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Bituminous mixes are generally designed with gradation and air void content ranges adopted by different agencies. The selected gradation and binder content are permitted to vary within specified tolerance limits. This leads to the possibility of a wide range of mixes with varying mix performance. Thus, it is essential to understand the influence of variation in these parameters on the performance of mixes. The present study aims to examine the sensitivity of the mix performance to variation within the specified gradation and air void ranges. Five aggregate gradations were considered for designing mixes for the volumetric design criterion of 4% air voids. For three of the five gradations, mixes were also designed for two additional design air void contents, 3% and 5%. Rutting resistance of the mixes was measured using a rut tester and moisture resistance was evaluated in terms of Tensile Strength Ratio (TSR). The densification characteristics represented by voids in mineral aggregate (VMA) values of the mixes prepared using the five aggregate gradations are similar to those of the corresponding aggregate packing characteristics (dry aggregate air voids, DAAV). A good relationship was observed between mix rutting and minimum voids in mineral aggregate and DAAV. Sensitivity analysis carried out with different aggregate gradations, design air void contents and tolerances, indicated that rut depth as well as TSR vary over a wide range for the combinations of mixes considered (all within the gradation, air void content and tolerance limits).Compared to the design air void content, aggregate gradation is found to have significantly larger effect on rut depth whereas both gradation and design air void content have similar effect on the TSR value. Using the results obtained from the present investigation, the Indian Marshall mix design criteria (MoRTH 2013) for stability and flow were revisited and new criteria are proposed. [ABSTRACT FROM AUTHOR]

Background : Accidental drowning occurs often in India, nearly 40, 000 Indians die annually from drowning. It occurs occasionally among swimmers due to their rashness in swimming, but it occurs mostly in non-swimmers who venture to go beyond their depth in the sea, rivers, canals and lakes. Many lives are lost during floods, which are so frequent. Objective : To study autopsy finding in drowning and conclude manner of death from Ranga Reddy district, Telangana Methods : A 3 years prospective study (January 2013 to December 2015) on 60 drowning cases brought to the Bhaskar Medical College and Hospital, R.R. District, Telangana were assessed. Subsequently, the medico legal autopsy was performed at mortuary of Osmania General Hospital, Hyderabad. This present study is directed to study the medico-legal aspects of violent asphyxial deaths special reference to drowning. Result : It is found that higher frequency of age group is present in the 21-30 years which is 29.1% of cases, male predominated and 41.14% were accidental in nature. Regarding the postmortem findings drowning cases, out of the total of 60 cases of drowning, cyanosis was observed in 47 (78.35%). Oozing of whitish to pinkish froth, copious in amount from mouth and nostrils was found in 53 (88.32%) cases. All the drowning cases, there were presence of heavy, voluminious, oedematous, congested lungs with weight of either lungs above 500 gm & cupious froth oozing on cut sections Conclusion : This study showed that majority drowning cases belonged to male, adolescent age group & accidental in nature. The findings of the study could be useful to develop accessible infrastructures to improve drowning intervention programs in this region. [ABSTRACT FROM AUTHOR]

Introduction: Burns are considered as one of the most destructive injuries, which cause not only deaths but also major economic and psychological impacts and long term somatic sequelae. Objective: To access the magnitude of the fatal burn injuries among the victims who came to hospital. Methods: A total of 188 patients with burn injury admitted to the Bhaskar Medical College and Hospital during July 2011 to July 2015 were assessed and subsequently there were 48 in-hospital deaths. Autopsies on the dead burned patients were performed at Osmania General Hospital, Hyderabad. Results: Around three fourths of the cases were women, with 58.4% of the total cases in 21-30 age group. Accidental deaths accounted for 76.5% of the cases, while 22.1% of the patients having more than 90% of burns on their body surface. The days of survival of the burn victims was, 72 hours in most of the cases, out of which many died within 48 hours. The leading cause of death was septicemia. Conclusion: Most burn deaths may be preventable with better airway management and more aggressive but precise resuscitative efforts. However, sepsis, due to multi-drug resistant organisms, may continue to impede efforts to increase survival if we cannot develop strategies to fight these organisms. [ABSTRACT FROM AUTHOR]

