of ITO, N,N’-bis(naphthalen- 1-yl)-N,N?-bis(phenyl)benzidine (NPB), adenine, Tris(8-hydroxyquinolinato)aluminium (Alq3) and aluminium (Al). We find that the thickness of the adenine light-emitting layer determined the brightness and efficiency, as well as the operating voltage. The thickness of the adenine layer was optimized to improve the efficiency of the OLEDs.
EnglishBioLED, Adenine, LuminanceINTRODUCTION
Digital displays using organic light emitting diodes (OLEDs) are widely used in commercially available mobile phones, computer monitors, personal digital assistants (PDAs) and television displays (Kamtekar et al., 2010). OLEDs are hetero-junction devices that are composed of electron and hole transport layers, as well as an emissive layer (Mathew et al., 2001). Electrons from the cathode and holes from the anode are transported to the emissive layer, and form an excited state, which then relaxes to ground state, giving rise to electroluminescence (EL). Organic materials are usually chosen for the emissive layer that have a large energy gap, and where a low charge density exists, which leads to excitation and emission by injecting electrons and holes (Howard, 2004). In 1987, Tang and Vanslyke first reported high-performance double-layer EL devices, in which electrons and holes recombined within an organic emitting layer. With this simple OLED structure, however, disorder limited the transport of charge carriers into the emitting zone (Bernius et al., 2000). For this reason, multilayered OLEDs devices have been developed, in which a well-ordered transparent conducting oxide anode, or hole transport layer (HTL), as well as an emissive layer(EML)an electron transport layer (ETL) and a metal cathode were used, each with specific functionality (Yersin, 2004). The improved efficiency offered by these multilayer structures has enabled the current technology, which has been implemented using two types of organic material: small molecules and polymers. Tang et al. (1987) first introduced small-molecule OLEDs, including coordination complexes such as tris(8-hydroxyquinolinato)aluminum (Alq3), which is a common compound of quinoline rings with luminescence properties (Montes et al., 2006). Such compounds, including perylene, rubrene and quinacridone derivatives, exhibit emission at wavelengths in the range 400–600nm (Sato et al., 1998). Triphenylamine derivatives have been used as HTLs (Bellmannet al., 1998), and Alq3 has been used not only as the emitting layer, but also as the ETL (Cheng et al., 2000). The first invention of a polymer OLED used poly(p-phenylene vinylene), which emits light when connected to an external voltage (Burroughes et al., 1990). Poly(p-phenylene vinylene) and polyfluorene derivatives are also widely used, and the substitution of side chains can alter the color of the emitted light (Heeger et al., 1993). Those polymers are more stable and soluble than small molecules, and are easier to process (Kiebooms et al., 2001). Typically, polymer OLEDs formed by spin-coating and inkjet printing have better workability, lower costs and are more suitable for large-area displays than small molecules, which typically require vapor deposition. Small molecules generally have longer lifetimes and better color purity; however, despite the improved color purity, many of colors cannot be achieved using existing small molecules. For this reason, a diverse range of compounds is required for using emission layer as well as electron and hole transport layers. In this work, a new small molecule candidate is investigated for applications in OLED devices: adenine. Four different device structures featuring adenine were fabricated, with the following layer sequences: indium tin oxide (ITO)/adenine/Al, ITO/adenine/Alq3/Al, ITO/N,N’-Bis(naphthalen-1-yl)-N,N′-bis(phenyl) benzidine(NPB)/adenine/Al and ITO/NPB/adenine/ Alq3/Al. The current–voltage characteristics, luminance– voltage characteristics, and the EL intensities were investigated.
MATERIALS AND METHODS
Adenine was diluted with dimethyl sulfoxide (DMSO) at a concentration of 1,000mg/ml, and1mlof the solution was placed in a cuvette for measurements using an ultraviolet (UV) spectrophotometer at a wavelength of 365nm. The luminescence was monitored using a Minolta spectroradiometer (CS-1000, Japan), as shown in Figure 1. To fabricate the OLED devices, transparent and conductive ITO was spin-coated on glass substrates purchased from Samsung Corning. The ITO layer had a surface resistance of 8.8±1.8Ω and a thickness of 1850±200Å. Photolithography was used to form stripe patterns. First, the ITO layer was coated with a photoresist (PR)developer using spin-coating, and baked at 100°C to remove any residual solvent and to harden the surface of the PR (Kang et al., 2015). Positive and negative PR processes were carried out to form the stripe patterns. The positive PR was removed using UV exposure, and the negative PR was non-UV. The patterned layer was hardened for 10 min at 130°C, and the ITO layer was etched for 3 min at 40°C ?Cin a nitrogen atmosphere. The patterned ITO layer was cleaned using ultra-sonication for 30 min in acetone, and then in MeOH and isopropyl alcohol for 5 min at 60°C. Finally, it was exposed to UV irradiation (184.9nm) for 20min, at a distance of 1°C. Vacuum evaporation was carried out at 5.5 ´ 10-6Torr in a heated chamber, and a quartz crystal microbalance (QCM) was used to measure the thickness of the coating during deposition. The rate of vacuum evaporation was 1–1.5Å/s. Four types of adenine-based multilayer OLED structures were formed: ITO/adenine/Al, ITO/NPB/adenine/Al, ITO/adenine/Alq3/Al and ITO/NPB/adenine/ Alq3/Al, as shown in Figure 2. The OLED devices were controlled using Labview (version 8.0) using a desktop personal computer and general-purpose interface bus (GPIB). The devices were placed in a darkroom and current was applied using a source–measure unit (SMU) (Keithley 236) PR (Kang et al., 2015). The emitted light was collected using a photodiode, and the resulting current was measured using a picoameter (Keithlye 487), to convert the signal into a luminance. The spectrum of the emitted light was measured using a spectroradiometer (Minolta CS-1000) to determine the red–green–blue (RGB) color coordinates.
