Spatial Analysis on the provision of Urban Amenities and their Deficiencies - A Case Study of Srinagar City, Jammu and Kashmir, India

The paper examined inequality in the distribution of urban amenities in Srinagar City. Inequality in the study area is manifested in the form of unequal provision of social amenities within the wards (municipal units) of the City. The spatial distribution and concentration of two social amenities, viz, educational institutions and fire service stations was studied. The study mainly relied on the secondary sources of data. The Z-score variate has been used to determine the spatial concentration pattern in the provision of these amenities. However, Lorenz Curve proved to be a useful tool in accessing and quantifying the spatial disparity. The results of the analysis indicate that inequalities exist in the provision of accessibility of these amenities among different wards in Srinagar city. The reasons for the uneven distribution of urban amenities are spurt urban growth in the last three decades and poor management planning. The paper suggests that planning body must keep pace with the urban sprawl in order to ensure the equitable distribution of urban amenities in the city. Keywords: Amenities, Wards, Srinagar City, Well-being, Accessibility, Lorenz Curv

Relationship between the levels of Serum Thyroid Hormones and the Risk of Breast Cancer

Breast cancer is still one of the leading causes of cancer death in women, but there has been a sustained decline in mortality rates over the last decades the relationship between breast cancer and thyroid diseases is controversial many works have been done in past also. The relation between autoimmune and non-autoimmune thyroid diseases has been investigated in patients with breast cancer and age-matched control individuals without breast or thyroid disease. Determination of serum thyroid hormone and antibody levels was done in 100 breast cancer patients and 75 control individuals. The mean values for thyroid hormones and anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients than in control individuals. Our results indicate an increased prevalence of autoimmune and non-autoimmune thyroid diseases in breast cancer patients. Keywords: breast, cancer, autoimmune thyroid diseases

Etiology and clinical profile of chronic calcific pancreatitis/tropical pancreatitis in Kashmir Valley.

Objectives: To study etiology and clinical profile of chronic calcific pancreatitis/ tropical pancreatitis in Kashmir valley. Methods: The present study was a prospective hospital based study from june2006 to January 2009. Patients with X-ray evidence of calcification in pancreatic region or Ultrasonography & ERCP evidence of pancreatic calcification were included. Clinical details of different presentations of the disease were recorded including pain, diabetes mellitus. All base line investigations were done as per need and stool was tested for fat globules. Patients were followed & were asked about symptoms. Patients were subjected to different modalities of treatment like medical (analgesics, enzyme replacement) / endoscopic treatment/ surgical treatment. Pain response to therapy was assessed by visual analogue scale up to 30%response as mild up to 70%as moderate & above70%as good response. Design: Hospital based study. Results: The mean age of patients was 37.2±13.9. Majority of patients (75.3%) were in the age group of 21-50 years. Pain was present in 77.7% patients; Diabetes mellitus was present in 39.1% and Ca pancreas was seen in 7.4%. Mean number of acute pancreatitis attacks was 1.2±1.4 (range, 1-6). Severity of pain at onset and/or during follow up had no significant difference (p=0.4) between males and females. Complications related to chronic calcific pancreatitis included Pseudocyst (5.9%), portal hypertension (3.4%), and pancreatic biliopathy (11.8%). CBD stones were found in 6.9% patients, OCH was found in 8.9%, diabetes related complications were found in 14.8% and history of alcohol intake was found in 2.4% patients. Mean age of diagnosis was 33.6 yrs with SD±14.47. Plain X ray abdomen showed stones in 95% patients whereas ERCP showed dilated PD in 100% patients. Medical treatment had relief of symptoms in 76% patients, giving endoscopic treatment had symptomatic improvement in 81%, and surgical treatment caused improvement in 83% patients, overall. Conclusions: Chronic calcific pancreatitis is quite prevalent in Kashmir valley; the disease is similar to chronic calcific pancreatitis of the West in clinical and pathological features but differs from the later in that, alcohol is not the cause and occurrence is at a young age

Regenerative γ‑Lactone Annulations: A Modular, Iterative Approach to Oligo-tetrahydrofuran Molecular Stairs and Related Frameworks

A unified, stereocontrolled, regenerative γ-butyrolactone annulation approach has been conceptualized and validated through syntheses of a range of oligo-THFs. The new protocol is short (four steps), simple (table-top reagents), and efficient (50–61% overall yields). Although the scope of this approach is unlimited, it has been demonstrated up to five iterations on commercial γ-butyrolactone to assemble six fused tetrahydrofuran moieties in a staircase-like architecture. A selection of exploratory transformations is presented to exemplify the potential applications of this protocol

A scalable and diversity-oriented synthesis of (±)-paeoveitols

Gram scale synthesis of (±)-paeoveitol, a nor-diterpene harboring an unusual benzofuran stitched benzopyran 6/5/6/6 tetracyclic ring system, and its analogues, emanating from bench-top reagents is reported. Scandium triflate-mediated inverse electron demand [4 + 2] cycloaddition reaction between pre-synthesized paeoveitol-D analogue (dienophile) and ortho-quinone methide precursor (diene), both resulting from the same starting material delivered (±)-paeoveitol in decent yield. Fine tuning of the synthetic strategy not only helped to procure scalable quantities of natural product but also provided ample scope to look for the diversity-oriented synthesis of its analogues. </p