Back ground: Death due to hanging is one of the most common forms of suicide in most parts of the world. It is the commonest method of suicide in India, Canada, second most common method in USA and most common method of suicide in men in UK.The incidence of suicide in all metropolitan cities in India is on the rise. Their magnitude is also quite significant among the total number of deaths. Aims & Objectives: To evaluate the types of hanging, the pattern of ligature mark and the type of material used as ligature in relation to the ligature mark. Material and Method: The study is done on dead bodies that were subjected to post-mortem examination. The study included 100 cases out of 108 cases selected from both the sexes for statistics. Result: The total of hanging deaths is 6.9%. The male to female ratio is 2:1 remains unaltered from previous studies. Age group is 21 years to 40 years .rural area 54% outnumbered the sub-urban 24% and urban area 22%.Low socio economic status 65% ranged over middle class25% and higher income 10%. Typical hanging is seen in 22 cases and atypical hanging in 88 cases. Partial hanging is seen in 68 deaths where as complete hanging is seen in 32 deaths. The ratio of male to female 2:1.Ligaturemark impression prominent in 94 percent deaths. In 6 cases ligature mark was faint. Conclusion: Suicidal atypical hanging deaths are common. Ligature mark is prominently seen and Ligature Material was whatever available in the surroundings-rope, electric wires, loop of trousers, nawar patti, neck threads bed sheets, dupatta, sari etc. [ABSTRACT FROM AUTHOR]

Background: Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people aged 15-29. More than a million people die each year on the world's roads, and the cost of dealing with the consequences of these road traffic crashes runs to billions of dollars. Current trends suggest that by 2030 road traffic deaths will become the fifth leading cause of death unless urgent action is taken. Objective: In road traffic accident fatalities, deaths are mainly due to head injuries, especially in case of two wheelers. An attempt is made in this study to make a scientific observation of these motor vehicle accidents with special reference to two wheelers, in the city of Hyderabad. A general reference is made towards the use of helmets in preventing head injuries. Methodology: A comprehensive study of pattern of injuries sustained by the victims of road traffic accidents involving two-wheeler reported to Osmania General Hospital, Hyderabad during a period of 2010-11. Results: The total number of autopsies conducted in the year 2010 are 4,636 which constitute roughly about 27.54 % and in the year 2011 are 4,530 which constitutes 28.69 %, RTAs showing a marginal increase of 100 cases per year. Two-wheeler rider fatalities are taken up as they themselves are constituting roughly about 39% in the year 2010 and 41% in the year 2011 of total number of road traffic accidents. Males are more prone to death by RTAs (83.78%) as compare to females (16.21%), making an M: F ratio of 5:1. Incidences of RTA are more in third (24.06%) and fourth decade (18.99%) as compared to both extremes of life. [ABSTRACT FROM AUTHOR]

Introduction: In the early phase of life, even with the advent of urbanization and civilization, children are not considered relatively as safe as they are vulnerable now. The advent of civilization and urbanization has failed to put children in safe zone. The infancy or childhood is no longer a protected period and subjected to all kinds of maladies of the society. Even childhood (or) infancy is not free from the vagaries like suicide, homicide, kidnapping, neglect and also the sexual assaults. Death from unnatural causes is a black remark on humanity. Study of all the factors causing death unnaturally will be useful in reducing the incidence. Materials and Methods: The present study has been conducted on the deaths of paediatric age group (i.e., 0 - 15 years) which are of medico-legal significance. This study is based on the Medico-legal autopsies conducted at Osmania General Hospital, Hyderabad. A total number of 500 cases occurred during the period of this study from July, 2007 to June, 2009. Conclusion: The incidence of death in paediatric age group was more between 13-15 years, least between 4-6 years age group, maximum deaths were due to accidents (56.20%) followed by suicides (27.80%) and homicides (7.8%). Total 500 death were studied of which (48.4%) were males and (51.6%) were females. Maximum incidence of paediatric deaths was from middle and lower socio-economic groups. [ABSTRACT FROM AUTHOR]

Death due to hanging is not an uncommon cause in the present day. Suicidal manner is more common in hanging deaths. The tendency towards suicidal hanging is found to be higher because of the easy availability of the ligature material. Deaths due to suicidal hanging are common in the Warangal area of Andhra Pradesh. Their magnitude is quite significant among the total number of deaths subjected to postmortem examinations. Hence it is necessary to analyze these deaths, in relation to their manner of occurrence. As a part of this study it is mandatory to know the different factors influencing suicide. Suicidal hangings are more common than others (95%). The number of deaths due to suicidal hanging is increasing in the society; the Male to Female ratio being unaltered at 2:1 and the common Age group of occurrence being 21-40 years Victims are usually from rural setup with low social economic background. Illiteracy is one of the main cause of deaths due to suicidal hanging (76%). The percentage of hanging deaths is found to be higher in married women (76%) than in the others. [ABSTRACT FROM AUTHOR]