RESULTS
Photoluminescence (PL) spectra were obtained using UV excitation at 365nmand measured over a broad range of wavelengths from 400 to 800nm, as shown in Figure 3.The optical emission was stronger in the range 380– 560nm, which corresponds to green. The maximum luminance was 1.7cd/m2 with a wavelength of 417nm. Figure 4 shows the current–voltage characteristics of the ITO/adenine/Al device with various thicknesses of the adenine layer in the range 30–100nm. With an adenine thickness of 30 nm, a current of 197mA flowed when the operating voltage was 14V. With an adenine thickness of 40 nm, a current of 97mA flowed when the voltage was 8V. The highest luminance was achieved with a thickness of 80nm, which was 1.6cd/m2 at a voltage of 23V, as shown in Figure 5. The emission spectrum was investigated in the ranges 380–400 and 780–800nm, which corresponds to color coordinates of X: 0.1526 and Y: 0.2364, respectively, as shown in Figure 6. Figure 7 shows the current as a function of voltage with the device structure ITO/adenine/Alq3/Al with thicknesses of the adenine layers in the range 20–80nm and a 40-nm-thick Alq3 layer. For a 20-nm-thick adenine layer, a current of 10mA flowed when the operating voltage was 20V. When the thickness of the adenine layer was 20, 40 or 60nm, less light was emitted than with the ITO/adenine/Al structures. The luminance as a function of voltage is shown in Figure 8 with an adenine layer that was 20-nm-thick optical emission was observed at voltages of 10 V or greater, and the largest emission was 13cd/m2 at 17V. The device emission spectrum was examined at wavelengths around 400nm, as shown in Figure 9. Figure 10 shows the current–voltage characteristics of devices with the ITO/NPB/adenine/Al layer sequence for thicknesses of the adenine layer in the range 40–80nm, and where the NBP film was 40nm thick. When the adenine layer was 40nm thick, a current of 24 mA flowed when a voltage of 15V was applied. For the 60-nm-thick film, the current was 25mA when the voltage was 20V. When the adenine layer was 80nm thick, the current was 21mA when the voltage was 27V. Figure 11 shows luminance as a function of voltage. For the 40-nm-thick adenine film, optical emission was observed at voltages of 10V or greater. A maximum luminance of 1.6cd/m2 was observed at 15.5V. For the 60-nm-thick film, optical emission was observed at voltages greater than 16 V, and the maximum luminance was 2.6cd/m2 at a voltage of 20V. For the 80-nm-thick film, optical emission was observed at voltages of 20V or more, and the maximum luminance was 1.8cd/m2 at 27V. The emission spectrum was examined in the range 450–480 nm, as shown in Figure 12. Figure 13 shows the current as a function of voltage for the ITO/NPB/adenine/Alq3/Al devices with thicknesses of adenine layers in the range 40–60nm. The NPB and Alq3 layers were 40-nm-thick. When the adenine layer was 40nm thick, the current was 23mA when operating voltage was 15V. For the 60-nm-thick film, the current was 12mA when the voltage was 20V. Figure 14 shows the luminance as a function of voltage. With the 40-nmthick adenine film, optical emission was observed at voltages of 8 V or greater, and a maximum luminance of 4,227cd/m2 was observed at 14V. For the 60-nm-thick film, optical emission was observed at voltages of 12V or greater, and the maximum luminance was 2,603cd/m2 at 16V. The emission spectrum was examined at wavelengths around 540nm, as shown in Figure 15; this emission wavelength corresponds to green.
DISCUSSION
Over the past decade, organic light-emitting devices have seen considerable development. The flexibility of these devices, coupled with the thin-film characteristics and transparency has resulted in a considerable global market. OLED technologies have made a significant contribution to the display industry. Academic and industrial research groups have developed this technology to advance the quality and workability of new materials (Borchardt, 2004). The light-emitting material is typically sandwiched between metallic materials, which are designed for efficient charge injection from the electrodes. Alq3 is widely used as electron-transport and light-emitting layers (Mathew et al., 2001). There has been much interest in utilizing biological molecules, for example, cytochrome, myoglobin, hemin and chlorophyll (Tajima et al., 2003; Tajima et al., 2005; Ikeda et al., 2005; Shimatani et al., 2005; Tajima et al., 2006). These materials are known to exhibit effective electron transport properties in biological systems. We fabricated OLED devices that employ adenine as the light-emitting layer, together with ITO, NPB, Al and Alq3as charge-transport layers. Vacuum deposition was used to fabricate uniform thin films (Tang and VanSlyke, 1989; Kido and Lizumi, 1998). PL from adenine was observed at wavelengths in the range 380–560nm. Adenine is a purine derivative, and is related to cellular respiration, forming adenosine triphosphate (ATP), nicotinamide adenine dinucleotide (NAD) and flavin adenine dinucleotide (FAD), is involved in protein synthesis, and is a base of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). OLED devices combined with adenine were investigated, in which the various thickness adenine films were formed. The simplest structure was a single-layer of adenine sandwiched between ITO and Al. When the thickness of the adenine layer was 30nm, the device exhibited a larger electric current than with a thickness of 100nm. We observed a broad optical emission spectrum. With the ITO/adenine/Alq3/Al structure, this luminance was lower when the adenine layer was thicker; however, this structure exhibited a six-fold increase in the luminance compared with the ITO/adenine/Al devices. Furthermore, characteristic adenine emission was observed at a wavelength of less than 400nm. OLED devices that incorporate DNA thin films as electron blocking layers have been reported, and significant increases in the luminance and luminous efficiency were observed (hagen et al., 2006). The ITO/NPB/adenine/Alq3/Al structure exhibited the lowest operating voltage, and also exhibited the largest EL intensity, with a peak luminance at a wavelength of 510nm. Choi et al. (2006) reported that the performance and stability of OLED devices is an important factor, and that interfacial issues such as poor adhesion are significant. Adenine is a biomolecule related to electrical and optical properties in nature, and has potential applications in optoelectronic devices. This biomolecule can be modified; for example, DNA and cetyltrimethyl ammonium may be chemically coupled so that is it insoluble in water but soluble in alcohol (Hagen et al., 2006). Furthermore, naturally occurring biomaterials are a renewable resource and are inherently biodegradable. We have shown that adenine can lead to high photoemission efficiency in OLEDs. Adenine functions as both a hole-transport and light-emitting layer, and has previously been shown to function as an electron-blocking layer. This study of adenine OLEDs indicates that their favorable charge transport properties, relative low cost, minimal pre-fabrication processing, and natural origin makes them attractive for applications in natural optoelectronic devices.
