A study on peak expiratory flow rate in patients with Type II Diabetes Mellitus

INTRODUCTION: Diabetes mellitus is a clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin. Type 2 diabetes mellitus is a serious, progressive condition associated with number of chronic complications that are mainly a consequence of macro vascular and micro vascular damage. Cardiovascular disease, nephropathy, diabetic retinopathy, neuropathy and lung damage are the important complications of diabetes mellitus. OBJECTIVE: To compare the peak expiratory flow rate of diabetic patients with normal populations and to study the association of duration of diabetes mellitus, fasting blood sugar value in relation to Peak Expiratory Flow Rate. STUDY DESIGN: Descriptive study, prospective randomized design. SETTING: Priya Clinic and Diabetic Center, Coimbatore. PARTICIPANTS: 50 diabetic females and 50 normal populations. METHODS: 50 Type 2 diabetic and 50 normal populations were selected. Their fasting blood sugar values, PEFR, duration of diabetes, anthropometric details were collected and documented. PEFR values between diabetic and controls were compared. RESULTS: Peak expiratory flow rate is significantly higher for diabetics compared to controls (‘t’ test value 26.810 significant at 0.01 level). There is significant association, significant at .01 level) ie PEFR is less as duration of diabetes is more. But there is no association between the value of FBS and PEFR (‘r’ value is -.176). CONCLUSION: Peak expiratory flow rate is significantly reduced in diabetics when compared to controls (P < 0.01) group participants. There is a significant associated between the duration of diabetes and PEFR (P < 0.01), An inverse relationship was found between the PEFR and the duration of diabetes, PEFR was found to be low in the participants with longer duration of diabetes and vice versa. There was no association between the fasting blood sugar and PERF in diabetic patient

In Vitro Biomechanical Testing and Computational: Modeling in Spine

Two separate in vitro biomechanical studies were conducted on human cadaveric spines (Lumbar) to evaluate the stability following the implantation of two different spinal fixation devices interspinous fixation device (ISD) and Hybrid dynamic stabilizers. ISD was evaluated as a stand-alone and in combination with unilateral pedicle rod system. The results were compared against the gold standard, spinal fusion (bilateral pedicle rod system). The second study involving the hybrid dynamic system, evaluated the effect on adjacent levels using a hybrid testing protocol. A robotic spine testing system was used to conduct the biomechanical tests. This system has the ability to apply continuous unconstrained pure moments while dynamically optimizing the motion path to minimize off-axis loads during testing. Thus enabling precise control over the loading and boundary conditions of the test. This ensures test reliability and reproducibility. We found that in flexion-extension, the ISD can provide lumbar stability comparable to spinal fusion. However, it provides minimal rigidity in lateral bending and axial rotation when used as a stand-alone. The ISD with a unilateral pedicle rod system when compared to the spinal fusion construct were shown to provide similar levels of stability in all directions, though the spinal fusion construct showed a trend toward improved stiffness overall. The results for the dynamic stabilization system showed stability characteristics similar to a solid all metal construct. Its addition to the supra adjacent level (L3- L4) to the fusion (L4- L5) indeed protected the adjacent level from excessive motion. However, it essentially transformed a 1 level into a 2 level lumbar fusion with exponential transfer of motion to the fewer remaining discs (excessive adjacent level motion). The computational aspect of the study involved the development of a spine model (single segment). The kinematic data from these biomechanical studies (ISD study) was then used to validate a finite element model

Prospective Study of Limb Salvage Surgery using Allograft in Malignant and Aggressive Benign Bone Tumours