Simultaneous pancreas-kidney transplantation (SPKT) is the treatment of choice for patients with end-stage renal failure due to type 1 diabetes mellitus. With advances in surgical techniques and immunosuppression management, outcomes have improved, with current 1- and 10-year pancreas graft survival rates of 86% and 53%, respectively. Induction therapy with either alemtuzumab or rabbit antithymocyte globulin (rATG) in combination with a calcineurin inhibitor (CNI) and mycophenolate mofetil (MMF) or sirolimus appears to be safe and effective in the setting of rapid steroid withdrawal (RSW), with excellent graft survival and low rejection rates. There are no large randomized trials between alemtuzumab and rATG to determine whether one is better than the other. Anti-interleukin (IL)-2 receptor antibody induction and no induction in combination with a CNI, MMF or sirolimus, and prednisone have demonstrated excellent graft survival rates but are associated with a higher incidence of acute rejection. The efficacy of anti-IL-2 receptor antibodies or no induction in the setting of RSW is unproven. Both of the CNIs, ciclosporin and tacrolimus, are effective in preventing acute rejection in SPKT recipients; however, pancreas allograft survival may be better with tacrolimus. MMF is more effective than azathioprine in preventing acute rejection. Sirolimus appears to be effective in preventing acute rejection, but the combination of sirolimus with a CNI may accentuate the nephrotoxicity of the CNI. RSW with induction therapy is safe and effective in SPKT recipients, but longer follow-up data on outcomes are needed. Recent analysis of registry data shows that most transplant centres are using an induction agent followed by a combination of tacrolimus, MMF and corticosteroids in SPKT recipients. [ABSTRACT FROM AUTHOR]

Potential donors with congenital renal anomalies but normal renal function are often overlooked because of a possible increase in technical difficulty and complications associated with the surgery. However, as the waiting list for a deceased donor kidney transplant continues to grow, it is important to consider these kidneys for potential transplant. This paper describes the procurement of a crossed fused ectopic kidney, and subsequent parenchymal transection prior to transplantation as part of a combined simultaneous kidney pancreas transplant. The transplant was uncomplicated, and the graft had immediate function. The patient is now two years from transplant with excellent function. [ABSTRACT FROM AUTHOR]

Data on body weight at 4 weeks age, age at first egg and cumulative egg production up to 12, 16 and 20 weeks of age of a total 617 Black and Brown strains of Japanese quails were analyzed. Strains, generations and hatches had significant influence on all the traits studied. Black quails were significantly heavier and laid more eggs. The quails of fifth generation recorded lowest least-squares mean for age at first egg with higher egg production. Heritabilities varied from moderate to high in Black and were high in Brown strains. Genetic and phenotypic correlations among the traits varied from low to high. [ABSTRACT FROM AUTHOR]

Backcalculation of pavement layer moduli refers to the process of evaluating the pavement layers using pavement surface deflections. The genetic algorithm (GA) technique was successfully used in the past for backcalculation. The BACKGA model developed by the Indian Institute of Technology, Kharagpur is one such program used for backcalculation using the GA technique. Though GA-based backcalculation models are considered to be robust due to the search algorithm adopted in the process, they require more computational time due to the large number of times the surface deflections are computed using different sets of layer moduli. In the present work, artificial neural network (ANN) models have been developed for computing surface deflections using elastic moduli and thicknesses of pavement layers as inputs. The ANN models have been used in BACKGA for forward calculation of surface deflections to combine the computational efficiency of ANNs with the robustness of the GAs. The performance of the resulting model, BACKGA–ANN, has been evaluated and found to be satisfactory. [ABSTRACT FROM AUTHOR]

In the context of pavement evaluation, backcalculation is the process of estimation of elastic properties of pavement layers using measured structural responses. A number of backcalculation programs are available for estimating effective pavement layer moduli from surface deflections. Different optimization techniques have been used in the development of these backcalculation models. Genetic algorithm (GA) has been used successfully in the recent past for backcalculation of pavement layer moduli. Selection of appropriate GA parameters is important for the efficient performance of the GA-based algorithm. However, there are no general guidelines available at present for the selection of GA parameters. This paper presents a study conducted for the selection of optimal GA parameters to be adopted for backcalculation of pavement layer moduli. The parameters have been selected on the basis of the level of accuracy desired and the corresponding computational effort (CE). The performance of the GA-based program with the selected parameters was evaluated using some hypothetical and field problems. [ABSTRACT FROM AUTHOR]