CONCLUSION
The purpose of this study was to investigate the effect of adenine light emitting materials for OLED devices. These results were showed that adenine has potential lightemitting activity and its multilayered devices have effects on the electrical and luminance performances. Naturally occurring substances as adenine has advantages of renewable organic compound, environmental friendly and low cost to OLED industries for future. Base on this study will be contributed to fundamental technology of OLED application of light emitting materials.
ACKNOWLEDGEMENT
This research was supported by the Basic Core Technology Development Program for the Ocean and the Polar Regions of the National Research Foundation (NRF) funded by the Ministry of Science, ICT and Future Planning (2010-0020711)
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Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareEVALUATION OF PARAMETRIC TECHNIQUE OF TECHNICAL EFFICIENCY MEASUREMENT: APPLICATION TO SMALLHOLDER COTTON FARMERS IN ZAMFARA STATE, NIGERIA
English6569Odedokun V.O.English Ahmed B.English Omolehin R.A.and Atala T.K.EnglishThe focus of this Study is on evaluation of parametric technique of technical efficiency of smallholder cotton farmers in Zamfara state, Nigeria. The aims of the study were centred on estimation of the level of technical efficiency, inputs and output relationship and to determine elasticity and returns to scale in cotton production. Zamfara state was used for this study. The field survey employed the list from reconnaissance survey of farmers conducted by Zamfara State Agricultural Development Project ZADP. A multistage sampling technique was used in selecting the study farmers consisting 220 farmers who produce cotton. The average technical efficiency score was 0.67 implying that farmers can still maximise the utilisation of inputs and increase their production frontier by 33%. The input-output analysis showed that the average yield of cotton produced was 773.319kg/ha. The returns to scale (RTS) was 0.791 depicting a positive decreasing returns to scale and at stage (II) of the production function while The coefficients of all variable inputs were inelastic since the coefficient of regression with respect to each input employed, holding all other inputs fixed resulted in less than 1% increase in cotton output.
EnglishParametric, Technical Efficiency, Smallholder, Cotton Farmers, NigeriaINTRODUCTION
At independence, the contribution of agri culture to the GDP was about 25% between 1975 and 1977. This was partly due to the phenomenal growth of the mining and partly as a result of the disincentives created by macroeconomic environment. Similarly, the growth rate of agricultural productivity exhibited a downward trend during the period. Thus, between 1970 and 1982 agricultural productivity stagnated at less than one percent annual growth rate at a time when the population growth rate was 2.5 to 3.0% per annum (Adubi, 2001). According to the National Bureau of Statistics (NBS) (2011), the percent share in the GDP of the crop sub-sector between 1981 to 1990 had been fluctuating between 28.37% and 22.99% and did not register any significant increase. This trend continued as the contribution of the crop sub-sector was almost stagnant at about 36% from 1994 to 1997 and from 2003 to 2006. With respect to cotton production trend had not witnessed remarkable improvement between 2007/2008 cropping year while the 2010 – 2012 cropping seasons experienced a decline. (USDA, 2011). . Batterham (2000) asserted that supply is yet to satisfy the level of demand for cotton. This is as result of low productivity and low efficiency of resource utilisation among cotton farmers. There are a number of factors affecting the productivity of farmers such as age, cropping patterns, years of farming experience, and lack of access to credit which tend to impact negatively on productivity and efficiency. Despite all human and material resources devoted to Nigerian agriculture, the productive efficiency of farmers for most crops still fall below 60%. The inefficiency problem is attributed to factors such as use of low input technologies, lack of knowledge of high input technologies and poor farm management skills, poor extension services, unavailability and high cost of inputs ( Obasi, 2005; Anyanwu and Obasi, 2010a; Anyanwu and Obasi, 2010b). This has caused great concern in the textile cotton fibre supply situation in the local market and export profile in the country thereby having a declining effect in its contribution to the agricultural economy of the country. It is with respect to this that cotton was chosen to form the basis of this study.
Research Question and Objectives
It is based on this credence that the following research questions and objectives were addressed by this study:
i. What is the level of technical, efficiency in cotton production in the state?
ii. What is inputs and output relationship in cotton production?
iii. What is the elasticity and returns to scale in cotton production?
The specific objectives of the study are:
i. To estimate the level of technical efficiency in cotton production;
ii. To estimate inputs and output relationship in cotton production;
iii. To determine elasticity and the returns to scale in cotton production.
