Morbidity and mortality profiles and outcomes of neonates admitted in the special newborn care unit of tertiary care hospital of Government Medical College Rajouri of district Rajouri of union territory of Jammu and Kashmir: a hospital-based study

Background: Neonatal deaths constitute major portion of under-five mortalities in India. Neonatal period is very important and precious period because most of the preventable morbidities and mortalities occur in this period. In our country, prematurity, infection and prenatal asphyxia are three major causes for neonatal mortality. Various special newborn care unit (SNCU) are established in different district Hospitals to provide neonatal care which further decrease neonatal mortality. Methods: This observational retrospective study was planned to determine the clinical profile and outcome of various neonatal admissions at SNCU, of department of paediatrics Government Medical College Rajouri, Jammu and Kashmir a newly established medical college in the rural setting of northern India which is a tertiary care hospital. The data was collected for a period of 1 year from 01 April 2021 to 31 March 2022. Detailed information was collected from files and registered onto the preset proformas and results were compiled. Results: A total 2495 newborns were enrolled for the study. 1796 (71.98%) were inborn and 699 (28.01%) were out born. Total male babies were 1569 (62.88%) and female babies were 926 (37.12%). Majority of patients were full term and weight ≥2.5 kg (86.05%). major indications for admission were sepsis 557 (22.32%), prenatal asphyxia 532(21.32%), neonatal hyperbilirubinemia 387 (15.5%), Low birth weight 348 (13.94%) and respiratory distress 308 (12.34%). Out of total, 1879 (75.3%) newborn were discharged successfully after treatment. 192 newborns were referred to higher centre for specialized care. 174 (7%) newborns died during the treatment. Conclusions: Neonatal period is a very crucial period for development of morbidity and mortality. SNCU with skilled staff can prevent the worst outcomes by early interventions

Energy Consumption Rate based Stable Election Protocol (ECRSEP) for WSNs

In recent few yearsWireless Sensor Networks (WSNs) have seen an increased interest in various applications like border field security, disaster management and medical applications. So large number of sensor nodes are deployed for such applications, which can work autonomously. Due to small power batteries in WSNs, efficient utilization of battery power is an important factor. Clustering is an efficient technique to extend life time of sensor networks by reducing the energy consumption. In this paper, we propose a new protocol; Energy Consumption Rate based Stable Election Protocol (ECRSEP). Our CH selection scheme is based on the weighted election probabilities of each node according to the Energy Consumption Rate (ECR) of each node. We compare results of our proposed protocol with Low Energy Adaptive Clustering Hierarchy (LEACH), Distributed Energy Efficient Clustering (DEEC), Stable Election Protocol (SEP), and Enhanced SEP(ESEP). Our simulation results show that our proposed protocol, ECRSEP outperforms all these protocols in terms of network stability and network lifetime

A Comparative Study of Process, Product and Process Genre Theory in Writing of Essay at Intermediate Level

Different approaches are introduced by number of researchers and scholars to improve writing skill of second language learner. The most prominent of them are product approach, process approach and genre process approach; these approaches 01 paved an instructional environment for learners in class room. The basic purpose of researcher to conduct this study is to investigate the effectiveness of these approaches on the writing skill of students at intermediate level. A quasi experimental study was conducted where one hundred and five students of Govt. college of Samnabad had participated in three and half month writing session, in this session different activities had been applied. To figure out the results pre and post- test were conducted. It is found that the genre process approach has more affirmative effect on the writing skill of students