The paper presents the details of various investigations conducted for the laboratory evaluation of the performance of crumb–rubber modified asphalt mixes. Crumb rubber (CR) obtained from discarded truck and bus tires was used to modify 80/100 penetration grade asphalt cement. Fatigue and permanent deformation characteristics, temperature and moisture susceptibility, and oxidative aging are some of the performance indicators of mixes evaluated. A static indentation test was adopted for assessing the relative permanent deformation characteristics of different mixes. Three aggregate gradations: (1) superpave; (2) gradation specified by the Ministry of Surface Transport, India for asphalt concrete; and (3) one gap gradation, were considered in the investigation. Compared to normal mixes, CR modified mixes were found to have improved fatigue and permanent deformation characteristics. They also showed lower temperature susceptibility and greater resistance to moisture damage compared to normal mixes. Superpave mixes gave better overall performance compared to the mixes having other aggregate gradations. [ABSTRACT FROM AUTHOR]

Abstract: Background: Laparoscopic live donor nephrectomy is becoming increasingly popular as it has been shown to minimize donor morbidity, length of hospital stay and length of time to return to work. Initial experience suggested that kidneys procured laparoscopically had higher rates of delayed graft function and ureteric complications but with increasing experience, these complications have become less common. Methods: Retrospective chart review of all patients who underwent living donor kidney transplant using kidneys procured laparoscopically at our centre was performed. From the initiation of the laparoscopic donor nephrectomy programme at our institution in November 1998 until February 2002, we performed 71 living donor kidney transplants (69 kidneys procured laparoscopically and two procured by open donor nephrectomy after failed laparoscopic approach). Donor left kidney was used in all except in one patient. Mean duration of warm ischaemia time was 206 ± 79 s. Results: The mean age of the recipients was 42 ± 15 years (range 1–68) including five paediatric recipients (age < 18 years). There were 48 males and 23 females. Nine (13%) were retransplants (seven second transplants and one each of third and fourth transplants). Two patients died with functioning grafts and four patients lost the graft (three thrombosis, one anastomotic rupture). No patient developed ureteric complications. The incidence of delayed graft function (need for dialysis in the first week post-transplant) was 4%. Patient and graft survival rates (actual) were 97% and 91%, respectively. Mean length of hospital stay was 9 ± 7 days (median 7 days). Conclusions: Recipient outcome is not compromised and excellent results can be achieved with living donor kidney transplantation using laparoscopically procured kidneys. [ABSTRACT FROM AUTHOR]

Presents a study on a two-stage heuristic approach for the allocation of buses to regional bus transit routes. Determination of routes and allocation of bus frequencies to different routes; Surplus allocation; Features of some of the existing frequency-setting models; Application of the model to a regional transit network in India.

The biliary anastomosis has been called ‘the Achilles heel’ of liver transplantation (Rabkin JM, Orloff SL, Reed MH. Transplantation 1998: 65 [2]: 193; Davidson BR, Rai R, Kurzawinski TR. Br J Surg 1999: 86 [4]: 447). Biliary complications after liver transplantation reportedly occur at an incidence of 20–30%, 10–15% as bile leaks. The management of bile leaks, especially early bile leaks, is controversial. In the present study, we report our experience with the management of bile leaks after liver transplantation. In this retrospective study, we reviewed 85 liver transplants over a 3-yr period. In 79, the biliary anastomosis was choledochocholedochostomy (CDCD) over a small-caliber T-tube, while choledochojejunostomy (CDJ) was used in 7. Over a mean follow up period of 13.5 months (median 10 months), 10 patients (12%) experienced a clinically significant bile leak within the first 3 months after liver transplantation. The early leaks, occurring within 1 month of transplant, were successfully managed by observation (Davidson BR, Rai R, Kurzawinski TR. Br J Surg 1999: 86 [4]: 447) or endoscopic retrograde cholangiopancreatography (ERCP) and the placement of a biliary stent for a duration of 6–12 wk (Randall HB, Wachs ME, Somberg KA. Transplantation 1996: 61 [2]: 258). One of these resulted from accidental dislodgement of the T-tube on postoperative day 1; one resulted from necrosis at the CDCD anastomosis and required CDJ; the remaining four resulted from leaks along the T-tube track. One of the late leaks occurred following the planned removal of the T-tube at 3 months after liver transplantation; the other two were leaks along the T-tube track. All were successfully treated by ERCP and stent placement, though in one case, ERCP was initially unsuccessful because of the inability to advance a guidewire, necessitating a fluoroscopically aided guide wire placement during a mini laparotomy. ERCP was then successfully performe... [ABSTRACT FROM AUTHOR]