Test of Hypotheses
i. Cotton farmers are not technically, allocatively and economically efficient in cotton production in the study area.
ii. There is no significant relationship between socioeconomic characteristics of farmers a n d the technical, allocative and economic efficiencies in the study area.
METHODOLOGY
Zamfara state was used for this study. The state lies between latitude 100 50`N and 130 38`N and longitudes 4o 16`E and 7o 18`E. The state is located in the Sudan Savanna ecological zone of Nigeria. It has a land area of 39,762km2 . Zamfara state shares common borders with Sokoto and the Republic of Niger to the north, Katsina and Kaduna states to the east, Niger and Kebbi states in the South (Yakubu, 2005., www.zamfarastate.net, 2010). The state has a population of about 3,259,846 people in 2006 according to the National Population Commission (NPC; 2006). This is projected in 2011 to be 3,667,326 People representing 3.2% annual growth rate in population. (UNFPA) (2013). The climate is essentially that of tropical climate. The rains usually commence in May/ June and end in September/October. The effective rainy season in the study area is restricted to July to mid September (Yakubu, 2005). Four local government areas namely Kaura, Gusau, Tsafe and Bungudu were randomly selected. A significant proportion of cotton produced in Zamfara state come from these areas (www.zamfarastate.net. 2010). The main ethnic groups in these areas are Hausas, Beriberis, Buzzaye and Fulanis. Indeed, agriculture forms the main occupation of the entire population. This constitutes the bulk of those involved in traditional farming, fishing, hunting and nomadic pastoralism. Sampling Procedures and Sample Size The field survey employed the list from reconnaissance survey of farmers conducted by Zamfara State Agricultural Development Project (ZADP, 2010). A multistage sampling technique was employed in selecting the study farmers. The first stage was random sampling of four local government areas (LGA’s). These are Kaura, Gusau, Tsafe and Bungudu. The second stage involve random selection of two villages known to be cotton growers from each of the local government areas based on the prevalence of cotton farmers and their involvement in cotton production and accessibility. Hence, a total of eight villages were selected for the study. The third stage involved using the list of cotton growers obtained from the reconnaissance survey to randomly select 15% of farmers from each of the eight villages in the ratio of 26, 33, 23, 26, 33, 22, 31 and 26 from KasuwaDaji, Kabarawa, Danba, Magami, Tsafe, Kucheri, Kwatarkwashi and Tashar-rawaya respectively constituting 220 out of a total of 1471 farmers. Primary data were used for this study. The primary data was collected for the study based on 2012/2013 cropping year known as cross-sectional data. The analytical tools that were used to achieve the stated objectives in this study were descriptive statistics and Stochastic Frontier Analysis.
Stochastic Frontier Models
This technique was used to achieve the stated objectives of the study. The Stochastic Frontier Approach (SFA) is parametric which uses econometric method employing the production function of Cobb-Douglas form. It is one of the methods for estimating frontier functions in efficiency of production. Using the SFA, it is suitable to test hypothesis to ascertain whether the cotton production enterprises were technically efficient or not. This approach was taken up by Aigner and others which subsequently resulted in the development of this method in econometric studies. Aigner and Chu (1968), Aigner et al (1977) and Van de Broeck (1979) considered the estimation of a parametric frontier production function which was later improved and applied by Battese and Coelli (1995). The Stochastic frontier production function model is specified as:
This Vi ’s are random variables which account for random variation in output due to factors outside farmers control such as weather, disease and measurement error in production. The random error (Vi ’s) are assumed to be independently and identically distributed N(σ2 v) and independent of . It constitutes noise or disturbance error (Vi ’s). The Ui ’s are random variables that account for technical inefficiency of the farm as reflected in the socio-economic characteristics and other variables within farmers’ control. The Ui ’s are assumed to be non-negative truncation of the half-normal distribution N(σ2 U).
TE = Technical efficiency, X1 = Farm size (ha), X2 = Seed (kg/ha), X3 = Family labour (man-days/ha), X4 = Hired labour (man-days/ha), X5 = Fertilizer (kg/ha), X6 = Agro-chemicals (liter/ha), β1 – β6 = vector parameters to be estimated, βo = Intercept term, ei = Vi – Ui (Composite error term)
This is the technical efficiency which is defined as the ratio of observed output to maximum feasible output which is called frontier output. The empirical stochastic frontier was specified by Cobb-Douglas production function by taking the logarithm form, the model can be written as;
When TEi = 1 it shows that a farm obtains the maximum feasible output while TEi < 1 provides measures of shortfall of the observed output from the frontier output. In this study, the production function specified in equation (5) above is amenable, tractable and compatible by been transformed in its logarithm form. According to Coelli (1995), a logarithmic transformation provides a model which is linear in the log of inputs and hence, easily used in econometric estimation. Aigner et al. (1977) and Meeusen and Van den Broeck (1977) independently proposed the stochastic frontier production function in which an additional random error Vi is added to the nonnegative random variable Ui. Its most attractive feature is its simplicity.
RESULTS AND DISCUSSION
Estimation of Technical Efficiency Indices among Cotton Farmers
This section deals with the stochastic frontier analysis as a parametric method that computes the parameter estimates. This is by iteratively maximizing a non-linear function of the unknown parameters in the model subject to the constraints. Ajibefun (2008), highlights parametric methods to include production, cost, profit and revenue functions as alternative methods of describing the production technology and estimating efficiency of production. Table 1 shows the frequency distribution of technical efficiency indices in cotton production. The minimum technical efficiency was 0.11 while the maximum technical efficiency score index was 0.97 with a mean technical efficiency score index of 0.67. This implies that farmers could increase their level of output by improving on their efficiency index of input allocation and utilization through adoption of recommended technological packages by 0.33.