Regenerative γ‑Lactone Annulations: A Modular, Iterative Approach to Oligo-tetrahydrofuran Molecular Stairs and Related Frameworks

A unified, stereocontrolled, regenerative γ-butyrolactone annulation approach has been conceptualized and validated through syntheses of a range of oligo-THFs. The new protocol is short (four steps), simple (table-top reagents), and efficient (50–61% overall yields). Although the scope of this approach is unlimited, it has been demonstrated up to five iterations on commercial γ-butyrolactone to assemble six fused tetrahydrofuran moieties in a staircase-like architecture. A selection of exploratory transformations is presented to exemplify the potential applications of this protocol

Comparison between phenylephrine and ephedrine in preventing hypotension during spinal anesthesia for cesarean section

Background: Maternal hemodynamic changes are common during spinal anesthesia for cesarean delivery. Many agents are used for treating hypotension. In this study we compared the efficacy of ephedrine and phenylephrine in preventing and treating hypotension in spinal anesthesia for cesarean section and their effect on fetal outcome. Materials and Methods: A total of 100 ASA Grade I patients undergoing elective cesarean section under spinal anesthesia with a normal singleton pregnancy beyond 36 weeks gestation were randomly allocated into two groups of 50 each. Group I received prophylactic bolus dose of ephedrine 10 mg IV at the time of intrathecal block with rescue boluses of 5 mg. Group II received prophylactic bolus dose of phenylephrine 100 μg IV at the time of intrathecal block with rescue boluses of 50 μg. Hemodynamic variables like blood pressure and heart rate was recorded every 2 minutes up to delivery of baby and then after every 5 minutes. Neonatal outcome was assessed using Apgar score at 1 and 5 minutes and neonatal umbilical cord blood pH values. Results: There was no difference found in managing hypotension between two groups. Incidence of bradycardia was higher in phenylephrine group. The differences in umbilical cord pH, Apgar score, and birth weight between two groups were found statistically insignificant. Conclusion: Phenylephrine and ephedrine are equally efficient in managing hypotension during spinal anesthesia for elective cesarean delivery. There was no difference between two vasopressors in the incidence of true fetal acidosis. Neonatal outcome remains equally good in both the groups

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Not AvailableThe study has explored econometrically the linkages between different sectors of the economy of Jammu & Kashmir state through co-integration approach and state space model on the net state domestic product (NSDP) data collected from the designated published sources for the period 1970-71 through 2013- 14.The study has revealed that primary sector registered a sustained decline in NSDP share, from 40.6 to 25.2 per cent, followed by the secondary sector which too has registered a decline after 1990 from 23.7 per cent to 9.2 per cent. However, the services sector has shown an upward trend from 38.5 per cent to 65.6 per cent during the study period. Some of the ECM equations have revealed even more than 90 per cent of the adjustments every year. The results of the state space model have suggested that over time, the dependence of primary sector on secondary and tertiary sectors (excluding CSPS) has decreased, while the dependence of primary sector on tertiary sector has increased.Not Availabl

Minimally invasive procedure for hemorrhoids: Surgical results

Objectives: The purpose of the present study was to determine the surgical results of stapled hemorrhoidectomy and overall satisfaction of the patient and to evaluate its suitability as a routine day care surgery procedure in this part of the world. Materials & Methods: A total of 30 patients were operated from June 2006 to Dec 2008. The median age of the patients was 49.1 years. The main symptom was digital recognition of perianal mass (96%). The procedure was performed under regional (epidural or spinal) or general anesthesia. The average operative time was 31.08 minutes. The procedure was performed with PPH03, a 33 mm diameter hemorrhoidal circular stapler. The patients were prospectively evaluated for postoperative pain and bleeding, satisfaction scores, anorectal function, return to work and cost effectiveness of the procedure. Results: The duration of the PPH procedure ranged from 30-45 minutes (average 31.08 minutes). The suture line was on average 3.5cm (3 - 4.5) above the dentate line. Excision of external skin tags while undergoing PPH was performed in 16.6% cases (n=5). No stapler failure was detected. Seven patients (23.3%) had bleeding after the stapler off and 3 patients (10%) had bleeding in the first post operative day. Patients average pain score was 1.57 (VAS 1-5) at 24 hrs in the 1st postoperative period. Of note, three patients had no pain at all immediately after surgery. No patients had recurrence of hemorrhoidal prolapse, bleeding or anastomotic stricture upon rectal exam or fecal incontinence Ninety percent of patients (n=27) were discharged in a day while as 10% were discharged after 2 days because of their co morbid conditions Return to work was early between 5-7 days postoperatively with high patient satisfaction score. Conclusions: Stapled hemorrhoidectomy (SH) is a safe, effective and well tolerated procedure in the treatment of grade 3 and grade 4 hemorrhoids with less postoperative pain and high patient satisfaction, which seems to have all the requirements for Day Care Surgery