Background. The piggyback technique (PT), with preservation of the cava, is being used more frequently in adult orthotopic liver transplantation (OLT). The advantages of PT include hemodynamic stability during the anhepatic phase without a large-volume fluid infusion and obviating the need for veno-venous bypass (VVB). At our center, we changed our practice in July 1997 from the standard technique (ST) of OLT with routine use of VVB to PT and selective use of VVB. The purpose of the present study was to analyze the results with the two different practices, ST-routine VVB versus PT-selective VVB. Methods. Forty OLTs were performed during the period July 1995–July 1997 using ST-routine VVB (group I) and 36 during August 1997–December 1998 using PT-selective VVB (group II). The etiology of liver disease was similar in the two groups, with hepatitis C and alcoholic liver disease accounting for half of the patients in each group. The UNOS status, age, sex, and percentage of patients with previous upper abdominal surgery were also similar between the two groups. Results. In the PT-selective VVB era (group II), 34/36 patients (94%) underwent OLT with PT and VVB was used for 8 (22%) patients. The decision to use VVB was elective for 3 patients (fulminant hepatic failure, 2; severe portal hypertension, 1) and urgent for 5 patients (hemodynamic instability during hepatectomy). The intraoperative use of packed red blood cells (PRBC) (mean±SD) was 15±12 units for group I and 9±8 units for group II (p=0.023). Anastomosis time and total operating time (mean±SD) were 91±30 min and 9.5±3.2 h, respectively, for group I patients compared with 52±28 min and 7.6±1.6 h, respectively, for group II patients (p<0.0001 and 0.002, respectively). Median post-operative stays in the intensive care unit (ICU) and in the hospital were 5 and 17 d, respectively, for group I and 4 and 11 d, respectively, for group II (p=NS). Mean serum ... [ABSTRACT FROM AUTHOR]

Background. Enteric drainage (ED) is associated with reduced morbidity compared with bladder drainage (BD) after simultaneous kidney–pancreas transplantation (SKPT) and is becoming increasingly common (more than 50% of SKPTs done in the US in 1998 were performed with enteric drainage). Although several studies have reported the morbidity and graft survival of ED compared with BD previously, there are limited data available comparing the length of stay and hospital charges between these two drainage procedures. Methods. Fourteen SKPTs were performed during the period January 1995–May 1998 using BD and 20 during June 1998–August 1999 using ED. Hospital charges analyzed included the following categories: pharmacy, inpatient room, laboratory, operating room, medical–surgical supply, radiology/nuclear medicine, and miscellaneous. Organ acquisition charges and professional fees were not included in this analysis. Results. The mean hospital stay for patients with ED was 7.8±2.2 d (range 5–12 d; median 7.5 d) compared with 15.9±7 d (range 8–38 d; median 15 d) for patients with BD (p=0.002). The mean hospital charges during initial hospitalization for the ED group were $36 582±11 424 compared with $64 555±29 054 for the BD group (p=0.005). There was a significant decrease in the charges relating to pharmacy, inpatient room, laboratory, radiology/nuclear medicine, and miscellaneous category in the ED group compared with the BD group, while the charges relating to operating room and medical–surgical supply were no different between the two groups. One-year actuarial kidney and pancreas graft survival rates were 83% and 93%, respectively, for the BD group and 90% and 80%, respectively, for the ED group (p=NS). Conclusions. SKPT patients with ED had a 43% reduction in hospital charges and equivalent pancreas and kidney graft survival rates compared with SKPT patients with BD. A shorter hospital stay a... [ABSTRACT FROM AUTHOR]

Discusses the differences between enteric drainage, which is associated with reduced morbidity, and bladder drainage after simultaneous kidney and pancreas transplantations (SKPT). Comparison of the lengths of hospital stays following each procedure; Number of SKPT patients who had enteric drainage who had reduced hospital stays.

Focuses on biliary anastomosis and how it tends to complicate liver transplantation. Occurrence of biliary complications in the form of bile leaks; Details of a three-year study on liver transplants; Methods; Results; Conclusions.

Discusses how the piggyback technique is being used more frequently in adult orthotopic liver transplantation. Advantages of the piggyback technique, including hemodynamic stability during the anhepatic phase without a large-volume fluid infusion; How the technique is safe and can be performed in the majority of adult patients.

Usual presentation of the Cases is common. This paper deals with presentation of peculiar cases which are not described in the books. Here a lady died with burns but presence of gagging and tying a cloth around the mouth is suggestive of homicidal burns. But circumstances are suggesting suicide. In another case mother and daughter died by hanging. But the house is locked from outside which suggests homicidal in nature. But as per the circumstances they are suicidal hangings. The above types of cases are useful to future generations and give guidance to juniors and these cases show the importance of circumstances in deciding the manner of death [ABSTRACT FROM AUTHOR]