In a similar study by Adzawla et al., (2013) in estimating technical efficiency of cotton production in Yendi Municipality, Northern Ghana, it was reported that the average technical efficiency level of 0.88, ranging from
0.70 and 0.99 were observed. This is comparable to that of many studies (Mohammed Yusuf, 2005; Tsimpo, 2010; Neba et al., 2010). The wide difference in technical efficiency among least practice and best practice farmer indicates an opportunity for efficiency improvement. Input-output Relationship in Cotton Production The result of the Stochastic Frontier Production Function showed that the estimated coefficients for most inputs were positive except for family labour and hired labour which were negative. Farm size and family labour were significant at 1% level of significance. The insignificance of hired labour may be attributed to the use of family labour by cotton famers as substitutes for hired labour. (Table 2).
This implies that increase in farm size and family labour would result to an increase in output level in cotton production in the study area. The coefficient of seed input was observed to be positive and significant at 5% level of probability. By implication, there exists a direct relationship between seed and cotton output produced by farmers. Hired labour input and family labour were negative in terms of their coefficients and the t-value was insignificant with respect to hired labour. This implies that hired labour input does not have any meaningful influence on the level of output in cotton production. Family labour was significant at 1% level of significance. Contrary to the a priori expectation, family labour cost had a negative and significant coefficient.
Elasticity of production and returns to scale
The coefficients of all variable inputs were inelastic since the coefficient of regression with respect to each input employed, holding all other inputs fixed resulted in less than 1% increase in cotton output. The sum of the elasticities derived from Cobb-Douglas equation was 0.791. This depicts that when all inputs were increased by 1% the output will increase by 0.79% showing that resources employed in cotton production were inelastic. The equation exhibits a positive decreasing returns to scale in stage II where every farmer strives to attain to maximize profit and minimize cost of production. (Table 3).
Test of hypothesis on technical efficiency model (Ho1)
Estimates of the parameters of the technical efficiency model are statistically significant with the null hypothesis that . The likelihood ratio test of hypothesis for parameters of production function model revealed that farmers were technically efficient in cotton production in the study area. The value of the likelihood ratio test statistic shown in table 4 is 193.75 which is far more than the critical t-value of 2.40 at 0.01 level of probabilities. Hence, the decision is to reject the null hypothesis Ho
The result of test of hypothesis on the stochastic frontier efficiency and inefficiency models imply that most of the variables had meaningful and direct bearing on farmer’s productivity and efficiency. This outcome may
be required by farmers, agro-service agencies and government when planning for production and investment in the cotton production industry.
CONCLUSION AND RECOMMENDATIONS
The results of the stochastic frontier analysis showed that the technical efficiency involved in cotton production was above average and farmers can still improve on them. Cotton production function exhibits positive decreasing returns to scale with inelastic response of variable inputs to the level output produced. It is on this basis that the following recommendations were proffered: i. Improved access to inputs required in production which are pre-requisite for adoption and use of improved recommended cotton production practices are proffered ii. Adequate and intensive research and extension programme are required to disseminate improved and recommended cotton production technological packages to farmers. iii. Adoption and use of appropriate recommended cotton production practices to enhance high yields through adequate implementation as a package are recommended.
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=533http://ijcrr.com/article_html.php?did=5331. Adubi, A. A. (2001). Agriculture in the Nigerian Economy. Being a Paper Presented At the Workshop on Planning and Management of Agriculture Sector, August 14 – 25, Organized by Nigeria Centre for Economic Management. (NCEMA), Ibadan.
2. Adzawla, W., Fuseini, J., and Donkoh, S.A. (2013). Estimating Technical Efficiency of Cotton Production in Yendi Municipality, Northern Ghana. Journal of Agriculture and Sustainability. 4: 115-140.
3. Aigner, D. J., and Chu, S. F. (1968). “On Estimating the Industry Production Function”. American Economic Review, 58, 826-839.
4. Aigner, D. J., Lovell, C. A. K. and Schmidt, P. (1977). Formulation and Estimation of Stochastic Frontier Production Function Models. Journal of Econometrics. 6. 21-37.
5. Ajibefun, I.A. (2008). An Evaluation of Parametric and Non-parametric Methods of Technical Efficiency Measurement: Application to Small Scale Group Production in Nigeria. Journal of Agricultural Sc; 4:95 -100
. 6. Anyanwu, S.O. and Obasi P. C.(2010a) ,Comparative Analysis of Land Productivities in low and High External Input Technology Agriculture in Imo State, Nigeria. Acta Agronomica Nigeriana. 10(1):15–21.
7. Anyanwu, S.O. and Obasi P.C. (2010b) Comparative Analysis of Aggregate Agricultural Productivity Between Low and High External Input Technology Farms in Nigeria. African Journal of Biotechnology. 9(34):5530–5534
. 8. Batterham, R. (2000). The Chance to Change. Discussion Paper by the Chief Scientist Camberra, African Summit, Abuja, Nigeria
. 9. Battese, G. E. and Corra, G. S. (1977). Estimation of a Production Frontier Model; with Application to the Pastoral Zone of Eastern Australia. Australian Journal of Agricultural Economics, 21:167-179.
10. Coelli, T. J. (1996). A Guide to FRONTIER Version 4.1: A Computer Programme for Coulibaly, O. Mbila, D., Sonwa, D. J., Adesina, A. and Bakala, J. (2006); Integrated Pest Management Reviews. Springerlink Journal. 7(3) 165-175.
11. Meeusen, W. and Broeck van de, J. (1977). “Efficiency Estimation from Cobb-Douglas Production Functions with Composed Error”. International Economic Review, 18: 435- 444.