Advanced Filler Network Characterization in Rubber

The present work is aimed at introducing new characterization techniques in filled rubber compounds. Rubber fillers such as carbon black are often used to enhance the physical properties of rubber compounds. With a sufficient amount of carbon black, a percolated filler network is formed, spanning the volume of the rubber compound. This phenomenon not only significantly improves the mechanical material behaviour, but also introduces a more complex mechanical response. Further enhancement is possible with the addition of reinforcing resins such as Novolaks, phenol–formaldehyde resins with a formaldehyde-to-phenol molar ratio of less than one. Based on the systematic studies performed, the two reinforcing materials are observed to exhibit synergistic behaviour resulting from their physical and chemical interaction. The reinforcing resin modifies the activity of the filler surface creating a more compact filler network. This leads to a lower filler network percolation threshold as well as increasing the reinforcing behaviour. This conclusion was derived from various thermo-mechanical measurements such as temperature stress scanning relaxation (TSSR) and dynamic mechanical analysis (DMA). The findings were also validated with advanced microscopical techniques such as atomic force microscopy (AFM) and transmission electron microscopy (TEM). A direct consequence of the filler network is a strain dependent behaviour such as the dynamic and quasi-static strain dependent softening effects known as Payne and Mullins effects, respectively. Within the conventional dynamic mechanical analysis (DMA) of rubber compounds, the mechanical response signal is often assumed to be rheologically linear (sinusoidal function) since in Fourier space, the first harmonic is more pronounced than the subsequent higher harmonics. However, valuable information contained in the higher harmonics can be utilised in order to further characterise the compound properties. One such approach is the large amplitude oscillatory shear (LAOS) technique which analyses the harmonics as a function of large strain deformation. While several studies have contributed to the understanding of this strain dependent nonlinearity, less emphasis was placed on the nonlinearity of the frequency domain. Utilising a resonance-based high frequency DMA, nonlinearities in the frequency domain were established by the observation of the superharmonic resonance, for the first time in rubber technology. Two distinct nonlinearities were observed, polymer induced nonlinearity and filler induced nonlinearity. The new method based on the superharmonic resonance has been successfully applied to characterise the filler network through the evaluation of the microdispersion of carbon black and its interaction with reinforcing resins.Die vorliegende Arbeit hat das Ziel, innovative Methoden zur Charakterisierung von gefüllten Kautschukmischungen einzuführen. Füllstoffe, wie Ruß, werden in Kautschuk eingesetzt, um seine physikalischen Eigenschaften zu verstärken. Mit einer ausreichenden Menge an Ruß wird ein perkolierendes Netzwerk erzeugt, das das Volumen der Kautschukmischung durchdringt. Diese Erscheinung verstärkt nicht nur das mechanische Materialverhalten, sondern führt zu einer komplexeren mechanischen Reaktion. Eine weitere Verstärkung ist durch den Einsatz netzwerkbildender Harze möglich, z.B. von Novolaken, Phenolharzen mit einem Formaldehyd-Phenol-Verhältnis kleiner eins. Auf der Basis von systematischen Studien wird ein synergistisches Verhalten der beiden verstärkenden Materialien infolge ihrer physikalischen und chemischen Wechselwirkung beobachtet. Das Verstärkungsharz verändert die Aktivität der Füllstoffoberfläche und erzeugt damit ein kompakteres Füllstoffnetzwerk. Dies führt zu einer reduzierten Perkolationsschwelle sowie zu einer zusätzlich höheren Verstärkung. Diese Schlussfolgerung wurde aus Messungen mit verschiedenen thermomechanischen Verfahren abgeleitet, wie der anisothermen Spannungsrelaxation (TSSR) und der dynamisch-mechanischen Analyse (DMA). Die Ergebnisse wurden auch mit anspruchsvollen mikroskopischen Techniken validiert, wie der Rasterkraftmikroskopie (AFM) und Transmissionselektronenmikroskopie (TEM). Eine direkte Folge des Füllstoffnetzwerks ist die Entstehung eines dehnungsabhängigen Verhaltens, das als dynamischer oder quasi-statischer Erweichungseffekt beobachtet und jeweils als Payne- oder Mullins-Effekt bezeichnet wird. Bei der dynamisch-mechanischen Analyse (DMA) von Kautschukmischungen wird häufig eine Linearität der Antwort in Bezug auf das angelegte Verformungssignal angenommen, da die Stärke der ersten Harmonischen viel höher ist als die der nachfolgenden Harmonischen. Es gibt jedoch wertvolle Informationen in den höheren Harmonischen, die verwendet werden könnten, um die Materialeigenschaften weiter zu charakterisieren. Ein solcher Ansatz ist die LAOS-Technik (engl. Large Amplitude Oscillatory Shear), mit der die Harmonischen als Funktion der Dehnung analysiert werden. Während einige Studien bereits zum Verständnis dieses dehnungsabhängigen Phänomens beigetragen haben, wurde weniger Wert auf die Nichtlinearität im Frequenzbereich gelegt. Unter Verwendung einer resonanzbasierten Hochfrequenz-DMA wurden erstmals in der Kautschuktechnologie Nichtlinearitäten im Frequenzraum durch Beobachtung von superharmonischen Resonanzen festgestellt. Zwei unterschiedliche Typen von Nichtlinearitäten wurden beobachtet, die polymerinduzierte und die füllstoffinduzierte Nichtlinearität. Die neue Methode auf der Basis der superharmonischen Resonanz wurde zur Charakterisierung des Füllstoffnetzwerkes durch Bewertung der Mikrodispersion von Ruß und dessen Wechselwirkung mit verstärkenden Harzen erfolgreich eingesetzt