INTRODUCTION: “Bone is the most commonly transplanted tissue in the body than any other tissue or organ except blood”. Transplanted bone, tendon and ligaments are used extensively in orthopedics, neurosurgery, dental surgery and plastic surgery for procedures including repair of fractures and damage caused by illness and injury. Allografts are preferred over synthetic implants by value of their desirable features of natural structure, shape and strength and biological capacity of incorporation. Bone is a unique tissue in that its ability to regenerate is more predictable than any other tissue in the body. Bone is often destroyed by infection, tumor, trauma and implanted materials and has to be replaced to restore structure and function. AIM: To evaluate the functional outcome of limb salvage surgery using allografts in malignant and borderline malignant bone tumors. MATERIALS AND METHODS: The materials for this study was based on a prospective study conducted at the Department of Orthopaedics and Traumatology, Government General Hospital, Chennai from a period of July 2003 to August 2005. Our inclusion Criteria for allografting are 1. Malignant bone tumors - Enneking staging I A to II B, 2. Aggressive benign tumors. Exclusion criteria are; 1. Presence of metastasis, 2. Involvement of major neurovascular structure, 3. Biopsy scars in atypical sites, 4. Presence of infection. In our 16 cases, 8 cases were malignant bone tumors and 8 cases were aggressive benign bone tumors. In malignant tumors, 3 tumors were belonging to Enneking grade II A and 5 tumors belonging to Enneking grade II B. All benign tumors were aggressive tumors according to Enneking grade. RESULTS: The results were evaluated by using Enneking scoring system. This system of functional evaluation has been adapted by the Musculoskeletal Tumor Society (MSTS) and International Symposium of Limb Salvage (ISOLS). This system assigns numerical values (0-5) for each of six categories. Pain, function and emotional acceptance in upper and lower extremities supports, and walking and gait in the lower extremity, and hand positioning, and dexterity and lifting ability in the upper extremity. In overall, the functional results as well as complication rates in our series are comparable with standard series. CONCLUSION: Massive bone allografts are one of the options for reconstruction after resection of bone tumors. Adequate tumors resection is the most important factor in determining local recurrence there by limb and patient survival. Autogenous cancellous bone grafting to be done in all cases at allograft host junction to improve union. Complication rates are higher in limb salvage therapy using allograft than amputation, and the patients should be properly motivated for long postoperative rehabilitation therapy

Effects of gamification on achievement, engagement and intrinsic motivation among students of different player traits in science learning

The infusion of educational technology on students depends not only on the purpose of learning but also on individual needs. This is vital in tackling issues of boredom and disengagement among students when it comes to learning Science. Therefore, gamification, use of game elements in non-gaming context has been adopted to help alleviate the issues. The research examined type of player traits, effects of gamification on engagement, intrinsic motivation and achievement levels, how game elements affect users as well as identify effects of player motivation as a mediating variable. Next, a model of gamification based learning and assessment was developed. A quasi-experimental research was carried out for 8 weeks. 28 students were in the experimental group and 26 students were in the control group. To reduce threats to the research, a dedicated system login, similar educator’s teaching experience and schools with sufficient IT equipment were used. The experimental group was exposed to gamification online via Zondle platform and the traditional classroom used offline via infusion of game elements. Both groups were tested for intrinsic motivation levels using Intrinsic Motivation questionnaire, and the pre-and post-tests were used to identify their achievement levels. The experimental group were tested for player traits using Player Motivation questionnaires and their participation level was based on Zondle Platform usage. The player traits showed that 68% of the experimental group retained their player motivation types and the highest player trait was immersion. Meanwhile, the engagement levels of the experimental students using the gamified platform peaked for Topic 6 at 36.21 times login in comparison to the lowest which was Topic 7 with 5.2 times login. Intrinsic motivation levels of the experimental group showed that their levels of interest, effort, perceived choice and usefulness construct had significant changes at the end of the research. The analysis of achievement levels, showed that pre-and post-test scores of the control group were strong and positively correlated (r=0.630,p<0.001) and the experimental group’s results were moderate and positively correlated (r=0.496,p< 0.007). There was a significant difference between pre-and post-test scores of the experimental group (t=8.040, p<0.000). As an indication of how game elements were affected, it was found that initially there was no preference. However, at the end of the research, the students favoured gamified leader board especially as it motivates them to be better academically and competitive. Meanwhile, badges were preferred offline as students prefer physically acquiring them, for online gamified learning, points and leader board were preferred. The mediating analyses in this research have paved the way to create a model for gamification based learning and assessment for future educators and researchers