12. Mohammad-Yusuf, T. (2005). The Effects of Market Reforms on Cotton Production Efficiency. The case of Tajkistan. Asian Pacific School of Economics and Governments Working Paper 05-5.
13. National Bureau of Statistics (NBS). (2011). Nigeria Gross Domestic Product at 1990 Constant Basic Prices.
14. National Population Commision (NPC), (2006). ,Population Census of the Federal Republic of Nigeria. Analytical Report at the National Population commission, Abuja, Nigeria.
15. Neba, C., Ngassam, S. and Nzomo, J. (2010). The Determinants of the Technical Efficiency of Cotton Farmers in Northern Cameroon. MPRA Paper No. 24814.
16. Obasi, P. C. (2006). Application of Trans-log Function to Productivity Estimation in Imo State, Nigeria. International Journal of Agriculture and Rural Development (IJARD). 6:26–33.
17. United Nations Population Fund (UNFPA) (2013). Available on-line @http: Nigeria. unfpa.org/zamfara.html. Retrieved: 05/12/2013.
18. United State Department of Agriculture. (USDA) (2011). Nigeria Cotton Production by year. http://www.indexmundi.com Accessed, 02/09/2011.
19. Yakubu, A. A. (2005). Risk and Risk Management in Cotton Production among Farmers in Zamfara State, Nigeria. Unpublished M.Sc. Thesis Submitted to the Department of Agricultural Economics, Usman Dan Fodio University, Sokoto, Sokoto State, Nigeria. 20. ZADP (2010). Zamfara State Agricultural Development Project (ZADP) Reconnaissance Survey. 21. Zamfara State (2010). www.zamfarastate.net Accessed Jan. 2013.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareSTUDY OF MORPHOMETRY OF PLANTARIS MUSCLE AND ITS CLINICAL RELEVANCE
English7071Sangeeta M.English Varalakshmi KLEnglish Shilpa NaikEnglishBackground: Aim of the study was to provide morphometric data on the anatomy of planataris muscle.
Material and Method: Forty legs from twenty embalmed cadavers were examined and morphometric measurements such as length of the muscle belly, length of the tendon inside the muscle belly, width of the tendon and total length of the tendon and muscle tendon ratio were measured.
Result: Mean length of the tendon extending into the muscle was 3.52 cm and the tendon has a mean width of .537 cm in the belly of the muscle. The mean length of the muscle belly was 8.15 cm the mean length of the plantaris tendon was 31.31cm.The mean muscle belly tendon ratio was .264 cm.
Conclusion: These findings might help in important surgical procedures such as tendon grafting, A-V valve repairs etc.
EnglishPlantaris, Tendon grafting, Belly, Muscle tendon ratioINTRODUCTION
Plantaris muscle is a small flexor group muscle with a short belly and a long thin tendon. It is one of the superficial muscles of the posterior compartment of the leg along with soleus and gastrocnemius. Plantaris arises from the lower part of the lateral supracondylar line and the oblique popliteal ligament. Its small fusiform belly is 7 to 10cm long and ends in a long slender tendon which crosses obliquely in an inferomedial direction between gastrocnemius and soleus ,then runs distally along the medial border of calcaneal tendon and inserts just medial to tendo Achilles (1,2) It is innervated by tibial nerve(S1,S2). It is a weak plantar flexor of the ankle joint and flexor of the knee joint. The tendon of the plantaris provides proprioceptive feed back information to the the central nervous system regarding the position of the foot(3) The aim of the present study was to study the morphometry of the plantaris and to discuss the functional significance of plantaris muscle. The topographic anatomy of plantaris assumes importance for orthopaedic surgery intervention. This may also be of academic interest and serve as a standard manual data.
MATERIALS AND METHODS
40 legs from 20 adult male embalmed cadavers were dissected out of which 20 were right and 20 were left legs. The cadavers belonged to anatomy department of MVJ Medical College. Cadavers that presented pathological deformities in the legs were excluded. The measurements were made using a digital callipers by marking the below shown points and finding were stastistically analysed.
RESULTS
Plantaris muscle was present in all the legs studied. The tendon of the plantaris passed obliquely downwards be tween the gastrocnemius and soleus to get inserted into the medial aspect of calcaneum. Mean length of the tendon extending into the muscle was 3.52 cm and the tendon has a mean width of .537 cm in the belly of the muscle. The mean length of the muscle belly was 8.15 cm the mean length of the plantaris tendon was 31.31cm.The mean muscle belly tendon ratio was .264 cm.
DISCUSSION
Plantaris varies in its mode of origin and more frequently in its insertion .The muscle may arise from the fascia of popliteus, the origin of the lateral head of gastrocnemius, the fibula between peroneus longus and flexor hallucis longus. Distally it frequently joins the tendo Achilles or ends in the fascia of the leg or tibial collateral ligament of the ankle (4). A variant, tensor fascia plantaris arises from the oblique line of tibia and inserts in the fascia overlying the calcareous (5).
When the morphometric parameters were compared by previous study by Aragao et al, it was found that all the parameters showed increased values in their study. This could account because of racial differences as the study was done in Brazil. Standard textbook of anatomy have reported the fact that the muscle may sometimes be absent or it may be double. In our study we did not observe absent plantaris or double head of plantaris. This finding is similar to what was described by Osny et al(6). Despite its small size injuries of the plantaris muscle and the tendon(Tennis leg)is quite common. The plantaris muscle may be injured during any tear and the diagnosis can be confirmed only by obtaining MRI or USG. Plantaris muscle can be used as an excellent graft for reconstruction of anterior talofibular and calcaneofibular ligaments(7). The tendon of plantaris has also been successfully used for flexor tendon replacement of hand and even for atrioventricular valve repair(8).
