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The modern era is witnessing a growing demand for sustainable and eco-friendly power sources. An interconnected power system capable of seamlessly integrating electric vehicles and renewable energy resources is being considered as a viable solution. However, this technology has some drawbacks, such as its lower system inertia, which limits its ability to respond to load capabilities. To overcome this issue, a Hybrid Energy Storage System (HESS) can be integrated with new techniques to enhance performance. This paper proposes a new Quasi Opposition Arithmetic Optimization Algorithm (QOAOA) optimized Fractional Order Proportional Integral Derivative with Filter (FOPIDN) controller cascaded One Plus Tilted Derivative (1 + TD) controller with HESS of super-capacitor (SC) and Redox Flow Battery (RFB) to mitigate frequency and tie-line power variations in a multi-area restructured smart-grid system. The proposed controller's performance is evaluated under various conditions, such as load fluctuations, wind speed variations, solar irradiation, Governor Dead Band (GDB), and generation rate limitations. For unsystematic load the improvement in the performance of the proposed controller indicated by maximum variation in frequency ( Δ f 1 , Δ f 2 , Δ f 3 ) and power change on the tie-lines ( Δ P tie 12 , Δ P tie 13 ) over FOPIDN controller is (98.65%, 48.78%, 52.52%) and (75.0%, 76.1%). The system performance is also analyzed when HESS devices are integrated into the three-area system, taking into account the varying nature of wind speed and solar irradiation. The improvement in performance indicated by maximum variation in frequency ( Δ f 1 , Δ f 2 , Δ f 3 ) and power change on the tie-lines Δ P tie 23 by incorporating HESS in the system is (45.21%, 33.33%, 29.59%) and 46.95% over without energy storage system. The proposed controller’s outcomes are validated using real-time hardware-in-the-loop (HIL) simulation with OPAL-RT.

Due to recent developments in the field of high-power and medium-voltage, the multilevel inverter has raised to such an extent owing to some of its amazing facts regarding harmonic spectrum, ease in control, reduced electromagnetic interference (EMI), filterless circuit, stress on power switches, common-mode voltage. This paper well describes a novel architecture of a single-phase multilevel inverter using a lesser number of overall components, especially the power switches. The proposed topology is generalized in the structure that can generate any number of voltage steps. A 7-level structure of the proposed topology is explained and is elaborately discussed. Simulation is carried out in MATLAB and corresponding experimental results verify the existence of the proposed multilevel inverter. The real-time experimental results were presented and are well verified by the simulation results for 7-level as well for 13-level across RL-Load. The nature of load current is also indicated as per the nature of load voltage. Nevertheless, the topology is further compared with some of the recent literature and found superior in each respect.

In the modern era, the demand for an interconnected power system, which can integrate electric vehicles and renewable energy sources is increasing day by day. The primary goal of this demand is to make a sustainable and green power source, which can be fulfilled by utilizing Electric vehicles and renewable energy sources. However, there are some demerits of this technology, its lesser system inertia and hence it is not sufficient to respond to the required load capabilities. Further, the approach of electric vehicles with moving batteries can enable higher performance and resolve the issue. In this current analysis, the vehicles to grid idea (V2G) technique has been discussed, which can react as automatic generation control (AGC) in a three-area deregulated environment including hydro, thermal, and gas turbine units. In this type of power grid, all the sources such as Solar, wind, geothermal, and DEG power is also incorporated. To grip various ambiguities, the current study proposed a cascade combination of Interval type-2 fuzzy and Fractional Order Proportional-integral-derivative (FOPIDN) controllers. Further, the current work proposed a modified quasi-opposition Arithmetic Optimization Algorithm (QOAOA) to tune the scaling factor and membership function of an interval type-2 fuzzy FOPIDN controller. To discuss the significance of the anticipated controller, the estimated outputs have been compared with previously reported controllers and optimization techniques. The effect of constant and variations in DG, the penetration level of (PEVs) in various operating modes, subjected to step and random load disturbances have been focused on. Finally, to validate the outcomes of the proposed controller, a real-time (RT) hardware-in-the-loop (HIL) simulation has been adopted by using OPAL-RT.