A Study on Surgical Management of Unstable Pelvic Fractures

INTRODUCTION: Pelvic injuries are an important aspect of orthopaedic trauma, which are caused by high velocity injuries such as road traffic accidents and industrial accidents. The management, especially those of unstable pelvic ring injuries is complex and challenging to the orthopaedic surgeon. In this study, a brief and comprehensive review of the anatomy of the pelvis, biomechanics, the mechanism of different types of unstable injury and the classification are presented followed by the clinico radiological assessment of patients with pelvic injuries and their management by various surgical modalities. We have analyzed then the outcome of these unstable pelvic injuries with surgical management. AIM: The aim of this study is to analyze the results and functional outcome of the patients with unstable pelvic fractures who were managed by surgical treatment. MATERIALS AND METHODS: Our study is an analysis of 21 cases of unstable pelvic injuries (Type B and C) managed surgically by external fixation or open reduction and internal fixation. The study period extends from October 2004 to October 2006 and conducted at the Government General Hospital and Madras Medical College, Chennai, India. All the patients with stable pelvic ring injury (tile type A) were excluded from the study. Unstable pelvic injury patients, who died before surgical intervention (3 patients) and patients who couldn’t be operated for various reasons were excluded from the study. Recently operated patients with less than three months duration at the time of conclusion of this study were excluded. RESULTS: Twenty one patients with unstable pelvic fractures were treated surgically and analyzed with an average follow up of 8.7 months (range 3-16 months). Functional outcome of the survived patients were assessed using the pelvic outcome scale by Cole et al. It is based on a 40 point scale for pain, ambulation, work and activity status, clinical examination and radiographic appearance. Three patients died and two patients were lost for follow up. In one patient the functional outcome couldn’t be assessed due to associated injury. Out of 15 remaining patients, 12 had good, 2 had fair, and 1 patient had poor outcome. CONCLUSION: Despite better understanding of the personality of the acutely injured pelvis and modern aggressive treatment modalities, the mortality rate still remains high. Early aggressive but thoughtful management of the patients with unstable pelvic injuries is essential for maximizing the immediate survival and long term functional outcome. Periodic thorough clinical and radiological assessment is mandatory to identify any occult injury. The role of team approach with various specialists cannot be over emphasized. The degree of hemodynamic instability does not correlate with type of pelvic injury. Emergent external skeletal fixation alone is not sufficient to restore hemodynamic stability in all patients who fail to improve after initial resuscitation. Acute management of unstable pelvic injuries is challenging and techniques of safe internal fixation are demanding. Constant dedication to improvement is and must be the goal of pelvic surgeons

The motivation for incorporation of microgrid technology in rooftop solar photovoltaic deployment to enhance energy economics

Deployment of rooftop solar PV technology in domestic premises plays a significant role in accomplishing renewable energy transformation. Majority of domestic consumers still do not have a positive perception about adopting rooftop solar PV technology, due to its high capital cost and prolonged payback period. In this aspect, the proposed work identifies the factors causing energy deprivation in the present distribution and utilization system. To explicitly express the importance of the present work, an extensive case study based on Indian scenario has been carried out to investigate where the losses occur in the existing distribution system and how the solar power and its storage system have been ineffectively utilized. The deep investigation has thrown light on several issues that lead to the performance deterioration of PV technology. Finally, in this work, a scheme to incorporate hybrid microgrid technology in the domestic distribution network has been proposed to effectively manage the distribution system and to efficiently utilize solar power and its storage systems. The real-time electricity tariff data have been taken for cost comparison and payback period calculations to prove the effectiveness of the proposed method. A crucial comparisons have been presented based on energy saving and CO2 emission reduction strategies.publishedVersio