CONCLUSION
Since very few studies are available on the morphometry of plantaries and plantaries tendon is clinically important for various surgical procedures, this study may be helpful for reconstructive surgeries.
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=534http://ijcrr.com/article_html.php?did=5341. Standring Susan. Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 39th ed. Elsevier Churchill Livingstone, Philadelphia, 2005. pp. 1499-500.
2. A.K. Datta. Essential of human anatomy(Superior and inferior extremities). 3rd edidtion. April 2004.pp
3. Menton D The plantaris and the question of vestigial muscles in man CEN Technical Journal 2000;14(2):50-53.
4. Miyauchu R. Illustrated encyclopedia of human anatomic variation. Opus 1:Muscular System: Alphabetical Listing of muscles.
5. Daseler EH, Anson BJ. The plantaris muscle: An Anatomical Study of 750 Specimens. J Bone Joint Surg Am. 1943;25:822–7.
6. Osny, S.; Carvalho, Jr. A. E.; Fernandes, T. D.; Romano, D.; Adachi, P. P.; Neto, R.S. Musculo solear acessorio: aspectosclinicos e achados cirurgicos. Rev. Bras. Ortop.,29(4):251-55, 1994.
7. Pagenstert, G. I. ; Valderrabano, V. and Hintermann, B. Lateral ankle ligament reconstruction with free plantaris tendon graft. Techniques in Foot and Ankle Surgery.,
8. Shuhaiber, J. H. and Shuhaiber, H. H. Plantaris tendon graft for atrioventricular valve repair: a novel hypothetical technique. Tex. Heart Inst. J., 30(1):42-4, 2003.04- 12, 2005.
Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-5241711EnglishN-0001November30HealthcareA STUDY OF VARIATION IN BRANCHING PATTERN OF AXILLARY ARTERY
English7275Parveen OjhaEnglish Seema PrakashEnglish Ghanshyam GuptaEnglishAim: To study variations in the branching pattern of axillary artery.
Material and method: The study was conducted at R.N.T. Medical College, Udaipur (Rajasthan) on 60 Upper Limbs of 30 adult cadavers (20 males and 10 females)
Results: During our study we have noticed anomalies in branching pattern in about 33% of cadavers. Some rare variations like absence of profunda brachii artery and its replacement by descending branches from posterior circumflex humeral artery, origin
of profunda brachii artery from II part of axillary artery were also noticed during the study.
Conclusions: Knowledge of variations is important especially for orthopaedic and vascular surgeons to avoid complications during various surgical procedures in axillary regions and during angiographies respectively. Various clinical implications of variations in branching pattern are discussed in this study.
EnglishAxillary artery, Variations in branching patternINTRODUCTION
Axillary artery is a continuation of the subclavian artery at the outer border of the first rib. The course of axillary artery is anatomically divided into three parts by the pectoralis minor muscle. The first part begins at the lateral border of the first rib and extends to the superomedial border of the pectoralis minor muscle. The second part lies deep to pectoralis minor muscle and third part lies between the inferolateral border of the pectoralis minor and the inferior border of the teres major muscle1 . The first part of the artery gives superior thoracic artery. The second part gives lateral thoracic and thoracoacromial artery. The third part gives subscapular artery, anterior and posterior circumflex humeral artery 2 . It is very common to find the variations in the branching pattern of axillary artery. Knowledge of variations is important for orthopaedic surgeons as well as for vascular surgeons to avoid complications during various surgical procedures.
MATERIAL AND METHOD
The study was conducted at R.N.T. Medical College, Udaipur (Rajasthan) in 60 Upper Limbs of 30 adult cadavers (20 males and 10 females). Dissection of pectoral, axillary region, arm and forearm was done according to the steps described in Cunningham’s manual of practical anatomy 3 . Skin and superficial fascia were removed. pectoralis major and then pectoralis minor with clavipectoral fascia were studied and separated. During dissection of axilla, axillary artery and brachial plexus were cleaned and studied. Observations: All the branches of three parts of axillary artery were carefully dissected and their relations with brachial plexus were studied. Variations in the branching pattern arising from three parts of axillary artery were recorded and photographed. Normal branching pattern was observed in about 40 upper limbs (67%). In 10 upper limbs (16.6%) anomalous branching pattern was found in II part of the artery while in another 10 upper limbs (16.6%) branching pattern variations were observed in III part. Some rare variations were also found during the study. One of the case showed profunda brachii artery from II part and while another showed bilateral absence of profunda brachii artery and its replacement by descending branch from posterior circumflex humeral artery.
Variations in the I part of axillary artery: No variation was observed in the 1st part of axillary artery.
Superior thoracic artery maintained its usual course.
Variations in the II part of axillary artery: (1) In 8 upper limbs (13%), bilaterally a common trunk from II part gave origin to posterior circumflex humeral artery, subscapular artery and lateral thoracic artery (Fig 1) while anterior circumflex humeral artery branched normally from III part of axillary artery. (2) In one upper limb (2%) profunda brachii artery was from II part(Fig 2). Anterior and posterior circumflex humeral artery and subscapular artery branched from a common trunk of this profunda brachii artery. (3) One upper limb (2%) had unilateral common trunk for lateral thoracic artery, posterior circumflex humeral artery, subscapular artery and circumflex scapular artery.
