Purpose:
To describe the prevalence and severity of diabetic retinopathy (DR) among different ethnic groups of North-East India and to study the associated risk factors.
Methods:
In this hospital based cross sectional study 7,133 individuals among the age group of 20-79 years, attending the OPD, were screened for presence of Diabetes Mellitus (DM) (HbA1c >7% or previously diagnosed). Among them, 780 (10.94%) had diabetes; they were evaluated for presence of any retinopathy (based on fundus photograph and fluorescein angiography), its grade (based on International DR severity scale), and risk factors. DR patients were further grouped into different ethnicities (Assamese, Bengali, minor tribes, and other immigrants).
Results:
Of the 780 patients with diabetes, 58 patients had type 1 DM and 722 patients had type 2 DM. The overall prevalence of DR was 30.0% with vision-threatening retinopathy and maculopathy being 10.00% and 4.49%, respectively. The prevalence of retinopathy range was the highest in the immigrants’ group (50.00% among type 1 DM and 44.93% among type 2 DM) and lowest in the tribal's groups (16.67% among type 1 DM and 22.35% among type 2 DM). The risk factors showing significant association with DR were longer diabetes duration, older age, family history of diabetes, higher HbA1c level, associated hypertension, hypertriglyceridemia, and pregnancy state (
P
value <0.05).
Conclusion:
Every third patient with diabetes had some form of DR with Vision Threatening DR (VTDR) affecting every tenth patient. There was also a wide variation in the prevalence of DR among ethnic groups and this difference could not be attributed to variation in the known measurable risk factors among different ethnic groups, thus signifying the role of ethnicity in occurrence and severity of DR.
The purpose of this study is to demonstrate the effects of biodiesel fraction on auto-ignition for gasoline–biodiesel blended fuel, which combines two fuels with widely different auto-ignition characteristics. First, gasoline was blended with biodiesel at 5%, 10%, 15%, and 20% by volume, and then tested in a rapid compression expansion machine at a compression ratio of 11 and a temperature range of 720–850 K to observe the auto-ignition delay phenomenon under engine-like conditions. The experimental conditions are focused on improving the auto-ignition characteristic of gasoline direct-injection compression ignition combustion strategies under low load and cold start. The heat release rate of the blended fuels was calculated from the pressure trace and displacement history of the piston in order to identify first-stage ignition and second-stage (auto-ignition) ignition delay. Second, a gasoline–biodiesel reaction mechanism was developed to predict the chemical ignition delay of the blended fuels. The reaction mechanism with 4285 species and 15,246 reactions was validated and implemented using the CHEMKIN PRO software. Finally, the chemical ignition delay was predicted by the simulation which was further compared to the experimental measured results. These results revealed that a higher biodiesel fraction helps to obtain shorter ignition delay, which reduces the requirement of intake temperature. The blended fuel with 20% biodiesel showed the lowest ambient temperature at the injection timing requirement and was 80 K lower than gasoline. Each blended fuel exhibited two-stage ignitions in the measured temperature range. The combustion duration and pressure peak of every blended fuel were similar to each other after increasing the biodiesel fraction.
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