Incorporation of Microgrid Technology Solutions to Reduce Power Loss in a Distribution Network with Elimination of Inefficient Power Conversion Strategies

The increase in energy-efficient DC appliances and electronic gadgets has led to an upheaval in the usage of AC–DC power convertors; hence, power loss in converter devices is cumulatively increasing. Evolving microgrid technology has also become deeply integrated with the conversion process due to increased power converters in its infrastructure, significantly worsening the power loss situation. One of the practical solutions to this disturbance is to reduce conversion losses in domestic distribution systems through the optimal deployment of the battery storage system and solar PV power using microgrid technology. In this paper, a novel energy management system is developed that uses a new control algorithm, termed Inefficient Power Conversion Elimination Algorithm (IPCEA). The proposed algorithm compares the Net Transferable Power (NTP) available on the DC side with the loss rate across the converter. The converter is switched off (or disconnected from the grid and load) if the NTP is less than 20% of the converter rating to avoid low-efficiency power conversion. The solar PV system is connected to the DC bus to supply the DC loads while the AC loads are supplied from the AC source (utility power). An auxiliary battery pack is integrated to the DC side to feed DC loads during the absence of solar energy. A battery energy storage system (BESS) is deployed to manage energy distribution effectively. The power distribution is managed using a centralized microgrid controller, and the load demand is met accordingly. Thereby, the power generated by the solar PV can be utilized effectively. Microgrid technology’s effectiveness is emphasized by comparative analysis, and the achievements are discussed in detail and highlighted using a prototype model.publishedVersio

Gamification: potentials and challenges in teaching and learning in science

Educational technology plays an important part in the growth of education in the 21st century. Yet the absence of infusion between technology and education in schools, has led to the de-motivation among many students and teachers with the current education system. Therefore with the evolution in technology, especially with the arrival of android devices, interaction with games has been on the rise; making it a daily routine and addictive part of people?s lives. By using the game design elements in non-game contexts, gamification is created. These elements are points, badges and leader board. In the corporate world, gamification has been used as a motivational pull in achieving goals. These qualities relate to the instigators of motivation; purpose, autonomy and mastery. So we can deduce that the capabilities of game in causing a change in human lives go beyond its intended purpose of fun. As students are familiar with the usage of technology, infusing gamification to improve teaching and learning in schools may reap favourable results. Yet there has been lacking research in the effectiveness of gamification in learning and teaching. This creates an opening for a research to be carried out in this field. The aim of this paper is to explore the potentials as well as challenges of using gamification to enhance the teaching and learning in Malaysia schools

Gamification : a look into the games elements that drive towards a meaningfull teaching and learning

The term gamification was first brought up a game designer Nick Pelling back in 2004, (Rughini?, 2013) whom tried to use game-like enhanced interface to make electronic transactions such as using the Automated Teller Machine (A.T.M); making it more attractive and engaging thus creating a game like fun to the transaction. From this came the definition of gamification; which is the "use of game design elements in non-game contexts" (Deterding et al., 2011)

Tourism Carrying Capacity for Beaches of South Andaman Island, India

The Andaman and Nicobar Islands (ANI) is one of the largest tourist areas in India attracting both the international and domestic tourists each year. The Island Administration has a vision to develop the islands as an upmarket island destination for ecotourism. Among the island group, the South Andaman region is the most visited tourist destination and beaches of these islands have great potential for tourism attractions. The present work is an attempt to understand the potential of these beaches by assessing the carrying capacity in terms of number of visitors that can be allowed over a period of time, which will further help with better tourism management. The methodology used to estimate the tourism carrying capacity (TCC) is based on the physical and ecological conditions of each site and the existing infrastructure. The total effective carrying capacity (ECC) estimated for the beaches of Port Blair area (126,301 visitors/day) reveals that the current tourism activity is in lower level compared to its carrying capacity. Such carrying capacity assessments can be used as an input into the regular planning process. Preliminary estimates suggest that A&N Islands can be promoted for high value-low volume, eco-friendly, and environmentally sustainable tourism