Variations in III Part of axillary artery: As already mentioned III part of 13% upper limbs didn’t have any branch. All the branches of III part were from II part of the artery. In another 13% of limbs a common trunk for origin of anterior and posterior circumflex humeral artery and subscapular artery was observed. An interesting variation was noticed in one of the upper limb (approx.3%) as bilateral absence of profunda brachii branch. Additionally we also observed on right side -(Fig 3) Anterior and posterior circumflex humeral arteries and subscapular arteries were originating from a common trunk from III part. Profunda brachii artery was absent .Brachial artery divided into radial artery and ulnar artery at the level of insertion of corachobrachialis.. In posterior compartment of arm posterior circumflex humeral artery had a large descending branch which continues along with the radial nerve. Median nerve was lateral to both axillary artery and radial artery. Median nerve passed deep to radial artery and then superficial to ulnar artery to gain its medial relation in elbow. On left Side (Fig 4)-IInd part of artery after giving lateral thoracic and thoracoacromial branches divided into two branches, a medial branch and a lateral branch. From the medial branch a common trunk for anterior and posterior circumflex humeral and subscapular artery was present. On tracing posterior circumflex humeral artery (Fig 5) in posterior compartment of arm a large descending branch from this artery continued along with radial nerve. Radial collateral and middle collateral branches were found to be from this descending branch which was probably due to absence of profunda brachii artery. Median nerve was formed in front of the medial branch. Lateral branch was superficial to the lateral root and musculocutaneous nerve. In the arm the medial branch followed the course of brachial artery and in forearm as ulnar artery and the lateral branch coursed as radial artery. Median nerve was medial to medial branch throughout its course in arm and then to ulnar artery in elbow.
DISCUSSION:-
The arteries of the limbs arise as a number of vessels contributing to a primitive capillary plexus, but eventually only one trunk – the subclavian – persists, and it has the positions and relations of the seventh intersegmental artery and probably represents its lateral branch. The main trunk to the upper limb, later forms the axillary and brachial arteries.4 The radial and ulnar arteries are the latest arteries to appear in the forearm. The anomalous blood vessels may be due to5 (i) the choice of unusual paths in the primitive vascular plexuses, (ii) the persistence of vessels normally obliterated, (iii) disappearance of vessels normally retained, (iv) incomplete development and (v) fusions or absorption of the parts usually distinct. Variations in branches of axillary artery are frequently found. Branches may arise together or their subbranches may be given off directly by main artery. Thus, instead of six, the branches may total anywhere from 5 -11. A rare but striking anomaly arises when instead of continuing as a single brachial artery, the axiliary artery divides in the axilla into two branches. On entering the arm, one of the branches usualy runs more superficially and may represent the radial or ulnar arteries, the deeper branch usually correspond to the brachial artery proper 6 . In our observation also in one of the case axillary artery has divided into two branches in axilla. Superficial one is continuing as Radial Artery and deeper one has given origin to all the branches of axillary artery and continues as brachial artery proper and then ulnar artery. (Fig-3) Numerous type of variations in branching pattern of axillary artery are reported by various workers .Gaur S et al (2012)7 have reported that variations in branching pattern are found in about 28% of cases. We have observed variations in about 40% of the cases. Variations in the branching pattern (8%) of III part is the most frequently noted anomaly by them. During our study also we have reported variations in the origin of branches of III part most commonly. Absence of profuda brachii and its replacement by posterior circumflex humeral artery is reported by K.G.Rao et al (2012)8 also where posterior circumflex humeral artery had a hair pin bend like course .In our study we have also observed absence of profunda brachii artery and its replacement by a descending branches of posterior circumflex humeral artery. This variation was reported bilaterally by us. A common trunk for all the branches of II and III part of artery was noticed by Chitra et al (2013)9 . Srimathi T (2011) 10have reported a common trunk for Thoracoacromial, Lateral thoracic, subscapular and posterior circumflex humeral artery from II part of artery. Sharma T et al (2009)11 and Sawant S. et al (2012)12 have reported bilateral superficial brachial artery. In a study by Yang H et al(2008)13 in 304 extremities in Korea, superficial brachial artery was found in 12.2% of cases and is one of the commonest arterial variation found in that area. Divison of superficial brachial artery into radial and ulnar artery is the commonest type of termination here. Considering the frequency of variations in the branching pattern of axillary artery it is important for the orthopaedic and vascular surgeons to be aware of these anomalies to avoid complications during the surgical procedures. Abnormal course of posterior circumflex humeral artery has been reported to be a cause of Quadrangular space syndrome by K.G.Rao et al (2012)8 . There is extensive collateral circulation associated with the branches of subclavian and axillary arteries particularly around scapula so that the sound knowledge of neurovascular variation is important for surgeons. Anomalous origin of the radial artery may cause the failure of the radial approach of the coronary angiography 14 and in the reconstructive surgery of the upper limb it can be ligated or cut considering it as a vein leading to disorder in circulation of the hand15. When the superficial brachial artery persists it is more vulnerable to the accidental injuries, 13 it can be easily mistaken as a vein and intravenous injections into it can be disastrous.16 Knowledge of branching pattern of axillary artery is useful during antegrade cerebral perfusion in aortic surgery17, while treating axillary artery thrombosis, reconstructing axillary artery after trauma, using the artery for microvascular graft to replace damaged arteries, creating axillary coronary bypass shunt in high risk patients18 and during surgical procedures of fractured upper end of humerus. Thus we see that accurate knowledge of the normal and variant arterial pattern of the human upper extremities is important both for reparative surgery and for angiography19.
CONCLUSION
Variations in branching pattern of axillary artery are found frequently. We have noticed variations in about 33% of cases. Most of the variations are noticed in III part of axillary artery. No variation is reported in Ist part of the artery. Knowledge of variations is important for orthopaedic and vascular surgeons to avoid complications during various surgical procedures in axillary regions and during angiographies respectively.
ACKNOWLEDGEMENT
This work was undertaken independently and there were no funding sources. Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.
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