Groundwater quality characterization using an integrated water quality index and multivariate statistical techniques.

This study attempts to characterize and interpret the groundwater quality (GWQ) using a GIS environment and multivariate statistical approach (MSA) for the Jakham River Basin (JRB) in Southern Rajasthan. In this paper, analysis of various statistical indicators such as the Water Quality Index (WQI) and multivariate statistical methods, i.e., principal component analysis and correspondence analysis (PCA and CA), were implemented on the pre and post-monsoon water quality datasets. All these methods help identify the most critical factor in controlling GWQ for potable water. In pre-monsoon (PRM) and post-monsoon (POM) seasons, the computed value of WQI has ranged between 28.28 to 116.74 and from 29.49 to 111.98, respectively. As per the GIS-based WQI findings, 63.42 percent of the groundwater samples during the PRM season and 42.02 percent during the POM were classed as 'good' and could be consumed for drinking. The Principal component analysis (PCA) is a suitable tool for simplification of the evaluation process in water quality analysis. The PCA correlation matrix defines the relation among the water quality parameters, which helps to detect the natural or anthropogenic influence on sub-surface water. The finding of PCA's factor analysis shows the impact of geological and human intervention, as increased levels of EC, TDS, Na+, Cl-, HCO3-, F-, and SO42- on potable water. In this study, hierarchical cluster analysis (HCA) was used to categories the WQ parameters for PRM and POR seasons using the Ward technique. The research outcomes of this study can be used as baseline data for GWQ development activities and protect human health from water-borne diseases in the southern region of Rajasthan.

Development of landslide susceptibility maps of Tripura, India using GIS and analytical hierarchy process (AHP).

Landslides are one of the most extensive and destructive geological hazards on the globe. Tripura, a northeastern hilly state of India experiences landslides almost every year during monsoon season causing casualties and huge economic losses. Hence, it is required to assess the landslide susceptibility of the area that would support short- and long-term planning and mitigation. The analytic hierarchy process (AHP) integrated with geospatial technology has been adopted for landslide susceptibility mapping in the state. Eight influencing factors such as slope, lithology, drainage density, rainfall, land use land cover, distance from rivers and roads, and soil type were selected to map the landslide susceptibility. Landslide susceptibility index (LSI) was found to vary from 6.205 during monsoon to 1.427 during post-monsoon season. The LSI values were classified into very high, high, moderate, low, and very low susceptibility. Landslide susceptibility maps for three different seasons, namely, pre-monsoon, monsoon, and post-monsoon, were prepared. The study showed that most of the areas of the state come under very low to moderate landslide susceptibility zones. Around 73.2% area of the state is found to be under low landslide-susceptible zones during the pre-monsoon season, around 62% area is prone to landslides with moderate susceptibility during the monsoon season, and 68.5% area comes under landslides with low susceptibility zones during the post-monsoon season. The results of this study may be referred to the engineers and planners for the assessment, control, and mitigation of landslides and the development of basic infrastructure in the state.

Integration of hydrogeological data, GIS and AHP techniques applied to delineate groundwater potential zones in sandstone, limestone and shales rocks of the Damoh district, (MP) central India.

The Damoh district, which is located in the central India and characterized by limestone, shales, and sandstone compact rock. The district has been facing groundwater development challenges and problems for several decades. To facilitate groundwater management, it is crucial to monitoring and planning based on geology, slope, relief, land use, geomorphology, and the types of the basaltic aquifer in the drought-groundwater deficit area. Moreover, the majority of farmers in the area are heavily dependent on groundwater for their crops. Therefore, delineation of groundwater potential zones (GPZ) is essential, which is defined based on various thematic layers, including geology, geomorphology, slope, aspect, drainage density, lineament density, topographic wetness index (TWI), topographic ruggedness index (TRI), and land use/land cover (LULC). The processing and analysis of this information were carried out using Geographic Information System (GIS) and Analytic Hierarchy Process (AHP) methods. The validity of the results was trained and tested using Receiver Operating Characteristic (ROC) curves, which showed training and testing accuracies of 0.713 and 0.701, respectively. The GPZ map was classified into five classes such as very high, high, moderate, low, and very low. The study revealed that approximately 45% of the area falls under the moderate GPZ, while only 30% of the region is classified as having a high GPZ. The area receives high rainfall but has very high surface runoff due to no proper developed soil and lack of water conservation structures. Every summer season show a declined groundwater level. In this context, results of study area are useful to maintain the groundwater under climate change and summer season. The GPZ map plays an important role in implementing artificial recharge structures (ARS), such as percolation ponds, tube wells, bore wells, cement nala bunds (CNBs), continuous contour trenching (CCTs), and others for development of ground level. This study is significant for developing sustainable groundwater management policies in semi-arid regions, that are experiencing climate change. Proper groundwater potential mapping and watershed development policies can help mitigate the effects of drought, climate change, and water scarcity, while preserving the ecosystem in the Limestone, Shales, and Sandstone compact rock region. The results of this study are essential for farmers, regional planners, policy-makers, climate change experts, and local governments, enabling them to understand the groundwater development possibilities in the study area.