Among the FACTS device, the distributed power flow controller (DPFC) is a superior device. This can be evaluated after eliminating the dc capacitor between shunt and series convertors of the unified power flow controller (UPFC) and placing a number of low rating single phase type distributed series convertors in the line instant of using single large rating three phase series convertors as in the UPFC. The power flow through this dc capacitor as in the UPFC now takes place through the transmission line at a third harmonic frequency in the DPFC. The DPFC uses the D-FACTS that allows the replacement of a large three-phase converter as in the UPFC by several small-size series convertors present in the DPFC. The redundancy of several series convertors increases the system’s reliability of the power system. Also, there is no requirement for high voltage isolation as series convertors of the DPFC are hanging as well as single-phase types. Consequently, the DPFC system has a lower cost than the UPFC system. In this paper, the equivalent ABCD parameters of the latest FACTSdeviceDPFChave been formulated with the help of an equivalent circuit model of the DPFC at the fundamental frequency component. Further, the optimal location in the transmission line and maximum efficiency of the DPFC along with Thyristor Controlled Series Compensator (TCSC), Static Synchronous Shunt Compensator (STATCOM) and UPFC FACTS devices have been investigated using an iteration program developed in MATLAB under steady-state conditions. The results obtained depict that the DPFC when placed slightly off-center at 0.33 fraction distance from the sending end comes up with higher performance. Whereas, when the TCSC, STATCOM and UPFC are placed at 0.16, 0.2815, 0.32 fraction distances from sending end respectively give their best performance.

Due to the erratic nature of renewable sources and repeatedly varying load burdens, variations happening in the execution of AGC is a significant problem concerning deregulated power system (DPS) frequency stability. To solve this, issue demand response (DR) regulation and a hybrid energy storage system (HESS) with a new technique are required. Hence, this paper presents a novel quasi-opposition arithmetic optimization algorithm (QOAOA) optimized cascade interval type-II fuzzy proportional–integral–derivative (IT2FPID)-fractional order PI controller with DR and HESS of super-capacitor and redox flow battery (RFB) for suppressing the variations of frequency and tie-line power in a two-area restructure smart grid system, where the proficiency of the new optimization algorithm (QOAOA) is confirmed by relating its figure of demerit with other present algorithms. Additionally, the supremacy of the suggested IT2FPID-FOPI controller’s implementation is confirmed by competing it with other dominant control strategy. The impact of demand response, load fluctuations, wind speed variations, solar irradiation, and other nonlinearities like the governor dead band (GDB) and generation rate limitation is also evaluated on the analyzed power system with the anticipated controller. Additionally, hybrid energy storage devices containing super-capacitor and redox flow batteries are integrated to study the impact on system dynamics and report higher occurrence. Sensitivity analysis exposes that the QOAOA—improved proposed controller estimated at minimal circumstances is capable of handling significant changes in the system conditions and parameters. Conclusively, by utilizing OPAL-RT, a real-time hardware-in-the-loop (HIL) simulation is estimated to approve the practical feasibility of the suggested controller for the AGC challenge in the smart grid scenario.

There has been an escalation of patients presenting with symptoms of Laryngopharyngeal reflux disease (LPRD) in the otorhinolaryngology clinics due to life style and dietary changes. This study was undertaken to evaluate the effect of various proton pump inhibitors in the treatment of LPRD using Reflux symptom index (RSI) and Reflux finding score (RFS). This was a prospective study conducted from June 2016 to February 2017 with a total of 240 patients with symptoms and signs of LPR. The patients were divided into 5 groups. Each group was subjected to particular proton pump inhibitor. There were 124 males 116 females with a mean age 34.3 and rural to urban ratio being 11. After 3 months, RFS and RSI score within each group, improved significantly with Proton pump inhibitor therapy. In our study patients who were treated with omeprazole 20 mg twice daily had the highest improvement in laryngeal symptoms and laryngeal findings. We conclude emphasizing the effectiveness of proton pump inhibitors with incorporation of lifestyle modification in the successful management of LPRD.

Introduction: Otitis media (OM) is one of the most frequent diseases affecting humans and is prevalent in both developed and developing countries. It is the leading cause of hearing loss and is associated with significant morbidity. Children are at a greater risk and suffer most frequently from Otitis media. Studies show that 80% of children would have experienced at least one episode of Otitis media by their third birthday and 40% would have six or more recurrences by the age of 7 years. Materials and Methods: Study was carried out from Department of Otorhinolaryngology & Pediatrics at Era's Lucknow Medical College and Hospital, Lucknow during a time period of January 2014 to June 2015. A total 850 subjects were included in our study between 1 - 5 years with symptoms such as ear discharge, ear pain and itching in ear. Observations and Results: Out of 851 children under study 186 (21.9%) were diagnosed as Acute Otitis Media cases, 462 (54.3%) as Chronic Otitis Media cases and rest 203 (23.9%) children were diagnosed to be affected by Otitis Media With Effusion. Out of 851 cases 510 cases were found to be malnourished i.e. 59.9%. Conclusion: Otitis media has a strong positive association with malnutrition. (P< 0.001).