Role of intra-cellular glucocorticoid regulation in vascular lesion development

Atherosclerosis and post-angioplasty neointimal proliferation, which are leading causes of cardiovascular morbidity and mortality, develop as a result of chronic or acute vascular injury producing inflammatory and proliferative responses in the vessel wall. Glucocorticoids, the stress hormones produced by the adrenal cortex, have anti-inflammatory and anti-proliferative characteristics and can also influence systemic cardiovascular risk factors. The systemic levels of these hormones are controlled by the hypothalamic pituitary adrenal axis. However, there is also a tissue-specific pre-receptor regulation of these hormones by the two isozymes of 11β-hydroxysteroid dehydrogenase (11β-HSD); type 1 regenerates active glucocorticoids within the cells and type 2 inactivates glucocorticoids. Whilst it has been shown that the inhibition of 11β-HSD1 has favourable effect on cardiovascular risk factors and the inhibition of 11β-HSD2 results in hypertension; the effect of these enzymes on vascular lesion development is not known. The work described in this thesis tested the hypothesis that 11β-HSD1 inhibition reduces vascular lesion development due to improvement in cardiovascular risk factors, whereas 11β-HSD2 inhibition leads to adverse vascular remodelling. Apolipoprotein-E deficient (ApoE-/-) mice fed on western diet were used to study atherosclerosis, whereas neointimal proliferation was investigated using a well-established mouse model of wire-angioplasty. Vascular lesions were assessed using novel imaging and standard histological techniques. 11β-HSD1 inhibition reduced the size of atherosclerotic lesions and improved markers of plaque stability with a reduction in lipid content and increase in collagen content of the plaques. This was associated with a reduction in weight gain and blood pressure but without any effect on lipid profile. 11β-HSD1 inhibition did not produce any significant effect on neointimal proliferation in C57Bl/6J mice. However in ApoE-/- mice, 11β-HSD1 inhibition reduced neointimal proliferation with corresponding increase in size of patent lumen and with an associated reduction in macrophage content of neointimal lesions. 11β-HSD2 deletion produced an outward remodelling in un-injured vessels but there was no effect on neointimal proliferation after wire-angioplasty. Administration of a selective mineralocorticoid antagonist, eplerenone, reduced neointimal lesions significantly but to a similar degree in both C57Bl/6J and 11β-HSD2-/- mice, associated with a significant reduction in macrophage content of lesions but without any effect on blood pressure. Data in this thesis highlight the potential therapeutic application of 11β-HSD1 inhibition in reducing the size and vulnerability of atherosclerotic plaques and also reduction in neointimal proliferation (and hence post-angioplasty restenosis) in high risk patients with „metabolic syndrome‟ phenotype. The results also indicate that 11β-HSD2 has a limited, if any, role to play in the development of neointimal lesions

A Comparative Study of Process, Product and Process Genre Theory in Writing of Essay at Intermediate Level

Different approaches are introduced by number of researchers and scholars to improve writing skill of second language learner. The most prominent of them are product approach, process approach and genre process approach; these approaches 01 paved an instructional environment for learners in class room. The basic purpose of researcher to conduct this study is to investigate the effectiveness of these approaches on the writing skill of students at intermediate level. A quasi experimental study was conducted where one hundred and five students of Govt. college of Samnabad had participated in three and half month writing session, in this session different activities had been applied. To figure out the results pre and post- test were conducted. It is found that the genre process approach has more affirmative effect on the writing skill of students