Iatrogenic Anterior Tibial Artery Pseudoaneurysm - A Rare Case Report.

INTRODUCTION: Interlocking tibia nail fixation for tibia shaft fracture treatment is one of the most commonest procedures performed in orthopedic trauma practices. We report one such case of a rare complication of anterior tibial artery (ATA) pseudo-aneurysm caused by the proximal coronal locking bolt performed by an unusual entry from lateral to medial side during shaft of tibia fracture fixation. CASE REPORT: A 86- years old female sustained a road traffic accident and was diagnosed with a closed tibia shaft fracture of the right leg for which she underwent intramedullary interlocking nail IMIL nailing elsewhere. She presented to us three 3 weeks after primary surgery with persistent pain and swelling in the right leg proximally. We investigated and diagnosed her as having a pseudoaneurysm of the Anterior Tibial Artery on color Doppler and magnetic resonance imaging (MRI) angiography. The pseudoaneurysm of ATA was clipped without any complications. To avoid the rupture of the pseudoaneurysm during manipulation of nail and bolts, their positions were not changed as they were supporting the fracture well and the fracture was also not united at that time. CONCLUSION: Though Although interlocking nailing of tibia shaft fracture is a commonly performed procedure, it can lead to disastrous vascular complications if the procedure is not performed with utmost care. ATA injury by proximal locking bolts of the tibia nail mandates the need for reconsideration of the nail design with better screw hole positions. We recommend preferring standard AO manual instructions for proximal tibia locking bolt direction.

Cerebral salt-wasting syndrome in a patient with status epilepticus: a rare association.

Hyponatraemia is one of the most common and serious electrolyte abnormalities in patients with neurological diseases. Assessing the intravascular fluid status, urine sodium, urine and serum osmolality helps to narrow down the differential diagnosis. Differentiation between cerebral salt-wasting syndrome (CSWS), diabetes insipidus and syndrome of inappropriate antidiuretic hormone (SIADH) secretion is absolutely necessary for correct management of hyponatraemia in this group of patients. In this case report, we have presented a 46-year-old gentleman who was admitted to intensive care unit (ICU) with status epilepticus and developed hyponatraemia during course of his ICU stay, diagnosed as CSWS and managed with normal saline and fludrocortisone. His serum sodium gradually improved, consciousness was regained and later shifted to general ward on antiepileptic treatment.

"OPD TRIAGE" - A novel concept for better patient management in heavily loaded orthopaedic OPDs.

BACKGROUND: A heavily loaded subsidized government run OPD at tertiary care hospital normally caters 200-300 patients daily. Constant improvement in management of OPD through new policies are essential for better patient management and for proper utilization of skill, expertises and time of senior faculty. We designed a new concept of OPD TRIAGE for the same. MATERIAL AND METHODS: Study was carried out on 1800 randomly selected patients, 950 each on triage & non triage interventional day.Patients were interviewed and changes in their satisfaction level were noted through a questionnaire. Senior treating faculty were also questioned about their changes in behaviour towards patient due to the intervention. RESULTS: On triage days around 91% patients are satisfied with professional care, depth of relationship, doctor's attitude, counselling from doctor. While on non triage days, this figure is only 51%. Regarding treating doctors, around 93% percent of the time, the consultants were more happy and enthusiastic to consult patients on OPD triage days. While on non triage days it was only 32%. CONCLUSION: The concept of OPD Triage can very efficiently be applied for better management of patients in heavily loaded government OPD setup, which will also help in proper data maintenance, increase patients satisfaction and for efficient utilization of time, skills and expertise of the treating consultant.