ABSTRACT Objectives: The study aimed to evaluate the effect of suture-less small incision cataract surgery (SICS) on the postoperative astigmatism refractive error compared to the effect of phacoemulsification.Background: [...]manual small incision techniques are gaining popularity, as they are quick,relativelyinexpensivetechniquesforlarge-scale cataract management in developing countries. The preoperative examination included uncorrected visual acuity (UCVA), refraction, best-corrected visual acuity (BCVA), color vision testing, pupillary light reflex testing, slit-lamp assessment of the anteriorsegment,intraocularpressuremeasurementby the schiotz tonometer, and posterior segment examination done by Ophthalmoscope and OCT. The information reviewed and documented in this study included patients' sex, age, preoperative and postoperative UCVA,BCVA, preoperative clinical diagnosis, preoperative and postoperative corneal astigmatism, and astigmatic axis using keratometric readings, calculating surgically induced astigmatism (SIA), and intraoperative and postoperative complications.

Worl dover the most important yardstick for the countrys progress and prosperity is the Maternal Mortality Ratio and Infant Mortality Rate. Every year countries make a concreted efforts to better their figures and a most important aspect is the utilization of the maternal and neonatal services. Maternal health services have a very important bearing on the Maternal and Infant mortality rate and the prevailing socio economic and services offered are an important determining influences. Various studies in India have concluded socio-economic factors and service delivery environment as important determinants influencing maternal health services. Use of ANC increases the likelihood of skilled attendance at delivery, which later increases the use of postnatal care. To determine the factors influencing the Antenatal Care services. To assess the antenatal care services and socio-demographic factors affecting ANC services in rural areas of Lucknow. It was a community based Cross sectional study . This study was conducted for a period of 3 months, from July 2014 to September 2014. Sample Size: a total of 100 RDW were included in the study. Multistage random sampling technique was used to select 100 RDW .Information was collected on Age, Religion, Caste, Educational status of RDW, Type of Family and Socioeconomic class, ANC registration, Number of ANC visits, Number of TT Injection received, IFA received and consumed, Antenatal check up etc. 56% of RDW, belong to age group 18-25, years.Majority of RDW were Hindu(61%).60% of RDW had Nuclear type of family, most of the RDW (60%) belonged to class IV. Amongst these 48% RDW had three antenatal visits, where as 41 % had more than three antenatal visits.100 % of RDW had government health facility as a place of ANC registration. no statically significant association was observed between the religion of RDW ,and antenatal visits/IFA tablet consumption.(p>.05).Variables such as ,socioeconomic status and educational status of RDW, were not significantly associated with either antenatal visits or IFA tablets,(p>.05) for all. In this study Antenatal care services were received by majority of RDW . The Utilization of ANC services was encouraging in the study area. Counseling on antenatal care is one of the main component of MCH services, but it was found to be lagging with respect to following components of antenatal care like birth preparedness and safe delivery, personal hygiene, rest, nutrition and management of ANC complications.

Cardiovascular disease (CVD) is the leading cause of death worldwide.Atheroscelerotic cardiovascular disease(ASCVD) is also a leading cause of death and disability. Statins can reduce the risk and prevent heart diseases. One of the best studied medication and in randomized controlled trials have been proven to reduce the no of Heart attacks and stroke even in individuals with normal cholesterol levels. A small no of individuals may develop Diabetes on statins.The benefit from lowering the risk of death, heart attack and stroke are likely to outweigh the development of diabetes in those individuals. The beneficial effects of statins may not only be due to the cholesterol lowering effects but also due to cholesterol independent or pleiotropic effects. These benefits include endothelial protective functions, enhancing stability of atherosclerotic plaques and inhibiting vascular smooth muscle proliferation and platelet aggregation. It remains to be seen to what extent these pleiotropic benefits of statin therapy can be attributed beyond cholesterol lowering.