Study of epidemiology and management of liver abscess in Jammu region

Background: Liver abscess is a common medical condition with different causes and variable morbidity and mortality in different parts of the world, this study has looked into epidemiology, pattern of disease gender and age of affected patients and associated factors. Methods: This prospective study was conducted at a government medical college over a period of one year from August 2022 up to July 2023. Data of patients managed at our centre was collected, analysed and interpreted on MS Excel. Results: The majority of affected patients were male (77.5%). 30 to 40 years age group was the most commonly affected, most of the patients presented with complaints of pain abdomen (85%). Amoebic abscess was present in 71.25% of patients. The right lobe of the liver was involved most commonly (67.5%). Conservative management was successful in 56.25% of patients. Alcohol intake was present in 43.75% of patients, complications were pleural effusion, portal vein thrombosis, necrotizing colitis and gastrointestinal bleeding. Conclusions: In the present era of modern medical science, diagnosis of liver abscesses has become easy through radiological and serological tests, and treatment modalities from minimally invasive to conservative have proved successful in the treatment of liver abscesses. Antibiotics remain the primary course of treatment for both amoebic liver abscess (ALA) and pyogenic liver abscess (PLA), unless there is persistent fever, a substantial abscess cavity, or complications that require surgical intervention. However, challenges persist in combating antibiotic resistance, stemming from incomplete and over-the-counter misuse of available medications. Special concerns include associated comorbidities, delayed medical consultation, and treatment-seeking behavior, as well as the misuse of unhealthy substances or alcohol

Impact of Training on Employee Performance in the Context of Telecommunication Sector of D. G. Khan, (Pakistan)

This paper examines the relationship between training and its impact on employees performance in the context of “Telecommunication Sector of D. G. Khan” Pakistan. There are three hypotheses and three objectives of this research study and by using a questionnaire 150 employees were chosen for data collection from telecommunication. “ANOVA and SPSS” Correlation coefficient was used for data analysis. Independent variable of this study is Training and dependent variable is employee performance. The independent variable training has two determinants salary and job involvement. Results showed Positive relationships between Training, Salary and Job Involvement with Employee Performance

Study of aetiological factors and clinical profiles of neonatal jaundice in the special newborn care unit of tertiary care hospital of Government Medical College, Rajouri, Jammu and Kashmir union territory: a hospital-based study

Background: Neonatal hyperbilirubinemia may be physiological or pathological. Neonatal hyperbilirubinemia is a common condition requiring inpatient treatment and monitoring and many time requires readmission to hospital. Estimated incidence of jaundice in neonates is 60% to 84% of late term and term infants. Present study was undertaken to study clinical profile of neonates with jaundice at our tertiary care centre. Methods: This prospective observational study was conducted in neonates with jaundice admitted in SNCU ward during study period with serum bilirubin more than 10 ml/dl. Results: During study period 339 neonates were considered for presented study. 192 newborns (56.63%) developed jaundice after 72hrs. of birth. Only 28.90% newborns developed jaundice within 24 hrs. Of birth. 61.65% babies were male as compared to 38.34% female babies. Jaundice was most commonly noted in babies delivered at more than 34 weeks gestational age (60.17%), while only 10.02% babies were delivered between 28-32 weeks gestational age. 2500- 4000 gm birth weight babies were 60.14% while only 39.82% babies had weight less than 2500 gms. Incidence of neonatal jaundice was 60.06%, 30.38%, 08.55% in vaginal, caesarean section and instrumental delivery respectively. Physiological jaundice (30.67%), prematurity (25.30%), Rh incompatibility (10.91%), breast feeding/jaundice (10%), ABo incompatibility (6.19) and idiopathic (5.01%) were most common causes noted in our study. Conclusions: Male gender, 2500-4000 gm birth weight, vaginal delivery, physiological delivery, prematurity were common causes associated neonatal jaundice in our study. Parent counselling and monitoring of baby is most important in management of neonatal jaundice